我国医疗失效模式与效应分析的应用现状及问题

医疗失效模式与效应分析（HFMEA）是目前较为先进的前瞻性预防医疗风险的方法,强调对整个流程潜在医疗风险的量化及“事前预防”。本研究通过文献计量分析发现,国内HFMEA的研究和应用主要集中在护理操作、手术操作、给药流程以及医疗设备管理等方面,尚处于起步阶段,研究论文的数量较少、研究主题多集中在护理风险管理领域且研究方法不够科学。今后应顺应医疗风险管理的趋势,更科学、有效地开展更多HFMEA研究及应用工作,逐步建立健全医疗风险监测和预警机制,提高医疗安全。     

Daily Behavior Report Cards with and without Home-Based Consequences: Improving Classroom Behavior in Low Income,African American Children with ADHD

Daily Behavior Report Cards (DBRC), which typically require teachers to evaluate students' daily behavior and parents to provide contingent consequences, are an effective and acceptable method for improving children's classroom behavior. The current study evaluated whether parent involvement is an essential treatment component or whether teacher feedback alone would be sufficient to produce children's behavior changes. The effectiveness of DBRC with teacher feedback to students and parent delivered consequences (PC) was compared to teacher feedback to students only (no parent delivered consequences, NPC) for increasing appropriate classroom behavior and academic productivity in African American, low income, elementary school children with Attention-Deficit/Hyperactivity Disorder (ADHD). Both treatments led to increased on-task behavior, although PC was superior to NPC. Academic productivity outcomes are less clear. Treatment implications and future directions for research on teacher feedback interventions are discussed.     

Suppression of Chronic High Frequency Spitting in a Multiply Handicapped and Mentally Retarded Adolescent

Excessive drooling and spitting are maladaptive behaviors often encountered among severely developmentally delayed children. In the present study a blind, deaf and retarded adolescent exhibited an extremely high rate of spitting which had resisted numerous classroom intervention efforts by teachers using punishment techniques. His recalcitrant spitting was eliminated with a behavioral intervention consisting of positive reinforcement for not spitting and facial screening for spitting. Experimental control was demonstrated using a multiple baseline across situations and within subject reversal design. The treatment package successfully eliminated the child's chronic spitting. Teacher reports one year later indicated the results maintained across time and spitting was no longer a problem. Social and academic implications of modifying such behaviors are discussed.     

Psychometric Properties of the Dyadic Parent-Child Interaction Coding System in The Netherlands

Abstract

The current study explored the psychometric properties of a parent-child interaction observation system, the Dyadic Parent-Child Interaction Coding System (DPICS) in the Netherlands. Participants included 31 Dutch mother-child dyads and 86?U.S. mother-child dyads for a community sample (2–7?years; 50% boys). Good one-week test-retest reliability was demonstrated among the Dutch sample. Similarities were found between Dutch and U.S. samples on most interaction codes, but mothers in the U.S. sample used more directive behaviors (e.g., commands) in some situations. Findings suggest that the DPICS is a reliable measure of mother-child interactions in the Dutch population. Cultural issues regarding the use of the DPICS are discussed.     

Written object naming,spelling to dictation,and immediate copying: Different tasks,different pathways?

Politeness theory posits that speakers can use verbal probabilities (e.g., there is a chance, it is likely) to hedge bad news. So far, only indirect evidence supports that claim: From the hearer's standpoint, verbal probabilities are interpreted either as plain likelihood-communication devices or as face-management devices, resulting in different risk perceptions. The present research aims to test more directly the postulate of politeness theory by focusing on the effects of speakers' intentions on risk communication. In three experiments, participants communicated a probability by choosing an expression from a list of verbal probabilities. Results consistently showed that polite speakers communicated a different risk magnitude than informative speakers. Further findings indicate that the effect of the speakers' intention depends on the valence of the uncertain outcome. The theoretical and applied implications of these findings are discussed.     

The ‘Blueprint’ framework for career management skills: a critical exploration

This article examines the Blueprint framework for career management skills as it has been revealed across sequential implementations in the USA, Canada and Australia. It is argued that despite its lack of an empirical basis, the framework forms a useful and innovative means through which career theory, practice and policy can be connected. The framework comprises both core elements (learning areas, learning model and levels) and contextual elements (resources, community of practice, service delivery approach and policy connection). Each of these elements is explored.     

Curricular Information Demand in Theological Degrees: Operationalizing a Key Concept for Library Services

If seminary libraries exist to support student information needs, then librarians need specific knowledge about how a given school's curriculum shapes such needs. This article puts forward a model of the intended curriculum in master's-level theological education. Based on analysis of the intended theological curriculum (giving special attention to the use of student time), the author posits curricular information demand (CID) as a way to describe with precision how courses and degree programs expect students to find, retrieve, analyze, and use information. CID has a weaker measure based on analysis of syllabi and a stronger measure based on analysis of actual student work. The author presents examples of CID for courses at Austin Presbyterian Theological School. Finally, the author calls for research to analyze the usefulness of the model.     

A terror management analysis of self-awareness and anxiety: The hierarchy of terror

Abstract

In this article, we apply terror management theory to the operation of self-awareness processes. According to the theory, self-esteem consists of accepting a cultural conception of reality and believing that one is living up to the standards of value inherent in that conception. The function of self-esteem is to buffer the anxiety that results from the awareness of human vulnerability and mortality that results from our capacity for self-awareness. We argue that self-awareness leads to comparisons with standards, and to behavior aimed at reducing any discrepancies that are detected, because of the potential for existential terror that self-awareness creates. Existential terror is seen as the emotional manifestation of the instinct for self-preservation. Management of this terror is conceptualized as the superordinate goal in a hierarchy of standards through which behavior is regulated. A hierarchical terror management model is proposed. This structure provides a unique analysis of the self-system and its relationship to other attitudes, values, and beliefs. The theory posits several dynamic principles that specify how self-awareness and disruptions determine the movement of conscious attention through various levels of the hierarchy. The implications of this analysis for unresolved theoretical questions about self-awareness processes, unconscius sources of motivation, and clinical problems are discussed.     

Motivation-Adaptive Skills-Trauma Resolution (MASTR) Therapy for Adolescents with Conduct Problems

Summary

Trauma is proposed as a key to understanding the development and persistence of adolescent conduct problems, in conjunction with other contributing factors. A trauma-focused individual therapy approach is presented as one example of how this population might be more effectively treated. This approach features motivational interviewing, self-control training (cognitive-behavioral therapy), and trauma resolution (eye movement desensitization and reprocessing). This paper reports on an open trial of six adolescents with school and conduct problems who received school-based Motivation-Adaptive Skills-Trauma Resolution (MASTR) treatment. Reductions in post-traumatic stress, related symptoms, and problem behaviors, along with improved school performance, indicate the value of further study of this treatment approach.     

Preschool Teacher Support Through Class-Wide Intervention

Abstract

Preparing professionals for class-wide consultation has a significant role in achieving goals associated with recent legislation and reform initiatives. Class-wide interventions are used to target achievement and social learning, are under a teacher's control and responsibility, and build on basic classroom interactions, routines, and resources. However, teachers may require considerable contextual appraisal and support from consultants. The purpose of this paper is to describe a teacher- support program evolving from Head Start consultations by school psychology students. Implications for training and practice are discussed.