卫生立法迫在眉睫

涉及医疗机构的法律事务处理方面明显存在“两个强化”的趋势,一是强化医疗责任追究,二是强化病家利益维护。但医疗行业在处理法律事务方面仍处于长期形成的各自为阵,自行处理的局面。鉴于以上情况,提出区域性医学法律协作中心问题。     

Demographic, Clinical, and Functional Characteristics of Youth Enrolled in Six California Systems of Care

We describe the demographic, functional, and clinical status of children served across six California counties implementing a longstanding integrated system of care approach called the California System of Care Model. The children enrolled in the care systems are an ethnically diverse group of predominantly pre-adolescent and adolescent males. The level of functional impairment and degree of symptomatology is high. Seventy to 80% of the youth were in the clinical or borderline clinical ranges as measured by the Child Behavior Checklist. Scores on the Child and Adolescent Functional Assessment Scale, provided by the treating clinician, indicated that up to 94% of the youth were in the moderate to severe levels of impairment. Children and adolescents rated themselves on the Youth Self Report as having lower levels of impairment than did parents. Caregivers and youth ratings emphasized externalizing rather than internalizing problems. Clinician ratings as captured by the CAFAS and the clinical diagnoses, presented a mix between internalizing and externalizing diagnoses and functional impairment areas. The six counties are serving children who have levels of impairment, similar to, or higher than, youth enrolled in other systems of care nationwide.     

Maternal Separation Anxiety and Attitudes About Maternal Grandmother Participation in Child Care

A sample of 75 primiparas in Athens, Greece were interviewed 3 days following birth (T1) regarding their attitudes towards maternal grandmother participation in child care. A follow-up questionnaire measuring the same attitudes and maternal separation anxiety (MSA) was answered 3–8 months later (T2). It was found that maternal grandmothers were going to assist in child care in 68% of the cases. Higher scores on the MSA subscale ‘employment-related separation concerns’ were obtained by all mothers who were not assisted in child care by the maternal grandmother and were highest among those mothers intending to work before the child was 1 year old. Mothers who intended to work as well as those who had a higher educational level had significantly lower scores on the MSA subscale ‘maternal separation anxiety’. Overall, mothers expressed favourable attitudes towards maternal grandmother participation at T1 and T2. Positive attitudes were especially observed among mothers who relied on grandmothers for child care.     

The challenges of comparative theology: An assessment of Kärkkäinen's Doing the work of comparative theology

Doing the Work of Comparative Theology by Veli-Matti Kärkkäinen seeks to do the work of understanding the parallels, similarities, and differences between Christianity, Judaism, Islam, Hinduism, and Buddhism through comparative theology. Comparative theology differs from comparative religion in that it investigates other religious traditions from the perspective of a particular tradition, rather than approaching all of the traditions from the outside. This approach, however, presents unique challenges, specifically, maintaining the same approach to a topic regardless of the tradition being explored, and presenting each tradition without universalizing the beliefs of the tradition as a whole.     

Primary care decision making in response to psychological complaints: the influence of patient race

Eighteen general practitioners indicated diagnostic and treatment decisions in response to patient vignettes. Results indicated that White patients were more likely to be correctly diagnosed as having anxiety than any other complaint. Asians were just as likely to receive a physical diagnosis as they were to receive one of anxiety. Copyright © 2000 John Wiley & Sons, Ltd.     

如何激发员工绿色行为?绿色变革型领导与绿色人力资源管理实践的作用

鉴于当今环境问题的严峻性, 如何激发绿色行为逐渐成为社会各界关注的一个话题。本研究从绿色变革型领导和绿色人力资源管理实践两大绿色管理利器入手, 探究两者能否共同激发员工绿色行为。基于以往文献, 本研究提出两组竞争性假设：基于线索一致理论, 认为绿色变革型领导与绿色人力资源管理实践正向交互影响员工绿色行为; 此外, 基于领导替代理论, 认为绿色变革型领导与绿色人力资源管理实践负向交互影响员工绿色行为。研究1a (N = 91)和研究1b (N = 220)采用实验法, 发现绿色变革型领导与绿色人力资源管理实践发挥协同作用, 正向交互预测员工绿色行为。研究2采用问卷法, 搜集了三时点上下级配对数据(N = 173), 不仅再次支持了研究1的发现, 还进一步揭示环保目标清晰度的中介作用。以上结果支持了线索一致性理论在绿色管理领域的适用性, 并启示企业在绿色管理过程中可以软硬兼施, 联合运用绿色变革型领导和绿色人力资源管理实践两大策略。     

Use of Trauma‐Informed Care With Incarcerated Offenders

Regardless of preexisting trauma history, offenders regularly experience traumatic events while incarcerated. Current therapeutic approaches focus on coping skills and behavioral responses. The authors recommend integrating the use of trauma‐informed care to address the deeper emotional responses tied to trauma.     

