急诊医疗中的知情同意问题

急诊医疗中的知情同意似乎与通常的临床情形不同,它不需要完全的知情同意,甚至可以被免除。这一特点可能给人以一种印象,即在急诊情况下对知情同意的考量,或可与其他情形有所不同。其实急诊情形下之所以出现知情同意的例外或免除,并非知情同意原则在急诊情况下不适用,或者是知情同意原则做出了让步。真正的原因是,知情同意在急诊治疗中往往以特殊或不同的形式表现出来。     

2005国际心肺复苏和心血管病急救指南的若干问题

2005年国际心肺复苏和心血管病急救指南制订中有5个最有争议的问题以及一些重要的新改变。这5个问题分别是:(1)室颤时,按压与电击何者优先;(2)按压—通气比;(3)一次电击与三次电击除颤的争议;(4)电击剂量;(5)复苏后处理。有利于在心肺复苏和心血管病急救工作中施行。     

直觉和分析在不同任务条件下的逃生决策效果

目的：探讨针对简单和复杂逃生任务时, 直觉和分析在不同判断依据条件下的逃生决策效果。方法：采用两个主实验和两个预备实验。实验一和实验二的被试人数分别为：85人和87人。两个主实验均采取2 (思维方式：直觉和分析) × 2 (判断依据：简单和复杂)组间实验设计。主要结果：(1)针对简单逃生任务, 直觉组和分析组在不同判断依据条件下的逃生决策效果差异不明显; (2)针对复杂逃生任务, 在简单判断依据条件下分析决策优于直觉决策; 在复杂判断依据条件下直觉决策优于分析决策。主要结论：直觉性和分析性逃生决策的效果主要与决策任务的复杂程度有关, 而与判断依据的复杂程度关系不大。     

Emergent social identities in a flood: Implications for community psychosocial resilience

Although the mobilization of pre‐existing networks is crucial in psychosocial resilience in disasters, shared identities can also emerge in the absence of such previous bonds, due to survivors sharing a sense of common fate. Common fate seems to operate in sudden‐impact disasters (e.g., bombings), but to our knowledge, no research has explored social identity processes in “rising‐tide” incidents. We interviewed an opportunity sample of 17 residents of York, United Kingdom, who were involved in the 2015–2016 floods. Using thematic and discourse analysis, we investigated residents' experiences of the floods and the strategic function that invocations of community identities perform. We show how shared community identities emerged (e.g., because of shared problems, shared goals, perceptions of vulnerability, and collapse of previous group boundaries) and show how they acted as a basis of social support (both given and expected). The findings serve to further develop the social identity model of collective psychosocial resilience in rising‐tide disasters. Implications for policy and practice are discussed.     

NLP简快心理治疗方法的模式整合及其优势

随着目前医患关系日趋紧张的状况,构建和谐的医患关系成为急诊科医生面临的一个重要课题。从救死扶伤为灵魂、有效解除患者痛苦、尊重和理解患者、良好的医患沟通、语言艺术为桥梁等不同角度深入探讨了急诊科医生如何构建和谐的医患关系。     

关于急诊医生的临床思维方法

急诊医学是一门新兴的综合学科,它涉及的范围很广。急诊患者具有急、危、重、难等特点,并要求在较短的时间内必须做出正确的判断。因此,严谨的临床思维方式和科学的逻辑思维方式,是每位急诊医生必需的训练。介绍急诊临床思维的特点,以及系统思维在急诊常见病诊治中应用的一些经验体会。     

美国公共卫生突发事件应急体系的结构分析

美国的公共卫生突发事件应急体系集中了美国现有最好的资源,保证了该体系强有力的指挥功能,其横向的政府各职能部门均能协同运作,纵向的"国家一州一地方"三级公共卫生部门也能高效协调,从而建立了一个全方位、立体化、多层次和综合性的公共卫生应急管理网络.     

The power of rituals in dealing with traumatic stress symptoms: cleansing rituals for former child soldiers in Northern Uganda

International guidelines for emergency response note the importance of cultural adaptions and facilitation of local spiritual and religious healing practices when appropriate. Deciding whether traditional medicine is safe, effective and appropriate is a complex matter. This study explores the therapeutic factors of a local cleansing ritual in Northern Uganda aimed at healing former child soldiers. The components of the ritual are analysed and compared with research-based therapy for post-traumatic stress disorder. Participant observation was used during the ritual, followed by qualitative in-depth interviews and follow-up interviews over three years. The key informant is a former child soldier participating in the ritual. He was abducted and forced to commit several killings during a three-year period. The collective mobilisation of social support, the collective forgiveness and the strength of the psycho-education appear central for the effect of the ritual. In addition, the ritual draws on common therapeutic factors. The findings indicate that such a ritual involves elements that safely and effectively deal with symptoms in accordance with modern research on trauma therapy, perhaps more powerfully than Western-style therapy. Implications for collaboration with local healers in emergency settings are indicated.     

急诊医学中的人文关怀

人文关怀是对人、人类社会的生存和发展、命运和前途的关心,是对人性和人权的尊重和保护,是对人独立思想和人格的容许与提倡。随着医学模式的转变和急诊医学的发展和完善,越来越需要重视对病人的人文关怀,也就是对病人人权和人格的重视。在急诊医学教学当中,不但要传授相关的专业知识,而且需要将人文关怀的理念贯穿于教学始终,培养医学生人文关怀的素养,教师同时要重视医学生自身对人文关怀的需求。     

Supreme Emergencies Without the Bad Guys

This paper discusses the application of the supreme emergency doctrine from just-war theory to non-antagonistic threats. Two versions of the doctrine are considered: Michael Walzer’s communitarian version and Brian Orend’s prudential one. I investigate first whether the doctrines are applicable to non-antagonistic threats, and second whether they are defensible. I argue that a version of Walzer’s doctrine seems to be applicable to non-antagonistic threats, but that it is very doubtful whether the doctrine is defensible. I also argue that Orend’s version of the doctrine is applicable to non-antagonistic threats, but that his account is not defensible, regardless of whether the threats are antagonistic or not.