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。     

医患沟通障碍的现象学诠释及对话调适

相当多的医患冲突不是由医疗技术的原因引起,而是医患沟通不畅造成的。从现象学视域诠释医患关系,分析了医患对于“疾病”意义的不同认识,只有在诠释学语境中建立“你我”对话关系,在倾听中领会,才能在理解中寻找到共享的意义世界。从一个全新的视角构建了医患视域融合的框架,在医患对话实践中,通过“移情”跨越医患视域前见的鸿沟,以达到医患视域的融合。     

The Spotlight Effect Revisited: Overestimating the Manifest Variability of Our Actions and Appearance

Three studies examined people's estimates of the perceived variability of their appearance and behavior in the eyes of others. Whether assessing the manifest variability of their physical appearance (Studies 1a, 1b, and 1c), their athletic accomplishments (Study 2), or their performance on a popular videogame (Study 3), participants consistently overestimated the extent to which their ups and downs would be noted by observers. The results of Study 3 suggest that this bias stems in part from a failure to appreciate the extent to which observers are preoccupied with managing their own actions. Discussion focuses on how this corollary of the “spotlight effect” can contribute to social anxiety and gnawing regrets of inaction.     

Facial Expressions of Emotion: Are Angry Faces Detected More Efficiently?

The rapid detection of facial expressions of anger or threat has obvious adaptive value. In this study, we examined the efficiency of facial processing by means of a visual search task. Participants searched displays of schematic faces and were required to determine whether the faces displayed were all the same or whether one was different. Four main results were found: (1) When displays contained the same faces, people were slower in detecting the absence of a discrepant face when the faces displayed angry (or sad/angry) rather than happy expressions. (2) When displays contained a discrepant face people were faster in detecting this when the discrepant face displayed an angry rather than a happy expression. (3) Neither of these patterns for same and different displays was apparent when face displays were inverted, or when just the mouth was presented in isolation. (4) The search slopes for angry targets were significantly lower than for happy targets. These results suggest that detection of angry facial expressions is fast and efficient, although does not "pop-out" in the traditional sense.     

Evaluation of a High School Peer Group Intervention for At-Risk Youth

The purpose of this paper is to examine the effectiveness of Reconnecting Youth, a prevention program for at-risk high school youth. Data are from a large, independently evaluated effectiveness trial in two diverse urban school districts. A total of 1,218 students participated; 50% were male; average age was 15. We tested whether positive efficacy trial effects could be replicated, and whether any negative behavioral effects occur when clustering high-risk youth. Although mixed program effects were observed at immediate post-intervention, only negative effects were found at 6-month follow-up. These effects included less optimal scores on measures of GPA, Anger, School Connectedness, Conventional Peer Bonding, and Peer High-Risk Behaviors. Overall, we found little support for the use of this social-influence—model intervention aimed at increasing school connectedness for high-risk youth. Further, this study provides evidence that clustering high-risk youth in preventive interventions has the potential for iatrogenic effects.     

Perspective and prejudice: antecedents and mediating mechanisms

The present work investigated mechanisms by which Whites' prejudice toward Blacks can be reduced (Study 1) and explored how creating a common ingroup identity can reduce prejudice by promoting these processes (Study 2). In Study 1, White participants who viewed a videotape depicting examples of racial discrimination and who imagined the victim's feelings showed greater decreases in prejudice toward Blacks than did those in the objective and no instruction conditions. Among the potential mediating affective and cognitive variables examined, reductions in prejudice were mediated primarily by feelings associated with perceived injustice. In Study 2, an intervention designed to increase perceptions of a common group identity before viewing the videotape, reading that a terrorist threat was directed at all Americans versus directed just at White Americans, also reduced prejudice toward Blacks through increases in feelings of injustice.     

人口逆淘汰及其预防

对人口逆淘汰必须全面、动态地加以认识.必须阻止人口逆淘汰,提高人口质量,变"人口"为"人力".教育是关键措施,医疗卫生和环境改善十分重要,但决不能鼓励高学历人口多生育而限制农村人口的出生.     

Children's competence for assent and consent: a review of empirical findings

This narrative review summarizes the empirical literature on children's competence for consent and assent in research and treatment settings. Studies varied widely regarding methodology, particularly in the areas of participant sampling, situational context studied (e.g., psychological versus medical settings), procedures used (e.g., lab-based vs. real-world approaches), and measurement of competence. This review also identifies several fundamental dilemmas underlying approaches to children's informed consent. These dilemmas, including autonomy versus best interest approaches, legal versus psychological or ethical approaches, child- versus family-based approaches, and approaches that emphasize consent versus those that emphasize assent, have implications for the measurement of children's competence and interpretation of findings. Recommendations for future research in the area of children's informed consent include the use of diverse samples and control groups, development of multidimensional and standardized measures of competence, utilization of multidimensional and standardized measures of competence, utilization of observational methods and longitudinal designs, examination of noncognitive aspects of children's competence and comparison of children's competence for treatment and research decisions.     

Homo Orans: Von Balthasar's Christocentric Philosophical Anthropology

Hans Urs von Balthasar's philosophical anthropology is the premise not only of his religious epistemology, but also of his whole theological enterprise. The importance of his anthropology to the rest of his theology is often overlooked, because its fundamentals are set out in an early work to which little critical attention has been given: Das Betrachtende Gebet – a work which emphasizes the "necessity of prayer". According to von Balthasar, in praying, one encounters God, and it is through this encounter that one can attain authentic personal identity and genuine fulfilment. In short, what this early work indicates is a conception of humanity as homo orans .