FOCUS超声刀与电刀在甲状腺手术中的比较研究

探讨FOCUS超声刀在甲状腺手术中的应用价值。选取2012年12月～2013年12月在我院乳甲外科住院手术甲状腺病例180例作为研究对象,其中FOCUS超声刀组90例,电刀组90例。比较两组手术时间、术中出血量、术后伤口引流量、术中气管前及腺体周围线结数量、手术并发症发生率。结果超声刀组在甲状腺手术平均时间（58．4±7．7）min ,术中平均出血量（24．8±8．1）ml,术后伤口引流量（41．5±6．7）ml,气管前及腺体周围线结数量（1．8±1．2）个,与电刀组比较,差异均有统计学意义（P＜0．05）。术后并发症发生率超声刀组与电刀组均较低。FOCUS超声刀在甲状腺手术中比传统电刀具有明显优势,安全、有效且不增加并发症发生率,值得在临床工作中推广。     

生活医学化与健康恐慌的关系及其反思*--论Michael Fitzpatrick《健康的暴政：医生及生活方式的控制》

迈克尔·菲茨帕特里克的《健康的暴政：医生及生活方式的控制》一书,以健康干预为主线,以健康政治化、生活医学化、疾病道德化为主题,论述了生活医学化的不同方面和形成过程,并力图揭示医学化背后隐含着的医学对社会的干预和控制。其中作者关于生活医学化和健康恐慌的一些哲学思考,尤其是生活医学化与健康恐慌的内涵及特点、生活医学化与健康恐慌的关系以及对生活医学化的审视与反思,在一定程度上蕴涵着对当今社会发展的启示。     

The Adventure of Research

In recent years, a number of studies corroborate the importance of an integrated or interdisciplinary curriculum for an effective education. However, contemporary proposals for the function of theology as the integrative center have been limited mainly to sectarian communities and remain a work in progress. Noting the fruitfulness of historical and worldview surveys of the relationship between theology and education in the works of Holmes, Knight, and Blamires, this essay is an attempt to contribute to these approaches by demonstrating how current research in biblical and patristic studies can contribute models for the integration of curricula and provide a more effective Christian education. Included are analyses of the counter-imperial thesis for Paul's theology and how it breaks down walls between Bible, Literature, History, and Government classes, the emergence of a distinctly Christian paideia and its contribution to the formation of Christian character, and the concept of cosmological axioms entailed in sacred discourse which provide a comprehensive interdisciplinary application of the lordship of Christ. Observations on the implications of such models for Christian education are then drawn from the data.     

The North American Career Development Partnership: Experiment in International Collaboration

This article describes how career development programs became the focus of an international partnership between the United States and Canada. Beginning in 1976 in the United States, the National Occupational Information Coordinating Committee (NOICC) and its State Occupational Information Coordinating Committees (SOICCs) developed training and materials that promote the use of occupational and labor market information. Similarly, in the early 1970s, Canada began to explore the feasibility of creating a computer‐based career information delivery system. What follows is the story of an unusual and significant international collaboration. It concludes with identification of lessons learned.     

THE ROLE OF JOB EMBEDDEDNESS ON EMPLOYEE PERFORMANCE: THE INTERACTIVE EFFECTS WITH LEADER–MEMBER EXCHANGE AND ORGANIZATION‐BASED SELF‐ESTEEM

Although job embeddedness was originally conceptualized to explain job stability or “why people stay” in their organizations, this investigation examines the role of job embeddedness as a hypothesized moderator of relationships among leader–member exchange (LMX), organization‐based self‐esteem (OBSE), organizational citizenship behaviors (OCBs), and task performance. Findings from 2 studies involving 367 employees and 41 supervisors, 1 in a telecommunications company and another in a manufacturing setting, support hypotheses concerning job embeddedness as a moderator of the relationship between (a) LMX and task performance within a telecommunication sample and LMX and OCBs in a sample of manufacturing employees, and (b) OBSE and OCBs in a manufacturing sample. Further, a hypothesized 3‐way interaction involving job embeddedness, LMX, and OBSE on task performance was found in a sample of manufacturing employees. The implications of these findings for studying and managing job embeddedness in relation to employee performance are discussed.     

Maternal Distress and Parenting in the Context of Cumulative Disadvantage

To read this article's abstract in both Spanish and Mandarin Chinese, please visit the article's full‐text page on Wiley InterScience ( http://interscience.wiley.com/journal/famp ). This article presents an emergent conceptual model of the features and links between cumulative disadvantage, maternal distress, and parenting practices in low‐income families in which parental incarceration has occurred. The model emerged from the integration of extant conceptual and empirical research with grounded theory analysis of longitudinal ethnographic data from Welfare, Children, and Families: A Three‐City Study. Fourteen exemplar family cases were used in the analysis. Results indicated that mothers in these families experienced life in the context of cumulative disadvantage, reporting a cascade of difficulties characterized by neighborhood worries, provider concerns, bureaucratic difficulties, violent intimate relationships, and the inability to meet children's needs. Mothers, however, also had an intense desire to protect their children, and to make up for past mistakes. Although, in response to high levels of maternal distress and disadvantage, most mothers exhibited harsh discipline of their children, some mothers transformed their distress by advocating for their children under difficult circumstances. Women's use of harsh discipline and advocacy was not necessarily an “either/or” phenomenon as half of the mothers included in our analysis exhibited both harsh discipline and care/advocacy behaviors. Maternal distress characterized by substance use, while connected to harsh disciplinary behavior, did not preclude mothers engaging in positive parenting behaviors.     

Younger Adults' Communication Experiences and Contact With Elders and Peers

Intergenerational communication research has overemphasized dissatisfying experiences and treated elderly conversation partners as an undifferentiated category. To redress these limitations, the authors surveyed 100 younger adults' (16–46 years) satisfying and dissatisfying experiences with both family and nonfamily elders, and compared these with own-age peers. Measures of social contact were also taken. As hypothesized, positivity of experiences and contact increased from nonfamily to family elders and to peers. Barriers of communication with nonfamily elders were due to contact more than experiences. For family elders and especially for peers, most measures of contact and experiences were positive. The authors also tested for effects due to respondents' gender and culture (New Zealanders of Chinese or European descent). Females had more positive experiences and contact on some of the measures. Views about elders held by Chinese were more favorable, yet this did not translate into improved experiences or contact.     

Age‐related variations and sex differences in gender cleavage during middle childhood

Gender cleavage, the segregation of the sexes, is a powerful phenomenon affecting socialization during childhood, but its developmental trajectory is far from clear. Sociometric responses by 299 boys and girls in Grades 3 to 6 from a group preference record were used to investigate age‐related variations and sex differences in gender cleavage. Moreno's (1953) developmental model of gender cleavage was examined in the light of sociocultural changes, as well as advances in the theory and measurement of gender cleavage. Sex differences were found in same‐gender preference, with older elementary girls showing greater same‐gender preference than boys of the same age. However, this finding, plus the absence of gender differences in cross‐gender evaluations, did not support more recent developmental accounts of gender cleavage. Linear trend analyses contradicted Moreno's basic precept of increasing same‐gender preference between Grades 3 and 6. While same‐gender acceptance and rejection were relatively similar regardless of grade level, cross‐gender acceptance was greater in higher than in lower grades and the reverse was true for rejection. Furthermore, weaker gender cleavage effects in rejection data than in acceptance data suggested that strong same‐gender liking does not infer equally robust cross‐gender dislike. Gender cleavage appears to be relative rather than absolute. A more complex model is proposed incorporating sex differences as well as rejection evaluations