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81.
While Bion's 1967 memory and desire paper reflected a crucial episode in his clinical thinking during his epistemological period, it was also central to his evolution as a Kleinian psychoanalyst who worked with seriously disturbed adult patients. The author explicates and contextualizes these claims with a new archival document, the Los Angeles Seminars delivered by Bion in April 1967, and the full‐length version of Notes on memory and desire. Bion here instigated a radical departure from years of theory‐laden work when he made his clinical work and ideas accessible to a new audience of American Freudian analysts. While this new group was keenly interested to hear about Bion's clinical technique with both borderline and psychotic patients, there were varied reactions to Bion's ideas on the technical implications of the analyst's abandonment of memory and desire. Both the Los Angeles Seminars and Notes elicited responses ranging from bewilderment, admiration to skepticism amongst his audience of listeners and readers. These materials also however allow for a more complete and systematic presentation of important ideas about analytic technique – and while his ideas in this domain have been long valued and known by many psychoanalysts, this contribution stresses the crucial aspect of the reception of his ideas about technique in a particular American context. American analysts gained a much more explicit idea of how Bion worked analytically, how he listened, formulated interpretations and factored in the analyst's listening receptivity in the here‐and‐now. The author concludes with a consideration of the importance of Bion's American reception in 1967.  相似文献   
82.
83.
Sexual assault is an insidious problem in the United States military. In 2005 the Department of Defense (DoD) created the Sexual Assault Prevention and Response Office, which centralizes responsibility for sexual assault training. However, this training initiative has undergone little evaluation by outside researchers. Addressing this need, we analyzed responses from over 24,000 active duty personnel who completed the 2010 DoD Workplace and Gender Relations Survey. We assessed whether sexual assault training exposure (None, Minimal, Partial, or Comprehensive) predicted accurate knowledge of sexual assault resources and protocols. Using a social-ecological framework, we investigated whether institutional and individual factors influenced Service members’ training exposure and judgment of training effectiveness. According to our results, exposure to comprehensive training predicted lower sexual assault incidence and superior knowledge. However, comprehensive training differed as a function of military branch, rank, gender, and sexual assault history. Judgments of training effectiveness also varied across these dimensions. Our results highlight the importance of considering context, gender, and victimization history when evaluating institutional efforts to end sexual violence. The DoD’s 2010 annual report on military sexual assault concluded that “most Active Duty members receive effective training on sexual assault” (p. 104). Our results cast doubt on that assertion.  相似文献   
84.
The process that community based participatory research (CBPR) implementation takes in indigenous community contexts has serious implications for health intervention outcomes and sustainability. An evaluation of the Elluam Tungiinun (Towards Wellness) Project aimed to explore the experience of a Yup'ik Alaska Native community engaged within a CBPR process and describe the effects of CBPR process implementation from an indigenous community member perspective. CBPR is acknowledged as an effective strategy for engaging American Indian and Alaska Native communities in research process, but we still know very little about the experience from a local, community member perspective. What are the perceived outcomes of participation in CBPR from a local, community member perspective? Qualitative methods were used to elicit community member perspectives of participation in a CBPR process engaged with one Yup'ik community in southwest Alaska. Results focus on community member perceptions of CBPR implementation, involvement in the process and partnership, ownership of the project with outcomes observed and perceived at the community, family and individual levels, and challenges. A discussion of findings demonstrates how ownership of the intervention arose from a translational and indigenizing process initiated by the community that was supported and enhanced through the implementation of CBPR. Community member perspectives of their participation in the research reveal important process points that stand to contribute meaningfully to implementation science for interventions developed by and for indigenous and other minority and culturally diverse peoples.  相似文献   
85.
Teen dating violence is an important public health problem, with implications for the future health and well-being of adolescents. However, most work on teen dating violence has developed separately from literature on normative adolescent romantic relationships and development; understanding teen dating violence within the framework of adolescent psychosocial development may provide new areas for research. Thus, the present paper summarizes five theories of adolescent development that are relevant to the study of teen dating violence victimization, as well as empirical literature that demonstrates support for key theoretical tenets in research examining adolescent romantic relationships. We also present questions for future dating violence study that arise from these key theoretical tenets and past empirical research. Researchers interested in dating violence victimization can use the presented theories to guide new directions in research inquiry, so that findings are situated within the broader field of adolescent development.  相似文献   
86.
