男科临床工作中的人文关怀

随着现代医学模式的转化和男科学诊治技术的发展,在男科临床工作中应该注重树立人文关怀理念和强化人性化服务意识。实施人文关怀的方法包括：重视心理应激,应用心理疗法;关注患者生活,有效预防疾病;营造人文环境,提供人性化服务;遵循最优化原则,做到适度医疗;关心老年人健康,关注社会特殊群体。在男科临床工作中应提高人文关怀的自觉性。     

不育症临床治疗中的人文关怀

随着不育症患者的不断增多,不育症治疗技术的迅速发展及医学模式的转化,在不育症临床诊疗中应树立人文关怀的理念,强化人性化服务的意识.在工作中应遵循患者第一的原则并恪守心身统一原则、保密原则、最优化原则、知情同意等原则.在治疗过程对患者同情、鼓励以及进行心理治疗,体现人文关怀,构建和谐的诊疗气氛.     

医学人文关怀在儿科临床实践中的应用

医学的人文精神决定了医疗服务必须体现人文关怀.医学人文关怀是医疗活动的重要组成部分,如今培养人文关怀精神已越来越成为医学教育中不可分割的一部分.儿科学,专科性强,对象特殊,疾病发展变化迅速,工作风险较大.这要求儿科医生应具有更扎实的临床基本功,同时也需要表现人文关怀精神并融入临床实践的每一个环节.这是高质量医疗服务和医学模式转换的必然要求,并且有助于正确决策,减少医疗纠纷.本文目的旨在阐明人文关怀与儿科临床实践之间的关系及其在儿科临床实践中的重要性,并针对目前存在于儿科临床实践中人文冷漠现象提出一些建设性意见.     

医院药学服务与人文关怀

医院药学服务是医院医疗服务中的重要组成部分,药师在医院人文服务中起着重要作用.本文阐述了人文关怀在医院药学服务中的实施,指出药师在日常工作中的每个环节都要为患者提供充满人文关怀的服务,并指出了现在医院药学服务的人文关怀中存在的困难及解决办法.     

无痛技术在侵袭性诊疗中的应用

大量住院患者及门诊患者均需实施一些侵袭性的诊疗措施,以便于疾病的诊疗,但由此给患者带来的心理及生理上的疼痛、痛苦却往往被忽视.在有些情况下,侵袭性诊疗给患者带来的痛苦甚至远远超过了疾病本身,而由此所致的机体功能紊乱则更为深远.因此,无痛技术在临床侵袭性诊疗中的应用更加体现当今医学人性化的服务,凸显医学的人文关怀.     

临床疾病多学科协作综合治疗的思考

认识生物-心理-社会医学模式在当代医学发展中的重要作用.分析临床多学科协作的客观必然性和现实性.用哲学辩证思维方法看待多学科协作的重要性,提出多学科协作的思路和途径,注重患者的人文关怀,实现临床疾病综合治疗和临床工作"以人为本"的服务目标,提高临床诊疗水平和医疗服务质量.     

麻醉科医师在晚期癌痛治疗中的作用

1986年WHO推出的"三阶梯"癌痛镇痛用药方案目前在临床工作中存在误区.麻醉科医师必须明确在晚期癌痛治疗转变中的责任和义务:具有专业能力、保健与防病能力,消除使用阿片类药物成瘾恐惧症;团队协作能力、新技术的评估能力,实行跨学科综合姑息保健;遵循生物心理社会医学模式,对晚期癌痛患者实施人文关怀.不仅会运用药物和医疗技术手段,还需配合心理和社会方面进行全面的诊疗,更好地为患者服务.     

药房工作中的人文关怀

药房工作是医院医疗服务不可或缺的重要组成部分,药剂师在落实医院人文服务过程中扮演着重要的角色.本文分别就药剂师在门诊药房、中心药房以及患者用药后的随访工作三方面进行阐述人文关怀的重要性和实施办法.强调在与患者的交流中,药剂师不仅要告知患者药物的使用方法和注意事项,还要为患者提供充满人文关怀的服务.     

