乳腺癌治疗的新视野与医院管理的改革

阐述了乳腺癌治疗方法的发展过程,包括外科、内科、放疗科、生物治疗。乳腺外科由扩大根治手术发展到保乳手术,由局部的病变认识到全身病变。内科治疗与外科配合,与内分泌的治疗相结合,又有大量的新药出现,使内科治疗从姑息性治疗走向根治性治疗。加上放疗技术和放疗设备的进步,靶向治疗药的层出不穷使人们越来越认识到乳腺癌是需要综合性治疗,从而推论到对医院管理制度及方法的探讨。认为医院需要建立正确的核心价值观即与患者携手同行让生命不再灰色,表现出更多的人文关怀,利用高科技为患者提供个性化的综合治疗,并付以相应的管理制度。     

麻醉科医师在晚期癌痛治疗中的作用

1986年WHO推出的“三阶梯”癌痛镇痛用药方案目前在临床工作中存在误区。麻醉科医师必须明确在晚期癌痛治疗转变中的责任和义务:具有专业能力、保健与防病能力,消除使用阿片类药物成瘾恐惧症;团队协作能力、新技术的评估能力,实行跨学科综合姑息保健;遵循生物心理社会医学模式,对晚期癌痛患者实施人文关怀。不仅会运用药物和医疗技术手段,还需配合心理和社会方面进行全面的诊疗,更好地为患者服务。     

群体健康与关系"正义"

生命伦理学具有广泛性和综合性,着眼于群体健康是当前生命伦理学发展的趋势.在群体水平的生命伦理学的研究中,有关"正义"的概念是核心的问题.涛慕思·W·博格提出了正义的"关系概念",借以考察范围广泛的社会制度与健康结果的产生具有什么样的因果关系,进而强调社会制度的制定者和支持者对其产生的健康结果负有责任.通过对此"关系概念"进行分析,以期对中国国内健康领域问题的解决有所启示.     

医疗风险管理与医患关系的调适

医疗行为具有高风险属性,但医疗机构经营目标不是追求自身利益最大化,而是公众健康,因此医疗机构风险管理的手段和目标应该着眼于影响目标实现的各种不确定因素,这就要求把医患关系状况纳入风险管理范畴。在当前社会环境下,医疗机构自觉地自留一部分风险成本更有利于经营目标的实现和医患关系的协调。     

权变管理理论与《易经》哲学思考

随着全球经济一体化的日益深入,组织所面临的内外环境更加复杂．权变管理理论对组织的决策、计划、领导等方面的作用越来越受到人们的重视,本文将结合《易经》哲学的一些观点从变化观、系统观、过程观等方面对权变管理理论进行探讨．     

Teachers' conflict management styles: The role of attachment styles and classroom management efficacy

Constructive conflict management strategies are important in maintaining a positive classroom environment yet little is known about interpersonal or school variables associated with teachers' use of such strategies with students. Teachers high in self-reported classroom management efficacy (CMEFF) and security of attachment (low on avoidance, anxiety) were predicted to endorse use of positive classroom management strategies (e.g., integrating, compromising) more than insecure teachers and those low in CMEFF. Teachers (N = 283) from eleven schools (seven elementary), largely female and white, responded to a questionnaire in their boxes (29.4% response rate). School and teacher demographic variables were included in a multivariate regression after preliminary analysis suggested that ignoring the multilevel structure of the data made little difference in results; school variances were small compared with teacher variances. CMEFF and years teaching had positive, significant effects on use of integrating and compromising strategies, while avoidance had negative effects on both and anxiety on integrating strategies. Implications for teacher development are discussed.     

Defining the Nature and Impact of Goals in Children and Adolescents with a Chronic Health Condition: A Review of Research and a Theoretical Framework

This paper presents a review of research related to goals in youth with a chronic health condition (CHC) and a related framework to inform theory and research. Performed literature review using PsychINFO and Medline with a combination of many key words related to health, goals, and youth. Sixteen studies related to goals in youth with a CHC were identified. An integrative framework to inform research on goals in pediatric CHCs was presented based on studies reviewed. The impact of a CHC on goals and related behaviors, impact of goal conflict and collaboration, interventions with goal-setting components, and impact of developmental, disease, socioeconomic, and cultural factors were described. Recommendations for future research were discussed. The application of theory related to the nature and impact of goals in youth with a CHC will advance the field from a research and clinical standpoint.     

文化与社会赞许反应:社会个人互动的观点

在处理社会赞许反应的文化差异时,常用的两种方法为实验控制和统计控制。我们在本文中提出另一个观点。通过回顾近期的相关文献,我们指出:社会赞许反应的文化差异,反映在不同社会环境中,人们在相应的文化要求下,以不同的自我呈现方式来加强他们追求个人目标的动力。这种社会、文化与个人的对话历程乃研究文化—心理关系的核心课题。用实验或统计方法将因这个历程产生的变量从跨文化数据中剔除后,所得的结果便只有微薄的文化意义了。因此,我们反对将社会赞许反应的文化差异视为跨文化研究的噪音。相反地,我们认为跨文化研究者应认真地分析社会赞许反应的社会文化意义,以社会赞许反应作为一个窗口,管窥社会、文化与行为相生相成的关系。     

CT故障停机时放射科危机管理的应用研究

放射科应用危机管理理论,在CT故障停机时,启动危机处理方案:用MRI替代检查,配以危机处理工作流程,MRI加班不停机和一小时内出报告等措施,保障了患者影像诊疗的持续性,使"以患者为中心"得以拓展和落实,为医院带来了良好的品牌效益、服务效益和技术效益。     

进展性脑梗死的形成机制与防治策略

进展性脑梗死是临床上常见的一种缺血性脑卒中,其发病率高,致残率高,预后较差,严重危害患者的生命和健康,成为临床卒中治疗的一大难题。本文结合近年来的有关研究文献,就进展性脑梗死的临床分型、形成机制、可能的危险因素及其防治策略等方面的研究进展作一综合性介绍。