哮喘教育和管理工作中的一些新的启示与思考

简要叙述了目前哮喘防治中存在的问题,提出必须彻底转变哮喘防控模式,简单介绍了我们自己的哮喘教育和管理的具体做法及其效果,最后就哮喘的防控和管理提出一些值得思考的问题,包括建立和谐医患关系,减轻医疗经济负担,建立新型疾病防控模式和医疗服务体系等。     

我国城镇社区医疗单位如何进行哮喘防控

哮喘防控工作是一项长期而艰巨的任务,城镇社区医疗单位在工作中应推广以"哮喘临床控制"为核心的哮喘治疗循环模式,即评估患者的哮喘控制水平、治疗并达到哮喘控制、监测并维持哮喘控制。当患者出现哮喘急性发作时,应遵循哮喘急性发作的治疗流程规范处理,尽快有效控制患者的症状。     

我国城镇社区医疗单位如何进行哮喘防控

哮喘防控工作是一项长期而艰巨的任务,城镇社区医疗单位在工作中应推广以"哮喘临床控制"为核心的哮喘治疗循环模式,即评估患者的哮喘控制水平、治疗并达到哮喘控制、监测并维持哮喘控制.当患者出现哮喘急性发作时,应遵循哮喘急性发作的治疗流程规范处理,尽快有效控制患者的症状.     

改变因症就诊的医疗模式搞好慢性呼吸疾病的防控

本文简单介绍了各种慢性呼吸疾病的特点、重要性、病因和发病机理,重点阐述认真搞好三级预防是有效防控慢性呼吸疾病的基础,而目前我国慢性呼吸疾病医疗服务模式是因症就诊,这种医疗服务模式不利于慢性呼吸疾病的管理和控制,必须尽快改变。     

哮喘控制与医疗改革

达到并维持哮喘控制和减少未来风险是哮喘的管理目标,绝大多数患者通过药物治疗可以实现这一目标.但目前哮喘控制率很低,除与GINA和我国哮喘诊治规范实施不足有关外,还与传统医疗结构、医疗体制和医疗观念有关,加速医疗改革,人人享有基本医疗卫生服务是提高哮喘控制率的重要环节.     

哮喘防控模式的几点思考

简单介绍了在支气管哮喘患者教育和管理工作中的若干体会。结果表明,我们所采取的哮喘教育管理体系(包括哮喘患者门诊、哮喘患者协会和哮喘宣教中心)是一种先进的医疗服务模式,不仅可以有效地改善医患关系,还可以显著提高哮喘患者对哮喘认知水平和防治疾病的依从性,提高哮喘控制水平、生命质量,减少非预约门诊、急诊、住院次数,降低医疗费用。     

哮喘防控模式的几点思考

简单介绍了在支气管哮喘患者教育和管理工作中的若干体会.结果表明,我们所采取的哮喘教育管理体系(包括哮喘患者门诊、哮喘患者协会和哮喘宣教中心)是一种先进的医疗服务模式,不仅可以有效地改善医患关系,还可以显著提高哮喘患者对哮喘认知水平和防治疾病的依从性,提高哮喘控制水平、生命质量,减少非预约门诊、急诊、住院次数,降低医疗费用.     

哮喘控制与医疗改革

达到并维持哮喘控制和减少未来风险是哮喘的管理目标,绝大多数患者通过药物治疗可以实现这一目标。但目前哮喘控制率很低,除与GINA和我国哮喘诊治规范实施不足有关外,还与传统医疗结构、医疗体制和医疗观念有关,加速医疗改革,人人享有基本医疗卫生服务是提高哮喘控制率的重要环节。     

改变因症就诊的医疗模式搞好慢性呼吸疾病的防控

本文简单介绍了各种慢性呼吸疾病的特点、重要性、痛因和发病机理,重点阐述认真搞好三级预防是有效防控慢性呼吸疾病的基础,而目前我国慢性呼吸疾病医疗服务模式是因症就诊,这种医疗服务模式不利于慢性呼吸疾病的管理和控制,必须尽快改变.     

