The Independent Living Skills Evaluation

With the recent trend of occupational therapy moving into the community, a need has arisen for assessment and treatment procedures to assist chronic mentally disabled individuals to cope successfully with environmental demands. This article describes a semisupervised apartment living program which provides training in the skills necessary for independent community living. The development of an evaluation tool is described which assesses clients' levels of living skills. This evaluation tool, the Independent Living Skills Evaluation (I.L.S.E.), comprehensively evaluates skills necessary for independent community living in the areas of household maintenance, personal and health care, community resources, communication and problem solving, and vocational and personal growth. Information on the administration and use of the I.L.S.E is included. The I.L.S.E. is used as an intial assessment to provide a basis for establishing objectives and treatment methods, to measure and document client progress, to determine client readiness for discharge, and to measure program effectiveness.     

活体肝移植供者心理社会方面问题的研究进展

活体肝移植供者心理社会方面问题的主要研究进展为：多数供者与受者之间有血缘关系,或者有亲密的情感联系;供者有利他主义动机;供者术后有短期健康相关生存质量下降,但术后1年之内可恢复正常。     

Pediatric Living Lung Donor Transplant Candidates: Psychiatric Status of Utilized and Non-Utilized Donors

Living donor lung (lobar) transplantation has greatly decreased in the past decade due to the success of the lung allocation score (LAS) system, instituted in 2005 by the Organ Procurement and Transplantation Network (OPTN). Between 1993 and 2006, 460 living lung donor transplants were performed in the United States with 369 donations occurring at the University of Southern California and Washington University in St. Louis. These two centers accounted for over 80% of all living donor lung transplants between 1994 and 2006. All potential donors received a psychological/psychiatric evaluation as part of the donor selection process, which is standard practice in the United States, Europe, and Asia. Utilized and non-utilized lung donors were compared in terms of their psychiatric history and present status. Results indicated that 31% (N?=?54) of the total sample had a lifetime prevalence of a psychiatric disorder, which is less than that the 46% lifetime rate for the general population (Kessler in Arch Gen Psychiatry 62:593–602, 2005). This study did find that psychiatric history or status was not exclusion factor for transplant surgery in either group. This observation about psychiatric issues in potential living lung donors should be useful to transplant centers who utilize adult live donors of any solid organ type for pediatric recipients and in Japan where live donor lung transplants still represent a significant proportion of lung transplants (Date in J Thorac Dis 8: S631–S636, 2016).

     

活体肝移植与供体安全

等候移植的病人增多和可用器官短缺,是我们目前所面临的主要问题。为降低等候期间的死亡率,活体肝移植(LDLT)是一种不错的选择,但其前提是要确保供体的安全。尽管活体肝移植术对供体而言是安全可行的,然而供体所发生的严重并发症、甚至死亡则是我们所不应忽视和低估的。     

活体肝移植与供体安全

等候移植的病人增多和可用器官短缺,是我们目前所面临的主要问题.为降低等候期间的死亡率,活体肝移植(LDLT)是一种不错的选择,但其前提是要确保供体的安全.尽管活体肝移植术对供体而言是安全可行的,然而供体所发生的严重并发症、甚至死亡则是我们所不应忽视和低估的.     

老龄活体供肾移植的临床应用

为缓解供体器官的严重短缺,老龄活体供肾移植逐渐成为一种可以接受的对策。老龄活体供肾移植有其特殊性并且更易于引发伦理争论。本文简要介绍此问题的研究现状,并就若干社会伦理学问题展开讨论。     

老龄活体供肾移植的临床应用

为缓解供体器官的严重短缺,老龄活体供肾移植逐渐成为一种可以接受的对策.老龄活体供肾移植有其特殊性并且更易于引发伦理争论.本文简要介绍此问题的研究现状,并就若干社会伦理学问题展开讨论.     

Uterus Transplantation: The Ethics of Using Deceased Versus Living Donors

Research teams have made considerable progress in treating absolute uterine factor infertility through uterus transplantation, though studies have differed on the choice of either deceased or living donors. While researchers continue to analyze the medical feasibility of both approaches, little attention has been paid to the ethics of using deceased versus living donors as well as the protections that must be in place for each. Both types of uterus donation also pose unique regulatory challenges, including how to allocate donated organs; whether the donor / donor's family has any rights to the uterus and resulting child; how to manage contact between the donor / donor's family, recipient, and resulting child; and how to track outcomes moving forward.     

活体肝移植供体伦理学思考

器官移植,特别是活体供体器官移植,面临着许多伦理、道德和社会方面的难题.一方面要鼓励人们为挽救他人生命贡献自己的器官,另一方面社会又要求医学技术保证"健康人"的绝对安全.作为活体供体,既冒着生命危险和承受健康损害,又特别关注自身器官是否能有效挽救指定患者的生命.根据我们开展临床活体肝移植的体会,从供体的知情同意权、自愿原则、风险和利益对等、优先考虑供体利益、供体的健康和经济风险、保护精神病人和青少年利益以及捐献者的骄傲感和光荣感等方面探讨伦理学的基本原则.     

