社区卫生服务中医发展战略

在社区卫生服务中发挥中医药优势,不仅能够提高人民健康水平,而且能够促进机构自身发展,用管理学的SWOT（斯沃特）战略分析法分析了当前中医药在社区卫生服务发展中的优势与劣势、外部机会与威胁,对其发展面临的问题作了综合性的剖析,并提出相应的发展策略。     

RESPONSIBILITY AND DISABILITY

Abstract: This essay explores the boundaries of the moral community—the collection of agents eligible for moral responsibility—by focusing on those just inside it and those just outside it. In particular, it contrasts mild mental retardation with psychopathy, specifically among adults. For those who work with and know them, adults with mild mental retardation are thought to be obvious members of the moral community (albeit not full-fledged members). For those who work with and theorize about adult psychopaths, by contrast, they are not members of the moral community (albeit not in such a full-fledged fashion as the insane). Both psychopaths and adults with MMR have a disability, and the essay is interested in how disability sometimes exempts one from the moral community and sometimes doesn't. It will be through two associated puzzles that we will eventually come to see the complicated tripartite relation between disability, responsibility, and moral community.     

Sequence and Timing of Three Community Interventions to Domestic Violence

Community responses to domestic violence typically involve the introduction of multiple interventions. Yet very little is known about the impact of the timing and sequencing of these interventions on community outcomes. A reason for this is the inherent limitations of traditional methods in social science. New methods are needed to understand the effect of varying the sequence and timing of interventions. This study responds to the issue by introducing system dynamics as a method for modeling community interventions. The paper presents a model of domestic violence cases moving through a criminal justice response, and uses the simulation model to evaluate the impact of implementing three interventions—mandatory arrest, victim advocacy, and changes in level of cooperation—on two system-level outcomes: improving offender accountability and increasing victim safety. Results illustrate the complex nature of these relationships. Implications for community practice and future research are also discussed.     

西方社区心理学形成背景与发展历程考略

本文考察了西方社区心理学的形成背景与发展历程,并展望其在中国的应用前景。西方社区心理学的形成受到美国社区心理卫生运动、民权运动的深刻影响。1965年社区心理学诞生后,经过众多学者的努力,已发展成一门以预防问题行为、促进社会能力为核心内容,以多学科交叉、行动研究为鲜明特色的应用心理学新兴领域。目前中国正在推进和谐社会建设。社区既是社会生活的基础,又是社会结构中承上启下的中枢,因而社区心理学在中国具有广阔的发展前景。     

Negative consequences of community group participation for women's mental health and well‐being: Implications for gender aware social capital building

Participation in community groups is argued to be an important way to create health‐promoting social capital. However, relatively little attention has been paid to the ways in which gender affects the health promotion potential of participation. This paper reports on a qualitative study of women's experiences of participation in a diverse range of community groups, and considers how such involvement can potentially have a negative impact upon mental well‐being. In‐depth interviews were conducted with 30 women in Adelaide, South Australia. Women's accounts of their group involvement reflected that their identities as mothers were particularly important in shaping their participation. Some women reported difficulties in combining group involvement with their family responsibilities. Stress attached to negotiating social interaction within groups was also raised as an issue. It was found that participation can reinforce gender inequality and potentially have severe negative consequences for mental health, issues that need to be considered alongside the potential health benefits. The findings are considered in light of Bourdieu's critical conceptualization of social capital. Copyright © 2008 John Wiley & Sons, Ltd.     

社区卫生服务的“管理模式”与“治理模式”比较

依据社区卫生服务的提供方与消费方之间的权力关系,社区卫生服务模式可以划分为管理模式和治理模式。在管理模式中,社区卫生服务提供方与消费方之间是建立在行政和技术权威基础上的管理与被管理关系。在治理模式中,社区卫生服务的提供方与消费方则是建立在沟通基础上的合作关系。我国社区卫生服务模式的发展趋势是从管理向治理的转变。     

A variable neighborhood search method for generalized blockmodeling of two-mode binary matrices

The clustering of two-mode proximity matrices is a challenging combinatorial optimization problem that has important applications in the quantitative social sciences. We focus on one particular type of problem related to the clustering of a two-mode binary matrix, which is relevant to the establishment of generalized blockmodels for social networks. In this context, clusters for the rows of the two-mode matrix intersect with clusters of the columns to form blocks, which should ideally be either complete (all 1s) or null (all 0s). A new procedure based on variable neighborhood search is presented and compared to an existing two-mode K-means clustering algorithm. The new procedure generally provided slightly greater explained variation; however, both methods yielded exceptional recovery of cluster structure.     

Social support, sense of community in school, and self-efficacy as resources during early adolescence: an integrative model

Influences of different sources of social support (from parents and friends), school sense of community, and self-efficacy on psychosocial well being (as measured by self-reported life satisfaction and psychological symptoms) in early adolescence were investigated in an integrative model. The model was tested using structural equation modeling. Multi-group comparisons were used to estimate differences between sex and age groups. The survey sample was composed of 7,097 students in Northern Italy (51.4% male) divided into three age cohorts (equivalent to 6th, 8th, and 10th grades with median ages of 11, 13, and 15). Findings obtained using SEM were consistent with self-efficacy and school sense of community mediating effects of social support on psychosocial adjustment. The multi-group comparison indicates a need for more complex developmental models and more research on how changing forms of support interact with each other as their effects also change during this important stage of the life. Implications for primary prevention and cross-cultural comparisons are discussed.     

Affiliation to Youth Gangs During Adolescence: The Interaction Between Childhood Psychopathic Tendencies and Neighborhood Disadvantage

Because youth gangs tend to cluster in disadvantaged neighborhoods, adolescents living in such neighborhoods are more likely to encounter opportunities to join youth gangs. However, in the face of these opportunities, not all adolescents respond in the same manner. Those with preexisting psychopathic tendencies might be especially likely to join. In this study, we tested whether a combination of individual propensity and facilitating neighborhood conditions amplifies the probabilities of youth gang affiliation. A subset of 3,522 adolescents was selected from a nationally representative, prospective sample of Canadian youth. Psychopathic tendencies (i.e., a combination of high hyperactivity, low anxiety, and low prosociality as compared to national norms) were assessed through parent reports, while neighborhood characteristics (i.e., concentrated economic disadvantage and residential instability) were derived from the 2001 Census of Canada. Our results indicated that neighborhood residential instability, but not neighborhood concentrated economic disadvantage, interacted with individual propensity to predict youth gang membership. Adolescents with preexisting psychopathic tendencies appeared especially vulnerable mainly if they were raised in residentially unstable neighborhoods.     

The Multidimensional Nature of Social Cohesion: Psychological Sense of Community, Attraction, and Neighboring

Items from the Neighborhood Cohesion Instrument were completed by 1,732 individuals from a random sample of households in 20 rural communities across Canada during the summer of 2001. Confirmatory factor analysis of the NCI items based on polychoric correlations and weighted least squares estimation found three underlying latent variables. Although items were related to the three latent variables in a somewhat different manner than they were in Buckner's original study, the same three latent variables were evident, providing convincing evidence that social cohesion has at least three subscales: psychological sense of community, neighboring, and attraction. Correlations between subscales were relatively high (between .67 and .87). Intraclass correlation coefficients for the three scales were .115, .127, and .112. In addition, the community means differed on different subscales in a manner that related to recognized characteristics of the communities. Thus the subscales are appropriate measures for both individuals and communities and can be recommended for further research on social cohesion.