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This paper is concerned with the appropriateness of various structural approaches t o the problem of medically underserved areas (MUAS). The failure of the private sector in this regard and the experience with public sector responses to the problem are noted. The paper compares the merits of applying the device of the special district to MUAs with arguments favoring a general government solution. The experience of the state of Arizona with Health Service District legislation is observed. The logic of the special district and the nature of medical underservice offerslim hope that this device might materially ameliorate the problem. A t the same time, the past initiatives of general purpose government have not served t o erase medical underservice. The point is made t h a t empirical evidence is needed t o fully test the assumptions underlying the arguments of the respective approaches. 相似文献
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The purpose of this study was to understand differences in patterns of supervisor support desired by female victims of intimate partner violence (IPV) and to examine whether the pattern of support desired at work is reflective of a woman's stage of change in the abusive relationship, IPV-related work interference, and IPV-related job reprimands or job loss. We conducted interviews in Spanish or English with adult women working in low-income jobs who had been physically or sexually abused by an intimate partner/ ex-partner in the past year ( N = 133). Cluster analysis revealed three distinct clusters that form a hierarchy of type of support wanted: those who desired limited support; those who desired confidential, time-off, and emotional support; and those who desired support in wide variety of ways from their supervisor. The clusters appeared to reflect stages of behavior change in an abusive relationship. Specifically, the limited-support cluster may represent an early precontemplation stage, with women reporting the least interference with work. The support-in-every-way cluster may represent later stages of change, in which women are breaking away from the abusive partner and report the greatest interference with work. Women in the confidential-, time-off-, and emotional-support cluster are in a transition stage in which they are considering change and are exploring options in their abusive relationship. Understanding the hierarchy of the type of support desired, and its relationship to stages of change in the abusive relationship and work interference, may provide a strong foundation for developing appropriate and effective workplace interventions to guide supervisors in providing support to women experiencing IPV. 相似文献
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This study continues previous work documenting the structure of violence perpetrated by males against their female intimate partners. It assesses the construct validity of a measurement model depicting associations among eight subtypes of perpetration: moderate physical violence, severe physical violence, forced or coerced sexual violence, sexual violence where consent was not possible, emotional/verbal psychological abuse, dominance/isolation psychological abuse, interactional contacts/surveillance related stalking, and stalking involving mediated contacts. Data were obtained from a sample of 340 men arrested for physical assault of a female spouse or partner, and court ordered into batterer intervention programs. Men were surveyed before starting the intervention. Confirmatory factor analyses (CFA) supported the validity of model as evidenced by good model to data fit and satisfaction of requirements for fit statistics. In addition, the eight factor solution was characterized by a slightly better model to data fit than a four factor higher order solution described in the author's previous work. Latent variable correlations across the broader categories of intimate partner violence (IPV) revealed that the violence subtypes were mostly moderately positively correlated and ranged from .381 (emotional/verbal psychological abuse with interactional contacts/surveillance related stalking) to .795 (dominance/isolation psychological with abuse with forced sex). Future studies should determine whether there are distinct risk factors and health outcomes associated with each of the eight IPV perpetration subtypes and identify possible patterns of co-occurrence. 相似文献
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The present study examines the quality of peer relations as a mediator between exposure to IPV (intimate partner violence) and internalizing behaviors in a sample of 129 preadolescents and adolescents (ages 10-18), who were interviewed via telephone as part of a multigenerational, prospective, longitudinal study. Relational victimization is also examined as a moderator of IPV exposure on internalizing behaviors. Results demonstrate a significant association of exposure to severe IPV and internalizing behaviors. Relational victimization is found to moderate the effects of exposure to severe IPV on internalizing behaviors. The present findings suggest that the effects of exposure to IPV had a particularly important effect on the risk for internalizing problems if the adolescent also experienced relational victimization. Conversely, the receipt of prosocial behaviors buffer against the effects of IPV exposure on internalizing symptoms in teen girls. 相似文献