流动人口生殖健康服务质量评价的相关理论研究

开展城市流动人口的生殖健康服务质量评价研究对于促进我国流动人口生殖健康状况持续改进和公平地享有生殖健康服务具有重要意义。从生殖健康的相关基本理论,我国生殖健康服务的政策支持,卫生服务质量评价的经典理论,系统思想及系统论,流动人口的特征等几个方面进行了流动人口生殖健康服务评价的理论基础系统论述。     

论社区卫生服务机构与城市大中型医院的协调发展

对当前社区卫生服务机构与城市大中型医院协调发展中存在的问题及原因进行了分析,在功能定位、制度层面、筹资及服务提供机制、社区卫生服务机构自我建设以及综合配套改革等方面提出改进建议,并对社区卫生与医院协调发展的现有模式进行了探讨,以期构建科学合理、切实维护群众健康的城市卫生服务体系。     

抑郁症的流行病学研究与预防——读《中国人群死亡及其危险因素流行水平、趋势和分布》有感

根据《中国人群死亡及其危险因素流行水平、趋势和发布》的报告和相关研究表明,全世界约有1亿人患有抑郁症,且数量有增无减,抑郁症将成为本世纪一种相当流行的病症.由于抑郁症是一种患病率高,严重危害人类身心健康,具有高自杀风险的精神疾病,更需要我们采取措施积极预防.目前采用的主要预防方法有:积极的心理健康教育、处理好家庭与社会的关系、社会支持、心理调适和体育锻炼等.     

青少年的同伴依恋与其互联网使用的关系

青少年期同伴群体的支持逐渐超过了父母的影响.青少年期同伴依恋在青少年认知、情感、人格以及行为的健康发展和社会适应中起着重要作用,拥有亲密的同伴关系的青少年出现情感问题和行为问题的可能性更小,并拥有更健康的青少年期适应能力.该研究采用同伴依恋量表、互联网服务使用状况量表以及青少年病理性互联网使用量表对405名中学生进行了问卷调查.旨在探讨青少年同伴依恋与其互联网使用之间的关系.结果表明: (1)同伴信任与社交和娱乐服务的使用偏好呈负相关,尽管都没有达到统计显著性; (2)同伴沟通可以正向预测青少年对信息、娱乐和社交服务的使用偏好,且都达到显著性水平;还可以通过互联网娱乐服务使用偏好间接预测PIU; (3)青少年与同伴的疏离程度可以正向预测青少年对社交服务的使用偏好,也可以直接正向预测PIU.     

服务消费中多次情绪感染对消费者负面情绪的 动态影响机制

在深入剖析情绪感染心理机制的基础上,深入研究了在服务消费中多次情绪感染对消费者负面情绪的动态影响。作者采用实验法,使用真实情景录像作为刺激物,验证了在服务消费中,正向情绪感染和负向情绪感染都是真实存在的,并且服务人员的情绪、语言和行为都会对消费者负面情绪产生持续的动态影响,同时证实了情绪感染敏感度对情绪感染过程产生明显的调节作用。     

某三甲医院各时段临床护理工作量的调查研究

通过测量不同科室不同时段的护理工作量,为护理人力资源管理提供科学依据。随机选取某三级甲等医院8个临床科室,采用观察法对每班护士进行一对一的现场跟踪调查,对8个临床科室不同时段的直接护理时间和间接护理时间进行测定,以分钟为单位记录,并计算得出护理工作量。不同科室不同时段护理工作量不同,不同科室同一时段护理工作量也不完全相同,同一科室不同时段护理工作量也不相同。10～12、12～14、19～21、23～1、7～9这五个时段各科室护理工作量集中,密集程度高,护士超负荷工作,而部分时段护士闲置,造成了护理人力资源浪费。医院相关部门可以通过定期对不同科室不同时段临床护理工作量的测量,来了解各科室所需要的护理人力,为配置护理人力资源提供客观数据支持。护理管理者应根据不同科室不同时段护理工作量的变化采取弹性排班。     

Participatory Organizational Change in Community-Based Health and Human Services: From Tokenism to Political Engagement

Community psychologists have long worked with community-based human service organizations to build participatory processes. These efforts largely aim at building participatory practices within the current individual-wellness paradigm of human services. To address collective wellness, human service organizations need to challenge their current paradigm, attend to the social justice needs of community, and engage community participation in a new way, and in doing so become more openly political. We use qualitative interviews, focus groups, organizational documents, and participant observation to present a comparative case study of two organizations involved in such a process through an action research project aimed at transforming the organizations’ managerial and practice paradigm from one based on first-order, ameliorative change to one that promotes second-order, transformative change via strength-based approaches, primary prevention, empowerment and participation, and focuses on changing community conditions. Four participatory tensions or dialectics are discussed: passive versus active participation, partners versus clients, surplus powerlessness versus collective efficacy, and reflection/learning versus action/doing.     

