Mini—CEX在临床教与学双向评估中的应用及意义——以临床八年制呼吸科床旁教学为例

临床医学八年制内科学床旁教学在高标准的要求下需要不断改进和提高,将Min-CEX评估应用于带教教师和学生的双向评估中。教师对学生进行分项评估的同时,学生也对所有带教教师进行教学评估,评分后在小组内讨论点评交流反馈。通过Mini—CEX的应用,增加了学生在床旁教学中的实践机会,加强了相互学习,并提高了学生在床旁教学中的学习整体观;在评教中Mini—CEX的应用改善了床旁教学课程的设置,强调了言传身教在医学教学中的应用。Mini—CEX的双向评估不但取得了较好的教学效果,还真正达到了教学相长。     

晚期乳腺癌局部病灶的外科处理探讨

晚期乳腺癌局部病灶的外科治疗目前仍存在较多争议。本文对近年来晚期乳腺癌外科研究进展、常用的手术技术方法,治疗中应注意的几个问题进行探讨。对于晚期乳腺癌应遵循个体化治疗原则,权衡手术风险与生存获益,而不应该简单笼统选择或放弃局部外科治疗。     

Humour styles,gelotophobia and self‐esteem among Chinese and Indian university students

This study examined the relationship between humour styles, gelotophobia and self‐esteem among 102 Indian and 101 Hong Kong university students. The Humour Styles Questionnaire, the GELOPH‐15 Scale and the Rosenberg Self‐Esteem Scale were used. Indian students rated the importance of humour significantly higher than Hong Kong Chinese students and considered themselves as being significantly more humorous as well. Both Indian and Hong Kong Chinese students engaged in significantly more affiliative and self‐enhancing humour. Indian students engaged in significantly more affiliative and self‐enhancing humour and reported less gelotophobia than Hong Kong students. Gelotophobia was negatively correlated with self‐esteem and affiliative humour in both samples and was positively correlated with self‐defeating humour in the Indian sample only. Affiliate humour mediated the relationship between self‐esteem and gelotophobia in both samples whereas self‐defeating humour mediated the relationship in the Indian sample only. Taken together, both Indian students and Hong Kong students valued adaptive humour, but Indian students valued humour more than Hong Kong students. This study is a pioneering study of its kind conducted in a Chinese‐Indian sample.     

Congestive Heart Failure and Quality of Life

Our study aimed to assess the quality of life (QoL) of patients with congestive heart failure (CHF) and to correlate the different aspects of QoL with relevant socio-demographic variables, CHF severity, somatic comorbidities, other clinical variables and depressive symptomatology. In a cross-sectional study design, a community sample of 103 adult patients with CHF (mean age 68 years, 73 % male) was recruited from an outpatient cardiology practice. CHF severity was assessed with physician ratings of the New York Heart Association (NYHA) functional class and measurement of brain natriuretic peptide (BNP) levels. The psychometric evaluation of quality of life was made using the Medical Outcomes Study Short Form-36 (SF-36) and the Kansas City Cardiomyopathy Questionnaire (KCCQ). The Beck Depression Inventory Second Edition (BDI-II) assessed depressive symptoms. Using multiple linear regression, predictors of poorer QoL included being a female, being older, living alone, NYHA functional class ≥ II, higher levels of BNP comorbidity (such as renal insufficiency and cerebrovascular disease), fluid retention, depressive symptomatology (assessed by BDI-II) and treatment with anti-dyslipidemics, diuretics and β-blockers. Among these correlates, psychological distress was the most strongly related to QoL. Also, functional status measured by NYHA demonstrated a high impact on QoL. Our findings suggest the need to address such factors in developing effective care to improve psychological and functional status in order to enhance QoL in these patients.     

Dimensionality of the Children’s Depression Inventory: Meta-analysis of Pattern Matrices

This meta-analysis of 24 studies, comprising 35 independent samples with 18,099 participants, examined the factor structure of the Children’s Depression Inventory (CDI). The 5-factor solution involving Somatic Concerns, Externalizing, Negative Self-Concept, Lack of Personal and Social Interest, and Dysphoric Mood was supported for all samples. The 5-factor solution was appropriate for child, adolescent, general, at-risk/clinical, and English-speaking samples, whereas the 4-factor solution was the best for samples using non-English versions of the CDI. As the factor structure varied among study subgroups, the strength of relations between scale items and their underlying depressive symptoms varied. Hence, comparisons of mean CDI scores can be misleading.     

Adolescent Neural Responses to Antismoking Messages,Perceived Effectiveness,and Sharing Intention

ABSTRACT

Health communication delivered via media channels can substantially influence adolescents’ choices, and the effects of messages are amplified through interpersonal sharing. However, the underlying psychological and neurocognitive mechanisms that influence message effectiveness and likelihood of sharing are not well understood, especially among adolescents. Based on research in adults, we hypothesized and preregistered that message-induced neural activation in regions associated with self-reflection, social processing, and positive valuation would be related to greater perceived ad effectiveness and intentions to share messages. We focused on brain activity in meta-analytically defined regions associated with these three processes as 40 adolescent nonsmokers viewed advertisements from “The Real Cost” antismoking campaign. Perceived message effectiveness was positively associated with brain activity in the hypothesized social processing regions and marginally associated with brain activity in self-relevance regions, but not associated with brain activity in valuation regions. By contrast, intentions to share the messages were not associated with neural response in these 3 systems. In contrast to previous neuroimaging studies with adult subjects, our findings highlight the role of social cognition in adolescent processing of persuasive messages. We discuss the possibility that the mental processes responsive to effective and shareworthy messages may reflect developmental processes pertinent to media effects.     

医学院校专业设置趋同性的结构剖析

我国医学院校专业设置存在着趋同性现象,主要表现为专业涉及的学科门类趋同,各学校之间专业设置趋同和各学校新增专业趋同,原因主要在于学校被动扩招、缺乏专业设置自主权、追逐经济利益的办学思想以及学校之间的相互模仿.今后医学院校要加强专业建设,形成特色专业,培育独特优势.     

The Profession of Family Therapy in South Korea: Current Status and Future Directions

The authors present a brief overview of the family therapy field in South Korea. Since its introduction in the late 1970s, family therapy has been developing into a professional field with education and training institutions, practice settings, credentials, and practitioners holding memberships in various professional organizations. While such issues as family values and types, filial piety, violence, interethnic marriage, and social polarization have resulted in an increased demand for family therapy, such services are not readily accessible to Korean families in need. Efforts should be made in increasing number of competent family therapists by strengthening both academic and clinical requirements for credentialing. Efforts are also needed in increasing accessibility of family therapy services by making them more available within a variety of human service contexts.     

医学书面语体的特征研究

以病历、医嘱、处方、检验报告、诊断学等教科书中书面语言为基础,对医学书面语体的内部结构和外部要素进行分析,认为医学书面语体作为一个相对新型的语体,在语词、句法、辞格和篇章等方面有显著的特征。还深入研究了这些特征与相关联的语言外部要素间联系。