從性別盲到性別敏感的教育研究：以婦女成人教育與性教育研究的文獻回顧為例

[[sponsorship]]臺灣女性學學會; 清華大學性別與社會研究室; 清華大學通識教育中心[[notice]]補正完畢[[conferencetype]]國內[[conferencedate]]20030927~20030928[[conferencelocation]]新竹, 臺

[[alternative]]From Gender Blind to Gender Sensitive: A Literature Review of Studies on Women Adult Education and Sex/uality Education in Taiwan

[[abstract]]　　有別於課程教學、行政領導、教育哲學等傳統上完全無視於性別作用的教育研究領域，「婦女成人教育」與「性教育」是兩個較為特別的領域：「婦女成人教育」早在女性主義與性別研究興起前，便明確地針對「婦女」處理與性別角色有關的議題；而「性教育」則主要是針對青少年，處理「性與性別」相關議題。 　　基於上述特性，本文考察在婦女運動與性別研究的衝擊之下，台灣這兩個領域的研究是否及如何開展出較具女性主義觀點的論述，並以性別主體的展現、立論的理論基礎與議題的多元性為考察的三大面向。「婦女成人教育」領域以1991至2003年間的主要期刊文獻為分析對象，發現婦女成人教育研究呈顯出主流漠視、婦女面貌單一或隱而不現、女性主義荒漠等處境。近年受婦女運動、教育部兩性平等教育委員會成立及婦女研究蓬勃發展之影響，彰顯女性主體性的婦女教育期刊文獻逐年增加，而如何開拓這片沃土、如何關注婦女教育的多元議題則值得進一步關注。「性教育」，係以如何在教育現場實施性別平權的性教育為終極關懷，故取材幾份在中小學校園中流通的刊物如《測驗與輔導》、《諮商與輔導》、《學生輔導通訊》，並以《兩性平等教育季刊》作為性教育與兩性平等教育論述發展的對照分析。本文以實例佐證指出「衛生教育」中的性教育論述的男流霸權運作，呈現出性別盲、性別差異二元對立化與異性戀中心的論述形貌；而在晚近受到女性主義與多元性別觀點的挑戰，性別敏感的性教育論述得以發展、性別平權的性教育亦開始實踐。本文同時引用西方多元文化論述中「差異政治」與「認同政治」兩個核心概念，來探討性教育論述當中如何處理性別差異與性別身份認同的問題。[[journaltype]]國內[[booktype]]電子版[[countrycodes]]TW

Brominated Flame Retardants Pollution and Health Risk---Effects of Decabrominated Diphenyl Ether (Deca-Bde) on Reproductive, Hepatic, and Endocrine Functions in Mice

