Social disadvantage and neglectful parenting as precursors to the development of antisocial and aggressive child behavior: Testing a theoretical model

The present study tested a theoretical model advanced to understand the direct and mediated effects of social disadvantage, neglectful parenting, and punitive parenting in the developmental trajectory of aggressive and antisocial behavior in young school‐aged children. To test the model, families of 310 first grade children and 361 fifth grade children, participating in a universal prevention trial in high‐risk areas of a medium‐sized metropolitan area, provided data. Multi‐method and multi‐source indices of the four predictive constructs (Social Disadvantage, Denial of Care Neglect, Supervisory Neglect, and Punitive Discipline) were obtained at the time of enrollment. Multi‐method and multi‐source indices of the criterion construct (Aggression and Antisocial Behavior) were obtained at the time of enrollment and at a five year follow‐up. Based on structural equation modeling, the results established care neglect as a mediator of social disadvantage, and the importance of care neglect to both punitive discipline and antisocial outcomes in the first‐ and fifth‐grade cohorts. Supervisory neglect, however, was important in the antisocial outcome of the fifth‐grade cohort only. Overall, the results established the importance of distinguishing between two subtypes of neglect and the need to consider the role of discipline in concert with neglect when attempting to understand the impact of parenting on the development of antisocial behavior. Aggr. Behav. 30:187‐205, 2004. © 2004 Wiley‐Liss, Inc.     

医疗保健政策与医患关系

医疗保健政策深刻地影响着医患关系,并左右着医患关系的发展与变化.在实行"以公平为主,兼顾效益"的福利性的医疗保健政策时期,我国的医患关系是和谐的.但自从医疗保健政策向"经济导向型"方向转变之后,国家大幅度减少了对卫生事业的投入,医院必须从病人身上取得卫生发展必要的资金,医药费用上涨是必然的,也失去了公平和公正,并最终导致医患关系的恶化.调整医患关系不能仅从医、患两方面着手,建立符合医学伦理的卫生政策,才是问题的关键.     

关于功利、理性或关怀--不同理论在评价人类基因组研究中的差异

从功利主义的角度审视治疗性克隆,治疗性克隆研究能够为人类造福,是可以得到辩护的.义务论认为,胚胎不能作为试验的客体,反对治疗性克隆研究.而关怀理论学家则不支持治疗性克隆研究.     

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.     

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...     

美国药物治疗管理服务的应用现状及对我国的启示

为解决不合理用药问题,美国政府正尝试利用药师的专业技术优势加强对患者药物治疗的管理。在查阅分析国外文献的基础上介绍了美国药物治疗管理服务的形成背景、运作模式、核心要素和实施效果等应用现状,以期为我国临床药学服务的发展提供启示和政策建议。     

现代姑息医学内涵在实践中的演化

积极开展姑息医学服务已成肿瘤临床工作者的共同实践,并使其在实践中得到发展。姑息医学在肿瘤整体治疗中的作用和地位已逐渐受到同行的认同,提高了肿瘤工作者对姑息医学实践的参与热情,使业内有识之士从全新的角度对姑息医学的内涵进行审视。本文拟结合姑息医学的发展历程及不同分期肿瘤患者姑息治疗的内容介绍现代姑息医学内涵的演化过程。     

ICU临终患者治疗抉择的伦理问题

医生面对ICU临终患者很难抉择是应该积极治疗到底还是提供舒适的保守治疗,目前相关的伦理及法律问题仍尚需完善,伦理指导是一项解决纠纷、政善沟通有效的工具,成立伦理委员会对医生进行合理的建议和指导是非常必要的。     

颈动脉病变的治疗现状

颈动脉病变尤其是颈动脉狭窄治疗上的分歧,颈动脉内膜切除术受欧美学者推崇,颈动脉支架成形技术受国内学者青睐,本文就近年来的文献复习发现颈动脉内膜切除术和颈动脉支架成形术各有相宜的适应证,各有优缺点,根据各自医院的设备条件、医师对颈动脉内膜切除术和颈动脉支架成形术熟悉程度来开展工作,对颈动脉狭窄治疗均有益处,存在的问题和困...     

后纵韧带骨化患者手术方式的选择及临床效果分析

通过研究颈椎后纵韧带骨化患者的不同手术方式对术后效果的影响,回顾性对分别行前路、后路手术治疗的颈椎后纵韧带骨化患者127例进行5年～10年的随访并依据手术前后不同时期的影像学结果及神经功能改善情况进行分析,探讨椎管狭窄率和颈椎序列变化等因素对手术方式的选择及术后疗效的影响。结果显示,前路手术组术后能够维持并改善颈椎前凸...