网络环境下医患关系的新变化及其改善对策

从正反两方面详细剖析了网络环境的发展给医患关系带来的影响,并分析了医患关系产生的新变化,针对这些影响和变化,提出培养适应网络时代的医务工作者、利用好网络环境双刃剑、不断完善网络医疗信息环境建设、借助网络媒体促进和谐医患关系等改善网络环境下医患关系的策略。     

网络舆论对医患关系的负面影响及应对

网络舆论具有突发突变、扩散迅速,主体多元、难以管控,理性不足、跟风明显等特点.在发挥监督作用的同时,其负面效应也日益显现.网络舆论对医患关系的负面影响,表现为以偏概全,丑化了医生群体的形象;先入为主,削弱了医患之间的信任;争相效仿,加剧了医患之间的冲突.基于此,医方应成立专门机构,应对网络危机;主动与媒体沟通,争取舆论导向;加强网上互动,增进医患了解;从而最大限度减少或消除医患间的误解,改善医患关系.     

网络医疗发展带来的法律问题

随着网络技术迅速发展,网络医疗以其方便快捷,患者足不出门便可得到一流的医院、最优秀的医生、最先进的医疗服务等,这些深受患者青睐。网络医疗对医学发展将起到不可低估的作用。然而网络医疗在其发展的同时,也存在一些不可忽视的问题。网络医疗在改变传统医患关系模式的同时也带来了一系列诸如保障患者隐私权、保护知识产权、法律关系改变等新的法律问题。这些问题不解决,对网络医疗健康发展,对医患合法权利保护等都会带来不利影响,针对这一系列问题展开论述,提出解决问题的办法。     

网络医疗发展带来的法律问题

随着网络技术迅速发展,网络医疗以其方便快捷,患者足不出门便可得到一流的医院、最优秀的医生、最先进的医疗服务等,这些深受患者青睐.网络医疗对医学发展将起到不可低估的作用.然而网络医疗在其发展的同时,也存在一些不可忽视的问题.网络医疗在改变传统医患关系模式的同时也带来了一系列诸如保障患者隐私权、保护知识产权、法律关系改变等新的法律问题.这些问题不解决,对网络医疗健康发展,对医患合法权利保护等都会带来不利影响,针对这一系列问题展开论述,提出解决问题的办法.     

网络空间医患话语权失衡现象的探讨

近年来,医患关系一直是网络舆论的热点和焦点,作为医患关系的主客体--医方和患方之间在网络话语权方面则出现了严重失衡.通过透视2009年两起代表性医疗事件"南平医闹事件"和"南京徐宝宝事件"在网络空间的话语权表达状况,来解读互联网时代下的网络空问对医患关系的现实影响.     

门诊服务接触质量对医患关系质量影响机理研究

从服务接触视角,构建了门诊服务质量对医患关系质量影响机理模型。对410名门诊患者的问卷调查的结果显示:有形环境接触和服务系统接触均对医患关系质量中患者满意因子产生显著正向影响,而对医患关系质量中的患者信任因子无直接影响,但会通过患者满意间接影响患者信任;医务人员接触对医患关系质量具有显著正向影响,且对患者信任因子的影响强度略高于患者满意因子;医务人员接触对医患关系质量的影响强度最大,其次为服务系统接触,再次为有形环境接触。     

网络环境下高校学生管理工作研究

互联网的快速发展给在校大学生提供了更加便捷的信息获取方式,开辟了新的师生交流平台,特别是QQ、微信、微博等网络社交平台,突破了传统的人际交往方式。网络已融入大学生生活的各个方面,全方位影响着大学生的的思维方式、行为模式、价值取向和道德素养等,在网络给高校学生管理工作带来机遇的同时,也带来了更加严峻的挑战。面对网络环境给高校学生带来的诸多影响,高校学生工作管理者必须要把握机会,转变思想,顺应变化,积极探索网络环境下学生管理工作的新方法,从而切实提高对在校大学生的管理水平。     

医疗保健政策与医患关系

医疗保健政策深刻地影响着医患关系,并左右着医患关系的发展与变化.在实行"以公平为主,兼顾效益"的福利性的医疗保健政策时期,我国的医患关系是和谐的.但自从医疗保健政策向"经济导向型"方向转变之后,国家大幅度减少了对卫生事业的投入,医院必须从病人身上取得卫生发展必要的资金,医药费用上涨是必然的,也失去了公平和公正,并最终导致医患关系的恶化.调整医患关系不能仅从医、患两方面着手,建立符合医学伦理的卫生政策,才是问题的关键.     

