Shared Explanatory Models (EM) of High Blood Pressure (HBP)/Hypertension (HTN) were explored using systematic data collection and analysis methods from cognitive anthropology. Older adults who were members of a Medica...Shared Explanatory Models (EM) of High Blood Pressure (HBP)/Hypertension (HTN) were explored using systematic data collection and analysis methods from cognitive anthropology. Older adults who were members of a Medicare HMO in Los Angeles were asked to list all the illnesses experienced by older adults that they could recall, and those listing HBP or HTN were asked to further list and discuss its symptoms, causes, treatments and prevention. Responses were tape recorded, transcribed, and analyzed to develop a systematic “sentence completion by card sort” follow-up procedure. Consensus Analysis (CA) of the systematically collected data identified shared EM for HBP/HTN. The model presented here is similar to models of HBP/HTN described by researchers working with patients from different regions and different ethnic groups, suggesting that there is a widely shared lay or popular model for this disease. Stress, lifestyle (diet, exercise, weight, and substance use), heredity and aging are thought to be the major causes of HBP/HTN. Physicians are thought to be the appropriate source of care, as HTN/HBP is serious, life threatening, and potentially disabling. The study of cultural understandings and shared EM of disease has direct relevance for clinical practice and public health education. For a disease such as HTN/HBP, knowing where and how such explanations differ systematically between patients and clinicians, and what impact this may have on patterns of adherence to prescribed treatment is a crucial area of concern.展开更多
We present qualitative data from a study in Ghana （2011）, where the National Health Insurance Scheme （NHIS） was introduced to improve access to health care. In 2011 membership enrolment and retention in the scheme...We present qualitative data from a study in Ghana （2011）, where the National Health Insurance Scheme （NHIS） was introduced to improve access to health care. In 2011 membership enrolment and retention in the scheme was stalling. To obtain better insights into socio-cultural factors that influence utilization of healthcare services and the NHIS this study compared Explanatory Models of healthcare clients with those of primary healthcare providers and the NHIS regarding illness, the need for, the quality of, and the control over heaithcare and health insurance services. We found critical disparities in socio-cultural beliefs and perceptions of healthcare and health insurance between these three stakeholder groups, such as the clients＇ holistic view on illness versus healthcare providers＇ bio-medical view; the clients＇ inter-relational focus in perceiving quality of services versus the providers＇ medical technical focus. These differences are leading to misconceptions, blame practice, poor services, non-adherence and low trust. The findings increase our understanding of clients＇ behavior and that of their service providers. We conclude with key messages for policy leaders and operational managers that can guide them in improving services and facilitating client trust and interest to participate in health insurance and utilize healthcare services.展开更多
Cruise value chain is to take the exchange of cruise products and services as the core in a certain spatial scope,and enterprises with core advantages within or between different industries establish associations in a...Cruise value chain is to take the exchange of cruise products and services as the core in a certain spatial scope,and enterprises with core advantages within or between different industries establish associations in accordance with certain technical and economic conditions,so as to realise the multi-dimensional extension and value appreciation of the cruise value chain in the vertical and horizontal links,and ultimately establish a chain-network type of enterprise strategic alliance.This paper tries to analyse the value-added factors of the cruise industry chain by constructing a multi-level hierarchical structural model with reference to the influencing factor analysis methods of relevant literature-DEMATEL(Decision Making Experiment and Evaluation Experiment)and ISM(Interpretative Structural Model).The study shows that the innovation and scale value-added module in the upstream of the cruise industry chain is the core module of value-added of the whole cruise industry chain,and the value-added mainly originates from the design and manufacturing of cruise ships.The middle reaches of the cruise industry chain are mainly cruise operation enterprises,and the specificity of cruise operation determines that its brand value-added is mainly accomplished through the global layout of multinational corporations,and the cruise brand is able to drive the consumption demand and has value-added ability.The downstream value-added of the cruise industry chain is mainly realised through the increase in profits of cruise tourism service products.展开更多
