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191.
In the last decade there has been a pragmatic turn in the work of those doing Christian ethics, especially as represented by the work of Jeffrey Stout and Franklin Gamwell. The pragmatic turn represents a critique of the highly influential work of Stanley Hauerwas and Alasdair MacIntyre, which argues for a strongly intra-church ethics. The pragmatists are correct in arguing that Christian ethics must engage the public sphere. However, I argue that they are deeply mistaken in their claim that this engagement must rest on a weak or non-existent theology. I show that the claim that robust theology adds nothing to ethics, and that we can get along without it, is unsustainable.  相似文献   
192.
    
In a previous issue of Zygon (Carvalho 2007), I explored the role of scientists—especially those engaging the science-religion dialogue—within the arena of global equity health, world poverty, and human rights. I contended that experimental biologists, who might have reduced agency because of their professional workload or lack of individual resources, can still unite into collective forces with other scientists as well as human rights organizations, medical doctors, and political and civic leaders to foster progressive change in our world. In this article, I present some recent findings from research on three emerging viruses—HIV, dengue, and rotavirus—to explore the factors that lead to the geographical expansion of these viruses and the increase in frequency of the infectious diseases they cause. I show how these viruses are generating problems for geopolitical stability, human rights, and equity health care for developing nations that are already experiencing a growing poverty crisis. I suggest some avenues of future research for the scientific community for the movement toward resolution of these problems and indicate where the science-religion field can be of additional aid.  相似文献   
193.
    
Aims: This qualitative study aimed to expand the limited evidence base about the long‐term effects of psychological therapies.Method: We conducted in‐depth interviews with 15 people, 1–3 years after primary care counselling, to investigate whether they could identify enduring benefits and the mechanisms that brought about and maintained them. From their narratives, we developed a model of the change process of counselling and mechanisms that were perceived as essential to produce lasting benefit. The model conceptualised movement through distinct phases: engagement; exploration of internal and external worlds; consolidation and negotiated ending. Results: Mechanisms integral to sustained impact were: the active engagement of people during and between sessions to work toward their own solutions; and acquisition through the change process of skills which could be further built on after the counselling ended. These enabled ongoing, dynamic change in the way people conducted their lives and relationships. Conclusion: A key concept in securing long‐term benefit was co‐production, both during counselling and in taking ownership of and using the ‘box of skills’ acquired. Support of the model was reinforced through comparison with the experience of three interviewees who reported no long‐term benefit.  相似文献   
194.
    
Despite the increased prevalence of dementia little work has been done to explore the extent and nature of care‐giving in black or Asian‐UK populations. Evidence that does exist suggests that the consequences of care‐giving are significant but different from those experienced by white carers and are mediated by a number of culture‐related factors. These include: ethnically specific conceptualisations of dementia; expectations of family duty; religiosity; the adoption of positive re‐appraisal strategies, and beneficial outcomes. Present approaches to research are narrow, do not take account of cultural dimensions and employ terminology and care‐giving frameworks which are of limited relevance. That the evidence base is characterised by small‐scale studies, and weak methodology further undermines its validity. Research deficits are systemic and fundamental and are both conceptual and methodological. A key contribution would be the development of a multi‐dimensional theoretical model that takes account of the role played by culture, ethnicity and structural inequality in shaping care‐giving experiences and profiles. Incorporating the perspectives of black and Asian carers, and the influence of the life course of individuals and communities and employing qualitative methods would also influence the direction of research, improve its quality and generate knowledge in this underdeveloped field. Copyright © 2005 John Wiley & Sons, Ltd.  相似文献   
195.
    
The document Changing Childbirth produced by the Department of Health (1993) requests provision of more choice, continuity and control for women during pregnancy and childbirth. In this context this study considers whether midwives'decisions are influenced by a senior midwife. A simple, valid and reliable scale—the Social Influence Scale for Midwifery (SIS‐M)—was devised to measure and score midwives' private anonymous responses to 10 clinical decisions. The SIS‐M was initially administered as a self‐completed postal survey by 209 midwives. Following a 9‐month time gap, a stratified sample of 60 (20 E, F, G grade midwives) were invited for interview in which a senior midwife attempted to influence SIS‐M responses in a conformist direction. Overall, a 3 × 2 (E, F, G grade midwives x private and interview SIS‐M scores) analysis of variance (ANOVA) revealed midwives were significantly more conformist when influenced by a senior midwife, in comparison to private anonymous responses. No significant interaction between groups was found. These findings indicate that there is influence of a senior midwife on clinical decisions that should be woman‐centred, according to Changing Childbirth (1993). The implication is that this influence may remove choice from women. Copyright © 2005 John Wiley & Sons, Ltd.  相似文献   
196.
    