谈中医认知方式及中医理论体系的构建

提出开箱式思维和闭箱式思维的概念,并以此为基础对中医认知方式和中医理论体系的构建进行初步的探讨.整体上,中医认知方式是一种宏观性闭箱式思维,中医学是一种闭箱式理论体系.     

活体器官移植中的矛与盾

随着临床医学的发展和免疫隔离技术的开发利用,器官移植目前已经被公认为是治疗终末期疾病的一个临床选择,本文综述器官移植中供体短缺与活体器官移植的优势与风险、活体器官移植后抗排斥与防治感染的问题以及哲学思想在器官移植诊疗过程中的指导作用.     

活体器官移植中的矛与盾

随着临床医学的发展和免疫隔离技术的开发利用,器官移植目前已经被公认为是治疗终末期疾病的一个临床选择,本文综述器官移植中供体短缺与活体器官移植的优势与风险、活体器官移植后抗排斥与防治感染的问题以及哲学思想在器官移植诊疗过程中的指导作用。     

亲属肾移植的伦理学探讨

活体亲属肾移植是当前解决器官匮乏最重要的途径,近年来我国亲属肾移植例数也不断增多。但是亲属肾移植因其具有一定的特殊性,相比尸体供肾移植更为敏感,也更易于引发伦理问题。简要介绍国内外亲属肾移植的研究进展,重点对亲属肾移植的生命伦理学问题加以探讨。     

The Care and Development of Children Living in Contexts of Poverty

Human development is determined by both genetic and environmental factors, especially during early childhood. Recently, research has indicated that the circumstances surrounding poverty can significantly influence children’s development. In this study, we aimed to measure the developmental level of children living in low-income, rural areas in northern Colombia. A total of 629 children (aged 0–5 years) were assessed using the Battelle Developmental Inventory. Results indicated that 17?% of the participants had a general developmental delay for their age group. This was especially true for scores on cognitive development (35.5?%) and communication (21.5?%). Moreover, the number of children with developmental delay increased at 6 months of age and continued to increase after 1 year in the communication and cognitive domains. The findings of this study suggest that impoverished social contexts—such as the one studied herein—offer opportunities that favor the development of the social domain, but restrict the development of the cognitive domain. Therefore, to promote cognitive development, individuals within children’s environment need to actively and intentionally stimulate them. Thus, there is a need for interventions that will improve environmental conditions; especially those that will help parents improve their caregiving practices and train educational staff to recognize and respond to the stimulation needs of children, especially those developmental domains that are affected by the environment.     

亲属肾移植的伦理学探讨

活体亲属肾移植是当前解决器官匮乏最重要的途径,近年来我国亲属肾移植例数也不断增多.但是亲属肾移植因其具有一定的特殊性,相比尸体供肾移植更为敏感,也更易于引发伦理问题.简要介绍国内外亲属肾移植的研究进展,重点对亲属肾移植的生命伦理学问题加以探讨.     

伦理学视域下活体肾移植供者身份认同

将活体肾移植供者的身份问题置于伦理学视域下,梳理活体肾移植整个医疗过程中供者身份的产生背景,分析供者身份出现与转变过程及其产生的伦理问题,进一步探讨其身份认同困境产生的实质是供者自身对其主体性的忽视以及过分依赖“他者”肯定。因此,解决这一问题的方法在于从供者自身和“他者”两方面帮助其建构自身身份完整性,协助其达成对自身的身份认同。供者建构其身份的完整性在于其自身实体性到主体性的转变,“他者”对供者适度关怀与尊重是对其主体性的成就。

     

Physician Identification and Management of Psychosocial Problems in Primary Care

Often the burden of identifying children with behavioral or developmental problems is left up to the primary care physician (PCP). However, previous literature shows that PCPs consistently underidentify children with developmental/behavioral problems in pediatric primary care. For the current study, questionnaires containing three vignettes followed by questions addressing common psychosocial problems, general questions about their practice and training, and the Physician Belief Scale were distributed to physicians. Results indicated that physicians were better at identifying severe problems, had more difficulty identifying psychosocial problems with mild symptomatology, and tended to refer to a medical specialist or mental health professional more often for severe problems, depression or a developmental problem. Physicians tended to view treating psychosocial problems favorably.     

Perspectives of Adults Living With Autism Spectrum Disorder: Psychosocial and Occupational Implications

The incidence of Autism Spectrum Disorder (ASD) has increased over the past decade suggesting a need for further research. This article describes a two phase phenomenological study which explored the lived experience of ASD and its psychosocial effects on relationships, socialization, and occupational participation. Phenomenological interviews were given to three women and three men with high functioning ASD. Phase two of the research included two additional individual interviews and four focus groups. Results indicated themes regarding participants' desires to engage in social occupations, and barriers caused by the nature of the ASD which may successfully be addressed by occupational therapy.