关于出生缺陷临床干预的决策与思考

出生缺陷是婴儿死亡、儿童和成人残疾的主要原因之一。不仅给社会带来巨大经济损失,同时还给家庭和个人带来了精神、道义负担以及痛苦。在其临床干预的决策上临床医生必须从以下三个方面努力:(1)丰富相关知识,把握科技发展动态,努力提高产前诊断正确率并对病人进行科学的引导;(2)遵守国家法律法规的前提下尊重个人意愿;(3)尊重医学伦理学的同时尊重国情。从而最大程度地减少或避免其给国家、社会和家庭带来的损失,同时消除医患纠纷,创造和谐的医疗环境。     

经济学评价在临床决策中的应用探讨

医生在临床工作中做出明确诊断,并据此给予有效的处理均属于决策过程。制定决策的整个过程,同时也是进行决策思维的过程。近年来,高新技术的迅猛发展以及医疗费用急剧增加,使制定决策更加复杂。如何进行正确的决策思维,做出最切实可行的和最佳的决策,对避免决策的盲目性具有重要的现实意义。     

年轻医生如何搞好临床科研

面对目前年轻医生对科研束手无策的状况,提出了科研的重要性。从科研选题要紧密结合临床实际、医学科研选题强调创新与实用的原则、医学科研需要的科研素质、培养独立从事临床科学研究的能力、充分利用优势科研资源,加强科研合作能力的培养五方面进行阐述如何进行临床科研工作,以便更好地促进临床医学事业的发展。     

产前筛查的几点思考

在临床工作中,患者因某些原因不能得到有效或常规的治疗,而最终选择停止继续治疗、即放弃治疗,及时、合理、正确地处理放弃治疗对患者、医务人员、家庭、社会等是极其重要的。对临床上常见的放弃治疗原因进行了全面分析,包括患方、医生、功利、无奈、道德等方面的原因,并提出了解决放弃治疗的临床决策,该研究为临床治疗过程中提供了重要的理论参考。     

影响乳腺癌诊疗过程的临床决策因素分析

多种因素可以影响乳腺癌的临床决策。本文从四个方面进行探讨,期望探索出适合我国国情的乳腺癌临床诊疗模式。首先,多专科的良好协作是乳腺癌临床决策的前提;其次,陈旧的乳腺癌诊疗观念限制了科学的临床决策;第三,防御性医疗行为降低了乳腺癌临床决策的质量;第四,要考虑到社会心理因素在诊疗决策中的影响。     

如何提高临床医学生与患者之间沟通的能力

正常有序的医疗活动应以良好的医患沟通为基础,要从根本上处理好医患关,首先要从培养临床医学生与患者之间的沟通能力入手,多数医学生在进入临床实习时都因紧张而不知道应该如何与患者沟通,因此培养医学生与患者间良好的沟通能力是当前迫切需要解决的问题。     

为什么无效的药物治疗会被认为有效？

把无效的治疗误认为有效,不仅在大众中非常普遍,而且很多医生也常如此。造成这种疗效假象有许多原因,主要由于疾病的自愈或自发缓解、药物和治疗的安慰效应、缺乏严格的评价疗效标准以及诊断不确实,以及把良性疾病误诊为严重或恶性疾病所造成的。对传统医疗的信仰也是原因之一。因此,对任何药物或医疗的效果必须进行严格的随机对照临床试验,并且得到同行的检验和公认。     

湖北省保健干部健康状况主要影响因素分析

为了解保健干部健康状况的主要影响因素,对2003年～2005年湖北省830名保健干部健康体检结果和其主要影响因素进行分析研究,发现性别、年龄、BMI、吸烟、饮酒是影响该人群体检指标的主要因素。为了健康,控制体重、戒烟、限酒,养成好的生活习惯很有必要,这给该人群的健康促进工作指明了重点。     

The Spanish language version of the Eating Disorder Examination Questionnaire: comparison with the Spanish language version of the eating disorder examination and test-retest reliability

This study compared the Spanish language questionnaire (S-EDE-Q) and interview (S-EDE) versions of the Eating Disorder Examination and examined the short-term test-retest reliability of the questionnaire version. Seventy-seven monolingual Spanish-speaking Latina women recruited from the community completed the S-EDE-Q and were then administered the S-EDE by fully bilingual doctoral-level research clinicians. The same assessment was repeated after approximately one week (5-14 days). The S-EDE-Q and the S-EDE were significantly correlated on frequencies of binge eating and all four subscales. Mean differences in the frequency of binge eating and the Restraint subscale were not significant, but scores on the Eating Concern, Weight Concern, and Shape Concern subscales differed significantly, with the S-EDE-Q yielding higher scores. Test-retest reliability for the S-EDE-Q was modest for binge eating but was excellent for the subscales (Spearman rho ranged 0.71-0.81), albeit somewhat variable for the individual items. Overall, the acceptable convergence between the S-EDE-Q and the S-EDE for many features of eating disorders and the good short-term test-retest findings provide preliminary support for the use of the S-EDE-Q. These findings, derived using a non-clinical sample of monolingual Spanish-speaking Latina women, require replication and extension. Evaluation with a clinical sample is necessary to further establish the reliability of the S-EDE-Q with an eating disordered group.     

Juvenile prostitution and community rehabilitation: an exploratory analysis of beliefs and values

A community, juvenile prostitution rehabilitation programme in Bogotá, Colombia, South America is described; and beliefs and values of the residents were explored. Multiple sorting procedures and multi‐dimensional scaling analysis elicited qualitative, structured, self‐report data, and investigated cognitive constructs. Participants discriminated between belief‐statements along two global dimensions: street‐life and prostitution; and rehabilitation. These were comprised of qualitatively different elements. Clinical implications for interventions with this group and the rehabilitation programme are discussed. Copyright © 2007 John Wiley & Sons, Ltd.