医科与农科大学生SCL——90测查比较研究

用心理卫生自评量表(SCL———90)调查了内蒙古蒙医学院和哲里木畜牧学院两高校大学生的心理健康和差异,结果表明,两高校学生男女总体心理健康水平无明显差异,存在的心理问题各具特点,而医科学生心理问题较多,强度较大。     

扬州市邗江区乡镇预防保健体制改革两种模式的比较研究

扬州市邗江区1999年对全区21所乡镇卫生院进行了产权制度改革。改制前3年,实行“医防合一”体制,从2002年起实行“医防分设”体制。文章采用定性调查和定量调查相结合的方法,比较改革前后农村卫生体系和农村预防保键资源、组织机构、服务效率、监督执法力度、农民满意度等方面的变化。研究表明,“医防分设”是必由之路,为进一步改革和完善预防保健体系提供了依据。     

家庭托育点管理实践及启示：政策工具的视角

家庭托育点的规范化对婴幼儿健康成长至关重要。通过文献收集和访谈获得既往管理举措和当前试点政策,运用政策工具进行分析和总结,探究管理家庭托育点的背景、对象和措施。结果表明：家庭托育点因经济优势而被纳入管理,现有征求意见稿管理对象偏向小规模邻托,但试点和市场偏向较大收托规模;消防审查依托既有消防验收,师资准入要求偏低,质量监管依靠政府。管理建议：应根据收托规模区分小型和大型家庭托育点开展试点;完善三方协同的管理架构,设定专门空间环境要求,提高师资准入要求,建立综合质量监管。     

Involvement of Ministries of Health in Health Service Coverage Decisions: Is England an Aberrant Case?

This article examines the involvement of ministries of health in making health service coverage decisions in Denmark, England, France and Germany. The study aims to inform debate in England about the feasibility of reducing perceived ministerial and bureaucratic ‘interference’ in decisions affecting the National Health Service, based on interviews with senior government officials and other health system stakeholders. Ministries of health differ in their involvement in health system governance and coverage decisions (‘the benefits package’), reflecting differences in institutional arrangements. In all four countries, organizations at arm's length or independent from government are either involved in providing technical advice to the ministry of health or have been mandated to take these decisions themselves. However, ministries of health occasionally intervene in the decision‐making process or ignore the advice of these organizations. The Department of Health in England is not an aberrant case, at least in relation to coverage decisions. Indeed, ministries of health in Denmark and France play a larger role in making these decisions. Public pressure, often amplified by the media, is a shared reason for ministerial and ministry involvement in all four countries. This dynamic may thus limit the feasibility of attempts to further separate the NHS from both the Department of Health and wider political pressures.     

Preschoolers' Attachment to Mother and Risk for Adjustment Problems in Kindergarten: Can Teachers Make a Difference?

Based on attachment theory, two aims were addressed. Firstly, we tested whether close teacher–child relationships may buffer children who are less securely attached to their mothers against negative outcomes, such as aggressive behavior. Secondly, our study evaluated whether teacher sensitivity may protect less securely attached children against forming less close relationships with their teachers. In a sample of 127 children, mother–child attachment was observed in preschool. In kindergarten, teacher sensitivity was observed, and teacher–child closeness and child aggressive behavior were rated by the teacher. Results of multilevel hierarchical regression analyses first showed that with high teacher–child closeness, less securely attached children are no longer at risk for more aggressive behavior. Secondly, it was found that with high teacher sensitivity, less securely attached children are no longer at risk for developing less close relationships with their teachers.     

Child custody issues and co‐occurrence of intimate partner violence and child maltreatment: controversies and points of agreement amongst practitioners

The situation of families undergoing separation in a context of co‐occurrence of intimate partner violence (IPV) and child maltreatment raises certain issues related to child custody. The results presented in this paper were collected and analysed within the framework of a qualitative study aiming to identify the principal points of agreement and the main controversies amongst practitioners in several different types of organizations. Focus groups were held with a total of 43 practitioners from six different settings concerned with child custody in cases of co‐occurrence of IPV and child maltreatment. Although they agreed on the importance of ensuring the safety of victims of violence, their views diverged on three points: (1) the importance of preserving the father–child relationship; (2) collaboration between voluntary organizations and semi‐voluntary or legal agencies; and (3) consideration of cultural differences.     

