我国医院感染管理存在问题及对策

医院感染是影响医疗质量的临床难题.控制医院感染,仅仅通过专职管理人员是不够的,应充分发挥国家政策导向作用,通过宏观调控与微观干预相结合的方法,促使医院真正重视医院感染,变"要我控制医院感染"为"我要控制医院感染",使医务人员变"被动接受感染控制"为"主动参与感染控制",促使医院感染控制工作不断深化.     

综合性ICU医院感染危险因素分析

了解ICU患者的医院感染率,查找导致医院感染的危险因素,提出有效预防和控制感染方法.调查2010年2月～7月收住综合ICU的患者,填写“ICU患者日志”及自制院感危险因素表,对各危险因素进行多因素分析.结果ICU医院感染发生率为22.99％,例次率为28.74％;年龄、慢性病、动静脉插管、血液腹膜透析为ICU医院感染的危险因素.ICU患者是医院感染易感人群,感染率高于医院其他科室;树立标准预防意识,加强手卫生依从性,是降低医院感染的有效措施.     

丈夫的异性情缘

我和丈夫经常讨论情人问题。我觉得,情人应该是一个感情较深的异性朋友,但绝对只能限于“情”,不可超越“性”的界线,丈夫的思想比我要保守一点,但我俩对情人现象共同的观点是,理解大于指责。 俗话说:“女人好吃,男人好色。”正由于我对情人的态度表现出如此宽容,而且在老公面前暴露无遗,就促使了本为正人君子的老公逐     

变与不变的辩证性

20 0 0年 4期《医学与哲学》发表了上海医科大学华山医院蔡定芳教授《变亦变 ,不变亦变》和上海中医药大学何裕民教授《知识社会中的中医学》的两篇具有学术争鸣性的文章 ,读后颇有启发。两篇文章都提出中医学术要“变” ,我完全赞同 ,但涉及“变”的具体内容和观点 ,在某些地方略有不同。现在我按照《医学与哲学》编者提出的“欢迎大家参加讨论”的要求前来参加讨论。1　变与不变的辩证性唯物辩证法认为 ,我们的宇宙是处于不断的变化运动之中 ,世界上所有一切事物 ,也都无时无刻处于不断变化运动之中 ,所以 ,“变”是绝对的。恩格斯也曾说 …     

爱在有“第三者”的日子

“老公,你晚上早点回来,我有好消息要告诉你!”当我忐忑不安地接过医生的化验单时,我高兴得差点晕过去,因为这已经是我结婚4年来第10次到医院做检查了。离开医院,我急忙给老公打电话。     

院牧侍奉体会点滴

记得20年前,我在明州Methodist医院做院牧值班时遇到了一件事。那是在半夜一点多钟,急诊电话铃响了。我拿起电话,听到对方的声音很慢、很弱、很轻,好像是哭泣的样子哀求道：“牧师,你能帮助我吗？”因为医院牧师有时也要处理“危机干预”（crisisintervention）,我就耐心地听她讲。     

医院感染与传染病的流行病学异同辨析

医院感染学作为一门新兴独立学科已经形成,对医院感染的定义、内涵、外延都作了详尽界定,但在构成因素的概念方面还与传染病之间存在着混用问题。本文对此进行了对比辨析,提出了使用“医院感染源、医院感染途径、医院人群”三个概念来区别于传染病的“传染源、传播途径、易感人群”的建议。     

她为什么排斥丈夫

妻是医院的心理医生,日前她说了一个特别的病例,要考我的判断能力。但她揭开“谜底”时,我却很吃一惊。自然,我的推断与真实情况相去甚远——     

论医院实行单病种限价的伦理学价值

从单病种限价在医院内部管理机制等方面的作用出发,探讨了实施单病种限价的伦理价值基础和伦理学意义。认为单病种限价政策能促使医院形成“以人为本”的管理理念,切实维护患者利益,培养医务人员的医德素质,促使医院重视德源资产和品牌形象的建设,强化医务人员精益求精的科学精神,取信于民并帮助医院树立诚信的道德形象,是医院可持续发展的可取途径。     

