继发性的高血压线索来自于基本的临床检查

继发性高血压病因的检出和针对病因的治疗,不仅可以提高高血压的治愈率和控制率,有利于保护靶器官,还可以极大程度地减少医疗资源的浪费。基本的临床检查,如血、尿常规,血浆电解质,血糖,血脂,血尿酸和血清肌酐,可以为继发性高血压的诊断提供重要的线索。     

Shared service centers and professional employability

This paper presents case study evidence of evolutionary changes in business support functions resulting in a fundamental hollowing out of the professional space over time and distance, creating the ‘hourglass’ profession. In an IT-enabled, boundaryless world, many professional activities can now be undertaken, in the manner of the Martini slogan, ‘any time, any place, anywhere’.This paper aims:

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  To investigate the shared service center as an emerging organizational form with the potential to drive fundamental change in the nature and location of professional work.

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  To explore the impact of these changes for individual professional workers, and to highlight the need for a greater focus on individual employability as the driver of an overall career trajectory.

     

The relationship between basic need satisfaction and emotional eating in obesity

Emotional eating has been identified as a factor that promotes the development and maintenance of obesity and hinders its treatment. This study investigated the relationship between unsatisfied basic needs and emotional eating, including the mediating factors of self‐esteem and coping strategies. The results from a survey of 136 obese individuals indicated support for a significant relationship between basic need satisfaction and emotional eating, with a mediating effect of negative coping strategies. These findings extend previous research and provide guidance on how to help individuals who engage in emotional eating by focusing on developing more adaptive coping strategies.     

The workable here and now and the why of there and then

At an earlier time our work as analysts was easier. We searched for the repressed in order to make constructions that connected the past to the present symptoms. Making these connections conscious, based upon the continuing influence of the Topographic theory, was thought to be the curative factor in psychoanalysis. Freud (1912, 1914) briefly expressed the importance of working in the present but his main focus remained the importance of reconstructing the past. The importance of working in the present started to be fully articulated approximately 30 years ago, and has become a central part of most views on technique. However, it is the contention of this paper that, while there is general agreement on the necessity of working in the here and now, the understanding of what this means or why it is useful runs along parallel lines rather than leading to a central point. Further, it is my impression there is little agreement on the reasons for interpreting the there and then. The idea of a 'workable here and now' is introduced to capture how the here and now might best include the analysand's readiness to synthesize what is offered, while a theory of the necessity for working in the here and now and the there and then is offered.     

Self-Efficacy in Service-Learning Community Action Research: Theory, Research, and Practice

The purpose of this article is threefold: In the first section, an overview of research and theory on the self-efficacy construct is provided, and the central role of self-efficacy in service-learning community action research is demonstrated. The second section reviews over 10 years of research validating the Community Service Self-Efficacy Scale (CSSES), which measures the individual’s confidence in his or her own ability to make clinically (meaningfully) significant contributions to the community through service. Within the context of this review, recent (previously unpublished) validation research is also reviewed. Alternate versions of the CSSES, each of which was developed for a specific purpose, are presented. The third section provides recommendations for further research focused on (a) validating the CSSES and (b) examining self-efficacy as an outcome, moderator, and mediating variable in service-learning community action research.     

预防导尿管相关性感染的临床问题及决策

留置导尿是一项侵袭性操作,易引起尿道黏膜损伤,且留置导尿时间过长,容易引起泌尿系统的逆行感染。为了预防导尿管相关性感染,我们从临床角度讨论是否需要更换一次性尿袋以及更换尿袋的时间,留置导尿尿道外口的清洗,留置导尿膀胱冲洗的必要性及是否应用抗生素,更换导尿管的时间及导尿管的选择等临床问题,为临床人员做该项操作时提供参考,做出正确的临床决策。     

我国临床药学发展史的回顾及展望

临床药学是一门近几十年发展起来的新兴学科,是近年来我国一个备受关注的领域。它的产生及在我国的发展经历了一个曲折的过程,但却是历史发展的必然结果。纵观整个出现发展过程及现状,让我们思考了很多,对其今后的发展以及我们科学的认识事物有很好的启示。     

动脉瘤性蛛网膜下腔出血的临床诊疗决策

探讨动脉瘤性蛛网膜下腔出血的临床诊疗决策。运用循证医学对动脉瘤性蛛网膜下腔出血早期诊断,及时、合理、有效地选择个性化的治疗方案,降低动脉瘤性蛛网膜下腔出血的病残率和死亡率。     

University psychology clinics in Australia: Their place in professional training

Abstract: There is universal recognition of the need for developmentally appropriate supervised clinical experience in professional psychology training. University clinics were established to provide a bridging function for postgraduate clinical psychology students, assisting the integration of psychological theory and research into real‐world clinical applications and professional identity development. The aim of training in university clinics is to provide opportunities for clinical practice and high‐quality supervision to monitor and shape clinical skills. The experiences gained in external practicum settings complement this initial training but cannot replace it. The recent introduction of Medicare rebates for psychology services has threatened the survival of university clinics because low‐cost psychological treatment is now available from experienced practitioners. This paper provides data on Australian university clinics collected before the introduction of Medicare. Concerted efforts are needed to protect university clinics in order to maintain standards required for accreditation of clinical psychology training programs. The potential impact of the loss of university training clinics is discussed and strategies to ensure their survival are suggested.     

Training clinical psychologists for rural and northern practice: Transforming challenge into opportunity

Abstract: The Rural and Northern Program (R&NP) of the University of Manitoba's Department of Clinical Health Psychology (DCHP) is a unique training and service delivery platform that was developed in response to the scarcity of psychological services in rural and northern areas of the province of Manitoba, Canada. Since 1996 rural and northern‐based psychologists, in conjunction with the faculty based in Winnipeg (Manitoba's largest city) have offered training to two interns and one postdoctoral resident (resident) yearly. The current article discusses the nature of the program, the regions of Manitoba that the program services, and recruitment and retention data. The authors conclude by offering suggestions for creating sustainable rural/northern psychological practice.