改革公立医院的一点思考

当前的看病难、看病贵不仅与政府的医疗投入不足有关,更与公立医院之间、公立医院与民营医院之间的无序竞争有关,导致了患者的过度医疗和超前医疗的畸形消费。重新界定一批公立医院,政府的全额资金投入和政策的约束与支持,才能从根本上解决看病难与看病贵的问题。     

全球化时代跨界民族国家认同的心理机制

全球化迅速改变着传统的生活方式和观念, 影响着人们的国家认同建构。跨界民族的国家认同具有复杂性、模糊性和不稳定性, 在全球化时代受到的冲击更大。一旦跨界民族的国家认同偏低, 就会影响跨界民族的国家情感, 危及边疆地区甚至国家的社会稳定。本项目拟通过4个研究, 预期实现以下目标：①将国家认同分成文化认同和公民认同两种成分, 并编制符合民族实际状况的跨界民族国家认同问卷; ②探讨民族认同、穆斯林认同在群际歧视知觉与国家认同间的中介作用; ③理清民族内隐理论对国家认同的影响; ④探讨管理体制、民生政策、经济发展水平和民族政策对国家认同的影响, 并尝试建立跨界民族国家认同数据库, 及时把握跨界民族国家认同的动态建构过程。研究结果对完善民族政策、开展宣传教育具有一定的指导意义。     

Research in Counseling

This column is based on the belief that research can provide meaningful data to the practicing counselor. While individual studies may not provide sufficient data on which to act, a combination of separate research efforts or a large-scale, long-term research project does have the possibility of providing sufficient data. This column will undertake to provide that data by either reviewing the current research in a specific area or examining the results from a long-term project. The emphasis will be on implications for the counselor, so there will be little if any information on research design or statistical procedures. Readers desiring more detail about a particular study should write directly to the original author(s). Readers who desire to have the results of their research and/or innovative approaches considered for review in this column should send the material to Richard W. Warner, Jr., Counselor Education, 2054 Haley Center, Auburn University, Auburn, Alabama 36830.     

Research in Counseling

This column is based on the belief that research can provide meaningful data to the practicing counselor. While individual studies may not provide sufficient data on which to act, a combination of separate research efforts or a large-scale, long-term research project does have the possibility of providing sufficient data. This column will undertake to provide that data by either reviewing the current research in a specific area or examining the results from a long-term project. The emphasis will be on implications for the counselor, so there will be little if any information on research design or statistical procedures. Readers desiring more detail about a particular study should write directly to the original author(s). Readers who desire to have the results of their research and/or innovative approaches considered for review in this column should send the material to Richard W. Warner, Jr., Counselor Education, 2054 Haley Center, Auburn University, Auburn, Alabama 36830.     

Research in Counseling

This column is based on the belief that research can provide meaningful data to the practicing counselor. While individual studies may not provide sufficient data on which to act, a combination of separate research efforts or a large-scale, long-term research project does have the possibility of providing sufficient data. This column will undertake to provide that data by either reviewing the current research in a specific area or examining the results from a long-term project. The emphasis will be on implications for the counselor, so there will be little if any information on research design or statistical procedures. Readers desiring more detail about a particular study should write directly to the original author(s). Readers who desire to have the results of their research and/or innovative approaches considered for review in this column should send the material to Richard W. Warner, Jr., Counselor Education, 2054 Haley Center, Auburn University, Auburn, Alabama 36830.     

Research in Counseling

This column is based on the belief that research can provide meaningful data to the practicing counselor. While individual studies may not provide sufficient data on which to act, a combination of separate research efforts or a large-scale, long-term research project does have the possibility of providing sufficient data. This column will undertake to provide that data by either reviewing the current research in a specific area or examining the results from a long-term project. The emphasis will be on implications for the counselor, so there will be little if any information on research design or statistical procedures. Readers desiring more detail about a particular study should write directly to the original author(s). Readers who desire to have the results of their research and/or innovative approaches considered for review in this column should send the material to Richard W. Warner, Jr., Counselor Education, 2054 Haley Center, Auburn University, Auburn, Alabama 36830.     

Research in Counseling

This column is based on the belief that research can provide meaningful data to the practicing counselor. While individual studies may not provide sufficient data on which to act, a combination of separate research efforts or a large-scale, long-term research project does have the possibility of providing sufficient data. This column will undertake to provide that data by either reviewing the current research in a specific area or examining the results from a long-term project. The emphasis will be on implications for the counselor, so there will be little if any information on research design or statistical procedures. Readers desiring more detail about a particular study should write directly to the original author(s). Readers who desire to have the results of their research and/or innovative approaches considered for review in this column should send the material to Richard W. Warner, Jr., Counselor Education, 2054 Haley Center, Auburn University, Auburn, Alabama 36830.     

