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141.
This article presents a consensus-building initiative to develop a statewide research agenda that responds to the needs of Illinois's child welfare community. Researchers conducted this process through a university-community partnership to engage those interested in child welfare services. The process and findings resulted in a living document that will guide child welfare research throughout the state. Findings of the inquiry suggest that the development of best practice models may be one of the most important contributions research can make to practice.  相似文献   
142.
Interest in change interventions that are common to different models of relationship therapy has spurred investigation of enactments as one such candidate. In change-focused enactments, therapists structure and coach couple/family interaction, as opposed to channeling interaction through the therapist. Still, varying levels of couple/family distress, volatility, and reactivity mean that readiness for enactment intervention varies along a broad continuum and changes over the course of therapy. This suggests the need for differentiated enactments. Currently, however, no model exists for adapting enactments to changing relationship conditions. We propose a five-stage developmental model of clinical operations in couple therapy that adapts the process and structure of enactments to changing levels of relationship distress, interactional volatility, and emotional reactivity. The model increases the possibility for therapists to use enactments successfully over the entire course of couple therapy. Issues to be considered in using the couple enactments model as a template for the development of enactment models for other relationship systems are noted.  相似文献   
143.
This study sought to understand the reasons for the lack of use of ICD diagnostic codes for child and adult abuse. New Jersey professionals were recruited to participate in three focus groups on child abuse, adult or primarily woman abuse, and elder abuse. Participants included health care providers, advocates from the community, and representatives of state agencies and the insurance industry. Concerns about coding abuse included further jeopardizing victims/patients, diagnostic uncertainty, and lack of resources. Members of the child abuse group were somewhat more receptive to coding abuse. Reasons to code, such as for documentation and reimbursement were discussed and rebutted. Most participants concluded that use of the abuse codes should be judicious because they have the potential to do more harm than good. More research is needed on the implications of coding for victims/patients along with medical education in the identification of abuse in general and coding abuse in particular.  相似文献   
144.
The attempt to recover gambling losses by continuing to gamble (chasing) has featured prominently in accounts of excessive gambling. This research represents the first attempt to operationalize and measure chasing in terms of its cognitive (behavioral intention), emotive (urges) and behavioral components, and to investigate the role of chasing in relation to impaired control over gambling. Two survey samples of 84 male off-course (betting shop) race gamblers (mean age 41, SD = 15) and 137 gaming machine players (73 females, mean age 48, SD = 15 and 64 males, mean age 43, SD = 16) were recruited at gambling venues. Respondents completed a structured questionnaire that investigated retrospective report of chasing and an impaired control scale (The Scale of Gambling Choices). It was found that the various components of chasing formed a composite measure with high internal reliability that was strongly related to indicators of excessive gambling (e.g. time spent gambling, expenditure as a proportion of income) and to impaired control scores. Reacting to large wins by further betting was almost as strongly related to impaired control as was persistence after losing. Those who returned later to chase had significantly higher impaired control scores than those who only chased within a session. Alcohol-related chasing was associated with impaired control over gambling. Chasing of losses and impaired control appear to be generic processes in evidence across both forms of gambling and gender (most format and sex differences were of minor significance).  相似文献   
145.
Diabetes accelerates the aging process and leads to complications that include blindness, renal failure, nerve damage, stroke, and cardiovascular disease. It has been hypothesized that high plasma glucose concentrations are responsible for increased mitochondrial free radical production and subsequent inactivation of glyceraldehyde phosphate dehydrogenase (GAPDH) in vascular endothelial cells and other cells implicated in these complications. As a result of the decreased ability of GAPDH to process upstream metabolites, three pathways of metabolic damage are activated, which include the advanced glycation end-product formation pathway, the protein kinase C pathway, and the hexosamine pathway. All three pathways have been implicated in abnormal cell signaling in diabetes. A group of German and U.S. scientists has now found that treating diabetic rats with high doses of benfotiamine, a lipid-soluble form of vitamin B1, can prevent diabetic retinopathy and all three forms of metabolic damage by stimulating transketolase activity and thus diverting excess metabolites toward the pentose pathway. Although vitamin B1 is available over the counter, the researchers at this time do not advocate self-treatment without further clinical data.  相似文献   
146.
In this case study, we describe the symptoms, neurological exam, neuropsychological test results, and brain pathology of a man who died with Huntington's disease (HD). HD is a rare neurodegenerative disease. Like other movement disorders involving the basal ganglia, HD affects motor, cognitive, and psychiatric functioning. The disease follows an autosomal dominant pattern of inheritance, with onset of symptoms most commonly occurring in the late 30s or early 40s, as in this patient. HD is caused by an unstable expansion of the trinucleotide CAG, coding for glutamine, on chromosome 4. Despite knowledge of the gene mutation responsible for HD, no definitive treatment is currently available to slow or halt progression of the disease. However, symptomatic treatment can significantly improve the quality of life for patients with HD.  相似文献   
147.
An industry specific rehabilitation programme was developed to cater for the special requirements of the New Zealand logging industry. The aims of the rehabilitation programme were to: reduce the amount of time lost due to injury, reduce the number of lost time injuries, and overall, to reduce the direct costs associated with logging injuries. The programme was field-tested on a logging company. The rehabilitation programme was effective for reducing the average amount of time lost due to injury and also for reducing the cost of the injuries. Although there were a number of factors that may have had an impact upon these results, this research provides evidence that this rehabilitation programme was effective for reducing the severity and cost of injury to the New Zealand logging industry.  相似文献   
148.
149.
Input‐output analysis is frequently used in studies of large‐scale weather‐related (e.g., Hurricanes and flooding) disruption of a regional economy. The economy after a sudden catastrophe shows a multitude of imbalances with respect to demand and production and may take months or years to recover. However, there is no consensus about how the economy recovers. This article presents a theoretical route map for imbalanced economic recovery called dynamic inequalities. Subsequently, it is applied to a hypothetical postdisaster economic scenario of flooding in London around the year 2020 to assess the influence of future shocks to a regional economy and suggest adaptation measures. Economic projections are produced by a macro econometric model and used as baseline conditions. The results suggest that London's economy would recover over approximately 70 months by applying a proportional rationing scheme under the assumption of initial 50% labor loss (with full recovery in six months), 40% initial loss to service sectors, and 10–30% initial loss to other sectors. The results also suggest that imbalance will be the norm during the postdisaster period of economic recovery even though balance may occur temporarily. Model sensitivity analysis suggests that a proportional rationing scheme may be an effective strategy to apply during postdisaster economic reconstruction, and that policies in transportation recovery and in health care are essential for effective postdisaster economic recovery.  相似文献   
150.
One of the basic functions of an MRP system is to issue rescheduling messages that urge the planner tospeed up or slow down open orders. It seems in practice that these messages are not used at all by planners. This is mostly due to the inaccuracy of MRP, that more or less ignores safety time, safety stocks and lotsize flexibility in the calculation of reschedule-in messages. Reschedule-out messages are usually ignored because planners do not see the value of the message. Other reasons for not adhering to rescheduling messages are a lack of maintenance of MRP parameters or simply the wrong use of the MRP function. In the future, MRP rescheduling functionality will be used even less than today, due to the changing role of MRP within the planning framework. With the uprise of finite capacity scheduling packages, MRP is being pushed one level upward in the planning hierarchy. This means that rescheduling functionalities for the short term will become completely obsolete in MRP systems.  相似文献   
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