Building a Life Worth Living During a Pandemic and Beyond: Adaptations of Comprehensive DBT to COVID-19

Our team at the Jefferson Center City Clinic for Behavioral Medicine has recently been challenged to find a synthesis between the need to adapt to circumstances associated with the COVID-19 pandemic, while at the same time retaining the spirit and essential components of comprehensive DBT. This fine balance between unwavering centeredness and compassionate flexibility is central to DBT (Linehan, 1993), and has proven essential during these times of uncertainty. This short article highlights challenges and innovations faced by our DBT Team, Skills Group, individual DBT sessions, phone coaching, and also our community at large, as we strive to help our patients and team members build a life worth living during and following a pandemic.     

Intelligence artificielle et médecine : quelles règles éthiques et juridiques pour une IA responsable ?

Combining AI and medicine means talking about the medicine of the future, but even more about improving the quality of care. Its fields of application: predictive medicine, precision medicine, decision support, prevention, computer-assisted surgery, robotic support for the elderly, etc. are all related concerns: the possibility of maintaining human contact with the patient, the explicability of the algorithm - the collection of health data - and the improvement of the health care system. AI applications are already improving the quality of care. Its deployment at the heart of the medicine of the future is in constant evolution. To be acceptable and legitimate, the decisions of any algorithm must be understood and therefore explained. Only a good understanding of the diagnoses and therapies proposed by the AI application will allow doctors to discuss with their patients and to explain the possible alternatives. In the opposite case, the doctor risks to dismiss the use of algorithms because he will not be able to justify the decisions which will pose problems in terms of liability research in particular.     

State-Supported Science and Imaginary Lock-in: The Case of Regenerative Medicine in Japan

Abstract

Regenerative medicine (RM) in Japan lays strong emphasis on a specific trajectory of its development, which deploys human induced pluripotent stem (iPS) cells as the primary sources for the technology. The technique to create these stem cells was developed in 2006 by a Japanese stem cell scientist, Shinya Yamanaka, and since its applicability to human cells was established about a year later, this new type of cells has become to be considered as a potential substitute for human embryonic stem cells. While the clinical value of these cells are yet to be confirmed, the Japanese Ministry of Education, Culture, Sports, Science and Technology decided to concentrate its support on iPS cells research and turned it into a national project. This decision reflected the state's vision of initiating the transition to a knowledge-based society, which was adopted in the 1990s to tackle the prolonged deflation in the country. As the research became intertwined with this policy vision, however, the Ministry came to see bringing its success as more important than ever, while other trajectories of RM were left underrated and largely unsupported. Industrial actors counteracted this situation and developed an initiative to recognize existing technical capability in the country, but its impact has been so far negligible. This indicates that the nation is locked in the particular trajectory of RM. Hence, this Japanese RM research enterprise presents an interesting case to understand how states' commitment may not only shape the course of scientific research but also reduce flexibility in technological development.     

肺癌防治三层一体整合医疗体系的建立

探索建立肺癌防治整合医疗模式的具体实施方案并对其效果进行评估.在大港医院建立肺癌防治整合医疗模式：由通科人才管理治疗患者、专科人才会诊治疗患者、健康管理师追踪管理患者的管理方式.把肺癌患者的诊断治疗分为三个层次,即对肺癌患者的癌症诊断治疗、宿主管理、危险因素调控三个层面的关注、管理和治疗,三个层面成为统一整体同时或序贯实施,即建立＂肺癌防治三层一体整合医疗体系＂.新的肺癌防治整合医疗模式作为整合医疗模式的具体体现,设计完整,已经形成体系.＂肺癌防治三层一体整合医疗体系＂设计合理,容易实施,可以推广.     

转化医学应用现状及其困境分析

转化医学的理念已经蓬勃发展起来,但对大多数处于临床一线的医生而言,却产生了较多困惑:基础医学与临床医学之间仍相互脱节,许多先进的基础医学研究难以为临床实践所用,基础医学的先进成果向临床的转化难以实现.因此,对于转化医学理念的提出,应有所反思,使转化医学的价值得以充分地发挥.     

近现代中西医教育课程内容和教育形式的演变

近现代的中西医教育从课程内容和学位教育形式方面表现出完全不同的发展态势,主要原因是在中西医的学术内部.中医学理论属于哲学范畴,缺少自我更新的能力,只停留在形式上的表面进步.而西医学是以自然科学为基础,科技水平的进步也会带动其迅速发展.这就是当前中医教育面临的结症所在,需要中医人士潜心研究,为中医教育开辟新路.     

河南省医疗改革的公平性分析

河南省医疗改革突出的难题在于如何实现保健资源的公平公正.影响河南医疗改革公平的因素是产权改制的方向偏差,道德异乡人的利益博弈,资本和技术对医学的剥蚀,医学、医疗自身发展的失衡.实现医疗改革公平的对策建议是显化政府责任伦理,重建医患利益共同体,整合优化卫生资源的配置,推行医学整体化的发展模式.     

关于内科临床技能培训教学课程设置的探讨

通过对参加内科临床技能培训的大连医科大学2007级、2009级五年制及七年制临床医学专业学生进行问卷调查及客观结构化临床考试（OSCE）,探讨内科临床技能培训课程的学时及课程内容等设置.100%的学生认为有开设临床技能培训课的必要,50%以上的学生认为在大学4年级开设本课程较合适,50%以上的学生认为12学时的设置较合理,80%以上的学生认为应每4人共用一名模拟人.OSCE证实毕业前12学时培训组成绩优于实习前8学时组.     

Psychiatric Patients’ Evaluation of the Efficacy of Obeah vs. Western Medicine in Treating Their Mental Illness

This study sought to determine any potential benefits in psychiatric patients’ use of traditional medicine in their treatment. Participants were 51 Jamaican patients who self-reported on concurrent use of western and alternative medicine. They completed the Jamaican Healthcare Perception Questionnaire. Data were analysed using the chi-square test of differences between proportions. Findings indicated that 58.8% of patients incorporated traditional medicine in their treatment. These were less likely to agree with the diagnosis given by the formal practitioner and that his treatment was effective or to rate the quality of service of the formal practitioner as being satisfactory. Patients believed alternative medicine should be incorporated into the healthcare system.