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61.
62.
This study examined moderating effects of age on longitudinal associations among quality of life (QOL) and its demographic (e.g., age), clinical [e.g., prostate-specific antigen (PSA) level], and affective and cognitive predictors (i.e., distress, worries about recurrence, decisional regret, subjective life expectancy) in prostate cancer patients treated with external beam radiation (N = 391). Demographic and clinical characteristics were assessed at diagnosis, affective and cognitive variables at 6 months after diagnosis, and QOL at 12 months after diagnosis. Multiple-group analyses showed that among younger patients (< or =68 years old, n = 199), lower levels of decisional regret were associated with better functional QOL, and lower Gleason scores and PSA levels were associated with lower levels of distress and longer expected survival time, respectively. Being employed was related to higher levels of functional QOL and frequent worries about recurrence. Among older patients (>68 years old, n = 192), lower levels of distress were associated with higher levels of functional QOL, and longer expected survival time was associated with better functional and physical QOL. 相似文献
63.
Assoc. Prof. Imre Szecsödy MD PhD 《Forum der Psychoanalyse》2007,23(4):393-401
The manifold functions of a supervisor in following the course of complex processes together with the trainee, are: ? to keep the goals of the supervision in view, ? to establish a teaching alliance and to support the wish and ambitions of the candidate to learn, ? to build a platform for the complex interactions with the trainee with regard to the dynamics of the training situation and keeping in mind the institutional influences, ? to lay down the setting for the work, ? to explore and to reflect how transference and counter-transference influence the interaction between patient and analyst as well as between trainee and supervisor, ? to examine these interactions together focussing continuously on the interaction between candidate and patient, and to encourage the candidate to do the same on his own, ? to continuously formulate hypotheses about the core conflict, the transference phenomena and resistance of the patient, ? to explore and reflect on the cooperative work. 相似文献
64.
Several visuo-motor tasks can be used to demonstrate biases towards left hemispace in schizophrenic patients, suggesting a minor right hemineglect. Recent studies in neglect patients used a new number bisection task to highlight a lateralized defect in their visuo-spatial representation of numbers. To test a possible lateralized representational deficit in schizophrenia, we used the number bisection task in 11 schizophrenic patients compared to 11 healthy controls. Participants were required to orally indicate the central number of an interval orally presented. Whereas healthy subjects showed no significant bias, schizophrenic patients presented a significant leftward bias. Therefore, these results suggest an impairment in higher order representations of the number space in patients with schizophrenia, an impairment that is qualitatively similar to the deficit described in neglect patients. 相似文献
65.
Joseph L Verheijde Mohamed Y Rady Joan McGregor 《Philosophy, ethics, and humanities in medicine : PEHM》2009,4(1):15-8
Organ donation after cessation of circulation and respiration, both controlled and uncontrolled, has been proposed by the
Institute of Medicine as a way to increase opportunities for organ procurement. Despite claims to the contrary, both forms
of controlled and uncontrolled donation after cardiac death raise significant ethical and legal issues. Identified causes
for concern include absence of agreement on criteria for the declaration of death, nonexistence of universal guidelines for
duration before stopping resuscitation efforts and techniques, and assumption of presumed intent to donate for the purpose
of initiating temporary organ-preservation interventions when no expressed consent to donate is present. From a legal point
of view, not having scientifically valid criteria of cessation of circulation and respiration for declaring death could lead
to a conclusion that organ procurement itself is the proximate cause of death. Although the revised Uniform Anatomical Gift
Act of 2006 provides broad immunity to those involved in organ-procurement activities, courts have yet to provide an opinion
on whether persons can be held liable for injuries arising from the determination of death itself. Preserving organs in uncontrolled
donation after cardiac death requires the administration of life-support systems such as extracorporeal membrane oxygenation.
