对麻醉药品的严格管理与癌症患者止痛的合理需求

药物止痛是治疗癌症疼痛的主要方法,而阿片类止痛药是治疗中、重度癌症疼痛的关键性用药.给癌症疼痛患者充分应用阿片类药物,并不意味着可以放松对此类药物的控制和管理,对麻醉药品进行严格管理可确保癌症疼痛患者合法、安全、合理用药.正确认识及合理使用麻醉药品是实现WHO提出"让癌症患者不痛"目标的重要保证.     

癌痛治疗中的辅助用药

辅助镇痛药物最初的用途都不是镇痛,但对癌痛患者却能起到缓解疼痛、降低麻醉药品用量、减轻大剂量麻醉药品带来的药物不良反应的作用。尤其适用于那些对阿片类药物不敏感或不仅对阿片类药物敏感的癌病病人。遗憾的是临床上通常在阿片类药物镇痛效果不理想的时候才考虑添加辅助用药,癌痛治疗还存在用药过于单一的弊端。因此,为了加强止痛治疗效果、优化治疗策略,必须充分重视癌痛治疗中的辅助用药。     

癌痛治疗中的辅助用药

辅助镇痛药物最初的用途都不是镇痛,但对癌痛患者却能起到缓解疼痛、降低麻醉药品用量、减轻大剂量麻醉药品带来的药物不良反应的作用。尤其适用于那些对阿片类药物不敏感或不仅对阿片类药物敏感的癌病病人。遗憾的是临床上通常在阿片类药物镇痛效果不理想的时候才考虑添加辅助用药,癌痛治疗还存在用药过于单一的弊端。因此,为了加强止痛治疗效果、优化治疗策略,必须充分重视癌痛治疗中的辅助用药。     

癌症疼痛治疗中麻醉药品的应用现状及对策

麻醉药品在癌症疼痛治疗中发挥着日益重要的作用,包括我国在内的大多数发展中国家在应用麻醉药品控制癌症疼痛方面存在很多不足,与西方发达国家相比有一定差距。为早日实现“让中国癌症患者不痛”的目标,广大医务工作者应积极更新观念,掌握癌症疼痛的治疗原则与方法;积极倡导改善癌痛治疗不足的现状。同时加大宣传力度,取得患者家属和相关部门的理解、支持,努力保障癌痛病人获得止痛治疗的权利。     

癌症疼痛治疗中麻醉药品的应用现状及对策

麻醉药品在癌症疼痛治疗中发挥着日益重要的作用,包括我国在内的大多数发展中国家在应用麻醉药品控制癌症疼痛方面存在很多不足,与西方发达国家相比有一定差距.为早日实现"让中国癌症患者不痛"的目标,广大医务工作者应积极更新观念,掌握癌症疼痛的治疗原则与方法;积极倡导改善癌痛治疗不足的现状.同时加大宣传力度,取得患者家属和相关部门的理解、支持,努力保障癌痛病人获得止痛治疗的权利.     

疼痛治疗方法在晚期癌痛病人中的应用

癌症是当今严重威胁人类健康和生命的疾病之一。解除癌症疼痛对改善晚期癌症患者的生存质量、延长生存期都具有十分重要的意义。癌痛的诊断和合理的疼痛评估是治疗癌痛的基础。癌症疼痛的治疗方法虽有多种,但其目的就是使用最佳方法解除患者痛苦,消除疼痛,从而提高生存质量。因此本文从科学的角度对晚期癌痛的治疗方法进行评价和阐述。     

药学监护中的人文关怀对推动合理用药的影响与思考

药物是治疗疾病的物质基础,要真正做到药到病除,合理用药才是关键.对患者进行药学监护是现代医院药学发展的新趋势,在药学监护的基础上进行必要的人文关怀目的就是为了更好的推动合理用药.药学监护中的人文关怀可以明显提高患者的用药依从性,从而减少药物不良反应(ADR)推动合理用药,对提高医院的整体医疗质量具有重大意义.     

