11,145 research outputs found

    Professional issues in maternal mental health scale (PIMMHS): The development and initial validation of a brief and valid measure

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    Introduction:The life-threatening consequences of perinatal mental health problems (PMHP) are well documented. Midwives are ideally placed to effectively identify women at risk and facilitate early intervention. However, a multitude of factors contribute to failure in recognition and treatment. It would be of value for service providers to be able to identify key professional issues in their own context. The present study sought to develop and evaluate a ‘professional issues in maternal mental health’ scale (PIMMHS), explore its psychometric properties and potential application.Methods:A cross-sectional design and instrument evaluation approach was taken to investigate the psychometric properties of the PIMMHS. A total of 266 student midwives from 10 UK institutions completed the PIMMHS via Survey Monkey.Results:PIMMHS comprises two sub-scales of emotion/communication (PIMMHSEmotion sub-scale) and training (PIMMHS-Training sub-scale). Both PIMMHS subscales demonstrate adequate divergent and convergent validity. Sub-optimal internal consistency was observed for the training sub-scale, however, the PIMMHS-Training had a more impressive effect size in terms of known-groups discriminant validity compared to PIMMHS-Emotion.Conclusions:The PIMMHS appears to be a sound psychometric instrument for assessing professional issues that influence the practice of student midwives in PMH. The PIMMHS could support education providers to identify areas for curriculum development, as well as maternity services in proactive assessment of service provision, to identify training and service development opportunities

    House Prices, Disposable Income, and Permanent and Temporary Shocks

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    This paper specifies a two-variable system of house prices and income for N.Z., U.K. and the U.S., covering periods from 1973:4 through 2008:2. The analysis allows the identification of differences in house priceincome relationships over sub-periods and, using an SVAR approach, compares the responses of house prices when faced with permanent and transitory shocks to income. It continues by decomposing each historical house prices series into their permanent, temporary and deterministic components. Our results suggest that while real house prices have a long-run relationship with real income in all three economies, the responsiveness of house prices to innovations in income will vary over both time and markets depending on whether the income disturbances are viewed as permanent or temporary. The evidence suggests that N.Z. and U.K. housing markets are sensitive to both permanent and transitory shocks to income while the U.S. market reacts to temporary shocks with the permanent component having a largely insignificant role to play in house price composition. In N.Z. the temporary component of house prices has tended to be positive over time, pushing prices higher than they would have been otherwise while in the U.K. both permanent and temporary components have tended to reinforce each other. Overall, there is no clear consistent global pattern regarding the importance of these shocks which implies that housing markets will react differently to the vagaries of global and domestic economic activity driving such shocks

    The development and initial validation of the Perinatal Mental Health Awareness scale in student midwives

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    Background & aim: Perinatal mental health problems have been demonstrated to impact upon maternal, and fetal/child outcomes. Despite the global evidence and a policy-driven responsibility for identification of these problems, research demonstrates that student midwives/midwives lack knowledge and confidence to assess, identify, and manage them. A similar context is evident for learning disabilities, despite the holistic care philosophy of midwifery. A brief assessment tool to identify knowledge and confidence defecits and strengths within a holistic care framework could support curriculum development. This study sought to develop a Perinatal Mental Health Awareness scale and evaluate its psychometric properties in student midwives.Methods: We employed a cross-sectional and exploratory instrument development and evaluation design to determine the measurement veracity of the new scale.Results: The scale demonstrated good psychometric properties, revealing three subscales mapping onto (i) mental health symptoms, (ii) physical/medical issues and (iii) learning disability. Results indicated a clear differentiation in scores across the subscales, indicating comparative deficits in mental health domains.Conclusion: Our findings facilitate confidence in the psychometric robustness of the measure. The scale enables student midwives to assess and compare different domains of midwifery practice, in line with a holistic model of midwifery care. A focus on physical health in midwifery education appears to disadvantage knowledge and confidence for managing mental health problems in a midwifery context. This valuable finding highlights the potential need for curriculum rebalancing. The measure offers the opportunity to assess and develop curriculum/training provision and monitor the effectiveness of subsequent curricular developments

    Palestinian Refugees in Gaza

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    Events since Arthur Helton\u27s death - including the change in leadership of the Palestinian Authority and the Israeli proposal for disengagement from Gaza make it even timelier to examine some practical solutions. For improving Palestinian lives in the short term, much can be learned from the approaches taken in other refugee situations. This Article begins with background information on Palestinian refugees in Gaza. It then discusses Israeli plans for disengagement from Gaza. In the following section, the Article reviews options for addressing the problems faced by Palestinian refugees in Gaza, utilizing the broader literature devoted to the integration of refugees and displaced persons in post-conflict and post-occupation societies. It concludes with an agenda of action for the international community, Palestinian Authority, and Israel

