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The purpose of this paper is to describe the patient level characteristics of government-assisted refugees (GARs) who had acquired family doctors after leaving specialized…
The purpose of this paper is to describe the patient level characteristics of government-assisted refugees (GARs) who had acquired family doctors after leaving specialized refugee clinics (RC).
A cross-sectional telephone survey of GARs households, three to six years after arrival to British Columbia, that used logistic regression to identify GAR characteristics associated with having a family doctor compared to having no family doctor or remaining at a RC.
Contact rate was 52 percent. Of 177 interviewed GARs who spoke 24 languages, only 61 percent had secured a family doctor. Only 57 percent were educated; 46 percent spoke English and 40 percent worked consistently. Central Asian or African origin was associated with having a family doctor (OR 10.6 (95 percent CI 3.1-36.8) for RC; OR 10.3 (95 percent CI 2.2-47.8) for no family doctor). Other significant characteristics in the comparison with GARs at a RC included English proficiency (OR 15.6 (95 percent CI 4.3-56.9)), and female sex (OR 4.0 (95 percent CI 1.4-1.1)). When compared to those with no family doctor, additional significant characteristics included Health Authority A compared to B (OR 8.9, 95 percent CI 1.4-55.6) and having recently visited a doctor (OR 7.7 (95 percent CI 1.9-30.7)).
The results of this study are limited to a specific environment and the low contact rate may have resulted in bias.
This study described characteristics of GARs who had successfully transitioned to a family doctor and those who had not. This population is rarely captured in studies because they are difficult to contact, ethnically diverse and not proficient in English.
– The purpose of this paper is to explore refugees’ experiences of the barriers and facilitators involved in finding a regular family doctor.
The purpose of this paper is to explore refugees’ experiences of the barriers and facilitators involved in finding a regular family doctor.
Hermeneutic phenomenology was used to produce an integrated description sensitive to the lifeworlds of refugees who came from multiple cultural perspectives. Participants consisted of refugees from Iran, Afghanistan, Myanmar, Vietnam, and Latin America who arrived in Canada between 2005 and 2007. Texts for analysis came from first language focus group discussions and interviews with the interpreters for those groups.
The principal themes that emerged from the experience of barriers were “futility,” “dependence,” and “relevance.” Themes related to the experience of facilitators were “inclusion,” “congruence,” and “benefit to family.” These themes provide key messages about sources of patient decisions to seek or not seek care, not comply, attend irregularly, and not disclose symptoms, which can be used by doctors and other health providers to enhance care planning.
The factors that facilitate refugees’ access to a regular family doctor have implications for the development of culturally appropriate healthcare information, policies that support adequate interpreter services, and cultural sensitivity training for physicians.
Previous research documents barriers such as lack of language access, differences in health beliefs, and lack of knowledge about western healthcare systems. However, little is known about how refugees experience these barriers, nor how they overcome them. This study contributes a rich and deeper understanding of how refugees experience these barriers and elucidates factors that facilitate their process of obtaining a regular family doctor.
The rapidly growing body of global leadership literature still lacks research on both global change and global leader cognition. This chapter presents two case studies…
The rapidly growing body of global leadership literature still lacks research on both global change and global leader cognition. This chapter presents two case studies describing large-scale global change efforts led by expert global leaders. This is complemented with the results of cognitive task analysis interviews with the two expert global leaders. The findings include task diagrams of the change process they employed and knowledge audits of the most difficult cognitive step in the change processes they led. The audit identifies the elements of expert cognition they utilized, the cues and strategies they employed, and the perceived difficulties novices would experience in similar situations. The findings confirm previous research, solidifying the role and nature of expert cognition in global leaders. We conclude with a discussion of the implications our analysis holds for research and practice.
An agency relationship exists whenever one party (the principal) delegates authority to another (the agent). Because agents are assumed to be self-interested and to…
An agency relationship exists whenever one party (the principal) delegates authority to another (the agent). Because agents are assumed to be self-interested and to possess goals that diverge from the principal's goals, the principal must expend resources (called agency costs) to insure that agents act in her interest (Jensen & Meckling, 1976). In chains, the firm can choose as outlet managers either employees who are paid a salary (and perhaps a bonus) or franchisees who are granted the right to their outlet's profits after royalties and other expenses. In both cases, an agency problem is created because the firm delegates local decision-making to outlet managers whose interests are not perfectly aligned with that of the franchisor's (Rubin, 1978).
This paper presents a systematic method for classifying research on international channels of distribution. It is used to examine 79 articles published during an 18‐year…
This paper presents a systematic method for classifying research on international channels of distribution. It is used to examine 79 articles published during an 18‐year period (1988‐2005). Based on content analysis, each article is classified by its primary research framework. Two frameworks are identified: (1) structural ‐ based on the economic and organizational aspects of international channels of distribution; and (2) behavioral ‐ based on the exchange relationship between channel members from different national environments. This simple organizing system offers a comprehensive way to analyze scholarship that has emerged in the field. For managers, it can bring the theoretical and practical developments together in an understandable fashion as they seek to interpret and apply research findings. For scholars, it may bring focus to an increasingly complex area of international business and guide future research efforts.
The purpose of this paper is, first, to utilize institutional theory to assess motivation for the adoption of Six Sigma. Second, to examine the role of an organization's…
The purpose of this paper is, first, to utilize institutional theory to assess motivation for the adoption of Six Sigma. Second, to examine the role of an organization's innovation implementation climate and the fit between the innovation considered and the values of the organization's members on the implementation of Six Sigma. Third, to study the impact that the adoption and implementation of Six Sigma has on organizational performance.
Methods advocated in case study research were employed in the conduct of seven case studies. The research protocol consisted of identifying organizations in a variety of manufacturing industries, and conducting focused interviews with a minimum of three respondents in each company in order to improve validity.
This paper suggests that institutional theory proves to be an effective means by which to examine the adoption of Six Sigma. In addition, support for innovation implementation model suggested by Klein and Sorra is found. Each of the studied firms reported performance improvements as a result of the adoption and implementation of Six Sigma.
This paper contributes to a better understanding of Six Sigma adoption, implementation, and implementation effectiveness of Six Sigma by exploring how it is applied in different manufacturing contexts.