Concurrent Validity of the Child Behavior Checklist DSM-Oriented Scales: Correspondence with DSM Diagnoses and Comparison to Syndrome Scales

This study used receiver operating characteristic (ROC) methodology and discriminative analyses to examine the correspondence of the Child Behavior Checklist (CBCL) rationally-derived DSM-oriented scales and empirically-derived syndrome scales with clinical diagnoses in a clinic-referred sample of children and adolescents (N = 476). Although results demonstrated that the CBCL Anxiety, Affective, Attention Deficit/Hyperactivity, Oppositional and Conduct Problems DSM-oriented scales corresponded significantly with related clinical diagnoses derived from parent-based structured interviews, these DSM-oriented scales did not evidence significantly greater correspondence with clinical diagnoses than the syndrome scales in all cases but one. The DSM-oriented Anxiety Problems scale was the only scale that evidenced significantly greater correspondence with diagnoses above its syndrome scale counterpart —the Anxious/Depressed scale. The recently developed and rationally-derived DSM-oriented scales thus generally do not add incremental clinical utility above that already afforded by the syndrome scales with respect to corresponding with diagnoses. Implications of these findings are discussed.     

转变理念规范治疗

学科带头人的理念、意识、能力对于学科的发展及功能的实现起着关键的作用,关系到学科的未来发展.本期"临床决策研究"栏目中,孙文兵等撰写的"论当代临床学科带头人的领导素质"深入分析了学科带头人提升领导能力必需的十个转变,指出学科带头人在服务理念上,要由经营思维向职业思维转变,树立"救人为本,经营为道"的发展理念,一切以患者的最大利益为着眼点,为患者提供有效、安全、便捷的医疗服务.     

论卫生改革的改革

首先讨论我国卫生改革的评价问题,指出对改革的评价表面上似乎是个事实判断,但实际上是个价值判断,并列举数据说明改革引起的不公正后果。其次指出我国的卫生改革一开始就缺乏伦理基准,并详细论述了应该具有的伦理基准是什么。最后讨论了市场在医疗卫生事业的作用,以及对卫生改革的改革建议。     

成人严重感染与感染性休克血流动力学监测与支持指南(草案)

严重感染(severe sepsis)及其相关的感染性休克(septic shock)和多脏器功能障碍综合征(multiple organ dysfunction syndrome MODS)是当前重症加强治疗病房(ICU)内主要的死亡原因,也是当代重症医学面临的主要焦点及难点[1-2].在美国,每年有75万的严重感染病例发生,超过了充血性心力衰竭或乳腺癌、结肠癌和艾滋病的患病数总和,病死率大概在20%～63%,和急性心肌梗死的院外病死率相近.     

国家卫生财政政策补助对象的顺序选择

论述了国家卫生财政政策补助对象的选择问题,公共卫生服务物品提供机构与医疗服务物品提供机构之间的选择、医疗机构与患者之间的选择、公共卫生服务物品提供机构与居民之间的选择以及医疗机构与医生之间的选择,提出了卫生财政政策补助对象的选择顺序,公共卫生服务物品生产和分配机构,医疗保障机构,患者,医生,医疗机构。     

Preventing Serious Conduct Problems in School-Age Youth: The Fast Track Program

Children with early-starting conduct problems have a very poor prognosis and exact a high cost to society. The Fast Track project is a multisite, collaborative research project investigating the efficacy of a comprehensive, long-term, multicomponent intervention designed to prevent the development of serious conduct problems in high-risk children. In this article, we (a) provide an overview of the developmental model that serves as the conceptual foundation for the Fast Track intervention and describe its integration into the intervention model; (b) outline the research design and intervention model, with an emphasis on the elementary school phase of the intervention; and (c) summarize findings to date concerning intervention outcomes. We then provide a case illustration, and conclude with a discussion of guidelines for practitioners who work with children with conduct problems.     

Time of day affects episodic memory in older adults

The neuropsychological test scores of 2030 cognitively normal older adults were examined to evaluate performance patterns as they related to time of day (TOD) at which testing was initiated. Multiple regression analyses were used to examine the association of TOD with scores on seven neuropsychological tests used in the clinical evaluation of dementia. Episodic memory performance was significantly related to TOD, while memory span and verbal fluency were not. Best performance occurred during early morning hours and late afternoon; worst performance occurred mid-day (i.e., noon). These findings may have implications for clinical assessment, the design of research on dementia, and the daily functioning of older adults.     

遗传学认识的特征、争论及其社会控制

20世纪遗传学取得的重大成就并不能掩盖它与人类社会的伦理、宗教、法律之间的不和谐.如何更加正确和高效地进行遗传学的研究和技术应用已经成为各国自然科学家和社会科学家共同关心的问题.概括了遗传学认识的特征,分析了现代遗传学理论同各种传统认识之间存在的争论,并结合当今在遗传学理论研究和技术运用中出现的社会问题提出社会控制的措施.     

脑死亡立法的伦理辩护

"脑死亡"立法是必要的并可以得到充分的伦理辩护:尊重人,特别是尊重人的自主性是"脑死亡"立法的伦理基础."脑死亡"立法符合有利和公平的伦理原则,符合功利主义伦理学追求社会利益最大化的目的.但我们在立法时,应尽量贯彻不伤害原则,注意保护患者及其亲属的利益.