适宜技术与诊疗最优化的可行性研究

在案例分析的基础上,作出了医生是临床诊疗中适宜技术的主要选择者的判断;论证了运用适宜技术实现诊疗最优化的可行性;认为适宜技术难以选择和实施的主要原因是利益关系、责任心不强和管理措施不到位;提出了必须着力培育适合于适宜技术生长的土壤的对策,即:实行政策引导与资金支持、进一步加大监管力度、营造良好的氛围、高度重视并加强医生道德素质的培养.     

食管癌内镜技术最优化原则的思考

随着消化内镜及其配件的不断更新和内镜医师操作技术的进步,消化内镜在食管癌的应用从诊断为主发展到诊断与治疗并重.回顾历史,医疗需求是医学科学进步的强大动力,科学技术进步推动医学的发展,内镜技术的发展促进了食管癌诊断与治疗水平的最优化.     

道家“因”论

＂因＂是道家政治哲学的核心范畴,＂因者,君之纲＂。道家＂因＂论包含有因循、因仍、因应和因凭四重内涵,其价值功用是＂因则无敌＂。道家＂因＂论作为一种＂君术＂,强调＂因臣之为＂和＂因民之性＂两个基本面,其总的原则是＂曲因其当＂,而核心本质则凸显为＂舍己而以物为法＂。     

Experiences related to expert supervisors' views of ideal therapeutic practice

Aims: This study examines the relationship between expert supervisors' professional experiences and their views about the importance of different psychotherapy techniques. Method: Thirty psychodynamic‐interpersonal (PI) supervisors and 13 cognitive‐behavioural (CB) supervisors (N=43) were instructed to rate 20 therapeutic techniques according to how characteristic each technique is of an ideally‐conducted session within their theoretical orientation. The measure used for this assessment was the Comparative Psychotherapy Process Scale. Results: Findings demonstrated that supervisors' beliefs about ideal therapeutic techniques are related to their number of years in post‐graduate clinical practice, training, and supervising trainees, as well as to the number of publications they have authored. Further, experience within a given orientation tends to lead to a greater endorsement of techniques within that orientation, although this finding is more uniform for CB supervisors than PI supervisors. Finally, differential types of experience lead to differential focusing on specific techniques. Discussion: The clinical importance of these findings is explored.     

Treatment manuals: use in the treatment of bulimia nervosa

As psychology has moved toward emphasizing evidence-based practice, use of treatment manuals has extended from research trials into clinical practice. Minimal research has directly evaluated use of manuals in clinical practice. This survey of international eating disorder professionals examined use of manuals with 259 clinicians’ most recent client with bulimia nervosa. Although evidence-based manuals for bulimia nervosa exist, only 35.9% of clinicians reported using a manual. Clinicians were more likely to use a manual if they were younger; were treating an adult client; were clinical psychologists; were involved in research related to eating disorders; and endorsed a cognitive-behavioral orientation. Clinicians were less likely to use a manual if they provided eclectic psychotherapy that incorporated multiple psychotherapeutic approaches. We conclude that psychotherapy provided in clinical practice often does not align with the specific form validated in research trials, and “eclecticism” is at odds with efforts to disseminate manuals into clinical practice.     

共同方法变异的影响及其统计控制途径的模型分析

共同方法变异(common method variance, CMV)指两个变量之间变异的重叠是因为使用同类测量工具而导致, 而不是代表潜在构念之间的真实关系。虽然以往研究显示CMV不一定导致研究结果的偏差, 在实际研究中应当加以考量。特别是在使用测量方法的研究中, 如果数据来源越单一, 测量方法越类似, CMV效应使研究结果产生偏差的可能性越大。CMV效应的控制方法包括过程控制法和统计控制法。在统计控制法的选择和使用上, 需要重点考虑该方法是否分离了三大变异(特质变异、方法变异和误差变异), CMV效应是在测量构念层面还是题目层面, CMV效应是加法效应还是乘法效应。控制潜在方法因子途径是统计控制方法中最重要的一类方法, 理解其模型是正确使用这类方法的前提。未来研究应当关注多个研究的CMV效应和侧重评估某个理论研究中CMV所引起的潜在的效度威胁。     

Optimal Partitioning of Testing Time: Theoretical Properties and Practical Implications

This paper deals with optimal partitioning of limited testing time in order to achieve maximum total test score. Nonlinear optimization theory was used to analyze this problem. A general case using a generic item response model is first presented. A special case that applies a response time model proposed by Wang and Hanson (2005) is also presented. Theoretical properties of the optimal solution are derived. Their practical implications to optimal test-taking strategies are also discussed. The theoretical properties are in general agreement with the conventional advice to the examinees on pacing strategy.     

下腰痛综合征的诊治与人文思想

下腰痛是一种常见的骨科病症,轻者可影响患者生活,重者可使患者丧失劳动力。它的发病原因有很多,治疗方法各有不同。在下腰痛的诊断中要按照适度医疗的原则选择合适的检查;在下腰痛的治疗中须按照最优化医疗的原则选择最佳的治疗方案。在治疗中要注意结合人文思想来提高下腰痛的治疗效果。