    Claims-Made and Reported Policies and Insurer Profitability in Medical Malpractice

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    The liability crisis of the 1970s led to the introduction of a new type of insurance policy designed, according to Doherty (1991), to reduce the un-diversifiable uncertainty associated with writing long-tail liability lines. These new claims-made and reported policies gained favor in place of the traditional occurrence coverage in the early eighties not only in medical malpractice, but also in the general liability arena. Under occurrence coverage, a loss incurred in a given year is covered by the contract for that year, regardless of when the claim is reported. In contrast, a claims-made policy pays only the claims reported in the policy year. Our paper presents a structure, conduct, and performance analysis Ă  la Joskow (1973) of the medical malpractice insurance industry by focusing on the differences between the two contracts. The main question we want to address is why there are two types of contracts that cover the same risk exposure in the medical malpractice insurance industry whereas in other lines of insurance, only one exists primarily. La crise de la responsabilitĂ© civile des annĂ©es 70 a menĂ© Ă  la crĂ©ation d’un nouveau type de contrat d’assurance qui avait pour but, selon Doherty (1991), de rĂ©duire le risque systĂ©matique associĂ© aux polices d’assurance Ă  longue durĂ©e. Ces contrats CMR (Claims-Made and Reported) ont obtenu la faveur du public dans les annĂ©es 80 particuliĂšrement pour ce qui est de l’assurance de la responsabilitĂ© civile des professionnels de la mĂ©decine. Nous prĂ©sentons ainsi une Ă©tude de la structure et de la performance de l’industrie de l’assurance de la responsabilitĂ© civile des professionnels de la mĂ©decine en mettant en relief les deux types de contrats dans ce marchĂ©. La question Ă  laquelle nous voudrions ultimement rĂ©pondre est la suivante : pourquoi dans le marchĂ© de l’assurance de la responsabilitĂ© civile des professionnels de la mĂ©decine retrouvons-nous les deux types de contrats alors qu’un seul type est gĂ©nĂ©ralement offert dans les autres marchĂ©s?medical malpractice insurance, industry structure and performance analysis, claims-made contracts, assurance de la responsabilitĂ© civile des professionnels de la mĂ©decine, analyse de la structure et de la performance de l’industrie, contrats CMR

    Yup’ik Language Assistance Tribal Outreach: Report to the Alaska Division of Elections

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    The Division of Elections contracted with the Institute of Social and Economic Research (ISER) at the University of Alaska Anchorage to help develop a network of key tribal organization and village representatives in the Bethel census area to work with the division on their Yup’ik language assistance program. The division asked ISER to help them communicate with tribes about the division’s current programs and to document additional ways that the division can improve its language assistance program. The Alaska Division of Elections is required under the Federal Voting Rights Act (VRA) to provide language assistance to voters in areas where more than 5% of the voting age citizens are members of a single-language minority and are limited English proficient. In July 2008, a federal court ordered the division to take the following remedial actions, many of which the division had already taken prior to the court order: 1. Provide mandatory poll worker training. 2. Hire a language assistance coordinator fluent in Yup'ik. 3. Recruit bi-lingual poll workers or translators. 4. Provide sample ballots in written Yup'ik. 5. Provide pre-election publicity in Yup'ik. 6. Ensure the accuracy of translations. 7. Provide a Yup'ik glossary of election terms. 8. Submit pre-election and post-election reports. Although the division has a Yup’ik language assistance program and has been addressing the court order, interviews with Bethel census area residents show that some people are unaware of the elements in the division’s language assistance plan. In addition, some Bethel area residents said they feel the election workers and the division should interpret the meaning of the ballot measures and explain the positions of the various candidates—activities that are forbidden by state statute. ISER agreed to help the division address this lack of awareness and the misconceptions about their programs by contacting tribal organizations and inviting them to attend a meeting in Bethel, Alaska, on May 27, 2009. Part I of this report, issued in July 2009, describes ISER’s contacts with tribal organizations and summarizes the comments and feedback from the participants at the election outreach meeting in Bethel. Part II describes ISER’s post-meeting contacts with tribal organizations and meeting participants and summarizes their responses to the post-meeting survey.Alaska Division of ElectionsIntroduction / Part I: Pre-Meeting Comments and Meeting Summary / Part II: Post-Meeting Feedback / Appendix A: ISER Script for Pre-Meeting Contact / Appendix B: ISER Letter of Invitation to Tribal Organizations / Appendix C: ISER Letter of Invitation to PLaintiff Tribral Organizations / Appendix D. List of Participants - Bethel Election Outreach Meeting / Appendix E: Agenda - Bethel Election Outreach Meeting / Appendix F: Pre-Meeting Interview Responses / Appendix G: Post-Meeting Letter to Tribes / Appendix H: Post Meeting Survey / Appendix I: Post-Meeting Interview Summar