锦州市区民营口腔医疗机构调查

目的：了解新医改背景下锦州市民营口腔医疗机构的资源状况。方法：通过调查问卷、现场采访等方式,以民营口腔医疗机构的负责人和口腔医生为调查对象,对锦州市区民营口腔医疗机构进行走访。结果：锦州市没有民营口腔医院,84个民营诊所拥有213台椅位,从业口腔专科医生186人。结论：个体诊所分布广泛,口腔业务量较大,占有一定市场份额;口腔诊所规模较小,医生素质偏低,专业化程度不高;民营口腔市场潜力较大,民营口腔机构也将成为口腔专业毕业生的一个重要就业渠道。     

Care Diamonds and Welfare Regimes in East and South-East Asian Societies: Bridging Family and Welfare Sociology

This paper tries to bridge the micro-level analyses of social networks for "care" provision which have been conducted in the field of family sociology, and the macro-level framework on welfare mix which has been developed in the area of welfare sociology, because the options for creating social networks are given to individuals by society. A group of Asian researchers including the author have conducted comparative research on social networks for childcare and elderly care in six Asian societies, namely Korea, China, Taiwan, Thailand, Singapore, and Japan. To reexamine the results, the author draws diagrams of the care diamonds in each society for each type of care (childcare or elderly care) to show the balance between four sectors (the state, market, family and relatives, and the community) which determines the pattern of welfare mix. The most prevalent pattern in Asian societies today is the pattern with a large family and relatives sector and a large market sector. We can interpret it as a familistic welfare regime combined with liberalism. However, Japan alone shows a pattern close to pure familism because the development of the market sector is restricted by immigration policies prohibiting the employment of foreign domestic workers. Unlike other Asian societies which were exposed to the global market before the family could become a closed organization and marketization of care work took place easily, in Japan, where the modern family system had been established, both socialization and marketization of care work have stagnated.     

Family involvement in the institutional eldercare context. Towards a new understanding

This article focuses on family involvement and its various patterns and expressions in the context of end-of-life care in a nursing home. Based on analyses from an ethnographic study carried out at a nursing home ward, the aim is to describe and analyze the conditions of aging and dying for the old residents, as well as effects on their visiting families and relatives. As in similar research findings, it became clear from the study that families continue to visit and contribute to the care of the old resident throughout the years, from the time of placement to their demise, but that this involvement might vary both in content and in extent. However, it was found that families' involvement (as well as their changing relationships and roles) is particularly shaped by the very process of dying and lingering aura of death on the ward. The analysis presented in the article evinces the difficult — and in many ways impossible — role of the family in the institutional end-of-life setting, and discloses the various patterns and manifestations of family involvement in this environment. Different meanings and implications of family involvement are discussed and highlighted.     

Children’s Psychosocial Rehabilitation: Clinical Outcomes for Youth with Serious Emotional Disturbance Living in Foster Care

Children living in foster care are an especially vulnerable population who often come to the attention of Medicaid mental health providers. These children experience a high incidence of emotional and behavioral disorders and may have specialized treatment needs related to their living arrangement status. This study assessed whether Children’s Psychosocial Rehabilitation could effectively treat youth with severe emotional and behavioral disorders who live in foster care. Analysis of data from an open trial of 218 clinically-impaired youth, aged 3–18 years, revealed no reliable differences in treatment outcome between foster versus non-foster children, with a trend toward more favorable outcomes for foster youth. Findings justify further study of the effectiveness of this Medicaid-funded service for the treatment of youth in care.     

Family Therapy for Kids Without Families: Working Systemically With Children and Young People in Residential Care

A significant proportion (4%, Australian Institute of Health and Welfare, 2008) of children and young people in Australia live in some form of residential care, usually in small group‐homes staffed by residential care workers in shifts. However, as Hawkins‐Rodgers (2007) points out, these placements are often not resourced to heal the effects of trauma and multiple attachment disruptions in their residents. The lack of an archetypal ‘family’ has led in the past to family therapists considering that there is little work to be done with such clients. This leaves such placements to be supported most frequently by clinicians who specialise in behaviour management and other linearly founded models of practice. The Alternate Care Clinic (ACC) is the first mental health service in New South Wales dedicated entirely to children and young people in out of home care with a high level of complex needs. This article examines the systemic therapeutic model the clinic has developed in the last two years. In particular, the article seeks to explore the importance of ‘meaning making’ in a diffuse parental system, particularly with regards to the term ‘family’. The complexities of working in this area and possible ways forward are illustrated with a closely worked case study.     

