Using the Delphi Method to Classify Medical Specialties

One medical specialty classification system applicable for research and career counseling is the person‐oriented versus technique‐oriented taxonomy. Given that the model was conceptualized in the 1960s, verification based on how medical specialties are practiced and viewed today is necessary. Five specialists in medical career development and advising verified the categorization of specialties. Based on their review, 100% consensus was reached regarding grouping of specialties. This outcome validates the taxonomy of medical specialties and supports its continued use for medical career specialty advising and choice.     

Designing Graphs that Promote Both Risk Understanding and Behavior Change

Graphs show promise for improving communications about different types of risks, including health risks, financial risks, and climate risks. However, graph designs that are effective at meeting one important risk communication goal (promoting risk‐avoidant behaviors) can at the same time compromise another key goal (improving risk understanding). We developed and tested simple bar graphs aimed at accomplishing these two goals simultaneously. We manipulated two design features in graphs, namely, whether graphs depicted the number of people affected by a risk and those at risk of harm (“foreground+background”) versus only those affected (“foreground‐only”), and the presence versus absence of simple numerical labels above bars. Foreground‐only displays were associated with larger risk perceptions and risk‐avoidant behavior (i.e., willingness to take a drug for heart attack prevention) than foreground+background displays, regardless of the presence of labels. Foreground‐only graphs also hindered risk understanding when labels were not present. However, the presence of labels significantly improved understanding, eliminating the detrimental effect of foreground‐only displays. Labels also led to more positive user evaluations of the graphs, but did not affect risk‐avoidant behavior. Using process modeling we identified mediators (risk perceptions, understanding, user evaluations) that explained the effect of display type on risk‐avoidant behavior. Our findings contribute new evidence to the graph design literature: unlike what was previously feared, we demonstrate that it is possible to design foreground‐only graphs that promote intentions for behavior change without a detrimental effect on risk understanding. Implications for the design of graphical risk communications and decision support are discussed.     

Grandparent support and mental and behavioural health in middle childhood

This study explored the significance of grandparents in middle childhood and assessed the level of grandparental support provided to children in relation to other social network members. The association between grandparental support and grandchildren's mental and behavioural health was also examined. We conducted structured interviews with 120 grade 4 and 5 learners (mean age = 10.41 years) from four schools in Cape Town, South Africa. Results indicated that subsequent to parents, children perceived grandparents as the most important and close relationship category. Furthermore, grandparents provided the highest levels of support to grandchildren after parents. Grandmothers provided more support than grandfathers. No associations between grandparental support and children's internalizing and externalizing behaviours were found. However, results revealed that grandparental support was positively associated with children's prosocial behaviour, independent of child gender, and the amount of support provided by other relationship categories (p = .04). Findings underscore a need for research to move beyond the nuclear family when considering potential influences on children's well‐being.     

多渠道医疗门诊挂号的时间策略研究

现阶段多种门诊挂号方式并存时，根据患者特性制定不同的等待时间策略尤为重要。本文考虑门诊挂号的三种渠道：直接排队挂号渠道、电话预约挂号渠道与O2O预约挂号渠道。在价格外生前提下，综合考虑患者的渠道偏好程度、时间敏感性与提前支付敏感性，基于效用理论构建患者的渠道选择模型。根据该模型推导得出不同市场条件下医院的需求，医院再据此制定患者的等待时间策略以达到利润最大化的目的。研究发现：当医院仅开通单一挂号渠道时，若患者的时间敏感度越大、渠道偏好程度越小，等待时间均越小；开通某两种挂号渠道时，还需考虑患者对两种渠道的偏好比例，偏好某种渠道的患者比例增加，选择该渠道的患者等待时间增加，选择另一渠道的患者等待时间减小；同时开通三种渠道时，最偏好某渠道的患者比例越大，选择该渠道的患者的等待时间也越大；在所有情况下，患者对提前支付的敏感度均不影响最优等待时间的制定。     

多元医疗背景下藏族民众择医实践的人类学分析——以甘孜藏族自治州C村为例

择医实践是指当一个人感到不适，为了证实是否有疾病和为了减少疾痛为目的寻求帮助的行为，是医学人类学研究主要课题之一。由于社会文化背景、地理条件等因素，藏族聚居地区医疗模式显现出多元共存，与之对应，当地民众的择医实践也呈现出一种多元状态。正是由于人们多元择医实践的诉求、固守与调适，才推进着多元医疗模式在发展中适应区域群体的文化变迁、需求改变而日趋完善，由此医疗模式与择医实践形成了互动、互构关系。     

