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1.
OBJECTIVE: To collect and compare the results of medical, child protective, and law enforcement evaluation of a sample of Maine children who were victims of abusive head trauma (AHT) in order to describe the clinical and evaluative characteristics as they relate to victims, families and perpetrators of such trauma and to improve the professional response to AHT in Maine.METHOD: Retrospective chart review of medical, child protective, and law enforcement records of all AHT victims admitted to two tertiary care hospitals in Maine or seen by the state medical examiner from 1991 to 1994.RESULTS: Nineteen children (age range 2 weeks to 17 months) were identified as victims of AHT (out of a total of 94 head trauma admissions) accounting for 20 hospitalizations during the study period. There was a history of prior injury in 30%, history of prior medical evaluations for possibly abuse related problems in 65%, while, on presentation, 75% had evidence or history of prior injury. The hospitals notified child protective services (CPS) in all 20 cases and correctly identified abuse in 18 (90%). Parental risk factors for abuse identified in CPS records included substance abuse (53%), domestic violence (42%), criminal history (32%), unrealistic expectations (42%), and attachment problems (32%). However, risk factors were inadequately assessed in 53% of homes. Law enforcement identified a likely perpetrator in 79% of cases and in the majority the identified suspect was the father. In the 15 cases where a perpetrator was identified by law enforcement, that person was alone with the child at symptom onset in 14 (93%).CONCLUSIONS: The medical response, at least at the inpatient level, was generally well done with regard to suspicion and reporting. Cases are possibly being missed at the outpatient level. Child protective risk assessment was limited overall yet in a third of the homes where AHT occurred, few if any risk factors were present to aid in identification and prevention. Law enforcement results suggest that a primary suspect for AHT is the caretaker alone with the child at the time of symptom onset. 相似文献
2.
This study examines the effects on nursing home nurses of a two-day training program concerned with nurses and their response to the dying patient. Utilizing the Solomon four-group design, the study investigates whether exposure to information on death and dying (a) results in the acquisition of greater knowledge about death and dying, (b) is accompanied by a more positive attitude toward the elderly, and (c) is accompanied by a change in anxiety about death. Based on t tests and one-way analyses of covariance, the results point up the mixed nature of short-term training programs. It was found that there was a significant increase in the nurses' knowledge about death and dying, there was no change in their attitudes toward the elderly, and there was a significant increase among the nurses in the death anxiety experienced. This is not to suggest that training programs of this sort should not be conducted with nursing home staff. On the one hand such programs provide information useful for job performance. On the other hand they create some sensitization to death, which at the very least could give nurses greater insights into the concerns of the patients and perhaps stimulate empathetic responses. 相似文献
3.
This article describes the inter‐relationship between school organization and classroom instructional style. Two distinct models of school organization, the bureaucratic and open‐systems models, are characterized in terms of three major dimensions of school life; a. the behavior of administrators, teachers and students, b. work design and tasks, and c. space‐time allocations. It is shown that the bureaucratic model of school organization parallels, and sustains, the traditional whole‐class method of teaching in all of the three dimensions. An open‐systems model of staff organization at the school level is required to sustain an alternative form of classroom instruction such as cooperative learning. The approach presented here emphasizes the inter‐relatedness of all three dimensions of schooling at the organizational and classroom levels. It also claims that the implementation of genuine instructional change, that entails new patterns of interpersonal relations in the classroom, is contingent upon similar changes being made at the level of the school as an organization. Lack of attention to school organizational change may explain why efforts at changing instruction at the classroom level frequently fail to yield results. 相似文献
4.
Agencies and institutions dealing with the elderly have only limited time, money, and personnel with which to plan and implement educational programs. Yet a basic knowledge of aging and death and dying seems to be essential for those working with older adults. The purpose of this paper is to review the literature on short‐term educational programs on death and dying and aging in order to offer practitioners some guidance for efficiently structuring programs to bring about desired changes in these areas. From 15 selected studies, 3 aspects of such programs are reviewed and analyzed: the length of the intervention, the type of treatment, and the nature of the target group involved. 相似文献
5.
