一体化医疗保障的理论释义与实践推进

从法理学、政治学、行政学意义上讲,建立一体化医疗保障有着重要的意义。一体化医疗保障应突破医疗保障一体化的思维限制,从医疗保障体系内部及外部思考其内涵与外延。现实中,我国一体化医疗保障主要是从医疗保障体系的扩容及保疗保障内部的一体化进行探索,医疗保障呈现碎片化和模糊化的状态,离一体化医疗保障的目标还有一定距离。一体化医疗保障的推进,需要从顶层设计上整合并细化医疗保障制度体系,从管理体系上形成整体性治理,推进贫困群体的识别机制与信息管理、保障基金预算与支出管理、医疗保障与医疗服务的一体化。     

The effects of mindfulness-based interventions for health and social care undergraduate students – a systematic review of the literature

Health and social care undergraduate students experience stress due to high workloads and pressure to perform. Consequences include depression and burnout. Mindfulness may be a suitable way to reduce stress in health and social care degree courses. The objective of this systematic review is to identify and critically appraise the literature on the effects of Mindfulness-Based Interventions for health and social care undergraduate students. PubMed, EMBASE, Psych Info, CINAHL, The Cochrane Library and Academic Search Complete were searched from inception to 21st November 2016. Studies that delivered Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, or an intervention modelled closely on these, to health or social care undergraduate students were included. Eleven studies, representing medicine, nursing and psychology students met the inclusion criteria. The most commonly used measurement tools were; the Five Facet Mindfulness Questionnaire and the General Health Questionnaire. Short term benefits relating to stress and mood were reported, despite all but one study condensing the curriculum. Gender and personality emerged as factors likely to affect intervention results. Further research with long-term follow-up is required to definitively conclude that mindfulness is an appropriate intervention to mentally prepare health and social care undergraduate students for their future careers.     

Pluralism and ethical dialogue in Christian healthcare institutions: the view of Caritas Catholica Flanders.

In this article, the place and the nature of an ethical dialogue that develops within Christian healthcare institutions in Flanders, Belgium is examined. More specifically, the question is asked how Christian healthcare institutions should position themselves ethically in a context of a pluralistic society. The profile developed by Caritas Catholica Flanders must take seriously not only the external pluralistic context of our society and the internal pluralistic worldviews by personnel/employees and patients, but also the inherent inspiration of a Christian healthcare institution. This article concludes with ten general orientations that could shape the ethical dialogue from a Christian inspiration in a pluralistic context.     

Long-term adverse health outcomes of physical workplace violence: a 7-year population-based follow-up study

The aim of the present study was to analyse whether physical workplace violence increases the risk of long-term adverse health outcomes (i.e., high number of visits to the general practitioner, outpatient treatment, hospital admittance, antidepressant use, and/or having a mental disorder). The study was based on representative survey data from 2006 and 2010 (entitled “How are you?”) merged with register data for a 7-year follow-up period (N = 30,812). To examine if physical workplace violence was a predictor of adverse health outcomes, logistic regression models were conducted for the total follow-up period and for each follow-up year with the different outcome measures as the dependent variables. In the follow-up period, individuals who were exposed to physical workplace violence had a higher number of visits to the general practitioner, had more often received outpatient treatment, and had more often been admitted to hospital than their non-exposed counterparts. Moreover, exposed individuals had higher odds of using antidepressants in the last three follow-up years than did non-exposed individuals. The findings call for heightened attention to securing preventive as well as rehabilitative strategies to help victims of physical workplace violence with the aim of avoiding adverse long-term health consequences.     

新医改中需要密切注意的若干问题

新医改方案在中国医疗卫生制度和现实的剧烈冲突中,顺应社会与历史发展的需要,应运而生,触发了中国新一轮卫生改革。结合中国实际,从有利于新医改方案能够成功与健康推进,提出与剖析了在推进新医改方案中需要密切注意的若干问题,并建议采取10项积极的预防措施。     

Mature adults' attitudes to mental health service utilisation

This qualitative study examined mature adults' attitudes to mental health services, in order to improve service utilisation among members of this group. Twenty individual and 12 focus group interviews were conducted with 111 West Australians aged ≥40 years living in urban and regional areas. The findings indicate that mature individuals may be receptive to information that assists them in differentiating the symptoms of ageing and mental illness and empowers them to make appropriate help‐seeking decisions. Perceived stigma and an aversion to medication were identified as barriers preventing individuals from acknowledging and addressing mental illness. A model of mature adults' intentions to utilise mental health services is proposed.     

A Critical Review of the Forms and Value of Religious Coping Among Informal Caregivers

A review of the literature revealed high rates of religiousness and religious coping among informal caregivers (i.e., unpaid family and friends) and some associations with better mental and spiritual health and caregiving experience. However, the information necessary to practically and empirically apply this knowledge to improve the lives of caregivers was noticeably absent. To this end five key issues were identified: (a) Measurement, (b) Process, (c) Effectiveness, (d) Moderators, and (e) Mediators. A greater understanding of the specific types of religious coping strategies used, how their use changes over time, for whom and what outcomes they are most effective, and what influences and explains their effectiveness, will better equip healthcare workers to promote the functioning and well being of caregivers.     

Ease-of-learning judgments are based on both processing fluency and beliefs

Processing fluency influences many types of judgments. Some metacognitive research suggests that the influence of processing fluency may be mediated by participants’ beliefs. The current study explores the influence of processing fluency and beliefs on ease-of-learning (EOL) judgments. In two experiments (Exp 1: n?=?94; Exp 2: n?=?146), participants made EOL judgments on 24 six-letter concrete nouns, presented in either a constant condition (high fluency) with upper-case letters (e.g., BUCKET) or an alternating condition (low fluency) with mixed upper- and lower-case letters (e.g., bUcKeT). After judging words individually, participants studied the words and completed a free recall test. Finally, participants indicated what condition they believed made the words more likely to be learned. Results show constant-condition words were judged as more likely to be learned than alternating condition words, but the difference varied with beliefs. Specifically, the difference was biggest when participants believed the constant condition made words more likely to be learned, followed by believing there was no difference, and then believing the alternating condition made words more likely to be learned. Thus, we showed that processing fluency has a direct effect on EOL judgments, but the effect is moderated by beliefs.     

5G医疗应用走向及相关问题思考

通过对当前我国医疗体系的痛点,5G医疗应用的技术基础、实践应用和意义进行总结,探索并思考5G医疗应用发展中将会遇到技术、经济、制度、利益和伦理等方面的问题,包括5G医疗下新的医疗成本核算、5G安全和病人安全、健康隐私、医疗数据保护及合理应用、医疗资源的公平性和可及性、相关监管政策的完善、5G医疗的发展对医疗生态变革的影响、5G医疗的未来发展走向等,以期为5G技术的医疗应用发展提供思路,推动我国医疗事业健康发展。