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Unwillingness to share depression experiences with primary care physicians contributes to the undertreatment of depression. This project examined college students’ reasons for depression nondisclosure to primary care providers (PCPs). Undergraduate participants read a vignette describing someone with depression and completed measures of disclosure barriers. Analyses indicated 26% of respondents would NOT disclose depression symptoms to PCPs. Reasons for nondisclosure included difficulty initiating the depression conversation, medication aversion, and fear of referral to a psychologist. Also, anger toward the vignette character varied with disclosure willingness, suggesting that nondisclosers feel more stigma than disclosers and are less likely to engage in psychotherapy. Because engagement in pharmacological and/or psychotherapeutic treatment requires identification of depression in healthcare settings, increased understanding of disclosure barriers could increase students’ access to depression treatment.  相似文献   
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Summary We will focus on the recent concern — and even ‘obsession’ — with quality in education from the perspective of changes in how we are governed and governing ourselves. Therefore, we will explore advanced liberalism as a form of ‘governmentality’ and point out that (political) government has to submit itself to a ‘permanent economic tribunal’, i.e. judge everything constantly by the principles of entrepreneurship and competition. Furthermore, not only political government, but foremost self-government should be understood in relation to the tribunal: free people objectify within them skills and competencies, which are valuable in a (market) environment. Moreover we argue that management rationality and technology try to establish a double bond within the organization by regarding the worker as an enterprising self. Having pointed out the relationship between entrepreneurship and (self-)management, it is possible to describe how quality becomes a permanent obsession to those managing their life or an organization as an enterprise. After describing management and quality (and their relation) as a ‘function’ of entrepreneurship it is possible to understand how learning is part of it, and how quality management and schooling become entwined at all levels.
Zusammenfassung ‚Gouvernementalité’, Bildung und Qualit?tsmanagement — Versuch einer Kritik des Konzepts der st?ndigen Qualit?tskontrolle Im vorliegenden Text wird die neuerliche — fast obsessive — Besch?ftigung mit ‚Qualit?t’ im Bildungssystem in den Blick genommen, und zwar vor dem Hintergrund der sich ver?ndernden Formen, in denen wir bestimmt (regiert) werden und uns selbst bestimmen. Dazu wird der fortgeschrittene Liberalismus als Form von ‚Gouvermentalité’ (Foucault) untersucht und herausgestellt, dass (politische) Kontrolle sich einem „st?ndigen wirtschaftlichen Tribunal“ unterziehen muss, d.h. alles kontinuierlich an Prinzipen von Unternehmertum (Entrepreneurship) und Wettbewerb auszurichten hat. Dieses wirtschaftliche Tribunal wird darüber hinaus nicht nur in Bezug auf das politische Regieren verstanden, sondern vor allem auf die individuelle Selbst-Regierung; denn freie Menschen zeigen in sich selbst Begabungen und Kompetenzen, die in einer marktwirtschaftlichen Umwelt wertvoll sind. Ferner wird argumentiert, dass Managementrationalit?t und-technologie versuchen, eine doppelte Bindung innerhalb der Organisation zu etablieren, indem sie den Arbeiter als ein unternehmerisches Selbst betrachten. Nach einer Darstellung der Beziehung zwischen Unternehmertum und (Selbst-)Management l?sst sich im Weiteren beschreiben, wie Qualit?t zur Obsession für diejenigen wird, die ihr Leben oder eine Organisation als Unternehmen managen. Im Anschluss an die Er?rterung von Management und Qualit?t (und deren Beziehung) als Funktion des Unternehmertums l?sst sich verstehen, welchen Part das Lernen in diesem Zusammenhang spielt und wie Qualit?tsmanagement und Schulwesen auf allen Ebenen miteinander verflochten sind.
