当前社会经济对过度医疗的影响

杜治政教授关于过度医疗的定义在国内理论界具有广泛的说服力,他认为过度医疗是由于多种原因引起的超过疾病实际需要的诊断和治疗的医疗行为或医疗过程.其判定标准:第一,诊疗手段是否超出疾病诊疗的根本需要;第二,是否符合疾病诊疗的规律和特点;第三,是否超出当时个人、社会经济承受能力和社会发展水平;第四,是否有利于患者的生理、心理的康复,而非损害[1].     

CAR-T治疗中的医疗干预与人体自然力的平衡

进入21世纪后,医疗干预手段的快速发展不可避免地造成了过度医疗的现象,导致了过分依靠外部干预的诊疗趋势,忽视了人体内环境以及机体自然功能对疾病治愈起到的作用。本研究针对医疗干预与人体自然力平衡的问题,阐述了人体自然力与医疗干预中过度干预的概念;并从CAR-T治疗入手,介绍了CAR-T治疗相关的原理、概念、过程、效果及不良反应,分析了CAR-T治疗在理念以及过程中体现的医疗干预与人体自然力的结合。并得出结论:将医疗干预与人体自然力相结合的治疗手段必会成为未来医学发展的趋势,为整个医学科学的发展带来前所未有的机遇和动力。     

铁过度负荷与疾病

铁是机体微量元素中含量最多的一种,是血红蛋白、肌红蛋白、细胞色素系统、呼吸链的主要复合物、过氧物酶和过氧化氢酶等的重要组成部分,广泛参与机体生理功能和生化反应,缺铁可导致贫血等疾病。体内铁过多,称为铁过度负荷。随着医疗条件改善、生活水平提高,源于生理性因素、病理性因素和外源性铁剂应用(治疗性应用、预防性应用),铁过度负荷相关疾病日益增多。铁过度负荷可对内分泌代谢、心血管、神经系统、肾脏、肝脏等系统器官产生损害,导致多种疾病或使疾病加重。目前铁过度负荷相关疾病的治疗措施主要有放血疗法和药物治疗。放血疗法,只可作于短期治疗。去铁胺作为目前较为有效的去铁剂,由于价格昂贵,不能广泛应用于临床。铁过度负荷对人体的影响和相关疾病尚未外起医学界的重视。深入研究以铁过度负荷为主要和次要病因相关疾病,探索正确补铁措施,是预防铁过度负荷相关疾病、增进人体健康的重要措施,也是临床面临床的新课题。     

铁过度负荷与疾病

铁是机体微量元素中含量最多的一种,是血红蛋白、肌红蛋白、细胞色素系统、呼吸链的主要复合物、过氧物酶和过氧化氢酶等的重要组成部分,广泛参与机体生理功能和生化反应,缺铁可导致贫血等疾病.体内铁过多,称为铁过度负荷.随着医疗条件改善、生活水平提高,源于生理性因素、病理性因素和外源性铁剂应用(治疗性应用、预防性应用),铁过度负荷相关疾病日益增多.铁过度负荷可对内分泌代谢、心血管、神经系统、肾脏、肝脏等系统器官产生损害,导致多种疾病或使疾病加重.目前铁过度负荷相关疾病的治疗措施主要有放血疗法和药物治疗.放血疗法,只可作于短期治疗.去铁胺作为目前较为有效的去铁剂,由于价格昂贵,不能广泛应用于临床.铁过度负荷对人体的影响和相关疾病尚未外起医学界的重视.深入研究以铁过度负荷为主要和次要病因相关疾病,探索正确补铁措施,是预防铁过度负荷相关疾病、增进人体健康的重要措施,也是临床面临床的新课题.     

人体生命活动若干规律与医疗干预

人体生命活动规律中的稳态充分体现了"度"的理念。某些过度医疗现象,背离了生命活动规律,对患者造成身心伤害,我们在认识和处理问题时要掌握适度原则。医疗干预是生命健康保障的重要手段,但我们应该敬畏自然,尊重生命自身发展的客观规律,充分支持人体的自然力,避免不必要的医疗干预。     