Assessment of Person-Centered Care in Gerontology Services: A new tool for healthcare professionals

Background/Objective: Retirement homes and other gerontology services are frequently criticized due to their lack of flexibility and tailored attention, leading to homogeneous treatment which compromises patients’ control of their lives. This study aims to develop and validate the first Spanish instrument for healthcare professionals to assess the degree of person-centered attention delivered by senior care centers. Method: A total of 844 healthcare professionals (mean age = 39.94 years old; SD = 10.56) with a mean of 6.56 years (SD = 6.15) of work experience participated in the study. The psychometric properties of the questionnaire developed were analyzed using both classical test theory and item response theory models. Results: The internal structure was unidimensional with an explained variance of 55.23%. Reliability was outstanding: internal consistency (α = .96, ω = .96) and test-retest (r = .88; ICC = .93). The total score was significantly correlated with two similar questionnaires, with associated variance of 58.83% and 55.20% respectively. Conclusions: The new instrument allows healthcare professionals to assess the level of person-centered care provided by gerontology centers with excellent reliability and validity.     

Evaluation of an integrated fluency and Acceptance and Commitment Therapy intervention for adolescents and adults who stutter: Participant perspectives

PurposeChildhood-onset stuttering is a neurodevelopmental disorder that may cause pervasive negative consequences for adults who stutter. In addition to significant challenges in personal, social, and emotional domains, stuttering has been shown to impose an economic burden on adults who stutter. Intervention for adults who stutter has historically addressed speech fluency more so than the covert psychosocial aspects of the disorder. There is an identified clinical need for holistic, efficacious, and cost-effective stuttering interventions that meet consumer needs. The purpose of the present study is to evaluate a novel, integrated intervention that combined traditional fluency techniques with Acceptance and Commitment Therapy, from the perspective of the adults who stutter who participated in the intervention.MethodTwenty-eight adults who stutter completed the intervention program. Participants were invited to complete an online post-program written survey (including qualitative comments) and a semi-structured interview to explore their evaluations of the program with respect to its authenticity, acceptability, and social validity.ResultsParticipants perceived positive psychosocial changes as a result of the program, and were satisfied with the program overall. Qualitative thematic analyses of the written survey comments and the semi-structured interviews identified two major themes: factors specific to the intervention and factors specific to the therapeutic process. Several important sub-themes were also identified.ConclusionFindings support the authenticity, acceptability, and social validity of an integrated fluency and psychosocial intervention for stuttering. Findings also highlight the need for consideration of the consumer voice in the management of stuttering disorders, in keeping with person-centred care.     

Use of a reference group in researching children’s views of psychotherapy in Malta

This paper explores the process and outcomes of a children’s reference group within the context of child psychotherapy research in residential care. The reference group was set up to consult children about the design of a research project which seeks to evoke, represent and understand children’s views of psychotherapy. No work to date has explored the experience of reference groups in the context of child psychotherapy in residential care in Malta. The paper contextualises the research within the literature on reference groups in child research, which identifies the potential of reference groups as a participative and co-reflexive activity which can inform research design. The paper critically examines the nature and conduct of the reference group by acknowledging the specific context of this work rather than assuming this is necessarily positive. It does so by specifying and evaluating the outcomes of the reference group in line with its aims. The paper draws on the recordings of the reference group meetings and reference group field notes taken by the researcher as key data which were thematically analysed. The main outcomes of the reference group include children’s contribution to the design of data collection methods especially in terms of not relying only on words during data collection. Children also identified key ethical issues from the point of view of young psychotherapy service users, especially in relation to issues of trust within a residential care context. Children also reviewed and appraised research information material. The reference group process drew from the researcher’s and participants’ contexts and contributed significantly to the researcher’s reflexive process especially in terms of acknowledging his power and positioning as an adult and his dual role as a practitioner/researcher.