依法行政加强药品监督管理

贯彻《行政许可法》，依法加强药品监督管理，其根本目的是保证药品质量，保障人民用药安全有效。必须加强药监队伍建设，树立公正执法形象，构建健康有序的药品市场，实现药品监督执法的规范化、法治化。     

Child protection workers dealing with child abuse: The contribution of personal,social and organizational resources to secondary traumatization

The present study compared secondary traumatization among child protection social workers versus social workers employed at social service departments. In addition, based on Conservation of Resources (COR) theory, the study examined the contribution of working in the field of child protection as well as the contribution of background variables, personal resources (mastery), and resources in the workers’ social and organizational environment (social support, effectiveness of supervision, and role stress) to secondary traumatization. The findings indicate that levels of mastery and years of work experience contributed negatively to secondary traumatization, whereas exposure to child maltreatment, trauma history, and role stress contributed positively to secondary traumatization. However, no significant contribution was found for social support and effectiveness of supervision. The study identifies factors that can prevent distress among professionals such as child protection workers, who are exposed to the trauma of child abuse victims. Recommendations are provided accordingly.     

Exploring policies for the reduction of child physical abuse and neglect

Policies can be powerful tools for prevention given their potential to affect conditions that can improve population-level health. Given the dearth of empirical research on policies’ impacts on child maltreatment, this article (a) identifies 37 state policies that might have impacts on the social determinants of child maltreatment; (b) identifies available data sources documenting the implementation of 31 policies; and (c) utilizes the available data to explore effects of 11 policies (selected because they had little missing data) on child maltreatment rates. These include two policies aimed at reducing poverty, two temporary assistance to needy families policies, two policies aimed at increasing access to child care, three policies aimed at increasing access to high quality pre-K, and three policies aimed at increasing access to health care. Multi-level regression analyses between within-state trends of child maltreatment investigation rates and these 11 policies, controlling for states’ childhood poverty, adults without a high school diploma, unemployment, child burden, and race/ethnicity, identified two that were significantly associated with decreased child maltreatment rates: lack of waitlists to access subsidized child care and policies that facilitate continuity of child health care. These findings are correlational and are limited by the quality and availability of the data. Future research might focus on a reduced number of states that have good quality administrative data or population-based survey data on child maltreatment or reasonable proxies for child maltreatment and where data on the actual implementation of specific policies of interest can be documented.     

Understanding forearm fractures in young children: Abuse or not abuse?

This retrospective study describes the characteristics and mechanisms of forearm fractures in children <18 months adding to the evidence-base about forearm fractures. It also examines which features of forearm fractures in young children may help discriminate between abusive and noninflicted injuries. Electronic medical records were reviewed for eligible patients evaluated between September 1, 2007 and January 1, 2012 at two children's hospitals in Chicago, IL. The main outcome measures were the type of fracture and the etiology of the fracture (abuse versus not abuse). The 135 included patients sustained 216 forearm fractures. Most were buckle (57%) or transverse (26%). Child protection teams evaluated 47 (35%) of the patients and diagnosed 11 (23%) as having fractures caused by abuse. Children with abusive versus non-inflicted injuries had significant differences in age (median age 7 versus 12 months), race, and presence of additional injuries. Children with abusive forearm fractures often presented without an explanation or a changing history for the injury. Children with non-inflicted forearm fractures often presented after a fall. No particular type of forearm fracture was specific for child abuse. Any forearm fracture in a young child should be evaluated with special attention to the details of the history and the presence of other injuries. Young age, additional injuries, and an absent or inconsistent explanation should increase concern that the fracture was caused by child abuse.     

Practitioner and communities’ awareness of CALFB: Child abuse linked to faith or belief

This paper reports the results of an online survey which aimed to explore practitioners’ and faith community groups’ awareness and understanding of child abuse linked to faith or belief (CALFB) and to identify their further training needs in this area. The survey was founded in the work of the National working group for CALFB; a multi-agency response group committed to raising knowledge and awareness of this form of child abuse. Despite the relatively small number of recorded cases, CALFB continues to be a matter of concern to professionals and faith communities in the UK and beyond. One thousand three hundred and sixty two respondents comprising of frontline practitioners, faith and community group members completed the survey. A mixed-method analysis of the survey data illustrates a wide-ranging understanding of the term CALFB and disagreement about whether this is a specific form of child abuse. The results also indicate a relationship between confidence levels in identifying and responding to CALFB and specific training in this area. There is a call for specialised training to be more readily available. Further work is needed to develop a toolkit, which identifies indicators of CALFB and effective response pathways together with research across communities. The current research is timely and important in providing a foundation on which to build more effective identification of cases, policy and intervention.     

