Critical trust: understanding lay perceptions of health and safety risk regulation

The binary opposition of trusting or not trusting is inadequate to understand the often ambiguous and contradictory ideas people possess about risk regulators, particularly when knowledge and experience of such institutions is limited. The paper reports qualitative and quantitative data from a major study of public perceptions (n?=?30 focus groups) of UK risk regulators. We compare the complex and widely different ‘trust profiles’ of two regulatory organisations which are institutionally related (the Health and Safety Executive and the Railways Inspectorate) but very separate in the minds of our participants. The paper develops the notion of critical trust to interrogate the various ways in which people make sense of such organisations, as well as discussing the modes of reasoning that people deploy. The paper argues that views of participants are the outcome of a reconciliation of diverse perceptions concerning the role of the organisation, structural factors and the nature of the regulated risk.     

Trusting patients, trusting nurses

Abstract  The general expectation that patients should be willing to trust nurses is rarely explored or challenged despite claims of diminishing public trust in social and professional institutions. Everyday meanings of trust take account of circumstance and suggest that our understanding of what it means to trust is contextually bound. However, in the context of health care, to trust implies a particular understanding which becomes apparent when abuses of this trust are reported and acknowledged as scandals. The predominant assumption in the literature that trust is something that occurs between equally competent adults cannot explain trust in nursing precisely because of the unequal power relationships between patients on the one hand and healthcare professionals on the other. Moreover, the tendency to conflate terms such as trust, reliance, confidence and so on suggests that confusion permeates discussions of trust in nursing. In this paper, I argue in support of Annette Baier's requirement of good will (or lack of ill will) as the essential feature of trust, and outline how this account (i) enables us to make the necessary distinctions between trust on the one hand and 'trust pretenders' on the other; and (ii) lays the foundations for understanding trust in relationships, such as those between patients and nurses, where power differentials exist.     

基于信任源模型的全科医疗服务医患信任问题及对策建议

在全科医疗服务制度背景下,增强医患信任是提升医疗服务质量的关键。基于医患信任源模型,结合文献分析,本文对全科医疗服务中的医患信任问题进行了深入探索,得出卫生行政部门对签约服务的监督力度、社区卫生服务机构的设施环境、全科医生提供的服务质量、居民自身的信任倾向是影响医患信任的关键因素。基于此,文章从四方主体角度出发,提出要加强卫生行政部门监管力度、提升制度信任、加强医患沟通、增强人际信任、发挥居民的社会监督力量等建议,以进一步提高居民对基层医疗卫生服务的利用意愿和全科医疗的服务质量。     

青少年归因方式与人际信任的关系

目的探求青少年归因方式与人际信任的关系。方法运用一般情况调查表、I—E量表、信任量表对413名青少年进行测查。结果①青少年的归因方式在性别、是否留守上均存在显著差异；②青少年的人际信任在性别、是否留守上均不存在显著差异；③青少年的归因方式对人际信任有极其显著的影响。结论青少年的归因方式极其显著地影响其人际信任。     

Regulating the gene: From genetic consumption to regulatory trust

In this article, we examine the changing terms on which genetics-based technologies in two areas agriculture (Genetically Modified Organism, GMOs) and health (genetic diagnostics) have been regulated. These are used to illustrate and examine the proposition that shifts in the politics of governance and regulation (associated in part with the advent of the negotiation state) have meant that the responsibility for the social management of new technology is increasingly shared between the state and the consumer. However, this redistribution of the social management of risk, we argue, fails to establish a sufficient basis for a legitimate regulatory trust. We suggest that trust will depend on embedding broad social values and a self-critical agenda within the regulatory regime itself.     

社会资本在健康领域的应用现状

在解释收入不平等对健康差异的影响作用时，流行病学家引入了社会资本的概念，尽管社会资本理论自身还存在很多争议，但其与健康关系的研究引起了众多学者的兴趣。本文从各种社会资本的概念，社会资本在健康领域研究中的应用，社会资本影响健康的可能机制，各种测量方法和存在的不足以及在中国目前的应用现状等方面进行了浅析。     

一种基于信任的Web服务工作流组织模型

跨组织工作流致力于跨越组织界限的业务重组,经过组织体间的网络行为的直接交互与间接推荐,从而形成松散藕合的工作流联盟。这种基于网络行为形成的联盟信任机制具有身份信任不可替代的作用。文章提出了一种基于网络行为的联盟信任模型,研究了D-S证据理论和冲突处理方法在工作流联盟信任模型中的应用。为了解决间接信任度的计算问题,对经验推荐路径的搜索进行了研究。利用这些理论来解决模型中信任的度量、传递和组合问题。结果分析表明,与已有的工作流联盟模型相比,提出的工作流联盟信任模型具有更细的可信实体粒度和更精确的组合信任度。模拟实验结果证实了工作流信任模型可有效提高联盟的稳定性,提高了工作流执行的成功率。     

Cluster of Ebola Virus Disease,Bong and Montserrado Counties,Liberia

Lack of trust in government-supported services after the death of a health care worker with symptoms of Ebola resulted in ongoing Ebola transmission in 2 Liberia counties. Ebola transmission was facilitated by attempts to avoid cremation of the deceased patient and delays in identifying and monitoring contacts.     

The relationship between psychosocial factors in the patient–oncologist relationship and quality of care: A study of breast cancer patients

This study examined the relationship between psychosocial factors in the patient–oncologist relationship and aspects of care among women with breast cancer. Breast cancer patients (N = 118) completed a questionnaire about their relationship with their oncologist, their treatment, and their health. While trust was related to several positive outcomes, physician supportiveness was most strongly related to satisfaction with care, and health care access was most strongly associated with general health. The results suggest that the addition of supportiveness and healthcare access to trust provide a more complete picture of patients' health outcomes.