Ethical implications in the allocation of scarce medical resources in Poland

The health care system in Poland is undergoing major change and it is possible that these changes could affect clinical research. Therefore, the situation of funding of health care is important for the future of medical research in this country. Some questions relevant in this field will be addressed. Since funds for health care and scientific research remain inadequate, their allocation raises moral, economic, legal and organisational dilemmas. The clinical aspects of resource allocation also include physicians’ responsibilities towards their patients. Scientific research, clinical medicine, and clinical research have a common denominator: they rely on trust. The physician should be a fiduciary of the patient as well as being a researcher for the benefit of the patient and for society. Some physicians and researchers, despite unethical conduct, escape disclosure and punishment, but decision-makers who wrongly allocate funds for health care and research are never held accountable for their actions. An earlier version of this paper was presented at a symposium, Scientific Misconduct: An International Perspective, organised by The Medical University of Warsaw, 16 November, 1998.     

Improved resiliency and well‐being among military personnel in a Swedish Naval Force after a counter‐piracy operation off the coast of Somalia

The aim of this study was to explore: (1) how the psychological health of the members of the first European Union Naval Force (ME01) was affected by international deployment off the coast of Somalia; and (2) if and how organizational and personal factors (e.g., type of personnel category, previous experiences, and resilience) affected their psychological health and well‐being post‐deployment. The study had an exploratory longitudinal design, where the participants were assessed both before and after deployment (i.e., T1 and T2). The participants (n = 129, 120 men, 9 women) were equally distributed between officers (n = 68; 64 men, 4 women) and sailors (n = 61; 56 men, 5 women). The members' average age was 31 years, ranging from 20 to 61. For the majority (78%) ME01 was their first international deployment and officers were, in general, more experienced than sailors. The overall results showed that the members' reported a positive experience with improved resilience and well‐being (e.g., sense of coherence). However, the result also showed that type of personnel category (i.e., officer or sailor) affected their psychological health. Why and how these differences among military personnel arise is discussed, but deserves further attention.     

Working hours, job stress, work satisfaction, and accident rates among medical practitioners and allied personnel

Predictors of accident behavior among German medical staff revealed that work-related injuries/accidents experienced during a recent 12-month period were significantly related to working hours per week, distance from home to practice, number of dependent children, gender, and job-related stress. The average yearly number of car accidents was predicted by age and number of working hours. Furthermore, driving accidents going to or coming from work during the last year was determined by working climate, hours of work, length of lunchtime break, distance traveled to and from work, number of dependent children, and gender. Physicians working in excess of 48 hours per week displayed significantly more driving accidents but not work-related accidents, and they reported significantly higher levels of job-related stress than those colleagues working fewer than 48 hours per week. The implications of these results are discussed in the framework on risk management in the health services.     

职务评价的方差分析法在制定职务等级中的应用

职务评价的方差分析法的技术核心是通过方差分析确定职务可比价值各成分的权重。此方法的有效性和实用性已在协助国有企业内部分配改革的制定工资标准中得到验证,并显示其普遍性的方法论意义：职务评价值是职务价值的线性映射：凡涉及职务价值差异的问题都可用此方法解决。本研究应用方差分析法为国有金融系统行员制改革中制定统一的职务等级标准提供技术支持和科学依据。评价程序中,职务分析、职务分类、计算职务评价值等前三个步骤与制定工资标准的作法相同。然后,推算各类职务评价值的变异范围（以９５％置信区间代表）,再将各类职务按管理层次合并为大类。最后,寻求一个合理划分各管理层次大类变异范围的约数,划分整个评价值变异范围。对某银行系统４５２种职务的８４１个样本评价的结果,所确定的职务等级数、各职务大类的等级跨度、位次,都符合该银行系统的人事管理经验及改革设想     

试论我国人才测评事业的发展

本文在简要回顾西方人才测评发展历史的基础上,对我国人才测评事业的发展过程进行分析,提出三个不同的发展阶段及其特点。最后在总结经验的基础上,指出我国人才测评事业发展中存在的问题并提出建议。     

Adapting Cognitive Processing Therapy for PTSD for People With Disabilities: A Case Study With a U.S. Veteran

Many veterans receiving treatment for PTSD in the VA health care system are also living with a disability and utilize assistive technologies for communication and/or mobility. While evidence-based treatments for PTSD have been disseminated in VA hospitals nationwide, clinicians may have concerns about implementing these treatments with people with disabilities or question how to adapt evidence-based protocols to facilitate successful outcomes. This clinical case study details the treatment of a 48-year-old male U.S. veteran with a diagnosis of military-related PTSD and significant functional and communicative complexities characteristic of locked-in syndrome. The study implemented an adapted protocol of Cognitive Processing Therapy (CPT), a first-line evidence-based psychotherapy for PTSD with unknown application to people with disabilities. CPT protocol structure, length, and delivery was adapted to accommodate the veteran’s assistive devices and functional abilities. The veteran experienced a clinically significant reduction in PTSD symptoms over the course of treatment, suggesting successful application of the adapted protocol. In addition to symptom reduction, the veteran reported advances in his ability to tolerate emotional distress while engaged in goal-directed behavior and improved interpersonal functioning. Results suggest that CPT can be adapted and effective in instances where the presence of disability and multiple assistive technologies impact standard treatment implementation. This information is valuable in its potential ability to make evidence-based psychotherapies more accessible and disability-sensitive. Clinical recommendations for using and adapting CPT for people with disabilities are provided.     

Buffers or Boosters? The Role of HRM Practices in Older Workers' Experience of Stereotype Threat

Building on the social identity approach and the HRM literature, this two-wave cross-sectional study examined the effects of negative age-based metastereotypes on the age-based stereotype threat experience of older workers and on organizational disidentification. The moderator role of HRM practices in the relationship between negative age-based metastereotypes and age-based stereotype threat was also investigated. Older workers survey results (n = 469) from 14 manufacturing companies indicated that negative age-based metastereotypes correlate positively with stereotype threat. Moderation results showed that age-awareness HRM practices (training for older workers) reinforced age-based stereotype threat, whereas general HRM practices (recognition and respect) impaired it. The article suggests that the combination of age-based metastereotypes with a stereotype threat framework contributes to further understand older workers' beliefs and attitudes. It also indicates that to be effective, HRM practices should emphasize positive social identities older workers share with their colleagues, rather than giving older workers special treatment that may, after all, reinforce stigmatization.