医疗机构伦理的内涵、意义及挑战

为推动国家卫生保健政策的落实,解决医务人员面临执业困境的现实问题,对医疗机构伦理的内涵、意义及其面临的挑战展开讨论。医疗机构伦理概念的提出来自于企业伦理经营的启发,其特征表现为实践性、中介性、导向性。医疗机构伦理的意义在于,这是医疗机构对社会的公开承诺,是医疗机构及医务人员行为道德的风向标,是医务人员团结的凝结剂,是执行卫生保健政策的铺路石。同时,应正视医疗机构伦理面临的挑战,包括医学市场化冲击人道主义的行善宗旨、医疗机构人文关怀日渐衰落、治病与致病的矛盾日益显现、医学公平性与可及性受到威胁。     

职业可续视角下的工作重塑行为研究：动力、路径及干预机制

社会经济高质量、可持续发展的实现, 须依托具备可持续职业能力的人才来引领、支撑和保障。鉴于此, 本研究考虑职业与日间工作行为的联动效应, 探究个体于工作中实现持续竞争优势的潜在动力、路径及干预机制。首先, 确定职业可持续力的概念界定与结构测量, 并揭示其潜在的影响因素、动态发展机理以及对职业主动行为的作用路径。其次, 结合资源保存理论和社会认知理论, 探究职业可持续力与员工工作重塑行为的动态交互作用机制。最后基于职业可持续视角, 探讨组织层面对个体工作重塑行为的纵向干预机制。本研究将为个体实现职业可持续发展以及组织开展共赢的职业管理支持提供策略依据。     

Using a Compromise Programming Framework to Integrating Spatially Specific Preference Information for Forest Management Problems

The development of forest management plans is a multi‐criteria problem that usually involves multiple stakeholders. In forested recreational areas or natural parks, stakeholders could include government officials, forest companies and visitors to the area. With the progress of mobile phone technology, preference information (including aesthetic values) can be conveniently obtained from stakeholders while they are in the forest. This paper develops a methodological approach that incorporates place‐specific opinion preference into the development of alternative forest management plans. Through the use of a modified Compromise Programming approach, prospective alternatives are developed, which optimize the opinions of stakeholders and the quantity of timber over time depending on specified parameters. The analysis is based on a small simulated forest holding and place‐specific simulated opinion data. To allow for a comparison between potential stakeholder groups, the opinion data was generated by a method that produced three separate groups. The results indicate the practical use of place‐specific preferences and provide a means to incorporate the information to generate possible alternative plans. In addition, the analysis highlights that by segregating the preference information into groups, the planning of more specific courses of actions can be made. Copyright © 2015 John Wiley & Sons, Ltd.     

Revue de littérature sur les techniques d’influence et de communication appliquées à la gestion des déchets

For more than thirty years, researchers conduct studies to define the forms of intervention to improve the practices of waste management. This study is a review of literature interesting communication and influence on sorting and waste prevention. Building on the classification by Geller (1990) of types of intervention on the management of waste, we distinguished four different types of interventions: we present successively the work based on incentives, rhetorical and behavioral strategies. Finally, we present researchs which studied the feedback. We propose for each of these forms of influence techniques, prospects of research and application that seem most relevant.     

关于甲状腺结节处理的一些思考

人群中甲状腺结节发病率很高,多数均为良性病变,但需要结合病史、临床症状、体征、甲状腺功能检查、超声及甲状腺细针抽吸细胞学(FNAC)检查,以排除恶性肿瘤。针对无恶性征象的甲状腺结节患者可以定期随访,必要时行外科手术治疗。     

Internet‐based self‐tailored deposit contracts to promote smoking reduction and abstinence

Deposit contracting may reduce costs and increase efficacy in contingency management interventions. We evaluated two Internet‐based deposit contract arrangements for smoking. In Experiment 1, nine participants deposited self‐selected amounts that could be earned back for meeting goals. During treatment, participants were reimbursed for breath samples with less than or equal to 6 parts per million carbon monoxide and met the criterion for 47% of samples compared to 1% during baseline. In Experiment 2, 10 participants’ deposits were matched up to $50. No samples met the criterion during baseline but 41.5% met it during treatment. The average deposit was $82 in Experiment 1 and $49 in Experiment 2. Participants rated the intervention favorably and sample submission rates were high. These experiments suggest that Internet‐based self‐tailored deposits are acceptable, feasible, and can promote brief reduction and abstinence in some smokers. Future research should investigate individual and intervention factors that affect long‐term cessation and uptake of deposit contracts.     

TRAINING RESIDENTIAL SUPERVISORS TO PROVIDE FEEDBACK FOR MAINTAINING STAFF TEACHING SKILLS WITH PEOPLE WHO HAVE SEVERE DISABILITIES

We evaluated procedures for training supervisors in a residential setting to provide feedback for maintaining direct-service staff members' teaching skills with people who have severe disabilities. Using classroom-based instruction and on-the-job observation and feedback, 10 supervisors were initially trained to implement teaching programs themselves. The training improved supervisors' teaching skills but was insufficient to improve the quality of feedback they provided to direct-service staff regarding the staff members' teaching skills. Subsequently, classroom-based instruction and on-the-job observation and feedback that targeted supervisors' feedback skills were provided. Following training in provision of feedback, all supervisors met criterion for providing feedback to their staff. Results also indicated that maintenance of teaching skills was greater for direct-service staff whose supervisors had received training in providing feedback relative to staff whose supervisors had not received such training. The need for analysis of other variables that affect maintenance of staff performance, as well as variables that affect other important areas of supervisor performance, is discussed.     

人之将尽,消费国货？死亡信息的暴露增加国货选择的现象、中介和边界条件解析

死亡信息无处无时不在。恐惧管理理论认为,死亡暴露会促使个体采取两种防御机制：支持文化世界观和提升自尊。来自西方发达国家消费者的数据显示,死亡暴露会促使这些消费者偏爱国货、支持文化世界观,内在机制是爱国主义情绪的唤醒。但对将购买外国货视为追求高自尊和高身份的发展中国家消费者而言,尚没有学者检验死亡暴露会促使他们继续购买外国货以提升自尊,还是转而购买国货以支持文化世界观。本文用实验检验了这两种竞争预测,发现死亡暴露会增加发展中国家消费者的国货选择,但机制是补偿个人控制感的缺失。同时,已有探讨死亡暴露与国货偏好的研究并没有检验何时死亡暴露将不再增加国货偏好,本文发现启动亲密的人际归属感是边界条件。     

组织中的揭发行为：决策过程及多层次的理论框架

组织中的揭发行为是员工对工作场所中的违法、破坏规则和不道德行为的检举揭露,是及时纠正组织中错误行为的有效机制。文章回顾了组织中揭发行为的研究起源、概念及测量方法;从不同理论视角探讨了揭发行为的决策过程;从多个层面系统梳理了揭发意愿或行为的影响因素和产生机制;归纳了揭发行为实践的影响结果。提出未来研究应关注跨学科视角的个体前因、区分特定情境变量的影响、探索行为产生机制和开展本土化揭发行为研究等问题。