关于发展上海市民营医院的政策思考

作者在深入调查研究的基础上，对上海市民营医院在发展中遇到的困难与问题进行了实事求是的分析和讨论，并从政府和行业协会两个方面就促进民营医院可持续发展的相关问题提出了政策建议。重点在于设立准入标准，合理布局，创建与公立医院公平的竞争机制，剥离公立医院的“特需服务”，完善依法监督、行业协会及自身管理。     

Improving knowledge and perception of HIV/AIDS among English language speaking children in rural areas through educational digital storytelling

Background/Objective:Previous research efforts have shown the need for improvement of knowledge and perception of HIV/AIDS among English Language speaking children in rural areas. Hence, the study at hand was designed to investigate the effect of using educational digital storytelling intervention to satisfy this need of English Language children in rural areas in Nigeria.Method:The study adopted a randomized control design involving a pretest, post-test, and follow-up measures. Eight-four children (n = 84) took part in the study. The HIV Knowledge Questionnaire (HIV-KQ-18) and the Perceived Risk of HIV Scale (PRHS) were used for data collection. Data were analyzed using t test statistics.Result:The educational digital storytelling intervention in appreciably improved knowledge and perception of English language children in rural areas who participated in the intervention concerning HIV/AIDS compared with their peers in the no-intervention control group. The improvement in knowledge and perception gained was also maintained throughout the follow-up evaluation period.Conclusion:The present study showed that the use of educational digital storytelling could improve knowledge and perception of HIV/AIDS among English Language speaking children in rural areas. Educational digital storytelling intervention effectively improved knowledge and perception of HIV/AIDS among children in rural areas. In return, we recommend that rural sociologists, counselors, language and communication experts, child educators, and other professionals involved in public health especially, as it concerns children be skilled in the use and application of educational digital storytelling intervention procedures to facilitate the move towards adopting the method in their professional practices.     

On the bullshitisation of mental health nursing: A reluctant work rant

This discussion paper offers a critical provocation to my mental health nursing colleagues. Drawing upon David Graeber's account of bullshit work, work that is increasingly meaningless for workers, I pose the question: Is mental health nursing a bullshit job? Ever-increasing time spent on record keeping as opposed to direct care appears to represent a Graeberian bullshitisation of mental health nurses' work. In addition, core aspects of the role are not immune from bullshit. Professional rhetoric would have us believe that mental health nursing is a therapeutically beneficent occupation organised around ideals of care and compassion and providing fulfilling work for practitioners. Yet, there are some key characteristics of the experience of mental health nursing work that afford alternative judgements on its value and meaningfulness. Not least of these is the fact that many mental health nurses feel quite existentially unsettled in the practise of their work and many service users do not recognise the professional ideal, especially when compelled into increasingly coercive and restrictive services. In this context, Graeber's thesis is explored for its applicability to mental health nursing with a conclusion that many aspects of mental health nursing work are commensurate with bullshit but that mental health care can possibly be redeemed from bullshitisation by authentically democratising reforms. Engaging with posthumanist ideas, this exploration involves a flexing of aspects of Graeber's theory.     

The philosophical and sociological context of mental health care legislation

This paper explores mental health legislation from a philosophical and sociological perspective. It is argued that mental health law exists primarily as a coercive social control instrument and that the maintenance of a separate legislative framework for the mentally ill is based upon dubious legal and philosophical grounds. The need for changes in mental health law has been accelerated by the move in Britain toward care in the community. One of the most important issues at the centre of the debate revolves around the concept of 'dangerousness' and mental disorder. The research into the extent to which the risk of violence can be predicted appears problematic from a reform perspective. Prediction is considered to be the overriding problem that leads to a violation of patients' civil rights, especially in relation to black and ethnic minority groups. Equity in law is necessary for the protection of patient's rights and particularly for the protection of those people who enter mental health care systems concerned with issues of control at the expense of care.     

Ethnic Clients in Diversional Therapy Programmes

A questionnaire survey of diversional therapists was conducted to examine their experiences with ethnic clients in diversional therapy programmes. The average therapist worked with the frail aged in a nursing home and had four ethnic clients, only one of whom spoke fluent English. Therapists experienced problems in communicating with clients and accommodating their needs. Ratings of ethnic clients' reactions to diversional therapy programmes indicated that they participated in and enjoyed 29 of 32 activities less than did other clients. While many therapists had introduced special activities and innovations, a tendency to deny the existence of ethnic clients' special needs could impede the development of ethnically sensitive diversional therapy programmes.     