Although reminiscence is a behavior common to all ages, research to date has been conducted only with older adults. This study sought to explore the phenomenon with adults of various ages with the anticipation that comparative information would lead to a better conceptualization of the behavior and its functions. It was hypothesized that there would be no difference in what adults reminisced about, why they reminisced, or how they reminisced with respect to age, sex, education, or socioeconomic status. A sample of 309 adults ranging in age from 18 to 90 were asked to complete a survey exploring various aspects of reminiscence. Analysis of variance and chi‐square were used to assess differences in reminiscent behavior across age, sex, education, and social class. There were no systematic differences with regard to education or social class. On several dimensions sex emerged as a more important variable than age, suggesting that age may not be as important a consideration in simple reminiscence as has been previously assumed. 相似文献
6.
The information age is changing the dynamics of many relationships, including mentoring. This article defines traditional mentoring according to its function and effectiveness and then expands the definition of mentoring to include computer-mediated communication (CMC), or e-mentoring. We propose that e-mentoring holds promise for redefining mentoring relationships and changing the conditions under which mentoring is sought and offered. E-mentoring could potentially make mentoring relationships more available to groups that have previously had limited access to mentoring. Benefits of and barriers to e-mentoring are considered, as are strategies for establishing an e-mentoring relationship. E-mentoring resources are reviewed. 相似文献
7.
Teachers' instructional practice is pedagogically vulnerable when not anchored within detailed and comprehensive observation and understanding of students' immediate responses during instruction. Professional noticing ability, then, is central to, and integrated within, teachers' ability to provide instruction appropriately adapted to students' immediate needs. This article explicates a model of expert noticing for literacy instruction and relates this model to the characteristics of microadaptive teaching decisions. Characteristics, for example, that distinguish expert from less expert noticing during literacy instruction include detailed hypothesizing, breadth and depth of elaboration, observation of learners' metacognitive behavior, and identification of pivotal events. Teacher noticing ability is generally not related to years of experience, but can be learned through participation in sustained, multilevel professional development with an explicit focus on noticing ability. This complex learning integrates teachers' pedagogical and content knowledge with observation of student behaviors, and supports teachers' learning from practice. 相似文献
8.
Uday Kumar Anand Sharan Shaheena Kamal 《Indian journal of clinical biochemistry : IJCB》2003,18(2):6-7
Usually CPK, CK-MB and lactate dehydrogenase (LDH) enzymes are measured in blood during the period of myocardial infarction.
The changes in LDH assay indicates duration of the infarction.
The level of lactate dehydrogenase is 500 times greater in tissue than those found in serum. A small mass of damaged tissue
causes leakage of enzyme and increases its level in serum.
Any cause of tissue break down/hemolysis which is sufficiently severe can produce LDH pattern similar to that in myocardial
infarction.
We report this case of small bowel volvulus showing significant increase in LDH.
It may be due to tissue necrosis which increases the level of LDH in serum. 相似文献
9.
Where the meaning of life can be found, and how people make meaning in their lives are age‐old questions pursued by philosophers, clergy, psychologists and educators. More recently, there has been a focus on the role of meaning‐making in learning and development in adulthood. Several writers have proposed that meaning‐making is what adult learning is all about, and a few have explicitly linked meaning‐making activity to development. First reviewed in this article are some of the basic understandings of meaning‐making advanced by classical and contemporary writers. Next, models of cognitive and ego development that directly link with meaning‐making are examined. Finally, a model of the relationship of meaning‐making to learning and development is presented and implications drawn for applying the model to adult education practice. 相似文献
10.
As the population of older adults increases, the field of adult education needs to respond accordingly. The study reported in this paper examined motivations for learning among older adults actively engaged in formal lifelong learning. One hundred eighty-nine members of a Learning in Retirement institute were surveyed using Boshier's Education Participation Scale. Cognitive interest appeared to be the strongest motivator for learning. Social contact was the second most influential motivator. The findings of this study are consistent with, and add to, our knowledge derived from previous studies pertaining to the participation of older adults in formal learning. Recommendations for future research on older adult learning in different settings are presented. 相似文献