行为主义交换论视角下的医患冲突问题思考

医患冲突已成为无法避免的社会问题,引起了社会各界的高度重视。医患关系实质上是一种以医患双方的投入和回报为内容的互惠性的交换关系。医生与患者周围的相关环境也会给予其刺激,影响其行为。运用行为主义交换论中的公平性原则、成本报酬、交换等理论,从经济利益和情感利益的角度对医患关系进行分析。运用行为主义交换理论对医患冲突问题进行分析具有理论上的可行性与实践上的应然性。基于行为主义交换论的分析框架,考虑相关环境的刺激,并辅之以麦金泰尔的内在利益理论对医患冲突产生的原因进行分析。     

医患关系的特征及现状分析

医生与患者,施治与被治表征的医患关系在任何国家社会中都是人际关系的特殊表现形式,是社会人文科学与环境发展的重要线索。医患关系状况如何从一个方面反映国家政治、经济、科学、文明与道德等项方面的综合发育程度,并受这些因素的影响,决定医患关系的最终相互作用结...     

Age-related differences in attentional networks of alerting and executive control in young, middle-aged, and older Chinese adults

Previous studies suggest that aging is associated with impairment of attention. However, it is not known whether this represents a global attentional deficit or relates to a specific attentional network. We used the attention network test to examine three groups of younger, middle-aged, and older participants with respect to the efficiency of three anatomically defined attentional networks: alerting network, orienting network, and executive control network. Age-related change was found to have the greatest effect on the executive network and the least effect on the alerting network as well as on overall mean response time. Impairment of the orienting network was found to be insignificant. Age-related deterioration of the prefrontal lobe, the dopaminergic system, and function of specific genes may explain the age-related changes in executive attention, which occur after the fourth decade of life.     

注意网络间的关系及其心理与生理机制

Posner和Petersen把注意系统分为警觉、定向和执行控制三个网络。注意网络测验及其变式是研究注意网络间关系的主要工具。生物化学、神经影像和行为研究从神经递质广泛调节、脑功能区共享、注意资源竞争和认知策略调节的角度证明了三个注意网络之间既相互独立又有机统一的关系。测量信度低、定义模糊成为注意网络及其关系的研究中亟待解决的问题。将来的研究需要改进测量工具, 并考虑注意网络的子成分对网络间关系的影响。     

A network conceptualization of the multiple facets of distress tolerance

ABSTRACT

Background and Objectives: Using a network analysis (NA) approach, the current study examined the relations among different facets of Distress Tolerance (DT). The NA approach quantifies and displays relations among variables in a visual network consisting of nodes (symptoms) and edges (partial correlations between symptoms). Design: An exploratory NA approach evaluated how manifestations of DT uniquely and systematically relate to one another. Methods: Undergraduate students (N?=?288) completed 10 commonly used measures of DT including cognitive, behavioral, and self-report measures. Results: Results indicated all relations in the network were positive apart from social sensitivity and suppression. Further, individual DT facets did not form distinct community structures (nodes that cluster together and thus have stronger relations with each other than other nodes in the network). Conclusions: The lack of community structures suggests that DT is a general ability to tolerate distress that is comprised of many different facets rather than the idea that DT is hierarchical and comprised of distinct domains; a current debate within the literature. The self-reported ability to tolerate life demands and tasks was the most influential facet in the overall network suggesting the Frustration Discomfort Scale may be the best global measure of DT.     

心理病理学网络理论、方法与挑战

对于精神障碍这一概念的理解, 传统DSM-ICD分类诊断系统和研究领域标准RDoC均基于潜变量视角, 认为精神障碍的症状由其潜在共同原因所致。这2种观点都忽略了症状间的相互作用。不同于分类和维度视角, Borsboom在2008年对精神障碍的概念化提出了的全新视角——心理病理学网络理论。此理论的核心观点是症状之间的动态因果关系构成了精神障碍。基于心理病理学网络理论的网络分析方法, 主要以结合EBIC的glasso算法估计症状间的偏相关网络, 并通过网络中节点中心性与网络连接性等指标, 来考查精神障碍症状的不同特性。近几年来, 研究者发现心理病理学网络分析方法在对症状间因果关系的推断、核心症状的识别和网络结构的可靠性与可重复性方面仍面临一些挑战。这些挑战为心理病理学网络理论与方法指明了未来可能的发展方向。     

反刍思维的脑功能网络机制

反刍思维是指个体在经历了消极生活事件后不由自主地反复思考该事件的产生原因、经过和结果, 表现出负性自我参照加工、消极情绪性以及持续性的特点。采用脑功能网络分析方法, 研究者发现反刍思维的上述三个特点分别与默认网络内部的异常活动模式、突显网络功能连接的改变以及注意相关网络之间的异常耦合有关。未来研究应进一步明确反刍思维与相关脑网络活动之间的因果关系, 探究反刍思维脑功能网络的结构基础, 同时也应关注反刍思维及其脑网络的老龄化特征, 并致力于探索有效干预反刍思维的神经调控技术。     

