Barriers and facilitators affecting the sustainability of dialectical behaviour therapy programmes: A qualitative study of clinician perspectives

Dialectical behaviour therapy (DBT) is a psychological treatment developed for individuals experiencing chronic suicidality and high‐risk behaviours. Despite the substantial evidence supporting the effectiveness of DBT, many programmes have problems with its sustainability. The goals of the current qualitative study were to identify factors that impact the sustainability of DBT programmes within a publicly funded mental health system and identify factors that are particularly relevant for youth DBT programmes. Interviews with trained adult and youth DBT clinicians (N = 31) were conducted to explore their experiences providing DBT. Three major themes that emerged as barriers to the sustainability of DBT programmes included the following: systemic challenges, conflicts within the consultation teams and clinician burnout. Factors influencing the success of DBT programmes included the following: systemic support, clinician commitment and “buy in”, and team cohesion. Factors specific to providing DBT with youth (i.e. level of commitment, simplifying the language, and parental investment) and recommendations for sustainability for adults and youth programmes were also identified. Findings of this study provide valuable information on factors impacting DBT programmes within the unique context of a Canadian mental health service system, where community‐based services are publicly funded. These findings have clear clinical utility and can be used to generate solutions to clinicians' perceived barriers and to foster perceived facilitators within similar contexts.     

人口统计学特征对公共服务动机有什么影响?来自元分析的证据

采用元分析方法探讨人口统计学特征与公共服务动机之间的关系。经筛选, 共纳入138篇492个独立样本(N = 1078442)。结果发现, 性别、年龄、教育程度、组织任期、工作任期、职位等级和收入与公共服务动机之间均呈显著的正相关关系, 且与公共服务动机不同维度之间的关系均存在差异, 婚姻状况与公共服务动机间不存在显著的相关关系。此外, 公共服务动机测量工具、测量时间点和文化背景对部分人口统计学特征与公共服务动机之间的关系有调节作用。研究结果为人口统计学特征如何影响公共服务动机提供了较为精确的估计, 对于发展公共服务动机理论, 激励员工工作积极性, 提高公共部门服务水平都有重要意义。     

我国市场经济"信用"动力机制分析及其体系建构

现代社会生活的生产实践表明,分工是交换的前提,交换是分工的实现,这就是现代社会活动的全部内容和过程。在此事实基础上构建的市场经济体制,其管理理念内含着丰富的伦理意蕴[1]。本文首先分析阐述了市场经济信用体系的建立是市场经济体制内在规律的必然要求,揭示了“信用”是承诺者之间能量均衡与博弈的结果,既具有丰富的道德理性又具有明显的功利要求。文章进而通过对信用体系维护的动力因素及其与市场主体行为的相关性进行比较研究后指出:政府在参与市场经济活动中要坚持“有所为,有所不为”,应把政府置于经济利益之外,使之具有超脱于市场各成员的地位;同时,信用体系的创立和维护并不必然由政府主导,而是市场经济环境中公共合意选择的必然结果。     

"结构":解读古典经济学哲学构架的逻辑中轴--瓦尔特·本雅明:作品、生活、时代和历史的交叠

马克思的"古典经济学"概念具有明确内涵、外延并与一定的"知识型"相关,这与西方学者在一般的、含糊的意义使用这个概念具有根本的异质性.它界划了一种分析的范式,说明了马克思与资产阶级经济学之间存在着"知识型"的断裂,这种分析范式就是从配第和布阿吉尔贝尔开始的探讨社会结构及由这种结构所决定的运动规律,这是"古典经济学"概念之独特内涵所在.福柯等人忽视了古典经济学的"结构"视角而从"劳动"范畴出发,认为马克思对李嘉图的修正在西方知识的最深层中并未产生真正的间断性,这是没有读懂马克思"古典政治经济学"的真正内涵.     

