Talking of HRD

This paper draws upon research exploring the emergence of HRD within the British National Health Service (NHS), the aim being to investigate how HRD has been talked into being, is talked about and accomplished through talk. HRD is conceptualized as a socialand discursive construction, and as discursive action. It is argued that conceptualizing HRD as a social and discursive construction can help identify and explain changes in ways of thinking and talking about HRD. Conceptualizing HRD as discursive action can help explain and justify HRD activity, in that much of what HRD practitioners and academics ‘do’ is ‘talk’. This paper explores these concepts and introduces a typology of the discourses of training and development (T&D), HRD and strategic HRD (SHRD), labelled Tell, Sell and Gel. It is suggested that this typology is a useful analytical tool for those practising HRD, providing ameans for HRD professionals to identify and analyse, and possibly change, their practices and discourse(s). The paper introduces a way of identifying how HRD might be talked ‘about’ and theorizes how discursive activities (the talk) might be changing.     

我国农村基本公共卫生服务的均等化发展

以制度化设计为重点的均等化公共卫生服务可以减少居民消费不确定性,促进社会公平和稳定,是国外经济社会发展政策的普遍趋势。我国农村公共卫生服务从均等化发展的目标来衡量,仍面临城乡环境差距较大、卫生资源布局不合理等诸多障碍,因此,必须加大改革力度,从推进农村公共服务设施与城市衔接、加强农村基础设施投入和完善农村医疗卫生体系等重点领域进行突破,全面推进农村公共服务与城市的融合。     

A case–control study relating railroad worker mortality to diesel exhaust exposure using a threshold regression model

A case–control study of lung cancer mortality in U.S. railroad workers in jobs with and without diesel exhaust exposure is reanalyzed using a new threshold regression methodology. The study included 1256 workers who died of lung cancer and 2385 controls who died primarily of circulatory system diseases. Diesel exhaust exposure was assessed using railroad job history from the US Railroad Retirement Board and an industrial hygiene survey. Smoking habits were available from next-of-kin and potential asbestos exposure was assessed by job history review. The new analysis reassesses lung cancer mortality and examines circulatory system disease mortality. Jobs with regular exposure to diesel exhaust had a survival pattern characterized by an initial delay in mortality, followed by a rapid deterioration of health prior to death. The pattern is seen in subjects dying of lung cancer, circulatory system diseases, and other causes. The unique pattern is illustrated using a new type of Kaplan–Meier survival plot in which the time scale represents a measure of disease progression rather than calendar time. The disease progression scale accounts for a healthy-worker effect when describing the effects of cumulative exposures on mortality.     

Beyond New Zealand's Dual Health Reforms

The New Zealand health system was substantially reformed in 1993 with the introduction of a purchaser–provider split, competitive contracting and managerialism. The new system failed to deliver the desired gains and, in 1996, the reforms were "reformed". While there has been widespread study of the 1993 reforms, there has been little discussion to date of the 1996 changes and the emerging directions for New Zealand health policy and service delivery, which remain unclear. This paper discusses the New Zealand health reforms of the 1990s. It briefly outlines the 1993 reforms and their results. Next, it details the 1996 "reforms". Third, it discusses developments since 1996, some of which have emerged out of the 1993 reforms, but which have gathered momentum only since the 1996 changes were announced. In the conclusion, the paper lists some of the directions in which the New Zealand health sector appears to be heading, noting that there is a need for coordination of the sector, and for permanence.     

Employee attitudes to work-based counselling services

Work-based counselling services have increasingly been introduced in organizational settings in the 1980s and 1990s. In this paper, a study is reported of the attitudes of 213 employees of a UK Health Authority towards an existing counselling service. Questionnaires sought information about attitudes to counselling, confidentiality, attitudes to those seeking counselling and general health. The results suggested that attitudes to work-based counselling services are predicted by employees' perceptions of those seeking counselling as trustworthy and their beliefs about the confidentiality of the service. The practical implications of these results are examined.     

新时期加强大学生心理健康教育的途径

近年来,大学生存在的心理问题日趋增多,而学生因心理疾病、精神障碍等原因伤害自己和他人的案例时有发生,且有上升趋势。由于心理问题而引发的学生休学、退学甚至自杀等恶性事件的发生,不仅给学生家庭带来了严重的心灵伤害,而且对学校和社会都产生了极大的影响,引起了社会的广泛关注和德育工作者的深刻思考。     

643例老干部健康体检患病情况分析

目的探讨影响老干部健康的主要疾病及预防策略。方法采用常规健康体检方法对我区643例老(≥60岁)干部进行全面体检及心电图、血液生化指标的检查,并以同时进行体检的1147例老年前期(50～59岁)干部作为对照。结果高脂血症、脂肪肝、高血糖、肾结石、高血压和前列腺增生为这些人群中患病率较高的前六位疾病。老年组中脂肪肝、高血压、高血糖和前列腺增生的患病率均高于老年前期组(P<0．05-0．005),高脂血症和肾结石的患病率在两组间均无显著性差异(P>0．05)。老年组心电图和超声心动图检查出现心肌缺血的改变均多于老年前期组(均P<0．005)。结论诸如高血压、高血糖等动脉硬化的高危因素在老年人中常见,定期健康体检是早期防治心血管疾病的有效方法。     

昆山市娱乐场所从业青年生殖健康教育研究——基线调查分析

昆山市娱乐场所从业青年生殖健康教育干预研究基线调查的结果表明:娱乐场所从业青年的流动性大;生殖保健知识欠缺;对性病/艾滋病的预防仍有误区,他们的性观念开放;无保护性行为比较普遍;有多个性伙伴的比例较高,是一个高度性活跃的年轻群体。部分从业青年涉及商业性性行为,已经成为传播性病/艾滋病的高风险桥梁人群。     

健康经济研究领域的潜在问题分析

从卫生服务的成本核算与定价、疾病负担与生命质量的测算、健康经济学技术分析方法的改进以及健康投资主体的微观化等六个方面阐述了当前健康经济研究领域的潜在问题。     

Mental load and work stress as two types of energy mobilization

A conceptual framework is presented in which mental load and stress are regarded as two distinct biobehavioural states in the work environment that differ in energy mobilization, mood and coping strategy. The framework combines two types of theory that are based on human performance research using laboratory tasks on the one hand and applied research in the work environment on the other. A high workload is regarded as an important but not a critical factor in the development of stress symptoms. Even under unfavourable conditions it is possible to work intensively and to be highly activated without feelings of strain or psychosomatic complaints. In contrast, working conditions that provide few possibilities for control and little social support or are associated with reduced well-being and increased health risks. The two states differ in activation, coping style and mood. A proper distinction is important not only for theory building but also for the reconstruction of the work environment. It may lead to recommendations that aim to enhance the work efficiency of employees while reducing the probability that stress responses will occur.