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71.
Emotional relationships in infant–mother dyads in families where mothers provided full‐time childcare were compared with those of families where mothers used in‐home childcare providers and family childcare providers (= 245). Infant relationships with childcare providers were also studied. Emotional relationships were adequate in all three childcare arrangements, but infant–mother dyads in in‐home childcare arrangements displayed healthier emotional relationships than infant–mother dyads in mother care arrangements; no differences in the health of emotional relationships with infants emerged among the three types of childcare providers (mother care, in‐home childcare, family childcare). Infant–mother dyads in in‐home childcare arrangements also displayed healthier emotional relationships than infant–in‐home childcare caregiver dyads, but infant–mother and infant–caregiver dyads were comparable in family childcare families. Emotional relationships in infant–mother and infant–caregiver dyads were not correlated, regardless of the type of childcare.  相似文献   
72.
This study investigates the impact of worker learning, worker flexibility, and labor attrition on the system performance of a dual resource constrained (DRC) job-shop. The effects of learning and labor attrition have not been previously addressed in DRC literature. Results from the study, consistent with previous literature, show that the greatest benefits are achieved when inter-departmental worker flexibility is incrementally introduced into the system. In addition, the learning environment, which depends on the initial processing time of jobs and the learning rates of workers, is shown to impact the acquisition of flexibility. The study also shows that the impact of labor attrition on system performance under certain shop conditions may be significant.  相似文献   
73.
Despite the impact that Deming and his 14 Points have had on the practice of quality management, empirical support for the effectiveness of the Deming Management Method has not advanced beyond the presentation of anecdotal, case-study evidence. In part, this is because theory to guide the conduct of empirical research has not been available. Only recently has such a theory of quality management to describe and explain the effectiveness of the Deming Management Method been articulated in the literature. This paper continues the journey of theory development; it reports the results of an exploratory empirical analysis of an articulated theory of quality management underlying the Deming Management Method. The constructs in the proposed theory are operationalized using measurement statements developed by the World-Class Manufacturing research project team at the University of Minnesota and Iowa State University. Path analysis is applied to the World-Class Manufacturing project data to explore the empirical strength of relationships advanced in the theory. The path analytic results provide support for several of the proposed relationships in the theory, and more importantly, suggest a number of new relationships which have not heretofore been proposed.  相似文献   
74.

Background

There is no current validated clinical assessment tool to measure the attainment of midwifery student competence in the midwifery practice setting. The lack of a valid assessment tool has led to a proliferation of tools and inconsistency in assessment of, and feedback on student learning.

Objective

This research aimed to develop and validate a tool to assess competence of midwifery students in practice-based settings.

Design

A mixed-methods approach was used and the study implemented in two phases. Phase one involved the development of the AMSAT tool with qualitative feedback from midwifery academics, midwife assessors of students, and midwifery students. In phase two the newly developed AMSAT tool was piloted across a range of midwifery practice settings and ANOVA was used to compare scores across year levels, with feedback being obtained from assessors.

Findings

Analysis of 150 AMSAT forms indicate the AMSAT as: reliable (Cronbach alpha greater than 0.9); valid—data extraction loaded predominantly onto one factor; and sensitivity scores indicating level of proficiency increased across the three years. Feedback evaluation forms (n = 83) suggest acceptance of this tool for the purpose of both assessing and providing feedback on midwifery student’s practice performance and competence.

