Impact of Co-Therapy Teams on Client Outcomes and Therapist Training in Marriage and Family Therapy

This study of 33 student therapists, 402 client systems, and three supervisors tested the efficacy of using student co-therapy teams as an aspect of clinical training in a marriage and family therapy program. This study utilizes both quantitative and qualitative methodology. Two research questions were addressed: “Do different pairings of co-therapists affect client outcomes?” and “Is co-therapy a viable option for a training program?” The results indicate that client outcomes using co-therapy are at least as effective as treatment using one therapist and in some circumstances produce more positive outcomes for both clients and student therapists.     

The Current State of Medical Psychology in Iran

This paper reviews medical psychology in Iran and describes the two major professional associations representing the profession. The unique role of religion in Iran is stressed, and limitations of the current health care system are described. The paper also addresses human resource issues and the educational requirements for the practice of psychology in Iran.     

Political and interpersonal aspects of ethics consultation

Previous papers on ethics consultation in medicine have taken a positivistic approach and lack critical scrutiny of the psychosocial, political, and moral contexts in which consultations occur. This paper discusses some of the contextual factors that require more careful research. We need to know more about what prompts and inhibits consultation, especially what factors effectively prevent house officers and nonphysicians from requesting consultation despite perceived moral conflict in cases. The attitudes and institutional power of attending medical staff seem important, especially where innovative interventions raise ethical questions. Ethics consultants also need to address the thorny problems of the origin(s) of the consultant's authority, whistleblowing, conflicts of interest that affect the consultant, persistently poor communications in hospitals, systemic inequity in the availability or quality of services for some, and the standing of the consultant's recommendations, including their appearance in the patient's medical record.     

Observational assessment of behavioral changes accompanying clinical improvement in hospitalized psychiatric patients

Naturalistic observational techniques were employed over a four-week period to assess the behavior of clinically improved (n=7) and unimproved (n=12) hospitalized patients suffering from acute psychiatric disorders. The population was selected from four clinical diagnostic groups. Patients were sampled on an individual basis. Categories of recorded behaviors included social behavior as well as spatial proximity measures between individuals. Social behavior was further divided into components of sending and receiving. Results showed that patients who clinically improved had significantly different behavioral profiles and greater degrees of behavioral change for the following categories: send affiliation, receive affiliation, send assertion, and receive assertion. Improved patients also maintained closer distance to other individuals during the latter stages of hospitalization. In most cases, week 2 of hospitalization marked the point at which behavioral divergence between improved and unimproved patients occurred. Clinical and theoretical implications of observational procedures are discussed.     

原发性肾病综合征合并甲状腺功能异常患者临床资料分析

分析原发性肾病综合征合并甲状腺功能异常患者的临床特征,探讨其,I盏床意义。对37例原发性肾病综合征合并甲状腺功能异常患者的,陆床资料进行回顾性分析,治疗前检测甲状腺过氧化物酶抗体（Anti～TPO）、甲状腺球蛋白抗体（Anti—TG）,并分别于治疗前后检测血清游离T3（FT3）、血清游离甲状腺激素（FT4）、促甲状腺激...     

日本临床药学人才培养模式对我国的启示

临床药学作为一门新兴学科,是医院药学的一个分支。日本作为药学教育发展较快的发达国家,在临床药学人才培养领域积累了丰富的经验。在分析社会对临床药学人才需求的基础上,总结日本临床药学人才培养目标、培养模式及课程设置特点,期望为我国临床药学教育和人才培养模式改革提供借鉴。     

医护患共同决策的影响因素及实施路径——以乳腺癌为例

医护患共同决策有利于帮助患者参与到临床治疗决策当中,提高患者依从性,改善治疗效果。这并非患者参与治疗决策的讨论与选择即可达到的。共同决策的有效实施需要医护人员、医院、患者及家属的共同参与。医护人员需要了解并分析影响患者参与共同决策的因素,加强彼此的沟通,鼓励帮助患者参与当中;而患者也需要具备一定的疾病相关知识才能更好地参与;医院作为医护人员与患者之间的载体,其所提供的恰当支持在共同决策中起着重要作用。医护人员应分析了解乳腺癌患者参与共同决策的现状,以促进医护患共同决策的有效实施,为乳腺癌患者的顺利诊疗多做贡献。     

研究者发起的临床研究之伦理跟踪审查探究

随着近年来中国临床研究的快速增长,研究者发起的临床研究(IIT)成为关注热点,而IIT的伦理跟踪审查是伦理委员会工作的一个薄弱环节。文章从政策支持不足、审查标准差异、伦理培训欠缺、工作量大而缺乏激励措施以及缺乏信息平台5个方面对IIT伦理跟踪审查的难点进行阐述,并从规范顶层设计、规范伦理跟踪审查程序、提高研究者伦理自律、加强伦理委员会建设和搭建伦理信息平台5个方面提出了应对措施,以规范IIT的伦理跟踪审查工作,促进受试者权益的维护。     

多元化建构医学生的临床决策能力——以麻醉专业学生为例

文章从多维视角对建构医学生的临床决策能力进行了研究和探讨,突出从科学决策(博学、信息层面、实践累积和思维模式)、伦理学和法律、心理学(个体和群体心理)以及经济学四个维度揭示了医学生临床决策能力建构的多元化,优化了构建医学生临床决策能力的培养模式,在麻醉专业学生取得了较好的效果,有助于综合素质的培养,能够更好地构建麻醉专业学生的临床决策能力,遵循临床决策的基本原则,保障医疗质量和安全、改善医患关系、提升医学生今后从事麻醉医疗服务能力。