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171.
Within the context of the creation of the internal market for health care, the paper examines the role of clinical directors, that is doctors who have retained their professional clinical positions whilst at the same time assumed roles as managers within increasingly well-defined corporate organizations providing health care. This represents considerable change from previous contexts in which doctors could always contract out of difficult managerial decisions. The role of clinical director is examined in terms of its own directorate and its involvement in contracting, co-operation and competition both within its own corporate organization and within the wider market place for health. Key issues are raised for the individuals and organization by these changes, they are discussed in terms of time, succession, managing colleagues, financial and human resources, market behaviour, support and terms of reference. These changes occasion wider discussion in terms of the challenge of coping with future demands for innovation, changes in the distribution of power within an emerging market for health care and the relationship among health care organizations, professionals and lay clients. 相似文献
172.
Diana Eades 《Journal of Sociolinguistics》2006,10(2):153-180
This paper presents a critical sociolinguistic exploration of the cross‐examination of three young teenage Australian Aboriginal boys in a Queensland court. The boys alleged that they had been abducted by six police officers, so they were prosecution witnesses in the case against the police officers. The paper examines the lexical strategies used by defence counsel to construct these victim‐witnesses as criminals with ‘no regard for the community’, and to reinterpret the alleged abduction as a consensual car ride. Of greatest concern is the strategy which I term ‘lexical perversion’– the rejection of a witness's labelling of their own experience, through overt correction with, or covert substitution of, another lexical item. These lexical strategies are central to the judicial legitimation of neocolonial control by the police over the movements of Aboriginal young people. 相似文献
173.
Children in child welfare are especially likely to have unmet mental health needs. The role of family factors in children's use of mental health services was examined in a longitudinal sample of 1075 maltreated or at-risk children. Vulnerable family environment (poor family functioning, low social support, and caregiver psychological distress) is an important predictor of children's mental health needs. It also predicts them not having these needs met. 相似文献
174.
Connections between Temperament and Social Development: A Review 总被引:12,自引:0,他引:12
This paper critically reviews the literature on the links between temperament and social development in children and adolescents. Social development is broadly defined to include externalizing and internalizing behaviour problems, prosocial behaviour and social competence. It concludes that there are clear links between specific dimensions of temperament and particular aspects of social development. Examples include the association of negative reactivity with externalizing behaviour problems, inhibition with internalizing behaviour problems, and attention regulation with school functioning. Theoretical and methodological issues to be confronted in future research are identified, including the need to investigate further the interactions between temperament and social context. Analysis of patterns of change in temperament, in relation to physiological changes and to such factors as parenting and socio‐cultural expectations of children, promise to refine our understanding of how temperament works in context. Some practical implications which can be drawn from the research are also discussed. 相似文献
175.
Marina Lalayants Meaghan Baier Anne Benedict Diana Mera 《Journal of Family Social Work》2013,16(5):305-326
Studies on risk factors and circumstances related to child maltreatment have continuously emphasized the important role of social support. As a result, peer support groups have been gaining attention and recognition in recent years in the field of child maltreatment prevention. However, little is known about the benefits that child welfare–involved parents receive in peer support groups, as well as the distinctive service elements that make these groups successful. By examining child welfare–involved parents’ experiences participating in peer support groups, this study provided a better understanding of the perceived beneficial aspects of peer support groups, specific types of supports offered to and by peers, and unique characteristics of these groups. 相似文献
176.
Verena W. Brown Susan M. Lamb Amy M. Perkins Diana W. Naim Suzanne P. Starling 《Journal of child sexual abuse》2013,22(6):674-689
The objective of this study was to ascertain beliefs and knowledge of pediatricians and parents regarding the hymen and to evaluate parental and pediatrician attitudes regarding sex education by pediatricians. Surveys were distributed anonymously to parents and pediatricians. Survey questions included knowledge of the female hymen and questions regarding attitudes toward sexual health education. There was a statistically significant difference in mean knowledge scores between pediatricians and parents regarding the hymen (3.7 versus 1.3; p < 0.0001). Almost two-thirds of pediatricians (63%) felt comfortable providing sexual health education directly to their patients, but only 41% felt comfortable educating parents. Pediatricians and parents demonstrate knowledge gaps about the hymen. 相似文献
177.
This study evaluates and compares the effectiveness of three group interventions on trauma symptoms for children who have been sexually abused. All of the groups followed the same treatment protocol, with two of them incorporating variations of animal-assisted therapy. A total of 153 children ages 7 to 17 who were in group therapy at a Child Advocacy Center participated in the study. Results indicate that children in the groups that included therapy dogs showed significant decreases in trauma symptoms including anxiety, depression, anger, post-traumatic stress disorder, dissociation, and sexual concerns. In addition, results show that children who participated in the group with therapeutic stories showed significantly more change than the other groups. Implications and suggestions for further research are discussed. 相似文献
178.
179.
Diana L. Rehling Ph.D. 《International Journal of Listening》2013,27(1):83-89
Present conceptions of listening, such as empathic or therapeutic listening, do not provide a way of alleviating the sense of being alone felt by individuals who are seriously ill or suffering in some other way. Compassionate listening, a kind of dialogic listening, provides a framework for approaching these significant listening situations that emphasizes our interconnectedness and our shared humanity and that seeks to overcome the isolation so commonly felt during serious illness. 相似文献
180.
Alicja Filus Anna Trzmiel Justyna Kuliczkowska-Płaksej Urszula Tworowska Diana Jędrzejuk 《The aging male》2013,16(3):134-139
Introduction.?It was found that vitamin D may have a direct effect on adipocyte differentiation and metabolism and might be involved in the glucose regulation of insulin secretion, as suggested from the discovery of a nuclear localization of 1,25-(OH)2D3 in pancreatic islets. In recent years, several polymorphisms in the VDR gene which are able to alter the activity of VDR protein have been described. The BsmI and FokI polymorphisms were described in relation to obesity and type 2 diabetes.The aim of the study was to find whether there are associations between BsmI and FokI polymorphisms and anthropometric (BMI, WHR, BP) and biochemical parameters describing metabolic syndrome.Materials and methods.?Studied were 176 randomly selected men aged 25–65 years (mean: 51.99 years) with a mean BMI of 28.06 kg/m2. Two polymorphisms of the VDR gene (FokI and BsmI) were explored using the PCR-RFLP method. Serum glucose, insulin, total cholesterol, LDL, HDL, and TG were measured using commercially available kits.Results.?It was found that BB carriers tend to have higher BMI (29.00 ± 3.74 versus 26.81 ± 3.76, p = 0.024) and waist circumference (101.79 ± 10.59 versus 96.23 ± 10.35, p = 0.014) compared with the bb genotypes. Similarly, FF and Ff carriers had higher fasting insulin levels than the ff genotypes (12.30 ± 10.26 versus 9.76 ± 5.88, p = 0.001 and 9.76 ± 5.88 vs. 6.35 ± 2.64, p = 0.008), and lover cHDL levels in comparison to ff genotypes (52.28 ± 10.02 versus 60.63 ± 16.58, p = 0.015 and 53.70 ± 12.03 versus 60.63 ± 16.58, p = 0.032. Besides these, no significant differences were found.Conclusions.?The BsmI VDR polymorphism seems to influence BMI, while the FokI VDR polymorphism appears to affect insulin sensitivity and serum cHDL level. 相似文献