Qualitative Exploration of the Experiences and Challenges of Adolescents during Pregnancy

This study explores and describes the experiences and challenges of pregnant adolescents (N = 9, mean age = 16.33 years, SD = 1.58 years) by focusing on their thoughts and feelings about their pregnancies and future prospects. The expectant mothers were in their in their second and third trimester of pregnancy. All participants were poor working-class Black South Africans from different ethnic groups. Two were Tsonga, three Zulu and four Tswana speakers. Data were collected using semistructured interviews and analysed using thematic content analysis. Findings suggest that family relationships after disclosure of the pregnancy were strained, particularly the father-daughter relationship. The teens expressed unpreparedness for the challenges of motherhood, uncertainty about the future and feelings of anger, regret and anxiety.     

德国卫生保健体系改革及相关伦理问题简析

从德国现有卫生保健及医疗保险体系在保障其社会稳定的重要作用角度出发,介绍了德国的原有整体医疗卫生保障体系的背景,指出政府的指导、政策稳定、完善的津贴体系保障了整体国民健康和卫生保健的公平分配,高素质,医术高超的医生队伍起到了核心作用。同时指出由于意识形态和经济原因,德国卫生保健体系改革所引发的问题。     

The Mentoring Relationship Challenges Scale: The impact of mentoring stage, type, and gender

The current study investigated the role of relational challenges as reported by 309 protégés in various stages and types of mentoring relationships. The Mentoring Relationship Challenges Scale (MRCS) was newly constructed using the results of an earlier qualitative study (Ensher & Murphy, 2005). The scale measured three factors of relational challenges which were: Demonstrating Commitment and Resilience, Measuring Up to a Mentor's Standards, and Career Goal and Risk Orientation. The results demonstrated that with respect to mentoring stages, those protégés in the beginning stages of their relationships reported experiencing significantly fewer challenges related to Demonstrating Commitment and Resilience than those in the mature or ending stages of the relationship. Also, it was found that the type of mentoring relationship (traditional, step-ahead, or peer) affected the prevalence of the three types of challenges. Protégés in peer relationships reported significantly fewer of all three types of challenges than those in step-ahead or traditional relationships. However, contrary to predictions, there were no significant differences found between those in informal versus those in formal mentoring relationships. As expected, protégé and mentor gender interacted significantly. Female protégés reported experiencing significantly fewer challenges related to the factor of Measuring Up to a Mentor's Standards, than did male protégés. Also, female protégés reported experiencing a significantly higher degree of relational challenges related to Career Goal and Risk Orientation from their male mentors than from their female mentors. Finally, after controlling for perceptions of career and psychosocial support for protégés in traditional mentoring relationships, two of the three relational challenges factors remained significant and explained a significant amount of variance in overall satisfaction with the mentoring relationship. This suggests that relational challenges, at least for traditional mentoring relationships, serve as an important mechanism to impact overall relationship satisfaction.     

慢性房颤导管消融：挑战与展望

随着对慢性房颤机制认识的深入以及消融方法不断探索,经导管消融在慢性房颤治疗的地位逐渐提高。尽管在适应证、消融策略、获益风险比及远期疗效等还存在一定争议,随着经验的积累和技术的进步,导管消融根治慢性房颤充满希望。     

如何提高慢性房颤导管消融的成功率

慢性心房颤动（房颤）的基本导管消融方法包括环肺静脉消融隔离、复杂碎裂心房电位消融和线性消融,肺静脉外异位兴奋灶的消融和基质改良是提高慢性房颤消融成功率的有效方法,复合式或个体化消融方案是治疗慢性房颤的趋势,但是如何针对不同患者选择个体化的消融策略进一步提高慢性房颤消融的有效性仍是一大挑战。     

Challenges in Disseminating Model Programs: A Qualitative Analysis of the Strengthening Washington DC Families Program

This article discusses the challenges faced when a popular model program, the Strengthening Families Program, which in the past has been implemented on a smaller scale in single organizations, moves to a larger, multiorganization endeavor. On the basis of 42 interviews conducted with program staff, the results highlight two main themes that address program and organizational characteristics. The themes relate to the cultural relevance of the program, the accessibility of program partners, the organization of program services, and the coordination of program activities. The article also offers a discussion of how to better prepare sites for program delivery. This discussion focuses explicitly on the need for good communication among program partners, extensive community outreach, and the ability to secure additional resources.     

Counselling psychology in South Korea

Counselling psychology (CP) in South Korea has grown tremendously as it establishes its unique niche in the mental health profession. Diverse practice under the roof of CP is a strength as well as a weakness. In this paper, we describe the characteristics of CP in South Korea in terms of history, credentialing, the service delivery system, organizations, training, distinctive features from other adjacent areas, core values, and the profession’s unique challenges and future directions. Future tasks include the establishment of clear professional identity, achievement of a governmental licensure system, a nationwide accreditation system, development of Korean-specific ways of counselling, protocols for trauma, and increased accessibility.     

EVALUATING TREATMENT CHALLENGES WITH DIFFERENTIAL REINFORCEMENT OF ALTERNATIVE BEHAVIOR

In prior research, differential reinforcement of alternative behavior (DRA) has been implemented at optimal treatment values: Problem behavior is never reinforced, and alternative behavior is always reinforced. However, in application, DRA is unlikely to be conducted optimally. In this study, following a functional analysis phase and a differential reinforcement at full implementation phase, we challenged initially positive treatment effects for 3 participants by implementing DRA at less than optimal parameters. For example, some occurrences of problem behavior were reinforced, and some occurrences of alternative behavior were not reinforced. Results suggested that when exposed to DRA at full implementation, participants showed a bias toward appropriate behavior in subsequent conditions during which “mistakes” (treatment challenges) were intentionally introduced. In addition, the negative effects of treatment challenges were quickly reversible, in comparison to the positive effects of DRA, which were not quickly reversible in the face of treatment challenges.     

言语学习引起的脑功能和结构变化

文章系统介绍了言语学习引起的脑功能和结构可塑性变化研究的最新进展,例如：第二语言的词汇——语义学习引起的脑功能变化主要受熟练程度的影响,而句法学习引起的脑功能变化主要受获得年龄的影响;实验室言语训练可以引起语言加工相关区域激活增强或减弱,以及出现新的激活区域;第二语言学习导致了左侧顶下皮层灰质密度增加。此外,文章还总结了言语学习的脑成像研究中常用的实验范式,并提出了有待于进一步解决的关键问题     

新医科语境下医学伦理的实践挑战与理论突围

在全球范围和中国语境下开启的新医科范畴,推进了医学伦理的纵深发展并打开新的向度。医学伦理作为动态平衡且不断发展的概念,伴随医学使命而生。在新医科语境下,医学伦理面临来自以利益为主线、以知识权力和专业技术两翼构成的三维挑战。这种挑战植根于医学能力的提升,社会资本的介入,医生的专业权力以及生物科技融合发展带来的专业话语。实践挑战的本质是理论困境,解决实践难题根本上需要理论突围。需要建构基于责任伦理为关键词、以公共伦理融合个体道德、以专业伦理深化常识道德的医学伦理体系。