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。     

Substance use among older youth transitioning from foster care: Examining the protective effects of religious and spiritual capital

Among older youth transitioning from the foster care system, this longitudinal study examined the association of religious and spiritual capital to substance use in the past year at age 19. Participants consisted of African American (N = 179) and White non‐Hispanic (N = 133) older youth in foster care. Drawing from social capital theory, it was posited that religious service attendance (a proxy for religious capital) and belief in a spiritual force (a proxy for spiritual capital) would be inversely associated with substance use. Multiple logistic regression results indicated support for the first and second hypothesis for White foster youth only. Among White foster youth, more frequent religious service attendance and greater belief in a spiritual force were associated with a lower likelihood of illegal substance and polysubstance use. No association between religious or spiritual capital and substance use was found among African American foster youth. The findings underscore the importance of conducting spiritual assessments to help ensure older foster youth who have strong religious or spiritual orientations are in environments where they are accommodated and supported.     

The sacred and the profane in life science work: The case of assisted reproduction laboratories

Reproductive medicine and assisted reproduction therapies have been developed over the last decades resulting in over five million babies. The handling of human reproductive materials and patients is based on the ability to combine health care work and techno-scientific expertise in both the clinic and the laboratory setting. This study of Swedish assisted reproductive technology clinics demonstrates that the active day-to-day manipulation of human reproductive materials enact both the ‘profane’, through treating the embryos as raw materials in standardized procedures enabling economies of scale, and the ‘sacred’ through enacting a separation, the potential to human life, the patients ordeals, and seriousness. The enactment of the profane and the sacred is mostly balanced but at certain points in the work procedures, their intersecting becomes particularly salient. Such points provide opportunities for the study of the sense making of professionals in organizational grey zones, during techno-scientific activities.     

Identity Formation in Children and Young People in Open Adoptions from Out-of-home Care in New South Wales,Australia

Semi-structured interviews were used to explore identity development for nine adoptees (aged 9–23 years) who were adopted by their foster carers in New South Wales, Australia. Adoptions were open, with court-ordered face-to-face contact with birth families. Findings suggest that participants had healthy adoptive identities, with coherent and meaningful narratives about their life histories. Adoption provided a sense of security and belonging. Openness provided information to build a self-narrative and encouraged discussion of adoption issues within adoptive families. Adoptive parents were critical in helping children understand their adoption and facilitating direct contact with birth families, thus laying foundations for positive identity development.     

Correlates of Depressive Symptoms among Homebound and Semi-Homebound Older Adults

ABSTRACT

This study aimed to provide a national profile of homebound and semi-homebound older adults with depressive symptoms and to compare risk factors of depressive symptoms by homebound status. A sample of 1,885 homebound and semi-homebound older adults was selected from Round 1 of the National Health and Aging Trends Study (NHATS). The prevalence of depressive symptoms was 43.9% in homebound older adults and 28.1% in semi-homebound older adults, representing over 830,000 and 1.4 million individuals in the population, respectively. Nearly two-thirds of homebound and over half of semi-homebound older adults with clinically significant depressive symptoms also had significant anxiety symptoms. Results from logistic regression showed that younger age, certain medical morbidities, severity of functional limitations, and pain were common risk factors for depressive symptoms among homebound and semi-homebound older adults. Some differences in the risk factor profile emerged between the homebound and the semi-homebound populations. Alleviating the burden of depression in the semi-homebound population may focus on early prevention that considers the diversity of this population. Home-based, integrated programs of health and mental health services that simultaneously address the medical, psychiatric, and neurologic comorbidities and disabilities of homebound older adults are needed to meet the complex needs of this population.     

Increasing Competency,Self-Confidence,and Connectedness Among Foster Care Alumni Entering a 4-Year University: Findings from an Early-Start Program

Research shows that few foster care alumni enroll and complete post-secondary education. For those who do enroll, many experience challenges associated with academic and social adjustment and are at risk of dropping out. Many college-based programs are being developed and are available to foster care alumni to support them during their post-secondary education. This study used pre-tests, post-tests, and journal entries of seventeen participants to evaluate a strengths-based, resilience-oriented early-start program for newly enrolled students at a large public university that provides knowledge about the institution, resources (e.g., tutoring), and social support necessary for foster care alumni to make a smooth transition into college life and to increase short and long-term student success. Quantitative and qualitative findings indicate that students who participated in the early-start program showed increased confidence and competency in academic and social adjustment. Findings also showed personal growth (e.g., building resiliency) and an increased connectedness among students who participated in the program. Study findings can inform the development of new on-campus support programs and help enhance existing programming. Future research should address short and long-term outcomes and experiences of students who are former foster youth who have participated in on-campus support programs.     

Intention to Leave the Profession: Welfare Social Workers Compared to Health Care and Community Social Workers in Israel

ABSTRACT

This study aimed to compare specific work related-factors (personal factor: length of work experience; structural factors: personal subjection to violence and fear of being subjected to violence; and psychological factors: professional quality of life—compassion satisfaction, burnout, and compassion fatigue) between welfare social workers (SWs) (n = 200) and health care and community SWs (n = 173). Furthermore, since the issue of turnover among SWs has important implications for the provision and programming of social services, the study also aimed to assess the relationship between these factors and SW intention to leave the profession. For the purpose of this study, online questionnaires were distributed to SWs working at social agencies and services. The findings suggest that the two categories of SWs showed a similarity with regard to the association between the personal and structural factors and intention to leave the profession. However, with regard to the psychological factors, the components of professional quality of life were found to operate differently in each category of SWs. It is suggested that future research examine other work-related factors and explore the intention to leave the profession among other social work specializations and employment sectors.     

The Experiences of Reciprocity among Filipino Older Adults in Canada: Intergenerational,Transnational, and Community Considerations

ABSTRACT

This article illustrates the concept of reciprocity in the context of immigrant families. It recommends that definition of reciprocity account for exchanges beyond the immediate family, and render visible the simultaneous location of older people as care recipients and providers, and care arrangements across generations, borders, community, and time. Adopting a critical ethnographic study on the aging and care experiences of older Filipinos in Canada, this article analyzes data from extended observations and in-depth semi-structured interviews with 18 older people, 6 adult children, and 13 community stakeholders. Findings highlight the unique configurations of care among the Filipino community whereby older people engage in care exchange as active participants across intergenerational, transnational, and fictive kin networks.     

Impact of job characteristics on turnover intention and the mediating effects of job satisfaction: experiences of home visiting geriatric care workers in Korea

This study investigated the effects of job characteristics on turnover intention and the mediating effects of job satisfaction. A survey of 317 Korean care workers currently providing in-home elderly care service in the city of Seoul and its suburbs was conducted. The results of multiple regressions and an analysis of mediating effects indicated that role ambiguity and workload had significant effects on turnover intention. In addition, job satisfaction had a mediating effect on the influence of role ambiguity and workload on turnover intention. Finally, theoretical and practical implications are discussed.