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41.
Alcohol-related problems are especially common among opioid treatment program (OTP) patients, suggesting that educating OTP patients about alcohol and its harmful effects needs to be a priority in OTPs. Using data collected in interviews with a nationwide U.S. sample of OTP directors (N = 200) in 25 states, we identified factors that differentiate OTPs that provided this education to all OTP patients from those that did not. Findings indicate that these factors include (1) providing this education in a greater variety of ways, (2) having a larger percent of staff knowledgeable about alcohol-related issues, (3) having a director who views alcohol issues as a high priority, and (4) having a written OTP policy.  相似文献   
42.

Background

Midwives have a significant impact on the clinical outcome and the birthing experience of women. However, there has been a lack of research focusing specifically on clinical midwives’ learning and development of professional competence.

Aim

The objective of the study was to describe how midwives reflect on learning and the development of professional competence and confidence.

Methods

A qualitative study based on focus groups with midwives employed in maternity services.

Findings

Four categories describe the results: (1) Feelings of professional safety evolve over time; (2) Personal qualities affect professional development; (3) Methods for expanding knowledge and competence; and (4) Competence as developing and demanding. The meaning of competence is to feel safe and secure in their professional role. There was a link between the amount of hands-on intrapartum experience and increasing confidence that is, assisting many births made midwives feel confident. Internal rotation was disliked because the midwives felt they had less time to deepen their knowledge and develop competence in a particular field. The midwives felt they were not seen as individuals, and this system made them feel split between different assignments.

Discussion

External factors that contribute to the development of knowledge and competence include the ability to practise hands-on skills in an organisation that is supportive and non-threatening. Internal factors include confidence, self-efficacy, and a curiosity for learning.

Conclusions

Midwives working within an organisation should be supported to develop their professional role in order to become knowledgeable, competent and confident.  相似文献   
43.
This research examined whether heightened neural activation to social cues confers adjustment advantages in supportive social contexts but adjustment disadvantages in stressful social contexts. Forty‐five adolescent girls were exposed to social exclusion during an fMRI scan and reported on parent–child relationship quality and depressive symptoms. Stressful parent–child relationships predicted subsequent depressive symptoms in girls with high and moderate but not low dorsal anterior cingulate cortex, subgenual anterior cingulate cortex, and anterior insula activation during exclusion. In the context of supportive parent–child relationships, however, neural activation to exclusion predicted particularly low levels of depressive symptoms. This support for a biological sensitivity to context model suggests the possibility of redirecting adolescent girls’ neural sensitivity to social cues toward more positive adaptation.  相似文献   
44.
Plant genetic resources constitute the biological basis for plant breeding and future agricultural development. Their transfer from developing to developed countries over centuries has sometimes been viewed as an example of exploitation, if not ‘biopiracy’. Modern gene flows are different in character and magnitude from historic exchanges, however. This article examines current patterns and finds that developing countries are major net recipients of germplasm samples from CGIAR centres, particularly if ‘improved materials’ are considered. Potentially problematic, intellectual property rights do not currently present major barriers to the availability and use of genetic resources by developing countries. Proposals to restrict flows and redress perceived injustices may reduce the benefits accruing at present to developing countries from germplasm exchanges.  相似文献   
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Diversion of commodities from their intended use to an unintended use, e.g., when commodities intended for consumption are used as seed for planting, is an important issue in agricultural trade that has implications for the establishment of pests and pathogens in an importing country and for the appropriate strength of plant health measures. Consequently, understanding and accurately characterizing the risk of diversion from intended use is highly relevant to policymakers, trading partners, and in trade dispute arbitration. To our knowledge, no risk assessments have ever accounted for the likelihood of diversion from intended use. Here we present an approach to analyzing this risk using diversion of U.S. table stock potatoes to seed for planting by Mexican potato producers as a case study. We use probabilistic pathway models to characterize the movement of white, yellow, and russet potatoes from the United States into Mexico at current and double export volumes. We then model the likelihood of these potatoes being diverted for seed and the subsequent establishment of bacteria, nematode, and virus pests in Mexico. Our approach demonstrates how diversion from intended use can be quantified in one scenario and, in particular, how it can be analyzed to estimate the magnitude of diversion required to produce a high risk of pest establishment.  相似文献   
48.
We report on our progress in developing a pilot online group teaching innovation with 14 participants, including five service users and carers, and nine social work students. Enhancing student learning by providing shared educational opportunities between students, service users, and carers can be a challenge to organise but the project demonstrates some success in doing so. The evaluation suggests that even the smallest level of service user and carer involvement can enhance student learning and personal development during social work education and training.  相似文献   
49.
Do electronic newspaper databases contain all of the stories that appear in the print edition? And does this depend on the database used? To explore these questions, we collected print copies of newspapers from cities across the USA and Canada. We compared coverage of two topics in these newspapers with the coverage obtained from keyword searches in three electronic newspaper databases. We conclude that the stories obtained through electronic searches are consistent across databases but can vary from the print source. Importantly, national and international coverage is more likely to be missing than local or statewide/provincial coverage.  相似文献   
50.
We address leadership emergence and the possibility that there is a partially innate predisposition to occupy a leadership role. Employing twin design methods on data from the National Longitudinal Study of Adolescent Health, we estimate the heritability of leadership role occupancy at 24%. Twin studies do not point to specific genes or neurological processes that might be involved. We therefore also conduct association analysis on the available genetic markers. The results show that leadership role occupancy is associated with rs4950, a single nucleotide polymorphism (SNP) residing on a neuronal acetylcholine receptor gene (CHRNB3). We replicate this family-based genetic association result on an independent sample in the Framingham Heart Study. This is the first study to identify a specific genotype associated with the tendency to occupy a leadership position. The results suggest that what determines whether an individual occupies a leadership position is the complex product of genetic and environmental influences, with a particular role for rs4950.  相似文献   
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