肿瘤临终关怀医疗对医疗资源需求和医患关系影响的初步研究

为了研究肿瘤患者临终的医疗需求和对医患关系的影响,我们收集肿瘤死亡病例,研究临终表现、治疗、住院时间及费用。乏力、纳差、咳嗽、疼痛是最痛苦的症状;末次住院平均天数为25．7日;末次住院人均医疗费用12946．428元。结果表明,临终患者治疗的重点是症状的改善,这能减轻患者的痛苦、营造和谐的医患关系。     

对新冠病毒肺炎危重症患者引入缓和医疗的伦理论证

新型冠状病毒肺炎尚无治疗特效药和疫苗。在继续加强防控的同时,把有限的资源优先放在探索对重症和危重症患者的支持性治疗,积极建立和完善对重症、危重症患者及其家属的缓和医疗等方面,有利于患者群体利益最大化,经得起伦理辩护。缓和医疗有助于改善患者预后,降低住院病死率,有效缓解患者濒死痛苦;对医患双方而言,如果死亡已无可避免,帮助临终者走得平安、少些痛苦,是医学对患者最后的人文关怀。     

胃部恶性肿瘤临床实践中的医疗艺术

医学是一门讲求艺术性的科学.随着社会的发展,医疗艺术在整个医学临床实践中的重要性越来越突出.医疗艺术体现了医生对生命的尊重和伦理的理解.讲求医疗艺术对于建立和谐的医患关系具有重要意义.因此,如何在过硬的现代医学技术基础上提高临床医疗的艺术性,是医学教育和临床实践领域都应该思考的问题.本文以胃部恶性肿瘤的临床实践为例,从态度、语言、表情以及医患互动等细节方面入手,探讨在初诊、术前、康复以及面对晚期临终患者的不同情况中应该如何提高医疗艺术.     

患者亲属——医疗决策的重要主体

在医患关系中,患者亲属起着重要作用,是医疗行为及后果生理和心理的承担者,患者的疾病本身和康复情况会直接对家庭生活产生影响.患者亲属也是患者医疗费用的主要承担者.由于医疗决策会涉及到患者的家庭利益,患者患病会对其决定能力产生不利的影响,在法律上确立患者亲属在医患关系中的主体地位,甚至在必要时赋予亲属医疗决定权是必要的和现实的.     

超高消费住院病例医疗费用研究

分析了1 165例超高消费住院病例医疗费用特点和影响因素.结果显示,超高消费住院病例主要以循环系统疾病和损伤中毒、肿瘤等病种为主,年龄、住院天数,住院次数、抢救次数和护理天数与医疗费用呈非线性正相关.加强对循环系统疾病和损伤中毒等病种的诊治研究、加快床位使用效率、控制药品和材料比例,是控制超高消费住院病例医疗费用的关键点.     

患者亲属——医疗决策的重要主体

在医患关系中,患者亲属起着重要作用,是医疗行为及后果生理和心理的承担者,患者的疾病本身和康复情况会直接对家庭生活产生影响。患者亲属也是患者医疗费用的主要承担者。由于医疗决策会涉及到患者的家庭利益,患者患病会对其决定能力产生不利的影响,在法律上确立患者亲属在医患关系中的主体地位,甚至在必要时赋予亲属医疗决定权是必要的和现实的。     

21世纪医疗服务模式必须转变

<正>近年来我国医患关系一直在不断恶化,社会公众和医学界纷纷探讨医患关系恶化的原因与对策。在原因方面,大多聚焦于医疗环境条件不好,在寻求对策上也倾向于国家增加医疗卫生费用的投入、改善舆论环境、加强人文医学教育等,少有从医疗服务模式方面找原因和调整诊疗服务方式的思考。笔者认为,尽管改善医疗服务环境进而改善医患关系仍是     

超高消费住院病例医疗费用研究

分析了1165例超高消费住院病例医疗费用特点和影响因素。结果显示,超高消费住院病例主要以循环系统疾病和损伤中毒、肿瘤等病种为主,年龄、住院天数、住院次数、抢救次数和护理天数与医疗费用呈非线性正相关。加强对循环系统疾病和损伤中毒等病种的诊治研究、加快床位使用效率、控制药品和材料比例,是控制超高消费住院病例医疗费用的关键点。     

临终患者自主权的两难困境与出路

面对人口老龄化程度越来越高的社会,尊重临终患者的自主权既是对患者知情同意的尊重,也是对生命价值的尊重。临终患者自主权的实现途径中存在诸多两难问题。研究临终患者自主权的两难困境问题,有助于权衡不同价值观念之间的冲突,并且从中找到与之相应的解决方案。破解临终患者自主权两难困境的出路在于充分尊重临终患者的自主权,构建互信的医患关系和共同决策机制。并探索预设医疗指示制度和伦理审查制度在我国医疗环境下实施的可行性。     

做好哮喘控制工作利国又利民

本文结合我院哮喘教育管理工作的成绩和经验,系统地阐述了做好哮喘控制工作的重要意义,包括减少哮喘发作减轻患者痛苦;提高哮喘患者生命质量;降低医疗费用;减轻社会和家庭负担;减少误工误学,保护社会生产力;有助于解决"看病贵"问题和构建和谐的医患关系等.     