Environmental problems and the use of information: The importance of the policy context

Factual information plays a vital role in public awareness of environmental problems, and in governmental interventions that this awareness provokes. There is a growing need for new information to define and explore these problems, and to allow consequent political decision-making. This article examines the policy process, making a distinction between knowing and deciding. It will become clear that information and policy, both of which arise when a minimal level of problem-consciousness is reached, are the two important prime movers toward a better understanding and acceptance of environmental problems. Attention is given to information management as a prerequisite of communication management to influence attitudes and behavior, and to the role of communication in a total intervention-mix.     

Choosing the Appropriate Design and Analysis of a Research Project

It is extremely important that the proper mental planning of a research project is considered before the data collection ever begins. Otherwise, problems may be encountered after the data have been collected and it may then be too late to correct them. This paper will explain some of the important considerations necessary in choosing an adequate design and analysis for a research project.     

Ecological-Economy and Society in Europe: Outline of a Research Project

By understanding better how certain socioeconomic systems work, what chances for transformation they contain, and hence determining on these bases how they may evolve, we will be in a better position to look for the compatibilities and synergies that may be established among economic activities, social policies, and interventions in defense of environmental equilibria. It will also become clearer if, and how, it is possible to make these different needs interact for the better of all concerned. The research project illustrated here intends to contribute to our knowledge in this sense.     

Immersive virtual reality as a rehabilitative technology for phantom limb experience: a protocol.

This paper describes a study protocol to investigate the use of immersive virtual reality as a treatment for amputees' phantom limb pain. This work builds upon prior research using mirror box therapy to induce vivid sensations of movement originating from the muscles and joints of amputees' phantom limbs. The present project transposes movements of amputees' anatomical limbs into movements of a virtual limb presented in the phenomenal space of their phantom limb. It is anticipated that the protocol described here will help reduce phantom limb pain.     

Politics on the move: The democratic control of the design of sustainable technologies

This article examines how “design rationality” could help remediate the controversy over environmental degradation. Drawing on the case of designing sustainable forms of traffic management, it argues that this will only be effective to a limited degree. “Policy conversation” does indeed take place but within a coalition of actions that pushes a particular set of solutions. This facilitates due procedure but erodes political legitimacy, thus potentially reproducing an intractable controversy. The article suggests a five-phase model of democratic control as an alternative. He primarily works in the field of sociology of technology and environment. He is presently involved in a research project on the social redefinition of mobility, analyzing the translation of sustainable development into new institutional arrangements.     

A mixed methods research study on the video‐based counselling method Marte Meo

Marte Meo is a video‐based counselling method founded by Maria Aarts in the Netherlands and now in worldwide use (Aarts, Aarts Production, 2008). Marte Meo has been adopted and put into practice by a large and diverse network of trained and certified counsellors across the world. It was invented, developed and spread by a vanguard of practising counsellors who have adapted it to a variety of contexts. This is a classic example of research and theory emerging from and following practice; we first need to synthesise the lessons the practitioners and families have learned. We need to better understand how it is implemented; how it is viewed by its practitioners and recipients; and the extent to which variability in implementation may be an asset or a drawback in the continuing evolution of the programme, and in any eventual attempt to document its effects. Therefore, the present article aimed to address this important and hitherto unexplored research topic of the Marte Meo method in counselling and to describe the current state of use of Marte Meo. How is Marte Meo used and applied in a counselling and therapeutic context? Who uses Marte Meo in professional practice? Which function and which meaning does Marte Meo have in general practice and especially in counselling and therapy? What are typical concerns, goals or areas of application? We report on an ongoing mixed methods research project which began in 2015. This paper focuses on the research methods. We will explain why an integrated exploratory sequential design (Cresswell, 2017) is best suited to our purposes. The exploratory sequential design of the Marte Meo project has five phases: as the first phase, we conducted a systematic literature review, analysing the status of existing research. The staged qualitative research consisted of designing, conducting and analysing semi‐structured interviews with parents and Marte Meo counsellors (phase 2), and then using that analysis to inform the design, the conduct and the analysis of videotaped observations of everyday situations in day‐care centres to examine the process and effects of Marte Meo interaction elements on children (phase 3). Combining these qualitative analyses then became the basis for the development of an online questionnaire that could enable us to collect quantitative data on the current use of Marte Meo in practice by experts (phase 4). This builds into the fifth phase in the final interpretation. One of the key findings of the qualitative parts is that Marte Meo is perceived as advantageous. The experts reported more joy and success in their work. In particular, in the pedagogical context, the daily, resource‐oriented ‘Marte Meo view’, which was sharpened by the training, seems to be essential, as it enables an awareness of the needs of the interaction partners and the beneficial interaction elements. Moreover, for some interviewees the use of Marte Meo does not seem to be limited to professional practice, but is expressed in a general humanistic attitude towards interpersonal relationships of all kinds. The quantitative survey has confirmed and supplemented these results. On the other hand, we found that Marte Meo is most often used in addition to the systemic approach. A later article will focus more on the findings. This article will conclude with a discussion of the advantages and disadvantages of the research design—concerning this special research project and concerning counselling research in general.     