过度医疗之我见

过度医疗是指在医疗过程中所采用的诊断、治疗措施超越疾病本身的需要 ,造成医疗资源和费用的浪费 ,甚至有害于机体的医疗行为。由于从业人员的水平、医疗条件和病人经济状况不同 ,可采取措施的伸缩性较大 ,对具体病人的“过度”、“适度”的界定就比较困难。特别是对某些主观愿望好的适度“过度” ,则不应过多指责 ,对某些病人甚至还可能获得意外的诊断线索。也绝不应将检查结果阴性的诊断措施均视为过度 ,只要这项检查是为证实或除外某种疾病所需要的 ,就应认为是合理的。过度医疗产生的因素错综复杂 ,有属于病人或家属的观念误区 ,譬如要…     

创伤骨科的不当医疗

不当医疗问题已经引起社会各界的广泛关注,它包括过度医疗行为、错误医疗行为和缺陷性医疗行为。创伤骨科疾病不当医疗既与医学发展水平和医学本身规律特点有关,又与现行医疗体制、医院经营机制有关,是患者及家属、医务人员和社会等多因素参与,受现行医学科学发展制约的治疗行为。应避免不当医疗,追求适度医疗,尽量达到最优化医疗。     

创伤骨科的不当医疗

不当医疗问题已经引起社会各界的广泛关注,它包括过度医疗行为、错误医疗行为和缺陷性医疗行为.创伤骨科疾病不当医疗既与医学发展水平和医学本身规律特点有关,又与现行医疗体制、医院经营机制有关,是患者及家属、医务人员和社会等多因素参与,受现行医学科学发展制约的治疗行为.应避免不当医疗,追求适度医疗,尽量达到最优化医疗.     

口腔颌面外科医疗实践中的过度医疗

通过对口腔颌面外科几种常见疾病的具体诊疗行为进行分析,从医疗技术本身探讨过度医疗的原因,认为评价一种医疗行为是否过度需要客观、全面、动态的标准,科学的认识和掌握疾病的客观规律并获得最优疗效的诊疗方案是避免过度医疗发生的可靠保证之一.     

关于外科过度医疗的初步研究

过度医疗问题引起社会各界的广泛关注,随着外科水平的提高,手术技巧、手术观念都发生了很大的变化,越来越多的疾病能够通过外科手术得到根治,同时外科治疗过程中过度医疗也成为一个重要的社会问题.分析外科疾病过度医疗的特点,探讨外科过度医疗的原因和后果,并提出针对外科过度医疗应采取的措施,有重要意义.     

Fear of Death in Hypochondriasis: Bodily Threat and Its Treatment Implications

This article aims to explore the perception of body in hypochondriasis and implications that it has for fear of death and for treatment of hypochondriasis. It is suggested that a sense of threat posed by the body in hypochondriasis is intimately related to the fear of body, expectations of bodily failure, fear of disease and pathological fear of death. Clinical aspects and potential antecedents of these phenomena are discussed in the article. It is emphasized that fear of the body and fear of death should be adequately addressed in the course of treatment, regardless of the nature of the primary treatment approach. Relevant treatment strategies are outlined, with treatment goals including an adoption of the non-threatening perception of one’s body, modification of attitudes and beliefs related to health, illness and death which heighten fear of death, and substantial alleviation or elimination of the pathological fear of death.     

Darwin, Social Theory, and the Sociology of Scientific Knowledge

This essay considers ways in which Darwin's account of natural processes was influenced by economic, ethical, and natural-theological theories in his own day. It argues that the Anabaptist concept of "the gospel of all creatures" calls into question alliances between evolutionary theory and social policy that are based on the dominance of conflictual images such as "the survival of the fittest" and questions the negative images of both nature and God that Darwinism has been taken to sponsor. The essay also considers developments in biology that have called into question dualist accounts of human nature as body and soul, thus reminding us that we are fully a part of the natural world and thus contributing, in turn, to a better theological grasp of God's relation to nature.     

