英国医疗服务创新模式分析——以NHS西北创新中心TrusTECH为例

英国医疗服务创新成果显著,值得借鉴.首先简要介绍了英国国家医疗服务体系(NHS)及其创新系统的主要情况,接着以NHS的西北创新中心TrusTECH为例,介绍了它的两种创新模式--商业化创新和服务创新计划,然后通过三个案例(生理学追踪和触发系统、信息管理工作手册和戒烟服务)深入分析了TrusTECH的服务创新流程和特点.最后总结了英国医疗服务创新模式的理论启示,以及对我国医疗服务创新的实践启示,包括培养医护人员创新意识和能力,建立系统化的创新平台,实现平台上的知识共享,以及重视非商业化创新等.     

Claims and counterclaims: institutional arrangements and farmers’ response to the delivery and adoption of innovations in the Okavango Delta,Botswana

Purpose: This article examined how institutional factors influencing the promotion of two elephant crop-raiding deterrent innovations (ECDIs) introduced to farmers through a ministry-based extension system in the Okavango Delta, Botswana, have impacted farmers’ adoption behaviour. Methodology: A standardised interview schedule was used to elicit responses from 388 randomly sampled subsistence arable farmers on how institutions influenced the adoption of ECDIs in five communities in the study area. This was complemented by focus group discussions to obtain in-depth information on the subject-matter. Key informants interviews were also conducted with purposively selected extension agents, village project committee chairpersons and village dikgosi. Findings: Four institutional factors were found to be critical for the adoption of ECDIs. These include institutional relations, availability and/or supply of deterrent innovation inputs, farmers’ contact with extension agents and government support for extension services. Theoretical Implications: Immediate and widespread adoption of ECDIs in the ever-changing socio-economic and political environment can be enhanced by context-specific institutional arrangements in addressing social and organisational constraints to innovation adoption. Originality: This paper invoked organisational theory to contribute to the scholarly debate on how agricultural extension systems influence farming clientele’s behaviour and social change. It offers the first attempt in the investigation of the role of extension and associated institutions/organisations in promoting adoption of ECDIs among subsistence farmers in the Okavango Delta, Botswana. Findings indicate that local farmers do not perceive extension agencies to hold monopoly of ideas and solutions to their unique problems.     

Lost in cyberspace: ethical decision making in the online environment

In this study, a 20-item questionnaire was used to elicit undergraduates’ (N = 93) ethical judgment and behavioral intention regarding a number of behaviors involving computers and internet usage. Machiavellianism was found to be uncorrelated with both ethical judgment and behavioral intention. Gender was found to be negatively correlated with both ethical judgment and behavioral intention, such that females judged the behaviors as being less ethical than males, and were less likely to engage in the behaviors than males. A disconnect was found between ethical judgment and behavioral intention, for both males and females, such that the ethical judgment mean for a number of issues was significantly lower (towards the “unethical” end of the continuum) than the behavioral intention mean (towards the “more likely to engage in” end of the continuum). The study raises questions regarding ethical awareness of technology-related issues, and the authors make suggestions for future research.     

What do adults remember from their high school mathematics? The case of linear functions

A qualitative study was designedto investigate adults' long-term memory ofmathematics learned in high school.Twenty-four men and women, aged 30 to 45,were requested to recall mathematicalconcepts and procedures during individualinterviews. This article reports findingsregarding the subjects' attempts to drawgraphs of simple linear functions. Ingeneral, these findings support the ideathat retaining high school mathematicalcontent strongly depends on the number,level, and total length of mathematicscourses taken by the student. Diverseresponses to the task of drawing a graph ofa linear function such as y=2x, weredocumented and categorized. In many ofthese responses, the basic mathematicalcommunal notion of linear graphing wasreplaced with personal on-the-spotconstructing of ideas. Detailed analysis ofthree cases is presented, based on recalltheories that explain the mechanism ofrecalling in terms of reconstruction vs.reproduction. This revised version was published online in July 2006 with corrections to the Cover Date.     

Where policy meets the pavement: Stages of public involvement in the prevention of school violence

Based on qualitative research on school and city violence, this article examines three forms of partnerships between community organizations and schools, including youth interventions by social services; community activism; and school liaisons with the police. The article examines how violence-prevention strategies are conceived within a context that includes the formation of policy directed at communities, youths, and schools; social science theories of delinquency; public rhetoric about youth and families; and efforts on the part of community residents, city departments, and social services. The underlying theory-base behind the research can be associated with cultural studies, since it combines cultural and structural interpretations of the topic and analyzes policies according to their processes, in light of their constructions, and in connection with the theories that guide them. It becomes obvious by the end of the article that community-based violence-prevention organizations collaborating with schools are sometimes blocked from doing good work by poor funding, power struggles, and a deficit model of youth. While the partnerships can, at times, help to initiate positive involvement of disenfranchised people, they can also become instruments of city power structures. For their positive and productive work to come out, the interagency and school collaborations must solve the problems that are discussed in the article.     

Face-to-Face Tutorials in a Distance Learning System: Meeting student needs

Many distance learning programmes include an element of face-to-face tuition. This paper reports on a research project concerned with various issues related to face-to-face tutorials in the Open University of Hong Kong's distance education system, including students' expectations of the benefits they will gain; their reasons for attending; the approaches they prefer; and their overall satisfaction with what tutors actually provide. Some comparisons are drawn between students in the university's different schools-and the overall findings are compared with those reported for distance learners in the West, in an effort to assess the impact of cultural context on student attitudes to tutorials. The research found that the Hong Kong students' attendance at tutorials was very high compared to that found in other similar studies, possibly reflecting Hong Kong's geographical compactness, but also possibly reflecting a preference for face-to-face meetings; that the students looked for specific guidance and support from tutors within a largely directive framework; that even where the format of the tutorial departed from the students' expectations, the students did not necessarily give the tutorial a low evaluation, provided that it was a fruitful experience; and that the cultural context within which a distance education system operates affects students' expectations and learning styles.     

President's Introduction: Religious Education for Peace and Justice

This article gives an overview of “practical theology” as an emerging paradigm, and discusses problems and possibilities in using the paradigm for religious education of “Generation X” in a postmodern context. The article posits that a postmodern sensibility does not imply the cognitive capacity for a truly postmodern style of meaning‐making. Drawing on Robert Kegan and the author's teaching experience with young adults, the article raises the caution that Generation X may not be prepared developmentally for postmodern educational approaches. Possibilities for using practical theological elements such as story, playfulness, and making connections are raised in relation to this age‐group.