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This article presents an evaluation framework developed to assess the first-level effects of introducing the Standard Days Method (SDM) in Peru Ministry of Health clinics. Four questions are asked: 1) To what extent do providers routinely achieve SDM service delivery standards? 2) Is the time invested in SDM delivery consistent with program norms? 3) How does SDM delivery compare with delivery of established methods? and 4) How does SDM introduction affect delivery of established methods? A study at 62 clinics demonstrated the framework's usefulness. The Standard Days Method introduction had positive overall effects on the quality of care but provider training needed adjustments.  相似文献   
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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.  相似文献   
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Our study aims at describing mortality among reported elder abuse experiences in rural Malaysia. This is a population-based cohort study with a multistage cluster sampling method. Older adults in Kuala Pilah (n = 1,927) were interviewed from November 2013 to May 2014. Mortality was traced after 2 years using the National Registration Department database. Overall, 139 (7.2%) respondents died. Fifteen (9.6%) abuse victims died compared to 124 (7.0%) not abused. Mortality was highest with financial abuse (13%), followed by psychological abuse (10.8%). There was a dose-response relationship between mortality and clustering of abuse: 7%, 7.7%, and 14.0% for no abuse, one type, and two types or more, respectively. Among abuse victims, 40% of deaths had ill-defined causes, 33% were respiratory-related, and 27% had cardiovascular and metabolic origin. Results suggest a link between abuse and mortality. Death proportions varied according to abuse subtypes and gender.  相似文献   
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The study purpose was to develop and pilot an undue influence screening tool for California’s Adult Protective Services (APS) personnel based on the definition of undue influence enacted into California law January 1, 2014. Methods included four focus groups with APS providers (n = 33), piloting the preliminary tool by APS personnel (n = 15), and interviews with four elder abuse experts and two APS administrators. Social service literature—including existing undue influence models—was reviewed, as were existing screening and assessment tools. Using the information from these various sources, the California Undue Influence Screening Tool (CUIST) was developed. It can be applied to APS cases and potentially adapted for use by other professionals and for use in other states. Implementation of the tool into APS practice, policy, procedures, and training of personnel will depend on the initiative of APS management. Future work will need to address the reliability and validity of CUIST.  相似文献   
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