癌症疼痛规范化治疗对肿瘤化疗效果的影响

为了探讨癌症疼痛规范化治疗对化疗疗效的影响,本文回顾分析了2012年1月~2013年12月大连医科大学附属第一医院收治的具有明显癌症疼痛并接受含铂两药联合方案化疗的肺癌患者312例,分为癌症疼痛非规范化治疗组和癌症疼痛规范化治疗组,结果显示:两组治疗后的生活质量均有所提高,规范化组更为显著,两组mOS有显著差异,在亚组中,有骨转移的患者的效果更好。提示癌症疼痛规范化治疗可提高化疗疗效,改善患者生活质量,延长生存期,与是否有骨转移无关。     

癌痛规范化治疗的制约因素分析

癌痛严重影响中晚期癌症患者生活质量,通过使用第三阶梯强阿片类止痛药物,绝大部分患者疼痛能得到很好的控制。微观上,癌痛治疗的疗效与患者及医务人员的认识程度密切相关,也与医院麻醉科等其他科室的参与程度有关。宏观上,社会人文、经济、政策管理等方面的不足都制约着癌痛规范化治疗的有效实施。癌痛的规范化治疗是一项管理措施,需要进行疼痛评估、家庭支持及宗教组织的参与帮助等。我们国家在文化、经济、教育等各个方面取得长足进步时,癌痛治疗会更加规范、合理、人性化。     

老年癌症患者疼痛管理

面对日益加剧的人口老龄化趋势,国际肿瘤界逐渐意识到老年肿瘤治疗问题的严重性。老年肿瘤患者在被确诊时多已处于晚期,基础疾病多,各脏器功能下降,姑息治疗对老年肿瘤患者显得非常重要,尤其是疼痛治疗。目前,因为对老年人疼痛的认识不足、评估不够、过分担心药物副作用,使得老年癌痛控制现状不容乐观。本文综述了老年癌痛的特点、评估方法及治疗原则,强调对于老年癌症患者治疗的目标不是重返工作或者延长生命,而是尽最大可能地提高生活质量,让老年癌症患者远离癌痛,真正享受到无痛人生。     

Together – apart: in touch in a time of separation

This paper explores the experience of working as a Jungian analyst through the various phases of the global COVID-19 pandemic, examining the importance of the physical containing space alongside the analyst’s internal mind and how technology can both help and hinder understanding. A number of clinical vignettes illustrate the challenge of communicating over a distance, paying particular attention to the way countertransference phenomena can become re-attuned. Reference is made to mythology and symbols of hope, and consideration given to the meaning and purpose of the pandemic.     

Language,politics and dreams: the challenges of building resilience in refugees

This paper describes a case study of a 60-year-old Peruvian refugee in some detail, focusing on the importance of building emotional resilience in a patient in Spanish in order to create a space for learning the English language – the patient did not speak English after 20 years of living in Britain. The work was carried out with an interpreter and some of the literature on working with interpreters is referred to. The paper also briefly outlines the refugee journey in broad terms, which is a journey from the culturally known to the culturally unknown. The question of how well the literature on resilience, which sits firmly within a Western developmental perspective, can be applied to refugees, most of whom come from group and family-based cultures dominated by ideas of honour and shame, is discussed. The paper also touches on the importance of the receiving country enabling or not, as the case may be, a transitional space for refugees who have lost their home and are seeking to find a safe haven in a strange culture.     

The Possibility of Meaning in Human Evolution

Science undermines the certitude of non-naturalistic answers to the question of whether human life has meaning. I explore whether evolution can provide a naturalistic basis for existential meaning. Using the work of philosopher Daniel Dennett and scientist Ursula Goodenough, I argue that evolution is the locus of the possibility of meaning because it has produced intentionality, the matrix of consciousness. I conclude that the question of the meaning of human life is an existentialist one: existential meaning is a product of the individual and collective tasks human beings undertake.     

