突破卫生资源宏观调控难关的思考

国务院决定 ,在建立城镇职工医疗保障制度的同时 ,进行医药卫生体制改革 ,以建立适应社会主义市场经济要求的城镇医药卫生体制 ,促进卫生机构和医药行业健康发展 ,提高人民的健康水平[1 ] 。这是进入 2 1世纪我国卫生事业改革与发展面临的历史任务。1　深化改革的关键切入点我国卫生体制改革从 80年代开始 ,首先进行了医疗机构所有制结构调整 ,形成了以公有制为主、多种所有制并存的格局[2 ] ,从而促进了卫生事业的发展。同时 ,卫生事业单位为了适应社会主义市场经济体制 ,也在管理模式、运行机制、经济管理、人事制度等方面 ,采取了多种改…     

The Contribution of Neuroimaging to the Study of Language and Aphasia

New structural and functional imaging methods continue to be developed at a rapid pace. In the last 25 years, advanced imaging techniques have provided insights into how language is represented and processed in the brain and how it can be disrupted by damage to, or dysfunction of, various parts of the brain. Imaging studies have also yielded new information regarding how individuals recover language after stroke. We briefly review the strengths and weaknesses of the various radiological methods currently used to study language and aphasia.     

Documentary Bioethics: Visual Narratives for Generations X and Y

Narrative bioethics is primarily understood to involve storytelling through the use of literature. This article suggests that other forms of media are necessary to convey stories of an ethical nature to an audience broader than one being trained as medical professionals. "Documentary bioethics" is a manner to present and interpret stories of an ethical nature using forms of popular electronic media in a reality-based documentary style to society at large, specifically Generations X and Y.     

The use of a consultation team to network families with other helping systems

Families, therapists, and other service providers often find themselves uncooperative and at cross purposes when working toward solutions to family problems. Sometimes each professional is involved in one small piece of the problem and may never have encountered other providers and all family members. This paper describes a family-agencies-team consultation model intended to address the above issues. The model uses a consultation team to facilitate better understanding of family needs, helping agency roles, and service provider constraints. The approach has been successful in creating dialogue, generating a wide range of goals, engendering cooperation, empowering families, and affirming agency participation.In addition to the authors, the consultation team included staff members at the Pitt County Mental Health Center working with client families and other agencies in Pitt County, North Carolina.     

Family therapy in primary health care: Skills training and outcome evaluation

Some of the theoretical tenets of family therapy such as emphasis on the activation and utilization of existing family resources and the importance it accords to context appear to have a good fit with primary health care's commitment to empowering individuals in their struggle against ill health and the circumstances in which it occurs. This paper explores the possibility of teaching a problem-solving approach to family therapy to nurses in a South African primary health care system. Training consisted of conceptual, pragmatic, and self-growth exercises, and trainees' conceptual and performance skills were compared to the skills of a group of untrained nurses.We thank Bukelwa Selema, co-trainer on the program, for her contributions to joining effectively with the nurses and enriching the experiential process. We also thank Dr. P.J. Beukes, Dr. J.H. Olivier, Dr. G.M. Louw, Matron L.C. Langley and other staff in the Soweto primary health care system for their support. In particular, we are grateful to nursing sisters Martha Nkoane and Millicent Matomela, who roleplayed clients on the videotaped training modules. We are also grateful to Edcent Williams, who was one of the videotape raters, and Mike Spruce, Ricky Snyders, Nico Cloete, Ricky Mauer, and Brenda Radebe for their inputs at various stages of designing and implementing the programme.     

Experienced closeness and distance among family members

This study looks at experienced emotional closeness among family members using a projective measure, the Family Paper Sculpture. Results support the hypothesis that, in a non-clinical population, experiences of extreme closeness and extreme distance may be different manifestations of the same underlying process. Some support is found for the hypothesis that families in which relationships are experienced as very close or very distant at one point in time may experience those same relationships as extreme in the opposite direction at another point in time. Global coding of taped family interactions supports the hypothesis that extremes of experienced closeness are associated with more conflict, less ability to resolve differences, and less warmth and support among family members. It is suggested that the experience of being very close, varying through time with the experience of being very distant, may be associated with disappointed attempts to achieve closeness with autonomy.worked on this research while a graduate student in psychology at the University of Houston-Clear Lake.David C. Bell, PhD, completed work on this report while at Texas A & M University. He is presently working on a book about connection and dependency.The studies reported here were supported by grants from the National Institute for Mental Health and the Hogg Foundation for Mental Health. The authors would like to thank David Gutterman, Sheila Jones, Judy Nunn, and Theresa Rourke for coding the global scales.     

学习效能感、自我决定动机对学业期望的作用:基于统合模型的分析

研究整群抽样山东某高中高二学生500人,通过统合模型分析自我决定动机在学习效能感预测学业期望中的作用.结果表明,学习效能感—自我决定动机—学业期望的模型与数据拟合良好,学生的学习效能感可以通过自我决定动机,正向预测其学业期望,自我决定动机在学习效能感和学业期望中起中介作用,非自我决定动机不能预测学业期望.说明学习效能感...     

自我损耗降低决策理性:心理机制与边界条件

处于自我损耗状态时, 个体在意愿上偏好即时利益和目标, 并且会做出许多非理性决策行为。在梳理自我损耗对行为决策的影响基础上, 指出自我损耗降低决策理性的注意机制和执行机制:一方面, 损耗使个体注意力更容易为即时利益所捕获, 进而重视短期利益而忽视长远利益, 即降低个体关注未来的能力; 另一方面, 损耗导致个体缺少计划性和行为实施的执行力, 即降低个体坚守未来的能力。此外, 损耗对决策理性的影响存在个体和情境两个方面的重要边界。未来可结合眼动技术验证损耗降低决策理性的注意机制, 进一步探究潜在边界条件以及寻找助推理性决策的方法。     

决策渐进调整过程的个案研究

许多以全面理性为基础的决策理论都倾向于把决策者对事物的认识作为决策的前提,认为一项好的决策只有在充分认识了事物的情况下才是可能的.许多心理学的研究发现,这种假设并不符合实际的情况.本研究以"行动理性"为出发点,运用个案分析技术,深入剖析了某电子原件厂历时半年的生产经营决策过程,揭示了决策在执行的过程中逐步调整和发展的特征.研究发现,作为决策的前提的认识,实际上是在该决策的执行过程中不断发展和完善的.决策者是在决策执行结果的评价基础之上,逐步深入地认识决策的关键问题,包括(1)决策所要解决的问题,(2)决策方案会产生什么样的结果,(3)决策执行方法是否适当,(4)决策应采取什么样的程序和方法,(5)决策的形势和条件如何.正是这些"后见",使决策者能够逐步调整决策,实现决策的"渐进发展".这种行动决策的思想,把决策者的认识、决策和决策执行三者的关系看做一种循环发展的过程.     

医疗保险实施中的新课题：构建合理的利益格局

大连市实施医疗保险制度6年来,在医疗保险制度改革中医保机构、医疗机构、医药行业及参职工在利益格局调整中,出现了一些问题。从有利于医疗保险制度改革和公平、公正、客观的角度,用辩证的方法分析了医疗保险制度改革过程中的几个主要矛盾,进而从改变利益观、完善政策、加快配套改革等方面提出了相应的建议。