92 research outputs found
When the Victor Cannot Claim the Spoils: Institutional Incentives for Professionalizing Patronage States
Protestant women in the late Soviet era: gender, authority, and dissent
At the peak of the anti-religious campaigns under Nikita Khrushchev,
communist propaganda depicted women believers as either naĂŻve
dupes, tricked by the clergy, or as depraved fanatics; the Protestant
âsektantkaâ (female sectarian) was a particularly prominent folk-devil.
In fact, as this article shows, womenâs position within Protestant
communities was far more complex than either of these mythical
figures would have one believe. The authors explore four important,
but contested, female roles: women as leaders of worship, particularly
in remote congregations where female believers vastly outnumbered
their male counterparts; women as unofficial prophetesses,
primarily within Pentecostal groups; women as mothers, replenishing
congregations through high birth rates and commitment to their
childrenâs religious upbringing; and women as political actors in the
defence of religious rights. Using a wide range of sources, which
include reports written by state officials, articles in the church journal,
letters from church members to their ecclesiastical leaders in
Moscow, samizdat texts, and oral history accounts, the authors
probe womenâs relationship with authority, in terms of both the
authority of the (male) ministry within the church, and the authority
of the Soviet state
Implementing academic detailing for breast cancer screening in underserved communities
<p>Abstract</p> <p>Background</p> <p>African American and Hispanic women, such as those living in the northern Manhattan and the South Bronx neighborhoods of New York City, are generally underserved with regard to breast cancer prevention and screening practices, even though they are more likely to die of breast cancer than are other women. Primary care physicians (PCPs) are critical for the recommendation of breast cancer screening to their patients. Academic detailing is a promising strategy for improving PCP performance in recommending breast cancer screening, yet little is known about the effects of academic detailing on breast cancer screening among physicians who practice in medically underserved areas. We assessed the effectiveness of an enhanced, multi-component academic detailing intervention in increasing recommendations for breast cancer screening within a sample of community-based urban physicians.</p> <p>Methods</p> <p>Two medically underserved communities were matched and randomized to intervention and control arms. Ninety-four primary care community (<it>i.e</it>., not hospital based) physicians in northern Manhattan were compared to 74 physicians in the South Bronx neighborhoods of the New York City metropolitan area. Intervention participants received enhanced physician-directed academic detailing, using the American Cancer Society guidelines for the early detection of breast cancer. Control group physicians received no intervention. We conducted interviews to measure primary care physicians' self-reported recommendation of mammography and Clinical Breast Examination (CBE), and whether PCPs taught women how to perform breast self examination (BSE).</p> <p>Results</p> <p>Using multivariate analyses, we found a statistically significant intervention effect on the recommendation of CBE to women patients age 40 and over; mammography and breast self examination reports increased across both arms from baseline to follow-up, according to physician self-report. At post-test, physician involvement in additional educational programs, enhanced self-efficacy in counseling for prevention, the routine use of chart reminders, computer- rather than paper-based prompting and tracking approaches, printed patient education materials, performance targets for mammography, and increased involvement of nursing and other office staff were associated with increased screening.</p> <p>Conclusion</p> <p>We found some evidence of improvement in breast cancer screening practices due to enhanced academic detailing among primary care physicians practicing in urban underserved communities.</p
Civil society leadership in the struggle for AIDS treatment in South Africa and Uganda
Includes abstract.Includes bibliographical references.This thesis is an attempt to theorise and operationalise empirically the notion of âcivil society leadershipâ in Sub-Saharan Africa. âAIDS leadership,â which is associated with the intergovernmental institutions charged with coordinating the global response to HIV/AIDS, is both under-theorised and highly context-specific. In this study I therefore opt for an inclusive framework that draws on a range of approaches, including the literature on âleadershipâ, institutions, social movements and the ânetworkâ perspective on civil society mobilisation. This framework is employed in rich and detailed empirical descriptions (âthick descriptionâ) of civil society mobilisation around AIDS, including contentious AIDS activism, in the key case studies of South Africa and Uganda. South Africa and Uganda are widely considered key examples of poor and good leadership (from national political leaders) respectively, while the Treatment Action Campaign (TAC) and The AIDS Support Organisation (TASO) are both seen as highly effective civil society movements. These descriptions emphasise âtransnational networks of influenceâ in which civil society leaders participated (and at times actively constructed) in order to mobilise both symbolic and material resources aimed at exerting influence at the transnational, national and local levels
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