Dementia care‐giving in black and Asian populations: reviewing and refining the research agenda

Despite the increased prevalence of dementia little work has been done to explore the extent and nature of care‐giving in black or Asian‐UK populations. Evidence that does exist suggests that the consequences of care‐giving are significant but different from those experienced by white carers and are mediated by a number of culture‐related factors. These include: ethnically specific conceptualisations of dementia; expectations of family duty; religiosity; the adoption of positive re‐appraisal strategies, and beneficial outcomes. Present approaches to research are narrow, do not take account of cultural dimensions and employ terminology and care‐giving frameworks which are of limited relevance. That the evidence base is characterised by small‐scale studies, and weak methodology further undermines its validity. Research deficits are systemic and fundamental and are both conceptual and methodological. A key contribution would be the development of a multi‐dimensional theoretical model that takes account of the role played by culture, ethnicity and structural inequality in shaping care‐giving experiences and profiles. Incorporating the perspectives of black and Asian carers, and the influence of the life course of individuals and communities and employing qualitative methods would also influence the direction of research, improve its quality and generate knowledge in this underdeveloped field. Copyright © 2005 John Wiley & Sons, Ltd.     

开放医疗市场 强化政府责任 解决看病难

当前对医疗改革的批评较多,不少人认为是过度市场化的结果。但是,“过度市场化”的问题不能一概而论,可以从两个方面来分析,从医疗服务方面来说,有过度市场化的倾向;但是从医疗资源的配置或投入来说,市场又没有充分放开。所以不能简单的或笼统的把医改的问题归咎于市场化。该开放的医疗市场未开放,政府责任不到位,才是当前中国医疗改革的问题所在。     

Widows, women, and the bioethics of care.

Widows, women, and the bioethics of care must be understood within an authentic Christian ontology of gender. Men are men and women are women, and their being is ontologically marked in difference. There is an ontology of gender with important implications for the role of women in the family and the Church. The Christian Church has traditionally recognized a role for widows, deaconesses, and female monastics, which is not that of the liturgical priesthood, but one with a special relationship to care and therefore with particular implications for health care and a Christian bioethics of care in the twenty-first century. In the shadow of early male mortality, women as wives should turn to support their husbands and as widows to support those in need. Widows, in becoming authentic Christian monastics, can bring into the world an icon of rightly ordered women providing rightly ordered Christian care for those in need. They can enter the moral vacuum created by misunderstandings of the place of women and the service vacuum created by a disappearance of religious nuns in Western health care facilities with a presence that is at one with the Church of the Fathers.     

终末期癌症病人诊治中的心理特征与人文关怀

在诊治终末期癌症病人过程中不仅要关心他们的躯体方面,更要关心他们的心理方面,在诊治过程中要根据他们的独特的心理特征来进行人文心理关怀,维持生命质量和保证他们应有的人格尊严.     

A Standard of Care for the Assessment of Suicide Risk and Associated Treatment: The Florida State University Psychology Clinic as an Example

The Florida State University has established a set of guidelines to be used as a standard of care for suicide. This standard of care guides therapists through a suicide risk assessment that focuses on key variables related to suicidal behavior that are among the best predictors of completed suicide. This standard of care includes necessary components of suicide risk assessment, critical steps to follow to ensure the safety of suicidal patients, treatment recommendations, and guidelines for minimizing the legal risk of the therapist. Though this standard of care was developed in a research and training clinic, these principles may be applied to all clinicians offering psychological services to patients, regardless of the nature of the clinic or setting.     

Social disadvantage and neglectful parenting as precursors to the development of antisocial and aggressive child behavior: Testing a theoretical model

The present study tested a theoretical model advanced to understand the direct and mediated effects of social disadvantage, neglectful parenting, and punitive parenting in the developmental trajectory of aggressive and antisocial behavior in young school‐aged children. To test the model, families of 310 first grade children and 361 fifth grade children, participating in a universal prevention trial in high‐risk areas of a medium‐sized metropolitan area, provided data. Multi‐method and multi‐source indices of the four predictive constructs (Social Disadvantage, Denial of Care Neglect, Supervisory Neglect, and Punitive Discipline) were obtained at the time of enrollment. Multi‐method and multi‐source indices of the criterion construct (Aggression and Antisocial Behavior) were obtained at the time of enrollment and at a five year follow‐up. Based on structural equation modeling, the results established care neglect as a mediator of social disadvantage, and the importance of care neglect to both punitive discipline and antisocial outcomes in the first‐ and fifth‐grade cohorts. Supervisory neglect, however, was important in the antisocial outcome of the fifth‐grade cohort only. Overall, the results established the importance of distinguishing between two subtypes of neglect and the need to consider the role of discipline in concert with neglect when attempting to understand the impact of parenting on the development of antisocial behavior. Aggr. Behav. 30:187‐205, 2004. © 2004 Wiley‐Liss, Inc.     

医疗保健政策与医患关系

医疗保健政策深刻地影响着医患关系,并左右着医患关系的发展与变化.在实行"以公平为主,兼顾效益"的福利性的医疗保健政策时期,我国的医患关系是和谐的.但自从医疗保健政策向"经济导向型"方向转变之后,国家大幅度减少了对卫生事业的投入,医院必须从病人身上取得卫生发展必要的资金,医药费用上涨是必然的,也失去了公平和公正,并最终导致医患关系的恶化.调整医患关系不能仅从医、患两方面着手,建立符合医学伦理的卫生政策,才是问题的关键.     

关于功利、理性或关怀--不同理论在评价人类基因组研究中的差异

从功利主义的角度审视治疗性克隆,治疗性克隆研究能够为人类造福,是可以得到辩护的.义务论认为,胚胎不能作为试验的客体,反对治疗性克隆研究.而关怀理论学家则不支持治疗性克隆研究.     

Parent-School and Community Partnerships in Children's Mental Health: Networking Challenges, Dilemmas, and Solutions

Inter-agency collaboration, service coordination, and the creation of successful partnerships among parents, teachers, and human services professionals continues to be a challenge for the development of responsive community-based systems of care for at-risk youth and their families. We explore how one inner-city neighborhood struggles to create successful community partnerships through traditional networking strategies. Our findings identify networking strategies that appear to work and those that do not. Recommendations for improving communication are provided.     

影响ICU护士落实“知情同意原则”原因及对策

重症监护（intensive care unit,ICU）医生越来越重视在诊疗活动过程中的知情同意权,各种重要诊疗活动都与患者和家属沟通,并取得口头或文字上的同意,但部分护理人员对知情同意原则不重视,在环节中落实不力,从而易引发护患纠纷。而保证患者获得知情同意权是护理人员必须落实的义务,护士的告知是维护患者知情同意权和...