833 resultados para maternity choice


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Wide spread and continuing use of multiple-choice testing in technical subjects is leading to a mindset amongst students which is antithetical with actual use of intellect.

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Using evidence from Durham, North Carolina, we examine the impact of school choice programs on racial and class-based segregation across schools. Theoretical considerations suggest that how choice programs affect segregation will depend not only on the family preferences emphasized in the sociology literature but also on the linkages between student composition, school quality and student achievement emphasized in the economics literature, and on the availability of schools of different types. Reasonable assumptions about how these factors differ for students of different races and socio-economic status suggest that the segregating choices of students from advantaged backgrounds are likely to outweigh any integrating choices by disadvantaged students. The results of our empirical analysis are consistent with these theoretical considerations. Using information on the actual schools students attend and on the schools in their assigned attendance zones, we find that schools in Durham are more segregated by race and class as a result of school choice programs than they would be if all students attended their geographically assigned schools. In addition, we find that the effects of choice on segregation by class are larger than the effects on segregation by race.

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Trust is important in medical relationships and for the achievement of better health outcomes. Developments in managed care in the recent years are believed to affect the quality of healthcare services delivery and to undermine trust in the healthcare provider. Physician choice has been identified as a strong predictor of provider trust but has not been studied in detail. Consumer satisfaction with primary care provider (PCP) choice includes having or not having physician choice. This dissertation developed a conceptual framework that guided the study of consumer satisfaction with PCP choice as a predictor of provider trust, and conducted secondary data analyses examining the association between PCP choice and trust, by identifying factors related to PCP choice satisfaction, and their relative importance in predicting provider trust. The study specific aims were: (1) to determine variables related to the factors: consumer characteristics and health status, information and consumer decision-making, consumer trust in providers in general and trust in the insurer, health plan financing and plan characteristics, and provider characteristics that may relate to PCP choice satisfaction; (2) to determine if the factors in aim one are related to PCP choice satisfaction; and (3) to analyze the association between PCP choice satisfaction and provider trust, controlling for potential confounders. Analyses were based on secondary data from a random national telephone survey in 1999, of residential households in the United States which included respondents aged over 20 and who had at least two visits with a health professional in the past two years. Among 1,117 eligible households interviewed (response rate 51.4%), 564 randomly selected to respond to insurer related questions made up the study sample. Analyses using descriptive statistics, and linear and logistic regressions found continual effective care and interaction with the PCP beyond the medical setting most predictive of PCP choice satisfaction. Four PCP choice satisfaction factors were also predictive of provider trust. Findings highlighted the importance of the PCP's professional and interpersonal competencies for the development of sustainable provider trust. Future research on the access, utilization, cognition, and helpfulness of provider specific information will further our understanding of consumer choice and trust. ^

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This research examined to what extent Health Belief Model (HBM) and socioeconomic variables were useful in explaining the choice whether or not more effective contraceptive methods were used among married fecund women intending no additional births. The source of the data was the 1976 National Survey of Family Growth conducted under the auspices of the National Center for Health Statistics. Using the HBM as a framework for multivariate analyses limited support was found (using available measures) that the HBM components of motivation and perceived efficacy influence the likelihood of more effective contraceptive method use. Support was also found that modifying variables suggested by the HBM can influence the effects of HBM components on the likelihood of more effective method use. Socioeconomic variables were found, using all cases and some subgroups, to have a significant additional influence on the likelihood of use of more effective methods. Limited support was found for the concept that the greater the opportunity costs of an unwanted birth the greater the likelihood of use of more effective contraceptive methods. This research supports the use of HBM and socioeconomic variables to explain the likelihood of a protective health behavior, use of more effective contraception if no additional births are intended.^

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The purpose of the study was to describe regionalized systems of perinatal care serving predominantly low income Mexican-American women in rural underserved areas of Texas. The study focused upon ambulatory care; however, it provided a vehicle for examination of the health care system. The questions posed at the onset of the study included: (1) How well do regional organizations with various patterns of staffing and funding levels perform basic functions essential to ambulatory perinatal care? (2) Is there a relationship between the type of organization, its performance, and pregnancy outcome? (3) Are there specific recommendations which might improve an organization's future performance?^ A number of factors--including maldistribution of resources and providers, economic barriers, inadequate means of transportation, and physician resistance to transfer of patients between levels of care--have impeded the development of regionalized systems of perinatal health care, particularly in rural areas. However, studies have consistently emphasized the role of prenatal care in the early detection of risk and treatment of complications of pregnancy and childbirth, with subsequent improvement in pregnancy outcomes.^ This study has examined the "system" of perinatal care in rural areas, utilizing three basic regional models--preventive care, limited primary care, and fully primary care. Information documented in patient clinical records was utilized to compare the quality of ambulatory care provided in the three regional models.^ The study population included 390 women who received prenatal care in one of the seven study clinics. They were predominantly hispanic, married, of low income, with a high proportion of teenagers and women over 35. Twenty-eight percent of the women qualified as migrants.^ The major findings of the study are listed below: (1) Almost half of the women initiated care in the first trimester. (2) Three-fourths of the women had or exceeded the recommended number of prenatal visits. (3) There was a low rate of clinical problem recognition. Additional follow-up is needed to determine the reasons. (4) Cases with a tracer condition had significantly more visits with monitoring of the clinical condition. (5) Almost 90% of all referrals were completed. (6) Only 60% of mothers had postpartum follow-up, while almost 90% of their newborns received care. (7) The incidence of infants weighing 2500 grams or less was 4.2%. ^

