心理咨询和治疗的知情同意原则及其影响因素

随着心理咨询和治疗的发展,患者的知情同意成为临床心理学实践的一个基本伦理观念和原则.首先提出心理咨询和治疗实践中的知情同意问题,介绍心理咨询和治疗知情同意的要素、过程、内容、意义和影响因素,并附心理咨询和治疗提供给患者的知情同意问卷,旨在引起从业者的注意和重视,并在临床实践中自觉地遵守.     

论我国刑法妨害传染病防治罪的完善

认为妨害传染病防治罪的可罚范围有待拓宽,应将一些乙类传染病和其他突发性强、致死率高的传染病纳入本罪规制的范围;行为方式有待明确,运用刑法典与附属刑法相配合的立法模式是一种较为理想的做法;刑罚设置上有待进一步完善,增加罚金刑的适用,对后果特别严重的情形可以结果加重犯来处理。     

Preattentive processing of heart cues and the perception of heart symptoms in congenital heart disease

The present study was aimed at clarifying whether preattentive processing of heart cues results in biased perception of heart sensations in patients with congenital heart disease (ConHD) who are also highly trait anxious. Twenty-six patients with ConHD and 22 healthy participants categorized heart-related (heart rate) or neutral sensations (constant vibration) as either heart or neutral. Both sensations were evoked using a bass speaker that was attached on the chest of the participant. Before each physical sensation, a subliminal heart-related or neutral prime was presented. Biased perception of heart-sensations would become evident by a delayed categorization of the heart-related sensations. In line with the prediction, a combination of high trait anxiety and ConHD resulted in slower responses after a heart-related sensation that was preceded by a subliminal heart cue. Preattentive processing of harmless heart cues may easily elicit overperception of heart symptoms in highly trait anxious patients with ConHD.     

重型肝炎治疗方案的理性选择

针对我国重型肝炎治疗现状,对重型肝炎常用的以及部分有争议的治疗药物和方法进行分析和讨论,就如何选择治疗方案提出医疗原则,认为应采取内科治疗-人工肝-肝移植的综合治疗模式,结合患者的治疗愿望及经济承受力,理性地选择治疗方案,以期达到合理、有效和经济的目的.     

The original risk: overtheologizing ethics and undertheologizing sin.

The project of articulating a theological ethics on the basis of liturgical anthropology is bound to fail if the necessary consequence is that one has to quit the forum of critical modern rationality. The risk of Engelhardt's approach is to limit rationality to a narrow vision of reason. Sin is not to be understood as the negation of human holiness, but as the negation of divine holiness. The only way to renew theological ethics is to understand sin as the anthropological and ethical expression of the biblical message of the justification by faith only. Sin is therefore a secondary category, which can only by interpreted in light of the positive manifestation of liberation, justification, and grace. The central issue of Christian ethics is not ritual purity or morality, but experience, confession and recognition of our own injustice in our dealing with God and men.     

An experimental approach to detecting dementia in Down syndrome: a paradigm for Alzheimer's disease

Measures developed from animal models of aging may detect dementia of the Alzheimer's type in a population at-risk for Alzheimer's disease (AD). Although, by middle age, individuals with Down syndrome (DS) show an extraordinarily high prevalence of AD-type pathology, their severe idiopathic cognitive deficits tend to confound the clinical diagnosis of AD. The current study was designed to improve detection of AD in DS by using measures of learning and memory derived from animal models of aging. Adults with DS (N=34) were assessed and reassessed (n=19) approximately one year later using stimulus-response (S-R) test methods derived from experimental literature, as well as standardized informant-based tests. Results demonstrated high validity and reliability of select tests. The implication of early symptom detection in a population at-risk for AD-type dementia was discussed in terms of potential brain regions of interest.     

Variability in subcortical aphasia is due to variable sites of cortical hypoperfusion

A variety of fluent and nonfluent aphasias have been reported after left basal ganglia stroke. It has been speculated that this heterogeneity may reflect variations in cortical hypoperfusion resulting from large vessel stenosis. To test this hypothesis, a consecutive series of 24 patients with left caudate infarct identified with diffusion-weighted imaging underwent language testing and perfusion-weighted imaging < 24h from onset of symptoms. Specific regions in perisylvian cortex were rated for the percentage of the region that was hypoperfused. Aphasia type was determined on the basis of speech fluency, comprehension, and repetition performance on the language tests. Association between aphasia type/language impairment and regions of hypoperfusion were identified with Fisher's exact tests. Results demonstrated that in patients with acute left caudate infarct, the presence and type of aphasia reflected regions of hypoperfusion, and generally followed predictions based on chronic lesion studies, regarding anatomical lesions associated with classic aphasia types.     

An experimentally confirmed statistical model on arm movement

The purpose of this research work was to develop a methodology to model arm movement in normal subjects and neurologically impaired individuals through the application of a statistical modelling method. Thirteen subjects with Parkinson's disease and 29 normal controls were recruited to participate in an arm motor task. An infrared optoelectronic kinematic movement analysis system was employed to record arm movement at 50 times per second. This study identified the modified extended Freundlich model as one that could be used to describe this task. Results showed that this model fit the data well and that it has a good correspondence between the observed and the predicted data. However, verification of the model showed that the residuals contained a sizeable autocorrelation factor. The Cochrane and Orcutt method was applied to remove this factor, which improved the fit of the model. Results showed that Parkinson's disease subjects had a higher autocorrelation coefficient than the normal subjects for this task. A positive correlation (r(s) = 0.72, p < 0.001) was found between the Langton-Hewer stage and the autocorrelation coefficient of PD subjects. This finding suggests that if autocorrelation is positively correlated with disease progression, clinicians in their clinical practice might use the autocorrelation value as a useful indicator to quantify the progression of a subjects' disease. Significant differences in model parameters were seen between normal and Parkinson's disease subjects. The use of such a model to represent and quantify movement patterns provides an important base for future study.     

The relationship between executive function and verbal memory in Parkinson's disease

A growing body of evidence suggests that the various cognitive symptoms found in Parkinson's disease (PD) are secondary to executive dysfunction. Studies addressing this possibility for memory impairment specifically have not included measures of working memory nor have they ruled-out potential mediating variables such as overall level of cognitive impairment or depression. The purpose of this study was to include measures of these variables in determining the relationship between multiple aspects of executive function and delayed verbal recall in 32 idiopathic PD patients. Results were consistent with the original hypothesis and further suggest that working memory is a key factor in recall memory and may mediate the relationship between other executive measures and recall in PD.     

A Meta-Analysis of Structural and Functional Brain Imaging in Dementia of the Alzheimer's Type: A Neuroimaging Profile

We conducted a quantitative review of the imaging literature using meta-analytic methodology to characterize further the magnitude of hippocampal deficit in probable Alzheimer's disease (AD) and to determine whether other neuroanatomic structures in AD can better discriminate the disease from normal aging. Additionally, we parceled the discriminability of neuroanatomic structures by duration of disease to determine those structures most sensitive to AD in its early and late stages. One hundred twenty-one studies published between 1984 and 2000 met criteria for inclusion in the present analysis. In total, structural (i.e., CT and MRI) and functional (i.e., SPECT and PET) neuroimaging results from 3511 patients with AD, and 1632 normal healthy controls were recorded across meta-analyses. Our results include neuroimaging profiles for both early onset and longer duration patients with AD. In sum, these profiles yield a signature of diagnostic markers in both cortical and subcortical neuroanatomic areas. This signature is consistent with the clinical phenomenology of Alzheimer's dementia and should aid in the positive identification of AD.