Comparison of the Effects of Telephone Suicide Prevention Help by Volunteers and Professional Paid Staff: Results from Studies in the USA and Quebec,Canada

Research since the 1960s has consistently found that lay volunteers are better at helping suicidal callers than professionals. Yet, professional degrees are increasingly becoming requirements for helpline workers. In our first study, we conducted post hoc comparisons of U.S. helplines with all professional paid staff, all lay volunteers, and a mix of both, using silent monitoring and standardized assessments of 1,431 calls. The volunteer centers more often conducted risk assessments, had more empathy, were more respectful of callers, and had significantly better call outcome ratings. A second study of five Quebec suicide prevention centers used silent monitoring to compare telephone help in 1,206 calls answered by 90 volunteers and 39 paid staff. Results indicate no significant differences between the volunteers and paid employees on outcome variables. However, volunteers and paid staff with over 140 hours of call experience had significantly better outcomes. Unlike the United States, Quebec paid employees were not required to have advanced professional degrees. We conclude from these results and previous research that there is no justification for requiring that suicide prevention helpline workers be mental health professionals. In fact, the evidence to date indicates that professionals may be less effective in providing telephone help to suicidal individuals when compared to trained lay volunteers.     

为医学"会诊”-当代医学的主要缺憾

现代医学发展迅速,方兴未艾,由于技术主义抬头,认识局限与医学发展水平的制约。出现某些缺憾性倾向。主要有：破足的医学、分裂的医学。被动的医学、治标的医学、人性淡漠的医学、不公正的医学等。在对上述进行分析与评论的基础上,对医疗服务变革真挚进行了预测与展望。     

非小细胞肺癌 EG FR 基因突变检测与临床意义

采用荧光PCR法对199例晚期非小细胞肺癌（NSCLC ）组织进行表皮生长因子受体（EGFR ）基因突变检测,分析EGFR基因突变的分布特征及其与临床病理特征的相关性。结果显示56例（28．1％）存在EGFR基因突变,其中27例（13．6％）为外显子19突变,25例（12．6％）为外显子21突变,2例为外显子18突变,1例外显子20突变,1例外显子18和20的共突变。另外,除广东及安徽省铜陵市外,辽宁地区NSCLC患者EGFR基因突变率及主要突变类型与其他地区相符,常见于外显子19、21突变,其中腺癌、不吸烟患者突变率更高,更适宜EGFR-TKI靶向治疗。     

Posttraumatic Stress Disorder Symptom Clusters and Acquired Capability for Suicide: A Reexamination Using DSM-5 Criteria

This study used the interpersonal–psychological theory of suicide to explore the relationships among DSM-5 posttraumatic stress disorder (PTSD) symptom clusters derived from the six-factor anhedonia model and facets of acquired capability for suicide (ACS). In a sample of 373 trauma-exposed undergraduates, most PTSD symptom clusters were negatively associated with facets of ACS in bivariate correlations, but the anhedonia cluster was positively associated with ACS in regression models. Structure coefficients and commonality analysis indicated that anhedonia served as a suppressor variable for the other symptom clusters. Our findings further elucidate the complex relationship between specific PTSD symptom clusters and ACS.     

The link between social interactions and trust recovery in customer–business relationships

Trust plays a crucial role in interpersonal relationships, including customer–company relationships, where the customer expects that a company will behave predictably in any particular situation. Companies do not always fulfill customers' expectations and thereby breach the trust relationship. To avoid negative consequences of this trust violation, companies may issue a formal apology as one possible path to regaining customer trust. In the same way, a previous social interaction, which can increase the customer's levels of oxytocin, can help to recover trust after service failures. In this study, three experiments were conducted as follows: the first manipulating a simulated social interaction with images; the second manipulating a physical social interaction, (i.e., a hug); and the third with exogenous oxytocin administration. The results showed that both physical interaction, (i.e., a hug) and simulated social interaction, (i.e., images of people interacting with each other) had a positive effect on customer trust recovery and provided support for oxytocin release as the underlying mechanism in this process. This research contributes to understanding of the link between social interactions and trust by elucidating the effects of both simulated and physical interactions on trust recovery.     

社会公正对权威合法性的影响:社会阶层的调节作用

社会层面中的权威合法性研究是国内外学者和管理实践者近来关注的重要问题。而社会公正的两个维度——分配公正和程序公正对权威合法性的交互作用的结果并不一致。本研究基于解释水平理论,提出社会阶层能调节分配公正和程序公正对权威合法性感知的交互作用,并通过实验室研究和情境启动两种方法进行验证。结果发现对低阶层者来说,无论是否程序公正,分配公正能显著提高个体的权威合法性感知;在分配公正和多得不公条件下,程序公正显著降低权威合法性感知。对高阶层者来说,分配公正能显著提高程序公正时的权威合法性感知;程序公正能显著提高分配公正时的权威合法性感知。研究结果启示社会管理者在推行依法治国时应针对不同阶层民众的思维方式采取管理策略。     

图示写实性对飞机安全须知卡可理解性的影响

本研究使用眼动技术及模拟操作任务考察了图示写实性对飞机安全须知卡可理解性的影响。三组被试分别阅读写实照片、卡通插画、目标实物+其余图画的混合呈现等三种不同呈现形式的安全须知示意图,随后完成模拟操作任务。结果显示,混合组较写实组能更好地引导被试注意投放到与安全操作有关的关键区域上;混合组与写实组的模拟操作绩效均优于卡通组。基于上述结果,笔者建议使用"混合呈现方式"的飞机安全须知卡向乘客传递安全信息。     

循证医学时代安慰剂的再认识

安慰剂的治疗作用早已被人们认识,但是对于其在医学上的应用却一直存在争议.在循证医学兴起的今天,我们应该如何辩证地看待安慰剂的作用及不足,以及在临床试验中应该如何应用安慰剂是一个值得探讨的问题.     

公共卫生的责任主体缺位是众多医学伦理问题产生的根源

我国的卫生、医疗服务系统近年来产生了大量严重的伦理问题,引起了国内外广泛的关注.通过对大量材料的归类、分析,找出我国众多严重伦理问题产生的主要根源是公共卫生责任主体的缺位.解决的主要措施是:加快卫生母法的建立;政府对"公共性"卫生服务责任到位,扭转卫生工作严重的市场化和趋利化倾向;彻底改变医疗费用的"后付制"和"第三方付费制",实行政府正向投入;改变当前在疾病预防和初级卫生保健投入方面过于细化的分级财政体制;制止药品广告和虚假的医疗广告;加大控制政府公立医院建设的成本和降低医院运行费用的工作,严格收费价格纪律等.