Conclusion

The AMSAT is a valid, reliable and acceptable midwifery assessment tool enables consistent assessment of midwifery student competence. This assists benchmarking across midwifery education programs.  相似文献   
75.
The contested definitions of “swinging” and “polyamory” reveal profound inconsistencies in the logics of sex, love, commitment, and coupledom. In this article, I use a number of non-monogamy blogs and online glossaries as examples of the way these two words are often deployed against each other in an effort to position the speaker in relation to mononormative practices of sex and love. Leaving aside questions of the accuracy of particular definitions, I map a range of definitions against two existing scholarly/activist tools for describing relationship styles, specifically Gayle Rubin’s “Charmed Circle” and Meg-John Barker’s sex/love continuums. This exercise is doubly fruitful: first, the tools reveal the political stakes of the definitional debates; second, the definitions demonstrate that the distinctions we commonly use to distinguish between types of relationships—including types of non-monogamous relationships—in fact rely on mononormative assumptions about sex, love, and friendship. If “mononormativity” is defined as the system of ideas, institutions, and practical orientations that provide the backdrop against which the idea of monogamy as coherent, common, natural, and right congeals, the sex/love skirmishes of “swinging” and “polyamory” remind us that its logics are both pervasive and deeply fractured.  相似文献   
76.
Levels of father participation in parenting interventions are often very low, yet little is known about the factors which influence father engagement. We aimed to qualitatively explore perceived barriers to, and preferences for, parenting interventions in a community sample of fathers. Forty‐one fathers across nine focus groups were interviewed using a semi‐structured interview. Data were analysed using inductive thematic analysis. Key barriers to father participation identified included: the perception that interventions are mother‐focused; beliefs about gender roles regarding parenting and help‐seeking; mothers’ role as ‘gatekeeper’; lack of knowledge and awareness of parenting interventions; and lack of relevance of interventions. Fathers reported preferences for specific content and intervention features, facilitator characteristics, practical factors, and highlighted the need for father‐targeted recruitment and advertising. Many of the barriers and preferences identified are consistent with previous research; however, fathers’ beliefs and attitudes around gender roles and help‐seeking, as well as the perception that interventions are predominantly mother‐focused, may be key barriers for community fathers. Strategies to overcome these barriers and better meet the needs of fathers in promoting and delivering parenting interventions are discussed.  相似文献   
77.
Despite increasing empirical support for an integrated approach to treating trauma and substance abuse, many substance abuse treatment programs have been slow to embrace integrated models of practice. Using an embedded case study design, the purpose of this study was to understand barriers that prevented a substance abuse treatment provider and 20 professionals and staff from adopting an integrated approach to treating substance abuse and trauma. Data analysis revealed 2 kinds of barriers that prevented substance abuse treatment professionals from fully integrating substance abuse and trauma: systemic and professional barriers. These barriers have to be taken into account when trying to move providers and professionals toward integrated approaches to treating substance abuse and trauma.  相似文献   
78.
Despite a re-evaluation of risks in recent years, hormone replacement therapy is still surrounded by controversy. Almost 30% of women in a recent survey sought a natural approach to combat climacteric symptoms. Nevertheless, a large proportion of patients felt that they wanted a good safety profile and strong evidence base for treatment. This article seeks to review the evidence supporting non-hormonal approaches to treatment. There is only conflicting evidence at best to support alpha-2 agonists, e.g. clonidine and limited evidence for dihydroepiandrosterone and natural progesterones. There is limited randomized controlled trial data for gabapentin, selective norepinephrine re-uptake inhibitors (SNRIs) and selective serotonin re-uptake inhibitors (SSRIs), many of these studies being related to breast cancer patients. Of the herbal medicinal products, the largest evidence base rests with phytoestrogens. A Cochrane Database review looking at all types of phytoestrogens, e.g. red clover extracts, dietary soya and soya extracts concluded that there was no evidence to support improvement in climacteric symptoms and the meta-analysis of a 178 studies on soy products was inconsistent. Nevertheless, other studies disagree. Mammographic density is not affected by soy or phytoestrogen products and recent in vitro work shows only a weakly proliferative effect of soy isoflavone on breast cancer cells and evidence that soy isoflavone blocks the proliferative effect of estradiol on these cells. There are no studies looking at clinical outcome measures for cardiovascular disease but a number of studies looking at biochemical markers including arterial wall stiffness and apolipo protein B. Recent studies have also looked at the effects of red clover isoflavone on mood and depression, using specific depression rating scales. Finally, it is important to note that herbal medicinal products should not be used without caution. Some may produce quite marked side-effects in high doses and others can interact with pre-existing medication. A strategy for which patients are suitable for herbal medicinal products is reviewed.  相似文献   
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