晚期癌症患者宁养疗护与伦理

晚期癌症患者宁养疗护强调人的生活质量与生命价值,其在实践中得到了长足的发展,正成为姑息医学中的重要部分。随着医学向生物心理社会医学模式转变和姑息医学快速发展,宁养疗护伦理问题日益凸显。宁养疗护伦理在医疗方面强调适度治疗与合理用药,护理方面强调患者生理、心理、灵性、社会和宗教等层面的整体性照顾。梳理宁养疗护伦理有利于在宁养疗护服务中做出最优伦理选择,这种选择需遵循不伤害原则,注重生命质量原则、适度治疗和舒适生存原则、尊重患者意愿原则以及公平正义的原则。     

志愿者在晚期肿瘤适度治疗中的重要作用

对于晚期肿瘤患者,舒缓治疗和宁养服务是WHO推荐的适度治疗,更是一种“积极治疗”,特别体现在提供社会、心理、灵性关怀及支持系统,帮助患者尽可能以积极的态度活着,直到死亡。本文探讨了志愿者在晚期肿瘤适度治疗中的重要角色,发挥作用的机制,并提出对我国舒缓治疗和宁养志愿服务发展的思考与建议。     

晚期癌症患者家属的病情告知态度探究

本文采用自行设计的调查问卷,对200例晚期癌症患者家属进行问卷调查,以探讨晚期癌症患者家属对病情告知的态度。结果显示,认为病情应绝对保密者55例（27．5％）;暂时保密者107例（53．5%）;而不保密者38例（19．0％）。晚期癌症患者家属普遍采取“慈悲原则”,对患者病情持保密态度;癌症患者家属普遍缺乏病情告知策略。临床医生在执行知情同意时应该依据患者不同的家庭情况,有针对性地进行告知。     

晚期乳腺癌如何选择内外科治疗

晚期乳腺癌包括局部病变较晚、无法直接手术的患者和初诊时已有远地转移M1及手术后的复发转移患者。目前,我们国家对于这些患者的处理非常混乱,往往初始治疗与首次接诊医生的专业范围大有相关。孤立病灶的晚期乳腺癌患者,全身播散背景已成定势,全身药物治疗才是最重要的治疗手段。对于已经全身转移的晚期乳腺癌患者来讲,是否加用局部病灶切除,需根据患者的全身情况而定。任何一种治疗的选择及安排都应按照药品临床试验管理规范（GCP）原则进行,以期最大限度改善生活质量及生存时间。     

Threats and Challenges to Feminist Therapy

No abstract available for this article.     

‘I quit’ versus ‘I’m sorry I used’: A preliminary investigation of variations in narrative ending and transportation

A narrative experience can partly depend on how a narrative ends or concludes. This study examined prevention effects of personal drug use narratives varying by type of ending and gender of protagonist. Additionally, the role of transportation in the persuasion process, particularly the association between transportation and cocaine use intentions, both directly and indirectly, through the mediation of anti-drug and pro-drug expectancies was assessed. A total of 500 undergraduate students at a large northern university in the UK participated in the experiment which was a 2?×?2?×?2 mixed design with ending (progressive vs. regressive) and gender of protagonist (male vs. female) as within-participants factors and participant gender (male vs. female) as between-participants factors. The results demonstrated significant main effects for ending, gender of protagonist in the narrative and participant gender, but no interaction effects. Finally, greater transportation was associated with stronger anti-cocaine expectancies, which were further associated with lower cocaine use intentions. Important theoretical and empirical implications are discussed.     

The ‘Matchbox School’ (1927–1932): Anna Freud and the idea of a ‘psychoanalytically informed education’∗

Of all the applications of psychoanalysis to various fields, perhaps none has been as important – or as fraught – as the application of psychoanalytic insights to education. This paper re-constructs some of the early debates around psychoanalysis and pedagogy that Anna Freud engaged with during the 1920s in Vienna, when the whole question of what education should be became a central issue for politicians, pedagogues and psychoanalysts alike. The paper focuses on the period leading up to the creation of the so-called ‘Matchbox School’, operating under Anna Freud's guidance between 1927 and 1932, and describes the influence of pioneers such as Seigfried Bernfeld and August Aichhorn. Compared to her more well-known work at the Hampstead War Nurseries during the Second World War, Anna Freud's involvement with this earlier educational experiment is relatively neglected. Yet one can argue that this short-lived project not only laid the foundation for much of Anna Freud's later work; it also had some far-reaching consequences, both for psychoanalysis and for the practice of progressive education.     

高强度聚焦超声配合FOLFOX4方案治疗晚期肝癌的临床观察

观察高强度聚焦超声(HIFU)配合FOLFOX4方案治疗晚期肝癌的疗效和不良反应。将58例晚期肝癌患者随机分成两组:热疗+化疗组(热化组)采用HIFU配合FOLFOX4方案,对照组为单纯FOLFOX4(单化组)治疗。结果显示热化组CR0例,PR18例,SD7例,PD2例,总有效率64.28%;单化组CR0例,PR11例,SD11例,PD7例,总有效率36.67%,两组差异均有统计学意义(P0.05)。HIFU配合FOLFOX4方案,治疗晚期肝癌近期疗效尚可,毒副反应较轻,值得临床推广试用。     

中医学习西医:权宜之计还是成功之路——以北京医学院中医进修班为例

1952年中央卫生部在北京医学院（现北京大学医学部）创办了一个5年制的“中学西”培训班,以期提升中医的科学素养,培养中医现代化人才。通过追述“中学西”班的开办始末及该班学员在中医现代化中的作用,探讨了“中学西”的教育模式在中医现代化教育中的作用与意义,希望对于中西医结合途径以及中医教育模式的探索提供可借鉴的经验。     

Preference for reinforcers under progressive- and fixed-ratio schedules: a comparison of single and concurrent arrangements

Progressive-ratio (PR) schedules were used to identify the break point (i.e., the last schedule value completed) for 2 reinforcers under single and concurrent schedules. After the respective break points were established, the same reinforcers were presented under concurrent fixed-ratio (FR) schedules that were yoked to the break points obtained with the PR schedules. Results suggested that the participants responded more for the high-preference item than for the low-preference item, regardless of the presentation arrangement (single or concurrent presentations). This pattern of responding was maintained when the reinforcers were presented under dissimilar FR schedules. The results suggest that responding for differentially preferred stimuli may vary as a function of differences in schedule requirements.