文摘Shared Explanatory Models (EM) of High Blood Pressure (HBP)/Hypertension (HTN) were explored using systematic data collection and analysis methods from cognitive anthropology. Older adults who were members of a Medicare HMO in Los Angeles were asked to list all the illnesses experienced by older adults that they could recall, and those listing HBP or HTN were asked to further list and discuss its symptoms, causes, treatments and prevention. Responses were tape recorded, transcribed, and analyzed to develop a systematic “sentence completion by card sort” follow-up procedure. Consensus Analysis (CA) of the systematically collected data identified shared EM for HBP/HTN. The model presented here is similar to models of HBP/HTN described by researchers working with patients from different regions and different ethnic groups, suggesting that there is a widely shared lay or popular model for this disease. Stress, lifestyle (diet, exercise, weight, and substance use), heredity and aging are thought to be the major causes of HBP/HTN. Physicians are thought to be the appropriate source of care, as HTN/HBP is serious, life threatening, and potentially disabling. The study of cultural understandings and shared EM of disease has direct relevance for clinical practice and public health education. For a disease such as HTN/HBP, knowing where and how such explanations differ systematically between patients and clinicians, and what impact this may have on patterns of adherence to prescribed treatment is a crucial area of concern.
文摘We present qualitative data from a study in Ghana （2011）, where the National Health Insurance Scheme （NHIS） was introduced to improve access to health care. In 2011 membership enrolment and retention in the scheme was stalling. To obtain better insights into socio-cultural factors that influence utilization of healthcare services and the NHIS this study compared Explanatory Models of healthcare clients with those of primary healthcare providers and the NHIS regarding illness, the need for, the quality of, and the control over heaithcare and health insurance services. We found critical disparities in socio-cultural beliefs and perceptions of healthcare and health insurance between these three stakeholder groups, such as the clients＇ holistic view on illness versus healthcare providers＇ bio-medical view; the clients＇ inter-relational focus in perceiving quality of services versus the providers＇ medical technical focus. These differences are leading to misconceptions, blame practice, poor services, non-adherence and low trust. The findings increase our understanding of clients＇ behavior and that of their service providers. We conclude with key messages for policy leaders and operational managers that can guide them in improving services and facilitating client trust and interest to participate in health insurance and utilize healthcare services.
基金Tropical Ocean University 2023 Provincial Key Discipline Construction Project-Business Administration.Project of the National Social Science Foundation:Research on the Cooperation Mechanism and Realisation Path for the Cooperative Development of the Cruise Industry in the Countries Surrounding the South China Sea(19XJY001)Key Laboratory of the Ministry of Culture and Tourism on Data Mining,Monitoring and Early Warning Technology for Island Tourism Resources(KLITRDMM 2022-15).
文摘Cruise value chain is to take the exchange of cruise products and services as the core in a certain spatial scope,and enterprises with core advantages within or between different industries establish associations in accordance with certain technical and economic conditions,so as to realise the multi-dimensional extension and value appreciation of the cruise value chain in the vertical and horizontal links,and ultimately establish a chain-network type of enterprise strategic alliance.This paper tries to analyse the value-added factors of the cruise industry chain by constructing a multi-level hierarchical structural model with reference to the influencing factor analysis methods of relevant literature-DEMATEL(Decision Making Experiment and Evaluation Experiment)and ISM(Interpretative Structural Model).The study shows that the innovation and scale value-added module in the upstream of the cruise industry chain is the core module of value-added of the whole cruise industry chain,and the value-added mainly originates from the design and manufacturing of cruise ships.The middle reaches of the cruise industry chain are mainly cruise operation enterprises,and the specificity of cruise operation determines that its brand value-added is mainly accomplished through the global layout of multinational corporations,and the cruise brand is able to drive the consumption demand and has value-added ability.The downstream value-added of the cruise industry chain is mainly realised through the increase in profits of cruise tourism service products.
