卫生服务公平性:理念、制度和实践——读《关于深化医药卫生体制改革的意见(征求意见稿)》有感

长期以来,我国的卫生服务一直存在着不公平的状况,看病难、看病贵等问题在农村表现十分突出,一直是社会关注的焦点。对卫生服务不公平问题的讨论也已经持续很久,正因为如此,人们对新一轮的卫生体制改革寄予厚望。人们深知,实现卫生服务公平性需要从理念转变到人、财、物的支持,从构建相应的制度、机制、法规到付诸实践等多方面着手,只有这样才能实现人人享有卫生保健的目标。     

当代医药卫生改革的话语逻辑

运用语言哲学的方法分析了目前中国关于深化医药卫生体制改革意见的话语方式和文本内容,认为,如何划分医药卫生体系往往是界定问题和言语行动的逻辑前提,也是最重要的话语权的体现;“看病难”和“看病贵”可能是被误读的流行语;文件说什么,如何说,这是一种影响政府和市场行为的言语行为;如果作为医改指导思想的核心概念的语义含糊不清,那么,就难以保证言语行为的正确了。     

关于“职业医闹”现象的法律思考

医疗纠纷中患方放弃法律途径而选择雇请“职业医闹”的非法律途径维权的现象日益普遍,严重扰乱了医疗秩序,进一步激化了医患矛盾。鉴于此,拟通过从法律层面上深入分析“职业医闹”产生的根本原因,积极寻求根治“职业医闹”的法律对策,以让患方维权回归法律途径。     

水本思想对《黄帝内经》理论构建之影响

从水崇拜与太一生水入手,探讨了水生万物与肾藏精、主生殖的关系,太一藏于水、行于时与《内经》八风九针的关系,盖天说与《内经》之海的关系,水为道与精气学说理论的关系,阐述了水本思想对《黄帝内经》理论构建的重大影响,以及对中医继承发展的意义。     

浅析中药现代研究的困惑,探究研究策略

中药现代研究是当前医药学界的热点和重点研究领域。在面对中药现代研究取得的某些方面”突破”的同时,也须正视中药现代研究的困惑。从中药研究所面临的困惑出发,探究中药现代研究的出发点、立足点、关键点和突破点,有助于理清研究思路,明确研究方向,确定研究方法与目标,促进中药现代研究的进程。     

必须关注防止医学领域内的唯心科学观

对医学科学领域内存在的和某些一度充斥的唯心科学观的社会表现进行分析,从过程管理和科学方法论的重要性入手,提出防范学术腐败和发展医学科学的方法和措施,从教育和民生的角度探讨医务工作者和社会学家必须关注的医学领域内的唯心科学观,并举例说明医学工作者的科学道德自律和社会责任感的重要性。     

认知心理学产生的历史背景分析

本文从外因与内因相结合,外因通过内因起作用的观点分析了认知心理学产生的历史背景。外因主要是信息论、控制论、计算机科学和乔姆斯基语言学的影响。内因主要是早期实验心理学的心理主义传统的影响,特别是冯特、顿德斯、屈尔佩、格式塔心理学、新行为主义以及近代布鲁纳的新观点等的影响。     

Civic Knowledge of High School Students in Israel: Personal and Contextual Determinants

Past research on civic education suggests that students' performance is largely influenced by individual socioeconomic background and motivational factors. There has been little attention to the effects of school and classroom ideological and social attributes, such as the socioeconomic make-up of the school or classroom, or how interested in politics are a student's classmates. The results of the present study support the contention that contextual effects play a vital role in determining students' civic knowledge scores. Analysis of Israeli 11^th graders' performance on the International Association for the Evaluation of Educational Achievement (IEA) civic knowledge test shows that while individual backgrounds and motivations play a significant role, school and classroom contexts greatly contribute to civic knowledge acquisition.     

Functional analytic psychotherapy and the treatment of obsessive compulsive disorder

This paper argues that Functional Analytic Psychotherapy (FAP) can contribute to the treatment of Obsessive Compulsive Disorder (OCD). FAP is a behavior analytically informed approach to talk-therapy, developed by Kohlenberg and Tsai. It uses natural occurrences of clinically relevant behavior in the client-therapist relationship to promote therapeutic change. A selection of vignettes of client-therapist dialogues involving two clients with OCD is discussed. The examples show how natural interactions between therapist and client can be used to bring therapeutic technique closer to the natural occurrences of obsessive-compulsive behavior. Furthermore, the fragments illustrate that FAP can encompass exposure and response prevention. Therefore, the in vivo learning during the session as promoted in FAP can be an asset in the treatment of clients with OCD, and it deserves attention in future treatment research.     

An effect size index for comparing two independent alpha coefficients

Since Cronbach proposed the α coefficient in 1951, researchers have contributed to the derivation of its sampling distribution and the testing of related statistical hypotheses. Yet, there has been no research on effect size index relevant to coefficient α to our knowledge. Considering the importance of effect size in understanding quantitative research findings, we therefore developed an effect size index Δ for the comparison of two independent αs with equal test length based on the asymptotic distribution of under the assumptions of normality and compound symmetry. Simulations indicated that the index was applicable when the sample size was at least 100. The robustness of the derived index when the required assumptions were violated was also explored. It is suggested that the index should be applicable in most cases of unequal test lengths and could be extended to non‐normally distributed component scores. Moreover, a small simulation was conducted to explore the behaviour of Δ with correlated errors, a frequently studied situation violating the assumption of compound symmetry. The proposed index was found to be robust unless a large number of highly correlated errors were present in the data.