临床决策与疾病发展的“度”

临床决策是十分复杂的专业劳动,良好而科学的临床决策取决于众多因素,包括医师的临床经验、知识水平、医师的爱心与责任心、患者病情的复杂性、医疗水平与条件、患者及家属的条件与配合程度等等,辩证法的“度”在临床的良好应用会帮助医师准确地把握病情,给予更加适度治疗;真正的个体化临床决策必须由医师与患者及家属的密切配合才能实现。     

护理观察在临床决策中的作用

在临床护理过程中,护士应充分利用护理工作的独特优势,从护理常规观察入手,使用望闻问切等观察手段,注重多向思维及病人的个性化特征,对病人实施全程观察,适时准确的观察患者细微的重要症状与体征变化,为及时正确的临床诊疗提供充分的、有效的信息,使护理观察能够在临床决策中发挥重要作用。     

外科医师临床培养中的矛盾与解决对策

外科医师临床培养中的矛盾,主要表现为师承的矛盾关系及实践的矛盾关系。在查房、病例讨论、外科手术操作等临床培养过程中,适当转换上级医师与其两者的角色地位,在层次提高过程中,采用请进来、送出去的开放式培养模式,有助于外科医师主动地实现认知知识向认知方法、知识向能力、学习基础知识向学习新知识新技术的多元综合转化。是矛盾解决、调动年轻医师学习主动性和积极性、引发其与上级医师互动学习的良好方法。     

理性看待微创外科

所谓“微创”,乃是传统外科发展的伸延和提升。微创不等于无创,微创需要科学的决策,同时微创要运用循证医学。微创具有广阔的前景,但它的治疗之路依然很长。它需要进一步的完善。目前,还不是丰收的季节。     

'The healing power of love': The literary/analytic bond of marriage in Freud's essay on Gradiva

Freud 's declared position regarding the management of 'transference love' advocated 'abstinence', objectivity and even 'emotional coldness in the analyst'. However, his essay on Jensen's Gradiva reveals an identification with an involved and responsive 'maternal' analytic position associated with theorists such as Ferenczi, Balint and Winnicott. These theorists attribute the origins of transference love to the pre-oedipal stage, shaping their analytic model on the basis of the early relationship with the mother. Freud generally had difficulty identifying with such a position, since it entailed addressing his own inner feminine aspects. Yet a literary analysis of his 'Gradiva' reveals this stance in his textual performance, i.e. in the ways in which he reads and retells Jensen's story. Freud 's narration not only expresses identification with Zoe, the female protagonist, but also idealizes her 'therapeutic' conduct, which is closer in spirit to that of object-relations theorists. His subtext even implies, however unintended, that an ideal treatment of transference love culminates in a psychical 'marriage' bond between the analytic couple, a metaphor used by Winnicott to describe the essence of the mother–baby (analyst/patient) bond. Freud 's reading process is itself analogous to Zoe's 'therapeutic' conduct, in that both perform a creative and involved interaction with the text/patient.     

ANALYSIS OF THE EFFECTS OF TASK PREFERENCES,TASK DEMANDS,AND ADULT ATTENTION ON CHILD BEHAVIOR IN OUTPATIENT AND CLASSROOM SETTINGS

Two studies were conducted with children who displayed behavior problems to evaluate the effects of task preference, task demands, and adult attention on child behavior. In Study 1, we conducted brief functional analyses in an outpatient clinic to identify variables that facilitated appropriate behavior. For 8 of 10 children, distinct patterns of performance occurred; 3 children displayed improved behavior with changes in task demands, 1 child displayed improved behavior with a preferred task, and 4 children displayed improved behavior with changes in adult attention. In most cases, the children's parents carried out the assessments with adequate procedural integrity. In Study 2, we applied similar assessment methods to a classroom setting over an extended period of time. We identified independent variables controlling appropriate, on-task, and academic behavior for 2 children on two tasks, with slightly different treatment procedures across tasks for both children. In addition, the results of brief functional analyses for both children corresponded to the extended classroom assessments.     

分子生物学视野下结构和功能的关系与临床疾病

分子生物学作为一门新兴学科,代表了生命科学研究领域的前沿,新理论、新技术、新成果层出不穷。生物大分子结构与功能关系的研究对分子生物学的发展起着极其重要的推动作用,是分子生物学科研和教学的主题,也为探索疾病的本质和规律提供了新思路。     

基于社会角色视角的村卫生室发展探讨

村卫生室是三级卫生服务体系的网底,是农民健康的“保护伞”和农村社会的“稳定器”。村卫生室在发展过程中遭遇制度和资源瓶颈,运用社会角色理论分析各个利益主体与村卫生室之间的互动关系,研究村卫生室的角色距离和角色期望的表现形式,识别村卫生室的新角色期望内涵,并据此探讨村卫生室新角色实践途径。通过分析得出农村卫生服务系统的角色结构和村卫生室在其中扮演的角色丛,村卫生室要扮演好自己的社会角色,必须同时考虑“公共产品”和“私人产品”特征,以“公共产品”为自己的主要角色,“私人产品”为次要角色。     

阿司匹林的临床应用与哲学思考

阿司匹林是最早应用的合成药物之一,随着对其研究的不继进展,其应用范围不断扩大.阿司匹林的发展应用历史带给我们许多哲学思考.