医疗保险费用控制的临床路径研究--胰腺炎医疗保险费用结算标准的确定

临床路径是现代医院管理的前沿技术之一,对于提高医疗服务质量和降低医疗费用具有现实意义.通过对急性胰腺炎病人的临床路径研究,探讨了我国临床实践中临床路径的实施方法,并在此基础上进一步研究了该疾病医疗保险费用结算标准的分类标准.     

循证医学与临床诊断学教育改革

探讨在临床诊断学教育中,导入循证医学的理念和方法,改变传统的经验医学教育模式,实现教学相长。以期提高医学生的理论知识水平和临床技能,提高临床实践能力,培养具有临床循证思维和创新思维的新一代医学人才。     

对癫痫的认识及其外科治疗

人们对癫痫的认识及其外科治疗的发展是一个漫长而复杂的过程,经历高潮、低谷的更迭。科技进步使人们对癫痫正确认识,也使治疗手段更趋于多样化、个性化。     

Longitudinal scalogram analysis: A methodology and microcomputer program for Guttman scale analysis of longitudinal data

Guttman scalogram analysis has been limited to cross-sectional analysis. Longitudinal scalogram analysis (LSA), a direct extension of cross-sectional scalogram analysis to longitudinal-data, is proposed as an alternative methodology. The benefits of LSA relative to cross-sectional methods of analysis are discussed.     

Gender roles and adjustment in elementary-school children: A multidimensional approach

The present study of fourth through sixth graders examined the relationships between their school adjustment and the extent to which their self-concepts conformed to stereotypic gender roles. Several dimensions of gender roles were assessed. Adjustments was assessed by teacher ratings of externalizing and of internalizing symptoms. Among boys, more stereotypic self-concepts were associated with high levels of externalizing symptoms. Among girls, stereotypy was associated with high levels of internalizing. Discussion emphasized the practical importance of these relationships between gender-role stereotypy and poor adjustment, since externalizing and internalizing symptoms constitute the most frequent reasons for clinical referral among boys and among girls, respectively. Further findings, however, indicated that conclusions about the unfavorable adjustment correlates of stereotypy should not be extended to the less gender-typical symptoms (i.e., neither to boys' internalizing nor to girls' externalizing symptoms). Implications of the findings were also discussed with regard to earlier results obtained with adults that suggest mental health advantages associated with higher levels of masculinity. It was suggested that the contradiction between adult and child results partially reflects an emphasis upon externalizing symptoms with children, while studies employing adults have emphasized internalizing ones.The authors acknowledge the assistance of the Jefferson County School District, and especially Ms. Diane Hill, Director of Research, for their assistance in this study. The following persons are thanked for their assistance in interviewing children and collecting data: Heidi Hauge, Carol Hathaway-Clark, Judith King, and Ed Priddy. The authors also wish to thank Drs. Ann Boggiano and William Hodges for commenting on earlier drafts of this paper.     

THE EFFECT OF A TOKEN ECONOMY ON DIETARY COMPLIANCE FOR CHILDREN ON HEMODIALYSIS

Adherence to dietary restrictions is a recurring problem for children on hemodialysis. The effect of behavior modification in maintaining dietary control is reported for four patients aged 11 to 18 years. Weight gain, potassium level, and blood urea nitrogen were utilized as criteria measures. A token reinforcement program implemented by the hemodialysis team resulted in significant changes in the dietary pattern of the children. The average weight gain between dialysis sessions for the four subjects during treatment was reduced by 45% and the degree of weight fluctuation was lessened. Potassium levels and BUN were controlled to their appropriate level for subjects who initially exceeded the criterion level. With the withdrawal of weight gain from the contingency system, increase of weight gain between dialysis sessions was noted for all subjects.     

A critical analysis of social development programs in elementary education

Four social development programs in elementary education are examined. The four programs are (1) A “Causal” Approach to Human Behavior, developed by Ralph Ojemann; (2) the Human Development Program, developed by Harold Bessell and Uvaldo Palomares; (3) Reality Therapy: Schools without Failure, developed by William Glasser; and (4) Developing Understanding of Self and Others, developed by Don Dinkmeyer. Published literature and research studies provided the information sources for the article. The major criticisms of each of the programs can be summarized into four major points: none of the programs (1) has a clearly articulated developmental rationale, (2) focuses heavily on a concern for others, (3) has ongoing programmatic research, and (4) has a rationale for its implementation strategy.     

代谢综合征发病机制研究进展

随着经济的发展和人们生活水平的提高以及生活方式的改变,代谢综合征（metabolic syndrome,MS）的患病率逐年上升。代谢综合征是一种涉及多种代谢异常、与心血管病紧密联系的疾病状态。肥胖或超重、糖调节异常或糖尿病、高血压和高血脂是MS的重要组成元素。代谢综合征一直是人们关注的热点,但截止目前确切机制仍不明确。主要围绕肥胖与胰岛素抵抗展开研究,特别是在脂毒性和脂肪分泌因子的调控以及各种炎性因子的影响方面取得了一些进展。     

《人体器官移植条例》颁布后面临的问题与对策

《人体器官移植条例》规范引导着我国器官移植健康发展,然而,随着《条例》对器官移植供、受者条件的严格限制,尸体供器官数量迅速下降,亲属活体移植逐步占据主导地位,由此引发一系列问题。结合《条例》,就器官来源短缺、保障活体供者安全、亲属活体供者选择和器官移植伦理委员会作用等问题做出较详细的分析,提出解决方法和对策。