北宋丹霞子淳行履考

曹洞宗在北宋初已成衰微之势,在梁山缘观时代几至法脉断绝。经大洪报恩(1058-1111)、芙蓉道楷(1043-1118)的振作,才开始走向繁荣,并在丹霞子淳(1063-1117)一系的弘扬下,发展到鼎盛时期,成为后世两大主流宗派之一。     

Effects of psychological interventions for patients with osteoarthritis: a systematic review and meta-analysis

The aim of this study was to determine the effects of psychological interventions (e.g. cognitive restructuring, relaxation) on physiological and psychological health in osteoarthritis patients. A systematic literature search was done using PubMed, Embase, PsycINFO, Web of Science, China National Knowledge Infrastructure, and Wanfang Database through November 2016. Studies were included if they used a randomized controlled trial designed to explore the effects of psychological interventions in osteoarthritis patients. Two independent authors assessed the methodological quality of the trials using criteria outlined by Jadad et al. Meta-analysis was done with the Revman5.0. Twelve randomized controlled trials, including 1307 osteoarthritis patients, met the study inclusion criteria. Meta-analysis showed that psychological interventions could reduce the levels of pain [standard mean difference (SMD) ?0.28, 95% CI ?0.48, ?0.08, P-value 0.005)] and fatigue (SMD ?0.18, 95% CI ?0.34, ?0.01, P-value 0.04). In addition, psychological interventions significantly improved osteoarthritis patients’ self-efficacy (SMD 0.58, 95% CI 0.40, 0.75, P-value 0.00) and pain coping (MD 1.64, 95% CI 0.03, 3.25, P-value 0.05). Although the effects on physical function, anxiety, depression, psychological disability were in the expected direction, they were not statistically significant. In conclusion, the role of psychological interventions in the management of osteoarthritis remains equivocal. Some encouraging results were seen with regard to pain, pain coping, self-efficacy, and fatigue. We believe that more methodologically rigorous large-scale randomized controlled trials are necessary to answer this study question.     

Discrimination threshold for haptic volume perception of fingers and phalanges

Humans exhibit a remarkable ability to discriminate variations in object volume based on natural haptic perception. The discrimination thresholds for the haptic volume perception of the whole hand are well known, but the discrimination thresholds for haptic volume perception of fingers and phalanges are still unknown. In the present study, two psychophysical experiments were performed to investigate haptic volume perception in various fingers and phalanges. The configurations of both experiments were completely dependent on haptic volume perception from the fingers and phalanges. The participants were asked to blindly discriminate the volume variation of regular solid objects in a random order by using the distal phalanx, medial phalanx, and proximal phalanx of their index finger, middle finger, ring finger, and little finger. The discrimination threshold of haptic volume perception gradually decreases from the little finger to the index finger as well as from the proximal phalanx to the distal phalanx. Overall, both the shape of the target and the part of the finger in contact with the target significantly influence the precision of haptic perception of volume. This substantial data set provides detailed and compelling perspectives on the haptic system, including for discrimination of the spatial size of objects and for performing more general perceptual processes.     

3～6岁儿童人格发展的群组序列追踪研究

目的:运用自编幼儿人格发展教师评定问卷对幼儿人格进行追踪测量,探讨其年龄及性别发展特点。方法:用整群抽样法选取3~3.5岁、3.5~4岁、4~4.5岁3个年龄群组幼儿为被试,采用群组序列的追踪设计,进行为期1年半的追踪测量,结合潜变量增长曲线模型和多层线性模型处理数据,探讨幼儿在3~6岁间人格的发展特点。结果:(1)幼儿的智能特征、认真自控、外倾性、亲社会性、情绪稳定性5个人格维度在3~4岁发展最快,4~5岁持续增长但发展速度放缓,到5~6岁时趋于平稳;(2)女孩的认真自控和亲社会性在3岁时显著高于男孩,但在3~6岁间的增长率不存在差异,即女孩的认真自控和亲社会性在幼儿阶段发展水平始终高于男孩。结论:从家庭进入幼儿园的环境变迁促使了幼儿人格的进一步发展,5岁左右幼儿人格开始初步形成;女孩的认真自控和亲社会性水平在幼儿阶段始终高于男孩。     

循证理念在当代传染病防控领域的应用

循证医学引发医学领域的创新和革命,其理念应用于公共卫生领域形成了循证公共卫生。21世纪多种新发和复发传染病的全球性暴发为循证理念的应用带来挑战。高风险的研究环境、复杂的干预手段、证据稀缺、研究设计困难,以及在高度不确定和紧迫时间下建立程序和生成建议的需求,使循证方法学必须通过拓展和调适以解决传染病问题。六步骤快速风险评估机制、AGREE Ⅱ指南评估工具、全球传染病循证资源数据库,成为满足传染病防治的特殊要求而创新的循证实践工具。

     

从平等与责任谈医患共同体何以可能

研究对“医患共同体”这一颇具可能性的命题进行分析,指出其成立的基础之一是对医患双方“分裂”处境的认知与承认,通过以对医患平等的探讨为起点,提出应将医、患双方知识/权力上的优劣转化为差异的能动性,在促进共同责任的基础上,建立在理论及实践的医患共同体。目前可能的临床实践包括鼓励医护讲述成为患者的真实体验,鼓励包括叙事医学在内的促进平等共情的实践以及赋能患者、使其具备更强能力参与医疗共同决策的实践等。

     

混沌理论对优化临床管理模式的启示——以孕产妇管理为例

围绕混沌理论与妊娠及分娩之间的联系,结合实践,提出可行的优化孕产妇管理工作的建议。强调医务人员应应用线上及线下多种方式,于孕前、孕期、产时、产后各阶段,针对孕产妇身心各方面,对其实施系统化的管理;应重点把握与孕妇首次接触的时机,建立信任关系以保证其良好的遵医行为;管理过程中应尊重孕产妇的个体差异,为其提供个性化的指导,同时应重视其支持系统的建立,医疗机构、社区、家庭应为孕产妇提供切实的支持。旨在为孕产期保健工作提供新思路,从而更好地为广大孕产妇服务。     

新型冠状病毒肺炎定点医院医护人员心理状况调查分析

为了解定点收治新型冠状病毒肺炎患者的医院中医护人员心理状况,从而针对性地进行心理护理,采用便利抽样法,应用《医护人员心理健康调查表》对3所定点收治新型冠状病毒肺炎患者的医院中1 266名医护人员进行问卷调查。结果显示,定点医院医护人员中,27.5%存在抑郁,26.3%存在焦虑,26.0%存在孤独。女性、已婚、传染科、发热门诊、监护室相比男性、未婚、普通门诊更容易抑郁;传染科、监护室相比普通门诊更容易焦虑。因此,医院应加强对这类群体的心理疏导和人文关怀,以减轻心理压力,提高工作效率。     

创伤后应激障碍与物质使用障碍共病的病因学及其启示

创伤后应激障碍与物质使用障碍共病率高,现有的治疗方法疗效差,总结20年来创伤后应激障碍与物质使用障碍共病研究中病因学方面的新认识,通过对病因的哲学思考可以为今后的治疗方向提供一条思路:两病同治;应提倡药物治疗、认知干预和社会支持综合的治疗手段。