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51.

Background

Australian midwives are regulated under the National Registration and Accreditation Scheme. Unregistered birth workers may provide midwifery services at homebirths without any regulatory oversight. To address this issue, several states have passed legislation enabling prohibition orders to be made (negative licensing) against unregistered health practitioners who fail to comply with a statutory code of conduct developed for those not covered by the National Scheme.

Aim

To explore the consequences for the availability of birth choices for women that arise from the introduction of negative licensing.

Discussion

An analysis of the regulatory framework and recent cases of unregistered birth workers attending homebirths reveals problems with equitable access to homebirth support, arising from issues with professional indemnity insurance, geography, and poor integration with hospitals and the wider healthcare system. These problems contribute to women choosing to employ the services of unregistered birth workers.

Conclusion

Negative licensing provides a useful additional tool for improving the safety of homebirths for mothers and babies, but it does not address the issues leading expectant parents to choose an unregistered birth worker to attend their births, and may contribute to an increase in high-risk behaviours, such as freebirthing.  相似文献   
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In this paper we examine how leaders' perceptions of the instrumental benefits of abusive supervision shape their tendencies to abuse their employees. We posit that leaders who believe abuse has a positive impact on employee performance will engage in more abusive supervision than their peers, with downstream implications for employees' counterproductive work behaviors. Furthermore, we position leader empathic concern as a boundary condition, whereby empathic concern mitigates the effects of leaders' perceptions of abusive supervision's instrumentality. Data from two studies employing both experimental and field survey designs offer convergent support for our hypotheses. Overall, our findings challenge the prevailing view that abusive supervision is primarily motivated by a desire to aggress, instead demonstrating that leaders sometimes abuse their employees in the pursuit of more pro-organizational goals.  相似文献   
53.
Most individuals will gamble during their lifetime, yet only a select few will develop gambling disorder. Gray’s Reinforcement Sensitivity Theory holds promise for providing insight into gambling disorder etiology and symptomatology as it ascertains that neurobiological differences in reward and punishment sensitivity play a crucial role in determining an individual’s affect and motives. The aim of the study was to assess a mediational pathway, which included patients’ sex, personality traits, reward and punishment sensitivity, and gambling-severity variables. The Sensitivity to Punishment and Sensitivity to Reward Questionnaire, the South Oaks Gambling Screen, the Symptom Checklist-Revised, and the Temperament and Character Inventory-Revised were administered to a sample of gambling disorder outpatients (N = 831), diagnosed according to DSM-5 criteria, attending a specialized outpatient unit. Sociodemographic variables were also recorded. A structural equation model found that both reward and punishment sensitivity were positively and directly associated with increased gambling severity, sociodemographic variables, and certain personality traits while also revealing a complex mediational role for these dimensions. To this end, our findings suggest that the Sensitivity to Punishment and Sensitivity to Reward Questionnaire could be a useful tool for gaining a better understanding of different gambling disorder phenotypes and developing tailored interventions.  相似文献   
54.
This article compares two different institutional models—state-sponsored rural partnerships and community-based development trusts—for engaging and empowering local communities in area-based regeneration, using the Isle of Wight as a case study. Following a critical review of the literature on community governance, we evaluate the effectiveness of community involvement in the Island's small towns through a comparison of the performance of the two development trusts in Cowes and Ryde, on the one hand, and that of the partnerships established under the Market Towns Initiative in Sandown, Shanklin and Ventnor, on the other. We conclude that both models reflect the structuring effect of central, regional and local state steering of the Island's regeneration policy community but also that a ‘development trust effect’ is observable in one location (Ryde), due to a capacity to stimulate new forms of community enterprise and to successfully alter political relationships within the local community. These findings support a ‘new institutionalist’ account of community empowerment which emphasises the importance of contextual variation and locally specific processes of institutionalisation rather than the determining effect of institutional design per se.  相似文献   
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The adoption of The International Conference on Harmonization Tripartite Guideline: Statistical Principles for Clinical Trials (ICH-E9) has provided a foundation for the application of statistical principles in clinical research and raised awareness of the value of a statistical contribution to the wider pharmaceutical R&D process. In addition, over the past decade globalization of the pharmaceutical R&D process and the measures taken to address reduced productivity and spiralling costs have impacted on the roles and career opportunities for statisticians working in the pharmaceutical sector. This has enhanced the need for continuing professional development to equip statisticians with the skills to fully contribute to creating innovative solutions. In the future, key areas of focus are the establishment of professional standards for statistical work and increasing the collaboration between statisticians working in industry, regulatory agencies and academia. In addition, the diversity of roles and potential career paths for statisticians embarking on a career in the pharmaceutical sector emphasizes the importance of mentoring and coaching. For the more experienced statisticians, there are unprecedented opportunities to lead and innovate.  相似文献   
57.
Troubleshooting when a link resolver goes wrong can be difficult as it usually relies on the user to report the problem. Using data on interlibrary loan requests that have been cancelled because the materials are available online is one way that libraries can examine where link resolvers may be failing. For the 2012/2013 school year, the Samford University Library looked at this cancelled interlibrary loan request data to determine where their new link resolver and knowledgebase needed further customization to improve the user experience. This process not only identified a number of problems all along the link resolution chain, but it also put in place an ongoing process for identifying and troubleshooting link resolution issues in the future.  相似文献   
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Refining Participatory Research with the methodology of Community Oriented Primary Care (COPC), sociologists, medical providers and other “professionals” were able to assist the people of a small, rural county in western Appalachian North Carolina create a “community health consortium.” The consortium grew out of a research process funded by the W.K. Kellogg Foundation, which included some 40 interviews with community groups that articulated health problems and barriers to health care. The consortium then undertook action projects, which in turn enhanced networking between community groups and agencies while reducing mistrust between them. The consortium empowered people to articulate their realities, needs and became a force for change able to make demands on political office holders and decision makers. Despite its democratic origins and ideology, the consortium needs to do more to extend its outreach to include the marginal and disenfranchised.  相似文献   
60.
This study examines the role of biological and social fathers in the lives of low‐income African American adolescent girls (N= 302). Sixty‐five percent of adolescents identified a primary father; two thirds were biological and one third were social fathers. Adolescents reported more contentious and less close relationships with biological than with social fathers. Multivariate regression analyses indicated that daughters' perceptions of anger and alienation from fathers was related to greater emotional and behavioral problems for adolescents, whereas perceptions of trust and communication with fathers were not predictive of youth outcomes. These relationships were generally similar for biological and social fathers, but differed according to fathers' level of contact with their daughters. A combination of low contact and high levels of either anger or trust in the daughter‐father relationship related to particularly deleterious psychosocial outcomes for adolescent girls.  相似文献   
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