全科医疗核心特征功能研究——基础保健的综合性

综合性是基础保健的重要特征功能,与首诊、可及性、连续性和协调性之间相互关联,共同形成基础保健高绩效的作用机制。面临人口老龄化、慢性病流行、医疗费用快速上涨的挑战,综合性服务的重要性日益凸显。明确基础保健综合性的概念内涵,是研究者、政策制定者和实践管理者亟待解决的一个根本性问题,是管理综合性服务的基础。针对我国基础保健综合性服务的概念及其内涵要素尚未清晰的现状,本文将系统梳理目前关于综合性定义与概念内涵的研究,把握综合性内涵、要素及其内涵;在此基础上,遵循可控性、穷尽性和互斥性原则,理清基础保健综合性与其他特征功能的内涵边界,给出全科医疗/基础保健综合性这一特征功能的定义与内涵,为后续建立全科医疗特征功能的可操作性定义奠定基础。     

医学院校大学英语翻译选修课程建设初探

医学院校开设大学英语翻译选修课程既有其必要性,也有其迫切性.课程建设中,需 要解决课时有限、内容庞杂、学生语言基础薄弱、医学翻译融入等难题.本文介绍了北京大学医学部在大学英语翻译选修课程建设中,以帮助学生建构起白己的翻译观念为核心,以侧重医学翻译为特色,尝试构建“观念建构+医学特色”教学模式的具体情况.     

Social Anxiety and the Fear of Causing Discomfort to Others

Patients with social phobia frequently report fearing that their symptoms of anxiety will adversely affect the comfort and performance of others, but these fears are not typically included in traditional measures. In Study 1, an initial 26-item pool was developed to assess this fear dimension and then administered in conjunction with measures of social phobia, anxiety and depression, to undergraduate students (n = 277), patients with social phobia (n = 101) and patients with panic disorder (n = 25). A unidimensional scale, the Social Anxiety—Discomfort to Others Scale (SA-DOS), was derived based on exploratory factor analyses and item-response theory. The unitary structure of the SA-DOS was replicated in a second sample of patients with social phobia (n = 100). In Study 2, participants with social phobia were found to have significantly higher SA-DOS scores than patients with panic disorder and student controls. Further, the SA-DOS was found to possess convergent and divergent validity in relation to validated measures assessing fear of negative evaluation and psychopathological constructs from the cross-cultural literature. In Study 3, baseline SA-DOS scores were found to be associated with poorer treatment response in a sample of patients with social phobia (n = 55) receiving Cognitive-Behavioral Group Therapy. These preliminary findings suggest that fear of causing discomfort to others is a related but distinct fear dimension of social phobia requiring greater attention in the conceptualization and treatment of the disorder.     

The Motion Behind the Symbols: A Vital Role for Dynamism in the Conceptualization of Limits and Continuity in Expert Mathematics

The canonical history of mathematics suggests that the late 19th‐century “arithmetization” of calculus marked a shift away from spatial‐dynamic intuitions, grounding concepts in static, rigorous definitions. Instead, we argue that mathematicians, both historically and currently, rely on dynamic conceptualizations of mathematical concepts like continuity, limits, and functions. In this article, we present two studies of the role of dynamic conceptual systems in expert proof. The first is an analysis of co‐speech gesture produced by mathematics graduate students while proving a theorem, which reveals a reliance on dynamic conceptual resources. The second is a cognitive‐historical case study of an incident in 19th‐century mathematics that suggests a functional role for such dynamism in the reasoning of the renowned mathematician Augustin Cauchy. Taken together, these two studies indicate that essential concepts in calculus that have been defined entirely in abstract, static terms are nevertheless conceptualized dynamically, in both contemporary and historical practice.     

When Do Misunderstandings Matter? Evidence From Survey Interviews About Smoking

This paper examines when conceptual misalignments in dialog lead to consequential miscommunication. Two studies explore misunderstanding in survey interviews of the sort conducted by governments and social scientists, where mismeasurement can have real social costs. In 131 interviews about tobacco use, misalignment between respondents' and researchers' conceptions of ordinary expressions like “smoking” and “every day” was quantified by probing respondents' interpretations of survey terms and re-administering the survey questionnaire with standard definitions after the interview. Respondents' interpretations were surprisingly variable, and in many cases they did not match the conceptions that researchers intended them to use. More often than one might expect, this conceptual variability was consequential, leading to answers (and, in principle, to estimates of the prevalence of smoking and related attributes in the population) that would have been different had conceptualizations been aligned; for example, fully 12% of respondents gave a different answer about having smoked 100 cigarettes in their entire life when later given a standard definition. In other cases misaligned interpretations did not lead to miscommunication, in that the differences would not have led to different survey responses. Although clarification of survey terms during the interview sometimes improved conceptual alignment, this was not guaranteed; in this corpus some needed attempts at clarification were never made, some attempts did not succeed, and some seemed to make understanding worse. The findings suggest that conceptual misalignments may be more frequent in ordinary conversation than interlocutors know, and that attempts to detect and clarify them may not always work. They also suggest that at least some unresolved misunderstandings do not matter in the sense that they do not change the outcome of the communication—in this case, the survey estimates.     

全科医疗核心特征功能定义与内涵界定研究——连续性

连续性是基础保健的一个十分重要而独特的特征,与首诊、可及性、综合性和协调性之间以一种互为基础、相互支撑、彼此强化的方式共同作用,形成基础保健的作用机制。本文首先系统梳理目前关于连续性定义与概念内涵的研究,把握连续性内涵要素,明晰服务连续性的显性要素与隐性要素之间的关系;在此基础上,遵循可控性、穷尽性和互斥性原则,厘清基础保健下连续性与其他四个特征功能的内涵边界,给出全科医疗/基础保健连续性这一特征功能的定义与内涵,为后续建立全科医疗特征功能可操作性定义奠定基础。     

全科医疗核心特征功能定义与内涵界定研究——可及性

可及性是基础保健五大核心特征功能之一,与首诊功能紧密联系,与综合性互相促进,影响连续性、协调性功能的实现。本文首先回顾普适的可及性概念,并在此基础上梳理基础保健可及性的概念内涵和主要特点,进而辨析基础保健可及性与其他基础保健核心特征功能的联系与区别,最后依据可控性、穷尽性和互斥性三大原则,得出基础保健可及性定义与核心要素,为全科医疗特征功能测量评价工具的研制提供理论依据。