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Background:Osteoarthritis is one of the leading causes of pain and disability worldwide,and a large percentage of patients with osteoarthritis are individuals who are also obese.In recent years,a series of animal models have demonstrated that obesity-inducing diets can result in synovial joint damage(both with and without the superimposition of trauma),which may be related to changes in percentage of body fat and a series of low-level systemic inflammatory mediators.Of note,there is a disparity between whether the dietary challenges commence at weaning,representing a weanling onset,or at skeletal maturity,representing an adult onset of obesity.We wished to evaluate the effect ofthe dietary exposure time and the age at which animals are exposed to a high-fat and high-sucrose(HFS) diet to determine whether these factors may result in disparate outcomes,as there is evidence suggesting that these factors result in differential metabolic disturbances.Based on dietary exposure time,we hypothesized that rats fed an HFS diet for 14 weeks from weaning(HFS Weanling) would demonstrate an increase in knee joint damage scores,whereas rats exposed to the HFS diet for 4 weeks,starting at 12 weeks of age(HFS Adult) and rats exposed to a standard chow diet(Chow)would not display an increase in knee joint damage scores.Methods:Male Sprague-Dawley rats were fed either an HFS diet for 14 weeks from weaning(HFS Weanling) or an HFS diet for 4 weeks,starting at 12 weeks of age(HFS Adult).At sacrifice,joints were scored using the modified Mankin Criteria,and serum was analyzed for a defined subset of inflammatory markers(Interleukin-6,leptin,monocyte chemoattractant protein-1,and tumor necrosis factorα).Results:When the HFS Weanling and HFS Adult groups were compared,both groups had a similar percent of body fat,although the HFS Weanling group had a significantly greater body mass than the HFS Adult group.The HFS Weanling and HFS Adult animals had a significant increase in body mass and percentage of body fat when compared to the Chow group.Although knee joint damage scores were low in all 3 groups,we found,contrary to our hypothesis,that the HFS Adult group had statistically significant greater knee joint damage scores than the Chow and HFS Weanling groups.Furthermore,we observed that the HFS Weanling group did not have significant differences in knee joint damage scores relative to the Chow group.Conclusion:These findings indicate that the HFS Weanling animals were better able to cope with the dietary challenge of an HFS diet than the HFS Adult group.Interestingly,when assessing various serum proinflammatory markers,no significant differences were detected between the HTS Adult and HFS Weanling groups.Although details regarding the mechanisms underlying an increase in knee joint damage scores in the HFS Adult group remain to be elucidated,these findings indicate that dietary exposure time maybe less important than the age at which an HFS diet is introduced.Moreover,increases in serum proinflammatory mediators do not appear to be directly linked to knee joint damage scores in the HFS Weanling group animals but may be partially responsible for the observed knee joint damage in the adults over the very short time of exposure to the HFS diet.  相似文献   
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Emergence of new industries from evolving technologies is critical to the global economy, yet has been relatively understudied due to the paucity of available data. This study draws lessons on industry emergence, by analyzing how a solid-state lighting (SSL) industry grew out of light emitting diode (LED) technologies that evolved for half a century, with participation by tens of thousands of researchers in universities, national laboratories, and firms. Using data on publications, patents, and firms combined with business history we trace the evolution of SSL through a succession of market niches. At times a few researchers with unorthodox research approaches made breakthroughs that greatly advanced particular technology trajectories and pushed LED research in unexpected directions. A succession of LED market niches advanced the technology and provided profits to incentivize continuing research while reducing cost and improving efficacy of LEDs. Innovating firms developed a thicket of patents and captured substantial profit, but were embroiled in extensive litigation that was ultimately resolved through cross-licensing. A major new generation of lighting products is now disrupting the traditional lighting industry. Although the leading incumbent lighting firms all invested early and heavily in SSL, the industry's future leadership is uncertain.  相似文献   
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Designed initially as a way of understanding the often anomalous rhetoric of those who lead social movements, Simons' “Requirements‐Problems‐Strategies” approach has been applied in recent years to other collective rhetorics and other leadership roles. Presented here is an extension and elaboration of RPS framework and a review of illustrative scholarship.  相似文献   
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Abstract

This article develops a conceptual model of users’ and designers’ knowledge roles in the information and communication technology design process. The “ideal” center at the intersection of the axes for division of knowledge work and privileging of knowledges represents a balanced distribution of knowledge work between users and designers and an avoidance of privileging either group over the other. The article then applies this model to analyses of the design process for six video games wherein the knowledges of Indigenous peoples in North America were mobilized. It concludes by discussing implications for research and design practice, particularly for broadening the participation and self-articulation of marginalized groups.  相似文献   
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A diverse sample of doctoral students completed an on-line questionnaire assessing their supervisors' academic, personal and autonomy support and their research self-efficacy. The more task-related help and personal support students received, the more positively they evaluated their supervision. The degree to which supervisors encouraged students to think and act autonomously (autonomy support) was not uniquely associated with students' supervision satisfaction but predicted greater research self-efficacy. A combination of high levels of autonomy and academic support was associated with the highest levels of research self-efficacy, whereas when greater levels of personal support were accompanied by low levels of autonomy support, students reported lower research self-efficacy. These results indicate that effective doctoral supervision involves supporting students to voice and act on their own ideas while simultaneously providing guidance on how to complete research tasks.  相似文献   
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