姑息医学在大肠癌治疗中的地位和应用策略

大肠癌的治疗应采用一种无缝的连接方式将姑息治疗与抗肿瘤治疗整合在一起。姑息医学的采用应贯穿肿瘤治疗的始终,以期更好地提高生命质量,尊重生命价值,体现医学本质和人文关怀。     

德性论视域下和谐“医患共同体”的构建

当前"医患共同体"的构建应当回归"德性基础主义"的建构路径。德性论思想从五个维度展现了其对构筑和谐"医患共同体"的理论价值及意义。在和谐"医患共同体"的实际构建中德性价值具体表现在以下几方面:"环境和谐"的德性建构、"文化和谐"的德性塑造、"医疗和谐"的德性创设、"生命和谐"的德性构造。     

鼻咽癌的姑息治疗

鼻咽癌诊断的复杂性及诊断水平的限制,很多的患者确诊时已是中晚期。姑息治疗作为一种新的医疗模式,能减轻鼻咽癌患者的痛苦,提高生存质量。姑息治疗的发展将提高癌症治疗效果,为患者带来希望。     

The life instinct

In psychoanalytic writing an oversimplified interpretation of Freud's concept of the life and death instincts sometimes colours the presentation. Roughly, there is an implication that the life instinct is 'good' and the death instinct 'bad'. Freud however is clear that: "Neither of these instincts is any less essential than the other; the phenomena of life arise from the concurrent or mutually opposing action of both"(1933b, p. 209). In this paper I look in detail at the characteristics of the life instinct as conceptualized by Freud, and draw on Bion's work 'on linking' to elaborate Freud's view that binding is the life instinct's key characteristic. I suggest that there are pathological forms of both the life and death instinct if defused (separated off) from the other, and I explore a pathological variation of the life instinct in which binding is without the negation, rest, limit or end provided by the 'opposing action' of the death instinct. I consider an instance of the kind that any analyst might meet clinically, in which an inhibited patient experiences severe anxiety that life-giving connections threaten to proliferate indiscriminately and to an overwhelming intensity and size.     

The effects of variable-time delivery of food items and praise on problem behavior reinforced by escape

Prior research indicates that reinforcement of an appropriate response (e.g., compliance) can produce concomitant reductions in problem behavior reinforced by escape when problem behavior continues to produce negative reinforcement (e.g., Lalli et al., 1999). These effects may be due to a preference for positive over negative reinforcement or to positive reinforcement acting as an abolishing operation, rendering demands less aversive and escape from demands less effective as negative reinforcement. In the current investigation, we delivered a preferred food item and praise on a variable-time 15-s schedule while providing escape for problem behavior on a fixed-ratio 1 schedule in a demand condition for 3 participants with problem behavior maintained by negative reinforcement. Results for all 3 participants showed that variable-time delivery of preferred edible items reduced problem behavior even though escape continued to be available for these responses. These findings are discussed in the context of motivating operations.     

Development and modification of a response class via positive and negative reinforcement: a translational approach

When responses function to produce the same reinforcer, a response class exists. Researchers have examined response classes in applied settings; however, the challenges associated with conducting applied research on response class development have recently necessitated the development of an analogue response class model. To date, little research has examined response classes that are strengthened by negative reinforcement. The current investigation was designed to develop a laboratory model of a response class through positive reinforcement (i.e., points exchangeable for money) and through negative reinforcement (i.e., the avoidance of scheduled point losses) with 11 college students as participants and clicks as the operant. Results of both the positive and negative reinforcement evaluations showed that participants usually selected the least effortful response that produced points or the avoidance of point losses, respectively. The applied implications of the findings are discussed, along with the relevance of the present model to the study of punishment and resurgence.     

A LORETA study of mental time travel: Similar and distinct electrophysiological correlates of re-experiencing past events and pre-experiencing future events

Previous studies exploring mental time travel paradigms with functional neuroimaging techniques have uncovered both common and distinct neural correlates of re-experiencing past events or pre-experiencing future events. A gap in the mental time travel literature exists, as paradigms have not explored the affective component of re-experiencing past episodic events; this study explored this sparsely researched area. The present study employed standardized low resolution electromagnetic tomography (sLORETA) to identify electrophysiological correlates of re-experience affect-laden and non-affective past events, as well as pre-experiencing a future anticipated event. Our results confirm previous research and are also novel in that we illustrate common and distinct electrophysiological correlates of re-experiencing affective episodic events. Furthermore, research from this experiment yields results outlining a pattern of activation in the frontal and temporal regions is correlated with the time frame of past or future events subjects imagined.     

生活事件与大学生自杀意念的关系——气质性乐观的调节作用

目的在医学生中探讨气质性乐观、生活事件与自杀意念的关系。方法采用自杀意念自评量表以及乐观问卷、青少年生活事件量表对两所医学院校的800名临床医学专业学生进行调查。结果①应激事件对医学生的自杀意念水平有正向预测作用,应激事件越严重,学生的自杀意念水平越高;②气质性乐观对应激事件与自杀意念之间的关系具有调节作用。结论气质性乐观是负性生活事件与自杀意念之间的调节器。     

生命意义心理学理论取向与测量

生命意义的心理学理论与实证研究始于20世纪中期,经由存在主义心理学取向、人格与动机取向,到相对主义观点,再到积极心理学取向,生命意义的心理学研究逐渐摆脱"哲学风格",从而完成了其"心理学化"的历程。20世纪60年代开始,研究者们从生命意义感和生命意义源这两个研究维度出发,陆续开发了大量的测量工具。生命意义感和生命意义源测量的综合化成为近年来测量工具发展的趋势。生命意义的心理学研究在理论视角、测量内容与方法、实践应用等方面有着广阔的发展前景。