Problem structure and the use of base-rate information from experience

This article is concerned with the use of base-rate information that is derived from experience in classifying examples of a category. The basic task involved simulated medical decision making in which participants learned to diagnose hypothetical diseases on the basis of symptom information. Alternative diseases differed in their relative frequency or base rates of occurrence. In five experiments initial learning was followed by a series of transfer tests designed to index the use of base-rate information. On these tests, patterns of symptoms were presented that suggested more than one disease and were therefore ambiguous. The alternative or candidate diseases on such tests could differ in their relative frequency of occurrence during learning. For example, a symptom might be presented that had appeared with both a relatively common and a relatively rare disease. If participants are using base-rate information appropriately (according to Bayes' theorem), then they should be more likely to predict that the common disease is present than that the rare disease is present on such ambiguous tests. Current classification models differ in their predictions concerning the use of base-rate information. For example, most prototype models imply an insensitivity to base-rate information, whereas many exemplar-based classification models predict appropriate use of base-rate information. The results reveal a consistent but complex pattern. Depending on the category structure and the nature of the ambiguous tests, participants use base-rate information appropriately, ignore base-rate information, or use base-rate information inappropriately (predict that the rare disease is more likely to be present). To our knowledge, no current categorization model predicts this pattern of results. To account for these results, a new model is described incorporating the ideas of property or symptom competition and context-sensitive retrieval.     

Pentecostal Dynamics of African Initiated Churches

This essay is a historical consideration of the body of churches known as African Initiated Churches (AICs). The key research questions I am investigating are whether this church can be classified as Pentecostal and how it employs transnational networking in its mission strategy. I have approached this question by exploring the Pentecostal dynamics and transnational networking of the Cherubim and Seraphim Church as an example of an AIC. To this end, I analyze the Pentecostal and transnational nature of an international ecumenical conference organized by the church in London in 2017. This essay is written from the perspective of someone who was born and raised within the church movement, but has also studied the movement as part of African Christianity. The originality of this essay is in its analysis of the transnational nature of the international ecumenical conference.     

A HANDBOOK FOR SCRIPTURAL REASONING

The essay includes twelve “rules” to define the nature and goals of the practice of Scriptural Reasoning (SR). These rules are intended for heuristic and pedagogic purposes to introduce Scriptural Reasoning to those who have little experience in and knowledge of the practice of SR. The rules emerged from my observations of SR practice and, taken together, the rules are meant to be a guide or “handbook” for future SR practice.     

Scientific Research and the Public Trust

This essay analyzes the concept of public trust in science and offers some guidance for ethicists, scientists, and policymakers who use this idea defend ethical rules or policies pertaining to the conduct of research. While the notion that public trusts science makes sense in the abstract, it may not be sufficiently focused to support the various rules and policies that authors have tried to derive from it, because the public is not a uniform body with a common set of interests. Well-focused arguments that use public trust to support rules or policies for the conduct of research should specify (a) which public is being referred to (e.g. the general public or a specific public, such as a particular community or group); (b) what this public expects from scientists; (c) how the rule or policy will ensure that these expectations are met; and (d) why is it important to meet these expectations.     

ATYPICAL DISCOURSES

This essay outlines novel ways of communicating with patients by altering semantics, syntax, word use, or sounds. Language is viewed as a tool for coping with problems rather than a medium with which to mirror external reality or internal human nature. This view of language emerges from a pragmatic critique of truth. The broader goal of this essay is to weave together the philosophy of pragmatism, especially as it has been articulated by Richard Rorty, with the theory and practice of psychoanalysis. Clinical case examples are discussed.     

The problem of mind in Confucianism

This essay explores the Confucian theory of mind. Doing so, it first examines the early Confucian concept of the human mind as a substance that has both moral and cognitive functions and a universal nature. It then explores the neo-Confucian concept of the human mind, the original mind, and the relationships between the human mind and human nature, as well as between the human mind and the human body. Finally, it explores the Confucian concept of cultivation of the mind.     

Quantifying developing country research capacity in the areas of malaria,schistosomiasis, and leprosy

Implicit in addressing the issue of how to build and strengthen health related endogenous research capacity is that both donor organizations and developing country policymakers distinguish betweenhealth priorities andhealth research priorities. This distinction has important policy consequences in that the majority of developing countries are not in a position, either in financial or human resource terms, to simultaneously generate and implement broad-based priorities in both areas. In this context, it is important that health research priority setting be developed in tandem with existing research capacity. This underlines the importance of assessing the amount and nature of available expertise, and positioning research output, both in the national health needs, and the international science research contexts. The present article, which more properly constitutes a feasibility study, uses scientometric methods to assess the amount and nature of scientific output in three important tropical diseases: malaria, schistosomiasis and leprosy. The major goals of this study have been to i) compare the amount and nature of research produced in developed and developing countries for the three diseases; ii) determine in how far scientometric methods can be used to measure research capacity, and whether this measurement can facilitate the determination of health (research) priorities.