Justice in Health Care Decision-Making: Patients’ Appraisals of Health Care Providers and Health Plan Representatives

This study describes the development of two versions of a Health Care Justice Inventory (HCJI). One version focuses on patients interactions with their providers (HCJI-P) and the other focuses on patients interactions with the representatives of their health plans (HCJI-HP). Each version of the HCJI assesses patients appraisals of their interactions (with either their Provider or representatives of their Health Plan) along three common dimensions of procedural justice: Trust, Impartiality, and Participation. Both the Provider and Health Plan scales assess indices that are relatively independent of patients demographic characteristics. In addition, patients appraisals of their interactions with their provider were only moderately related to their appraisals of their interactions with representatives of their health plan, indicating that the Provider and Health Plan scales tap distinct aspects of patients overall experience with the health care system. Overall, procedural justice dimensions were significantly related to patient satisfaction in both the Provider and the Health Plan contexts. As predicted, procedural justice factors were more strongly tied to patient satisfaction in the Provider than in the Health Plan context, and health care decisions based on distributive justice principles of Need (rather than Equity or Equality) were most closely tied to patient satisfaction in both contexts.     

维生素D受体基因多态性研究进展

维生素D受体(vitaminDreceptor,VDR)基因多态性可能与骨密度、骨质疏松、身高相关。本文作者就近年国内外所开展的VDR基因4个单核苷酸多态性(singlenucleotidepolymorphism,SNP)位点FokI、BsmI、ApaI、TaqI与骨密度、骨质疏松、身高关联性研究进行综述,发现各国的研究结果虽不尽相同,但VDR基因多态性在遗传学、临床内分泌代谢,尤其在法医学领域对身高的研究中,有重要的应用价值。     

扩增TP53内含子8用于生物检材的种属鉴定

目的扩增常见动物TP53内含子8片段,确定其在法医学生物检材种属鉴定中的应用价值。方法收集标本为包括人在内的15种常见动物的血痕或肌肉组织,提取DNA后定量,应用PCR扩增TP53内含子8,PAGE电泳,银染后观察结果。结果人和猕猴都扩增出一条长度为460bp的片段,鳝鱼、鲢鱼、青蛙、鸭、兔、猫、小白鼠、豚鼠、猪、牛、羊虽有扩增产物,但不在分型区内,鸡、狗未见扩增产物。结论扩增TP53内含子8进行种属鉴定,方法简单,灵敏度较高。     

Fatal impalement with transfixion of the neck in a road traffic accident

The authors describe a singular case of fatal impalement due to penetration of a metal tube at the level of the neck in a victim of a road traffic accident. The man was traveling in the passenger seat ("death seat") of a car that hit the parapet of a bridge head on; death was attributed to hemorrhagic shock, which was brought on virtually instantly at the moment of impact.