第三方远程医疗模式的伦理困境和对策

通过对第三方远程医疗模式的理性思考,阐述了不同主体视角下第三方远程医疗模式面临的伦理困境:患者面临知情权与诊疗需求的冲突,隐私权保护等伦理问题;第三方远程平台视角下,面临经济效益与社会责任的冲突;求诊端医生面临患者的质疑,患者生命健康与自身利益保护的伦理困境;远程端医生面临推卸责任以及自身利益和社会效益冲突的伦理问题。进而提出加强规划和宣传,明晰权利义务;规范平台准入和医疗责任,加强信息安全管理;建立解决医疗伦理问题的常设机构,健全医疗伦理监察制度等建议,以期推动远程医疗健康发展。     

Seeing and hearing and space and space and time

A previous experiment had shown spatial location to be judged in terms of the framework provided by the modality in which stimuli were presented. In the present study, digits were either auditorally or visually presented, and in either form the three digits appeared successivly to the left, in the center, and to the right of the S. The digit which occurred temporally in the middle of the sequence was never central from the spatial viewpoint. The S was asked to indicate which digit was the middle one. Ss were blind, deaf, or normal. The deaf and two control groups saw visual displays, and the blind and their controls heard auditory displays. The former groups predominantly chose the spatially middle digit and the latter groups the temporally middle. It was concluded that modality of presentation was the trigger which switched in the coding dimension of time or space.     

Bob and Carol and Tess and Ali

Conflicting religious experiences in different traditions do not necessarily defeat the rationality of conflicting beliefs sustained by those experiences in those traditions. The circularity that protects religious beliefs from such mutual defeat is not vicious. Moreover, the lack of ‘epistemological humility’ exhibited by such believers poses no threat to world peace. In fact, a campaign for compulsory humility would itself constitute a much greater threat.     

Law and Gospel,and Youth and Family Ministry

Abstract : If “faith comes through hearing” the word of God comprised in law and gospel, how do the imperatives that characterize ‘Youth and Family Ministry’ make such hearing possible? Here, literature delineating ‘Youth and Family Ministry’ is analyzed in light of its biblical foundations. The primary lens implemented in this analysis is the law/gospel hermeneutic advocated by Martin Luther and other reformers.     

Extremes of self-esteem and narcissism and the experience and expression of anger and aggression

This study examined the level of self-esteem and narcissism as personality variables involved in the disposition to experience and express anger. Three hundred thirty-eight subjects were sampled across two higher education centres and one student teaching programme in the United Kingdom. It was reasoned that individuals with both high self-esteem and narcissism would report especially high tendencies to experience and express anger and aggression and that those with high self-esteem and low narcissism would report the lowest. These predictions were influenced by theories that emphasise the role of threats to high self-esteem in the production of aggression and violence. Results indicate that groups defined by their extreme scores on self-esteem and narcissism scales produced levels of anger expression in the predicted direction. The importance of considering extreme levels of self-esteem and narcissism (in conjunction with other factors) in an analysis of anger is discussed with reference to currently influential theories in the field. Aggr. Behav. 24:421–438, 1998. © 1998 Wiley-Liss, Inc.     

Dance and psychotherapy--possibilities and limits

From a starting point of therapeutic and prophylactic components identifiable in the dance, the authors regard the dance as deserving of greater attention than was hitherto the case in programs of physiotherapy, psychotherapy, and sociotherapy. From the existing essays at a therapy basing on body and motion, they infer basic common points, and to promote discussion, they state their attitudes in respect of the potential and rank of the dance in the concept of complex multimodal psychotherapy.     

Yin and Yang,and the Hot and the Cold

Yin and Yang are important concepts in ancient Chinese philosophy.Western scholars have become more familiar with these two concepts recently,but for a long time almost no one considered comparing them with their own tradition such as the ancient Greek philosophy,and especially with the ideas of the Hot and the Cold in Presocratic philosophy.In this paper,I make an attempt to do exactly that,and especially make a detailed comparison between the thoughts of two ancient thinkers:Laozi and Anaximander.I discuss the thought of Yin and Yang in Laozi-who was the earliest philosopher making use of the concepts Yin and Yang-to express his cosmological thought in ancient Chinese philosophy.Comparatively,I discuss the ideas of the Hot and the Cold in Anaximander,the earlier among Presocratic philosophers referring to the Hot and the Cold as fundamental concepts used to establish his cosmological system.Through this comparison,I indicate that the similarity between ancient Chinese and Western traditions is far more significant than what people are used to imagining.     

