包医合同法律效力分析

虽然医疗行为存在多种风险与不确定性,但也不是所有的医疗行为都是不确定的。生活中经常有医方向患者承诺保证治疗效果的情形,从法律的角度来说,这时在医方与患者之间就形成了包医合同关系。论述了包医合同的性质及其法律效力。     

Substance use/abuse as a predictor to illegal and violent behavior: A review of the relevant literature

The preponderance of the research evidence supports the conclusion that abuse of certain types of illicit drugs, separately from the abuse of alcohol, predisposes to subsequent violent behavior. The relationship of cocaine/crack to violent crime has been established more clearly for users of crack in inner city areas than it has for those who are users of other forms of cocaine in the general population.In regard to any race/ethnic or socioeconomic factors in the relationships between substance use/abuse and violent behavior, most clearly established is that a higher proportion of young Black males, compared to other race/ethnic groups, are actively involved in dealing cocaine/crack in some inner city poverty areas.As for gender differences, the research evidence indicates that alcohol abuse as a predictor to and a precipitant of violent behavior, is more clearly established for males than for females. Drug abuse, as distinct from alcohol abuse, has been found to predict subsequent violent behavior, for females as well as for males. “Co-morbidity,” the combination of substance use with and psychopathology, appears more likely to predict for females to later violent behavior. Psychopathology and mental health problems are less likely to predict occurrence of either violent or criminal behavior in the future than are either alcohol abuse or drug abuse.     

Personality characteristics in primary benzodiazepine-dependent patients: Comparison with controls and polydrug users

The present study applied Karolinska Scales of Personality (KSP) to study (i) if patients with benzodiazepine dependence have a characteristic personality profile, (ii) if the personality characteristics in patients with benzodiazepine dependence differ from those of polydrug users and normal controls, (iii) if differences in treatment outcome existed between the groups, and (iv) if the possible difference in treatment outcome was associated with any particular personality characteristic shown by the patients. The personality characteristics of primary benzodiazepine dependent patients (BDZ) and a group of polydrug users (MIX) were studied initially (during the first week in project as an inpatient) and approximately one year after drug discontinuation, and a comparison was made with healthy controls on both test occasions. The results showed that the personality of both groups of patients differed significantly from the Controls in the following characteristics: Detachment, Socialization, Somatic Anxiety, Muscular Tension, Psychic Anxiety, and Psychasthenia. Significant differences existed between the polydrug and benzodiazepine users in Somatic and Psychic Anxiety as well as in Socialization. The MIX group differed significantly from the BDZ group and from the Controls in Suspicion. Results of treatment outcome indicated that the benzodiazepine dependent patients were significantly more successful in quitting their drug use compared to polydrug users. Further, the results demonstrated that patients scoring high in the investigated personality characteristics are those who fail the treatment goal of quitting their drug use, especially the patients with a high level of anxiety and detachment.     

The Relative Contribution of Sibling Deviance and Peer Deviance in the Prediction of Substance Use Across Middle Childhood

This study investigated the quality of sibling relationships and sibling deviancy in a sample of children at-risk for substance use and antisocial behavior. Based on a history of empirical and theoretical models suggesting strong associations between children's development in the context of relationships and the emergence of delinquency and drug use, this research extends previous efforts by including sibling relationships in this developmental model, linking siblings with later substance use. Sibling relationship quality as well as peer deviance were examined using a multirater, multimethod assessment procedure. We tested 3 constructs (deviancy, warmth, and conflict) related to sibling behavior. Only sibling deviance and peer deviance directly predicted substance use. When both sibling deviance and peer deviance were examined as predictors of changes in substance use over time, only sibling deviance was significant. Implications for the development of substance use behavior in middle childhood are discussed.     

结核病诊治进展与科技革命

现代科技革命极大地促进了结核病各方面的发展.微生物学和免疫学的发展,揭示了结核病的病因、发病机制、病理生理的本质,分子生物学技术使结核病的基础研究不仅停留在器官、细胞水平,而是深入到蛋白质、核酸、基因的水平;基因治疗的方法可望从根本上治疗结核病.高新技术的产物如X线照片、电子计算机断层扫描、纤维支气管镜检查和新药的出现等极大地提高了临床诊治的能力.借助于各种先进的医疗设备而进行精确的诊断,基因治疗将成为一种崭新的治疗手段.     

Comorbidity and Internet-Delivered Transdiagnostic Cognitive Behavioural Therapy for Anxiety Disorders

Internet-delivered transdiagnostic anxiety interventions aim to reduce symptoms across several anxiety disorders using one treatment protocol. However, it is unclear whether comorbidity affects outcomes of such treatment. This study re-examined data from a recent randomised controlled trial (N = 129) that evaluated the efficacy of an Internet-delivered transdiagnostic cognitive behavioural therapy (iCBT) intervention for participants with principal diagnoses of generalised anxiety disorder (GAD), social phobia (SP) panic disorder and agoraphobia (PDA), of whom 72% met criteria for a comorbid anxiety disorder or depression. Participants were divided into two groups based on whether or not they had a comorbid disorder before treatment. Participants with comorbid conditions reported higher symptom levels at pre-treatment, post-treatment, and follow-up across a range of measures. Both groups showed significant reductions in symptoms over treatment; however, participants with comorbid disorders showed greater reductions in measures of GAD, PDA, SP, depression, and neuroticism. In addition, treatment significantly reduced the number of comorbid diagnoses at follow-up. These results indicate transdiagnostic iCBT protocols have the potential to reduce comorbidity.     

Evaluating the Acceptability of Four Versions of a Child Sexual Abuse Prevention Program

Fifty-nine college students used a modified version of the Treatment Evaluation Inventory-Short Form to evaluate the acceptability of four versions of a sexual abuse prevention program for 10-year-old children. The four versions include an information-based training approach or a behavioral skills training (BST) approach with a focus on strangers or known individuals as perpetrators of sexual abuse. A significant effect was found for both training method and type of perpetrator, with information-based approaches involving strangers as perpetrators rated the most acceptable. These results suggest that college students were most comfortable with sexual abuse prevention training programs for 10-year-olds when the programs did not involve an active rehearsal component and when the program focused on abuse perpetrated by a stranger rather than a known individual.     

No Safe Place

Summary

This article addresses ethical issues associated with the concept of professional and scientific responsibility as related to Principle C, “Integrity” of the APA's 2002 Ethics Code. Differences between aspirational and enforceable ethical standards are noted and contextualized in APA's and other professional society's ethics codes. Three case examples are presented and discussed.     

A Child Trauma Treatment Pilot Study

We examined outcomes of a promising 21-session trauma treatment model for children aged 3 to 17 and their caregivers. All children in treatment had experienced at least one traumatic event. The treatment intervention was rooted in theories of trauma and attachment and combines parent training with cognitive behavioral therapy to form a comprehensive trauma treatment program. We report on 27 families who completed the program. Results reflect significant reductions in conduct disorder, problems in social relations, and caregiver depression at an average of a one-year post-treatment follow-up. Results from our preliminary study offer support for further evaluation of the model.