Forensic telepsychiatry in the United Kingdom

Forensic telepsychiatry remains in its infancy in the United Kingdom. This article sets out to describe how it can be used within a community forensic service, and the future challenges ahead in the United Kingdom. It looks at relevant academic, governmental, and legal resources and is designed as a scholarly reflection by clinicians rather than as a formal literature review.     

Good design as design for good: exploring how design can be ethically and environmentally sustainable by co-designing an eco-hostel within a Mayan community

Designers acknowledge that their skills can assist the visualization and materialization of a desirable future and have gone as far as proposing that design can achieve societal change. Designing for a better world is associated with decreasing environmental depletion impacts while making good for both people and the environment, if possible. Evidently, this is a space where design deals with ethical matters, defining what is good or questioning if good has a universal meaning. This paper discusses the case of Aalto LAB Mexico's (ALM) Eco-hostel project, a practical and ethical design exploration. It shares the impressions of the design team when co-designing with(in) the Mayan community of ‘20 de Noviembre’ (20 Nov), located in Calakmul, Campeche, México. The Eco-hostel project was proposed as an element which can play a central role in achieving betterment of several aspects of the community's daily life. Several of those aspects were communicated by the inhabitants of 20 Nov, and some others were identified by ALM's experts. Whereas some universal principles were applicable to the construction, the context-centred approach of ALM generated a unique proposal, conceptualized to achieve harmony with the local environmental and cultural conditions.     

环境基因组计划(EGP)对预防医学发展的影响

1998年美国正式启动环境基因组计划,该计划旨在探讨环境－基因的交互作用,寻找对环境因素损伤的易感基因及环境反应基因的多态性在疾病病因和发病过程中的作用,因而该计划的实施将对预防医学的发展产生重要的影响。     

Testing the role of adolescent sexual initiation in later-life sexual risk behavior: a longitudinal twin design

The consistent association between adolescent sexual initiation (ASI) and risky adult sexual behavior (RASB) has generally been assumed to indicate that ASI has a causal effect on RASB; consequently, it is assumed that delaying ASI will reduce RASB. Yet the ASI-RASB association might be better accounted for by some third variable. We evaluated the causal role of ASI (initiation of oral, anal, or vaginal sex at or before age 16) in influencing RASB in a longitudinal sample of 2,173 twins (followed from ages 11 to 24 or from ages 17 to 29) using two methods: the discordant-twin design and the propensity-score design. The former controlled for unmeasured genetic and shared environmental factors, and the latter controlled for measured nonshared environmental factors. We replicated the link between ASI and RASB reported in previous research, but results from the discordant-twin and propensity-score analyses suggested that this association is better explained by common genetic or environmental risk factors than as a causal effect. These findings suggest that preventing ASI is unlikely to reduce RASB.     

The development of a psychoanalytic outcome study: choices, conflicts, and consensus

This article tells the story of the development of an outcome study of psychoanalysis and describes the debate that took place over critical methodological issues. The protocol committee included career psychotherapy researchers who have conducted rigorous outcome studies, clinical psychoanalysts, study methodologists, and a statistician with clinical trial expertise. The committee worked for two years to develop the study design. This project is based on the premise that clinical psychoanalysis is a treatment. Areas specifically addressed are the goals and hypothesis of the study, inclusion and exclusion criteria, choice of psychotherapies as comparison treatments, definition of treatments and selection of therapists, use of medication, development of a treatment adherence measure, randomization of patient assignment vs. patient self-selection, and primary outcome measures. The execution of this outcome study will require significant effort and resources. A positive result would boost the standing of psychoanalysis, but the results may not support the primary hypothesis that there are therapeutic benefits unique to psychoanalysis and that psychoanalysis can effect demonstrable changes in a patient's mental life and adaptation that are not achieved by treatments of different orientation and/or lesser intensity. However, more important than whatever specific results emerge is what executing such a study requires of our field: the process of addressing the clinical issues that a study design requires, the creation of a network of analysts around the country working on a common project, and the joining of the clinical psychoanalytic community with a community of psychodynamic researchers.     

Involving Parents in Indicated Early Intervention for Childhood PTSD Following Accidental Injury

Accidental injuries represent the most common type of traumatic event to which a youth is likely to be exposed. While the majority of youth who experience an accidental injury will recover spontaneously, a significant proportion will go on to develop Post-Traumatic Stress Disorder (PTSD). And yet, there is little published treatment outcome research in this area. This review focuses on two key issues within the child PTSD literature—namely the role of parents in treatment and the timing of intervention. The issue of parental involvement in the treatment of child PTSD is a question that is increasingly being recognized as important. In addition, the need to find a balance between providing early intervention to at risk youth while avoiding providing treatment to those youth who will recover spontaneously has yet to be addressed. This paper outlines the rationale for and the development of a trauma-focused CBT protocol with separate parent and child programs, for use with children and adolescents experiencing PTSD following an accidental injury. The protocol is embedded within an indicated intervention framework, allowing for the early identification of youth at risk within a medical setting. Two case studies are presented in order to illustrate key issues raised in the review, implementation of the interventions, and the challenges involved.