湖北省农村集中供养五保老人生活质量研究

为了解湖北省农村福利院集中供养五保老人生活质量及其相关影响因素,利用中文SF-36量表对900例湖北省农村60岁及以上的集中供养五保老人、分散中供养五保老人和普通老年人选行调查。经多因素分析结果显示,五保老人的生活质量不仅要注意疾病、体力劳动、担心的问题等方面,更要注重不同供养环境对其产生的影响。     

产前诊断中的伦理学问题

探讨我国产前诊断技术开展的现状,阐述产前诊断面临的伦理道德问题及其相应的伦理学处理原则,建议开创一个伦理学评价体系,使产前诊断向着合理、完善的方向发展,从而达到提高人口出生质量、确保母婴健康的社会共同目标。     

年轻医生如何搞好临床科研

面对目前年轻医生对科研束手无策的状况,提出了科研的重要性。从科研选题要紧密结合临床实际、医学科研选题强调创新与实用的原则、医学科研需要的科研素质、培养独立从事临床科学研究的能力、充分利用优势科研资源,加强科研合作能力的培养五方面进行阐述如何进行临床科研工作,以便更好地促进临床医学事业的发展。     

癌症患者生存质量研究进展

随着癌症患者生存时间和生存人数的增加,生存者本人和家属更加重视生存质量。本文总结分析近年来国内外癌症患者生存质量的研究状况,以期在癌症治疗过程中,不仅关注躯体功能和疾病本身以及由治疗带来的症状和体征,同时注重心理和社会职能。     

Forgiveness, acceptance and the matter of expectation

In this paper, the author argues for a dynamic conceptualization of forgiveness during psychoanalysis. The trauma of failed expectations in intimate relationships is narcissistically dislodging. When legitimate expectations in relationships are not met, forgiveness becomes a challenge for ego to restore the lost narcissistic balance through the resumption of a significant internal bond. The author argues that the ending of any successful analysis is marked by three possibilities regarding the patient's relationship to significant others and his traumas: in cases where the relationship was marked by minimal expectations, one simply learns to accept the wrongdoer without ever feeling the need for forgiveness; in cases where a relationship was marked by high expectations, the patient can learn to accept the trauma without the will or need to forgive its perpetrator. However, even with the painful frustration of high expectations in an intimate relationship, the patient can come to forgive his wrongdoer if there remains enough of a positive internal bond to be salvaged. The developmental roots of such forgiveness, as well as the addictive characteristics of 'nursing a grudge' and the conversion of the qualitative mode of seeking fulfillment into a quantitative one, are further investigated.     

诺贝尔生理学或医学奖获得者科学素质分析

通过对诺贝尔生理学或医学奖184位获得者科学素质的形成过程中,高校学习经历、最高学位授予单位、教授首聘年龄与单位等可以量化的指标进行测度分析,发现他们具有超越一般人的多维度的科学素质,具有学术前沿的国际视野,能把握研究方向的社会意义。     

For-profit/nonprofit differences in center-based child care quality: Results from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development

In secondary analyses of National Institute of Child Health and Human Development Study of Early Child Care and Youth Development data, multiple indicators of quality (caregiver wages and turnover; child/staff ratio; caregiver education and professionalism; positive caregiving) were compared between child care centers by sector (for-profit/nonprofit) and subsector (for-profit independent/chain, nonprofit church/nonchurch) at multiple points from infancy through prekindergarten. Nonprofit centers evidenced higher caregiver wages and education at most ages and better quality child/staff ratios, turnover, caregiver professionalism, and positive caregiving for toddlers and preschoolers. Subsector differences in preschool classrooms were more complex. In general, quality was higher in nonprofit non-religiously affiliated centers, intermediate in nonprofit religiously affiliated and for-profit independent centers, and lower in for-profit chains, but differences were not found on every indicator or between every group. Further, for-profit chain status predicted lower quality positive caregiving, controlling for family characteristics, staff, and structural quality, at 54 months, but not 36 months. Results support and extend prior research by controlling for family characteristics. Policy implications regarding supply- and demand-side quality-improvement strategies that address market competition and parent choice across subsectors are discussed.     

Attribute weighting methods and decision quality in the presence of response error: a simulation study

This paper uses a simulation approach to investigate how different attribute weighting techniques affect the quality of decisions based on multiattribute value models. The weighting methods considered include equal weighting of all attributes, two methods for using judgments about the rank ordering of weights, and a method for using judgments about the ratios of weights. The question addressed is: How well does each method perform when based on judgments of attribute weights that are unbiased but subject to random error? To address this question, we employ simulation methods. The simulation results indicate that ratio weights were either better than rank order weights (when error in the ratio weights was small or moderate) or tied with them (when error was large). Both ratio weights and rank order weights were substantially superior to the equal weights method in all cases studied. Our findings suggest that it will usually be worth the extra time and effort required to assess ratio weights. In cases where the extra time or effort required is too great, rank order weights will usually give a good approximation to the true weights. Comparisons of the two rank-order weighting methods favored the rank-order-centroid method over the rank-sum method. © 1998 John Wiley & Sons, Ltd.     

Increasing Communication Among Nursing Home Residents

In this preliminary, intrasubject study (N = 8), we examined the effects of communication skills training and the use of memory books by Nursing Assistants (NAs) on the social ecology of a nursing home. Through inservice and on-the-job training, NAs were taught to use communication skills and memory books during their interactions with residents with mild to moderate cognitive impairment (Mini Mental Status Examination, M = 16.25), but relatively intact communication abilities. An abbreviated staff motivational system called Behavioral Supervision (Burgio and Burgio, 1990. Int. J. Aging Hum. Deve. 30: 287–302.) was attempted to encourage performance of these skills on the nursing units. Results showed that, regardless of sporadic implementation of the intervention by nursing staff, the intervention improved communication between staff and residents during care routines, increased the amount of time other residents and visitors spent talking with target residents, and increased the rate of positive statements made by the target residents and others in their immediate environment. Results are discussed in terms of limitations of the staff motivational system and modifications made to the system in a larger ongoing intervention trial.