我国中小学生心理健康服务从业人员及工作状况调查

该研究的目的是考察我国中小学生心理健康服务从业人员及专业工作的基本情况,并比较其地区差异,分析存在的问题。调查包括来自重庆、甘肃、辽宁、福建、湖北以及西藏等6个省市自治区的596名被试。研究采用自编问卷调查中小学生心理健康从业队伍情况及其专业工作情况。结果发现各地区之间发展确实存在不均衡的状况,辽宁、福建等东部发达地区从业人员专业化水平相对较高;西藏、甘肃等地区则相对较为落后,特别体现在人员结构不合理、职称待遇偏低、缺少专业培训等方面。     

Individual attitudes and perceived social norms: Reports on HIV/AIDS‐related stigma among service providers in China

This study examined HIV/AIDS‐related stigma among Chinese service providers by comparing their personal attitudes toward people living with HIV/AIDS with their perception of social norms related to people living with HIV/AIDS. We randomly selected three provincial hospitals, four city/prefecture hospitals, 10 county hospitals, 18 township health clinics, and 54 village clinics from Yunnan, China. Doctors and nurses were randomly sampled proportionally to the doctor–nurse ratio of each hospital or clinic. Lab technicians were over‐sampled in order to include an adequate representation in the analysis. A total of 1,101 service providers participated in a voluntary, anonymous survey where demographic characteristics, individual attitude and perceived social norms toward people living with HIV/AIDS, discrimination intent at work, general prejudicial attitude and knowledge on HIV/AIDS were measured. A majority of the sample demonstrated a similarity between their personal views and what they thought most people in society believe. Multiple logistic regressions revealed that participants who were younger or reported personal contact with people living with HIV/AIDS were significantly more likely to report personal attitudes toward the population that were more liberal than their perceived social norms. Holding a more liberal personal attitude toward people living with HIV/AIDS than perceived social norms was significantly and negatively related to the level of discrimination intent at work, perceived discrimination at interpersonal level and the level of general prejudicial attitude toward people living with HIV/AIDS. Results underscored the importance of understanding social norms and personal attitudes in studying HIV‐related stigma and called for the incorporation of existing human capital into future HIV stigma reduction programs.     

Overt naming fMRI pre- and post-TMS: Two nonfluent aphasia patients, with and without improved naming post-TMS

Two chronic, nonfluent aphasia patients participated in overt naming fMRI scans, pre- and post-a series of repetitive transcranial magnetic stimulation (rTMS) treatments as part of a TMS study to improve naming. Each patient received 10, 1-Hz rTMS treatments to suppress a part of R pars triangularis. P1 was a ‘good responder’ with improved naming and phrase length; P2 was a ‘poor responder’ without improved naming.Pre-TMS (10 years poststroke), P1 had significant activation in R and L sensorimotor cortex, R IFG, and in both L and R SMA during overt naming fMRI (28% pictures named). At 3 mo. post-TMS (42% named), P1 showed continued activation in R and L sensorimotor cortex, R IFG, and in R and L SMA. At 16 mo. post-TMS (58% named), he also showed significant activation in R and L sensorimotor cortex mouth and R IFG. He now showed a significant increase in activation in the L SMA compared to pre-TMS and at 3 mo. post-TMS (p < .02; p < .05, respectively). At 16 mo. there was also greater activation in L than R SMA (p < .08). At 46 mo. post-TMS (42% named), this new LH pattern of activation continued. He improved on the Boston Naming Test from 11 pictures named pre-TMS, to scores ranging from 14 to 18 pictures, post-TMS (2–43 mo. post-TMS). His longest phrase length (Cookie Theft picture) improved from three words pre-TMS, to 5–6 words post-TMS.Pre-TMS (1.5 years poststroke), P2 had significant activation in R IFG (3% pictures named). At 3 and 6 mo. post-TMS, there was no longer significant activation in R IFG, but significant activation was present in R sensorimotor cortex. On all three fMRI scans, P2 had significant activation in both the L and R SMA. There was no new, lasting perilesional LH activation across sessions for this patient. Over time, there was little or no change in his activation. His naming remained only at 1–2 pictures during all three fMRI scans. His BNT score and longest phrase length remained at one word, post-TMS.Lesion site may play a role in each patient’s fMRI activation pattern and response to TMS treatment. P2, the poor responder, had an atypical frontal lesion in the L motor and premotor cortex that extended high, near brain vertex, with deep white matter lesion near L SMA. P2 also had frontal lesion in the posterior middle frontal gyrus, an area important for naming (Duffau et al., 2003); P1 did not. Additionally, P2 had lesion inferior and posterior to Wernicke’s area, in parts of BA 21 and 37, whereas P1 did not.The fMRI data of our patient who had good response following TMS support the notion that restoration of the LH language network is linked in part, to better recovery of naming and phrase length in nonfluent aphasia.