医师多点执业制度实施的现状调查及相关建议——以成都市为例

我国于2009年新医改方案提出实施“医师多点执业”制度, 但有关数据显示, 该制度在推进过程中效果并不理想, 为了探究医师多点执业制度的实施现状及其影响因素, 通过问卷调查和访谈对成都市医疗机构人员进行调研。最后在分析调研结果的基础上提出相关建议:采取措施取得医院管理者支持、平衡各方利益冲突、借鉴“团队多地点执业”模式降低医疗风险、加强政策的宣传、建立完善的基层服务体系等, 期望对成都市乃至我国该方案的实施推进提供参考依据。     

河南省医疗改革的公平性分析

河南省医疗改革突出的难题在于如何实现保健资源的公平公正.影响河南医疗改革公平的因素是产权改制的方向偏差,道德异乡人的利益博弈,资本和技术对医学的剥蚀,医学、医疗自身发展的失衡.实现医疗改革公平的对策建议是显化政府责任伦理,重建医患利益共同体,整合优化卫生资源的配置,推行医学整体化的发展模式.     

Making the audience a key participant in the science communication process

The public communication of science and technology has become increasingly important over the last several decades. However, understanding the audience that receives this information remains the weak link in the science communication process. This essay provides a brief review of some of the issues involved, discusses results from an audience-based study, and suggests some strategies that both scientists and journalists can use to modify media coverage in ways that can help audiences better understand major public issues that involve science and technology. Carol L. Rogers is editor of the interdisciplinary journal Science Communication.     

我国大学生的职业价值观研究

考察从８０年代初期到９０年代中期我国青年学生择业标准的变迁及其原因。同时,探讨了不同职业兴趣类的人在职业价值观上的异同。从而揭示了环境的变化及职业兴趣类型对职业价值观的影响作用。     

In re Edna MF: Case Law Confusion in Surrogate Decision Making

I review the recent case of Edna Folz, a 73 year-old woman who was suffering through the end stages of very advanced Alzheimer's dementia when her case was adjudicated by the Wisconsin Supreme Court. I consider this case as an example of how courts are increasingly misinterpreting the ethical and legal decision-making standards known as substituted judgment and best interests and thereby threatening individuals' treatment decision-making rights as developed by other courts over the past two decades and creating serious roadblocks to health-care providers' ability to render appropriate patient care. The Wisconsin Supreme Court held that Edna's legal guardian could not authorize withdrawal of Edna's treatment, ruling that as a matter of law, if an incompetent person is not in a persistent vegetative state, it is not in his or her best interests for life-sustaining treatment to be withdrawn unless (s)he has executed an advance directive or other statement clearly indicating his or her desires.     

TEACHING JANITORIAL SKILLS TO THE MENTALLY RETARDED: ACQUISITION,GENERALIZATION, AND MAINTENANCE

A task analysis of janitorial skills required for cleaning a restroom was performed. Six subtasks with a total of 181 component responses were identified. Subjects were required to progress through a series of four prompt levels ordered generally from more to less direct assistance for 20 of the most difficult component steps. Another series of four prompts, ordered from less to more direct assistance, was used to teach the other 161 responses. Subjects progressed to the next more intense prompt level contingent on a failure to respond appropriately with less assistance. A multiple baseline across subjects as well as the six subtasks was employed to evaluate the efficacy of the procedures. Six moderately retarded adolescents were trained in their public school. The results show rapid response acquisition, skill generalization to a second restroom, and maintenance of the newly learned behavior. The present research provides evidence of a model for analyzing and training vocational skills to the mentally retarded.     

Young adults with intellectual and other developmental disabilities acquire vocational skills with video prompting

Students with intellectual and other developmental disabilities often require substantial support to acquire the skills needed to secure work experience and paid employment. Prior findings suggest that video prompting is likely to be an effective and feasible strategy for establishing such skills. To evaluate this possibility in a special education transition program, we examined the effectiveness of a video prompting procedure in teaching 8 young adults with developmental disabilities to perform job-related tasks (doing laundry, checking in to work, vacuuming, stripping bed). The intervention was effective with all participants. The skills maintained over 3 months, and the participants performed the tasks accurately in a new setting with different materials. Participants were reportedly satisfied with the intervention and deemed it easy to use.     

关于先秦齐国是我国职业教育思想策源地的论证

本文在春秋时期齐国齐桓公和管仲的经济政治改革中相伴产生了“四民分业”的社会职业教育思想,这是据现有文献记载的中国最早的比较全面系统而深刻的社会职业教育思想,有很强的时代和自身的特色,对后世的职业教育产生了深远的影响。从中可以看出当时先进国家中,教育是如何为富国强兵的政策服务的。     

In Defense of the Jurisdiction Theory of Rights

This essay critically examines three theories of moral rights, theBenefit, the Interest, and the Choice theories. The Interest andChoice theories attempt to explain how rights can be more robustthan seems possible on the Benefit theory. In particular, moralrights are supposed to be resistant to trade-offs to supportprincipled anti-paternalism, to constitute a distinct dimensionof morality, and to provide right holders with a range ofdiscretionary choice. I argue that these and other featuresare better yet provided by a fourth theory of moral rights, theJurisdiction theory.     

Evaluating backward chaining methods on vocational tasks by adults with developmental disabilities

Backward chains are widely used to teach complex skills to individuals with developmental disabilities. Implementation of chaining procedures may vary regarding untaught steps and there is little to guide practitioners in the selection of chaining procedures. Moreover, there is a dearth of research evaluating effectiveness and efficiency of procedural variations of behavior chains. The purpose of this study was to extend previous research by evaluating the effectiveness, efficiency, and preference for four procedural variations (i.e., teacher‐completion, participant‐completion, no‐completion, and a control condition) of backward chains across vocational tasks with adults with developmental disabilities. Although procedural variations effectively established vocational skills, the participant‐completion procedure (in which the instructor implemented a least‐to‐most prompt hierarchy during all untrained steps in the chain) was the most efficacious backward chaining procedural variation and efficient in terms of sessions to mastery. The no‐completion procedure (in which the instructor completed all untrained steps in the chain out of view of the participant) was least efficient across trials, sessions, errors, and total duration to mastery. One participant preferred the no‐completion condition while the other two participants showed an initial preference for the teacher‐completion condition that changed to preference for the no‐completion condition. Vocational skills maintained 1‐ and 4‐weeks postmastery. Stakeholders rated goals, procedures, and outcomes as socially valid.