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目的 分析研究我国部分大中城市产科资源配置的公平性情况,为制定妇幼健康相关策略和措施提供依据. 方法 选取北京市(海淀区和朝阳区)、深圳市、武汉市和成都市作为监测地区,收集辖区所有助产机构内2013年各季度有关数据,利用洛伦兹曲线、基尼系数和泰尔指数法分析评价产科资源(产科医生、护士、助产士和床位)按孕产妇、户籍人口和地理面积分布的公平性. 结果 2013年监测地区产科医生、护士、助产士和床位按孕产妇分布的基尼系数分别为0.2213、0.1927、0.1695和0.1465;按户籍人口分布的基尼系数分别为0.3832、0.4064、0.3902和0.3338;按地理面积分布的基尼系数分别为0.7043、0.7324、0.7322和0.6851.城市间的差异对产科资源按地理分布不公平的贡献率在30%左右,北京市和深圳市内部的贡献率很低,但武汉市和成都市的城市内部贡献率均达到了1/3左右. 结论 监测地区各产科资源按孕产妇分布公平性较高;产科医生、助产士和床位按户籍人口分布公平性一般,但护士按户籍人口分布处于警戒状态;各产科资源按地理面积分布公平性较差.不同城市间的差异对监测地区按地理分布不公平性的影响仅占30%左右,而成都市和武汉市内部各区县产科资源分布的差异是引起整个监测地区产科资源按地理分布不公平的主要原因. 相似文献
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《Educación Médica》2020,21(4):265-271
Apart from its enormous health and economic impact, the COVID-19 pandemic has changed the way of practicing medicine and medical education. It is likely that this effect may accelerate the transformation that both activities are experiencing. The present article, written at the peak of the crisis, sets out some thoughts on four topics: 1) the publication of false and sensationalist news; 2) the risks of taking medical decisions not based on the evidence; 3) the bioethical implications when there are sufficient resources available for everybody and; 4) the possible effects of the crisis on the teaching of medicine.This crisis should enable doctors, teachers and, students of medicine to draw conclusions and be better prepared for the future. Firstly, it is essential to maintain critical thinking that may protect against the ‘infodemic’. Furthermore, the scientific and ethical standards learned in the faculty, should not be forgotten. Lastly, it should be remembered that, in a devastating pandemic like the current one, apart from scientific medicine, which is practised with the brain, the other medicine that is practiced with the heart must also be practised. 相似文献
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Yi Luo Tingting Wu Lucas S. Broster Chunliang Feng Dandan Zhang Ruolei Gu Yue‐Jia Luo 《Psychophysiology》2014,51(9):834-842
This study investigated the potential causes of anxious people's social avoidance. The classic ultimatum game was utilized in concert with electroencephalogram recording. Participants were divided into two groups according to levels of trait anxiety as identified by a self‐report scale. The behavioral results indicate that high‐anxious participants were more prone to reject human‐proposed than computer‐proposed unequal offers compared to their low‐anxious counterparts. The event‐related potential results indicate that the high‐anxious group showed a larger feedback‐related negativity when receiving unequal monetary offers than equal ones, and a larger P3 when receiving human‐proposed offers than computer‐proposed ones, but these effects were absent in the low‐anxious group. We suggest anxious people's social avoidance results from hypersensitivity to unequal distributions during interpersonal interactions. 相似文献
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研究通过视频诱导的方式,诱导出孤独症儿童悲伤的情绪,探讨被诱导的情绪对孤独症儿童在最后通牒任务中决策行为的影响。被试为13名情绪诱导组孤独症儿童及13名情绪控制组孤独症儿童参与实验。结果发现,孤独症儿童作为接受者时,诱导出悲伤情绪的孤独症儿童比控制组的孤独症儿童在面对2:8、3:7、4:6的不公平分配比例时,表现出更多的负性情绪,并倾向于做出拒绝的决策。但是面对极端的0:10、1:9不公平分配时,视频诱导的情绪对决策是没有作用的,两组被试之间不存在显著差异。通过呈现视频的方法诱导出与最后通牒任务无关的情绪也会影响孤独症儿童在最后通牒任务中的表现。 相似文献
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《Social neuroscience》2013,8(1):118-128
