资本主义经济关系中的政治、哲学与伦理——以MEGA2中马克思文本为基础的阅读与理解

<正>政治学与经济学的结合并非始于马克思;19世纪初,随着资本主义经济的迅速发展,在英国和欧洲大陆产生了相当一批政治经济学家,他们尝试从原则①上去理解、认识和论证资本主义经济关系的产生、存在和发展。19世纪40年代中期,马克思的批判思路由哲学、法学、社会学逐渐转向政治经济学。这一方面是其自身思想发展的逻辑性结果:对异化劳动关系的实证性论证,只能从政治经济     

并发症内涵刍议

并发症概念的不明确,使得临床及司法实践中出现诸多问题,如部分医务人员注意力降低、医患矛盾升级,对医疗损害鉴定及判决产生了不利影响.应从疾病诊断和诊疗操作两方面理解并发症的内涵,明确并发症并不一定是医院的免责事由,并规范对这一概念的使用.     

ARDS:现状与挑战

ALI/ARDS是以难治性低氧性呼吸衰竭为主要临床特点的症候群,是重症医学最具挑战性的领域之一.近期其诊断标准更新为“柏林标准”;治疗方面除了常规机械通气策略之外,因潜在的降低病死率的作用,高频震荡通气(HFOV)、体外膜肺氧合(ECMO)的价值越来越受到重视,而大环内酯类抗生素和干细胞基因治疗则成为药物治疗的热点.根据现有趋势,相信未来ALI/ARDS的病死率将会随着研究的深入和新疗法的开展而逐渐降低.     

Predictors of Deliberate Self-Harm Behavior Among Emerging Adolescents: An Initial Test of a Self-Punitiveness Model

The current study examined the extent to which an expanded self-punitiveness model could be applied to deliberate self-harm (DSH) among students making the transition to university. Specific components of the self-punitiveness model included perfectionism, overgeneralization, self-criticism, and shame. A sample of 319 university students completed a measure of deliberate self-harm as well as two multidimensional perfectionism measures and measures of self-criticism, overgeneralization, and shame. Correlational analyses found few significant associations among deliberate self-harm and the self-punitiveness factors among men. In contrast, among women, deliberate self-harm was associated with dimensions of trait perfectionism such as parental criticism and socially prescribed perfectionism, as well as with overgeneralization, self-criticism, and both characterological shame and bodily shame with the strongest associations found with shame. Supplementary analyses found a strong link between overgeneralization and shame and an association between self-criticism and shame among women. The results support the contention that particularly among young women making the transition to university, deliberate self-harm behavior is a reflection of a self-punitive personality orientation with multiple facets and a sense of shame associated with an overgeneralized sense of failing to meet social expectations.     

Racial and Ethnic Differences in Direct-to-Consumer Genetic Tests Awareness in HINTS 2007: Sociodemographic and Numeracy Correlates

To examine the association of 1) race/ethnicity and 2) numeracy with awareness of DTC genetic tests. Secondary analysis of 6,754 Hispanic, black, and white adult respondents to the National Cancer Institute’s 2007 Health Information National Trends Survey (HINTS). Logistic regression was used to examine sociodemographic predictors of DTC genetic tests awareness including race/ethnicity, income, education, and gender. Next, two numeracy variables were added to the model. After controlling for sociodemographic variables, black respondents were significantly less likely to have heard of DTC genetic tests compared to white respondents (OR = 0.79; CI: 0.65–0.97). When numeracy variables were added to the model, the effect of black race was no longer significant (OR = 0.84; CI: 0.69–1.04). Hispanic respondents did not significantly differ from white respondents in awareness of DTC genetic tests. Other significant correlates of DTC genetic tests awareness in the full model included education, income, age, and numeracy variables including degree to which people use medical statistics and numbers to make health decisions, and preference for words or numbers when discussing “the chance of something happening.” Although black respondents were generally less aware of DTC genetic tests than white respondents, this relationship appears to be partially mediated by numeracy.     

