政府与个人的责任——中国当代医疗改革的责任伦理学剖析

卫生改革的重点必须放在政府部门;公共卫生,预防与初级医疗保健是人类生存的需要,带有鲜明的公益性和福利性。应由政府投资为主筹集资源,以国家投资为主体负担费用,这个层次的卫生服务产品,属非商品经济部分,并不以赢利为目的,不能引进市场经济,个人对健康负有重要责任,包括：选择医疗保健,决定花费数额,生活方式和卫生习惯的养成,主动接受健康教育,抵抗压力,支持国家与地区的卫生保健政策;个人对自身健康负责是一种道德责任,健商（health quotient)这一重要概念,具有伦理价值和普遍的医学人类学意义;个人对健康负责是一种社会风尚。     

试论《周易》的原初意义与现代意义

文章首先阐述了考察《周易》价值的方法,然后运用这一方法全面考察了《周易》的原初意义与现代意义。作者认为,《周易》的产生标志着中华民族抽象思维能力的关键性跃迁;《周易》的内容折射着当时的自然、社会和人文状况,记载着古代先民对于当时复杂的自然、社会和人生问题的特别关注与初步思考;《周易》的人生智慧和行为原则,反映着趋利避害和预见未来的价值取向;《周易》的思维方式汇集着当时的思维工具和认识方法,表达着最初的终极关怀和哲学意识。而《周易》所提供的始源性材料,有助于我们从根源性上来把握中华文化及其当代特点;易学史的演变与发展则为我们更好地把握历史文化发展进程提供了重要的思想资料;《周易》所表达的人生智慧和思维方式对于当今人类把握现实与面向未来也具有极为重要的启示和借鉴意义。     

Cross-national differences in older adult loneliness

Loneliness concerns the subjective evaluation that the number of relationships is smaller than the individual considers desirable or that the intimacy that the individual wishes for has not been realized. The aim of this study was to assess variations in levels of late-life loneliness and its determinants across Europe. Data came from the SHARE surveys, Wave 2 (Borsch-Supan et al., 2008), encompassing adults aged 50 years and over in Austria, Belgium, the Czech Republic, Denmark, France, Germany, Greece, Ireland, Italy, the Netherlands, Poland, Spain, Sweden, and Switzerland (N = 12,248). Loneliness was measured by a single item derived from the CES-D (depression) scale. Using logistic models, the present authors tested several types of explanations for country differences: differences in demographic characteristics, wealth and health, and social networks. Older adults in the southern and central European countries were generally lonelier than their peers in the northern and western European countries. In the southern and central European countries, loneliness was largely attributable to not being married, economic deprivation, and poor health. Frequent contacts with parents and adult children, social participation, and providing support to family members were important in preventing and alleviating loneliness in almost all countries. To combat loneliness among older adults, the findings suggest both (a) generic approaches aimed at improving social embeddedness and (b) country-tailored approaches aimed at improving health and wealth.     

The relationship between performance-based self-esteem and self-reported work and health behaviors among Danish knowledge workers

Since knowledge intensive work often requires self-management, one might fear that persons who are dependent on work success for self-esteem will have difficulties in finding a healthful and sustainable balance between internal needs and external demands. Accordingly, we examined to what degree work-related performance-based self-esteem (PBS) was linked to work and health behaviors in 392 knowledge workers (226 women, 166 men). In the women group, multiple binary logistic regression analyses with repeated measurements showed that the PBS score was associated with 10 of the 17 examined work and health behaviors. For men the corresponding figure was 3 of 17. In both men and women, higher PBS scores were positively associated with reports of efforts and strivings for work as well as attending work while ill. In conclusion, statistically significant relationships between PBS and work and health behaviors were more clearly visible among women than men. Whether this gender difference is dependent on the study design, or on true inherent differences between women and men, cannot be concluded with any certainty. However, persons who described themselves as being relatively more dependent on work accomplishments for a high self-esteem, as expressed by the PBS score, seem to display work behaviors that may lessen their restitution time. In addition, they also seem to be more prone to work while sick.     

Training Counsellors to Work with People who Live with Cancer: A Needs-led Approach to Planning

This paper traces the development of a cancer counselling service within a voluntary helping agency. The steps of recognizing the needs of people with cancer, identifying multi-faceted desired outcomes and the implementation of one specific goal, that of provision of a counselling service, are outlined. Significant events, stages and decisions made during this process are described and discussed. The emphasis throughout is on the importance of needs analysis and client group consultation in order that the planned service is best placed to meet such needs.     

Older Adults’ Psychosocial Responses to a Fear of Falling: A Scoping Review to Inform Occupational Therapy Practice

Abstract

Falls in older adults are a major health concern, yet the “fear of falling”, a common psychosocial response that can occur post-fall, has seldom been investigated. A scoping review was conducted to identify and map interventions that occupational therapists can use to manage the fear of falling psychosocial response (FoFPR) among older adults. Thirteen electronic databases were searched and 22 studies were retrieved. Cognitive behavioral therapy, guided imagery, and Tai Chi were interventions found to help older adults deal with their FoFPRs. Occupational therapists assisting older adults in this area can play a significant role.     

COVID-19 and Religious Ethics

The editors of the JRE solicited short essays on the COVID-19 pandemic from a group of scholars of religious ethics that reflected on how the field might help them make sense of the complex religious, cultural, ethical, and political implications of the pandemic, and on how the pandemic might shape the future of religious ethics.     

Reliability of self-reported service use: Test-retest consistency of children's responses to the Child and Adolescent Services Assessment (CASA)

This paper reports on the reliability of children's responses on the Child and Adolescent Services Assessment (CASA) — a self-report instrument for use with 8– to 18-year-olds that gathers information about services used to address mental health problems. Findings were based on interviews completed by 77 children at a one week test-retest interval. Results showed that reports of lifetime service use were as reliable as were reports of service use in the preceding three months. Children reported restrictive and intrusive services more reliably than services that were provided in their natural environment. Reliability appeared to be associated more strongly with characteristics of the type of service than with characteristics of the child. Children also could report reliably on some details about their encounters with service providers (e.g., length of stay, number of visits, and onset of service use).     

Influences of character-based coping style on psychological health

This study explores the moderating effects of early adult character style on correlations between social relationships in adolescence and midlife psychological health. Participants were drawn from the ongoing longitudinal studies at the Institute of Human Development. Individuals who beat the odds of an adverse environment and those who failed to capitalize on beneficial environments were identified and compared at age 30 on the California Psychological Inventory, the Meredith-Millsap Component Scores, and the Thematic Apperception Test. Social relatedness and personal independence were characteristics at age 30 of all subjects who went on to develop good psychological health by age 50. Social relatedness was more associated with overcoming a difficult environment, while self-assurance was more associated with capitalizing on a good one.