"管办分离"模式下公立医院出资人制度的探索——以上海申康医院发展中心为例

上海申康医院发展中心是卫生领域推进政事分开、管办分开的一次改革试点,以上海申康医院发展中心为例,分析该模式探索公立医院管理体制改革,建立所有权与经营权适度分离,管资产与管人、管事相结合的市级医院出资人制度,促进市级医院加强内部管理,构建有效的约束激励机制,不断提高医院的营运质量和绩效的成功经验。     

孝道信念的形成与发展：不同文化下亲子互动的视角

个体的孝道信念是在与父母的互动过程中形成的。在养育子女阶段, 父母依据其家庭模式的要求塑造子女的自主意愿, 子女的自主意愿又进而影响了其孝道信念; 在父母年老阶段, 个体所在文化的代际互惠模式塑造了亲子的孝道期待和信念; 亲子关系的变化, 调整着亲子间孝道观的内容及影响方式。未来研究应关注家庭模式重构对亲子孝道观的影响, 进一步探索中国家庭模式及代际互惠模式下的亲子孝道观特点, 并建立有效的干预方案, 以提高子女的孝道信念。     

亲子关系、朋友关系影响问题行为的3种模型

家庭和同伴是影响个体发展的最重要的微系统, 是儿童青少年问题行为的重要影响因素,以往对上述问题的实证研究非常广泛, 但很零散。对前人研究的分析发现亲子关系、朋友关系影响问题行为有3种模型：独立模型、交互影响模型和间接效应模型, 然而这些模型及其有关研究仍存在诸多问题与不足, 如亲密关系测量指标不统一, 内外化问题行为研究不均衡, 评价主体单一化, 文化差异, 缺乏充分的追踪研究和实验设计等, 未来研究应对上述方面加以关注。     

社会负性环境对流动和留守儿童问题行为的影响：亲子和同伴关系的调节作用

使用问卷法对4279名流动、留守和农村普通儿童的亲子、师生和同伴关系、社会负性环境和问题行为的调查发现：（1）小学流动儿童的轻度问题行为得分显著高于留守儿童和普通儿童,小学流动和留守儿童的重度问题行为显著高于普通儿童;中学流动儿童的轻度问题行为得分依次显著高于普通儿童和留守儿童;（2）普通和留守儿童的亲子、师生关系和社会环境显著好于流动儿童;（3）亲子关系在社会负性环境对流动和普通儿童的问题行为的预测中起调节作用;同伴关系在社会负性环境对留守和普通儿童问题行为的预测中起调节作用。     

农村亲子关系模式及特点研究

本研究通过半结构访谈,分析了我国农村亲子关系的模式和特点。研究发现：(1)农村亲子间的亲密度低。亲子依恋不强．亲子交往的频率低。(2)农村父母对子女有偏爱现象,更加偏爱男孩和排行靠前的孩子。(3)农村儿童对母亲更加信任和依恋。更亲近母亲。     

Diagnosing a male hysteric: Don Juan-type

The aim of this paper is to provide a clinical account of a male hysteric, Don Juan-type, taken from the early stages of treatment. The patient presented with a relationship problem but there soon emerged a form of compulsive sexuality or hypersexuality in his love relations that became a central feature of the clinical picture. This hypersexuality expressed itself in a compulsive need to stage, or to stage-manage, interpersonal scenaria of a sexual or sexualised nature. These scenaria, which were repeated in different variations and with different personnel, are seen by the author as a dramatisation of the primal scene with the patient taking up the position of the oedipal father. Explanations for the disappearance of male hysteria are given, including a new theory which claims that an imbalance in psychoanalytic theory itself led to the feminisation of hysteria. This critique allows certain forms of hypersexuality in men to be promoted as a form of hysteria, the most common example being Don Juanism-a form of compulsive sexuality that encompasses normative, conversion and character features. The paper also examines the male hysteric's developmental agenda. What the patient's compulsive sexual tableaux exposed was that he had never faced a separation that was not a triangular experience. This meant that his separations were experienced as two developmental agonies telescoped into one-separation (pre-oedipal) and exclusion (early oedipal). This combination, the author suggests, is so frightening in a particular group of men as to explain the choice of hysteria as opposed to some other choice of neurosis.     

Nonlinear Associations Between Co-Rumination and Both Social Support and Depression Symptoms

Co-ruminating about one's problems appears to involve both beneficial self-disclosure and harmful rumination, suggesting that moderate levels may be the most adaptive. This study used nonlinear regression to determine whether moderate levels of self-reported co-rumination in relationships with a sibling, parent, friend, and romantic partner are linked to the highest levels of self-perceived social support and lowest levels of self-reported depression symptoms in 175 emerging adults (77% female; M = 19.66 years). As expected, moderate co-rumination was associated with high social support across all four relationship types, but, somewhat unexpectedly, high levels of co-rumination were also associated with high social support. As predicted, moderate levels of co-rumination with friends and siblings were associated with low levels of depression. Contrary to hypotheses, high levels of co-rumination were associated with high depression within romantic relationships. Co-rumination with a parent did not have a linear or quadratic association with depression. These findings suggest that high co-ruminating in supportive relationships and to a lesser extent low co-ruminating in unsupportive relationships are maladaptive interpersonal processes but that co-rumination's relation to depression depends on the co-ruminating partner. Psychotherapies for depression may target these maladaptive processes by supporting clients' development of balanced self-focused negative talk.     

Mentalisation-based therapy for parental conflict – parenting together; an intervention for parents in entrenched post-separation disputes

High-conflict relationship dissolution has been shown to cause substantial emotional risk and psychological harm to children’s developmental outcomes. Parents in chronic post separation conflict who repeatedly use the courts to address their disputes are by nature difficult to engage in therapeutic services. This paper describes the theoretical and practical key elements of a mentalisation-based therapeutic intervention, Mentalization-Based Therapy for Parental Conflict – Parenting Together (MBT-PT), that has been developed in order to address some of the unique challenges that these parents and the professionals working with them are facing. Specifically, the intervention aims to reduce anger and hostile conflicts between parents and mitigate the damaging effects of inter-parental conflict on children. The implementation procedure of the MBT-PT intervention among parents in entrenched conflict over their children, in the context of a random allocation pilot study, is briefly described. Next, the MBT-PT intervention is exemplified using clinical examples, followed by potential implications concerning practice and policy for professionals working with this population of parents.     

分类精确性指数Entropy在潜剖面分析中的表现:一项蒙特卡罗模拟研究

本研究通过蒙特卡洛模拟考查了分类精确性指数Entropy及其变式受样本量、潜类别数目、类别距离和指标个数及其组合的影响情况。研究结果表明:(1)尽管Entropy值与分类精确性高相关,但其值随类别数、样本量和指标数的变化而变化,很难确定唯一的临界值;(2)其他条件不变的情况下,样本量越大,Entropy的值越小,分类精确性越差;(3)类别距离对分类精确性的影响具有跨样本量和跨类别数的一致性;(4)小样本(N=50~100)的情况下,指标数越多,Entropy的结果越好;(5)在各种条件下Entropy对分类错误率比其它变式更灵敏。