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121.
Recent curriculum changes at McGill University include a mandatory 4-week clerkship for third-year medical students. The basis of this clerkship is the assessment and management of frail elderly who have a combination of complex acute and chronic medical problems and functional disabilities. It includes the understanding of the need for continuity of care across settings and the transition from hospital to the community. Our main purpose is to offer students a learning experience based upon self-reflection, access to technology, interactive learning and permanent feedback. To accomplish the technological goals, didactic sessions were mostly electronic-based with two main components: web-based interactive modules that include the contents in seven web-based interactive lectures complemented with pre- and post-tests, and an electronic portfolio to assess students' acquisition of skills and attitudes. We expect that implementation of this model of clinical clerkship will prepare future physicians, not only for the practice of geriatric medicine, but also for different medical and surgical specialties, and will enhance the attitudes, knowledge, and skills practitioners need to care for older people.  相似文献   
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The purpose of this research was to determine the ways in which power relations that exist in the wider social context are played out in the teaching and learning dynamics of adult education classrooms. The research design was a qualitative comparative case study of two courses taught by the authors in a university setting. Data sources included students’ evaluations, teachers’ observations, interviews with students, interviews with both teachers, and conversations with similarly situated faculty members. The themes of mastery, voice, authority and positionality found in previous research were used to organize the results. The results showed the many complex ways in which power relations based on race, class, gender, disability and sexual orientation played out across all four themes and how these dynamics directly influenced the teaching and learning process. The positionality of the teachers and learners, in particular the racial category of whiteness, emerged as a key power relationship mediating classroom dynamics. We suggest that the facilitation model of teaching does not account well for these dynamics and that further efforts are needed to better understand how societal power relations affect teaching and learning efforts and what responses adult educators can make to negotiate these issues.  相似文献   
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Family mealtimes have the potential to promote healthy child development. This observational study of 200 family mealtimes examined the relation between child health in a group of children (ages 5 to 12) with persistent asthma and 3 dimensions of mealtime interaction: Action, Behavior Control, and Communication. Percent time spent in Action and Positive Communication varied by asthma severity, child quality of life, and sociodemographic variables. Positive communication during mealtimes predicted child quality of life. Significant interactions between demographic variables and behavior control suggested that higher levels of behavior control affected child quality of life in the context of lower maternal education. Guidance is offered for practitioners and policy makers toward promoting healthy family mealtimes as a public health priority.  相似文献   
128.

Objective

This paper presents comprehensive and up-to-date data covering 4 years of Serious Case Reviews into fatal child maltreatment in England.

Methods

Information on all notified cases of fatal maltreatment between April 2005 and March 2009 was examined to obtain case characteristics related to a systemic classification of 5 broad groups of maltreatment deaths (severe physical assaults; covert homicide/infanticide; overt homicide; extreme neglect/deprivational abuse; deaths related to but not directly caused by maltreatment).

Results

A total of 276 cases were recorded giving an incidence of 0.63 cases per 100,000 children (0-17) per year. 246 cases could be classified based on the data available. Of these the commonest specific group was those children who died as a result of severe physical assaults. Apparently deliberate overt and covert homicide was less common, while deaths as a direct consequence of neglect were rare. In contrast, some evidence of neglect was found in at least 40% of all cases, though not the direct cause of death.

Conclusions

Class characteristics differ between the different categories of death and may suggest the need for different strategies for prevention.  相似文献   
129.
This multi-method study sought to identify parameters of developmental change and stability of child reaction patterns to interparental conflict in the context of family relations in a sample of 223 6-year-old children and their parents followed over the course of one year. Consistent with the sensitization hypothesis, interparental withdrawal and hostility each consistently and uniquely predicted child distress reactions to conflict even after analytically controlling for parental warmth. Associations were found across multiple domains of child responding (i.e., overt negative affect, subjective negative affect, internal representations) and both concurrent and prospective, autoregressive analyses. Results of the autoregressive path analyses indicated moderate stability in each of the domains of conflict reactivity over the 1-year longitudinal period.  相似文献   
130.
The effects of test stimulus range on generalization gradients in humans were assessed for discriminations between faces that varied in brightness, faces that varied in orientation in the picture plane, and morphed faces. In Experiment 1, significant range effects, predicted by adaptation level theory, occurred when faces varied along the brightness or orientation dimension, but not for morphed faces. Changing the difficulty of discrimination of both training and test stimuli for Experiment 2 produced range effects in morphed faces. Experiment 3 explored training and testing stimulus factors as determinants of range effects in morphed faces. The results suggest that sufficiently biased testing ranges create shifts in response distributions (generalization gradients), and this may be amplified by using relatively difficult discriminations between training stimuli.  相似文献   
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