The influences of valence and arousal on judgments of learning and on recall

Much is known about how the emotional content of words affects memory for those words, but only recently have researchers begun to investigate whether emotional content influences metamemory—that is, learners’ assessments of what is or is not memorable. The present study replicated recent work demonstrating that judgments of learning (JOLs) do indeed reflect the superior memorability of words with emotional content. We further contrasted two hypotheses regarding this effect: a physiological account in which emotional words are judged to be more memorable because of their arousing properties, versus a cognitive account in which emotional words are judged to be more memorable because of their cognitive distinctiveness. Two results supported the latter account. First, both normed arousal (Exp. 1) and normed valence (Exp. 2) independently influenced JOLs, even though only an effect of arousal would be expected under a physiological account. Second, emotional content no longer influenced JOLs in a design (Exp. 3) that reduced the primary distinctiveness of emotional words by using a single list of words in which normed valence and arousal were varied continuously. These results suggest that the metamnemonic benefit of emotional words likely stems from cognitive factors.     

人与非人动物"嵌合体"研究的伦理学分析与思考

人与非人动物嵌合体的研究,作为人类提高自身健康素质的技术工具,以科学技术的形式改变着人们的生活方式和思维方式,寻找遗传性或者难治性疾病的致病基因和治疗新途径,追求个人和社会整体的良好生存状态,有着巨大的医疗价值,符合"行善"的伦理原则,应该允许限制性的开展.考虑到可能引发的伦理和高技术风险,履行审慎的准入制度.进行规范的伦理管理和严格的法规、行政管理是非常必要的.     

The effect of difficulty and chance success on item-test correlation and on test reliability

An equation is derived for predicting the effect of chance success, relative to item difficulty, on item-test correlation. The values predicted by this equation and by equations derived by Guilford and Carroll for predicting the effect of chance success on item difficulty and test reliability are compared with empirical values in an experiment which used identical test items in multiple-choice and answer-only form.Condensation of a dissertation presented in partial fulfillment of the requirements for the Ph.D. degree to the University of Chicago. Grateful acknowledgment is made to Professor Harold Gulliksen for his guidance as thesis advisor and to Professor L. L. Thurstone and Dr. D. W. Fiske of the University of Chicago who served as members of the thesis committee. The author is also indebted to Professor S. S. Wilks for review of the derivations and development of statistical tests used in the thesis, to Dr. L. R Tucker for technical advice, and to Dr. W. G. Mollenkopf for critical comments on the derivations and interpretations. The writer expresses appreciation to the Educational Testing Service for making available its technical facilities, and to the University of Chicago for the flexible administrative arrangement which made this thesis possible.     

Influence of tonal and temporal expectations on chord processing and on completion judgments of chord sequences

Pitch and time are two principal form-bearing dimensions in Western tonal music. Research on melody perception has shown that listeners develop expectations about "What" note is coming next and "When" in time it will occur. Our study used sequences of chords (i.e., simultaneously sounding notes) to investigate the influence of these expectations on chord processing (Experiments 1 and 4) and subjective judgments of completion (Experiments 2 and 3). Both tasks showed an influence of tonal relations and temporal regularities: expected events occurring at the expected moment were processed faster and led to higher completion judgments. However, pitch and time dimensions interacted only for completion judgments. The present outcome suggests that for chord perception the influence of pitch and time might depend on the required processing: with a more global judgment favoring interactive influences in contrast to a task focusing on local chord processing.     

本体的反思与表征--追问和理解哲学的一种思路

在我看来 ,追寻本体是哲学存在的根据 ,对本体的反思与表征则是哲学存在的方式。一、追寻本体哲学为何存在 ?这是对哲学的最朴实无华而又最切中要害的追问。这个追问不仅直指哲学存在的根据 ,而且直接把哲学存在的根据诉诸于人类的存在。哲学是人类把握世界的一种基本方式。在人类创造自己的生活世界并实现人类的自我发展的各种基本方式中 ,哲学的不可或缺和不可替代的特殊作用和独特价值何在 ?这就是对哲学存在的人类性根据的追问。这种追问 ,把对“哲学为何存在”的追问诉诸于对“人是怎样的存在”的追问。人的存在就是人的生命活动。人的…     

线索熟悉性与易接近性对FOK影响的实验研究

本研究目的探讨线索熟悉性和易接近性与FOK判断的关系。两个实验以中文词为材料．采用重复启动操纵线索的熟悉性,用联想集大小操纵易接近性,线索词和目标词之间无联想关系。实验结果表明：线索熟悉性和易接近性都有促进FOK判断的作用,但二者对FOK的作用是独立的,且不同步。文章最后讨论了线索熟悉性与易接近性的控制条件可能影响二者在FOK判断上的关系。