卫生政策走向与公共健康及其伦理思考

政府通过决策决定卫生政策,卫生政策对于公共健康具有导向和引领作用。卫生政策走向直接影响公共健康,决定公共健康的发展方向。卫生政策与公共健康的关系是因果关系,前者决定后者。卫生政策需要有伦理学基础和伦理学专家的伦理论证,坚持公正、公平、公益的原则。     

抑郁症的流行病学研究与预防——读《中国人群死亡及其危险因素流行水平、趋势和分布》有感

根据《中国人群死亡及其危险因素流行水平、趋势和发布》的报告和相关研究表明,全世界约有1亿人患有抑郁症,且数量有增无减,抑郁症将成为本世纪一种相当流行的病症.由于抑郁症是一种患病率高,严重危害人类身心健康,具有高自杀风险的精神疾病,更需要我们采取措施积极预防.目前采用的主要预防方法有:积极的心理健康教育、处理好家庭与社会的关系、社会支持、心理调适和体育锻炼等.     

健康公平--概念、影响因素与政策

长期以来健康不平等和不公平一直是卫生改革与发展所关注的重点,并已经成为了国际卫生政策的主要方向.在国家之间健康不平等和不公平也存在不同的理解.发达国家主要集中在产生疾病和导致死亡率差异的社会经济阶层的形成机制,将健康不平等作为疾病病原学的一个函数,关键措施是加强初级卫生保健;在中低收入国家,人们却趋向于通过提供基本的医疗保健服务来解决这一问题.     

20世纪全球卫生发展的回顾与展望

20世纪人类的健康状况发生了革命性的转变,同时也面临着前所未有的挑战。疾病谱的改变及人口寿命的延长以及医疗费用的上涨仍然是困扰各国决策者的难题,卫生发展与改革任重道远。完善健康保障体系最理想的选择方案是政府为居民“购买”基本卫生服务,由国家财政和居民共同承担保险基金,普及初级卫生保健,鼓励多种形式办医,WHO确定的卫生工作目标是各成员国卫生系统改革与发展的指导方针。     

Clinical psychology in medical settings: Psychology's role in health care

The number of clinical psychologists working in medical settings has grown along with the range of services provided by psychologists to patients with a multitude of medical problems across the lifespan. Medical care cost savings brought about by these psychological interventions is highlighted along with issues of public policy and specialization of training. The opportunity for ongoing development of clinical psychology in medical settings is described as unlimited and the mission of the newJournal of Clinical Psychology in Medical Settings is presented as supporting that growth.     

Career Development and Public Policy

The rationale for policy interest in career development services and the way in which this rationale is being strengthened by the current transformations in work and career are discussed. The potential roles of public policy in relation to career development services are explored, along with ways in which such services can influence the policy‐making process. A range of policy issues related to making career development services available to all throughout life are identified. Stronger structures and processes are needed to bring together career development practitioners with policy makers and other stakeholder interests in order to address tasks of common concern.     

The Social Determinants of Health: Why Should We Care?

A growing body of empirical research examines the effects of the so-called “social determinants of health” (SDH) on health and health inequalities. Several high-profile publications have issued policy recommendations to reduce health inequalities based on a specific interpretation of this empirical research as well as a set of normative assumptions. This article questions the framework defined by these assumptions by focusing on two issues: first, the normative judgments about the (un)fairness of particular health inequalities; and second, the policy recommendations issued on this basis. We argue that the normative underpinnings of the approach are insufficiently supported and that the policy recommendations do not necessarily follow from the arguments provided. Furthermore, while many of the policies recommended—such as improving people's living conditions and reducing inequalities in wealth and power—are justified in their own right, the way these recommendations are tied to health is problematic.     