Direct-to-Consumer Personal Genomic Testing: A Case Study and Practical Recommendations for “Genomic Counseling”

Technological advances and information-seeking consumers have pushed forward the movement of direct-to-consumer (DTC) genetic testing. Just like with other types of testing, there are potential risks, benefits and limitations. A major limitation of DTC testing is the incomplete view it provides regarding lifetime risk for common, complex diseases, since most tests only analyze 1–2 single nucleotide polymorphisms (SNPs) and do not include evaluation of medical or family histories, which is necessary to risk assessment. Further, it is not currently well-established whether personal genomic testing results will lead toward improved health behaviors, adverse psychological effects or potential overuse of the health care system. To display these and other issues, we present an in-depth case study of an individual who ordered DTC genetic testing and subsequently sought genetic counseling. This case presents a unique learning experience for the field of genomic counseling, as the patient did not fit the typical assumptions regarding ‘early adopters’ of DTC testing. It also allowed the genetics health care providers involved in the case to identify gaps in current genetic counseling practice that need to be filled and approaches to employ for successful delivery of genomic counseling. Based on our experience, we developed practical recommendations for genomic counseling, which include novel approaches to case preparation, use of electronic tools during the counseling session, and focusing on education as the major component of the genomic counseling session, in order to provide patients with the knowledge necessary to independently interpret and understand large amounts of genomic testing information provided to them.     

A Mediated Moderation Model of Conformative Peer Bullying

We investigated the relationship between conformative peer bullying and issues of peer conformity among adolescents. This relationship is examined through the establishment of a mediated moderation model for conformative peer bullying using structural equation modeling in a sample of 391 second-year middle school students in Seoul, South Korea. We found that peer pressure and resistance to peer influence interact with one another to affect antisocial conformity, which then affects conformative peer bullying, thereby establishing its mediated moderation effect. The results suggest that conformative peer bullying that encourages and assists active bullies is affected by antisocial conformity; moreover, an individual’s capacity to resist peer influence plays a protective role against peer conformity, and this must be acknowledged as a significant influence in conformative peer bullying among adolescents.     

After School Care for Children on the Autism Spectrum

Few programs exist for after school care designed to support children with Autism Spectrum Disorder (ASD). Not only do parents often depend on after school care, but also children with ASD are likely to benefit from opportunities to generalize skills in an authentic setting and interact with typically developing peers. This lack of support occurs at a time during which there is increasing research and community awareness regarding the need for high quality after school programs to support typically developing children. This study investigates reported experiences with and needs for after school care by parents of children with ASD. Survey results (N = 54) revealed that the majority of parents surveyed desired after school programs within their child’s school but are often denied access to such services or received low quality care for their child in after school programs. Recommendations are provided for future research and program development.     

Students’ Perceptions of Unsafe Schools: An Ecological Systems Analysis

In the aftermath of several school shooting incidents in recent years, students’ perceptions of unsafe schools has been a major concern for parents, teachers, school officials, school practitioners, and policy-makers. Using Bronfenbrenner’s ecological systems framework, we examined the micro-, meso-, and exosystem level factors associated with perceptions of unsafe school environments in a nationally representative sample of 10- to 15-year-old youth in the United States. We found that for the socio-demographic characteristics, students who were older, male, and poor had increased risks of perceiving higher levels of unsafe school environments. Within the microsystem of the family, our results indicate that parent-youth discussions of school activities/events decreased the risk of students perceiving unsafe schools. All of the school environment variables—ease of making friends, teachers’ involvement, observed weapon carrying, and school rule enforcement—were related in the expected direction to students’ perceiving their schools as unsafe. At the mesosystem level, findings from our study demonstrate that variables measuring parental school involvement were unrelated to perceptions of school safety. Finally, at the exosystem level, we found that students’ perceptions of residing in a safer neighborhood and residence in a non-central city metropolitan area, compared with a central city, decreased the odds of perceiving school environments as unsafe. School policy and practice implications are discussed.