“言”说

世上大学问多的是,但作为人的第一件大事就是要学会说话;善于用语言来表达自己的思想和观点。会不会与人沟通交流,除与环境和对象有关以外,关键一点在于自己是否有言谈,会辩的技巧;这种技巧主要体现在表达的能力上。常言道:会说话的人不抢着讲,不会讲话的人争着说。其实这一来说明自己态度不谦虚、没礼貌;二来说明个人的表现欲很强;三者说明没有表达涵养。太上爷曰:“知者不言,言者不知。”有智谋的人遇事沉稳,并不急于表现自己;同时说明夸夸其谈只不过是“纸上谈兵”、故弄玄虚、卖弄自己而已;空话一大堆,只会招来别人的厌恶、心烦。进一步…     

Disparities in access to family physicians among transgender people in Ontario,Canada

Background: Informed by the Gelberg-Andersen behavioral model for vulnerable populations, this study examined the prevalence of and factors associated with not having a family physician among transgender (trans) people in Ontario, Canada.

Methods: Data were drawn from a respondent-driven sampling (RDS) survey of trans Ontarians age 16 and above (n = 433) conducted between 2009 and 2010. All analyses were weighted using RDS II methods. Prevalence ratios were estimated using average marginal predictions from logistic regression models.

Results: An estimated 17.2% (95% CI, 11.0 to 22.9) of trans Ontarians (median age = 28.7, 77.3% White) did not have a regular family physician. In multivariable analyses accounting for other predisposing and need-related factors, transfeminine persons (trans women and non-binary persons assigned a male sex at birth) who were Indigenous and/or persons of color were less likely than other transfeminine persons to have a family doctor. In addition, trans persons who were homeless or had unstable housing were less likely to have a family doctor than those who were adequately housed.

Conclusions: These results provide the first quantitative evidence of health disparities by race and gender within a Canadian transgender population and suggest a social gradient in access to care within Ontario's “universal health insurance” system.     

中国道教协会会长办公会议在京召开

3月8日,中国道教协会会长办公会议在北京白云观召开.国家宗教事务局副局长齐晓飞莅会并发表讲话.出席会议的有中国道教协会会长任法融,副会长张继禹、黄信阳、黄至安、丁常云、唐诚青、赖保荣、刘怀元、林舟、张金涛、张凤林及协会驻会副秘书长张立光、孙同昌、冯正伟、李兆彩、王炳旸等.在京参加全国政协十一届二次会议的湖北省道教协会名誉会长李光富列席了会议.     

2岁幼儿的社会朝向反应——本质及功能

本研究以66对17至32个月的幼儿和母亲为研究对象,研究了在实验室情境中,幼儿在不同实验情境下对母亲的社会朝向反应,并探讨了幼儿社会朝向行为的功能以及母亲的行为对幼儿社会朝向反应的影响。结果显示,（1）大多数幼儿在实验中都表现出了至少一次的社会朝向反应,社会朝向反应的发生是酱遍的;（2）在不同情境中,幼儿的社会朝向反应不同,在积极的情境中,社会朝向反应有分享情绪经历的功能;在抗拒诱惑的任务中,社会朝向行为与获得支持有关;（3）母亲对情境的非信息性反应对幼儿的社会朝向行为有影响,社会朝向是幼儿对社会情境的适应性行为,对这种非语言的情感交流行为的研究可以帮助我们探究幼儿情绪社会化的过程。     

医疗机构伦理的内涵、意义及挑战

为推动国家卫生保健政策的落实,解决医务人员面临执业困境的现实问题,对医疗机构伦理的内涵、意义及其面临的挑战展开讨论。医疗机构伦理概念的提出来自于企业伦理经营的启发,其特征表现为实践性、中介性、导向性。医疗机构伦理的意义在于,这是医疗机构对社会的公开承诺,是医疗机构及医务人员行为道德的风向标,是医务人员团结的凝结剂,是执行卫生保健政策的铺路石。同时,应正视医疗机构伦理面临的挑战,包括医学市场化冲击人道主义的行善宗旨、医疗机构人文关怀日渐衰落、治病与致病的矛盾日益显现、医学公平性与可及性受到威胁。     

举证责任倒置与临床实践中证据的思考

医疗纠纷的举证责任倒置对医疗患双方产生广泛而深远的影响,也使医学与法律产生了碰撞,这就要求医务工作者在临床实践中既要为患者服务又要做到每个临床决策都必须有章可循,有法可依,有据可查以维护自己的合法权益,正确认识举证责任倒置的要求和掌握在临床实践中遵循证据的方法以避免陷入越来越多的医疗纠纷。     

Evaluating the filial behaviour scale across three cultural groups using exploratory structural equation modelling

Filial piety is a Confucian concept that guides how children treat and take care of their parents. The Filial Behaviour Scale (FBS) is a 25-item instrument developed in the Chinese context measuring behavioural manifestations of filial piety. Although the components of filial piety have been found to be relevant across cultures, little research has investigated the psychometric properties of the FBS in other cultural contexts. The present study evaluated the factor structure, internal consistency, measurement invariance and construct validity of the FBS across three cultural groups: the United States, Italy and Malaysia. Participants were 1090 emerging adults (67% females; M_age = 21.29 years, SD = 1.97; White Americans: n = 455, White Italians: n = 428, Malays: n = 328). A two-factor structure emerged across groups: Obedience/Obligation (behaviours showing obedience and obligation towards parents) and Relationship (behaviours expressing affection and promoting positive parent–child relationships). The two factors demonstrated adequate internal consistency, full configural, partial metric and partial scalar invariance, as well as unique associations with depressive symptoms and parent–child relationships across groups. These findings yielded a more nuanced understanding of filial behaviour and supported the utility of a two-factor FBS among emerging adults in various cultural contexts.     

Impact of Spina Bifida on Parental Caregivers: Findings from a Survey of Arkansas Families

The well-being of caregivers of children with spina bifida and other conditions is an important topic. We interviewed the primary caregivers of 98 children aged 0–17 years with spina bifida sampled from a population-based birth defects registry in Arkansas and the caregivers of 49 unaffected children. Measures of caregiver well-being were compared between the groups and by level of lesion (sacral, lower lumbar, and upper lumbar/thoracic). We performed linear and logistic regression analysis to test the associations controlling for other characteristics. Among caregivers of children with spina bifida, the average number of hours of sleep was significantly less than reported by other caregivers and was associated with lesion level among children less than 7 years of age. Significant associations, often varying by child age, were also found for the caregiver’s reports of lower Quality of Well-Being (QWB) score, often feeling blue, rarely feeling happy, fair or poor health, lack of leisure days, and not hosting friends, but no significant association was found with not visiting friends. The intensive long-term care required by children with spina bifida, particularly by those with higher lesions, can negatively impact caregiver health and well-being. Support for these caregivers is needed.