This study examines a practice which is characteristic of an era of intensifying globalization: As part of a transnational lifestyle, an increasing number of immigrants to North America send infants thousands of miles back to their country of origin to be raised by members of their extended families—a culturally sanctioned tradition. After several years of separation, the children return to the biological parents to attend school in the adopted country, a custom which, according to Western mental health models, could have significant sequelae for attachment relationships and other facets of development. This practice is particularly prevalent among immigrants from the People's Republic of China, but a modified version of it can be found in other groups as well. The work described here is the first phase of a longitudinal project that explores the advantages and potential repercussions, for both infants and parents, of a transnational lifestyle. The current study reviews the decision‐making process of a group of Chinese Canadian immigrant parents who are considering a separation from their infants. Preliminary findings show that the expected concerns about disrupting attachment relationships are embedded in more salient considerations of economic need and cultural perspective. These exploratory data exemplify an emergent field of culture‐focused research and practice in infant mental health, and support the call for innovative models to situate infant developmental pathways in global and transcultural contexts. 相似文献
Research to date has shown that health professionals often practice according to personal values, including values based on faith, and that these values impact medicine in multiple ways. While some influence of personal values are inevitable, awareness of values is important so as to sustain beneficial practice without conflicting with the values of the patient. Detecting when own personal values, whether based on a theistic or atheistic worldview, are at work, is a daily challenge in clinical practice. Simultaneously ethical guidelines of tone-setting medical associations like American Medical Association, the British General Medical Council and Australian Medical Association have been updated to encompass physicians’ right to practice medicine in accord with deeply held beliefs. Framed by this context, we discuss the concept of value-neutrality and value-based medical practice of physicians from both a cultural and ethical perspective, and reach the conclusion that the concept of a completely value-neutral physician, free from influence of personal values and filtering out value-laden information when talking to patients, is simply an unrealistic ideal in light of existing evidence. Still we have no reason to suspect that personal values, whether religious, spiritual, atheistic or agnostic, should hinder physicians from delivering professional and patient-centered care.
From a biomedical perspective, variations in the quality of life of chronic obstructive pulmonary disease (COPD) patients may be attributed to changes in pulmonary function; thus, an increase in lung function should be correlated with an increased score on a health-related quality-of-life measure. However, inconsistent results regarding correlations between various measures of pulmonary function and quality of life have been reported in the literature. The authors evaluated a social cognitive model of quality of life among persons with COPD by analyzing relationships among biomedical measures, self-efficacy measures, and quality-of-life measures in a recursive path model. Path analysis results indicated that the association of pulmonary function and symptoms with quality of life was mediated by perceived self-efficacy for functional activities. 相似文献