This study had two aims: to evaluate the relationship between bullying and psychiatric disorders and to study the probability of using mental health services among children involved in bully/victim problems. The data consisted of interviews with 423 parents and 420 children. Diagnostic measures were based on the Isle of Wight Interview. Children involved in bullying as bullies, bully‐victims, and victims were compared with other children. Children involved in bully/victim problems were more prone to have psychiatric disorders than noninvolved children. The probability of being disturbed was highest among male bullies, followed by male bully‐victims and female victims (9.5‐fold, 7.9‐fold, and 4.3‐fold, respectively) compared with noninvolved same‐sex children. The most common diagnoses among children involved in bully/victim problems were attention deficit disorder, oppositional/conduct disorder, and depression. Furthermore, children involved in bully/victim problems were more likely to have used mental health services at some time during their lives and also during the previous 3 months. Special attention should be paid to children’s mental health when dealing with bullying problems at school. Referral pathways to mental health services and factors affecting the referral processes among children should be further studied. Aggr. Behav. 27:102–110, 2001. © 2001 Wiley‐Liss, Inc.  相似文献   
197.
    
BackgroundTo determine the effect of developmental care on neurodevelopmental outcome in formerly preterm infants at a corrected age of 2 years.MethodsA prospective phase-lag study was performed at an Austrian neonatal intensive care unit (NICU). From January 2003 to December 2005 (study period of conventional care) and January 2007 to December 2009 (study period of developmental care), we enrolled all infants born in Tyrol at less than 32 weeks of gestation. During this period a total of 261 of 359 preterm infants (participation rate 72.7%) completed the follow-up visit at 2 years of age; there were 124 children in the conventional and 137 in the developmental care group. The association between developmental care and delayed motor or mental development (Bayley Scales of Infant Development II; psychomotor or mental developmental index <85) was analyzed by means of logistic regression analysis at a corrected age of 24 months.ResultsChildren in the developmental care group showed less psychomotor delay than did those in the control group (developmental care group: 16.1%, conventional care group 27.4%; adjusted odds ratio 0.37 [95% confidence interval: 0.19–0.74], P = 0.005). Not smoking in pregnancy and higher gestational age were also significant predictors for a better psychomotor outcome at 2 years of age. Regarding cognitive outcome, no significant difference was observed between these two groups.ConclusionOur data implicate that developmental care may result in an improved 2-year psychomotor outcome in formerly preterm infants.  相似文献   
198.
199.
    
This article is a response to Coyne, Thompson, Palmer, Kagee, and Maunsell's (2000) article, “Should We Screen for Depression? Caveats and Potential Pitfalls.” We address four points that we view as central to their argument: (1) current screening measures are inadequate; (2) correct identification of depressed patients does not result in improved clinical outcomes; (3) screening is too expensive; and (4) screening may have harmful negative effects. We discuss the following important issues: (1) screening and prevention are still in the research and development phase; (2) the kindling phenomenon is an important reason to screen; (3) there is a need to focus screening and prevention efforts on ethnic minorities; and (4) high depressive symptoms have a substantial public health impact. Finally, we present reasons why screening is advisable, both for prevention and treatment purposes, and provide our recommendations. Our stance is that, in order for screening and prevention to become practical, they need to be implemented in both research and practice contexts. Therefore, we should make screening for major depression a priority.  相似文献   
200.
    
System-of-care models that offer a continuum of integrated mental health services for children are being widely implemented in local communities. Preventive services, arising from the theoretically grounded prevention sciences, are an important but neglected component of this model. Studies of the use of mental health services by children are reviewed, and an integrative model is proposed to incorporate prevention services as a component of the child mental health service system. Construction of the prevention sciences has followed a linear phase model that has advantages and disadvantages for bridging prevention sciences and services research. As prevention science progresses into broader field tests of its effectiveness, studies of child services can be informative, especially in advancing the applicability and dissemination of research findings. Future directions are outlined to strengthen the nexus between services research and prevention science, and to construct a new genre of prevention services research.  相似文献   
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