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181.
182.
Leslie LK Raghavan R Hurley M Zhang J Landsverk J Aarons G 《Child abuse & neglect》2011,35(5):333-342
Objectives
Public Law (P.L.) 110-351, the “Fostering Connections to Success Act,” calls for state child welfare agencies to partner with Medicaid and pediatric experts to provide planning and oversight regarding the provision of health and mental health services, including medication, to children in state custody. Recent reports, media cases, and class action lawsuits suggest over-use of psychotropic medications to address the behavioral needs of children in the child welfare system. We examined geographic variability in psychotropic medication use across US child welfare agency catchment areas to determine how rates of psychotropic medication use vary in relation to child, community, child welfare, and health system-level factors.Methods
Cross-sectional analysis of Wave 1 data for the 92 child welfare catchment areas participating in the National Survey of Child and Adolescent Well-being, a random probability sample of 2,504 children ages 2-15 years undergoing investigation for abuse and neglect. We employed multilevel regression modeling to examine the impact of catchment-level variables on medication use, controlling for child-level variables.Results
Fifteen percent of children reported taking psychotropic medications. Rates of medication use across catchment areas ranged widely from 0 to 40%, a 40-fold difference. On multi-level logistic regression modeling, older age (p < .001), male gender (p < .001), emotional and behavioral problems (p < .001), and insurance (p = .05) were associated with psychotropic medication use at the child-level. At the catchment-level, stressful environment within the child welfare system was negatively associated with medication use. No other catchment-level variables examined were found to explain use.Conclusions
Striking disparities in medication use exist across catchment areas in this national sample. Of the catchment variables examined, only stressful environment was related to medication use.Practice implications
These findings highlight significant geographic variation in medication use that most likely reflect both under-use and over-reliance on psychotropic medication. The link between child welfare environment and medication use suggests the influence of systemic, as opposed to clinical, causes of variation in medication use. This requires greater implementation of organizational processes governing quality of care for this highly vulnerable population. 相似文献183.
Step 6: does not routinely employ practices, procedures unsupported by scientific evidence: the coalition for improving maternity services: 下载免费PDF全文
Step 6 of the Ten Steps of Mother-Friendly Care addresses two issues: 1) the routine use of interventions (shaving, enemas, intravenous drips, withholding food and fluids, early rupture of membranes, and continuous electronic fetal monitoring; and 2) the optimal rates of induction, episiotomy, cesareans, and vaginal births after cesarean. Rationales for compliance and systematic reviews are presented. 相似文献
184.
A sample of 187 female students, attending a sixth‐form study day on religious studies, completed a questionnaire containing four scales concerned with assessing: attitude towards theistic religion, attitude towards science, scientism and creationism. The data demonstrated a negative correlation between attitude towards religion and attitude towards science. However, this negative correlation was transformed into a positive correlation after taking into account individual differences in the students’ views about scientism and creationism. The implications of this finding are discussed in the context of the increasing support within society for the teaching of alternatives to evolution within the science curriculum. The authors argue both that it is important to challenge scientism by developing a better understanding of the role and limits of scientific methods, and that religious belief about creation should be recognised as essentially a claim about the ontological dependence of nature rather than about the details of its origins and development. 相似文献
185.
Leslie Robinson 《Journal of Further & Higher Education》2016,40(4):466-485
This study used grounded theory methodology to investigate whether learning in a problem-based learning (PBL) group was influenced by student demographic diversity. Data comprised observations, in the form of video footage, of one first-year PBL group carried out over the period of an academic year, along with student interviews. Using the concepts of ‘face’ and face-threatening acts to critically explore student interactions, it appeared that inter-generational issues could reflect and create positions of power. At interview, all individuals constructed themselves as similar to or different from others in the group first and foremost by age, suggesting this is a primary concern for students. The data also highlighted many occasions, linked to generational difference, where students failed to share knowledge and experiences or to engage critically in deep exploratory learning. This finding has not been reported previously in the PBL literature. 相似文献
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187.
P. C. B. Saul B. Robinsohn J. J. Grant David C. Thomas Franz Hilker George W. Parkyn Urban Dahllöf Gilbert F. Peaker Kurt Spangenberg S. Leslie Hunter Gilbert de Landsheere M. J. Langeveld 《International Review of Education/Internationale Zeitschrift für Erziehungswissenschaft/Revue internationale l'éducation》1965,11(4):492-508
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189.
ABSTRACT The Klarchek Information Commons is a collaboration between Loyola University Libraries and Information Technology Services (ITS). The Information Commons has been open almost 2 years and was in the planning stages for almost 2 years before its grand opening in January 2008. During that period the library and ITS have learned how to work together to successfully operate this new service hub on campus. In this article, the authors look at the challenges faced by the two groups and how they resolved problems and faced the challenges inherent in running a large, complex, service-oriented organization. 相似文献
190.
Leslie McMurtry 《Journal of Radio & Audio Media》2017,24(2):270-288
Imagery generation in dramatized audio drama is still poorly understood with the majority of work having been done from a radio advertising perspective. This study sought to understand audio drama imagery generation by using teenage listeners. The study demonstrated that teenagers can follow purely auditory narrative with ease and can generate unique and vivid imagery through aural dramatic stimulation. The study also showed that listening in the dark and as a group are appealing for audiences. 相似文献