中国卫生监督人员配置现状及公平性分析

目的通过分析中国卫生监督人员配置现状及公平性,以期为卫生监督人员的进一步合理配置提供参考依据。方法通过查阅《中国统计年鉴》、《中国卫生和计划生育统计年鉴》获取卫生监督人员数量和结构等资料,运用集中指数法评价中国卫生监督人员配置公平性。结果 2011~2015年中国卫生技术人员数、其他技术人员数、管理人员数均呈下降趋势,年平均下降率分别为1.06%、11.05%、12.43%;卫生技术人员集中指数介于-0.0162~0.0311,其他技术人员的集中指数介于-0.0249~0.0016,管理人员的集中指数介于-0.1157~0.320。结论卫生监督人员数量有所减少,卫生监督人员结构有待进一步优化,卫生技术人员、其他技术人员配置公平性优于管理人员。     

Four Applications of Embodied Cognition

This article presents the views of four sets of authors, each taking concepts of embodied cognition into problem spaces where the new paradigm can be applied. The first considers consequences of embodied cognition on the legal system. The second explores how embodied cognition can change how we interpret and interact with art and literature. The third examines how we move through architectural spaces from an embodied cognition perspective. And the fourth addresses how music cognition is influenced by the approach. Each contribution is brief. They are meant to suggest the potential reach of embodied cognition, increase the visibility of applications, and inspire potential avenues for research.     

The Ultimatum Game and the brain: A meta-analysis of neuroimaging studies

Social decision-making tasks involve psychological processes key to effective functioning in a complex, social world. The Ultimatum Game (UG) is a widely studied social decision-making task, which models responses to fairness. A number of neuroimaging studies have investigated the UG to identify neural correlates of unfairness and decisions to reject versus accept an offer. We present the first quantitative summary of neuroimaging studies in social decision-making with a meta-analysis of 11 fMRI studies of the UG, including data from 282 participants. Effect-Size Signed Differential Mapping was used to estimate effect sizes from statistical parametric maps and reported peak information before meta-analysing them. Consistent activations were seen in the anterior insula, anterior cingulate cortex (ACC), supplementary motor area (SMA) and cerebellum in response to unfair offers. Robust activations in the ACC, SMA and putamen were seen when deciding to reject rather than accept UG offers. These are consistent with models of motivational conflict during the UG decision-making process, a response to norm violations, with a possible role for the reward system.     

Baccalaureate nursing students' perceptions of peer assessment of individual contributions to a group project: a case study

A group project is a common method of assessment in higher education worldwide. The use of an adjunct peer assessment (PA) scheme as a means to award marks for individual student contributions to a group project has increased. However, nursing students' perceptions of PA have not been well studied. This paper examines baccalaureate nursing students' perceptions of PA in assessing individual contributions to a group project. Using a case study design with both quantitative (an anonymous survey with 123 students), and qualitative methods (six focus group interviews with 21 students), data were collected from students in a baccalaureate nursing programme. Merging of quantitative and qualitative findings indicated that students overall had positive perceptions of PA, especially its ability to reduce 'free-riding'. However, students also had some interpersonal and operational concerns about the PA implementation process. Based on the findings, we recommend: (1) further developing students' abilities to assess the contributions of others to the task and relationship functions in group work; and (2) adopting a confidential online system for submission of PA forms.     

河南省中医类医院卫生资源配置公平性评价

目的 评价河南省中医类医院卫生资源配置公平性,为优化河南省中医药卫生资源提供参考依据。方法 利用基尼系数和泰尔指数,从人口维度评价2014—2018年河南省中医类医院卫生资源配置公平性。结果 与2014年相比,2018年河南省中医类医院卫生技术人员、实有床位和财政补助收入分别增加了36.97%、40.37%和179.51%;每千人口卫生技术人员、实有床位与全国同期水平持平,每千人口财政补助收入低于全国同期平均水平。基尼系数显示,卫生技术人员、实有床位和财政补助收入按人口配置的基尼系数分别在0.2136~0.2257、0.2040~0.2295和0.3379~0.4345之间,均呈下降趋势;泰尔指数结果显示,河南省中医类医院卫生技术人员、实有床位和财政补助收入的总体泰尔指数分别在0.0754~0.8833、0.0669~0.0834和0.1252~0.3238之间,各项指标区域内泰尔指数及差异贡献率均远高于区域间泰尔指数及差异贡献率。结论 河南省中医类医院各项卫生资源配置量逐渐增加,卫生资源配置公平性提升,公平性差异主要来源于区域内部差异,财政补助收入资源分布均衡性较差,需进一步落实财政倾斜政策。     

A Fair Range of Choice: Justifying Maximum Patient Choice in the British National Health Service

In this paper I put forward an ethical argument for the provision of extensive patient choice by the British National Health Service. I base this argument on traditional liberal rights to freedom of choice, on a welfare right to health care, and on a view of health as values-based. I argue that choice, to be ethically sustainable on this basis, must be values-based and rational. I also consider whether the British taxpayer may be persuadable with regard to the moral acceptability of patient choice, making use of Rawls’ theory of political liberalism in this context. I identify issues that present problems in terms of public acceptance of choice, and also identify a boundary issue with regard to public health choices as against individual choices.     

2000年世界卫生报告带给我们的新启示

<2000年世界卫生报告>以全新的视角和观念提出了卫生系统的3个目标、4个功能、4个战略方向、5个技术评价指标,为世界各国提供了评价卫生系统绩效的新框架.作者在充分肯定世界卫生报告新思维、新框架的同时,提出个人评论意见,并对某些评价指标和评价结果提出商榷.     

我国优质医疗资源分布特点与改善策略

促进医疗资源公平分布是卫生改革的主要目标之一,也是解决“看病难、看病贵”的根本途径。在明确优质医疗资源概念的基础上,对我国医疗资源分布特点进行了宏观分析,并提出了改进建议。     

Retaliation or selfishness? An rTMS investigation of the role of the dorsolateral prefrontal cortex in prosocial motives

Equity, fairness and cooperative behavior are crucial for everyday social interactions. Recent neuroimaging studies suggest that the dorsolateral prefrontal cortex (DLPFC) is involved in the evaluation of violations of fairness rules, though difficulties remain to determine its role in implementing retaliating or forgiving responses to unfairness. Accordingly, we applied repetitive transcranial magnetic stimulation (rTMS) to the left and right DLPFC and investigated the impact of the DLPFC on retaliation and selfishness using a sequential neuroeconomic task establishing a role reversal. That is, participants first played an Ultimatum Game (in the role of a recipient) against fair or unfair proposers, followed by a Dictator Game in the role of a proposer. Following inhibition of the right DLPFC, subjects showed an increased punishment rate regarding previously unfair opponents. Surprisingly, previously fair opponents were also treated less fairly after rTMS to the right DLPFC, but not after left or sham rTMS. Previous work suggests that the right DLPFC provides “top-down” cognitive control over prepotent emotional responses to unfairness. Our results indicate, however, that the right DLPFC may be involved in controlling selfish behavior and that its suppression leads to maximization of one’s own benefit, regardless of another’s fairness or unfairness in previous encounters.     

2019年中国内地县(市)级放疗单位人员设备现状及公平性分析

目的:调查了解中国内地县(市)级医院的放疗人员及设备的基本情况并评价各放疗资源分布的公平性。方法:以全国所有县(市)级放疗单位为研究对象,资料来源于中华医学会放射肿瘤治疗学分会在2019年4月10日至9月20日期间,以线上问卷形式进行的第九次行业调查所得的数据。对数据进行统计描述与分析,运用基尼系数、泰尔指数和集聚度对...