The growing complexity of international policy in intellectual property

Intellectual property has historically been a self-contained policy at the international level. With the introduction of the TRIPs Agreement in 1994 and developments since the conclusion of the TRIPs Agreement, the relationship between intellectual property policy and other areas of public policy has become much more complex and interactive. This shift reflects the centrality of intellectual property in the knowledge economy, the rapid development of enabling technologies, notably the Internet and biotechnology, and the advent of the networked society. The consequences of this shift are manifold and herald the increased sophistication and complexity that may be expected of intellectual property regimes in the knowledge economy. An earlier version of this paper was presented at an international conference, “The Ethics of Intellectual Property Rights and Patents,” held in Warsaw, Poland on 23–24 April, 2004.     

Exploring dynamics of abusive lesbian relationships: preliminary analysis of a multisite,qualitative study

This paper presents preliminary results from a multisite, qualitative study on violence in lesbian relationships. A framework for conducting community-based, empowerment research that draws on theories of community psychology, feminism, and postmodernism is presented. The study was designed to understand the dynamics of abusive lesbian relationships and social service providers' responses to the abuse. Results from 80 in-depth interviews with lesbians who have experienced relationship violence are examined with a particular focus on a pattern of first relationships being abusive and a theme of shifting power dynamics. Analysis of focus group discussions with 45 feminist service providers (e.g., counselors, shelter workers, social workers, healthcare providers) reveals the difficulties in assessing the power dynamics of abusive same-sex relationships and in developing appropriate responses when relying on heterosexually gendered models developed to address men's violence against women. The preliminary results present implications both for how we theorize and research this form of violence, and for improving the practices and policies of social services that work with lesbian, gay, bisexual, and transgendered communities.     

健全社区卫生服务功能与防控"非典"传播的理性思考

针对我国当访“非典”防治工作的严竣形势,对健全社区卫生服务“六位一体”功能与防控“非典”传播问题进行哲学思考,着重在健全社区卫生服务功能是防控“非典”传播的客观要求;社区卫生服务功能不全将会对防控“非典”工作产生不利影响;构筑防控“非典”传播的有效机制和基础防线,必须健全社区卫生服务功能等方面作了分析论述。     

THE EFFECT OF TOKEN REWARDS ON “INTRINSIC” MOTIVATION FOR DOING MATH

This study used a multielement baseline design to analyze the effects of token rewards delivered contingent upon completion of math problems by 2 middle-school boys. Time spent on math and number of work pages completed increased (with high accuracy) during reward conditions and were maintained during fading and withdrawal. At follow-up, time spent and work pages completed remained well above baseline for 1 boy and fell below for the other, while accuracy remained high and ratings of liking math were the highest possible for both boys. Overall, the results are inconsistent with warnings about use of token rewards to motivate children.     

Customer reactions to encountering consecutive service failures

According to previous studies, many consumers in Taiwan have experienced consecutive service failures. Despite these failures, many consumers still remain loyal to a service provider for a variety of reasons, such as money deposits, contractual agreements, associated costs, time constrains, and health concerns. We attempt to investigate the emotional reactions and expectations of consumers after they have experienced two consecutive service failures. Our findings reveal that for high‐involvement services, although customers display strong negative emotional reactions after each service failure, the reaction to the second service failure is less intensive than that to the first one. Furthermore, our findings show that as long as the products or services remain in use, customers tend to retain high levels of expectation in regard to the service provider. Copyright © 2012 John Wiley & Sons, Ltd.     

Piety,Power, and the Purse: Religious Economies Theory and Urban Reform in the Holy Roman Empire

The religious economies model has been influential in the sociology of religion. Yet, propositions drawn from the model have been difficult to test in the comparative and historical study of religion, generally for lack of appropriate data. We develop a general theory of religious disestablishment and apply it to the Reformation in 16th‐century Europe to explain variation in the abolition of the Catholic monopoly. We suggest three principal factors—changes in demand, entry control mechanisms, and political incentives—that explain why incumbent religious firms may lose their monopoly. We then analyze the resulting hypotheses in a systematic analysis of cities in the Holy Roman Empire. Our analysis yields mixed support for demand‐side factors and entry control mechanisms, and firm support for political incentives in the institution of reform.