临床医学中人性化医疗的非显性误区辨析

随着现代医疗技术的迅猛发展,人们在享受高新技术提供服务的同时,却对临床医学存在的非人性化趋势提出越来越多的质疑,因此,需要对医学目的和价值进行重新审视。本文阐述了人性化医疗中存在的某些非显性误区,这是医学人文削减的主要内在原因,面对技术与人文之间的矛盾关系,出路在于医疗技术的人性化方向,赋予非人性化手段以人性化关怀,在探索人性化的医疗手段中实现医疗的人性化复兴。     

宫颈癌普查与人文关怀

随着不育症患者的不断增多,不育症治疗技术的迅速发展及医学模式的转化,在不育症临床诊疗中应树立人文关怀的理念,强化人性化服务的意识。在工作中应遵循患者第一的原则并恪守心身统一原则、保密原则、最优化原则、知情同意等原则。在治疗过程对患者同情、鼓励以及进行心理治疗,体现人文关怀,构建和谐的诊疗气氛。     

意识和无意识的关系--实证的视角

意识和无意识的相互关系曾经是纯粹的哲学问题,科学心理学的诞生促进了对这一问题的实证视角考察。实证取向认为,意识和无意识同属人类心理的机能,并能够在外在的任务操作中表现出来。现代认知心理学发现了对应意识机能的外显过程和对应无意识机能的内隐过程,两者相对独立又共生共存。任何认知过程都是意识和无意识共同作用的产物,两者之间存在复杂的相互作用,并表现出权衡的特点。神经生理学的研究揭示了意识和无意识在发生学意义上可能的先后关系。无意识在心理过程中起的作用是普遍的、抽象的、抗干扰的,而意识则建筑在无意识的基础之上,有着更大的变异性。     

Toward a unified theory of narcosis: brain imaging evidence for a thalamocortical switch as the neurophysiologic basis of anesthetic-induced unconsciousness

A unifying theory of general anesthetic-induced unconsciousness must explain the common mechanism through which various anesthetic agents produce unconsciousness. Functional-brain-imaging data obtained from 11 volunteers during general anesthesia showed specific suppression of regional thalamic and midbrain reticular formation activity across two different commonly used volatile agents. These findings are discussed in relation to findings from sleep neurophysiology and the implications of this work for consciousness research. It is hypothesized that the essential common neurophysiologic mechanism underlying anesthetic-induced unconsciousness is, as with sleep-induced unconsciousness, a hyperpolarization block of thalamocortical neurons. A model of anesthetic-induced unconsciousness is introduced to explain how the plethora of effects anesthetics have on cellular functioning ultimately all converge on a single neuroanatomic/neurophysiologic system, thus providing for a unitary physiologic theory of narcosis related to consciousness.     

A Survey of Ethical and Professional Challenges Experienced by Spanish Health-Care Professionals that Provide Genetic Counseling Services

Genetic testing is increasingly applied for diagnosis and clinical treatment. In some countries, genetic counseling services are provided by professionals with specific training in this discipline, whereas other countries have no teaching programs and counseling is offered by physicians, nurses, pharmacists or biochemists. This counseling raises more and more ethical dilemmas for health professionals at their clinics. The purpose of this study was to analyze the characteristics of Spanish professionals devoted to providing genetic counseling services and to investigate the frequency of the ethical dilemmas they face. Results from 72 survey respondents revealed this counseling is provided by an almost even number of male and female professionals, mostly physicians with many years of professional experience. The overall frequency of the ethical dilemmas encountered was not high. The most frequent dilemmas corresponded to emotional responses by patients, informed consent, uncertainty about test results, and limitations on health-care resources. The frequency of dilemmas involving discrimination and provider directiveness was very low. Additional findings, practice implications, and research recommendations are presented.     

意识和无意识权衡现象的四个特征

本实验以探讨意识和无意识之间的复杂关系为目的 ,采用 5 (年龄 :老年、中年、大学生、初三和高小 )× 2 (贡献来源 :意识和无意识 )的两因素混合设计 ,通过加工分离程序 (PDP)的包含和排除测验 ,计算意识和无意识的贡献大小。结果表明在对具体图片的记忆中 ,1)意识和无意识贡献出现了发展上的分离 ;2 )老年组的无意识贡献高于意识贡献 ,但未达到显著水平 ,其余四个组别则表现出意识贡献水平极其显著地高于无意识贡献水平。在此基础上 ,本研究对意识和无意识的权衡现象的四个特征 (相互独立、相互作用、互为主次、互相依存 )分别进行了阐述     