关于耳蜗传出神经系统功能研究的启示

对卫生管理中具有战略地位的卫生政策的理论与实践领域的背景和文献进行分析,认为卫生政策基本理论与方法论研究、卫生政策分析方法及技术研究、卫生决策科学化研究、卫生决策体制与过程的研究,社会公众参与卫生决策的研究等,是当前我国卫生政策的理论与实践中值得研究的主要问题。     

ISLAMIC VERDICTS IN HEALTH POLICY DISCOURSE: PORCINE‐BASED VACCINES AS A CASE STUDY

In this article, I apply a policy‐oriented applied Islamic bioethics lens to two verdicts on the permissibility of using vaccines with porcine components. I begin by reviewing the decrees and then proceed to describe how they were used by health policy stakeholders. Subsequently, My analysis will highlight aspects of the verdict's ethico‐legal arguments in order to illustrate salient legal concepts that must be accounted for when using Islamic verdicts as the basis for health policy. I will conclude with several suggestions for facilitating a more judicious use of verdicts in policy‐relevant discourse. My analysis is meant to contribute to the dialogue between science and religion, and aims to further efforts at developing health policies that value health while accommodating religious values. In the encounter between the Islamic tradition and global public health, a multidisciplinary dialogue, where Islamic legists become aware of the health policy implications of their ethico‐legal pronouncements, and where health policy actors gain a literate understanding of Islamic ethico‐legal theory, will lead to verdicts that better meet the needs of patients, health workers, and religious leaders.     

Capturing the Child’s Perspective: A Review of Self-Report Measures used with Children

Recent policy extends the patient-professional collaboration in making health care decisions to children. As a result, the development of self-reporting measures allowing children to express their concerns is growing. A literature review identified 33 self-report measures for children among a range of disciplines. While these tools allow children to be part of the rehabilitation process, the information obtained does not seem to capture what matters to children. This is particularly true for children with mental illness whose views are often ignored. More research is needed on clinical approaches that access the unique experiences of children with mental illness.     

医疗社会工作：现实意义和发展趋向

医疗社会工作是社会工作专业的重要实务领域之一,在西方发达国家的医疗事业中扮演着不可替代的角色,具有解决患者及其家属问题、处理医患关系,并促进公共卫生政策的改善等多种功能。从我国目前的发展来看,尚处于起步阶段,还有诸多需要努力的方面,包括完善相关政策、提高服务质量、修正教育模式、突出中国特色等。     

Innovation,research integrity,and change: A conflict of interest management framework for program developers

Psychology and the social sciences have an important role to play in developing innovative solutions to pressing global mental health and social problems. Programs developed by psychologists and other social scientists have immense potential to alleviate suffering and to promote healthy human development across the lifespan. In order to realise this potential program developers must manage the research and development challenges involved in testing an intervention, evaluating, and then preparing it for wider dissemination and scaling. Particular challenges and conflicts can occur in managing the joint roles of being a program developer and a researcher evaluating an intervention or innovation. This article examines the management of various forms of conflicts of interest that have the potential to produce bias and decrease the confidence of policy makers, funders, practitioners, fellow researchers, and the public in the value of psychological interventions. We argue that best practice guidelines are needed to assist developers negotiate the predictable, sometime unavoidable but challenging conflicts of interest that arise in the research process.     

我国妇幼保健机构公共卫生属性淡化的机制研究

妇幼卫生是公共卫生体系的重要组成部分,妇幼保健机构是妇幼卫生工作的实现主体,为了促进我国妇幼保健机构的健康和可持续发展,提高妇女、儿童健康水平,通过对妇幼保健机构的社会功能、行为动因和行为特征的系统分析,构建出妇幼保健机构公共卫生属性淡化的作用机制模型.公共卫生的实质是公共政策,建议政府要实现市场机制与政府宏观调控的有机结合,促进妇幼保健事业健康发展.     

CBT in the British NHS: Vague imposition or imposition of vagueness?

The multi-faceted controversy created by the ascendance of cognitive behaviour therapy (CBT) in the British mental health industry is outlined. The historical and philosophical nature of this controversy is traced, by looking at CBT as a psychiatric form of treatment and eclectic form of applied psychology. CBT has become a policy battleground, which can be understood by putting its modernist credentials and its appeal to rationalism, pragmatism and techno-centric optimism into a mixed pre-modern and post-modern context. Given that there are diverse representatives of these realms of belief alive today in our society, the current singular policy emphasis on CBT is anti-democratic and insensitive to diversity. The paradox of this restrictive policy is that CBT itself is now a very diverse set of practices held together mainly by a faith in evidence-based practice. Consequently, a version of pluralism is being tolerated on the supply side of mental health services but a full offer of true choice is not being made on the demand side.     

