DEVELOPING AND USING INTERDISCIPLINARY CASE STUDIES IN TEACHING GERIATRICS TO PRACTICING HEALTH CARE PROFESSIONALS

Continuing education programs for health care professionals who practice in geriatrics are an important part of improving the health care provided to older adults. Programs utilizing active forms of learning that mimic the clinical environment are more successful at changing the behavior of health care professionals than traditional didactic styles of teaching. Problem-based learning methods allow learners to identify their own areas of strength and weakness and to work toward improvement in a manner best suited to their needs. This article describes an interdisciplinary team of educator-clinicians in geriatrics who developed clinical case studies embodying these approaches as one method of improving the learning process for adult health care providers. An actual sample case study is presented as an illustration of the principles embodied in this process. Lessons learned from the development and use of these case studies are summarized in the context of improving the quality of continuing education programs for health care professionals in geriatric practice.     

Strategic ambiguity in the role development process

Today's turbulent business and social environment often compels organizations to adopt internal programs that will help them cope with complexity. One organizational sector in which this is particularly true is the health care industry, as managed care programs and competitive forces have changed the way hospitals and clinics operate. This study looks at a specific organizational program designed to cope with these industry changes and considers the impact of the program on the nurses involved. Drawing on theory and research on role development and strategic ambiguity, this case analysis looks at a hospital system in which the nursing role of “care coordinator”; was defined in a strategically ambiguous way. After analyzing interviews with 19 care coordinators, conclusions are drawn regarding affective reactions to strategic role ambiguity, behavioral adaptation to strategic role ambiguity, and the importance of conceptualizing role ambiguity as a systemic process.     

Market Ideology and Accountability: case studies in the early childhood and special education sectors in New Zealand

ABSTRACT

Conservatism is becoming evident in recent policy changes affecting some sectors in the New Zealand education system, such as the early childhood and special education sectors. An administrative mechanism called ‘contestability’ by the Treasury is used to encourage new providers to compete with services traditionally offered by the welfare state. The author argues that this introduced competition has meant women in particular, and Maori, have suffered setbacks to their progress towards better life chances.

Two models of ‘contestability’ are described and analysed in these case studies. The analyses show that the implementation of the models has been problematic and strenuously resisted by teachers and others. Teachers (and parents) are not comfortable with being thrust into the role of consumer as competition is created by the state.

Michael Apple's theory about Market Liberals reconstructing our ideas about managing inequality is used to explain the persistence of decision‐makers in the face of resistance.     

运动对糖尿病大鼠ASP影响的研究

研究运动对链脲佐菌素所致糖尿病大鼠ASP的影响。选用雄性SD大鼠，随机分为4组（每组10只），即：正常对照组，正常运动组，糖尿病模型组，糖尿病模型＋运动组。运动组进行10周的游泳训练。结果表明：1）糖尿病模型组与正常对照组大鼠相比，血浆ASP浓度、血糖、TG、和LDL明显升高，血清FFA有升高趋势，血清胰岛素和ISI明显降低；2）糖尿病模型＋运动组较其非运动组血浆ASP浓度、血糖、TG、TC、FFA和LDL明显降低，血清胰岛素和HDL含量明显升高。提示：糖尿病机体血浆ASP浓度升高，伴随着其活性下降，使得FFA和富舍TG的脂蛋白消除障碍，长期中等负荷运动可以降低血浆中ASP浓度，增加其活性，进而降低FFA和TG水平，升高HDL，改善糖尿病机体的脂质代谢，预防其慢性并发症的发生。     

Development of School Attendance Difficulties: An Exploratory Study

This article discusses aspects of school attendance difficulties, focusing on why a minority of children decide to miss school. It is an exploratory study representing a developmental approach that aims to establish the immediate determinants of school absence to gain more understanding of the nature of attendance difficulties and eventually inform practitioner methods. Questionnaires, designed to measure attitudes, perceptions and parent–child interaction over school absence were administered to two hundred and nine 12–13 year olds attending a comprehensive school. Thirty-five individual interviews were carried out with good and poor attenders to clarify the questionnaire responses. It was concluded that school attendance difficulties develop like other defiant behaviour problems, with parental reaction playing a major role. Government policies encouraging the use of punitive measures with parents of poor attenders do not provide practitioners or pastoral staff with the sophisticated working methods necessary to help poor attending children achieve an education.