患者权利冲突的法伦理思考

随着患者权利意识的增强及患者权利趋于多元化,医患关系逐渐由医生家长主义模式向患者自主决定模式转变,患者权利冲突日益增多并呈现多面向的图景。这种冲突引发如下之追问:患者权利冲突有什么特点?应当如何进行价值判断与取舍?医学的终极目的是什么?应当依据医疗卫生事业的终极人文价值与伦理原则,实现一般情况下的对患者所有权利的同等保护和特定情况下的对患者某种权利的优先保护,从而实现权利与善的统一。     

Strengthening the united states’ database protection laws: Balancing public access and private control

This paper develops three arguments for increasing the strength of database protection under U.S. law. First, stronger protections would encourage private investment in database development, and private databases have many potential benefits for science and industry. Second, stronger protections would discourage extensive use of private licenses to protect databases and would allow for greater public control over database laws and policies. Third, stronger database protections in the U.S. would harmonize U.S. and E.U. laws and would thus enhance international trade, commerce, and research. The U.S. should therefore follow the European example and develop two tiers of protection for databases: 1) protection for creative databases under copyright law; 2) protection for non-creative databases through a special type of sui generis protection. In order to balance private control of data and public access to data, sui generis protections should define a “fair use” exemption that permits some unauthorized extraction of data for private, educational, and research purposes, provided that such extraction does not adversely impact the economic value of the database.     

Equal channel angular pressing of magnesium at room temperature: the effect of processing route on microstructure and texture

Various processing routes were applied to as-cast magnesium during equal channel angular pressing with back-pressure (BP) at room temperature (RT). Multiple passes with BP resulted in crack-free microstructures independent of the processing route. Microstructure and texture examination by electron backscatter diffraction and X-ray diffraction techniques after four passes revealed largely recrystallised grains. The most profound finding was the formation of special grain boundaries Σ13a and {10-12} twin boundaries during recrystallisation at RT.     

On Opening Panoora's Box

Summary

The problem of partner violence has assumed a level of importance in the field of medicine only within the past 5 to 10 years. Impetus for this increased interest lies with strong leadership from two previous surgeons general. Another source of impetus is a growing research body which clearly shows that violence, especially partner violence, (a) is not rare in medical settings, and (b) results in considerable morbidity and mortality. This article briefly reviews research on incidence and prevalence of violence victimization among medical system utilizers. Literature illustrating a dearth of physician identification and response to victims of violence is also considered. Finally, given the high rates of violence victims in medical practice and the relative lack of appropriate physician response, it is argued that a need exists for physician training in identification and intervention with violence victims.     

Persian speaking children's acquisition of relative clauses

The current study examined the acquisition of relative clauses (RCs) in Persian-speaking children. Persian is a relatively unique data point in crosslinguistic research in acquisition because it is a head-final language with post-nominal RCs. Children (N = 51) aged 2 to 7 years completed a picture-selection task that tested their comprehension of subject-, object-, and genitive-RCs. The results showed that the children experienced greater difficulty processing object and genitive RCs when compared to subject RCs, suggesting that the children have particular difficulty processing sentences with non-canonical word order. The results are discussed with reference to a number of theoretical accounts proposed to account for sentence difficulty.     

Ethics in Research

Summary

This article presents an overview of the history of efforts to protect human subjects in research. It discusses the establishment of international, national, organizational, and institutional procedures designed to protect human participants. The article provides a detailed summary of the principal ethical codes for research and their origins. It includes discussions of the most frequently encountered ethical issues ranging from the initial decision to undertake the project, through the selection and application of the various research procedures, to the analysis and interpretation of the data.     

Mediation analysis of decisional balance,sun avoidance and sunscreen use in the precontemplation and preparation stages for sun protection

Objective: Mediation analyses of sun protection were conducted testing structural equation models using longitudinal data with three waves. An effect was said to be mediated if the standardised path between processes of change, decisional balance and sun protection outcomes was significant.

Design: Longitudinal models of sun protection using data from individuals in the precontemplation (N = 964) and preparation (N = 463) stages who participated of an expert system intervention.

Main outcome measures: Nine processes of change for sun protection, decisional balance constructs of sun protection (pros and cons), sun avoidance behaviour and sunscreen use.

Results: With the exception of two processes in the preparation stage, processes of change predicted the pros (r = .126–.614), and the pros predicted the outcomes (r = .181–.272). Three models with the cons as mediator in the preparation stage, and none in the precontemplation stage, showed a mediated relationship between processes and outcomes.

Conclusion: In general, mediation analyses found both the process of change-to-pros and pros-to-behaviour paths significant for both precontemplation and preparation stages, and for both sun avoidance and sunscreen use outcomes. Findings provide support for the importance of assessing the role of underlying risk cognitions in improving sun protection adherence.     

Associations between authoritative parenting and the sun exposure and sun protective behaviours of adolescents and their friends

Associations between the sun exposure and sun protective behaviours of adolescents and their friends were examined along with the role played by authoritative parenting and other family and peer socialisation factors. Four hundred and two adolescents (198 males, 204 females) participated in the research. It was found that these adolescents and their friends shared similar sun exposure and sun protective behaviours and had similar parenting backgrounds. Parental authoritativeness was positively associated with the use of sun protection, even after the effects of other familial and peer variables were controlled, but not with the time spent sunbathing which was associated with friends’ behaviours. The theoretical and practical implications of these findings are discussed.     

Are smokers interested in genetic testing for smoking addiction? A socio-cognitive approach

Genetic advances have made genetically tailored smoking cessation treatments possible. In this study, we examined whether smokers are interested in undergoing a genetic test to identify their genetic susceptibility to nicotine addiction. In addition, we aimed to identify socio-cognitive determinants of smokers’ intention to undergo genetic testing. Following the protection motivation theory (PMT), we assessed the following constructs using an online survey among 587 smokers: threat appraisal (i.e. susceptibility and severity), fear, coping appraisal (i.e. response efficacy and self-efficacy), response costs and intention. In addition, knowledge, social norms and information-seeking behaviour were measured. Mean intention rates were 2.57 on a 5-point scale. Intention was significantly associated with threat appraisal and coping appraisal, as predicted by the PMT. Fear of the outcome was negatively associated with the intention to undergo genetic testing, but response costs, knowledge and social influence were not. Intention to undergo genetic testing in turn was positively related to seeking information about genetic testing and genetically tailored smoking cessation treatments. Smokers seem ambivalent or ‘on the fence’ with regard to undergoing a genetic test for smoking addiction. Socio-cognitive concepts such as susceptibility, severity, response efficacy and self-efficacy may be used to inform or educate smokers about the value of genetically tailored smoking cessation treatments.