THE INTERPLAY BETWEEN RELIGIOUS LEADERS AND ORGAN DONATION AMONG MUSLIMS

Bioethics and health researchers often turn to Islamic jurisconsults (fuqahā’) and their verdicts (fatāwā) to understand how Islam and health intersect. Yet when using fatwā to promote health behavior change, researchers have often found less than ideal results. In this article we examine several health behavior change interventions that partnered with Muslim religious leaders aiming at promoting organ donation. As these efforts have generally met with limited success, we reanalyze these efforts through the lens of the theory of planned behavior, and in light of two distinct scholarly imperatives of Muslim religious leaders, the ?ilmī and the islāhī. We argue for a new approach to health behavior change interventions within the Muslim community that are grounded in theoretical frameworks from the science of behavior change, as well the religious leadership paradigms innate to the Islamic tradition. We conclude by exploring the implications of our proposed model for applied Islamic bioethics and health research.     

互动支持者在临终病人与家属关于临终问题互动中的作用——基于田野研究之情境分析

通过在某三级医院安宁疗护科为期5个月的田野研究,分析临终病人与家属的临终互动过程,阐明互动支持者在促进其临终互动过程中的作用。期间共收集21例研究对象的20份家庭会议录音、79张照片、21份个案笔记,梳理出7个临终互动情境。研究显示,互动支持者发挥的作用有互动促发激发互动意愿、互动支持增加互动勇气和互动保障促进互动进行。由此得出结论,互动支持者作为病人与家属的互动桥梁,通过互动促发、互动支持和互动保障,翻译其行为背后的情感与期待、转述情感的表达,促进有效陪伴和及时表达爱,使病人善终、家属善别。

     

Parent Perspectives on Family Involvement in Therapeutic Foster Care

There has been an increasing focus on family involvement in the treatment of children with serious emotional disorders, but it has received only limited attention in relation to out-of-home placements. I present the findings from a qualitative study of family involvement from the perspectives of parents whose children were placed in therapeutic foster care (TFC). Parents' perspectives on their involvement in placement decisions, relationships with professionals and TFC providers, practices related to family involvement, barriers to involvement, and strategies to enhance family involvement are described. Parents of children in TFC wanted to have contact with their children and to participate in decision making. They described relationships and practices that contributed to their involvement.     

影响ICU护士落实“知情同意原则”原因及对策

重症监护（intensive care unit,ICU）医生越来越重视在诊疗活动过程中的知情同意权,各种重要诊疗活动都与患者和家属沟通,并取得口头或文字上的同意,但部分护理人员对知情同意原则不重视,在环节中落实不力,从而易引发护患纠纷。而保证患者获得知情同意权是护理人员必须落实的义务,护士的告知是维护患者知情同意权和...     

Multidimensional treatment foster care (MTFC): results from an independent replication

This study examines 24‐months post‐baseline outcomes for thirty‐five Swedish antisocial youths who received either treatment in multidimensional treatment foster care (MTFC) or treatment as usual (TAU). MTFC is a community‐based treatment programme that has been successful in treating chronic juvenile offenders in the USA. This study is the first randomized control study outside the USA. The youth treated in the MTFC programme consistently showed some statistically significant positive treatment effects compared to the youth exposed to TAU. The results suggest that MTFC might be an effective method in treating youth with severe behaviour problems in a Swedish context. The authors conclude that the programme ought to be of great interest for Swedish social services as an alternative to traditional care.     

Parent-School and Community Partnerships in Children's Mental Health: Networking Challenges, Dilemmas, and Solutions

Inter-agency collaboration, service coordination, and the creation of successful partnerships among parents, teachers, and human services professionals continues to be a challenge for the development of responsive community-based systems of care for at-risk youth and their families. We explore how one inner-city neighborhood struggles to create successful community partnerships through traditional networking strategies. Our findings identify networking strategies that appear to work and those that do not. Recommendations for improving communication are provided.     

Treatment Foster Care in a System of Care: Sequences and Correlates of Residential Placements

We examined Treatment Foster Care (TFC) in residential trajectories for youth with psychiatric disorders and aggressive behavior. We analyzed residential placements of a statewide sample of youth during the 12 months preceding and following admission to TFC. Prior to TFC, the majority of youth were residing in more restrictive settings (group homes or residential treatment). Two-thirds of youth remained in TFC throughout the follow-up year. Of those who left, nearly half returned home, and slightly fewer were discharged to group homes. By the end of the 12-month follow-up period, rates of group home use were similar to those seen in the pre-TFC period. Movement out of TFC during the year was associated with being older at placement and with increased problem behavior (particularly externalizing behaviors). TFC serves as a step-down placement for a substantial number of youth. However, this is not the only way it is used, and models based on short-term transitioning or reunification with families may not be widely implemented or relevant in practice. Additional research is needed to understand current functions of TFC in residential trajectories and to maximize its utility in systems of care.     

Performance of Mental Health Counselors in Integrated Primary and Behavioral Health Care

Integrated primary and behavioral health care (IPBH) is becoming a preferred mode of service delivery in the United States. Integrated care includes the participation of medical and mental health professionals, such as mental health counselors. The clinical outcomes of these professionals need to be studied to determine their effectiveness in such settings. We examined the performance of 10 mental health counselors on the clinical outcome of 1,747 clients treated in an IPBH center. Analyses using growth curve modeling and pre‐post test design revealed that mental health counselors were effective overall, but they differed in client dropout rates and efficiency in reducing clients' initial symptoms. We used the analyses to rank order counselors based on their effectiveness. Counselors who were the most effective varied in their efficiency but demonstrated the lowest client dropout rates. Implications for future research and counseling practice were discussed.     

政府与个人的责任——中国当代医疗改革的责任伦理学剖析

卫生改革的重点必须放在政府部门;公共卫生,预防与初级医疗保健是人类生存的需要,带有鲜明的公益性和福利性。应由政府投资为主筹集资源,以国家投资为主体负担费用,这个层次的卫生服务产品,属非商品经济部分,并不以赢利为目的,不能引进市场经济,个人对健康负有重要责任,包括：选择医疗保健,决定花费数额,生活方式和卫生习惯的养成,主动接受健康教育,抵抗压力,支持国家与地区的卫生保健政策;个人对自身健康负责是一种道德责任,健商（health quotient)这一重要概念,具有伦理价值和普遍的医学人类学意义;个人对健康负责是一种社会风尚。