Tragic Dilemmas and the Priority of the Moral

My purpose in this paper is to argue that we are not vulnerableto inescapable wrongdoing occasioned by tragic dilemmas. I directmy argument to those who are most inclined to accept tragicdilemmas: those of broadly Nietzschean inclination who reject``modern moral philosophy' in favor of the ethical ideas of theclassical Greeks. Two important features of their project are todeny the usefulness of the ``moral/nonmoral distinction,' and todeny that what are usually classified as moral reasons always oreven characteristically ``trump' nonmoral reasons in anadmirable agent's deliberations.I show critics of modern moral philosophy such as BernardWilliams that their acceptance of tragic dilemmas underminestheir project of denying the moral/nonmoral distinction and thepriority of moral reasons. The possibility of tragic dilemmasrequires an account of practical deliberation in which moralreasons appear as already in-force obligations, with blame andguilt ready to be invoked, while nonmoral reasons appear as merereasons. This makes moral reasons importantly different fromnonmoral reasons in how they achieve their deliberative weight,and also makes them characteristically weightier. Thus,accommodating tragic dilemmas reinforces the moral/nonmoraldistinction and the priority of moral reasons, the very thingsthese critics want to deny. By accepting the possibility oftragic dilemmas, these critics are undermining their own project.The standard normative theories are dead set against tragicdilemmas, and the critics of modern moral philosophy shouldreject tragic dilemmas for the good of their project. Thus we allshould reject tragic dilemmas.     

The Definition of Moral Dilemmas: A Logical Problem

This paper concerns one of the undecided disputes of modern moral philosophy: the possibility of moral dilemmas. Whereas proponents of the possibility of moral dilemmas often appeal to moral experience, many opponents refer to ethical theory and deontic logic. My aim in this paper is to clarify some of the tension between moral experience and ethical theory with respect to moral dilemmas. In Part One I try to show that a number of logical arguments against the possibility of moral dilemmas, though apparently very different, turn out to be basically the same, as they are all based on the following concept of ought: if A ought to be done, doing B is impermissible and doing A itself is permissible. In Part Two I present an overview of several definitions of moral dilemmas that have been given by proponents of moral dilemmas: definitions that define moral dilemmas in terms of oughts and definitions that define them in terms of reasons. I conclude that, while reason is to weak, ought is too strong a concept to define moral dilemmas with. In this way, the arguments from Part One create a logical problem for proponents of the possibility of moral dilemmas to define moral dilemmas.     

Application of Child Protective Services in Korea

Abstract

Because childrearing is a very culturally oriented practice, cultural sensitivity in Child Protective Services (CPS) is a very important factor for effective services. Korea has recently begun social intervention in cases of child abuse, but faces many difficulties resulting from cultural dilemmas. In particular, Korean society has the value of corporal punishment and negative attitudes toward social intervention into family issues. These cultural characteristics result in strong resistance to intervention by CPS. In the future, the success of child abuse intervention in Korean society will depend on how these cultural dilemmas are resolved. The development of a CPS model based on Korean culture can be an alternative to reduce conflicts in the application of CPS.     

再认中意识和无意识的贡献大小--兼论内隐记忆的抗老化现象

本研究以探索记忆中意识和无意识贡献大小为目的,采用年龄和材料两个自变量,年龄分中青年和老年两组,被试均为23人,材料分文字和非文字两种。实验通过PDP的包含和排除测验计算意识和无意识的贡献大小。结果发现：(1)意识在不同年龄和不同材料的记忆中所起作用的差异极为显著;(2)无意识在文字材料的记忆中所起作用的差异极为显著;(3)无意识在非文字材料和不同年龄的记忆中所起的作用的差异均不显著。由此推论,老年人记忆中无意识贡献并未下降。这似说明,老年人内隐记忆并未老化。     

What Does Taste Represent?

What does vision represent? What does hearing represent? Smell? Touch? Competing answers to each of these questions have been defended. The present paper argues that the issue of what taste represents is categorically more complicated. In particular, it raises two very difficult dilemmas.     

无意识元认知调控下的策略转换

通过两位数乘法算式答案判别任务研究无意识元认知调控下策略转换的的认知加工特征。整个算式答案判别任务分为两种策略使用情境：一种为只可以使用尾数策略的任务情境;另一种为既可以使用尾数策略,又可以使用奇偶策略的任务情境。实验结果表明：1）无意识元认知具有高选择性、高效性和高潜力,能在策略使用情境转变之后,快速察觉并选择使用更为简单、高效的奇偶策略;2）尾数策略使用的强大思维定势阻止奇偶策略的意识化,致使绝大多数被试未能发现任务情境的变化而在内隐状态下使用了奇偶策略;3）策略在内隐或外显状态下使用具有同等效力,策略内隐使用具有高效性和高潜力。