Effects of the function-specific instruction approach to neurofeedback training on frontal midline theta waves and golf putting performance

A recent meta-analysis has shown inconclusive results on the effectiveness of traditional electroencephalography (EEG) neurofeedback training (NFT) protocols in changing EEG activity and improving sports performance. To enhance the effectiveness of EEG NFT protocols, we explored a new approach to EEG NFT, namely the function-specific instruction (FSI) approach. The basic tenet underpinning effective verbal instruction is to induce mental states as the verbal instructions consider the meaning of the brainwave function in the target region and the EEG power magnitude. This study aimed to test whether a single session of FSI is efficacious in improving frontal midline theta (FMT) activity and putting performance. Method: Thirty-six skilled golfers with a handicap of 14.05 ± 9.43 were recruited. A consecutive sampling method was used to form three groups: an FSI group (n = 12), a traditional instruction (TI) group (n = 12), and a sham control (SC) group (n = 12). In the pre- and post-tests, each participant performed 40 putts from a distance of 3 m, and the number of holed putts was recorded. The participants were asked to perform 50 trials in a single session of NFT. Putting performance improved significantly from before to after NFT in the FSI group. Moreover, the FSI group demonstrated a significant decrease in FMT power, whereas the SC group demonstrated a significant increase in FMT power from before to after NFT. These findings suggest that the FSI approach is more effective in enhancing sustained attention and putting performance in skilled golfers than TI.     

Network Size, Social Support and Happiness in Later Life: A Comparative Study of Beijing and Hong Kong

This study investigates how happiness of elderly Chinese is related to their social support networks, based on survey data collected in 2000 from Beijing and Hong Kong. These two Chinese cities share a common cultural heritage but differ in social-economic structure. It was found that in both cities, income is more significant than gender and education in determining happiness, but it is less important than personal network size and particularly perceived social support. More importantly, findings from the two cites consistently lend support to the thesis that older persons with a larger network are happier and that social support plays a mediating role. Controlling for social-demographic factors does not change this pattern of relationships. There are, however, differences between the two cities. Beijing’s elderly were found to be happier and have larger social networks than Hong Kong’s elderly. Also, our explanatory models consistently account for less variance in the happiness of older persons in Beijing. These findings are probably due to the differences between socialist Beijing and capitalist Hong Kong in degrees of modernization and urbanization and in social organization of work and community life.     

舞动治疗：一种自下而上的精神分裂症干预探索

皮层-基底节-丘脑网络与脑岛网络属于感觉运动相关网络, 这两个网络的改变可能是导致精神分裂症的重要原因。目前主流研究与临床干预聚焦于患者的高级脑区异常, 对感觉运动系统的关注不足。对健康个体的研究发现舞蹈训练对感觉运动相关脑网络具有显著提升作用, 并自下而上地促进高级功能。以上研究提示舞蹈训练可能是干预精神分裂症、改善患者认知功能的新途径。本研究拟借助多模态磁共振成像技术, 以精神分裂症感觉运动相关网络为着力点, 通过分析精神分裂症患者在舞蹈训练前后的脑影像、临床症状及认知行为的改变, 揭示舞蹈训练临床干预的神经机制。     

Contextual effects of personal network on individuals' tendency to blame the victims of sexual harassment

Victim-blaming has been studied extensively, especially in the context of sexual violence. In the present study, the distribution of opinion with regard to female victims of sexual violence among people in the respondents' networks was used to explain their victim-blaming tendency. Data from respondents' personal networks were collected, and the results revealed that respondents' attitudes towards victim-blaming correlated positively with the proportion of network others who had positive attitudes towards victim-blaming. The correlation was stronger among respondents who had low concern for the issue. The results supported a model of information bias of personal network on attitudes.     

Practice‐based research networks: Origins,overview, obstacles,and opportunities

Aims: This article focuses on the historical origins of Practice‐based Research Networks (PbRNs), particularly in the UK, and provides an overview of exemplar networks, together with a consideration of the obstacles and opportunities of such networks. Method: A selective narrative review was carried out relating to the origins of PbRNs together with a selective systematic review using the SCOPUS database to consider landmark articles in this field. Results: A historical account is provided with the origins of PbRNs deriving from pioneer GPs working alone, with their ideals then becoming embedded in family practice. Key articles are presented and also consideration given to the threats to their survival. Conceptual and developmental models of PbRNs are presented that reflect the variety of networks but also common hallmarks. Finally, the opportunities are summarised that PbRNs offer for providing a vehicle for research that is linked more closely to communities of practitioners, people, and patients. Conclusions: PbRNs provide the opportunities for including practitioners in the research effort by being part of a community. Results will have direct relevance to their practice and advances in data analysis provide more valid means of analysing data. But there are also continuing threats due to lack of infrastructure funding and a gap between PbRN activity and trials methodology that needs to be addressed.