'I made some mistakes . . . but I love them dearly' the views of parents of children in informal kinship care

In-depth semi-structured interviews with 30 parents of children living with relatives in informal kinship care arrangements revealed the parents' views of the reasons for the informal kinship care arrangements, quality of their relationships with the children and their caregivers, their current and future roles in their children's lives, feelings experienced when with and away from the children, positive and negative aspects of kinship care, future goals and dreams for their children, and their assessments of their own strengths and challenges. Results of these interviews suggest several implications for social work practice and research.     

Contractual audit and mental health rehabilitation: a study of formulating effectiveness in a Finnish supported housing unit

Saario S, Raitakari S. Contractual audit and mental health rehabilitation: a study of formulating effectiveness in a Finnish supported housing unit Int J Soc Welfare 2010: 19: 321–329 © 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. Mental health NGOs in Western Europe are increasingly managed by contractual audit procedures. This article concerns how contractual audit and its emphasis on effectiveness of care impact on the practices of long‐term mental health rehabilitation. To demonstrate this, a case study of a Finnish NGO that provides supported housing is presented. The study looks at how service purchasing practices, as stated in the contract between the municipality and the NGO, are reflected in the meetings among practitioners. Documentary and meeting data were utilised together with Mitchell Dean's notion of technologies of agency. It was found that practitioners actively sought to show the effectiveness of their everyday work in terms of contractual audit by demonstrating both the economic and progressive aspects of care. Thus, professional competency in mental health rehabilitation appears to entail both the skills of care interventions and the ability to perform these interventions as efficient and financially accountable activities.     

Using a mixture model for multiple imputation in the presence of outliers: the 'Healthy for life' project

Summary.  We consider the problem of obtaining population-based inference in the presence of missing data and outliers in the context of estimating the prevalence of obesity and body mass index measures from the 'Healthy for life' study. Identifying multiple outliers in a multivariate setting is problematic because of problems such as masking, in which groups of outliers inflate the covariance matrix in a fashion that prevents their identification when included, and swamping, in which outliers skew covariances in a fashion that makes non-outlying observations appear to be outliers. We develop a latent class model that assumes that each observation belongs to one of K unobserved latent classes, with each latent class having a distinct covariance matrix. We consider the latent class covariance matrix with the largest determinant to form an 'outlier class'. By separating the covariance matrix for the outliers from the covariance matrices for the remainder of the data, we avoid the problems of masking and swamping. As did Ghosh-Dastidar and Schafer, we use a multiple-imputation approach, which allows us simultaneously to conduct inference after removing cases that appear to be outliers and to promulgate uncertainty in the outlier status through the model inference. We extend the work of Ghosh-Dastidar and Schafer by embedding the outlier class in a larger mixture model, consider penalized likelihood and posterior predictive distributions to assess model choice and model fit, and develop the model in a fashion to account for the complex sample design. We also consider the repeated sampling properties of the multiple imputation removal of outliers.     

The EPA Health Risk Assessment of Methylcyclopentadienyl Manganese Tricarbonyl (MMT)

This paper describes the U.S. Environmental Protection Agency's assessment of potential health risks associated with the possible widespread use of a manganese (Mn)-based fuel additive, methylcyclopentadienyl manganese tricarbonyl (MMT). This assessment was significant in several respects and may be instructive in identifying certain methodological issues of general relevance to risk assessment. A major feature of the inhalation health risk assessment was the derivation of Mn inhalation reference concentration (RfC) estimates using various statistical approaches, including benchmark dose and Bayesian analyses. The exposure assessment component used data from the Particle Total Exposure Assessment Methodology (PTEAM) study and other sources to estimate personal exposure levels of particulate Mn attributable to the permitted use of MMT in leaded gasoline in Riverside, CA, at the time of the PTEAM study; on this basis it was then possible to predict a distribution of possible future exposure levels associated with the use of MMT in all unleaded gasoline. Qualitative as well as quantitative aspects of the risk characterization are summarized, along with inherent uncertainties due to data limitations.