萨顿的新人文主义及其意义

萨顿提出的新人文主义观,分析批判了科学与人文的分裂对立,指出科学人性化是科学与人文融合的方法,其人性化的科学现有利于我们今天深度解读、审视医学的人性化,张扬价值理性,在实践中克服目前医学异化的倾向,开掘医学和人文融合的路径,实现医学人性化的真正回归。     

Bi-Directional Relationship Between Self-Regulation and Improved Eating: Temporal Associations With Exercise,Reduced Fatigue,and Weight Loss

ABSTRACT. Severely obese men and women (body mass index ≥ 35 ≤ 55 kg/m²; M_age = 44.8 years, SD = 9.3) were randomly assigned to a 6-month physical activity support treatment paired with either nutrition education (n = 83) or cognitive-behavioral nutrition (n = 82) methods for weight loss. Both groups had significant improvements in physical activity, fatigue, self-regulation for eating, and fruit and vegetable intake. Compared to those in the nutrition education group, participants in the behavioral group demonstrated greater overall increases in fruit and vegetable intake and physical activity. These group differences were associated with changes that occurred after Month 3. Increased physical activity predicted reduced fatigue, β = ?.19, p =.01. A reciprocal relationship between the mediators of that relationship, which were changes in self-regulation and fruit and vegetable intake, was identified. There was significantly greater weight loss over six months in the behavioral nutrition group when contrasted with the nutrition education group. Self-regulation for eating and fruit and vegetable intake were significant predictors of weight loss over both three and six months. Findings enabled a better understanding of psychosocial effects on temporal aspects of weight loss and may lead to more effective behavioral treatments for weight loss.     

Evaluating the method of levels

An investigation of the method of levels (MOL) was undertaken. Based on the principles of perceptual control theory (PCT), MOL is a way of helping people to reduce psychological distress. MOL assumes that psychological distress results when people are unable to control experiences that are important to them. The approach was implemented over six months in a large urban GP practice. Patients attended for between one and six sessions. Patients who attended for more than one session demonstrated significant reductions in scores of symptomatology on a standardized questionnaire. Effect sizes of these differences were relatively large. There appeared to be no relationship between the number of sessions a patient attended and the amount of reduction in symptomatology that was recorded. Similarly, there was no relationship between the number of sessions a patient attended and their recorded level of symptomatology at their first appointment. Although the study has important limitations we suggest that these findings might offer new directions for future research and might provide a way of unifying the specific and common factors as well as understanding the Dodo Bird effect.     

Parent and actometer measures of motor activity level in the young infant

Motor activity level is one dimension of infant temperament for which parental judgment can be validated against a truly independent criterion. Two studies were conducted, the first involving a 27-min sample of behavior in a structured, attention-getting situation, and the second involving a 24-hr sample of in-home behavior. In both studies, parent perception of the 3- or 4-month-old as measured by the Activity Level (AL) scale of the Rothbart Infant Behavior Questionnaire was compared to the composited readings from four mechanical motion recorders (actometers) worn, one per limb, by the infant. The AL scale did not correlate with the actometer measure, r=.05 and R=.00, and the expected convergence of the 3-month version of the IBQ activity scale with its mechanical counterpart was not found. In the 24-hr study, birth order and ponderal index were significantly correlated with 24-hr actometer scores; first-borns and thin infants were most active.     

国内医疗保障研究的知识图谱分析——基于CNKI数据库（2005年～2016年）

系统展现国内医疗保障领域的研究热点、重要学者、科研合作关系、期刊情况,对医疗保障研究形成直观的印象。利用可视化软件CiteSpace和文献计量学方法从关键词、作者、研究机构、期刊等方面进行知识图谱分析。分析结果表明,已有的医疗保障领域研究集中在新农合、医改、商业医疗保险参与社会保险、弱势群体和农民工医疗保障五类研究主题;出现了商业医疗保险、城乡统筹、大病保险等新的研究领域;学者之间的研究比较独立,少有稳定的研究团队,缺乏交流和资源共享。     

白求恩精神的形成和发展

通过对白求恩的成长和生活经历, 尤其是在中国抗日前线的医疗与教学实践活动的研究,揭示了白求恩精神的形成机制：基督教家庭的教养和西方社会的文化熏陶奠定其精神品质的底蕴,所接受的医学教育和丰富的医疗社会实践形成其精神品质的职业特征,所认同的共产主义思想和秉承的共产主义信仰构成其精神品质的内核,参加中国抗日战争过程中深感中国军民不屈不挠的精神成为其精神升华的热焰。由情感基础、实践逻辑、理论逻辑乃至文化逻辑,构成了白求恩精神形成的逻辑脉络。

     

关于实验动物运动模型建立的伦理思考

基于目前广泛应用的动物实验伦理3R和5F原则,通过深入分析已有运动干预文献中的动物运动模型构建方法,分别就运动模型建立前实验动物的选取,运动模式、运动剂量的确定,模型建立过程中不同阶段不同运动形式所涉及的伦理问题,以及实验动物安乐死等各个方面进行伦理分析,探讨伦理关怀在动物运动模型建立中的必要性和重要性。运动模型的构建作为研究运动干预的关键环节是极其重要的,此建立过程中涉及到诸多动物实验伦理问题。

     

麻醉科医患沟通现状及认知分析一一我国45家医院联合调查报告——

2017年8月1日~9月30日,在全国45家医院进行了电子问卷调查,旨在从医方角度调研麻醉科医患关系的现状。结果显示在导致医患沟通不畅的原因中除客观因素(病情复杂及疗效不确定)之外,麻醉科医务人员对患者防备心理过重位列首位(37.8%),其次为沟通时间不够(33.4%)、沟通意识缺乏(29.2%)以及沟通能力不足(28.3%),由此可见如今麻醉科医患沟通问题比较突出。建议麻醉科医生通过转变医疗观念,强化沟通意识;掌握语言工具,提高沟通技能;积极向患者科普麻醉学科的进展和局限等综合措施,逐渐改善麻醉科医患沟通现状。

     

现代医学异化现象的再讨论——兼论疗治型国家的诞生

现代医学异化现象,首先,要从医学职业化进程中承认异化的客观性和偶然性;其次,要从官僚化和市场化角度,认清知识、技术和消费如何围绕权力形成“疗治型国家”;再次,应从日常生活意识中,反思现代医学异化所造成的非家庭化结果及其表现;最后,我国现代医患关系,既表现出陌生人社会中的“物的关系”,又表现为熟人社会中的“人情关系”,而我国医学异化的本土特征是围绕“人情”形成的医学境遇异化。因此,立足本土情境特征,是重新理解我国医学异化现象特殊性的必由之路,也是“治愈”我国医学异化“阵痛”的“对症”之药。

     

以叙事医学实践促教学医院医学人文教育

叙事医学可以作为大学教学医院进行医学人文教育的重要手段。医学院可以进行细读训练,进入临床后,通过阅读和书写平行病历培养医学生的叙事能力。临床带教教师在医学人文教育中具有关键的示范作用,通过叙事性问诊、用叙事的方法与患者和家属建立关联,用叙事方法协助患者和家属做出临床决策,以及提供案例、点评升华其中的价值元素等叙事性带教方法,实现医学人文教育的言传身教, 这也是医学人文教育的重要组成部分。