国内外预立医疗照护计划社会经济效益的探讨

从卫生经济学视角,探讨预立医疗照护计划的社会经济效益。通过分析预立医疗照护计划的卫生经济政策、经济分析模式及社会经济效益评价研究等发现,预立医疗照护计划具有较明显的社会经济效益。借鉴国外经验和结合我国文化背景提出预立医疗照护计划在我国发展的对策和建议,包括建立相关政策突破发展障碍;构建激励制度,加强人才培养以支撑预立医疗照护计划发展;开展评价预立医疗照护计划经济效益的研究,以价值为导向构建本土化的医疗模式,以期为我国发展预立医疗照护计划的卫生经济学研究领域提供理论依据。

     

Fostering networking behavior,career planning and optimism,and subjective career success: An intervention study

The present study evaluated personal resource-oriented interventions supporting the career development of young academics, working at German universities within the STEM fields. The study sought to foster subjective career success by improving networking behavior, career planning, and career optimism. The study involved a quasi-experimental pre-post intervention with two intervention and two control groups (N = 81 research associates). Participants of the first intervention group received networking training; participants of the second intervention group received the same networking training plus individual career coaching. Participants of both intervention groups were female. Participants of the control groups (i.e., male vs. female group) did not participate in any intervention. As expected, path analyses, based on mean differences from pre-test to post-test, revealed an increase in career planning and career optimism within the networking plus career coaching intervention group, that was indirectly positively related to changes in subjective career success. Contrary to our expectations, the networking group training alone and in combination with the career coaching showed no effectiveness in fostering networking behavior. Results are discussed in the context of career counseling and intervention effectiveness studies.     

Translating intentions into nutrition behaviors via planning requires self-efficacy: evidence from Thailand and Germany

A first step towards the improvement of daily dietary behaviors is forming an intention to change one's nutrition. However, an intention by itself is not sufficient for successful action. Rather, to translate intentions into behavior, careful planning is recommended. Thus, planning constitutes a mediator between the intention and the behavior. However, if a person lacks self-efficacy, this mediation might fail. Previous research in Costa Rica and South Korea has identified perceived self-efficacy as a moderator of the intention-planning-behavior relationship. To examine further the moderator role of self-efficacy, two additional studies were designed in Thailand and Germany. Study 1 surveyed 1718 Thai university students in terms of a low-fat diet; Study 2 surveyed 1140 German internet users in terms of their fruit and vegetable consumption at two measurement points in time, 6 months apart. Intentions served as predictor, planning as mediator, self-efficacy as moderator, and behaviors as outcomes. First, intentions were translated into nutrition behaviors by planning. Second, self-efficacy moderated this mediation in both studies: The strength of the mediated effect increased along with levels of self-efficacy, even when accounting for baseline behaviors. For planning to mediate the intention-behavior relation, people must not harbor self-doubts. If they lack self-efficacy, intentions are not well translated into nutrition behavior through planning.     

Young Adults' Attitudes toward Multiple Role Planning: The Influence of Gender, Career Traditionality, and Marriage Plans

This study examined personal and relationship influences on attitudes toward multiple role planning, specifically preparing to combine work and partnership roles. Survey data were collected from 66 young adult heterosexual couples. Results revealed that marriage plans related positively to knowledge and certainty about multiple role planning. Gender and career traditionality interacted with marriage plans in its influence on commitment to and involvement in multiple roles. Moreover, attitudes toward multiple role planning mediated the association between marriage plans and planning activity for work-family balance. Implications for research and application in multiple role planning are addressed.     

Identification and Responsibility

Real-self accounts of moral responsibility distinguish between various types of motivational elements. They claim that an agent is responsible for acts suitably related to elements that constitute the agent's real self. While such accounts have certain advantages from a compatibilist perspective, they are problematic in various ways. First, in it, authority and authenticity conceptions of the real self are often inadequately distinguished. Both of these conceptions inform discourse on identification, but only the former is relevant to moral responsibility. Second, authority and authenticity real-self theories are unable to accommodate cases in which the agent neither identifies nor disidentifies with his action and yet seems morally responsible for what he does. Third, authority and authenticity real-self theories are vulnerable to counterexamples in which the provenance of the agent's real self undermines responsibility.     

