关于重大医疗纠纷行政干预认识的调查分析

为了解医患双方对重大医疗纠纷的基本认识,对上海市徐汇区35家医疗机构医患双方进行问卷调查.就医患双方对重大医疗纠纷的产生原因、救济途径、行政干预作用等方面的认知情况展开分析,从而得出为了有效解决重大医疗纠纷,需发挥行政干预作用、健全纠纷解决机制以及正确引导舆论导向的结论.     

医学教育发展的困局与突破

受“大跃进”思维模式影响,我国高等教育由精英化快速过渡到大众化,医学教育呈现出急剧膨胀的发展态势,在教育理念、培养体系、办学模式、学制结构、专业设置、教育质量等方面出现了许多新情况、新问题,陷入了发展困局.面对困局必须更新教育观念,加强统筹协调,推动医学教育科学发展.     

Shaping Medical Students' Attitudes Toward Ethically Important Aspects of Clinical Research: Results of a Randomized,Controlled Educational Intervention

The effects of research ethics training on medical students' attitudes about clinical research are examined. A preliminary randomized controlled trial evaluated 2 didactic approaches to ethics training compared to a no-intervention control. The participant-oriented intervention emphasized subjective experiences of research participants (empathy focused). The criteria-oriented intervention emphasized specific ethical criteria for analyzing protocols (analytic focused). Compared to controls, those in the participant-oriented intervention group exhibited greater attunement to research participants' attitudes related to altruism, trust, quality of relationships with researchers, desire for information, hopes about participation and possible therapeutic misconception, importance of consent forms, and deciding quickly about participation. The participant-oriented group also agreed more strongly that seriously ill people are capable of making their own research participation decisions. The criteria-oriented intervention did not affect learners' attitudes about clinical research, ethical duties of investigators, or research participants' decision making. An empathy-focused approach affected medical students' attunement to research volunteer perspectives, preferences, and attributes, but an analytically oriented approach had no influence. These findings underscore the need to further examine the differential effects of empathy-versus analytic-focused approaches to the teaching of ethics.     

Profiles of Chronic Illness Knowledge in a Community Sample of American Adults

The author identified profiles of chronic illness knowledge (i.e., heart disease, cancer, diabetes) in a community sample of American adults and examined the effect of sociodemographic influences on relations of illness knowledge to health practices and well-being. Participants were 181 women and 120 men who completed measures of illness knowledge, sociodemographics, personal health practices (e.g., diet, exercise, substance abuse, adaptive healthcare use), well-being (e.g., self-rated physical health, depression, social support), and perceived illness risk. Two-step cluster analyses performed on random subsets of the sample identified three levels of illness knowledge: low, medium, and high. Knowledge groups were differentiated on most measures of health practices, well-being and perceived illness risk. However, effects were substantially attenuated after controlling for differences in age and SES. Findings indicate that age and other sociodemographic factors are related not only to levels of illness knowledge but also to the application of knowledge in relation to health practices and well-being.     

OCCUPATIONAL AND INDUSTRIAL THERAPY

No abstract available for this article.     

Voices from the Street: How Structural and Individual Factors Influence Homelessness

This study compared structural and individual factors related to persons who are homeless and how these factors affected their ability to utilize and benefit from available services. A qualitative case study design was used to conduct in-depth interviews with two participants receiving hospice care in a residence for the homeless. Results support previous findings that chronic homelessness is the result of multiple structural and individual factors that occur over time. Contrary to the literature on chronic homelessness, however, both participants were unique in their history of employment and strong desire to work, despite having limited work skills. Responses from both participants underscored the value of daily structure and meaningful occupation in residential addiction treatment.     

Review of "The Cultural Context of Sexual Pleasure and Problems: Psychotherapy With Diverse Clients," edited by Kathryn S. K. Hall and Cynthia A. Graham

A content and thematic analysis was conducted using forum messages from websites developed for wives of online gamers who play World of Warcraft. Blog posts from 50 women describing conflict in their marital relationship involving their husband's online game play were analyzed. Four overarching themes were identified and discussed in terms of the impact of online gaming on family functioning and relationships, emotional outcomes, and coping mechanisms. Results of ensuing issues arising from excessive gaming as perceived by the non-gaming spouse and ways in which they cope with these issues are shared.     

APP conference summary

This is an account of the extended assessment of a 22-year-old man who was initially sent for a court report, having been accused of setting fires. He had a history both of delinquency and, importantly, of childhood asthma. Although he proved unable to engage in psychotherapy, some management was provided, such as Winnicott advocates in cases of delinquency. This paper explores the symbolic meanings and functions of the patient's delinquent acts, drawing upon theoretical concepts from Freud, Aichhorn, and Deutsch. Of particular importance is the link between this patient's delinquency, his asthma, and the unresolved mourning for his dead mother which he carried not simply for himself but for his whole family.     

WOMEN EXPERIENCE:

No abstract available for this article.