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。     

自发性气胸致失血性休克诊疗策略

分析自发性气胸(spontaneous pneumothorax,SP)出现失血性休克时的临床特点、探讨诊疗策略.分析331例SP并失血性休克的病例资料.结果采用手术治疗者效果最佳.SP致失血性休克者多见于青年男性,多为胸膜顶粘连带出血,急诊微创手术是治疗发展方向.     

门脉高压症治疗观点之辩

对立统一规律是辩证法的实质,在唯物辩证法的理论体系中占有核心地位。门脉高压症的外科治疗有分流术与断流术两种不同的手术方法,这两种方法从治疗机制上看是矛盾的,用对立统一观来认识这两种手术的联系并揭示门脉高压外科治疗发展的哲学依据。     

Evidence-based treatment of stuttering: II. Clinical significance of behavioral stuttering treatments

An evidence-based framework can be described as an empirically-driven, measurement-based, client-sensitive approach for selecting treatments. It is believed that using such a framework is more likely to result in a clinically significant outcome. For this paper, a clinically significant outcome was defined as a meaningful treatment change. It was suggested that there are at least three groups for whom a treatment's outcome is meaningful. These groups include clinicians/clinical researchers, the clients, and relevant others who have some interest in the outcome (e.g., parents of a child who stutters). The meaning and measurement of clinical significance was discussed for each of these three groups, based on research from the behavioral stuttering treatment literature. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to (1) broadly define a clinically significant outcome and identify some of the groups who are interested in such an outcome and (2) describe how clinical significance has been evaluated in stuttering treatment within an evidence-based framework.     

Towards a functional neural systems model of developmental stuttering

This paper overviews recent developments in an ongoing program of brain imaging research on developmental stuttering that is being conducted at the University of Texas Health Science Center, San Antonio. This program has primarily used H₂¹⁵O PET imaging of different speaking tasks by right-handed adult male and female persistent stutterers, recovered stutterers and controls in order to isolate the neural regions that are functionally associated with stuttered speech. The principal findings have emerged from studies using condition contrasts and performance correlation techniques. The emerging findings from these studies are reviewed and referenced to a neural model of normal speech production recently proposed by Jürgens [Neurosci. Biobehav. Rev. 26 (2002) 235]. This paper will report (1) the reconfiguration of previous findings within the Jürgens Model; (2) preliminary findings of an investigation with late recovered stutterers; (3) an investigation of neural activations during a treatment procedure designed to produce a sustained improvement in fluency; and (4) an across-studies comparison that seeks to isolate neural regions within the Jürgens Model that are consistently associated with stuttering. Two regions appear to meet this criterion: right anterior insula (activated) and anterior middle and superior temporal gyri (deactivated) mainly in right hemisphere. The implications of these findings and the direction of future imaging investigations are discussed.

Educational objectives: The reader will learn about (1) recent uses of H₂¹⁵O PET imaging in stuttering research; (2) the use of a new neurological model of speech production in imaging research on stuttering; and (3) initial findings from PET imaging investigations of treated and recovered stutterers.     

Profiles of Counseling Pioneers: A Visit With Kathleen and Gilbert Wrenn

The authors have had the honor of knowing Gilbert and Kathleen Wrenn for 20 years; this story is about them. As Gilbert stated, “I am not a lone star, but part of a constellation… ”(Wachowiak & Aubrey, 1976, p. 76). The authors are privileged to know that for Gilbert, Kathleen (his partner of 72 years in 1996) is the center of that constellation. This article briefly captures pieces of the journey of 72+ years, on which Gilbert and Kathleen, each at 96 years of age, are continuing to travel together.     

Clergy involvement in occupational safety and health

The toll exacted by occupational injuries and illnesses on employed people involves a degree of personal and family suffering of such magnitude that clergy can legitimately consider it a part of their pastoral responsibilities to address the problem. Several cogent reasons for clergy involvement in occupational safety and health are provided, along with approaches clergy can implement to help parishioners reduce their workplace risks. Resources for assistance in engaging in these activities are suggested.This article represents an expansion of a paper that appeared originally inCurrents in Theology and Mission, Fall 1979.     

Leadership Style and Leader Title

In a 2 by 4 design, leadership style (authoritarian versus democratic) was varied against form of address (Mr., Ms., Miss, Mrs.) in a simulated small group case study. Subjects (374 college and high school students) read the case study and then rated their reactions to the leaderson behavioral differential factors of "subordination" and "friendship." These ratings indicate significant effects due to leader style (i.e., greater subordination and stronger friendship attraction to democratic rather than authoritarian leaders). Leader title produced no significantmain effects although authoritarian leaders using the title Ms. evoked higher subordination (p <.001) than other authoritarian leaders.     

人际愤怒的利与弊：来自元分析的证据

愤怒是因愿望落空、目标受挫或边界被犯而产生的负性情绪, 指向他人的愤怒即为人际愤怒。人际愤怒对接收者的影响有争议, 有人认为人际愤怒弊端极大, 有人认为人际愤怒是可资利用的工具。这种分歧可能源于评价指标、参照对象和应用场景的不同, 有必要用元分析系统考察人际愤怒的利与弊。本研究对67篇文献, 总样本量为15462人的185个效应值进行了分析, 结果发现：人际愤怒会让接收者让步更多、亲社会行为减少、问题解决行为提升, 同时情境不公平感增加, 对愤怒表达者的态度和能力评价均降低, 这些效应受接收者文化背景和相对权力大小的调节。这提示人际愤怒利弊相依, 能改变愤怒接收者的某些行为, 却增加对表达者的消极评价, 应视情景谨慎使用。     

经济正义:当代伦理学面临的重大课题

正义是一个历史范畴。人类对正义的追求经历了一个由个人正义到社会正义、由政治正义到经济正义的过程。随着经济关系成为支配社会发展的主要力量,经济发展的单向度价值取向的危害日益严重,社会不公正现象在经济领域中日益凸现,经济正义已成为当代社会正义理论中最重要、最具有社会意义的内容和形式。