Who cares and how much: exploring the determinants of co-residential informal care

The importance of informal care provided inside the household (co-residential care) is widely acknowledged in policy circles. However, the factors that determine the likelihood and scale of provision are not fully understood. A two-part model (2PM) is used to investigate both participation and levels of provision. Random effects dynamic panel specifications are employed. Results show that co-residential informal care competes with other time demanding activities, such as childcare and employment. Wealthier individuals are less likely to be caregivers, whereas wealthier households have a higher tendency towards caregiving. Evidence of both substitution and complementarity is found between formal and informal care. Informal care and health status are significantly related, with carers more likely to report worse General Health Questionnaire scores than non-carers. Finally, significant dynamic effects are observed with the continuance of the provision of informal care being more likely than the initiation of such activity, while heavy commitment in the past increases the hours provided in the current period.

城乡差异、就医惯性与老年人卫生服务利用

现有对城乡老年人卫生服务利用不公平的研究多忽略了长期的城乡差异所导致的隐性的农村老年人就医惯性的存在。本研究在控制了收入、医疗保障和就医可及性等因素的条件下,发现就医惯性的存在;并运用集中指数分解法发现,卫生服务的利用存在不公平,偏向于富人,而就医惯性在两种卫生服务利用中的贡献度分别为12%和5%。这种城乡固定差异造成了农村老年人在身体健康、心理健康和自我照料能力上都显著地低于城市老年人。     

Translation and factor analysis of structural models of Edinburgh Postnatal Depression Scale in Serbian pregnant and postpartum women – Web-based study

BackgroundThe Edinburgh Postnatal Depression Scale (EPDS) is well accepted for detecting symptoms of postnatal depression. The aim of this study was to examine psychometric properties and to evaluate structural models of the Serbian translation of EPDS in pregnant and postpartum women.MethodsThe original English version of the EPDS was translated into Serbian, and checked by means of back-translation. Data were collected via an anonymous online questionnaire posted on a Serbian website devoted to pregnancy topics. The study sample included 201 women (76 pregnant, 125 postpartum). The internal consistency of the scale was measured by Cronbach's α coefficient. Principal component analysis was used to determine scale dimensions while confirmatory factor analysis was used to evaluate model fit.FindingsCronbach α coefficient was 0.84 and 0.83 in pregnant and postpartum women, respectively, which indicated good internal consistency of the Serbian EPDS. Three dimensions of the scale were revealed in both groups of women. Goodness of fit indices described good and excellent model in pregnant and postpartum women, respectively. High level of depression symptoms (score ≥13) was recorded in 27.6% and 24.8% (p > 0.05) of pregnant and postpartum women, respectively. Moderate level of depression symptoms (score 10–12) was recorded in 21.1% and 16.8% (p > 0.05) of pregnant and postpartum women, respectively.ConclusionThe Serbian translation of the EPDS showed good consistency and good model characteristics in pregnant and postpartum women. However, cut-off values, sensitivity and specificity of the scale should be determined in the further studies with more representative samples of women.     

新医改背景下医科大学生价值取向变化趋势及教育引导研究

新医改的价值目标是公益性,对于当前医科大学生价值取向的产生、形成具有重要导向作用。当前医科大学生价值取向出现了价值目标趋于功利化、迷失医学真正目的;医学技术至上、自身技术能力下滑;科研作风不够严谨,人文素质滑坡等趋势。因此,应从树立崇高职业理想,提升使命感和责任感;创新医德教育体系,强化思想政治教育育人功能;关注物质精神需求,提高从医幸福感等方面教育引导医科大学生树立正确价值取向。