从乳腺癌患者的生活质量谈医学模式的转变

随着医学模式从生物医学模式向生物-心理-社会医学模式的转变,乳腺癌患者的生活质量亦日益引起社会的普遍关注.至今,许多通科医生的医学模式还没有完全转变过来.只有医学模式的彻底改变,才能真正提高乳腺癌患者的生活质量.介绍生活质量的概念、影响因素,以及乳腺癌患者的生活质量与医学模式的关系.     

医学哲学是临床医学创新的不竭动力

受诸多复杂因素的影响,现代医学在取得巨大成就的同时,也有自身的局限与不足.医学哲学是医学精神的精华.哲学的本质是批判,是创新,是全面地、发展地认识问题,促进事物前进、发展.哲学是医学创新的不竭动力,确定医学的历史方位,引导医学的未来发展方向,是解决当代医学前沿中难点、热点问题的钥匙,促进临床医学模式"以疾病为中心"向"以病人为中心"和"以健康为中心"模式转变.     

"EQ"在医学科研工作中的重要性

结合医学工作实际,讨论EQ(情商)的意义,医学工作者在开展科研工作过程中,能否做出成绩,能否成功均与其EQ之高低有密切关系,可以说情绪智商与情绪能力是制约医学工作者工作业绩的重要因素之一.基于上述认识,提醒医学工作者,在具备天生的IQ(智商)后,要注意对自己的EQ多加培养,以便在医学科研工作中能做出更大成绩.     

System-of-Care Practice Review Scores as Predictors of Behavioral Symptomatology and Functional Impairment

The longitudinal comparison study of the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program assesses factors in service delivery systems that may shape the impact of systems of care. We evaluated the extent to which services embodying the principles of a system of care, as measured by the System-of-Care Practice Review (SOCPR), affect clinical outcomes for children being served in federally-funded systems of care and matched comparison communities. The participants included 75 children and families selected for participation in the SOCPR. Results indicated that experience of services embodying system-of-care principles at a high level was associated with lower symptom and impairment scores one year after entry into services. Children in systems of care were rated to have experienced high levels of system-of-care principles implemented within their services, and their symptom severity and functional impairment did not vary as a function of their experiences. Children in matched comparison communities had more variable rated experiences of system-of-care principles within their services, and their symptom severity and functional impairment decreased as their experiences of the principles increased.     

Evaluation of a Brief Group Based Psychological/Educational Treatment Programme for Women with an Iatrogenic Chronic Hepatitis C Virus Infection

Thirty-two women with an iatrogenic chronic hepatitis C virus (HCV) infection were assigned to a treatment or waiting list control group and completed the SF-36, GHQ30, Battles SE, and two in-house questionnaires. A series of mixed model ANOVAs indicated a significant Group × Time effect for SF-36 physical functioning (F = 9.01, p < .01) and a series of repeated measures ANOVAs (treatment group only) indicated a significant time effect for a sustained improvement in psychological well-being (F = 8.01, p < .01) at 3 months posttreatment. Furthermore, most women posttreatment felt more positive and informed about their illness, had more confidence, and reported a greater ability to control and cope with their lives. Psychological/educational treatment programmes show promise for increasing adjustment and coping in women with an iatrogenic HCV infection and may be modified for use in other HCV cohorts.     

Thoughts of an Old Therapist About the Impact of Age on Her Clinical Work

This article deals with the impact of old age on the clinician as well as on the patients and families. The factors which seem to play an important role are: (a) The personal events in the clinician's life; (b) The changes which took place in the profession; (c) The life histories of the individuals and families which influenced the author's work as well as how her age affected families and the individuals. Several case illustrations are given to demonstrate the author's ideas. It is the author's hope that her experiences will encourage older therapists to continue in their practice.     

How Do Master's Level Marriage and Family Therapy Students View Their Basic Therapy Skills? An Examination of Generic and Theory Specific Clinical Approaches to Family Therapy

This study examined the similarities and differences between marital and family therapy (MFT) students' beliefs about the importance of specific MFT skills, and the perceptions of experienced therapists in practice about the same skills. The data suggest overlap but not complete agreement between the perceptions of novice and experienced therapists regarding both generic and theory specific skills. Similarities and differences between these findings and earlier research about common factors in family therapy are addressed. Recommendations about clinical training that is not organized around traditional family therapy theories, but rather based on two trans-theoretical approaches to therapy labeled expert and collaborative are explored.     

企业核心竞争力与企业伦理品质

企业真正的核心竞争力来自企业伦理品质所产生的道德实力。企业的道德实力是企业遵循与市场经济理性相适应的道德准则,它一贯尊重和尽力满足利益相关人利益,并与利益相关人和谐交往共同发展而产生的道德凝聚力和影响力。与企业经营实力一样,企业道德实力是可以描述和量度的客观状态。具体可以从顾客忠诚度、员工忠诚度、股东忠诚度、融资资信度、同行联系度、供销稳定度、社区融洽度和社会美誉度等八个方面进行考量。     

Developmental trajectories of internalising behaviour in the prediction of adolescent depressive symptoms

Using a community‐based Australian birth cohort, groups with distinct longitudinal profiles (trajectories) of internalising behaviour from early childhood through mid‐adolescence were identified for boys and girls from parent ratings. Six internalising trajectories were identified for both genders, comprising stable, decreasing, and increasing pathways. Hierarchical regression models predicted the contribution of internalising trajectories to self‐reported age 17 depressive symptoms for males (n = 557) and females (n = 633), after controlling for the effects of a range of adolescent precursors. Internalising trajectories and adolescent psychosocial factors, each contributed to the prediction of subsequent depressive symptoms, with girls and boys on increasing internalising trajectories and boys on a fluctuating high trajectory particularly at risk. Results suggest that parent ratings can identify coherent internalising behaviour pathways that originate early in life and influence subsequent adjustment.     

The Effects of Assisted Housing on Child Well‐Being

The most rigorous research on the causal effects of assisted housing on children's outcomes finds no such effects. The present study uses rich longitudinal data from the Panel Study of Income Dynamics, augmented with Census, American Community Survey and U.S. Department of Housing and Urban Development administrative data, to unpack these nil effects. Analyses include 194 children ( age = 6.2 years) living in assisted housing in 1995 or later who were 13–17 years old in 2002 or 2007, and an unassisted comparison group of 215 children who were income‐eligible for, but never received, housing assistance. Results suggested no mean effects of living in assisted housing during childhood on adolescent cognitive, behavior, and health outcomes, addressing selection through propensity score matching and instrumental variables. However, quantile regressions suggest assisted housing provides an added boost for children with the best cognitive performance and fewest behavior problems but has opposite effects on children with the lowest cognitive scores and most behavior problems. Further tests indicate that these differences are not explained either by neighborhood effects or housing quality. A potentially fruitful avenue for future research investigates differences in how parents take advantage of the housing affordability provided by assisted housing to benefit their children.