现代麻醉医学与人文关怀

历史上医学是最具人文精神传统的一门科学。然而,随着现代医学技术的迅速发展,人们在享受医学技术提供服务的同时,却对医学的非人性化趋势提出越来越多的批评。文章指出随着医学模式的转换,医学需要人文关怀的呼声已开始被医学界重视。在现代医学迅猛发展背蒂下,尤其是麻醉科,作为临床中最易引起医疗纠纷的科室,应当清醒地认识到,必须在精湛的麻醉专业技术与人文关怀两者保持一种平衡和必要的张力——二者既都不可或缺也不能相互替代。     

流行病学病因推断的辩证思维

随着疾病谱和死亡谱的改变,生物医学模式逐渐地不能满足医学发展的需要,取而代之的是生物-心理-社会医学模式.生物医学模式向生物-心理-社会医学模式的转变,是医学思维方式从单纯的还原论走向整体综合辩证思维的必然结果.因此,疾病病因的内涵及病因推断方法也相应地发生变化.     

对我国高等医学教育学制与学位改革和发展的思考

通过对国内外医学教育学制与学位的比较,以及对我国目前试行的住院医师培训制度存在问题的分析,提出我国六年制培养医学硕士的模式;认为这有利于提高中国高等医学教育层次,有利于统一医学教育学制和学位,有利于国际交流;也为毕业生衔接新体制留下了接口。     

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。     

中医古籍信息特征的学术探源与哲学思考

以中医古籍的信息特征为切入点,分析中医古籍,认为书名未标明书的内容是其外部特征,一书含有多科内容是其内容特征;探源中医古籍信息利用障碍认为基础学科认识不清,临床各科分化不足,基础与临床界限不清是其主因;对本体论的限制,认识论的规范,方法论的约束进行了哲学思考。     

产前诊断中的伦理学问题

药价虚高已成为影响广大人民群众切身利益的突出的社会问题。国家有关部门通过政府行政手段进行了多次药品降价行动,但效果并不明显,"药价虚高"的现状并未得到根本扭转。影响药价虚高的因素归纳起来,就是医疗卫生体制因素和市场流通机制因素,从药品市场角度探讨药价虚高现象的成因和解决途径。     

从高血压防治论医学从临床走向预防

高血压防治中出现的“三高”、“三低”和“三个误区”,反映了我国在高血压防治方面医学知识的普及和全民宣教的滞后,在加强诊治的同时全民预防的滞后。为此,我国政府加大了高血压病防治工作的力度,使其逐步实现由医疗、科研为主向群众预防为主的方向转化。这是高血压防治“战线”前移,从医院移到社会,从临床移到预防的过程。     

Balancing Ethical Principles in Emergency Medicine Research

This paper attempts to provide a broader view into the ethical issues surrounding the field of emergency medicine (EM) research. It starts from defining bioethically relevant features of EM and presents this field in the context of different models of health care provider–patient relationship. The paper also provides a short overview of the “post-Nuremberg” evolution of the main international research ethics guidelines relevant to EM research which demonstrates a tendency of liberalization of research on incapable persons. This tendency culminates with the exceptions to informed consent for EM research which is supposed to be balanced by other research ethics principles, especially a careful rationing of risks and benefits. This finally brings us towards a critical analysis of the minimal risk standard which is one of the main fundamental safeguards in EM research. An earlier version of this paper was presented at The 7th International Conference on Bioethics on “The Ethics of Research in Emergency Medicine”, held on June 2, 2006, Warsaw, Poland.     

The Institute for Music Physiology and Musicians’ Medicine

The Institute of Music Physiology and Musicians' Medicine of the University of Music and Drama in Hannover, Germany, is a unique Institution in Europe whose scope includes teaching the basics of music physiology and musicians' medicine and research into the physiological and neurobiological principles of professional music performance and music perception. Furthermore, the institute conducts research into the causes of occupational injuries in musicians and provides means for prevention, diagnosis and treatment of such injuries.     

Idiographic outcome analyses of the clinical significance of two interventions for patients with musculoskeletal pain

This study adopted a perspective of the individual to define domains of everyday life for the analysis of clinically meaningful change. The purpose was to compare the clinical significance of two interventions for patients with musculoskeletal pain, applying an idiographic outcome measure, The Patient Goal Priority Questionnaire, in combination with the Jacobson and Truax methodology [(1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 67 (3), 300-307] for determination of clinical significance. The concurrent validity of the outcome variables behavioral performance, satisfaction with behavioral performance, and fulfilled pre-treatment expectations was also studied. Eighty-two patients, randomized to either individually tailored behavioral medicine treatment (experimental group) or physical exercise therapy (control group) were evaluated at baseline and 3 months post-treatment regarding behavioral treatment goals. The experimental intervention had high impact on participants' performance of their highest ranked everyday life activities, and resulted in larger proportions of clinically significant outcomes compared with controls. The concurrent validity of the outcomes was high for those reporting clinically significant changes, but more generally, there was a moderate agreement across outcome categories. The individual should be the unit for analyses of clinical significance to enhance the ecological validity of the construct. Further development of idiographic outcome measures is necessary, as is the inclusion in pain intervention research.