Abstract Despite evidence that anterior cingulate cortex (ACC) activity is related to social exclusion, rejection and unfairness, evidence that medial frontal negativity (MFN), which has its source in the ACC, reflects these constructs remains unforthcoming. In the present study, subjects participated as recipients in an ultimatum game, while we recorded their electro-encephalogram (EEG). Participants responded to fair and unfair offers from different human proposers. In addition, participants rated themselves on a measure evaluating their concern for fairness. Results showed that MFN amplitude was more pronounced for unfair offers compared to fair offers. Moreover, this effect was shown to be most pronounced for subjects with high concerns for fairness. Our findings suggest that the MFN not only reflects whether outcomes match expectations, but also reflects whether the process by which these outcomes came about matches a social or even a moral norm. In addition, the present results suggest that people in bargaining situations are not only concerned with their own outcomes, but are also concerned with the fairness of the process that resulted in these outcomes. 相似文献
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《Substance use & misuse》2013,48(3):489-509
The existing literature on drinking patterns of Black alcoholics is relatively limited; however, most of the data suggest that drinking behavior of Blacks may be different from that of Whites. A summary of recent studies in this area is presented in Table 1. Robins et al. (1968) indicated that heavy drinking is a common pattern among Black urban males and that drinking behavior usually resulted in objective difficulties and personal worry. Maddox and Williams (1968) reported that drinking is twice as common in urban Black men as in urban White men of similar socioeconomic class origins. King et al. (1969), in a study of the social problems of Black men, demonstrated the significance of alcohol abuse in the Black urban ghetto and how this related to broken homes, delinquency, sexual and reproductive irresponsibility, and underemployment. 相似文献
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《Best Practice & Research: Clinical Gastroenterology》2014,28(2):281-292
We describe the medical state of the art in liver, pancreas and small bowel transplantation, and portray the ethical issues. Although most ethical questions related to these transplantations are not specific for liver, pancreas and small bowel, they do challenge ethical analysis as well as new policies and clinical procedures. Firstly, outcomes continue to be of utmost concern, as information is only limited available, is developing over time and is surrounded by many uncertainties. Secondly, characteristics of donors and recipients should be carefully evaluated. The question of what qualifies a donor and a recipient should be considered against the background of a quest for extended criteria, embracing marginal cases, and a judgment with regard to what counts as a good enough outcome. Thirdly, ethical principles of autonomy and fairness are pushed, given the circumstance of severe scarcity, towards limits that can easily be crossed. 相似文献
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目的研究内蒙古巴彦淖尔市乌拉特前旗乡镇(苏木)卫生院卫生资源配置公平性,查找存在的问题,为和谐社会建设和政府决策提供科学依据。方法采用整群分层随机抽样的方法,对巴彦淖尔市乌拉特前旗9个乡镇(苏木)卫生院大型仪器设备、实有床位数等进行了调查,结果均采用SPSS15.0软件建立数据库进行统计分析,用数学软件Matlab7.0绘制Lorenz曲线并计算Gini系数值。结果 2004-2008年五年间乌拉特前旗乡镇(苏木)卫生院总建筑面积、大型仪器设备、实有床位数逐年增加,分别为:5 632.00、5 772.005、805.00、6 025.006、155.00;74.00、74.00、76.00、78.00、91.00;79.00、98.00、98.00、98.00、102.00;大型仪器设备、实有床位数按人口分布、地理分布的Gini系数分别为:0.05、0.38、0.22、0.27。结论巴彦淖尔市乌拉特前旗乡镇(苏木)卫生院规模、布局不尽合理,卫生资源拥有量较少,条件较差;但资源的公平性较为合理,而大型仪器设备资源的公平性要好于床位资源的公平性。 相似文献
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公立医院改革进入攻坚之年,作为以收治精神疾病为主的精神疾病专科医院该如何推进,这无疑是一个亟需解决的问题。本文通过对人文理念与社会责任的关系进行探讨,并分析了精神病专科医院的社会责任与价值,希望能在精神病专科医院如何发展这一问题上给予一定的借鉴意义。 相似文献
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