医疗保健是权利还是特权

分析了医疗保健是权利还是特权的问题,美国和中国的医疗保健供给体制在医疗保健的概念上被界定为医疗市场的一种商品。虽然作为商品的医疗保健的性质已被讨论,但更具社会责任感的论证应是强调医疗保健是一种权利。社会表示对其成员健康的关不的主要方式主要是通过国家健康保险而体现的,从这个角度出发回顾了美国和中国的医疗保健情况。     

The association between adverse childhood experiences and personality,emotions and affect: Does number and type of experiences matter?

BackgroundThere is strong evidence that adverse childhood experiences (ACEs) negatively impact mental health. However, the association between ACEs and personality, emotions and affect are poorly understood. Therefore, we examined the association between composite ACE score and ACE type and personality, emotions and positive and negative affect.MethodsThree waves of data from the Midlife Development in the United States (MIDUS) study were used. ACE was the primary independent correlate. Covariates included demographic variables and survey wave. Outcome variables included generativity, personality traits (agreeableness, conscientiousness, extraversion, neuroticism, openness, agency), and affect (positive, negative). Statistical analyses included 3 approaches: (1) treatment of ACE as dichotomous, (2) ordinal composite of ACE score, and (3) three individual ACE type components to assess the association between ACE and psychological constructs.ResultsOf 6323 adults in the sample, 53% were female, and 56% had a past ACE. In the adjusted analyses, dichotomized ACE was significantly associated with neuroticism (β = 0.10; 95% CI 0.07, 0.13) and conscientiousness (β = −0.03; 95% CI −0.05, −0.01). All ACE scores were significantly and positively associated with neuroticism and negatively associated with conscientiousness. Abuse was significantly associated with neuroticism (β = 0.20; 95% CI 0.16, 0.24), openness (β = 0.08; 95% CI 0.05, 0.11), conscientiousness (β = −0.05; 95% CI −0.08, −0.02), and agency (β = 0.06; 95% CI 0.02, 0.10). All ACE categories, except financial strain, were significantly associated with affect.ConclusionACEs are significantly associated with personality, emotions, and affect, with greater effect seen at higher ACE scores and with ACE abuse type, which helps support the cumulative risk hypothesis and our study hypothesis. There is a need for continued research to understand the mechanistic processes and the directionality of the association between ACEs, emotions, and behaviors to help continue to drive biopsychosocial interventions.