When is it time to stop? When good enough becomes bad enough

This article draws on Winnicott’s concept of the good enough mother to discuss how to know whether a therapeutic situation is good enough to continue or bad enough to end. This dilemma is explored in terms of clinical syndromes, such as anorexia and pathological gambling, but focuses mainly on analyst-initiated endings, which are termed the ‘Casablanca dilemma’, based on an amplification of the ending of the film Casablanca. The author goes on to discuss such one-sided endings, drawing on interviews with 40 analysts and therapists about their clinical experience. A typology of bad enough endings is presented. The psychological differences between a good enough analysis as opposed to a bad enough one are explored through the ideas of Winnicott and Neumann.     

The transcendent function in Spitteler’s Prometheus and Epimetheus

In August 2020, John Beebe and Steve Myers met via Zoom to discuss their differing interpretations of psychological typology and the different sources within Jung’s writings that influenced their books: Integrity in Depth: Energies and Patterns in Psychological Type (Beebe), and Myers-Briggs Typology vs Jungian Individuation (Myers). The discussion centred on Spitteler’s epic poem Prometheus und Epimetheus, which forms the basis of chapter V of Psychological Types. This is both the largest chapter and one of two chapters that Jung highlighted in the Argentine foreword as containing the essence of the book. Jung’s book is primarily about the transformation of personality rather than the categorization of people. Although it contains a critical psychology that deconstructs the nature of consciousness, that is only one half of the book and a stepping-stone to the other half, which is the reconciliation of opposites with particular emphasis on the relation of consciousness and the unconscious. Jung assumed that readers were already familiar with Prometheus und Epimetheus, an understanding of which sheds light on the nature of the transformation that Jung described – the development of a new attitude towards attitude itself.     

Kann Es Ein Argument Für Den Skeptizismus Geben? Das Epistemische Problem Der Irrtumsmöglichkeit

Summary  Is there any argument for scepticism? The epistemic problem of the possibility of error. Arguments for scepticism rest on the assumption that knowledge claims are fallible. For this reason the concept of knowledge appears to be questionable. Since it is necessary to distinguish doubts from possible doubts, the arguments for scepticism appear to be unconvincing. If we take it into account that we know something that is immune to doubt, we should draw the conclusion that, contrary to scepticism, knowledge claims have to be compatible with being fallible. Thus any knowledge claim is capable of being doubted.     

Chapter 6: Biblical Foundations for a Practical Theology of Aging

SUMMARY

This article reviews Biblical sources pertaining to the elderly, particularly the frail elderly. Founded on these sources, implications for elderly with Alzheimer's Disease and other forms of dementia are addressed through a personal perspective informed by writings of Christian mystics.     

Mythological Underpinnings of Feminine Development

In the manner of Oedipus Rex, the myth of Myrrha—a story about a daughter's initiation of sex with her father—promises to divulge insights about feminine development. Given parallels between these two myths, the author asks why Jung identified Electra rather than Myrrha as the feminine counterpart to Oedipus, and revisits Freud's and Jung's differing interpretations of the incest theme in personality development. To break open the metaphor of Myrrha's incest, the author analyzes a similar account of incest in the Old Testament story of Lot and his wife and finds that they share a theme of female bitterness related to wounding of the mother and its arresting effect on the daughter's maturation. The article then considers the Demeter-Persephone myth, a tale not of incest but rape in Persephone's initiation into womanhood. In contrast to Myrrha, Persephone's development unfolds with strong maternal support tempered by the opposing claims on her by the masculine. The article draws these stories together to illuminate the archetypal forces that drive feminine development as well as the human affairs that resist and complicate them. The article concludes with a case study of a client whose developmental “stuckness” follows the contours of the Myrrha myth.     

Contribution de la neuropsychologie développementale à l'étude des sujets à haut potentiel : une revue de questions

Developmental neuropsychology studies cognitive development in relation with brain maturation and cerebral plasticity. Some authors have reported physiological correlates of intellectual precocity with the purpose of demonstrating neural basis of intelligence. A part of the literature also reports various cognitive profile and specific talents in information processing in the clinical population of gifted children. Thus, the study of exceptional performances may contribute to our knowledge of functional brain organization taking into consideration individual differences.