基于泰尔指数的辽宁卫生资源配置公平性分析

利用泰尔指数对辽宁省卫生资源配置公平性进行分析评价,其中包括医院(卫生院)床位、卫生总人员、卫生技术人员、医师和护士(师)等五项.研究结果显示,辽宁卫生资源配置的总体公平性较好,但不同经济发展水平区域卫生资源配置的公平性存在较大差异,区域间差异是导致辽宁卫生资源配置不公平的主要成因.     

区域卫生规划与卫生资源配置

区域卫生规划与卫生资源配置的关系密不可分,同时也是解决医疗保健供需平衡的重大举措和主要手段。首先提出了区域卫生规划的现实意义和基本理论,并分析了建立区域卫生规划对解决以上问题怎样产生积极的影响。     

韩国医疗保险制度对我国的启示

阐释了韩国医疗保险制度建立的背景、过程、目标和主要内容。认为其在保障公平、发挥政府部门良好的宏观调控作用,注重预防保健,使制度从分散逐步过渡到整合等方面取得了重大成就,但也存在医疗费用上涨过快、卫生资源配置不合理、私立医疗机构占比过大和过度检查等方面的问题。韩国医疗保险制度在许多方面与我国有相似之处,总结其制度建设过程中取得的经验和教训,对我国统筹城乡基本医疗保险制度具有重要的启示作用,我国尤其应注重制度设计、逐步整合城乡和加强政府的作用。     

我国乡镇卫生资源二次配置模式探讨

长期以来,我国卫生资源配置城乡不均衡的局面比较严峻,大量优质卫生资源主要积聚在大中城市,而乡镇基层医疗机构的卫生资源比较稀缺。以增加政府财政投入,引入私人资本与第三部门力量等方式来提高农村卫生资源增量势必会遇到投入缓慢、资金不足、技术瓶颈等现实障碍。通过改革公立医院,调整城市卫生资源存量,把大中城市公立医院中的富余卫生资源以二次配置方式转移到农村卫生服务机构,是破解农村卫生资源存量不足、增长缓慢的困境,提高农村卫生服务能力和水平,改善农民就医问药问题的新途径。     

我国卫生资源配置公平性的研究概况

优化卫生资源配置、提高其配置公平性,满足人们的健康需要是我国深化医药卫生体制改革的首要问题之一。利用文献计量法和内容分析法对已有科研文献的分布情况和研究现状及进展情况进行统计分析。研究发现,文献主要采用Lorenz曲线、Gini系数和Theil指数等经济学方法研究我国省级范围的卫生人力和物力资源的数量配置公平性;我国省际间、区域间和省辖市间的卫生资源配置公平性总体向合理趋势发展,配置公平性人口优于地理,卫生物力优于卫生人力。卫生资源配置公平性的研究深度和广度还需扩展,配置公平性的研究和指导有待加强。     

城乡融合视角下乡村设计路径的思考

《“十四五”新型城镇化实施方案》强调要坚持以工补农、以城带乡，以县域为基本单元、以国家城乡融合发展试验区为突破口，逐步健全城乡融合发展体制机制和政策体系。基于城乡融合时代背景，围绕乡村设计面临的问题，结合具体案例，探讨乡村设计路径，对于推进乡村振兴、城乡产业协同发展具有重要意义。     

城镇化概念解析与实践误区

不同学科对城镇化的阐释与研究的角度和侧重点不同,而城镇化本身是一个涉及人口、经济、社会以及空间的综合性概念,实践中对城镇化理解的偏差引起城镇化演进的偏差,出现"鬼城"、城市贫穷、农民工、乡村撂荒等问题。我国城镇化道路经历了改革开放前的城乡分割阶段、改革开放后以小城镇快速发展为标志的农村工业化阶段,以及尝试大中小城市协调发展的特色城镇化阶段,当前存在的显著问题是:生活方式城镇化滞后于人口城镇化、经济城镇化,且远远滞后于土地城镇化;城镇化偏差导致要素产出效率低、资源消耗多、社会问题易于发生。以人为本、城乡一体、效率提升、低碳绿色,是中国城镇化道路的新趋势。     

