社区卫生服务——体现效率与公正特征的改革之路

社区卫生服务比较全面地体现了公正与效率的原则，是卫生改革的一项重大举措。它公正有效地突破了固有的卫生体制；公正有效地实现了“人人享有初级卫生保健”的目的；公正有效地推进了医学模式的转移；公正有效地抓住了纠风的症结；公正有效地解决了医疗费居高不下的顽症。     

Do performance approach‐oriented individuals generate creative ideas? The roles of outcome instrumentality and task persistence

The literature is inconclusive about the positive and negative effects of performance approach goal orientation (PAGO) (i.e., a focus on demonstrating high performance and outperforming others) on creativity. To address this issue, this study examines when and how PAGO stimulates or hinders employee creativity. Drawing on trait activation theory and a self‐regulatory perspective, we propose that outcome instrumentality (i.e., the perception that one will receive desired organizational outcomes when performing well) moderates the effects of PAGO on task persistence bidirectionally, which, in turn, facilitates or hinders employee creativity. Results based on a two‐wave, multi‐source field survey provided strong support for our hypotheses. We found that the relationship between PAGO and task persistence was positive when outcome instrumentality was high but became negative when outcome instrumentality was low. Moreover, we found a moderated mediation effect, such that the indirect effect of PAGO on creativity through task persistence was positive when outcome instrumentality was high but negative when outcome instrumentality was low. These findings extend the PAGO literature by elucidating the goodness and badness of PAGO and provide practical implications on how to manage performance approach‐oriented employees to capitalize on their creative potentials and minimize the possible detrimental effects of PAGO on creativity.     

Vocabulary growth rate from preschool to school‐age years is reflected in the connectivity of the arcuate fasciculus in 14‐year‐old children

The acquisition of language involves the functional specialization of several cortical regions. Connectivity between these brain regions may also change with the development of language. Various studies have demonstrated that the arcuate fasciculus was essential for language function. Vocabulary learning is one of the most important skills in language acquisition. In the present longitudinal study, we explored the influence of vocabulary development on the anatomical properties of the arcuate fasciculus. Seventy‐nine Chinese children participated in this study. Between age 4 and age 10, they were administered the same vocabulary task repeatedly. Following a previous study, children's vocabulary developmental trajectories were clustered into three subgroups (consistently good, catch‐up, consistently poor). At age 14, diffusion tensor imaging data were collected. Using ROI‐based tractography, the anterior, posterior and direct segments of the bilateral arcuate fasciculus were delineated in each child's native space. Group comparisons showed a significantly reduced fractional anisotropy in the left arcuate fasciculus of children in the consistently poor group, in particular in the posterior and direct segments of the arcuate fasciculus. No group differences were observed in the right hemisphere, nor in the left anterior segment. Further regression analyses showed that the rate of vocabulary development, rather than the initial vocabulary size, was a specific predictor of the left arcuate fasciculus connectivity.     

如何减少医疗差错

医疗差错是危及医疗安全、制约医疗质量、影响医患关系、引发医患纠纷的核心问题,是医院管理的重点和难点.本文通过对医疗差错的分析和美国七大减少医疗差错的借鉴来探讨如何结合我国医院的实际来有效地减少医疗差错的发生.     

临床研究最小风险的伦理争论

介绍了最小风险概念的伦理作用,阐述美国学者L.M.Kopelman对澳大利亚、加拿大、南非、美国及国际医学组织会理事的<涉及人的生物医学研究国际伦理准则>法规或伦理规章对于最小风险不同解读方式之分析及建议,最后论述Kopelman对最小风险概念的分析及建议的意义.     

围手术期血糖控制

糖尿病患者围手术期血糖控制是临床糖尿病处理的一大难题,围手术期血糖控制状况对术后病死率及感染等并发症有重要影响.良好的血糖控制可以改善患者预后,但严格控制血糖也会增加低血糖和多项不良事件发生的风险.目前时围手术期血糖控制的目标尚无统一标准,缺乏充分的前瞻性对比研究和循证证据.本文作者对近几年关于围手术期血糖控制相关文献综合整理,结合相关临床经验,就围手术期血糖控制进行探讨.     

道德认知的测量

文章研究梳理了道德认知研究中的测量方法的理论脉络及其演进。道德认知的测量始于皮亚杰和科尔伯格的临床访谈法。后来者从中汲取精髓,采用量表的形式进行道德认知测评,比如莱斯特的确定问题测验以及林德的道德判断测验。随着内隐社会认知理论的发展,研究者将实验测量方法(比如IAT)用于道德认知测评。文章研究分析了各种测量方法的优势和劣势,并对未来的道德认知测量作出展望。     

Predicting Job Seeking Frequency and Psychological Well-Being in the Unemployed

Unemployed (n = 118) and employed (n = 120) people were contrasted on variables of well-being, confidence, and employment commitment. The unemployed scored lower on the General Health Questionnaire (Goldberg, 1972) and the General Self-Efficacy Scale (Sherer et al., 1982). No differences were Identified on levels of employment commitment. For the unemployed sample, predictors of job-seeking behavior and well-being were then examined. Intention to seek work predicted job-seeking behavior, while self-efficacy, employment commitment, and intentions to seek work predicted well-being. Results are discussed in light of current theories of job seeking behavior, and recommendations are made for practice.     

移动窗口条件下语音、字形信息在汉语阅读中的作用

采用移动窗口方法,初步探讨了音音、字形在汉语阅读中的作用。结果发现：在错词经一、二个字上,被度的阅读反应时加长;同音错词和形似错词同时引起反应时的增加;同音词引起的反应时增加效应消失得较早、较彻底,这表明：Ｔ上的汉语阅读理解过程中,（１）对语音和这形的加工是比较好时的;（２）语音和字形在正常阅读的字词识别早期同样起作用;（３）在在发现错误一,语音引导错误恢复的能力强于字形。