Quantitative cell dispersion analysis: new test to measure tumor cell aggressiveness

Tumor progression requires the dispersion of epithelial cells from neoplastic clusters and cell invasion of adjacent stromal connective tissue. Aiming at demonstrating the precise relationships between cell dispersion and cell invasion, related respectively to expression of E-cadherin/catenin complex and matrix metalloproteinases (MMPs), we developed an original in vitro model of cell dispersion analysis. Our study reports the validation of this model that allowed us to analyze and quantify the cell cohesion level by means of time-lapse videomicroscopy and computer analysis based on the observation of spatial and temporal cell distribution. Our model was able to distinguish 2 groups among different human bronchial and mammary epithelial cells previously characterized for the expression of E-cadherin/catenin complex and MMPs and their invasive capacity in the Boyden chamber assay. The first group (16HBE14o(-), MCF-7, T47D) that expressed membranous E-cadherin and beta-catenin, and was negative for MMP-2 expression and non-invasive, displayed a highly cohesive pattern corresponding to a cluster spatial distribution. The second group (Beas2B, BZR, BZR-T33, MDA-MB-231, MDA-MB-435, BT549 and HS578T) that was invasive and showed lack of expression of E-cadherin and a cytoplasmic redistribution of beta-catenin, displayed a dispersed pattern corresponding to a random spatial distribution. Downregulation of E-cadherin by a blocking antibody induced a more random distribution. Conversely, expression of E-cadherin by cDNA transfection induced a cluster distribution. Moreover, tumor cell lines that co-expressed MT1-MMP and MMP-2 (Beas2B, BZR, BZR-T33, MDA-MB-435, BT549 and HS578T) showed a more dispersed pattern than tumor cell lines that did not express MMP-2 (MDA-MB-231). In conclusion, we demonstrated that the spatial group behavior of cell lines, i.e., their cohesion/dispersion ability, reflects their invasive properties. Thus, this model of cell dispersion analysis may represent a new test to measure tumor cell aggressiveness.     

我国药事管理学科应开展社会学研究和教育

为改善药学专业人员的知识结构,适应社会发展需要,推动药学界由面向药品向面向病人和面向社会转变,本文通过分析社会发展和体制改革对药学的影响,对比中美药事管理学发展史,认为我国药事管理学科应开展社会学研究和教育,并提出了改革的方向和内容。     

性高潮：美国的观念和实践

本文调查了由科学家、性学家和女性主义者关注的文化渗透问题.在对1053名男性和女性实施的一项由27个问题组成的网络调查中发现,性别、年龄和文化明显地影响了性高潮的表现、发生频率、假装高潮、性交时的同时高潮、达到和促进性高潮的方式.30~35岁年龄群的女性最有可能与伴侣性交时假装高潮,并在报告同时高潮发生率时表现出与男性较低水平的一致性.大多数调查对象都认为阴蒂和阴道高潮有差异（男性64.3%,女性73%）,而老年组（36~69岁）则认为没有阴蒂刺激是不太可能激发女性性高潮的（男性76.1%,女性77.2%）.除了实施唐乐可养性健身术的调查对象外（男性16.4%,女性17.4%）,促进高潮的方式是具有性别特异性的.在使用启动停止技术（男性70.6% 相对于女性40.3%）和耻尾肌刺激技术（男性25.6%相对于女性60.2%）后两性性行为存在显著差别.作为一项志愿参加的调查,女性对象报告了较高水平的射精高潮（46.4%）,而男性对象报告了较高水平的非射精高潮（44.8%）.接近半数（46%）的调查对象同意不经历高潮也可以拥有满意的性交体验,而另外的43.7%的调查人群则认为性交中高潮的重要性要依赖于情感纽带、爱与相互亲抚.     

An assessment of the geographical approach to health inequality

New interest is being shown in the geographical approach to health inequality at both the research and the service provider level. The scientific and methodological basis of this approach does not take into consideration the social structure and the history of the locations/communities under investigation. The analysis of geographical differences must be verified and consideration given to possible variations in internal health inequalities between entities compared. Our approach to health inequalities is based on the theory that social health inequalities are essentially the final product of living conditions and lifestyle taking account of individual and collective history.     

Hepatitis C prevention and convenience: why do people who inject drugs in sexual partnerships ‘run out’ of sterile equipment?

Rates of hepatitis C virus transmission among people who inject drugs in Australia remain high despite decades of prevention education. A key site of transmission is the sharing of injecting equipment within sexual partnerships. Responsibility for avoiding transmission has long been understood individually, as have the measures designed to help individuals fulfil this responsibility, such as the distribution of sterile injecting equipment. This individualising tendency has been criticised for placing an unfair level of responsibility on poorly resourced, marginalised people and ignoring the social nature of injecting drug use and related health care. Likewise, although research has demonstrated that injecting drug use is gendered, gender and sexual partnerships remain marginal to health promotion efforts. In this article, we address these weaknesses, drawing on a qualitative, interview-based project that explored equipment sharing within (hetero)sexual partnerships. In conducting our analysis, we explore a key theme that emerged in discussions about accessing and sharing injecting equipment, that of convenience, using critical marketing theory to understand this theme. In particular, we investigate the issues of convenience that affect the use of sterile injecting equipment, the many factors that shape convenience itself, and the aspects of equipment use that go beyond convenience and into the realm of intimacy and meaning. We conclude that injecting equipment needs to be both meaningful and convenient if sharing within partnerships is to be reduced further.