Estimation of the Coefficient of Variation with Minimum Risk: A Sequential Method for Minimizing Sampling Error and Study Cost

The coefficient of variation is an effect size measure with many potential uses in psychology and related disciplines. We propose a general theory for a sequential estimation of the population coefficient of variation that considers both the sampling error and the study cost, importantly without specific distributional assumptions. Fixed sample size planning methods, commonly used in psychology and related fields, cannot simultaneously minimize both the sampling error and the study cost. The sequential procedure we develop is the first sequential sampling procedure developed for estimating the coefficient of variation. We first present a method of planning a pilot sample size after the research goals are specified by the researcher. Then, after collecting a sample size as large as the estimated pilot sample size, a check is performed to assess whether the conditions necessary to stop the data collection have been satisfied. If not an additional observation is collected and the check is performed again. This process continues, sequentially, until a stopping rule involving a risk function is satisfied. Our method ensures that the sampling error and the study costs are considered simultaneously so that the cost is not higher than necessary for the tolerable sampling error. We also demonstrate a variety of properties of the distribution of the final sample size for five different distributions under a variety of conditions with a Monte Carlo simulation study. In addition, we provide freely available functions via the MBESS package in R to implement the methods discussed.     

Self-efficacy,planning, and preparatory behaviours as joint predictors of physical activity: A conditional process analysis

Objective: Planning can bridge the gap between intentions and action, but what bridges the gap between planning and action? This study helps to answer the question by disentangling the interrelationships between self-efficacy, planning and preparatory behaviours in predicting physical activity. Preparatory behaviours are tested as a working mechanism of planning. Moreover, it is tested whether the utility of preparatory behaviours depends on an individual’s level of self-efficacy.

Methods: A survey assessed planning, self-efficacy and preparatory behaviours for physical activity. Adults (N = 166) provided data at two measurement points. In a longitudinal model, preparatory behaviours were specified as a mediator between planning and physical activity. Self-efficacy was specified as a possible moderator at two points in the model.

Results: Preparatory behaviours mediated the relationship between planning and physical activity. An interaction between self-efficacy and preparatory behaviours on physical activity was found, indicating that individuals with low self-efficacy beliefs were more active if they engaged more frequently in preparatory behaviours.

Conclusion: Planning seems to stimulate preparatory behaviours, which in turn make future physical activity more likely. Furthermore, as performing preparatory behaviours represent a step forward towards the enactment of behavioural goals, preparatory behaviours may be particular beneficial for individuals afflicted by self-doubts regarding physical activity.     

Clinical Exchange: The Architectural Failure

The Clinical Exchange invites eminent clinicians of diverse persuasions to share, in ordinary language, their clinical formulations and treatment plans of the same psychotherapy patient—one not selected or nominated by those therapists—and then to discuss points of convergence and contention in their recommendations. This Exchange concerns a Mr. L, a 47-year-old, married man presenting for outpatient individual psychotherapy with chief complaints of depression, anxiety, and a lengthy history of vocational underachievement. Drs. Herbert Fensterheim, Leslie Greenberg, and Leigh McCullough, who anchor their practices in the cognitive-behavioral, experiential, and psychodynamic orientations, respectively, are the featured commentators. Finally, Dr. Jerold Gold, the case contributor and Mr. L's psychotherapist, provides a few closing comments.     

Determining the implementation order of a general plan by using a multicriteria method

We describe a real-life application of a new multicriteria method in the context of assisting the decision-making for a general plan in the municipality of Kirkkonummi in Uusimaa, Finland. At the time our group started working on the problem, a proposal for an overall plan had already been completed, but the order in which different regional parts of the plan should be implemented needed to be considered based on the environmental impact assessment (EIA) procedure. The EIA procedure generated a large amount of data about the different impacts of the alternatives. For this group decision making problem we developed the SMAA-3 decision support method which does not require any explicit preference information from the decision makers during the procedure. The uncertainty of the basic data is modelled using ELECTRE III-type pseudo-criteria with preference and indifference thresholds. © 1998 John Wiley & Sons, Ltd.