脐尿管囊肿是一种少见畸形,为探讨其病因、临床表现及诊治方法,对2010年1月~2013年12月于我院诊断为脐尿管囊肿的13例患者进行回顾性分析。结果显示,脐尿管囊肿主要发现于男性患儿,可表现为腹痛、脐部或膀胱不适等合并症,常伴有发热,也可无明显临床表现,由单纯查体发现。B超和CT是推荐检查方法,确诊需依靠组织病理学检查。手术切除是治疗该病的首选方法,临床效果满意。随着技术的发展,治疗脐尿管囊肿可优先选择腹腔镜切除术。  相似文献   
87.
系统思维是20世纪中期以后发展起来的一种新型思维,它与传统还原论思维根本不同,强调立足于事物整体来认识和处理问题,注重揭示事物内部机制以及环境对整体的作用和影响。我国临床医学专业学位研究生的培养应该纳入这种现代思维方式,使其善于应用系统思维来指导诊断和治疗,并应用在医学科研中。这不仅有利于提高其服务广大患者的能力,而且有利于提高其临床医学科研能力,从而提高临床研究生的整体素质。  相似文献   
88.
临床共情是一种能体验患者内心世界的能力,通过患者的言语和非言语表达,觉察和认识患者情感和情绪需求,并对其做出恰当的回应.临床共情具有科学的理论和实践基础,具有缓解患者心理上的痛苦,改善护患关系,促进患者康复等作用.在当今复杂的医疗环境下,务必要重视共情培养,适时运用临床共情.然而,我们强调临床共情的重要作用,并不能忽视护理技术的根本作用,根除躯体上的病变仍有赖于护理技术的有效性.在临床护理实践中,坚持共情与护理技术的有机结合,推进人性化的护理构建.  相似文献   
89.
This study presents a taxonomic foundation for research on employee performance management practices based on a comprehensive review of the literature (198 articles and book chapters). The taxonomy consists of 50 practices organized within seven topic categories, including an evaluation of the amount of research evidence supporting each practice. This taxonomic foundation facilitates the aggregation, integration, interpretation, and explanation of performance management research based on a role-theoretic perspective derived from the behavioural approach to strategic human resource management. The proposed direct-linkage path model shows how this taxonomic foundation ties performance management practices to behaviours and results. We build on this Practice – Behaviour – Results (PBR) critical path model with moderators and mediators based on cognitive and social factors identified in the extensive previous research. This PBR model provides a foundation for orderly and structured growth for future research that will enhance the connection between research and improved organizational practices in performance management, as well as a guide to best practices in performance management.  相似文献   
90.
Lately, the development and implementation of automated driving moved to the center of interest in the automotive industry. In this context, one of the central issues – the configuration of adequate trajectories – is mainly tackled using a technical approach. However, it appears that a technically ideal driving performance does not necessarily coincide with the drivers’ subjective preferences. This study strives to determine thresholds of a subjectively accepted driving performance regarding lateral vehicle control. A second objective is to analyze the influence of selected personal and situational factors on these thresholds. An empirical online survey with 161 participants rating video sequences of driving performances was conducted. The video sequences differed not only with regard to the lateral offset of the ego-vehicle but also concerning the weather (sun/rain) and traffic conditions (existence/driving behavior of oncoming traffic). Additionally, the participants’ driving experience and sensation seeking were considered in the data evaluation. To analyze the data, binary logistic regression analyses were calculated. They revealed that the subjective evaluation of driving performances varies primarily depending on the lateral offset of both the ego-vehicle and the oncoming traffic. The results indicate that regarding the lateral offset certain thresholds of subjectively accepted driving performances do exist. Regarding the development of automated driving systems, two issues need to be considered in order to ultimately guarantee user acceptance. First, the subjective thresholds need to be integrated into the systems’ trajectory planning. Second, the oncoming traffic’s driving behavior has to be considered.  相似文献   
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