What factors increase Dutch child health care professionals’ adherence to a national guideline on preventing child abuse and neglect?

Guidelines to support health care professionals in early detection of, and responses to, suspected Child Abuse and Neglect (CAN) have become increasingly widely available. Yet little is known about professionals’ adherence to these guidelines or the determinants that affect their uptake. This study used a cross-sectional design to assess the adherence of Dutch Child Health Care (CHC) professionals to seven key activities described in a national guideline on preventing CAN. This study also examined the presence and strengths of determinants of guideline adherence. Online questionnaires were filled in between May and July 2013 by 164 CHC professionals. Adherence was defined as the extent to which professionals performed each of seven key activities when they suspected CAN. Thirty-three determinants were measured in relation to the guideline, the health professional, the organisational context and the socio-political context. Bivariate and multivariate regression analyses tested associations between determinants and guideline adherence. Most of the responding CHC professionals were aware of the guideline and its content (83.7%). Self-reported rates of full adherence varied between 19.5% and 42.7%. Stronger habit to use the guideline was the only determinant associated with higher adherence rates in the multivariate analysis. Understanding guideline adherence and associated determinants is essential for developing implementation strategies that can stimulate adherence. Although CHC professionals in this sample were aware of the guideline, they did not always adhere to its key recommended activities. To increase adherence, tailored interventions should primarily focus on enhancing habit strength.     

Coordinating multiple representations of polynomials: What do patterns in students' solution strategies reveal?

We investigate the strategies used by 64 advanced secondary mathematics students to identify whether a given pair of polynomial representations (graphs, tables, or equations) corresponded to the same function on an assessment of coordinating representations. Participants also completed assessments of domain-related knowledge and background skills. Cluster analysis of strategies by representation pair revealed patterns in the participants' strategy use. Two clusters were identifiable on tasks that required matching equations to graphs and graphs to tables. We identified overlap between these two clusters, suggesting that while the representation pair influenced strategy choice, there was also a general distinction between students who used more and less sophisticated strategies. However, students who used more sophisticated coordination strategies were similar to the others on measures of domain-specific knowledge or background skills. We consider implications for future investigations testing interventions to promote coordinating representations.     

女大学生瑜伽练习中呼吸运用的现状与分析

在高校体育选修课程中,瑜伽通过调吸调身调心,达到身心灵合一的境界,受到众多女大学生的欢迎和喜爱,而在教学过程中,学生普遍存在一些有关呼吸方面的困惑。针对这一问题的现状进行简单分析,提出解决方案,希望对以后的教学工作有一定的指导意义。     

Community differences in the implementation of Strong Communities for Children

In 1993, the U.S. Advisory Board on Child Abuse and Neglect recommended a neighborhood-based strategy to prevent child abuse and neglect. The Board further recommended the development of Prevention Zones to allow for testing of the effectiveness of community-wide child protection efforts in neighborhoods of differing population density, ethnic and cultural composition, and social and economic resources. Following the Board's recommendation, this article presents the results of a trial of the effectiveness of a neighborhood-based strategy in low- and high-resource communities. Using management, survey, and administrative data, the research showed that both community types experienced declines in founded cases of and injuries suggesting child maltreatment for children under age 5. Low-resource communities experienced greater levels of mobilization, as measured by community and institutional engagement, and a greater number of positive outcomes related to changes in the quality of life for families and community norms relative to child and family well-being. In particular, the low-resource communities experienced the largest increases in receiving help from neighbors, neighboring, perceived household safety for neighborhood children, and observed positive parenting. High-resource communities experienced greater increases in intermediate outcomes related to self-reported parenting practices. The findings suggest that, ultimately, community mobilization can occur and be an effective means of preventing child maltreatment across community types. It appears, however, that community mobilization may play a more significant role in low-resource communities.