These life-support systems can lead to return of signs of life that, in turn, have to be deliberately suppressed by the administration
of pharmacological agents. Finally, allowing temporary organ-preservation interventions without expressed consent is inherently
a violation of the principle of respect for a person's autonomy. Proponents of organ donation from uncontrolled donation after
cardiac death, on the other hand, claim that these nonconsensual interventions enhance respect for autonomy by allowing people,
through surrogate decision making, to execute their right to donate organs. However, the lack of transparency and the absence
of protection of individual autonomy, for the sake of maximizing procurement opportunities, have placed the current organ-donation
system of opting-in in great jeopardy. Equally as important, current policies enabling and enhancing organ procurement practices,
pose challenges to the constitutional rights of individuals in a pluralistic society as these policies are founded on flawed
medical standards for declaring death. 相似文献
66.
Joseph L Verheijde Mohamed Y Rady Joan L McGregor 《Philosophy, ethics, and humanities in medicine : PEHM》2007,2(1):19
Advance health care directives and informed consent remain the cornerstones of patients' right to self-determination regarding
medical care and preferences at the end-of-life. However, the effectiveness and clinical applicability of advance health care
directives to decision-making on the use of life support systems at the end-of-life is questionable. The Uniform Anatomical
Gift Act (UAGA) has been revised in 2006 to permit the use of life support systems at or near death for the purpose of maximizing
procurement opportunities of organs medically suitable for transplantation. Some states have enacted the Revised UAGA (2006)
and a few of those have included amendments while attempting to preserve the uniformity of the revised Act. Other states have
introduced the Revised UAGA (2006) for legislation and remaining states are likely to follow soon. 相似文献
67.
Fréaadéric Slama MD Bénédicte Dehurtevent MD Jean‐Daniel Even MD Aimé Charles‐Nicolas MD Nicolas Ballon MD PhD Rémy Slama MD 《Suicide & life-threatening behavior》2008,38(6):720-727
Research on vulnerability factors among ethnic groups, independent of primary psychiatric diagnosis, may help to identify groups at risk of suicidal behavior. French African Caribbean general psychiatric patients (N = 362) were recruited consecutively and independently of the primary psychiatric diagnosis. Demographic and clinical characteristics and lifetime history of suicide attempts were recorded. Sixty‐five patients (18%) had a history of at least one suicide attempt. Presence of professional qualifications, children, poor social contacts, treatment with benzodiazepine at inclusion, and poor treatment compliance were all associated with a lifetime history of suicide attempts. 相似文献
68.
Cynthia A. Claassen PhD Thomas Carmody PhD Robert Bossarte PhD Madhukar H. Trivedi MD Stephen Elliott MD Glenn W. Currier MD MPH 《Suicide & life-threatening behavior》2008,38(6):637-649
Fatal and nonfatal intentional self‐harm events in eight U.S. states were compared using emergency department, hospital, and vital statistics data. Nonfatal event rates increased by an estimated 24.20% over 6 years. Case fatality ratios varied widely, but two northeastern states' total event rates (fatal plus nonfatal) were very high (New Hampshire 206.5/100,000 person years; Massachusetts 166.7/100,000). Geographic context did not uniformly impact the likelihood of self‐harm across event types. The state‐level public health burden posed by such acts cannot, therefore, be accurately estimated from either mortality or morbidity data alone. 相似文献
69.
Martin Voracek DSc DMSc PhD Lisa Mariella Loibl BSc Viren Swami PhD Mona Vintilǎ PhD Kairi Kõtlves PhD Dhachayani Sinniah MD Subash Kumar Pillai MD Subramaniam Ponnusamy MD Gernot Sonneck MD Adrian Furnham DLitt DSc PhD David Lester PhD 《Suicide & life-threatening behavior》2008,38(6):688-698
The genetics of suicide is increasingly recognized and relevant for mental health literacy, but actual beliefs may lag behind current knowledge. We examined such beliefs in student samples (total N = 686) from Estonia, Malaysia, Romania, the United Kingdom, and the United States with the Beliefs in the Inheritance of Risk Factors for Suicide Scale. Cultural effects were small, those of key demographics nil. Several facets of construct validity were demonstrated. Marked differences in perceived plausibility of evidence about the genetics of suicide according to research design, observed in all samples, may be of general interest for investigating lay theories of abnormal behavior and communicating behavioral and psychiatric genetic research findings. 相似文献
70.