Listening to the Voices of Children in Early Schooling in the South African Context of HIV/AIDS

This study explored how children in early schooling interpreted their social reality to construct vulnerable childhoods in an HIV/AIDS context. Ten males and ten females between the ages of eight and nine years from low-income families in KwaZulu-Natal participated in the study. In order to raise the voices of the children, a listening framework was created through participatory techniques. Focus group interviews, drawings, story telling and projection techniques were used in the study. The study found that children actively interpreted their social reality through engaging with circumstances that surrounded their lives in an HIV/AIDS context. Child activism is important to HIV/AIDS education.     

HIV/AIDS Awareness of In—School Adolescents in Nigeria: Implications for Adolescence Sexuality

This study investigated HIV/AIDS awareness of in-school adolescents in Nigeria to determine their risk for contracting HIV/AIDS. A total of 892 purposively selected adolescents (mean age = 16. 5 years; SD = 5. 2; males = 492; females = 400) participated in the study. The participants responded to the HIV/AIDS Awareness Inventory (HAAI). The questions on the survey included the following aspects: meaning of HIV/AIDS; prevalence; mode of transmission; consequences and prevention. Differences in gender, age, school location and father's educational background in understanding HIV risk were examined. A group means comparison procedure revealed a significant difference in HIV awareness by gender, age, school location and father's educational background. Female adolescents, the older adolescents, those living in urban centres and those whose fathers are literate had higher HIV/AIDS awareness than their counterparts from rural areas. Nigerian adolescents need education regarding HIV/AIDS awareness.     

Finding Voice: The Photovoice Method of Data Collection in HIV and AIDS-Related Research

This study examined the efficacy of photovoice as a research technique to explore the lives of children and families living in the context of HIV and AIDS. Participants were volunteers at a Day Care and Support Centre (n=18), and members of a community support group consisting of People Living with AIDS (n=5). The findings revealed that the photovoice method is particularly useful for dealing with the ‘unspoken’ lived experience of children and families.     

生前预嘱推广：实践与建议

目前世界上所有提供安宁缓和医疗服务的国家和地区,都将生前预嘱以及功能相似的一系列文件作为开展这项服务的合法性前提。通过对十几年来在中国大陆开展生前预嘱推广工作的总结,以及目前所有生前预嘱签署者的大数据分析,可以看出其与整个社会政治经济发展水平以及法律政策、伦理道德、传统文化、国族心理、医疗制度改革、临床学科发展等均有极其密切的关系。在生命科学和医疗技术迅猛发展的背景下,生前预嘱使得个人意愿和医疗偏好成为现代医学成长和成熟过程中越来越重要的伦理依据。     

平行病历在门诊癌痛患者规范管理中的应用研究

为探索平行病历在门诊癌痛患者规范管理中的作用,选取在疼痛科癌痛门诊就诊的76例患者为研究对象,随机分为对照组37例、观察组39例。所有患者均于首诊、第2周、4周、12周复诊时,完成相关问卷调查。对照组给予常规治疗,用药指导等。观察组除常规治疗和用药指导外,为每位患者建立平行病历及复诊档案。结果显示：观察组疼痛控制情况、生活质量改善、服药依从性及就诊满意度,均优于对照组,差异有统计学意义(P＜0.05)。本研究提示,平行病历有助于改善患者疼痛控制情况和生活质量,提高服药依从性和就诊满意度,改善医疗人文环境,为癌痛患者及家属提供富含共情、关注和尊重的诊疗服务,有利于门诊癌痛患者规范化管理。

     

供精助孕技术的社会伦理问题

供精助孕技术作为人类辅助生殖技术之一,是实现不育症家庭生育后代的重要手段。通过对人类精子库的发展历程和相关政策的介绍,探讨全球不同社会环境下供精助孕技术所面临的对个人、家庭、社会等方面的伦理问题。讨论供精过程对捐精者的心理社会影响、供精助孕技术后代的知情权及其与供精者的关系界定、供精助孕后代近亲婚配及社会地位和心理状况、实施供精助孕技术对社会学父亲心理社会的影响等问题。如何充分发挥供精助孕技术在辅助生育上的优势并协调社会家庭结构将是未来辅助生殖技术政策调整的方向。

     

HIV感染者遭受医务人员歧视的经历和体验的文献研究

通过Meta整合方法系统梳理关于艾滋病病毒（human immunodeficiency virus,HIV）感染者遭受医务人员歧视的经历和体验的质性研究,为提高HIV感染者就医体验提供参考依据。经过文献筛选和质量评价后共纳入19篇文献,通过Meta整合共得出27个研究结果,其中相近结果可归类为7个新类别,最终归纳出3个整合结果：（1）医务人员歧视产生的原因;（2）医务人员歧视的表现形式;（3）遭受医务人员歧视的危害。提示医务人员对HIV感染者具有多种歧视,并会严重影响患者的治疗行为和心理健康,未来有必要采取干预措施,减轻甚至消除医务人员对HIV感染者的歧视现象。

     

智力障碍女性生育权与代理权的伦理探讨

基于伦理审查中的真实案例以及境遇伦理学,讨论了涉及以下四个层面在不同情况下实施人工流产的道德性：（1）孕妇与胎儿权利之争;（2）智障女性能否胜任自主抉择？（3）家属代理权的行使及限制;（4）如何使最终决策实现善意？在此类案例中如果采用原则主义容易导致“一刀切”,因此,采取境遇伦理学的策略才能真正解决类似的道德困境。对相同的情形采取相同的措施,不同的情形采取不同的措施,如此方可真正做到符合伦理。

     

医患双方对中晚期肺癌在EICU的治疗抉择

急诊重症监护室收治的肺癌中晚期患者往往因突发的危重并发症而打乱既往的抗肿瘤计划,因其病情特点呈现一定的可逆性,救治效果或好于传统终末期患者,家属对治疗的态度也更为积极,这些均不同于以往肿瘤自然进程发展下的终末期患者。从生存率及生存质量两个方面来着重探讨此类患者在急诊重症监护室中治疗能否获益,以及在救治患者的过程中,患者家属及医生对待放弃治疗时的矛盾心理及产生原因,并将就此问题提出尊严死教育的重要性,提出建立健全撤除生命支持系统的具体实施方案。