Secondary traumatic stress in emergency medicine clinicians

Previously called Secondary Traumatic Stress (STS), secondary exposure to trauma is now considered a valid DSM-5 Criterion A stressor for posttraumatic stress disorder (PTSD). Previous studies have found high rates of STS in clinicians who treat traumatically injured patients. However, little research has examined STS among Emergency Medicine (EM) physicians and advanced practice providers (APPs). The current study enrolled EM providers (N = 118) working in one of 10 hospitals to examine risk factors, protective factors, and the prevalence of STS in this understudied population. Most of the participants were physicians (72.9%), Caucasian (85.6%), and male (70.3%) with mean age of 39.7 (SD = 8.9). Overall, 12.7% of the sample screened positive for STS with clinical levels of intrusion, arousal, and avoidance symptom clusters, and 33.9% had at least one symptom cluster at clinical levels. Low resilience and a history of personal trauma were positively associated with positive STS screens and STS severity scores. Borderline significance suggested that female gender and spending ≥10% of one’s time with trauma patients could be additional risk factors. Findings suggest that resilience-building interventions may be beneficial.     

艺术治疗的概念、发展及教育

综述了国内外近10年来关于艺术治疗的文献资料,回顾了艺术治疗的概念、学科范围界定、应用、发展,比较了中西方艺术文化差异,同时对于艺术治疗与健康和疾病的关系,及其机理等进行了探讨.也对国外艺术治疗在高等院校中的课程设置、讲解内容等进行了阐述.根据作者多年的研究和教育实践,试图探索出中国艺术治疗学科体系的构建框架.     

"人造美人"的几个法律问题--兼与孙福川教授商榷

针对2004年<医学与哲学>第7期孙福川教授<对"人造美人"医学的十大人文拷问>一文,提出自己的观点,认为"人造美人"是临床医疗行为,其出现并没有偏离医学的目的,"人造美人"的法律主体地位应是患者,因人造美人而出现的纠纷可以适用于处理医疗纠纷的相关法律、法规,同时造美广告也是医疗广告.     

虚假医药广告问题与对策

夸大其词、耸人听闻的虚假广告给人民群众造成了巨大的身心伤害,对社会的侵害与污染极为严重。这些非法广告之所以存在,一方面是相关法律法规制定不完善和执行不严格,一方面是医药卫生领域和广告传媒领域职业道德的缺失。医药信息关系群众的生命安全,所以清除带有虚假成分的医药广告刻不容缓。     

用循证医学证据丰富经验医学内涵——谈临床医生如何面对医学实践模式改变

从具体病例分析入手谈临床医生实践循证医学既需要思维模式转变、又要求掌握实际应用方法,即要敢于分析循证医学证据的实用性、又要善于用循证医学证据丰富经验医学内涵。新医学模式的普及将是临床医生群体认识史上一次具有深度和广度的飞跃。     

药价“虚高”:成因、结果分析与对策探讨

药品价格“虚高”已成为近年来药品市场中的一个突出问题。通过考量药价“虚高”的成因,并从实证的角度分析药价“虚高”的结果———“有效需求人数”和“消费者剩余”的减少,提出一些建议。     

Are psychodynamic and psychoanalytic therapies effective?: A review of empirical data

There is a need for empirical outcome research in psychodynamic and psychoanalytic therapy. However, both the approach of empirically supported therapies (EST) and the procedures of evidence‐based medicine (EBM) have severe limitations making randomised controlled trials (RCTs) an absolute standard. After a critical discussion of this approach, the author reviews the empirical evidence for the efficacy of psychodynamic psychotherapy in specific psychiatric disorders. The review aims to identify for which psychiatric disorders RCTs of specific models of psychodynamic psychotherapy are available and for which they are lacking, thus providing a basis for planning further research. In addition, results of process research of psychodynamic psychotherapy are presented. As the methodology of RCTs is not appropriate for psychoanalytic therapy, effectiveness studies of psychoanalytic therapy are reviewed as well. Studies of psychodynamic psychotherapy published between 1960 and 2004 were identifed by a computerised search using Medline, PsycINFO and Current Contents. In addition, textbooks and journal articles were used. Twenty‐two RCTs were identifed of which 64% had not been included in the 1998 report by Chambless and Hollon. According to the results, for the following psychiatric disorders at least one RCT providing evidence for the efficacy of psychodynamic psychotherapy was identifed: depressive disorders (4 RCTs), anxiety disorders (1 RCT), post‐traumatic stress disorder (1 RCT), somatoform disorder (4 RCTs), bulimia nervosa (3 RCTs), anorexia nervosa (2 RCTs), borderline personality disorder (2 RCTs), Cluster C personality disorder (1 RCT), and substance‐related disorders (4 RCTs). According to results of process research, outcome in psychodynamic psychotherapy is related to the competent delivery of therapeutic techniques and to the development of a therapeutic alliance. With regard to psychoanalytic therapy, controlled quasi‐experimental effectiveness studies provide evidence that psychoanalytic therapy is (1) more effective than no treatment or treatment as usual, and (2) more effective than shorter forms of psychodynamic therapy. Conclusions are drawn for future research.     

肢体延长与美容增高的启示

美容医学持续升温,“美容增高”即“肢体延长术”被越来越多的爱美男女所尝试。纵观其发展经历了许多挫折与失败,并发症多且严重,应慎重认识其实际效果。如不加选择地运用美容医学,是对医学核心价值体系的扭曲和嘲弄。只有坚持运用正确的哲学思维进行引导,肢体延长术才会健康发展。     

人文社会医学教育应纳为继续医学教育的重要内容

从人文社会医学的概念、现状及加强人文社会医学继续教育的重要性,阐述了应将人文社会医学教育纳为继续医学教育的重要内容的现点.指出加强人文社会医学继续教育应统一认识,加强领导;强化培训,纳入正规;注重实践,回归社会.