Adolescent health. Challenges for behavioral scientists

Clearly, the role of behavioral scientists in adolescent health is not limited to service delivery. They also have a role to play via their contributions to basic knowledge of adolescent health and development, their involvement with the design and evaluation of health systems, their efforts to design and evaluate interventions to reduce adolescent morbidity and mortality, and their contributions to adolescent health policy. The once popular view of adolescence as a period of inevitable storm and stress has been replaced by one that emphasizes the potential of this developmental stage for constructive adaptation and maturation. Behavioral scientists have an important role to play in assuring that the potential of this life stage is reached for future generations of youth.     

医疗保障制度改革过程中的价值取向问题及其影响

随着社会主义市场经济体制的建立,我国传统的劳保医疗制度和公费医疗制度已越来越不适应社会发展的要求,呈现出诸多弊端,亟待改革。作为一项公共政策,医疗保障制度在改革与完善的过程中应根据科学行政的要求对政策的价值取向进行深入分析,以便顺利实施改革的各项方案。分析医疗保障制度改革中所涉及的各方面的价值观及其对改革的影响,希望唤起政策制定者对不同群体利益的关注,从而保证政策体系的稳定。     

Psychosocial aspects of successful ageing and resilience: critique,integration and implications / Aspectos psicológicos del envejecimiento exitoso y la resiliencia: crítica,integración e implicaciones

Abstract

As the number of older adults increases worldwide, it is becoming increasingly important to find effective ways of fostering better ageing trajectories. The models used to shape this process inform research, policy and practice and impact older adults themselves. Two important ageing models are successful ageing (SA) and resilience (RES). Aligning the conceptual framework in research contexts with those of older adults’ perspectives is an integral component of driving forward the research agenda in a manner that has the greatest potential to benefit older adults. Studies conducted with laypersons indicate that psychosocial components are important components of successful ageing models; therefore, it is imperative that these non-biomedical components are incorporated. There are many similarities between SA and RES models, but an important distinguishing feature is the incorporation of adversity into conceptualizations of resilience. SA models suggest high levels of functioning as a requirement for ageing successfully, regardless of the circumstances the individual experiences; resilience models take into account the level of adversity being experienced by the individual. Individuals can demonstrate RES by having a more positive outcome than would be expected given their level of adversity. The incorporation of psychosocial constructs into SA models and the integration of SA and RES paradigms has important implications for research and for older adults themselves. Through the promotion of models of ageing that include psychosocial components and elements of adversity, greater generalizability to a broader population is possible with enhanced potential for research derived from these efforts to more positively influence individuals’ trajectories of ageing.     

Withdrawing Versus Withholding Freedoms: Nudging and the Case of Tobacco Control

Is it a stronger interference with people's freedom to withdraw options they currently have than to withhold similar options they do not have? Drawing on recent theorizing about sociopolitical freedom, this article identifies considerations that often make this the case for public policy. However, when applied to tobacco control, these considerations are shown to give us at best only very weak freedom-based reason to prioritize the status quo. This supports a popular argument for so-called “endgame” tobacco control measures: If we believe that cigarettes would and should be withheld from entering markets in hypothetical scenarios in which they do not yet exist, then we also have reason to seek their abolition in situations, such as ours, in which cigarettes do exist—if necessary by banning their sale. The same considerations are then used to disarm objections that have recently been raised to using nudges in public policy.     

和谐社会卫生观论纲

和谐社会卫生观是在卫生事业的发展中人与自然;人与社会;卫生事业与社会;卫生事业内部子系统;卫生政策主体与客体处于一种互动共生的观念.和谐社会卫生观的基本内涵是:有序、平衡、协调、良性运行与发展.和谐社会卫生观既是一种世界观,也是一种方法论.在卫生领域,是一种卫生观.