Just health care (II): Is equality too much?

In a previous essay I criticized Engelhardt's libertarian conception of justice, which grounds the view that society's obligation to assure access to adequate health care for all is a matter of beneficence [1]. Beneficence fails to capture the moral stringency associated with many claims for access to health care. In the present paper I argue that these claims are really matters of justice proper, where justice is conceived along moderate egalitarian lines, such as those suggested by Rawls and Daniels, rather than strong egalitarian lines. Further, given the empirical complexity associated with the distribution of contemporary health care, I argue that what we really need to address the relevant policy issues adequately is a theory of health care justice, as opposed to an all-purpose conception of justice. Daniels has made an important start toward that goal, though there are some large policy areas which I discuss that his account of health care justice does not really speak to. Finally, practical matters of health care justice really need to be addressed in a ‘non-ideal’ mode, a framework in which philosophers have done little.     

父母心理控制与小学生的欺负行为:敌意归因和冷酷无情的作用检验

采用班级整群抽样法选取1847名3~6年级小学生（男生987名;平均年龄10.73±1.16岁）及其家长为被试,采用问卷法考察父母心理控制与小学生欺负行为的关系,同时探讨敌意归因和冷酷无情的中介作用。结果发现：（1）父母心理控制显著正向预测小学生的欺负行为;（2）冷酷无情在父母心理控制与小学生欺负行为间的关系中存在中介作用,敌意归因不发挥中介作用;（3）父母心理控制对小学生欺负行为影响的中介机制不存在显著的性别差异和学段差异。本研究结果表明,冷酷无情是父母心理控制影响小学生欺负行为的重要机制,但敌意归因不是。研究者和实践者应注重对欺负者情感加工能力的关注和干预。     

受欺负与青少年外化问题关系的“健康环境悖论”：敌意性归因的中介作用

“健康环境悖论”是指在总体受欺负水平较低的环境中, 受欺负的个体会表现出更多适应问题。本研究以来自47个班级的1764名5年级到8年级学生为被试(男生956人, 平均年龄14.46岁), 考察了班级平均受欺负水平在个体受欺负经历与外化问题间的调节作用及敌意性归因的中介作用。结果发现：(1)受欺负与外化问题的关系存在“健康环境悖论”现象, 即班级平均受欺负水平能调节个体受欺负经历与外化问题的关系, 在班级平均受欺负水平较低的班级中受欺负经历与外化问题的关联更强; (2)班级平均受欺负水平对受欺负与外化问题的调节作用通过敌意性归因的中介作用实现。本研究证实了受欺负与外化问题的健康环境悖论现象, 并首次揭示了敌意性归因的中介作用机制。     

温水煮青蛙：专业认同对大学生抑郁的影响机制

为探讨专业认同、学业情绪与大学生抑郁之间的关系,采用大学生专业认同问卷、青少年学业情绪问卷与抑郁自评量表对329名大学生进行调查。结果发现：（1）专业认同对大学生抑郁有显著负向预测作用;（2）专业认同对积极学业情绪均有显著正向预测作用,但只对消极低唤醒学业情绪有显著负向预测作用;（3）在专业认同对抑郁的影响中,积极低唤醒与消极低唤醒学业情绪起到完全中介作用。结果表明,专业认同对大学生抑郁的影响实际上是一种“温水煮青蛙”效应。     

New approaches to demystifying insight

After a person has become stuck on a problem, they sometimes achieve a clear and sudden solution through insight--the so-called Aha! experience. Because of its distinctive experience, the origins and characteristics of insight have received considerable attention historically in psychological research. However, despite considerable progress in characterizing insight, the underlying mechanisms remain mysterious. We argue that research on insight could be greatly advanced by supplementing traditional insight research, which depends on a few complex problems, with paradigms common in other domains of cognitive science. We describe a large set of mini-insight problems to which multiple methods can be applied, together with subjective reports to identify insight problem-solving. Behavioral priming and neuroimaging methods are providing evidence about what, where, and how neural activity occurs during insight. Such evidence constrains theories of component processes, and will help to demystify insight.     

帕金森病与重症抑郁障碍两者中的抑郁及睡眠障碍特征对比

由于帕金森病早期常仅存在抑郁、睡眠障碍等非运动症状表现,其与重症抑郁障碍难以鉴别.本研究通过对帕金森病患者及重症抑郁障碍患者行汉密尔顿抑郁量表、匹兹堡睡眠指数及多导睡眠监测评定抑郁及睡眠特征,尝试发现两者之间差异,为早期鉴别及诊断帕金森病提供理论基础.     

基于利益相关者角度分析居民健康档案存在的问题及对策

居民健康档案对政府、卫生机构、居民都具有重要意义.健康档案工作开展时间不长,还存在诸多不足.主要总结其在管理、质量、利用、信息化建设、管理对象等方面存在的不足,从利益相关者角度分析影响因素,并针对政府、基层医疗卫生机构、卫生人员这三方具有较大影响力的利益相关者提出促进健康档案实施建议.     

The prepared mind: neural activity prior to problem presentation predicts subsequent solution by sudden insight

Insight occurs when problem solutions arise suddenly and seem obviously correct, and is associated with an "Aha!" experience. Prior theorizing concerning preparation that facilitates insight focused on solvers' problem-specific knowledge. We hypothesized that a distinct type of mental preparation, manifested in a distinct brain state, would facilitate insight problem solving independently of problem-specific knowledge. Consistent with this hypothesis, neural activity during a preparatory interval before subjects saw verbal problems predicted which problems they would subsequently solve with, versus without, self-reported insight. Specifically, electroencephalographic topography and frequency (Experiment 1) and functional magnetic resonance imaging signal (Experiment 2) both suggest that mental preparation leading to insight involves heightened activity in medial frontal areas associated with cognitive control and in temporal areas associated with semantic processing. The results for electroencephalographic topography suggest that noninsight preparation, in contrast, involves increased occipital activity consistent with an increase in externally directed visual attention. Thus, general preparatory mechanisms modulate problem-solving strategy.