Primary Care Providers’ Attitudes,Practices, and Knowledge in Treating LGBTQ Communities

ABSTRACT

Cultural competency in lesbian, gay, bisexual, transgender, and queer (LGBTQ) health care has been found to be lacking within various medical specialties, but no studies have compared competency among primary care providers. The authors compared 127 primary care providers’ cultural competency regarding LGBTQ health using a survey that assessed providers’ attitudes, practices, and knowledge. Overall, 78.0% of respondents agreed that they were comfortable treating LGBTQ patients. Yet many providers did not feel well informed on specific LGBTQ health needs (70.1%), on clinical management of LGBTQ care (74.8%), nor on referring patients with LGBTQ issues (78.7%). Overall accuracy on LGBTQ knowledge questions was 51.0%. This study revealed a lack of cultural competency and much need for improvement as primary care providers endorsed negative attitudes, biases, inconsistencies in clinical practice, and deficiencies in medical knowledge in specialty-specific ways. There is a need for greater LGBTQ-specific education to increase providers’ comfortability and competency in the needs, management, and referrals within LGBTQ health care.     

人文关怀视域下的现代高校教育管理

本文中的人主要指的就是高校教育、管理者和受教育管理的学生。本文将针对高校这两类教育管理的主体对象提出相应的人文关怀的具体实现措施,最终推进高校教育管理工作的理论创新和模式创新。     

中国公立医院社会托管:理论、实践、案例

中国医疗卫生体制改革进退维谷,其瓶颈在于市场与政府"双失灵"下的公立医院经营改革取向,创设的"社会托管"是市场失灵与政府失灵的解决途径之一。基于动态的社会契约理论,公立医院问题的重要出路在于社会托管经营,即以第三部门的社会管理职能来弥补市场与政府的缺陷,具体应由特定的官方非政府组织承担起托管责任。社会托管相关问题包括:国有产权的主导地位、社会托管的创新理念、非政府组织的社会作用、所有与经营的分类处理、公益与效率的统筹兼顾等。通过"宿迁医改"与"潞河托管"的现实案例对比,佐证了上述方案的必要性与可操作性。     

Same Profession,Different People: Stratification,Structure, and Physicians' Employment Choices

Professions such as medicine are in the midst of profound change. This paper explores how recent stratifying forces within the medical profession relate to the trend toward salaried employment for physicians. Specifically, growing segments of female, black and Hispanic, and lower and middle class doctors are focused upon in the analysis. Several important structural forces related to managed care and the nature of medical work are discussed and examined as well. The results suggests that it is useful to consider factors internal to professions in explaining large-scale professional change. This does not mean forgetting about the role played by structure in this change. Instead, it supports incorporating stratification perspectives into studies of professionals and of considering micro levels of analysis which acknowledge and investigate the effects of intraprofessional diversity.     

Instability in patchworks of child care when moving from welfare to work

We use longitudinal, qualitative interview data collected from 38 initially welfare‐reliant women in Cleveland, Ohio to examine the factors driving instability in child‐care arrangements when women transitioned from welfare to work. Grounded theory analysis revealed that decisions about care were circumscribed by scarce social and economic resources, women went to extraordinary lengths to patch together arrangements that typically involved multiple providers, relative care was central to patchworks of care, and patchworks of child care were often highly unstable. These complex arrangements and their instability were influenced by mothers’ desires to find the most suitable arrangements for their children within resource and job constraints, dissatisfaction with providers, difficulties accessing subsidies, and changes in provider availability. Findings suggest that policymakers must consider instability in patchworks of multiple child‐care providers as they consider alternatives for meeting low‐wage working women's and children's needs for safe, affordable, accessible, and enriching nonmaternal child care.     

从医疗纠纷案例中看病历档案的管理

本文主要从若干医疗纠纷入手,从纠纷中所涉及到的有关病历问题来探讨对病历档案的管理,开列出主要的管理缺陷,并提出相对应的建议,旨在规范对病历档案的管理,完善档案工作的开展,减少医疗纠纷的发生,为建立和谐的社会主义社会做出具体的贡献。     

“三个代表”重要思想与“以人为本”的科学发展观

“三个代表”重要思想是社会主义理念发展的新高度，是我党对社会主义“人文关怀”本质不断反思的结果；而“以人为本”的科学发展观是“三个代表”重要思想在新时期、新任务下的新发展。     

我国居民医疗需求影响因素的实证分析——有序probit模型的半参数估计

本文以个人潜在医疗需求为潜变量,以表示患病情况的有序离散变量为被解释变量,建立了有序probit回归模型,日的在于考察年龄、收入、性别、教育等主要个人人口特征和经济社会地位变量对医疗需求的影响.本文实证分析采用的是中国健康与营养调查2004年的微观调奁数据,采用半参数方法对模型进行了估计.估计结果显示:年龄、性别、婚姻状态、居住在农村、收入水平、教育水平对个人的医疗需求有不同程度的影响.实证分析结果对于预测我国医疗费用的发展趋势和缓和医疗服务中的不平等问题都有参考价值.