Prevalence of mental health problems in Australian university health services

General practice patients report greater mental health problems than the general population, and students attending one university health service have reported greater prevalence rates at the end of the academic year. This study assessed the overall prevalence rate of mental health problems in university students using a cross‐sectional survey design of 1,168 students from three large, predominantly urban, Australian university health services. Approximately half of the students attending university health services reported elevated levels of psychological distress. The majority of severely distressed students had not sought any professional assistance for mental health problems. While there is scope for general practitioners to take a lead role in the identification of mental health problems in tertiary students, adequate treatment pathways need to be available. Implications for the role of universities in prevention work are discussed.     

Molar functional relations and clinical behavior analysis: implications for assessment and treatment

The experimental analysis of behavior has identified several molar functional relations that are highly relevant to clinical behavior analysis. These include matching, discounting, momentum, and variability. Matching provides a broader analysis of how multiple sources of reinforcement influence how individuals choose to allocate their time and offers an empirical rationale for reducing problem behavior by increasing adaptive behavior. Discounting highlights the functional relations that affect self-control. Momentum specifies the variables responsible for persistence in challenging situations. Variability characterizes a functional dimension of behavior that is essential for learning and problem solving. These concepts have important implications for clinical practice and research. A selective review of these concepts is presented, and their implications for assessment and treatment are discussed with two goals: to inform basic scientists about the relevance of their work and to invite clinical behavior analysts to broaden the conceptual basis for their work.     

In search of meaning: values in modern clinical behavior analysis

Skinner described behavior analysis as the field of values and purpose. However, he defined these concepts in terms of a history of reinforcement and failed to specify whether and how human and nonhuman values might differ. Human values have been seen as theoretically central within a number of nonbehavioral traditions in psychology, including humanism and positive psychology. However, these approaches have failed to provide explanations of the behavior-environment relations involved in valuing that might allow prediction and influence with respect to this phenomenon. Modern clinical behavior analysis in the form of acceptance and commitment therapy (ACT), however, succeeds in providing a functional definition of human values that meets this latter criterion. ACT is rooted in behavior analysis and relational frame theory (RFT) and defines values in terms of verbally established motivation. ACT empirical research into values has begun to blossom in recent years, and ACT-RFT researchers are currently investigating the concept at the most basic empirical level as well as in the applied clinical arena, heralding new interest in and insight into values within clinical behavioral psychology.     

癌症姑息治疗的临床意义和社会伦理思考

姑息医学作为医学学科之一,内容包括癌痛控制,处理缓解其他症状。癌症姑息治疗缓解了紧张的医患关系,有效的防止有限医疗资源的浪费及分配不公,同时姑息治疗给人们留下诸多社会伦理思考,如告知、癌痛控制等问题。如何将姑息治疗扩展到其他非恶性疾病面临着巨大挑战。     

论个体差异与诊疗决策

诊疗决策最优化的过程,本质上是针对特定的患者,制定最适合其个体差异的决策过程。对个体差异认知方式,经验医学基于对个体的不完全归纳,循证医学基于对群体随机、双盲、对照、大样本,人类基因组学基于对人类基因的差异表达、单核苷酸多态和复制变异的研究。最优化的治疗方案应体现关注患者心理、社会差异、关注生命质量、远离趋利性等人文特征;体现针对个体病患生物学特性差异、个体病程病期和个体最佳疗效差异等科学特征。     

医学人文关怀在儿科临床实践中的应用

医学的人文精神决定了医疗服务必须体现人文关怀。医学人文关怀是医疗活动的重要组成部分,如今培养人文关怀精神已越来越成为医学教育中不可分割的一部分。儿科学,专科性强,对象特殊,疾病发展变化迅速,工作风险较大。这要求儿科医生应具有更扎实的临床基本功,同时也需要表现人文关怀精神并融入临床实践的每一个环节。这是高质量医疗服务和医学模式转换的必然要求,并且有助于正确决策,减少医疗纠纷。本文目的旨在阐明人文关怀与儿科临床实践之间的关系及其在儿科临床实践中的重要性,并针对目前存在于儿科临床实践中人文冷漠现象提出一些建设性意见。     

听觉植入技术的进展与临床应用

听觉植入技术是随着现代科学技术的进展而发展起来的新技术,其成功应用得益于现代科技的进步,更离不开科学家的创新思维和勇于探索精神。听觉植入技术的进展体现了多学科联合发展的要求及创新思维的重要性,其应用前景也是无限光明的。     

腹膜透析相关性腹膜炎诊治的临床决策

腹膜透析相关性腹膜炎的治疗以前主要着眼于抗生素的选择,但其防治应该是从腹透管置管开始的整体策略,包括预防性抗生素的使用、患者的强化培训、腹膜炎的早期快速诊断、给药途径与疗程,以及拔管指征等.肾科医师临床决策是需要根据最新的治疗指南及研究进展,结合患者的个体特点进行综合判断,以期达到最佳的治疗效果.     

Conceptualising dimensions of quality of life in poverty

Are existing health‐related quality of life (QoL) measures adequate for use in poverty? Focus groups of development researcher‐practitioners were convened to discuss QoL in the low–middle‐income countries of Ethiopia, Bangladesh, Peru and Thailand. Newly elicited themes were mapped onto the QoL concept consisting of 25 original facets from the WHOQOL‐100, plus 24 additional facets derived from five subsequent WHOQOL modules (49 facets) organized in seven domains. Qualitative themes and importance ratings were used to identify seven novel themes that relate to poverty in these countries. Most are not included in QoL instruments: physical fitness & survival, social status, community relations, family life, work opportunity and environment, fairness and equality, and perception of political institutions. Community relations extended the social domain, and a political rights and freedoms domain was consolidated as a seventh domain. This cross‐national study provides a new conceptual foundation for the international assessment of QoL in poverty. Copyright © 2008 John Wiley & Sons, Ltd.     

INTERTEACHING: THE EFFECTS OF QUALITY POINTS ON EXAM SCORES

Although previous studies have found interteaching to be an effective alternative to traditional methods of instruction, few studies have examined which of its components contribute to its effectiveness. In the current study, we examined whether manipulating quality points had an effect on our students' exam scores. In two sections of an undergraduate general psychology course, we used interteaching but alternated between quality points and no quality points several times throughout the semester; we also counterbalanced the order of presentation across sections. We found that quality points did not have an effect on exam scores.