Heterogeneous treatment effects on Children's cognitive/non-cognitive skills: A reevaluation of an influential early childhood intervention

The 1962–67 High/Scope Perry Preschool Program, a well-known experimental early childhood intervention study that provided quality preschool education to disadvantaged children, has been shown to have had positive impacts on early child development and on a variety of adulthood outcomes. However, most previous analyses have only examined average treatment effects across all program participants without exploring possible effect heterogeneity by children's background characteristics. We investigated this question by first using the 1964–65 Current Population Survey data in combination with the Perry data to construct a scale of child socioeconomic status based on the estimated propensity for inclusion in the Perry program, then analyzing effect heterogeneity within the Perry sample by strata of our socioeconomic scale. We found that the treatment effects of enrollment in the Perry preschool on cognitive and non-cognitive skills were much larger and more persistent among the most disadvantaged children than among others in the Perry program. Furthermore, among the most disadvantaged children, the treatment (i.e., preschool enrollment) affects later outcomes through a reinforcement mechanism of skill development (i.e., early cognitive gain leads to a non-cognitive gain, which in turn leads to later cognitive gain) and a sequential improvement of cognitive skills over time. These findings have important implications for the evaluation of policy interventions in early child development using experimental data.     

Advice to mothers about managing children's behaviours in Canada's premier woman's magazine: a comparison of 1945–1956 with 1990–2010

Recent research and theorizing has characterized contemporary mothering as medicalized, intensive and risky. The rate of diagnosis of children's mental health issues has grown rapidly, particularly since the 90s. This paper examines the construction of mothering in regard to children's behaviours and mental health through an exploratory and qualitative content analysis of the portrayal of advice to mothers in Chatelaine Magazine, the premier women's magazine published in Canada. The time periods chosen for comparison were 1945–1956 and 1990–2010. The first period was selected because it was a time of dramatic changes that occurred in family, occupational and domestic life for women immediately after World War II. The second represents the modern period. The findings of the paper suggest that mothering was intensive, medicalized and risky in both periods although the conceptualizations of problems differed.     

论《侵权责任法》规定的医疗产品损害责任

《侵权责任法》规定的医疗产品损害责任，从性质上来说，既是医疗损害责任的一个特殊类型，也属于产品责任的范畴，适用无过错责任原则。其中第59条规制的适用范围包括有缺陷的药品、消毒药剂和医疗器械以及不合格的血液，但此适用范围应予以界定。在此界定内，导致患者损害的医疗机构、生产者所承担的赔偿责任才是《侵权责任法》第59条规定的医疗产品损害责任。     

医学生择业过程中的心理状况与职业生涯规划

随着大学毕业生人数的激增以及用人单位对于专业化程度要求的提高，就业形势变得日益严峻。同时，由于地区间经济发展的不平衡，人才往城市倾斜现象较为严重，由此出现城市与乡镇医院人才供求比例严重失衡。伴随社会问题出现的是医学生对于职业生涯规划的定位不准确而产生的各种心理问题，这些心理上的困境正严重地威胁着医学生职业前途。本文通过对医学生择业困境中的心理状态进行溯源与探讨，并结合我国目前医学生群体的就业状况，论述医学生择业过程中存在的心理问题，提出有针对性的解决方案与符合医学生群体特征的职业生涯规划，以期能为医学生群体带来一定的帮助。     

医学生医德教育的困境及对策

医德是保证社会医疗卫生事业健康发展的一个重要因素，而关于医德方面的教育也是医学教育中的重要组成部分之一。可以说，医德教育的好坏直接关系到社会医德风尚，但是从目前的形势上来看，在我国现行的医学生医德教育中实际上是存在着许多问题的，医德教育很多时候都是在困境中前行的。因此在本文中作者在对医德教育其重要意义进行了阐释的基础上就医学生医学教育中存在的诸多问题进行了剖析，并就这些问题提出了相应的解决方案和应对策略，旨在以此为提高医学生医德教育的质量提供一定的参照和指导。