降低医疗的二次伤害是医学人性化发展方向

医学是一种人性化的表达,然而,医学手段的伤害性特征也是现代医学本身无法回避的一个缺陷,忽视对医学技术本身的伤害性因素的认识,是当下医学人文衰退的一个重要原因,也是构建人性化医疗的一道障碍,面对越来越多的对医学伤害性的质疑,医学应该进行自我剖析,撕开医学手段的非人性化面纱,务必直面问题和解决问题,用医学的人性化关怀弥补医学手段的伤害性缺陷,并以医学技术本身的发展,促进医学向无伤害的人性化方向发展,这是现代医学发展的终极目标。     

片段弓矫治技术在前牙外伤中的应用

本文探讨片段弓矫治技术在前牙外伤中的应用效果。利用方丝弓矫治器对上前牙外伤68例患者（共89颗外伤牙,其中29颗松动Ⅱ度,51颗松动Ⅲ度,9颗完全脱位）进行复位、固定,并在治疗结束后半年、一年进行随诊观察。一年后固定成功率达到90％以上,患牙及颌骨复位精确,咬合关系恢复良好,并发症少。应用片段弓矫治技术治疗前牙外伤可获得良好的疗效,该技术安全可靠。     

Off-Unit Activities Programming for Long-Stay Psychiatric Inpatients

The significance of program site for inpatient therapeutic activities offered to chronic patients is rarely discussed. This paper reviews experiences with the development of a facility-wide off-unit activities program in a state psychiatric center. The organizational, clinical, and administrative implications of off-unit proramming are examined in relation to on-unit treatment ractices. iecommendations are made to assist the successful introauction of off-unit programming and the identification of the most effective location for specific activities.     

A comparison of cortico-cortical communication during air-pistol shooting in elite disabled and non-disabled shooters

This study examined the difference in electroencephalographic (EEG) coherence, an index of cortico-cortical communication, during air pistol shooting between disabled and non-disabled elite shooters. Participants included 22 non-disabled and 12 disabled members of the Korean national air-pistol shooting team at the world class level. Electrocortical activation was recorded during 20 self-paced 10-meter air pistol shots. Higher cortico-cortical communication between brain regions was observed in disabled shooters. The higher functional communication appears to be a strategy to compensate for the attenuated function of the brain resulting from spinal cord injury. This compensatory mechanism could explain why there is no significant difference in shooting performance between elite disabled and non-disabled shooters.     

Conceptualizing Nonsuicidal Self‐Injury as a Process Addiction: Review of Research and Implications for Counselor Training and Practice

Nonsuicidal self‐injury (NSSI) may be characterized as a process addiction for some individuals who self‐injure. The authors review findings on the addictive features of NSSI, including compulsivity, loss of control, continued use despite negative consequences, and tolerance.     

A Biopsychosocial Model for Understanding Relationship Aggression

SUMMARY

Aggression in adult, intimate relationships is a significant problem with far reaching effects on victims, perpetrators, their families, and society. Recognizing the import of the problem, the U.S. Department of Justice has established a Violence Against Women office, and many states have enacted legislation to protect victims and deal with perpetrators. It is urgent that we understand the dynamics of relationship aggression so that effective interventions and preventive programs can be developed. This article reviews the current status of research on relationship aggression and identifies several omissions, most notably, ignorance of the potential contributions of biological factors. Recent research regarding the relevance of biological factors is reviewed and a Biopsychosocial model is presented. Finally, some suggestions are made for future research.     

A Pilot Randomized Trial of an Online Parenting Skills Program for Pediatric Traumatic Brain Injury: Improvements in Parenting and Child Behavior

This pilot study examined changes in parenting skills and child behavior following participation in an online positive parenting skills program designed for young children with traumatic brain injury (TBI). Thirty-seven families with a child between 3 and 9 years of age who sustained a moderate to severe TBI were randomly assigned to one of two interventions: online parenting skills training (n = 20) or access to Internet resources on managing brain injury (n = 17). Parent–child interaction observations and parent ratings of child behavior were collected pre- and post-treatment. Generalized estimating equations and mixed models were used to examine changes in parenting skills and child behavior problems as well as the moderating role of family income on treatment response. Participants in the parenting skills group displayed significant improvements in observed positive parenting skills relative to participants in the Internet resource group. Income moderated improvements in parent ratings of child behavior, with participants in the low-income parenting skills group and high-income Internet resource group reporting the greatest improvements in behavior. This is the first randomized controlled trial examining online parenting skills training for families of young children with TBI. Improvements in positive parenting skills and child behavior support the utility of this intervention, particularly for families from lower socioeconomic backgrounds.     

Supportive psychotherapy of a psychodynamic orientation as an adjunctive treatment for drug-induced depression: A case study

Abstract

Treatment for drug-induced depression usually consists of cessation or reduction of the causative agent and psychopharmacologic management. In addition, psychotherapy can be useful as an adjunctive treatment. The author presents case material related to a young woman with an inborn physical illness, who became depressed during the course of interferon treatment for a medical complication, hepatitis virus infection. In addition to the cessation of interferon and pharmacologic management, supportive psychotherapy of a psychodynamic orientation was started in order to address the patient’s low self-esteem and anxiety about her future. During the course of psychotherapy, it was understood that the premature cessation of interferon was, to her, a narcissistic injury. It was also important to explore the meanings of her inborn illness and her guilty feelings. After reviewing various formulations of depression, the author discusses the case material from an integrative perspective, which describes vicious cycles of depression.     

Dimensionality of the Beck Anxiety Inventory in a Polytrauma Sample of OEF/OIF/OND Veterans: Findings From Exploratory and Confirmatory Factor Analysis

The Beck Anxiety Inventory (BAI) is commonly used as a screening instrument for symptoms of anxiety in clinical settings. The factor structure has been researched in a variety of different clinical settings with results ranging from a 2- to 5-factor structure. The purpose of this study was to explore the factor structure of this instrument in a polytrauma veteran sample. A sample of 304 veterans was used for this study. All subjects were administered the BAI screening measure as part of an evaluation in an outpatient polytrauma clinic. Exploratory factor analysis was conducted for half of the sample, followed by confirmatory factor analysis for the remaining sample to determine the best model. Factor analyses revealed that a 5-factor model provided a best fit. It is interesting to note that previously identified models of the BAI with other types of samples did not provide the best fit for this polytrauma sample. The BAI may provide additional information for clinicians when examining the 5-factor model with veterans in polytrauma settings. The factor structure of the BAI includes 1 factor (i.e., personal safety) that may be unique for veterans who have served in combat zones.