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921.
General practitioners (GPs) are assumed to occupy an important position in the prevention of suicide through the introduction of risk assessment techniques commonly used in psychiatric practice. Despite this theoretical role for primary care services, it remains unclear how frequently GPs implement risk assessment in patients who may be vulnerable to suicide. To address this, a retrospective survey of probable suicides was conducted within a primary care setting utilizing a questionnaire of GPs who had experienced a patient suicide and was augmented by hospital and coroners' records. 85% of questionnaires were returned and 61 deaths were adjudged as suicides during the year long census period. 75% of suicides were male and 54% were aged under 35.28% were in contact with psychiatric services prior to death, although 60% had some diagnosis of mental disorder. GPs had little knowledge of a patient's life circumstances in up to half of cases. Recording of risk assessment occurred in 38% of subjects, was positively associated with prior psychiatric contact (p = 0.001) but negatively associated with presence of physical illness (p = 0.004), older patient age (p = 0.04), and GPs length in practice (p = 0.05). One GP felt their suicide case was preventable. The low rate of risk assessment and limited knowledge of patient lifestyle point to the need for active engagement of GPs in future suicide prevention strategies and should influence the content of training programs in primary care. 相似文献
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923.
Evidence is presented regarding strengths and limitations of portfolio approaches as applied to diversifying export earnings. An empirical application using data from Malawi, Tanzania, and Zimbabwe is used to demonstrate these strengths and limitations. Modifications of the typical portfolio approach to export diversification are presented; these modifications help make the approach more plausible for use in developing countries. The modified approach is shown to provide guidance to policymakers who seek simultaneously to increase export earnings and reduce their instability. 相似文献
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926.
B. Douglas Skelley 《国际公共行政管理杂志》2013,36(2):179-206
Because there has been considerable interest in the Japanese management model, this study explores its limitations for the American setting and particularly the American public sector. These limitations include (1) cultural barriers, (2) the incompleteness of the model, and (3) undesirable elements in the model. This analysis concludes that there is little new in humanistic or participative terms to be found in the Japanese approach. Despite several objectionable elements in the model, some of its devices are instructive and may be carefully adapted to public sector use, but adoption of the whole model is unlikely and undesirable. 相似文献
927.
David W. Mushinski 《发展研究杂志》2013,49(2):88-112
Economists have sought to identify institutions which might fill the gap in household access to credit arising from rationing by formal lenders. Credit unions have been identified as institutions which might use informational and monitoring advantages to fill that gap. Using information on household perceptions of their access to credit, this article analyses the impact of certain credit unions on the access to credit of households in Guatemala. Regression results indicate that credit unions serve markets unserved by formal lenders and that information on household perceptions of their access to credit is important in making inferences about lender lending activities. 相似文献
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929.
David Bayliss 《Local Government Studies》2013,39(4):89-92
Since the early 1990s, reports on topics ranging from neighbourhood renewal and low demand to social exclusion have highlighted the damaging effects of anti-social behaviour. Local authorities are urged to develop a 'holistic' response to anti-social behaviour. Recent research into the effectiveness of legal remedies reveals a tension between attempts to address the underlying causes of anti-social behaviour and the government's emphasis on legal action to control and punish perpetrators. Drawing on this research, the article examines why many landlords are still evicting perpetrators rather than dealing with the underlying causes of their behaviour. The article concludes by outlining the barriers that landlords and other agencies must overcome in order to develop a holistic approach to the problem. 相似文献
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