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Managed care poses numerous opportunities and challenges for today's health care organizations and their employees. This article investigates the ways that hospital nurses develop and make sense of their professional roles and organizational environments in a changing and often uncertain managed care setting. The case study approach used in this research combined qualitative methodologies to gain a rich, detailed, and contextual understanding of nurses' work roles and organizational experiences. After an analysis of interviews with 24 nurses and observations of nurses' communicative activities on one inpatient unit, the complexity of sensemaking and role development in a managed care environment is considered. Conclusions are then drawn regarding the theoretical and pragmatic implications of nurses' communicative processes, as they attempted to develop and understand their roles in a changing organizational context.  相似文献   
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The poor reading achievement of African-American children in urban schools is well established. African-American children from low-income homes may be at particular risk for reading difficulties, although middle-income children often fare poorly as well. Intervention efforts have focused on children in kindergarten through fifth grade. This article suggests that prevention efforts must begin prior to kindergarten entry. Several key variables that may influence young children's performance, including poverty, general oral language skills, dialectal variations, home literacy practices, standardized testing bias, and teacher expectations, are explored. Future directions for research addressing emergent literacy in African-American children are discussed throughout.  相似文献   
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This article reports the results of a survey of literature on measures of library effectiveness. This survey led to the formulation of six criterion concepts (accessibility, cost, user satisfaction, response time, cost/benefit ratio, and use). The advantages and disadvantages of each method of measurement are discussed. Several points which became clear during the analysis are discussed. First, there is a relative lack of concern with the rationale behind the evaluation process, although the results invariably lead to a confused interpretation when there is no clear understanding of the purpose of an evaluation. Second, the total library system is rarely considered; instead, each evaluation criterion is taken in isolation rather than as part of the whole. Third, the library's preservation function has not been considered at all.  相似文献   
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This paper discusses the use of systems development research methods in the context of ongoing research that is formulating a specification for a metadata schema registry. The paper extrapolates from this discussion how such methods can be utilized in archival systems research and how such an approach differs from commercial systems engineering. In particular, the paper suggests that adopting a user-centred prototyping approach in a research context allows for exploration of the interplay between theory and practice, advancing the practice, while also offering new insights into theoretical concepts. It argues that these research methods are of increasing interest to the archival profession in order to conceptualise and realise the tools necessary to support recordkeeping and archival processes in digital environments.  相似文献   
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In 2001, the Regenstrief Institute for Health Care and the Indiana University School of Medicine (IUSM) began an IAIMS planning effort to create a vision and a tactical plan for the first Integrated Advanced Information Management Systems (IAIMS) implementation to cross a large area and include unaffiliated institutions. A number of elements made this planning effort unique. Among these elements were the existence of a network infrastructure that supported the Indianapolis Network for Patient Care, the existence of a mature medical informatics program at the Regenstrief Institute, and the existence of a wide-area knowledge network fostered by the IUSM libraries. However, the leadership for a strong information technology role in the IUSM that could promote collaboration in support of education and research across the diverse Indianapolis hospital systems had been lacking. By bringing together various groups, each with a commitment to improve health care quality and public health across the Indianapolis metropolitan area, regardless of individual institutional affiliation, the strategic directions for I3-Indianapolis IAIMS Initiative have been defined and the foundations for a third generation IAIMS construct have been laid in Indianapolis, Indiana.  相似文献   
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ABSTRACT

Online learning has become a ubiquitous part of the educational landscape and how teachers are supported in developing approaches to teaching online is a fundamental aspect of the students’ learning experience. Based on the implementation of a professional development course on becoming an online teacher offered in a blended learning mode at one university in Hong Kong, this article proposes that offering this type of professional development in a blended mode is very effective in facilitating enhanced usage of the university’s learning management system. In a blended mode, teachers are actively engaged with blended learning and were found to make more extensive use of features/tools in Blackboard after they attended the professional development course. Results support that offering professional development in a blended mode provides teachers with an authentic student perspective, at the same time as they take guided steps in the teacher’s role in blended learning.  相似文献   
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