探析美国国家生命伦理学委员会--历史沿革及启示

在一个没有单一国教或价值权威能全盘解决科技政策与价值问题的多元社会中,由政府设置公共论坛性质的政策咨询委员会,是一项值得采纳的作法.美国先后设立过6个国家生命伦理学委员会,探析它们的建立与变迁,可以为我国类似组织提供参考.     

论卫生改革的改革

首先讨论我国卫生改革的评价问题,指出对改革的评价表面上似乎是个事实判断,但实际上是个价值判断,并列举数据说明改革引起的不公正后果。其次指出我国的卫生改革一开始就缺乏伦理基准,并详细论述了应该具有的伦理基准是什么。最后讨论了市场在医疗卫生事业的作用,以及对卫生改革的改革建议。     

美国社区卫生服务运行机制和管理模式研究

美国的卫生服务系统由社区卫生服务和医院服务两大部分组成。通过从组织形式、筹资机制、人力资源、动力与约束机制以及管理几个方面,对美国社区卫生服务的运行机制与管理模式进行分析,以期对我国社区卫生的发展有所借鉴与帮助。     

循证卫生管理的探讨

培养博学而人道的医学工作者是医学教育所追求的目标。作为一门交叉学科,医学哲学在医学生的人文素质培养中占有重要地位。对医学哲学的教学内容、理念与方法分别进行探讨,期望医学哲学教育能够提高医学生对与现代医学有关的知识、活动和态度进行批判性反思的意识和能力。     

“健康国家”战略发展的过程与国际经验

基于健康价值概念,居民健康所面临的挑战,以及医疗卫生服务发展趋势,系统描述了“健康国家”战略的发展过程与国际社会实施“健康国家”战略的基本情况,并提出了可借鉴与学习的经验。     

国家卫生财政政策补助对象的顺序选择

论述了国家卫生财政政策补助对象的选择问题,公共卫生服务物品提供机构与医疗服务物品提供机构之间的选择、医疗机构与患者之间的选择、公共卫生服务物品提供机构与居民之间的选择以及医疗机构与医生之间的选择,提出了卫生财政政策补助对象的选择顺序,公共卫生服务物品生产和分配机构,医疗保障机构,患者,医生,医疗机构。     

Preventing Serious Conduct Problems in School-Age Youth: The Fast Track Program

Children with early-starting conduct problems have a very poor prognosis and exact a high cost to society. The Fast Track project is a multisite, collaborative research project investigating the efficacy of a comprehensive, long-term, multicomponent intervention designed to prevent the development of serious conduct problems in high-risk children. In this article, we (a) provide an overview of the developmental model that serves as the conceptual foundation for the Fast Track intervention and describe its integration into the intervention model; (b) outline the research design and intervention model, with an emphasis on the elementary school phase of the intervention; and (c) summarize findings to date concerning intervention outcomes. We then provide a case illustration, and conclude with a discussion of guidelines for practitioners who work with children with conduct problems.     

Styles of pulling in youths with trichotillomania: exploring differences in symptom severity, phenomenology, and comorbid psychiatric symptoms

To date, no studies have examined possible phenomenological differences between the automatic and focused styles of pulling in youths with TTM. The aims of the current study were to examine differences in TTM severity, phenomenology, comorbid psychiatric symptoms, and functional impact across youths with varying degrees of these pulling styles. Youths between the ages of 10 and 17 years (and their parent) were recruited via an Internet-based survey. A total of 186 youths with chronic hair pulling was classified as “high-focused” or “low-focused” and either “high-automatic” or “low-automatic” based upon scores obtained on the Milwaukee Inventory for Styles of Trichotillomania-Child Version (MIST-C) using a median-split procedure. Results demonstrated significant differences between pulling styles. More specifically, “high-focused” pullers reported more severe TTM and greater symptoms of anxiety and depression than “low-focused” pullers, and “high-automatic” pullers reported greater symptoms of depression than “low-automatic” pullers. Subsequent analyses suggest that, in comparison to youths with low levels of both automatic and focused pulling, those experiencing high levels of focused pulling but low levels of automatic pulling reported phenomenological differences and were more likely to engage in additional repetitive behaviors (i.e., skin picking, lip/cheek biting). Clinical and research implications, study limitations, and future areas of research are discussed.     

Time of day affects episodic memory in older adults

The neuropsychological test scores of 2030 cognitively normal older adults were examined to evaluate performance patterns as they related to time of day (TOD) at which testing was initiated. Multiple regression analyses were used to examine the association of TOD with scores on seven neuropsychological tests used in the clinical evaluation of dementia. Episodic memory performance was significantly related to TOD, while memory span and verbal fluency were not. Best performance occurred during early morning hours and late afternoon; worst performance occurred mid-day (i.e., noon). These findings may have implications for clinical assessment, the design of research on dementia, and the daily functioning of older adults.