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Surgery is an important part of contemporary health care, but currently much of surgery lacks a strong evidence base. Uptake of evidence‐based medicine (EBM) methods within surgical research and among practitioners has been slow compared with other areas of medicine. Although this is often viewed as arising from practical and cultural barriers, it also reflects a lack of epistemic fit between EBM research methods and surgical practice. In this paper we discuss some epistemic challenges in surgery relating to this lack of fit, and investigate how resources from feminist epistemology can help to characterize them. We point to ways in which these epistemic challenges may be addressed by gathering and disseminating evidence about what works in surgery using methods that are contextual, pluralistic, and sensitive to hierarchies. 相似文献
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Beulah Joseph Arlene Walker Matthew Fuller-Tyszkiewicz 《European Journal of Work and Organizational Psychology》2018,27(1):1-15
The rapid growth of employee assistance Programmes (EAPs) has not been matched by the accompanying research base of their efficacy. Given the inconsistent information relating to the effectiveness of EAPs in enhancing employee and organizational outcomes, the present review systematically appraised available evidence from organizational psychology and business databases and grey literature sources. A total of 17 studies examining the impact of EAPs, met the inclusion criteria. These were mostly from North America and utilized quantitative methodology and pre- and post-intervention designs. The majority of studies focused on EAPs offered by external providers and the counselling service, with the most common limitations being discrepancies in variable definitions and an absent comparable control group. Overall, this review found that utilizing EAPs enhanced employee outcomes, specifically improving levels of presenteeism and functioning. Absenteeism was most commonly investigated but produced mixed results. Presenteeism demonstrated a stronger effect size and greater improvement than absenteeism, suggesting presenteeism as a better variable for assessing EAP effectiveness. This review clarified parameters of existing evidence and highlighted the narrow range of measures used to date, omitting important constructs such as health and well-being and productivity. A broader evaluation capturing a wider range of variables is urgently needed. 相似文献
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Mary Sue Dehmlow Dreier 《Dialog》2015,54(2):151-161
This article provides glimpses of the emerging missional church within the civil society arena from the perspective of congregational case studies. Civil society studies offer five potential community contributions that provide congregations expanded possibilities for discerning and fulfilling their missional vocations in their communities. Framed within trinitarian missional theology, these create a meaningful framework for congregations to expand their imaginations and strengthen their public participation with God's mission in today's world. 相似文献
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A Longitudinal Study of Racial Discrimination and Risk for Death Ideation in African American Youth 下载免费PDF全文
Rheeda Walker PhD David Francis PhD Gene Brody PhD Ronald Simons PhD Carolyn Cutrona PhD Frederick Gibbons PhD 《Suicide & life-threatening behavior》2017,47(1):86-102
Although multiple studies have found that African Americans commonly experience racial discrimination, available studies have yet to examine how perceived racism might be related to suicide vulnerability in African American youth. The purpose of this study was to examine a framework for how perceived racial discrimination contributes to symptoms of depression and anxiety as well as subsequent suicide ideation and morbid ideation. Data were obtained from 722 African American youth at mean age 10.56 years (SD = 0.64); a second wave of data was obtained 2 years later. Results revealed both a direct effect and mediated effects of perceived racism on later suicide and morbid ideation. For boys and girls, the effect of perceived racism was mediated by symptoms of depression. However, the association was mediated by anxiety for girls, but not for boys in the current sample. Implications for future research and interventions are discussed. 相似文献
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