谦之生前二三事

光阴似箭,往事苍茫,有些事记忆犹新。１９７０年１０月朱谦之忽患半身不遂脑溢血症,留医同仁医院。１９７１年５月３０日病危,只有４克血。医生说:“该输血,但无血可输,就打针吧,回家舒服些,可来门诊。”要朱谦之出院。我想国家设医为救死扶伤,怎么要病危的人出院？赖着不肯走。恰巧有一位女医生问我:“老先生怎样？”我说:“不好,该输血无血可输。”那位医生说:“有,有,有,血库有血。”不过医院里有关同志说:输血要机关证明病人无政治问题。我就打电话告诉陈光辉同志。她赶来医院,要求抢救。她说:朱谦之先生在“文革”中无问题,还有许多事…     

Sadomasochism as Make‐Believe

In “Rethinking Sadomasochism,” Patrick Hopkins challenges the “radical” feminist claim that sadomasochism is incompatible with feminism. He does so by appeal to the notion of “simulation.” I argue that Hopkins's conclusions are generally right, but they cannot be inferred from his “simulation” argument. I replace Hopkins's “simulation” with Kendall Walton's more sophisticated theory of “make‐believe.” I use this theory to better argue that privately conducted sadomasochism is compatible with feminism.     

A Narrative Inquiry into a Female Athlete’s Experiences with Protracted Concussion Symptoms

This article explores a female university volleyball student-athlete’s experience with protracted concussion symptoms. Through the methodology of narrative inquiry, four salient themes became apparent related to Daphnée’s experiences: (a) “I felt so alone,” (b) “I had to make one of the hardest decisions of my life,” (c) “I feel like I’m in prison,” and (d) “There’s no light at the end of the tunnel.” Overall, this study offers a rare look into the impact of concussion on an individual’s athletic and academic identities, career progression, and in turn, her imagined stories of who she was and who she was becoming.     

Rationalization,Evidence, and Pretense

In this paper I distinguish the category of “rationalization” from various forms of epistemic irrationality. I maintain that only if we model rationalizers as pretenders can we make sense of the rationalizer's distinctive relationship to the evidence in her possession. I contrast the cognitive attitude of the rationalizer with that of believers whose relationship to the evidence I describe as “waffling” or “intransigent”. In the final section of the paper, I compare the rationalizer to the Frankfurtian bullshitter.     

Toward a more inclusive understanding of the “brain drain”

I argue in this paper that the proposals developed by Gillian Brock in Debating the Brain Drain: May Governments Restrict Emigration? should not only be applied to so-called “highly skilled” emigrants. I contend that Brock’s proposals, in order to be implemented justly, must be re-framed such that they are inclusive of so-called “low-skilled” or “unskilled” migrants. I argue for a more inclusive understanding of the “brain drain” in immigration policy – one that can make use of Brock’s important proposals in an expanded fashion – and I provide an account of what this more inclusive understanding should look like.     

Conceptual Analysis and Epistemic Progress

This essay concerns the question of how we make genuine epistemic progress through conceptual analysis. Our way into this issue will be through consideration of the paradox of analysis. The paradox challenges us to explain how a given statement can make a substantive contribution to our knowledge, even while it purports merely to make explicit what one’s grasp of the concept under scrutiny consists in. The paradox is often treated primarily as a semantic puzzle. However, in “Sect. 1” I argue that the paradox raises a more fundamental epistemic problem, and in “Sects.1 and 2” I argue that semantic proposals—even ones designed to capture the Fregean link between meaning and epistemic significance—fail to resolve that problem. Seeing our way towards a real solution to the paradox requires more than semantics; we also need to understand how the process of analysis can yield justification for accepting a candidate conceptual analysis. I present an account of this process, and explain how it resolves the paradox, in “Sect. 3”. I conclude in “Sect. 4” by considering the implications for the present account concerning the goal of conceptual analysis, and by arguing that the apparent scarcity of short and finite illuminating analyses in philosophically interesting cases provides no grounds for pessimism concerning the possibility of philosophical progress through conceptual analysis.     

