我国乡镇卫生资源二次配置模式探讨

长期以来,我国卫生资源配置城乡不均衡的局面比较严峻,大量优质卫生资源主要积聚在大中城市,而乡镇基层医疗机构的卫生资源比较稀缺。以增加政府财政投入,引入私人资本与第三部门力量等方式来提高农村卫生资源增量势必会遇到投入缓慢、资金不足、技术瓶颈等现实障碍。通过改革公立医院,调整城市卫生资源存量,把大中城市公立医院中的富余卫生资源以二次配置方式转移到农村卫生服务机构,是破解农村卫生资源存量不足、增长缓慢的困境,提高农村卫生服务能力和水平,改善农民就医问药问题的新途径。     

新疆农村医疗救助制度实施效果评价

为评价新疆农村医疗救助制度实施效果,利用2008年和2012年两次横断面调查资料,分析医疗救助对象和非医疗救助对象的卫生服务需要、利用及费用变化.救助对象的两周患病率由2008年的181.34‰下降到2012年的87.81‰,2008年两周患病率救助对象高于非救助对象.救助对象两周就诊率由2008年的110.92‰下降至2012年的46.93‰,2012年两周就诊率救助对象高于非救助对象.年住院率救助对象均高于非救助对象.新疆农村医疗救助制度提高了贫困人口对卫生服务的利用,应将医疗救助制度与新农合紧密结合,持续资助贫困家庭参合.     

The Transformative Effects of Stigma: Coping Strategies as Meaning‐Making Efforts for Immigrants Living in Greece

The present article examines the strategies that immigrants living in Greece use to cope with stigma that arises in their interaction with both Greek society and their communities of origin. Drawing on interviews and focus groups conducted with immigrants from a variety of countries, a dialogical analysis illuminates the ways in which immigrants actively negotiate stigmatizing perspectives and transform themselves. Strategies include the deployment of social categories such as those of ‘human being’ and ‘crazy’ person, and concepts such as those of ‘lawfulness’ and ‘fate’. These were used to construct meanings of equality and inclusion into society, to deny responsibility for stigma and to discredit stigma as absurd. They enabled participants to see themselves as proud, equal, self‐dependent individuals who plan actions for social change. The article suggests that coping with stigma should not only be understood in terms of stress regulation, leading to positive or negative outcomes, as suggested by current literature, but as a meaning‐making effort, through which individuals transform the way they see themselves and act within their world. A meaning‐making approach moves away from individualistic, outcome‐oriented explanations to a socially situated perspective on stigma that studies the processes through which social meanings are subjectively perceived as stigmatizing and are used to challenge stigma. Copyright © 2013 John Wiley & Sons, Ltd.     

Conventionalism Revisited

Conventionalism in sport philosophy has been rejected as unable to provide a theory of normativity and as collapsing in ethical relativism, but this criticism is rather imprecise about its target, which invites doubt about the legitimacy of the concept of conventionalism described by its critics. Instead, a more charitable and legitimate account of conventionalism is proposed, one that draws inspiration from conventionalism in axiomatic geometry and is able to avoid the counterarguments directed against conventionalism. This new model allows for a number of non-conventional elements of sport, namely the definition of sport and certain central moral norms, while at the same time arguing that normativity in sport is not exhausted by them, which leaves athletic communities with authority over a broad range of norms.     

Eating Disorders Among Urban and Rural African American and European American Women

Abstract

It is alleged that eating disorders are nonexistent in African American women and that eating disorder symptomatology occurs predominantly among White middle class women (Kumanyika, Wilson, & Guilford-Davenport, 1993; Smolak & Striegel-Moore, 2001). This research attempted to identify differences in eating disorder symptomatology in African American and White American women. An eating disorder is a disability because it can damage the person physically, emotionally and socially. It can be undetected for years and society may reinforce the hidden disorder by being complimentary regarding the thin appearance of the person. The Eating Disorder Inventory (EDI) was used to measure psychological traits and symptom clusters associated with the understanding and treatment of eating disorders (Garner, 1990). Measures of self-esteem, depression and coping were also examined. Findings indicated differences between African American and White women on the Ineffectiveness scale of the EDI, differences between the urban/rural women on Ineffectiveness and Perfectionism, and differences in coping strategies and education among this sample group of women. Successful treatment usually involves psychotherapy and/or medication for depression.     

The Inter-Life project: researching the potential of art,design and virtual worlds as a vehicle for assisting young people with key life changes and transitions

ABSTRACT

Careers work in the twenty-first century faces a key challenge in terms of digital technologies: to evaluate their potential for careers work in challenging settings. Given the rapidity of developments, technologies require evaluation in research innovations and naturalistic settings. Virtual worlds offer potential for careers and guidance work, and the therapeutic domain. To illustrate this, we present examples in which young people explore their feelings and ideas, plans and difficulties, while preparing for film-making. During this they develop important life transition skills. We argue that the power of virtual worlds – to support emotional and cognitive engagement – could be utilised in practice settings. We conclude that they are serious candidates as digital tools in the careers and guidance domain.     

HIV voluntary counselling and testing among recently initiated and traditionally circumcised men in the Eastern Cape Province of South Africa

HIV voluntary counselling and testing (VCT) is a cornerstone of the national strategic plan for HIV/AIDS treatment, care and support in South Africa. However, research shows that the utilisation of VCT services is disappointingly low, particular among males. This article focuses on the factors associated with the intention to test for HIV-infection among recently initiated and traditionally circumcised men in the rural areas of Eastern Cape Province, South Africa. Individual face-to-face interviews were conducted among 1656 sexually active men. Logistic regression analyses were used to explore the association between intention to test for HIV and psychosocial factors. Overall, 35.1% of the participants reported ever having tested for HIV. Intention to test for HIV was positively associated with perceived probability of getting an STI, positive attitudes towards gender-based violence, received general teachings about being a responsible man and highest grade passed. These findings provide specific information that can be used in the development of a focused cultural sensitive STI/HIV prevention programme aimed to increase VCT uptake among sexually active young men, which can be integrated into initiation and health education practices.     

Natural Mentors, Mental Health, and Risk Behaviors: A Longitudinal Analysis of African American Adolescents Transitioning into Adulthood

Patterns of substance use are examined in a sample of over 1,200 youth in a non-metropolitan region of New England. Self-reported history and frequency of alcohol, tobacco, marijuana, inhalants, pain medications, and other hard drug use was assessed for 9th and 10th grade students. Latent class analyses identified four patterns of substance use: non-users (22%), alcohol experimenters (38%), occasional polysubstance users (29%), and frequent polysubstance users (10%). Contextual risk and protective factors in the individual, family, peer, and community domains predicted substance use patterns. Youth report of peer substance use had the largest effects on substance use class membership. Other individual characteristics (e.g., gender, antisocial behavior, academic performance, perceived harm from use), family characteristics (e.g., parental drinking, parental disapproval of youth use), and community characteristics (e.g., availability of substances) demonstrated consistent effects on substance use classes. Implications for prevention are discussed from a social-ecological perspective.