[[abstract]]多溴聯苯醚(polybrominated diphenylethers, PBDEs)屬於持久性與生物蓄積性之有機污染物，不僅被發現存在環境中、也在血液與乳汁中被偵測到。PBDE 209使用量在PBDEs中佔第二位，目前對經由子宮暴露PBDE 209引發相關的生殖、肝臟與荷爾蒙的研究仍有限。本研究探討「懷孕期暴露PBDE 209對雄性子代生殖功能、甲狀腺荷爾蒙及肝臟酵素表現」將懷孕母鼠分別餵食三種不同濃度PBDE 209（10, 500, and 1500 mg/kg/day），以及玉米油之控制組直到生產為止。在哺乳期時記錄仔鼠之發育標記，當出生後第71天，每隻母鼠同窩子代隨機選取三隻公鼠進行實驗。實驗項目包括（1）發育之評估，包括體重及組織重量、尿道至肛門口距離(AGD)、尿道至肛門口距離指數(AGI)以及睪丸指數；（2）精子功能，包括精子數目、活動力、運動參數、精子型態、精子染色質DNA結構之完整性、精子反應性氧化物生成以及精子粒線體膜電位；（3）睪丸功能，包括每日精子產生數睪丸細胞DNA含量分析、血清睪固酮濃度以及睪丸切片檢查；（4）肝臟的評估，包括肝臟酵素活性的分析以及肝臟切片檢查；（5）甲狀腺的評估，包括甲狀腺荷爾蒙之分析及甲狀腺切片檢查；以及（6）子代的發育標記觀察。暴露於1500 mg/kg劑量組之子代其AGD、AGI、精子型態異常、精子DNA變性（X αT）均達顯著性差異。暴露於10 mg/kg劑量組之子代其精子H2O2生成以及DNA變性（X αT）均呈顯著性改變。在所有暴露組睪丸的間質細胞及/或生精小管均發現有空泡化的現象。更進一步的研究發現1500 mg/kg暴露組其肝臟酵素S9 EROD活性呈現輕微的上升並達顯著性增加(54%)。在10 mg/kg以及1500 mg/kg暴露組之子代，血清中總T3均呈顯著性減少(21%)。子代精子功能及血清總T3之最低觀察危害效應劑量(LOAEL)為10 mg/kg。本研究證實子宮內暴露PBDE 209可能會影響雄性子代生殖功能與誘發肝酵素分泌，表示PBDE 209可能具有干擾胎兒發育過程生殖與內分泌之毒性。[[abstract]]Polybrominated diphenyl ethers (PBDEs) are persistent and bioaccumulative compounds and have been found not only in the environment, but also in human blood and breast milk. Decabrominated diphenyl ether (PBDE 209) is the second most used PBDEs. Little is known about the adverse health effects of PBDEs on reproductive, hepatic, and hormone systems. The objective of this study was to evaluate the effects of prenatal exposure to PBDE 209 on reproductive function, thyroid hormone homeostasis and hepatic enzymes induction in male mice offspring. Pregnant mice were administered different doses of PBDE 209 (10, 500, and 1500 mg/kg/day) or corn oil for controls per gavage from gestational days (GD) 0 to GD 17. At postnatal day 71, three male mice in each litter were randomly selected and analyzed. Parameters were measured as following: (1) evaluation of development, including body and organ weights, anogenital distance (AGD), anogenital index (AGI) and testis index (TI); (2) characterization of sperm functions, including sperm chromatin DNA structure integrity (SCSA), reactive oxygen species (ROS) generation and mitochondrial membrane potential (MMP); (3) serum testosterone hormone levels and histopathology; (4) estimate of liver, including hepatic enzyme activity and histopathology assay; (5) thyroid assay, including hormone analysis and histopathology; and (6) evaluation of developmental landmarks of F1 generation mice. We found that the AGD, AGI, sperm morphological abnormality, and sperm DNA denaturation (X T) were significantly altered at 1500 mg/kg group. Sperm H2O2 generation and X T were significant increased at 10 mg/kg group. The interstitial cells and/or seminiferous tubules were found in testis that showed vacuolization in all treated groups. Moreover, 1500 mg/kg group that hepatic enzyme activity of S9 EROD was weak but significantly increased (54%) in offspring. Serum T3 was found to have decreased significantly (ca. 21% both 10 mg/kg and 1500 mg/kg) in offspring. Histopathological examination revealed that PBDE 209 might cause cell swelling of hepatocytes in all treated groups and show dose-related in postnatal or prenatal exposure. These results showed that prenatal exposure to PBDE 209 might affect reproductive function, thyroid hormone homeostasis and hepatic enzymes induction in male mice offspring, indicating that PBDE 209 is more likely an endocrine disruptor and providing related evidences for environmental and occupational health.[[note]]NSC96-2314-B327-001-MY

影響醫院醫師及資訊主管電子病歷交換意圖之因素

[[abstract]]研究背景與目的：為提升醫療照護品質、減少醫療錯誤及降低醫療成本，近年來，歐美先進國家逐步推行電子病歷的建置及資訊交換。目前國內雖亦藉由國家政策推行電子病歷跨院互通，但各醫院推動互通之時間及執行程度等情形均不相同。再者，醫院醫師與資訊主管在電子病歷交換中是重要成員，但兩者分別扮演使用者及服務提供者不同的角色。因此，瞭解國內醫院電子病歷互通使用情況及交換意圖，並進一步探討醫院醫師與資訊主管觀點的影響因素，成為重要的研究議題。方法：本研究為一橫斷性研究，以科技-組織-環境理論為研究架構，發展結構式問卷。以國內已實施電子病歷交換之343 家醫院的電子病歷委員會醫師成員及資訊主管為研究對象。共回收醫師樣本155 份、資訊主管168 份問卷，問卷回收率為45.2%及49%，後續以SPSS 21.0 進行統計分析。結果：雙變項分析結果顯示，醫師及資訊主管僅在「法令規章」題項有顯著差異(t=-2.656，p 值＜0.01)。從迴歸分析發現，認知利益(β=0.208, p＜0.05)、相容性(β=0.231, p＜0.05)及法令規章(β=0.180, p＜0.05)子構面對醫師之電子病歷交換意圖影響顯著。而資訊主管部份，有顯著影響之子構面包含認知利益(β=0.270, p＜0.01)、上級支持(β=0.265, p＜0.001)及法令規章(β=0.215, p＜0.01)。結論：雖然認知利益及法令規章之變項對醫師及資訊主管電子病歷交換意圖有顯著影響，但醫師較關切電子病歷互通時之相容性，而資訊主管特別需要上級支持。因此建議醫院需具備足夠的資訊能力及高階主管的支持來建置電子病歷交換系統，同時政府機關應訂定相關規範及提供誘因，以提高醫院使用電子病歷交換的意願

