医疗保险与基层医疗卫生资源配置机制转型

基层医疗卫生事业的健康发展取决于医疗卫生资源的均衡配置。要促进医疗卫生资源的均衡配置,必须重构医疗卫生资源的配置机制。由于基层医疗机构缺乏较高的行政级别和较厚的盈利空间,所以医疗卫生资源的市场配置机制和计划配置机制均会陷入失灵。基于这个观点,提出以计划与市场联手为途径配置基层医疗卫生资源的思路,即让医疗保险承担对基层医疗卫生资源的配置功能。医疗保险配置基层医疗卫生资源主要通过三种途径：设立门诊统筹账户、建构购买服务机制、采取按人头预付费方式。     

BION'S THINKING ABOUT GROUPS: A STUDY OF INFLUENCE AND ORIGINALITY

One of Bion's least‐acknowledged contributions to psychoanalytic theory is his study of the relationship between the mind of the individual (the ability to think), the mentalities of groups of which the individual is a member, and the individual's bodily states. Bion's early work on group therapy evolved into a study of the interplay between mind and bodily instincts associated with being a member of a group, and became the impetus for his theory of thinking. On the foundation of Bion's ideas concerning this interaction among the thinking of the individual, group mentality, and the psyche‐soma, the author presents his thoughts on the ways in which group mentality is recognizable in the analysis of individuals.     

Multidimensional Suicide Inventory-28 (MSI-28) Within a Sample of Military Basic Trainees: An Examination of Psychometric Properties

Suicide and suicidal ideation are serious public health concerns. Accurate detection and assessment are critical first steps in addressing this challenging issue. The present study examined self-reported suicidal ideation in a sample of United States Air Force enlisted active duty basic trainees (N = 470) using the Multidimensional Suicide Inventory (MSI-28). Exploratory factor analyses revealed a 4-factor structure for the MSI-28 in this sample. Together, these 4 factors explained approximately 72% of the variance in the MSI-28. The MSI-28 evidenced moderate to strong associations with measures of resilience (Dispositional Resilience Scale-15; DRS-15) and psychological distress (Outcome Questionnaire; OQ-30.2). These findings demonstrate that the MSI-28 is a promising tool for clinical measurement of self-reported suicidality. Future directions for further validation of the MSI-28 are discussed.     

Effects of voice and similarity on procedural fairness and trust: A dual process model of public acceptance based on representatives’ participation

In citizen participation, a few representatives of the total citizen population participate in discussions with authorities regarding public decisions and policies. The present study examines a dual process model in which the representatives’ voice and similarity of values facilitate public acceptance through procedural fairness and trust in representatives, respectively. The results of an experiment employing a scenario method, which included participants from Japan (n = 211) and the Netherlands (n = 200), indicate that the representatives’ voice increased procedural fairness and public acceptance when the similarity of representatives was high. The effects of representatives’ voice on public acceptance via procedural fairness was supported in both nations, while other effects of representatives’ similarity on acceptance via trust were indicated only in Japan. These results suggest that the indirect voice of citizens, as conveyed by representatives, plays an important role in increasing perceptions of procedural fairness and public acceptance among citizens.     

The Relation Between Children's Trust Beliefs and Theory of Mind Abilities

The study examined the relation between children's trust beliefs and Theory of Mind (ToM) abilities. A sample of 168 Italian children (M = 9 years–6 months, SD = 7 months) were administered the Italian Children's Generalized Trust Beliefs (ICGTB) Scale, two Second‐Order False Belief ToM measures, and an Advanced ToM measure. As expected, the ICGTB scale demonstrated: (1) validity by its three factor structure and (2) reliability by exhibiting acceptable internal consistency and test–retest stability. As expected, the children's emotional trust beliefs in others were associated with both second‐order false belief ToM ability and advanced ToM ability. These relations were not attributable to verbal ability. The findings are discussed with respect to the relations among children's emotional trust beliefs, personal disclosure, and quality of attachment. Copyright © 2014 John Wiley & Sons, Ltd.     

The Role of Temperament in Children's Reliance on Others as Sources of Information

By 3 years of age, children generally have a firm understanding of others' reliability, but there is considerable variation among individual children. Little attention has been paid to factors that influence such individual differences. This study addressed this by assessing the relation between reliability understanding and temperament in children approaching their third birthday. We measured children's ability to judge a speaker's trustworthiness and to selectively learn new information from a reliable informant. Observer ratings provided assessments of children's activity, task orientation, and affect/extraversion. Significant associations between selective trust and the temperament dimension of affect/extraversion were found, along with associations between selective trust and gender and language ability. This indicates that the ability to ascertain whether a speaker is a reliable person from whom to learn is related to several individual child characteristics. Copyright © 2014 John Wiley & Sons, Ltd.     

Does a Nation's Religious Composition Affect Generalized Trust? The Role of Religious Heterogeneity and the Percent Religious

Is religion more of an integrative or a divisive force in contemporary societies? We use multilevel analyses of World Values Survey data from 77,409 individuals in 69 countries to examine how both the percent of the population that is religious and the religious heterogeneity of a country are related to generalized social trust, the willingness of individuals to trust “most people.” When we first examine the main effects of the percent religious and religious heterogeneity we find no evidence that either variable is related to trust in the ways predicted by major theories. However, the combination of these two variables has a huge negative relationship with trust. Countries that are both highly religious and religiously heterogeneous (diverse) have, on average, levels of trust that are only half the average levels of countries with other combinations of these two variables. The results have important implications for understanding the role of religion in modern societies.     

Trust in the medical profession and patient attachment style

Attachment style is a person’s approach to interpersonal relationships, which develops from early experiences with primary caregivers and can remain stable into adulthood. Depending on a person’s attachment style, the amount of trust one has in others can vary when forming relationships, and trust is important in formation of the patient–physician relationship. The purpose of this study was to see if there is an association between attachment style and trust in physicians in general. Participants were recruited from an emergency department (ED) and an online university participant pool, and completed short questionnaires assessing attachment style and trust in the medical profession. Results revealed that individuals with a fearful attachment style reported significantly lower levels of trust in the medical profession than those with a secure attachment style. ED participants also reported higher levels of trust in the medical profession in comparison to student participants. This study provides a better understanding of trust in the medical profession, and insight into future care for patients who have low trust.