基于供给需求理论的老龄化人口卫生服务的探讨

运用卫生经济学理论分析我国老年人的卫生服务需求和供给、疾病经济负担及卫生费用影响的因素,探讨老年人卫生服务的特点,为老龄化社会卫生服务供给提供政策建议。老年人主要罹患慢性疾病,疾病经济负担沉重;影响老年人卫生费用增长的主要因素包括健康状况、医疗保险、城镇化等;老年人的卫生服务需求具有多样性,应针对性地提供卫生服务。通过建立慢性病的分级诊疗、分类管理制度,引导老龄患者就近就医,并通过进一步完善老年社会医疗保险制度,制定实现健康老龄化的国家战略,保证老龄社会的可持续发展。     

和谐医患环境与公民健康权的保障

在健康权保障体系中,卫生资源配置的公平与效率的失衡是导致现阶段我国公民健康权不平等的关键。而作为一级经济主体的医疗机构,在促进卫生资源配置和享用的公平性作用上,则是无效率的,因此国家应积极运用法律、政策等外部手段,实现其协调性的复位,以服务于建设和谐医患环境的需要。     

卫生资源优化配置的伦理要求

卫生资源是稀缺资源,卫生资源只有优化配置,才能达到我们的医学目的。卫生资源的优化配置的以公平为优先,坚持公平和效率相结合的原则。就目前所存在的和我们的医学目的不相适应的卫生资源配置方式的现状和主要问题进行分析,并提出了相应的改进方法。     

Extremes of self-esteem and narcissism and the experience and expression of anger and aggression

This study examined the level of self-esteem and narcissism as personality variables involved in the disposition to experience and express anger. Three hundred thirty-eight subjects were sampled across two higher education centres and one student teaching programme in the United Kingdom. It was reasoned that individuals with both high self-esteem and narcissism would report especially high tendencies to experience and express anger and aggression and that those with high self-esteem and low narcissism would report the lowest. These predictions were influenced by theories that emphasise the role of threats to high self-esteem in the production of aggression and violence. Results indicate that groups defined by their extreme scores on self-esteem and narcissism scales produced levels of anger expression in the predicted direction. The importance of considering extreme levels of self-esteem and narcissism (in conjunction with other factors) in an analysis of anger is discussed with reference to currently influential theories in the field. Aggr. Behav. 24:421–438, 1998. © 1998 Wiley-Liss, Inc.     

Face aftereffects suggest interdependent processing of expression and sex and of expression and race

Bruce and Young (1986) proposed that functionally different aspects of faces (e.g., sex, identity, and expression) are processed independently. Although interdependent processing of identity and expression and of identity and sex have been demonstrated previously, evidence for interdependent processing of sex and expression is equivocal. Using a visual adaptation paradigm, we show that expression aftereffects can be simultaneously induced in different directions along anger–fear continua for male and female faces (Experiment 1) and for East Asian and Black African faces (Experiment 2). These findings for sex- and race-contingent expression aftereffects suggest that processing of expression is interdependent with processing of sex and race and are therefore problematic for models of face perception that have emphasized independent processing of functionally different aspects of faces. By contrast, our findings are consistent with models of face processing that propose that invariant physical aspects of faces and changeable social cues can be processed interdependently.     

Values and Beliefs of Vegetarians and Omnivores

Abstract

Following the claim by some anthropologists and sociologists that 1 symbolic meaning of meat is a preference for hierarchical domination (C. J. Adams, 1990; N. Fiddes, 1989; D. D. Heisley, 1990; J. Twigg, 1983), the authors compared the values and beliefs of vegetarians and omnivores in 2 studies conducted in New Zealand. They compared the full range of vegetarians and omnivores on right-wing authoritarianism, social dominance orientation, human values, and consumption values. The participants tending toward omnivorism differed from those leaning toward veganism and vegetarianism in 2 principal ways: The omnivores (a) were more likely to endorse hierarchical domination and (b) placed less importance on emotional states. Accordingly, the acceptance or rejection of meat co-varied with the acceptance or rejection of the values associated with meat; that finding suggests that individuals consume meat and embrace its symbolism in ways consistent with their self-definitions.     

