Health care trends, Part 2. The new health care team. Panel discussion

In Part 2 of this third annual panel discussion, six experts talk about the growing diversity of health care providers and what it means for consumers and physicians. Americans are getting their wellness and health care services from a wider variety of non-physician practitioners than ever before. The number of allied health and alternative providers with direct patient access is likely to continue growing. This trend is being driven by consumer demand, by the lobbying efforts of non-physician providers, and by federal, state, and private payers who see the potential for reduced health care spending, greater consumer satisfaction, and better outcomes. In practice, this means physicians and non-physician providers, some of whom may not be sanctioned by the medical establishment, are obligated to collaborate as a team. Members of this new provider team will have to communicate effectively (with each other, with consumers, and with payers) and make evidence-based clinical decisions. Physicians may have to share decision-making with other members of this new health care team.     

马克思、恩格斯和列宁的正义观(上)

凯·尼尔森是分析学派马克思主义的成员之一,也是西方"左翼"平等主义的主要代表。这篇文章是他的专著《马克思主义与道德观:道德,意识形态和历史唯物主义》中第四章的节选。这篇文章紧扣马克思主义原著,以《哥达纲领批判》为基点,从马克思主义发展史的角度,梳理和阐释了马克思、恩格斯、列宁的正义观,不失为当代国外马克思主义领域一篇较为本真的阐发马克思主义正义观的力作。这篇文章有助于国内学者深化理解马克思主义经典作家的政治哲学思想,也有助于我们了解和学习西方马克思主义理论家的文本解读方法和思路,对于我们构建中国特色社会主义正义理论具有理论借鉴意义。     

Market Liberalisation,Vertical Integration and Price Behaviour in Tanzania's Coffee Auction

Whether market liberalisation can promote agricultural development in Africa depends on how well existing institutions can facilitate trade by private agents. This article assesses the performance of the Tanzania coffee marketing system after liberalisation and the emergence of private, vertically integrated exporters (VIEs). Increasing producer prices, declining marketing margins, and the continued provision of a useful auction for coffee that is delivered by traders who are not VIEs all suggest a degree of success for liberalisation. The presence of VIEs seems to have provided investment to reduce marketing costs, whilst a sufficient number of competing firms has limited non‐competitive behaviour in the market for coffee that is traded at the auction by non‐VIEs.     

Trends in Gambling Studies Research: Quantifying, Categorizing, and Describing Citations

As opportunities to gamble have increased during the 20th century, so has gambling research. This study used new strategies, methods, and technology to examine citation trends and the growth of knowledge in the field of gambling studies. The sample included 2,246 citations that were published between 1903 and 2003. By using multiple keywords to classify each citation into distinct topic areas, this study yielded a more comprehensive analysis than was previously available. The results reveal that gambling-related research has grown at an exponential rate. The most prevalent topics explored within gambling studies citations have been pathology, risk-taking, decision-making and addiction. Between 1999 and 2003, studies addressing epidemiology, drug abuse, comorbidity and neuroscience have become increasingly prevalent. Based on these trends and their implications, this paper provides several recommendations for both future areas of inquiry within the field of gambling studies and better classification techniques for citations within all fields of psychology.     

The Proxy Effect: Gender and Gambling Problem Trajectories of Iowa Gambling Treatment Program Participants

Recent research has found that men and women who end up in gambling treatment tend to follow different trajectories to that endpoint: women generally begin gambling later in life, but progress to problems and seek treatment more quickly. With women’s prevalence rates of gambling and disordered gambling increasing, it has become important to identify the causes and consequences of these trajectory differences. The current study used a sample of 2,256 gamblers enrolled in the Iowa Gambling Treatment Program to examine the relationship of gender and other demographic, economic and health-related (i.e., psychosocial) factors to empirically-identified gambling problem trajectories. The results indicated that gender made a statistically significant contribution to the prediction of trajectory, but increased predictive accuracy by only 1–2% beyond a model with psychosocial predictors. Gender’s contribution was limited to its relationship to age of initiation; men and women’s problem progression did not differ meaningfully once age of gambling initiation was taken into account. Gender is a unique contributor to the development of gambling problems among treatment seekers, but it is only one small part of the myriad psychosocial characteristics that influence gambling problem development.

HIV/AIDS stigma manifestations during clinical interactions with MSM in Puerto Rico

HIV/AIDS stigma can have detrimental effects on physician/patient interactions when manifested by health professionals. Unfortunately, HIV/AIDS stigma is usually manifested in an intersectional manner with other preexisting stigmas, including stigma toward men who have sex with men (MSM). Therefore, our study aimed to examine the behavioral manifestations of HIV/AIDS stigma among physicians in training during simulated clinical interactions with MSM, and explore the interrelation between HIV/AIDS stigma attitudes and behaviors. We implemented an experimental design using Standardized Patient simulations with a sample of 100 physicians in training in Puerto Rico. Results show a significant difference in the two groups’ means (p?<?.001), with a higher number of stigma behaviors in the HIV MSM patient condition (M?=?6.39) than the common cold control condition (M?=?5.20). Results evidence that stigma manifestations toward MSM with HIV may continue to be an obstacle for public health in Puerto Rico, and that medical training to prevent stigma is still needed.     

A Social Capital Basis for Environmental Concern: Evidence from Northern New England*

This study, based on a random‐digit‐dialing telephone survey of adults in Maine, New Hampshire, and Vermont, uses ordinary least squares regression to examine a relatively neglected element in the sociological literature on environmental concern, namely, the influence of an individual's social capital on the formation of environmental attitudes. We argue that it is those individuals with a greater diversity of social connections who are most likely to be influenced by ecological perspectives grounded in conservation and environmental protection. Controlling for other theoretically relevant variables, we regress an index of environmental concern that gives special emphasis to environmental‐economic trade‐offs on our measures of relational and community social capital. While confirming much of the earlier work in this area, our model provides evidence that connections to other people play an important role in determining individual concern for the environment. Specifically, the number of respondents' “weak ties”—that is, not their closest relationships—and the average occupational status of respondents' social ties, in general, were both positively correlated with environmental concern. Additionally, one of our three measures of community social capital, the number of visits from friends over the past month, was statistically significant and negatively correlated with environmental concern.