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Four basic medical decision making models are commonly discussed in the literature in reference to physician-patient interactions. All fall short in their attempt to capture the nuances of physician-patient interactions, and none satisfactorily address patients' preferences for communication and other attributes of care. Prostate cancer consultations are one setting where preferences matter and are likely to vary among patients. Fortunately, discrete choice experiments are capable of casting light on patients' preferences for communication and other attributes of value that make up a consultation before the consultation occurs, which is crucial if patients are to derive the most utility from the process of reaching a decision as well as the decision itself. The results of my dissertation provide strong support to the notion that patients, at least in the hypothetical setting of a DCE, have identifiable preferences for the attributes of a prostate cancer consultation and that those preferences are capable of being elicited before a consultation takes place. Further, patients' willingness-to-pay for the non-cost attributes of the consultation is surprisingly robust to a variety of individual level variables of interest. ^

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Objective: To review published literature on the impact of restaurant menu labeling on consumer food choices.^ Method: To examine all relevant studies published on the topic from 2002 to 2012.^ Results: Sixteen studies were identified as relevant and suitable for review. These studies comprised of one systematic review, one health impact assessment, and fourteen research studies conducted at restaurants, cafeterias, and laboratories. Three of ten studies conducted at restaurants and cafeterias and two of four studies conducted at laboratories found positive effects of menu labeling on consumer food choices. Conversely, the systematic review identified for this review found that five out of six studies resulted in weakly positive effects. The health impact assessment estimated positive effects; however, the results of this assessment must be cautiously interpreted since the authors used simulated data.^ Conclusion: Overall, there is insufficient evidence to provide support for the majority of the types of menu labels identified in this review on consumer food choice.^

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This paper presents some research on the choice of a course of study as related to a certain social, family and labor context. The methodology used included the definition of the theoretical basis and a series of empirical investigations which comprised different kinds of sur- veys, records, observations, participants as well as other fieldwork. The results obtained shed some light on the issue and raise new questions. This study was especially carried out to analyze the choice of the following courses of study: Law, Psychology and the different Teaching Courses.

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This paper presents some research on the choice of a course of study as related to a certain social, family and labor context. The methodology used included the definition of the theoretical basis and a series of empirical investigations which comprised different kinds of sur- veys, records, observations, participants as well as other fieldwork. The results obtained shed some light on the issue and raise new questions. This study was especially carried out to analyze the choice of the following courses of study: Law, Psychology and the different Teaching Courses.

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This paper presents some research on the choice of a course of study as related to a certain social, family and labor context. The methodology used included the definition of the theoretical basis and a series of empirical investigations which comprised different kinds of sur- veys, records, observations, participants as well as other fieldwork. The results obtained shed some light on the issue and raise new questions. This study was especially carried out to analyze the choice of the following courses of study: Law, Psychology and the different Teaching Courses.

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Nest choice in loose-housed laying hens is influenced by nest characteristics, position and social factors. We examined the relative preference of laying hens for two group-nests differing in the presence or absence of a partition in the middle of the nest and whether this was influenced by social status. We hypothesized that hens would prefer the partitioned nest as it provides more enclosure, and that social status would affect nest choice. Relative preference for the nests was assessed in a free choice preference test conducted in two consecutive trials each with eight groups of 20 hens from 18 to 31 weeks of age. The hens were individually marked and had access to two commercial group-nests (49 × 114 cm), one of which contained an internal wooden partition (30 × 10 cm) which divided the nest in two halves. At 28 weeks of age, the position of the nests was switched. The number of eggs laid was recorded daily. On one day each at 24 and 28 weeks of age (after the nest switch) video recordings were made of the first 5 h of daylight. From these videos we recorded the number of nest visits per egg per nest and the number of nest visits for individual hens. On one day each at 24 and 27 weeks of age we also recorded videos from within the nests to assess individual nest choice for egg-laying. In addition, we recorded aggressive interactions between individual hens during the first hour of light on one day each at 18, 24 and 27 weeks of age to establish social status. We found a relative preference for the partition nest with a greater proportion of eggs laid in these nests as well as fewer nest visits per egg. The hens were also consistent in their egg-laying location over the two days of observation. After the nest switch, however, the hens did not switch egg laying location and the number of visits per egg no longer differed between nests suggesting that the preference for the partitioned nest was only important at the beginning of lay. In addition, although social rank had no impact on preference of nest type, lower ranking hens performed more nest visits and laid their eggs slightly later on the second observation day (week 27 of age) compared with higher ranking hens. Therefore, the use of partitions could improve the attractiveness of group-nests.

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In the IT industry, there has been a remarkable increase in the demand for system LSI. A system LSI must be tailor-designed for each electrical appliance, and then produced. It is said that in recent years, this production method has made the IC cycle ambiguous. It can be sought that the choice of whether the economy pursues a development path centering on technology which is tradable or technology which is embodied in labor, depends on the historical background. In this paper, the economic background is explained in order to analyze and capture movements in the IT industry and technology. Then, an econometric model for Hungary has been constructed to estimate the effect of technological progress on the economy.

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This paper investigates Japanese trade by mode of transport, i.e., air transport versus maritime shipping. Some facts about Japanese machinery exports by mode of transport in the 1990s are examined first. Then it will be shown that products of the machinery sector where international fragmentation prevails are more likely to be exported by air.