影響醫院醫師及資訊主管電子病歷交換意圖之因素 The factors affecting hospital physicians and information officers’ electronic health records exchange intention

[[abstract]]研究背景與目的：為提升醫療照護品質、減少醫療錯誤及降低醫療成本，近年來，歐美先進國家逐步推行電子病歷的建置及資訊交換。目前國內雖亦藉由國家政策推行電子病歷跨院互通，但各醫院推動互通之時間及執行程度等情形均不相同。再者，醫院醫師與資訊主管在電子病歷交換中是重要成員，但兩者分別扮演使用者及服務提供者不同的角色。因此，瞭解國內醫院電子病歷互通使用情況及交換意圖，並進一步探討醫院醫師與資訊主管觀點的影響因素，成為重要的研究議題。方法：本研究為一橫斷性研究，以科技-組織-環境理論為研究架構，發展結構式問卷。以國內已實施電子病歷交換之343 家醫院的電子病歷委員會醫師成員及資訊主管為研究對象。共回收醫師樣本155 份、資訊主管168 份問卷，問卷回收率為45.2%及49%，後續以SPSS 21.0 進行統計分析。結果：雙變項分析結果顯示，醫師及資訊主管僅在「法令規章」題項有顯著差異(t=-2.656，p 值＜0.01)。從迴歸分析發現，認知利益(β=0.208, p＜0.05)、相容性(β=0.231, p＜0.05)及法令規章(β=0.180, p＜0.05)子構面對醫師之電子病歷交換意圖影響顯著。而資訊主管部份，有顯著影響之子構面包含認知利益(β=0.270, p＜0.01)、上級支持(β=0.265, p＜0.001)及法令規章(β=0.215, p＜0.01)。結論：雖然認知利益及法令規章之變項對醫師及資訊主管電子病歷交換意圖有顯著影響，但醫師較關切電子病歷互通時之相容性，而資訊主管特別需要上級支持。因此建議醫院需具備足夠的資訊能力及高階主管的支持來建置電子病歷交換系統，同時政府機關應訂定相關規範及提供誘因，以提高醫院使用電子病歷交換的意願。 Background & Object: In recent years, US and some European countries has implemented the Electronic Medical Record (EMR) Exchange system to enhance the quality of care, reduce medical errors and costs of healthcare. Although Taiwan followed advanced countries’ steps to promote EMR exchange by government policies, hospital had different approaches and completions individually due to their strategies and resources. Hence, the factors affecting hospitals’ EMR exchange intention was an important issue for us to explore. Methods: A cross-sectional study conducted which was used structured questionnaire based on the technology-organization-environment theory. The subjects included the in charge physicians and information officers of electronic medical records exchange from 343 hospitals implemented EMR exchange system. 155 hospital physicians and 168 information officers were responded and the response rate was 45.2% and 49% respectively. SPSS 21.0 statistical software was used for subsequent analysis. Results: According to the bivariate analysis, hospital physicians and information officers had significant difference in the variable of ＂laws and regulations＂ (t=-2.656，p value＜0.01). We also found from multiple regression analysis, the factors which influenced the physicians' intention of EMR exchange were ＂perceived benefits＂(β=0.208, p＜0.05), ＂compatibility＂(β=0.231, p＜0.05), and ＂laws and regulations＂(β=0.180, p＜0.05). in contrast to the information officers, the factors influenced the intention of EMR exchange were ＂perceived benefits＂(β=0.270, p＜0.01), ＂management support＂(β=0.265, p＜0.001), and ＂laws and regulations＂(β=0.215, p＜0.01). Conclusion: For the intention of EMR exchange, both the ＂perceived benefits＂ and ＂laws and regulations＂ were significant factors for hospital physicians and information officers. However, hospital physicians were more concerned about EMR’s ＂compatibility＂ and information officers demanded for ＂management support＂ from hospital executives. We suggest that hospital should get IT capability and executives support to build up EMR exchange system. Also government should establish policies and provide incentives for hospitals to increase the EMR adoption intention and behaviors