Perversion and infancy and adolescence

Abstract

Studying the works of Freud and Lacan, the authors carried out research on perversion in childhood. Their work covered the perverse polymorphism of infantile sexuality and the perception of the anatomic difference between the sexes that leads the child to create sexual theories and fantasies. The phallic mother and the fetish are viewed as imaginary solutions directly related to the Oedipus and castration complexes. In perversion, a particular position is taken in relation to the Oedipus complex: a serious flaw occurs in the symbolization of the law, and the mechanisms of denial and disavowal take form. Sexuality requires a second “logical time,” separated from infancy by the latency period, in order to confirm (in action) that a fixed position of jouissance (enjoyment) has actually been established. This can only happen in a period after adolescent enhancement. The distinction between perverse traces and a perverse structure is made, taking into account the fact that, in the case of child analysis, the analyst should free the child from the family fantasy and help him/her to build his/her own fantasy.

Campos Santoro V. et al. Perversion und Kindheit und Adoleszenz.

Im Studium der Arbeiten von Freud und Lacan haben die Autoren Forschung über Perversion in der Kindheit gemacht. Die Studien behandeln den perversen Polymorphismus der infantilen Sexualität und die Wahrnehmung des anatomischen Unterschiedes zwischen den Geschlechtern, welche das Kind dazu führt, Sexual-Theorien und Phatasien zu schaffen.

Die phallische Mutter und der Fetisch werden als imaginäre Lösungen angesehen, die sich direkt auf den Ödipus- und Kastrations-Komplex beziehen. Bei der Perversion wird eine besondere Position in Bezug auf den Ödipus angenommen; ein ernsthafter Mangel tritt bei der Symbolisierung des Rechts auf; die Mechanismen der Verneinung und der Verleugnung bilden sich. Sexualität erfordert eine zweite “logische Zeit”, von der Kindheit durch die Latenz Periode getrennt, um (in der Handlung) zu bestätigen, daß eine fixierte Position der jouissance (Vergnügung) sich tatsächlich etabliert hat. Das kann sich nur in einer Periode nach der adoleszenten Verstärkung ereignen.

Es wird die Unterscheidung zwischen perversen Spuren und einer perversen Struktur gemacht, in Rechnung stellend, daß im Fall der Kinder-Analyse der Analytiker das Kind von der Familien-Phantasie befreien sollte und ihm/ihr helfen sollte, seine/ihre Phantasie auszubilden.

Campos Santoro V. Perversión e infancia y adolescencia.

Estudiando los trabajos de Freud y Lacan, los autores han investigado la perversión en la niñez. Los estudios cubren la sexualidad infantil perversa polimorfa y la percepción de la diferencia anatómica entre los sexos, que llevan al niño a crear teorías sexuales y fantasías.

La madre fálica y el fetiche son vistos como soluciones imaginarias relacionadas directamente con el complejo de Edipo y de castración. La perversión, toma una posición particular en relación al Edipo; un fallo importante tiene lugar en la simbolización de la ley; los mecanismos de negación y repudio toman forma. La sexualidad requiere un segundo “tiempo lógico” separado de la infancia por el periodo de latencia, para confirmar (en acto) que una posición fija de jouissance (goce) se ha establecido. Esto solo puede ocurrir en un periodo posterior a la intensificación adolescente.

La distinción entre las huellas perversas y la estructura perversa se ha hecho, teniendo en cuenta que, en el caso del análisis de niños, el analista debe librar al niño de la fantasía familiar y ayudar a el/ella a construir su propia fantasía.     

神圣、凡俗与净明、忠孝

本文结合有关宗教学理论,对宋元净明道所推崇的"净明"、"忠孝"概念进行了解析.作者以为:宋元净明道视世俗性的道德实践为"神圣"的宗教修炼,实与宗教学中的凡俗可以"转换"为神圣之理论相合;而净明道徒的这种"转换",则多与其个体的"宗教体验"有关.至于元代净明道借"无极"概念来释"净明",以"净明"为回复宇宙根源之境界,则合于宗教人经验到与万物的根源、终极的本体或神圣的世界契合之感.换言之,宋元净明道的"净明"、"忠孝"说,实与各种宗教的本质有着相通之处.