胸部双源性疾病外科治疗的临床决策

胸部双源性疾病随人口的老龄化而逐年增加,而老年人的心肺及各种脏器功能随年龄的增长逐渐衰退,并发症多,手术风险大,对此类病人的外科治疗如何做出正确的临床医疗决策?我们以循证医学理论为基础,努力做到临床医疗决策的科学性,治疗方案的合理性,大胆尝试,逐步从分期手术向一期手术过渡,既达到了解决病人疾苦,救治病人的目的,又解决了医疗需求的增加和卫生资源短缺的矛盾,取得了满意的效果,降低了医疗成本,节约了医疗资源,产生了明显的社会和经济效益。     

Pediatric–Psychology Partnership for Abuse Prevention

Intimate partner violence (IPV) is a significant, albeit underreported and underidentified, public health problem that requires the informed and coordinated efforts of the health care system for appropriate recognition and intervention. In addition, health disparities are seen in the incidence, prevalence, and burden of IPV among specific population groups in the United States. Pediatric–Psychology Partnership for Abuse Prevention is a graduate psychology education training project focused on developing an integrated primary health-care based workforce that is culturally sensitive and competent in the identification and remediation of IPV. In addition, this project aimed to increase the number of health service psychologists from diverse backgrounds who are culturally competent and aware of health disparities. The training included clinical psychology trainees and pediatric residents working together in an ambulatory pediatric health care setting. Project methods, outcomes, and implications for predoctoral clinical psychology training programs are described.     

Clinical Geropsychology: Implications for Practice in Medical Settings

Older adults are a rapidly growing segment of the population, who have high rates of chronic illness and who utilize health care resources heavily. Psychologists must become better prepared to work with older patients in geriatric settings, including geriatric assessment units, memory disorders clinics, and nursing homes. In addition, all psychologists will increasingly encounter older patients in environments such as primary care clinics, rehabilitation settings, and disease management programs focusing on problems that are prevalent in older patients (e.g., cancer, diabetes). Suggestions are offered for adaptation of usual clinical practice to address the special needs of older patients and their families, and recommendations made for advancing and expanding the practice of clinical geropsychology.     

创新思维:临床移植医学兴起与发展的灵魂

临床移植医学是人类在与疾病作斗争的过程中敢于幻想、勇于实践的结晶。在其兴起与发展的过程中,创新思维起着决定性作用,这在解决供肝短缺问题上体现得十分突出。我国临床移植医学的发展,同样也处处闪耀着创新思维的光辉。     

信息与中西医临床诊治和决策研究

医学、生命科学是世界上最复杂的学科,其所涉及的知识面,几乎包含了现代科学及相关学科所有领域的知识面。这些知识面均以“信息的载体”表达出来,且信息随着各学科的发展,各种信息浩如烟海,因此如何对待医学知识信息的获取、选择、寻觅、探索、利用知识信息密切联系所诊治的病人及其专业,作出临床决策,将各种信息、包括信息知识标准规范化和信息反映疾病过程出现的假象和隐蔽信息的获取等予以分类,并用实际病例举例例证,以说明“信息”评价在医学思维临床决策中的重要性。     

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。     

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。     

Transgenerational patterns of abusive parenting: Analog and clinical tests

Two studies were conducted to determine whether there was an association between punitive childhood histories and abusive parenting. In the first experiment, undergraduate students who reported more punitive childhood histories and undergraduates who reported mild or nonpunishing childhoods were tested with an Analog Parenting Task. The task used photographic stimuli to depict child behaviors and to elicit disciplinary choices in response to children's transgressions. Persons from the more punitive backgrounds were significantly more likely to endorse potentially injurious disciplinary responses. Additionally, in a post-hoc analysis, women with mild punishment backgrounds were more likely to indicate they were annoyed by the depicted child behaviors than women with the severe punishment backgrounds and men with both punishment histories. In the second experiment, childhood histories of parents of children seen at a psychiatric clinic were assessed. The data indicated an association between severely punitive backgrounds of parents and the probability that the referred child had been physically abused. Also, the punishment histories of the parents were associated with the presence of antisocial and aggressive presenting problems displayed by the referred child. The two experiments together were considered to provide support for a modified version of the trans-generational hypothesis of abuse.     

关于证候定义的三点商榷

对证候定义研究中存在的问题进行剖析,提出三点商榷意见.首先,"证"是病理学概念,不是诊断学概念.其次,"证"发生在病人身上,并非由诊断"概括"出来.第三,应当把内在的病理改变与外在疾病征象区别开来.     

临床心理干预对白血病患者生存质量影响研究

本研究按随机和匹配的原则,将64名白血病患者分入干预组和对照组。对于干预组进行了为期1 5天的临床心理干预,对照组仅接受相应的医学治疗和护理。以欧洲癌症研究与治疗组织编制的肿瘤患者生存质量量表(EORTCQLQ -C30 )为指标,观察临床心理干预对白血病患者生存质量的影响。结果发现,与对照组相比,干预组患者生存质量显著改善