Towards a literary account of mental health from James' Principles of Psychology

The field of mental health tends to treat its literary metaphors as literal realities with the concomitant loss of vague “feelings of tendency” in “unusual experiences”. I develop this argument through the prism of William James’ (1890) “The Principles of Psychology”. In the first part of the paper, I reflect upon the relevance of James' “The Psychologist's Fallacy” to a literary account of mental health. In the second part of the paper, I develop the argument that “connotations” and “feelings of tendency” are central to resolving some of the more difficult challenges of this fallacy. I proceed to do this in James' spirit of generating imaginative metaphors to understand experience. Curiously, however, mental health presents a strange paradox in William James’ (1890) Principles of Psychology. He constructs an elaborate conception of the “empirical self” and “stream of thought” but chooses not to use these to understand unusual experiences – largely relying instead on the concept of a “secondary self.” In this article, I attempt to make more use of James' central division between the “stream of thought” and the “empirical self” to understand unusual experiences. I suggest that they can be usefully understood using the loose metaphor of a “binary star” where the “secondary self” can be seen as an “accretion disk” around one of the stars. Understood as literary rather the literal, this metaphor is quite different to more unitary models of self-breakdown in mental health, particularly in its separation of “self” from “the stream of thought” and I suggest it has the potential to start a re-imagination of the academic discourse around mental health.     

Contradictory Information: Too Much of a Good Thing

Both I and Belnap, motivated the “Belnap-Dunn 4-valued Logic” by talk of the reasoner being simply “told true” (T), and simply “told false” (F), which leaves the options of being neither “told true” nor “told false” (N), and being both “told true” and “told false” (B). Belnap motivated these notions by consideration of unstructured databases that allow for negative information as well as positive information (even when they conflict). We now experience this on a daily basis with the Web. But the 4-valued logic is deductive in nature, and its matrix is discrete: there are just four values. In this paper I investigate embedding the 4-valued logic into a context of probability. Jøsang’s Subjective Logic introduced uncertainty to allow for degrees of belief, disbelief, and uncertainty. We extend this so as to allow for two kinds of uncertainty—that in which the reasoner has too little information (ignorance) and that in which the reasoner has too much information (conflicted). Jøsang’s “Opinion Triangle” becomes an “Opinion Tetrahedron” and the 4-values can be seen as its vertices. I make/prove various observations concerning the relation of non-classical “probability” to non-classical logic.     

Neo-positivism,religious language,and the problem of evil in Eberhard Herrmann's philosophy of religion

In Religion, Reality and a Good Life (2004) Eberhard Herrmann argues that “religious utterances” are not “statements.” I argue that this thesis, when properly unpacked, directly parallels the logical positivist thesis from the 1930s and 40s that “religious sentences” are not “cognitively meaningful.” I consider a number of indirect objections to Herrmann's thesis which target the verification criterion of meaning used to support the thesis, along with the more direct objection that the thesis is unable to make sense of the problem of evil. My conclusion is that Herrmann's neo-Positivism is deeply problematic.     

对塔斯基“真”理论的批评与重建

塔斯基首先提出关于真之定义的T模式即:"p"是真的,当且仅当,p。随后他又用X取代T模式中的"p",并且用"满足"来定义"真"。本文一方面根据"内容恰当性"要求,提出另一种模式T′即:"p"是真的,当且仅当,p是存在的;用以补充T模式,并完善塔斯基的语言层次论。另一方面根据"形式正确性"要求,指出塔斯基对T模式的这两项修改都是多余的。     

Heidegger and the narrativity debate

One unresolved dispute within Heidegger scholarship concerns the question of whether Dasein should be conceived in terms of narrative self-constitution. A survey of the current literature suggests two standard responses. The first correlates Heidegger’s talk of authentic historicality with that of self-authorship. To the alternative perspective, however, Heidegger’s talk of Dasein’s existentiality, with its emphasis on nullity and unattainability, is taken as evidence that Dasein is structurally and ontologically incapable of being completed via any life-project. Narrativity imports into Being and Time commitments concerning temporality, selfhood, and ethics, which Heidegger rejects. Although both positions find good exegetic support for their conclusions, they can’t both be right. In this article, I navigate a path between these two irreconcilable positions by applying insights derived from recent debates within Anglo-American literature on personal identity. I develop an alternative thesis to Narrativism, without rejecting it outright, by arguing that Dasein can be analysed in terms of what I call “narratability conditions.” These allow us to make sense of the prima facie paradoxical notion of “historicality without narrativity.” Indeed, rather than reconciling the two standard positions, I hold that the tension between them says something important about Dasein’s kind of existence. Thus I conclude that while the narrativist question “Who ought I to be?” is perfectly legitimate within limits, what the existential analysis of the limits on narratability reveals is that no answer to this question can ever be definitive.