Racialized Risk in Clinical Care: Clinician Vigilance and Patient Responsibility

Racial/ethnic identity is contingent and arbitrary, yet it is commonly used to evaluate disease risk and treatment response. Drawing on open-ended interviews with patients and clinicians in two US clinics, we explore how racialized risk is conceptualized and how it impacts patient care and experience. We found that racial/ethnic risk was a common but poorly defined construct for both patients and clinicians, who intermingled concepts of genetics, biology, behavior, and culture, while disregarding historical or structural context. We argue that racializing risk embodies social power in marked and unmarked bodies, reinforcing inequality along racial lines and undermining equitable health care.     

基于新政府会计制度探究公立医院财务精细化管理

随着社会的高速发展,政府会计制度不断革新,医院是医疗卫生行业的重要构成部分,应当不断适应社会的发展而改革。基于此,该文以公立医院的财务管理作为分析目标,对公立医院财务管理中已有的问题和未来改善措施进行分析探讨,从而为以后的发展提供意见。     

Sentencing Offenders with Foetal Alcohol Spectrum Disorder (FASD): The Challenge of Effective Management

The criminal justice system in Australia is increasingly being required to deal with offenders exhibiting the symptomatology of Foetal Alcohol Spectrum Disorder (FASD). Disproportionately they are indigenous. Diagnosis of the disorder is challenging and too frequently still not being made accurately. More challenging still is responding to it in the forensic system so that options for provision of suitable support are availed of, and thereby the risk of ongoing offending which puts the community at risk is minimised. This paper reviews the creative and compassionate judgment of the Western Australian Court of Appeal in Churnside v The State of Western Australia [2016] WASCA 146. It argues that the decision constitutes a model for the efforts that can and should be made by sentencing judges and magistrates required to deal with recidivist offenders with FASD.     

Responsabilidad social corporativa en los centros de la red hospitalaria de utilización pública de Cataluña

The adoption of a management approach that integrates corporate social responsibility in organizations is an increasing trend that responds to the demands of society related to sustainability, ethics and transparency. Health organizations are adopting corporate social responsibility asymmetrically, which raises the analysis of the implementation models and the developed initiatives. Through qualitative research, with four in-depth case studies of the Catalan health sector, this article analyzes the need to address this new approach and to identify good practices and the challenges for its implementation.     

我国西部市级政府医疗卫生支出的边际收益归属研究

目的:实证探究分析新医改以来我国西部市级政府医疗卫生支出的边际受益归属问题。方法:利用边际受益归属分析法,实证测度2009—2017年我国西部149个地级市(区)的政府医疗卫生支出边际受益情况。结果:动态研究发现,随着时间推移,低经济水平组在政府医疗卫生支出的扩张中获益呈现波动式增长,在2011年达到高峰后(0.951),于2016年超过高经济水平组。中等经济水平组支出受益均超过1,最高时达到1.505。结论:支出受益并不具有明显的亲富性,而是更倾向于中低经济水平组。建议应注重调整医疗卫生投入方向、多途径多渠道提高居民支出受益水平。     

Du parricide rêvé à l’infanticide réel,ou l’expertise mentale dans tous ses états

The authors describe at length the case of a 33-year-old woman who shot and killed her 9-year-old daughter and attempted suicide immediately afterwards. The judicial inquiry revealed that this infanticidal mother originally intended to kill her own father, who she accused of having sexually abused her in her own childhood and now her daughter, but that unforeseen circumstances changed the mode of operation. She was the subject of seven more or less contradictory psychiatric experts opinions over a period of more than three years before finally being found criminally irresponsible by the court of assizes. She was suffering from delusional psychotic mental disorders at the time of the homicide-suicide. The authors discuss and criticize the conclusions of the experts opinions and instead recommend a multidisciplinary criminological analysis that takes all the objective ans subjective aspects on the case into account.     

Personal responsibility modulates neural representations of anticipatory and experienced pain

An individual's sense of personal responsibility is crucial for adaptive functioning in ever‐changing social situations. This study investigated how the sense of personal responsibility affected the neural dynamics of anticipating one's own pain and another person's pain, using EEG. Participants played a cooperation game in which either the participant (self‐context) or the confederate (other‐context) received a mild electric shock whenever one of them erred. At the anticipatory stage of pain, feedback‐related negativity (FRN) and P300 were sensitive to the degree of responsibility in both contexts. The FRN was more negative when the participant had full responsibility (only the participant had erred) than when the participant shared responsibility with the confederate (both had erred) or had no responsibility (only the confederate had erred), and shared responsibility elicited more negative FRN than no responsibility. Having no responsibility produced larger P300 amplitudes than having shared or full responsibility, whereas there was no significant difference in P300 amplitude between the shared responsibility and the full responsibility conditions. When the shock was delivered to the participants, the P2 was smaller when there was no responsibility than when there was shared or full responsibility. When participants observed the painful facial expressions of the confederates, the P300 was not sensitive to responsibility level. Our results suggest that responsibility level modulates FRN and P300 in anticipation of pain experienced by both self and others, reflecting the attentional and affective experiences in both pain‐ and empathy‐related processes.