"易"论医学之道

"易"作为中国古代便形成的通俗唯物主义哲学,在指导社会及科技发展过程中,始终发挥着极其重要的作用.而历代医学先贤,无不对"易"有着深刻的理解."不知易,不足为大医"之论也始终是历代医者所遵循的至理名言.的确如此,人类社会的发展,无不体现在"变"的过程之中,传统哲学"易"的形成及发展,不仅本身是变的展示,而且对变化之道进行了精确的阐述,而祖国医学的形成及发展正是在这种理论的指导之下产生并逐步发展完善的.因而,"易"对传统医学而言,是根,是本,是原动力.     

Learning to stand tall: Idiopathic scoliosis,behavioral electronics,and technologically-assisted patient participation in treatment,c. 1969–1992

Drawing on the archives of American learning psychologist Neal E. Miller, this article investigates the role of instrumentation in the expansion and diversification of the behavior therapy domain from the late 1960s to the early 1990s. Through the case of Miller's research on the use of biofeedback to treat idiopathic scoliosis, it argues that the post-World War II adoption of electronic technology by behavioral psychologists contributed to extending their subject matter to include physiological processes and somatic conditions. It also enabled a technologically-instrumented move outside the laboratory through the development of portable ambulatory treatment devices. Using the example of the Posture-Training Device that Miller and his collaborators invented for the behavioral treatment of idiopathic scoliosis, this paper considers how electromechanical psychological instrumentation illustrated a larger and ambiguous strategic shift in behavior therapy from an orientation toward external control to one of self-control.     

现代阳痿辨治思路创立与思辨

阳痿是临床常见、难治性病症,自古以来多从肾论治,尤其是壮阳一法几乎成为辨治阳痿的代名词.在万艾可面市后,中医药辨治阳痿的市场日见萎退,表面看是中医缺乏速效性治疗手段,实质上是在辨治阳痿的理论及临床方面存在客观的问题.本文拟从心肝在勃起中的指令性调节、气血在勃起中的实质性支撑,以及肾精、天癸在勃起中的本质性作用等角度,从勃起生理、病理、治疗等方面构建中医现代阳痿辨治的临床思路.     

Do hospital treatments represent a ‘teachable moment’ for quitting smoking? A study from a stage-theoretical perspective

Hospital treatments are assumed to be a ‘teachable moment’. This phenomenon, however, is only poorly conceptualised and untested. A stage-theoretical perspective implies that a cueing event such as hospital treatments is a teachable moment if a stage progression, change of cognitions, or both occur. This concept is examined in a cross-sectional study by comparing smokers in two treatment settings, an emergency department (ED) and inpatient treatment after elective surgery, with smokers in a control setting. Setting differences were hypothesised in stage distribution, and levels of and stage differences in social-cognitive factors under control for possible confounders. Stage, social-cognitive factors and possible confounders were assessed in 185 ED smokers, 193 inpatient smokers and 290 control smokers. Compared to control smokers, ED and inpatient smokers were in higher stages; they perceived fewer risks and cons; inpatient smokers reported more concrete plans. Stage differences in self-efficacy among ED and inpatient smokers differed from those among control smokers, but the former corresponded more strongly to the theoretical stage assumptions. The results suggest that hospital treatments lead to a stage progression and change of corresponding cognitions, and thus represent a ‘teachable moment’. Stage-matched interventions should be provided but consider differences in cognitions to be effective.     

肠癌肝转移综合治疗的现状和展望

结直肠癌肝转移是影响结直肠癌预后的重要因素,目前提倡综合治疗,以手术为核心,辅以化疗、靶向治疗、局部治疗(放疗、介入治疗等).随着新药的研发,新技术的应用,个体化治疗、转化治疗的开展,其预后显著改善.而生物心理社会医学模式同样使患者获益.本文对结直肠癌肝转移的综合治疗进行综述.     

Satisfaction with therapist-delivered vs. self-administered online cognitive behavioural treatments for depression symptoms in college students

Participants with symptoms of depression received either eight sessions of therapist-delivered email cognitive behaviour therapy (eCBT; n=37), or eight sessions of computerised CBT self-administered treatment (cCBT; n=43). At post-treatment participants completed a questionnaire to determine what they found satisfying about their online treatment. Quantitative and qualitative analysis was employed to report outcomes. A sample of 25 participants(eCBT n=10; cCBT n=15) completed the satisfaction questionnaire. Both groups were satisfied with accessing and using an online treatment and that they had self-control over their treatment. Perceived anonymity was important for the eCBT group. For the cCBT group they found the treatment user-friendly, engaging and also a source of learning. Both groups disliked that the online treatment could at times be complicated and impersonal.     

In-Home Parent-Child Interaction Therapy: Clinical Considerations

ABSTRACT

Parent-Child Interaction Therapy (PCIT) is an empirically-supported behavioral parent training program designed to be administered in a clinic or laboratory-based setting. Recently, an empirical investigation revealed that in-home PCIT produced comparable results as the PCIT trials conducted in more controlled environments (this issue). Administering PCIT in a home setting carries both drawbacks and advantages. This article provides an overview of both the positive and negative clinical aspects of conducting in-home PCIT and presents effective solutions to potential treatment barriers.     

Does Depression Affect Clinical Practice?

Abstract

While recent autobiographical accounts of women psychotherapists with depressive illnesses have provided vivid and compelling portraits of therapists' experiences in therapy (e.g., Jamison, 1995; Manning, 1995), further research is needed to clarify the impact that depression and its treatment have upon both collegial relationships and clinical practice. A subset of the membership of the Association for Women in Psychology (AWP) was surveyed concerning therapists' experiences with depression and its treatment. Of 220 respondents, 76% reported some form of depressive illness. Eighty-five percent of respondents indicated that they participated in personal therapy. When evaluating their clinical work, respondents reported both positive and negative consequences resulting from their depression. While some respondents noted improvement in collegial relationships, many felt judged and avoided.     

An Evaluation of a Self-Protection Skills Program for the Mildly Handicapped

The purpose of the present investigation was to determine the effects of a self-protection curriculum with a group of 10 junior high special education students. The curriculum (Ryerson & Sunden, 1981) was designed to increase the student's ability to identify strangers, recognize unsafe situations, use refusal skill, and understand acceptable and unacceptable touch. The effects of the curriculum were examined using a multiple baseline pre-posttest design across subjects. The results indicated a significant improvement in self-protection skills. Post testing data indicated the self-protection skills ere maintained over time.