Recognition of faces of ingroup and outgroup children and adults

People are often more accurate in recognizing faces of ingroup members than in recognizing faces of outgroup members. Although own-group biases in face recognition are well established among adults, less attention has been given to such biases among children. This is surprising considering how often children give testimony in criminal and civil cases. In the current two studies, Euro-Canadian children attending public school and young adults enrolled in university-level classes were asked whether previously presented photographs of Euro-American and African American adults (Study 1) or photographs of Native Canadian, Euro-Canadian, and African American children (Study 2) were new or old. In both studies, own-group biases were found on measures of discrimination accuracy and response bias as well as on estimates of reaction time, confidence, and confidence-accuracy relations. Results of both studies were consistent with predictions derived from multidimensional face space theory of face recognition. Implications of the current studies for the validity of children's eyewitness testimony are also discussed.     

颅内动脉瘤的诊断、治疗时机及方法

分析颅内动脉瘤各种常用诊断方法的价值以及治疗时机和方法,认为对颅内动脉瘤应该在准确、快速诊断的基础上,按照安全、有效、经济的原则进行治疗。     

Focus of attention and causal attributions of actors and observers

An experiment was conducted to test the hypothesis that actors' and observers' causal attributions are a function of their focus of attention. In the presence of observer-subjects, actor-subjects made a choice among several art works in a supposed decision-making study. The experiment was a 2 × 2 × 2 factorial design with the factors (1) source of attribution (actors, observers); (2) camera (actor videotaped, actor not videotaped); and (3) situational stability (stable, dynamic environment). As predicted by the focus of attention-causal attribution notion, it was found that actors attributed more causality to the situation than observers under normal circumstances, when the camera was not operative, but that videotaping the actor reversed the usual actor-observer pattern such that actors attributed less causality to the situation than did observers. Further, when the environment was stable, actors attributed more causality to the situation in the no camera condition than in the camera condition, while observers attributed less to the situation in the no camera conditions than in the camera conditions. Additionally, both actors and observers attributed more causality to the situation when the environment was dynamic than when the environment was stable.     

整合临床医学的必要性、可行性及途径——以睡眠呼吸暂停防控为例

长期以来以专科划分为主的医疗发展方式确实促进了现代医学的进步.然而,人是一个整体不应该被割裂对待.所以,这种医学发展趋势应该加以控制,否则必然会阻碍医学事业的健康发展.另外,如果只关注局部治疗想要取得突破已经越来越难.因此,整合临床医学势在必行.本文分别从阻塞性睡眠呼吸暂停的病因、临床表现(包括合并症)及诊断和治疗三个方面阐述了只有全面进行医学整合才能提高阻塞性睡眠呼吸暂停的整体防控水平.     

理论思维、工程思维、评价思维的界定与联系——谈对缺血性脑血管病临床实践若干问题的思考

理论思维是力求逻辑自恰、规避自相矛盾;工程思维是对逻辑地发现的属性进行非逻辑的复合;评价思维是虚体思维和筹划因素相分离所导致的思维方式。理论思维的成果必须通过工程思维付诸实践,评价思维是对实践的结果进行评价,评价的结果是对工程思维或/和理论思维的成果进行反思。对缺血性脑血管病实践中的理论思维、工程思维和评价思维的界定与相互联系进行探讨。     

Human Dignity and the Ethics and Aesthetics of Pain and Suffering

Inasmuch as unmitigated pain and suffering areoften thought to rob human beings of theirdignity, physicians and other care providersincur a special duty to relieve pain andsuffering when they encounter it. When pain andsuffering cannot be controlled it is sometimesthought that human dignity is compromised.Death, it is sometimes argued, would bepreferred to a life without dignity.Reasoning such as this trades on certainpreconceptions of the nature of pain andsuffering, and of their relationships todignity. The purpose of this paper is to laybare these preconceptions. The duties torelieve pain and suffering are clearly mattersof moral obligation, as is the duty to respondappropriately to the dignity of other persons.However, it is argued that our understanding ofthe phenomena of pain and suffering and theirrelationships to human dignity will be expandedwhen we explore the aesthetic dimensions ofthese various concepts. On the view presentedhere the life worth living is both morally goodand aesthetically beautiful. Appropriate``suffering with' another can help to maintainand restore the dignity of the relationshipsinvolved, even as it preserves and enhances thedignity of patient and caregiver alike.