Preventing Serious Conduct Problems in School-Age Youth: The Fast Track Program

Children with early-starting conduct problems have a very poor prognosis and exact a high cost to society. The Fast Track project is a multisite, collaborative research project investigating the efficacy of a comprehensive, long-term, multicomponent intervention designed to prevent the development of serious conduct problems in high-risk children. In this article, we (a) provide an overview of the developmental model that serves as the conceptual foundation for the Fast Track intervention and describe its integration into the intervention model; (b) outline the research design and intervention model, with an emphasis on the elementary school phase of the intervention; and (c) summarize findings to date concerning intervention outcomes. We then provide a case illustration, and conclude with a discussion of guidelines for practitioners who work with children with conduct problems.     

Time of day affects episodic memory in older adults

The neuropsychological test scores of 2030 cognitively normal older adults were examined to evaluate performance patterns as they related to time of day (TOD) at which testing was initiated. Multiple regression analyses were used to examine the association of TOD with scores on seven neuropsychological tests used in the clinical evaluation of dementia. Episodic memory performance was significantly related to TOD, while memory span and verbal fluency were not. Best performance occurred during early morning hours and late afternoon; worst performance occurred mid-day (i.e., noon). These findings may have implications for clinical assessment, the design of research on dementia, and the daily functioning of older adults.     

Maternal and child contributions to cortisol response to emotional arousal in young children from low-income, rural communities

Relations of maternal and child characteristics to child cortisol reactivity to and recovery from emotional arousal were examined prospectively at approximately 7 months of age (infancy) and then again at approximately 15 months of age (toddlerhood). The sample was diverse and population based (N = 1,292 mother-infant dyads) and included families from predominantly low-income, rural communities. Maternal behavior, family income-to-need ratio and social advantage, and child temperament, attention, and mental development were assessed, and children's saliva was sampled before and after standardized procedures designed to elicit emotional arousal. Maternal engagement in infancy was associated with greater cortisol reactivity at the infancy assessment and with reduced overall cortisol level at the toddler assessment. Also at the toddler assessment, child attention, mental development, and temperamental distress to novelty were associated with increased cortisol reactivity and regulation, whereas temperamental distress to limitations and African American ethnicity were associated with reduced cortisol reactivity. Findings are consistent with prior work linking early caregiving to the development of the hypothalamic-pituitary-adrenal axis stress response system and with a conceptual model in which developing temperament is characterized by the interplay of emotional reactivity and the emergence of the ability to effortfully regulate this reactivity using attention.     

利益冲突的调节机制

利益的平衡取决于相关利益群体参与政策过程的能力的平衡.成立患者权利保护协会,使患者以组织化方式有效参与卫生改革的政策过程,制衡相关利益群体的利益最大化诉求,是平衡卫生服务领域利益冲突的根本途径.     

遗传学认识的特征、争论及其社会控制

20世纪遗传学取得的重大成就并不能掩盖它与人类社会的伦理、宗教、法律之间的不和谐.如何更加正确和高效地进行遗传学的研究和技术应用已经成为各国自然科学家和社会科学家共同关心的问题.概括了遗传学认识的特征,分析了现代遗传学理论同各种传统认识之间存在的争论,并结合当今在遗传学理论研究和技术运用中出现的社会问题提出社会控制的措施.     

脑死亡立法的伦理辩护

"脑死亡"立法是必要的并可以得到充分的伦理辩护:尊重人,特别是尊重人的自主性是"脑死亡"立法的伦理基础."脑死亡"立法符合有利和公平的伦理原则,符合功利主义伦理学追求社会利益最大化的目的.但我们在立法时,应尽量贯彻不伤害原则,注意保护患者及其亲属的利益.     

关注健康公平,保障健康权益

在卫生改革与发展的过程中,健康公平与健康权益的问题不断引出争论,而且,出现的许多新问题也都与健康公平相关.获得基本医疗服务对于全体居民来说,并不仅仅具有提高劳动力素质的意义,而且还是人们充分发挥自身潜力的一个前提,是人们参与社会经济政治决策过程的一个前提,有着超出个人投资回报的社会效益.因此,在卫生改革过程中应该关注健康公平,合理保护居民的健康权益.