小儿重症肺炎的诊治策略

肺炎是儿童常见的呼吸道疾病,小儿重症肺炎及其导致的并发症特别全身炎症反应综合征和多脏器功能衰竭是严重威胁儿童健康和生命的重要原因.随着基础医学和临床医学的发展,人们的认识逐渐深入,防治水平也取得重要进展.但病原学的变迁,不恰当的临床监测和干预仍然影响着人们对该病的正确认识和处理.运用哲学的辩证思维来探讨小儿重症肺炎诊治中的若干问题,将为儿科临床工作提供新的指导.     

加强小儿围术期疼痛管理——医学伦理的必然要求

近年小儿围术期疼痛管理日益引起人们的重视。小儿围术期疼痛管理包括围术期疼痛的监测和评估,疼痛治疗的原则和策略等方面的内容。鉴于儿童是一个相对独立的利益群体,即使新生儿在围术期也有完善的疼痛治疗的需求,重视小儿围术期的疼痛诉求,体现了对小儿的人文关怀和基本权力的维护,是医学伦理的必然要求。     

加强小儿围术期疼痛管理——医学伦理的必然要求

近年小儿围术期疼痛管理日益引起人们的重视.小儿围术期疼痛管理包括围术期疼痛的监测和评估,疼痛治疗的原则和策略等方面的内容.鉴于儿童是一个相对独立的利益群体,即使新生儿在围术期也有完善的疼痛治疗的需求,重视小儿围术期的疼痛诉求,体现了对小儿的人文关怀和基本权力的维护,是医学伦理的必然要求.     

肺炎支原体肺炎流行病学特点及耐药现状

肺炎支原体(MP)是社区获得性呼吸道感染的重要病原体,引起的呼吸道感染每3年7年出现一次流行,国内外文献报道,监测到多个国家和地区出现MP的爆发流行,流行特点与气候等因素相关,不同地区有所差异,近几年难治性和重症肺炎支原体肺炎增多,对儿童和青少年健康危害严重,目前临床上治疗首选大环内酯类抗生素。自2001年日本首次从临床标本分离到对大环内酯类抗生素耐药的肺炎支原体以来,世界多个国家和地区也相继报道。大环内酯类抗生素耐药的主要机制是23SrRNA基因单个碱基突变,使大环内酯类抗生素与核糖体主要结合部位发生结构改变,亲和性降低,从而产生耐药。合理使用抗生素,在肺炎支原体耐药控制与治疗上至关重要。     

韦克斯勒学前儿童智力量表在上海郊县的应用

我国是一个城乡差别较大,农村人口众多的国家.因此,必须有一个农村儿童WPPSI 的正常数据。为此,我们于85年10月—12月对上海郊县385名4—6.5岁儿童进行测试。为了恰当评价郊县儿童的智力发育水平,按照韦氏手册制表原理,重新编制了量表分转换表及语言、操作和总智商的换算表。调查结果:①本样组小儿智商低于市区儿童,说明城乡差别显著,影响小儿智力发育的差异。②358名小儿智商分布呈常态。③男女小儿智商经统计处理无显著差异。④本样组来自五个郊县有一定代表性.因此,可作为目前郊县学前儿童智力量表试用常模.     

观察学习的概念与应用

观察学习是人类重要的学习方式之一.在社会生活中,人们通过观察,从他人那里获得新行为的信息。模仿他人的所做所为,接受他人行为的影响。观察学习因而构成人们适应社会或社会化的重要手段.家长、教师和其他教育工作者无不利用榜样的影响,指导儿童通过观察获得正确的行为方式,培养儿童优良的思想品德.因此为了有效地指导儿童的     

儿童白血病治疗的几点思考

儿童白血病是小儿发病率最高的恶性肿瘤。随着分子生物学、遗传学、免疫学的发展,抗白血病的新药物不断被发现,新的治疗方法不断被采用。在选择治疗方法时,应用哲学思想进行指导,显得尤为重要。     

试论小儿肾脏病研究的发展方向

小儿肾脏疾病是儿科临床上的常见病与多发病。1987年对全国 2 1省市地区 2 2 4 2 91名 2～ 14岁儿童进行尿筛查结果发现 ,泌尿系统疾病患儿占总受检人数的 0 83%。据此估计我国约有 30 0万儿童患有各种泌尿系统疾病 ,严重地危害了我国儿童的身心健康。其中有相当一部分患儿病情反复迁延不愈 ,最后发展至终末肾。因此 ,小儿肾脏病研究究竟应走向何处 ,才能解除肾脏病患儿的身心痛苦 ,成为摆在我们每位儿科肾脏学工作者面前的严峻课题。1　基因组学的发展为彻底解除肾脏病的困扰带来了一丝曙光早年由于肾脏病免疫学基础的认识、肾活体组织检…     

儿童白血病治疗的几点思考

儿童白血病是小儿发病率最高的恶性肿瘤.随着分子生物学、遗传学、免疫学的发展,抗白血病的新药物不断被发现,新的治疗方法不断被采用.在选择治疗方法时,应用哲学思想进行指导,显得尤为重要.     

肥胖与儿童的身心发展及家庭干预

人人都希望自己有健康的体魄,对于正在生长发育中的儿童也不例外。影响健康的因素有很多,但现代医学的发展和人们物质生活水平的普遍提高,已使传染病和营养缺乏等不再是威胁人类健康的主要疾病,取而代之的则是与人们的社会心理因素和生活方式密切相关的疾病,因而儿童肥胖就成了20世纪影响儿童健康的一个重要问题。近些年来,我国儿童肥胖的发生率呈上升趋势。陈锐等[1]总结我国1985—1995年十年来肥胖儿童及超体重儿童情况指出:肥胖儿童及超体重儿童比率与十年前相比,7—18岁男童从1985年的3.38%上升为7.18%,尤其是城市男生的超体重及肥胖率高达12.03%。     

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.     

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.     

Phenotypic plasticity and archetype: a response to common objections to the biological theory of archetype and instinct

Since Jung’s death in 1961, scholars have attempted to integrate growing biological science data into Jungian concepts such as the collective unconscious, instincts and the archetypes. This enterprise has been challenging due to persistent false dichotomies of gene and environment occasionally arising. Recent works by Roesler (2022a, 2022b) for example, have raised objections to the biological theory of archetypes, but the objections are plagued by such dichotomies. The concept of phenotypic plasticity, however, helps to both avoid this problem as well as bridge the gap between competing theories into a more integrated model with solid biological foundations.     

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.     

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.     

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.     

Seeing in the Dark: A View into Dissociation and Healing

In this paper, I will explore the role of art-making, the experience of trauma and dissociation, and the process of working with self-states from an analytic and creative frame. Relevant literature on dissociation, trauma, and the use of art will be discussed. A case involving my work with an adolescent girl who had experienced sexual abuse from a family member will be shared, with an emphasis on the meaningful role images played during the therapeutic process. Both Jungian and psychoanalytic models of conceptualizing and working with dissociation are included, following Donald Kalsched’s (2013) recommendation for a “binocular stance” to treatment, including both a focus on the inner, intrapsychic world and the interpersonal, relational realm, and how art images both illuminated and expressed these realms. Within the therapeutic process, art images allowed the therapist a view into the client’s unconscious process, and created a meeting ground for dissociative barriers to be gradually seen, felt and known, by both therapist and client. The experience of dissociation, in images and in session, provided a reference point for myself and my client, Taylor, to develop a shared understanding and a framework for growth.     

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.