Ecological Momentary Assessment is a Neglected Methodology in Suicidology

Ecological momentary assessment (EMA) is a group of research methods that collect data frequently, in many contexts, and in real-world settings. EMA has been fairly neglected in suicidology. The current article provides an overview of EMA for suicidologists including definitions, data collection considerations, and different sampling strategies. Next, the benefits of EMA in suicidology (i.e., reduced recall bias, accurate tracking of fluctuating variables, testing assumptions of theories, use in interventions), participant safety considerations, and examples of published research that investigate self-directed violence variables using EMA are discussed. The article concludes with a summary and suggested directions for EMA research in suicidology with the particular aim to spur the increased use of this methodology among suicidologists.     

Momentary pain and coping in temporomandibular disorder pain: Exploring mechanisms of cognitive behavioral treatment for chronic pain

The purpose of this study was to determine whether cognitive–behavioral treatment (CBT) operates by effecting changes in cognitions, affects, and coping behaviors in the context of painful episodes. Patients were 54 men and women with temporomandibular dysfunction-related orofacial pain (TMD) enrolled in a study of brief (6 weeks) standard conservative treatment (STD) or standard treatment plus CBT (STD + CBT). Momentary affects, pain, and coping processes were recorded on a cell phone keypad four times per day for 7 days prior to treatment, and for 14 days after treatment had finished, in an experience sampling paradigm. Analyses indicated no treatment effects on general retrospective measures of pain, depression, or pain-related interference with lifestyle at post-treatment. However, mixed model analyses on momentary pain and coping recorded pre- and post-treatment indicated that STD + CBT patients reported greater decreases in pain than did STD patients, significantly greater increases in the use of active cognitive and behavioral coping, and significantly decreased catastrophization. Analyses of experience sampling data indicated that post-treatment momentary pain was negatively predicted by concurrent active coping, self-efficacy, perceived control over pain, and positive-high arousal affect. Concurrent catastrophization was strongly predictive of pain. Active behavioral coping and self-efficacy reported at the prior time point (about 3 h previously) were also protective, while prior catastrophization and negative-high arousal mood were predictive of momentary pain. The results suggest that CB treatment for TMD pain can help patients alter their coping behaviors, and that these changes translate into improved outcomes.     

Hope as experienced in women newly diagnosed with gynaecological cancer

AimThis article presents findings from a hermeneutic-phenomenological study with the aim to investigate the meaning of the lived experience of hope in women newly diagnosed with gynaecological cancer.MethodFifteen women were interviewed the day they were receiving the diagnosis at a gynaecological department of a Danish university hospital. The women, aged 24–87 (median 52 yrs), were diagnosed with ovarian, endometrial, cervical and vulvar cancer.ResultsHope was found to be connected to both diagnosis, cure, family life and life itself and closely tied to hopelessness. The newly received cancer diagnosis made the women oscillate between hope and hopelessness, between positive expectations of getting cured and frightening feelings of the disease taking over. Five major interrelated themes of hope were identified: hope of being cured, cared for and getting back to normal, hope as being active and feeling well, hope as an internal power to maintain integration, hope as significant relationships and hope as fighting against hopelessness. Thus, hope was woven together with hopelessness in a mysterious way; it took command through inner strength and courage based on a trust in being cured and of being in relationship with significant others.ConclusionThe findings of the close relationship between the shades of hope and hopelessness support the need for nurses to continue to practice hope-inspiring nursing. Nurses need to understand the complexity of hope and its close connection to hopelessness when newly diagnosed with a threatening disease as cancer; and the findings might help nurses assist patients in fighting hopelessness.     

社区卫生服务团队户籍健康责任制建设的实践和体会

目的为了切实提高社区卫生服务的水平和质量，落实社区综合预防保健措施，提高社区健康水平，实现“让医生走进家庭．让家庭拥有医生”。方法①实行社区卫生服务中心-服务站-家庭三站式服务。②组建6个社区卫生服务团队，实行网格化、户籍健康责任制管理、双向签约．落实社区服务团队责任。③建立监督考核机制、工作激励机制，与上级医院建立双向转诊关系。结果给应建尽建的74811份健康档案做出社区健康诊断，明确社区危险因素，加强社区教育；对高血压、糖尿病、肿瘤、慢阻肺、精神病和结核病等患者落实规范管理。80％的居民首诊选择社区．医疗费用明显下降．社区满意度不断提升。结论社区卫生服务团队户籍健康责任制管理．团队人员责任感强．病人依从性强，有利于综合预防保健措施的落实，有一定的推广价值。     

培养药师良好药学习惯的实践与体会

目的:培养药师良好的药学习惯,提高药学服务水平。方法:在具体的药学服务实践中,培养药师的工作习惯、卫生习惯、学习习惯和交流习惯。结果:通过培养良好的药学习惯,可使药学人员的服务更加规范,服务质量和水平得到提高。结论:在药学服务中,药学人员只有养成良好的药学习惯,才能更好地发挥作用。     

多发性大动脉炎的辨证论治体会

文章介绍了多发性大动脉炎的辨证论治体会,认为可采用散寒祛湿、益气活血;清热化湿、活血通脉;清热凉血、解毒通脉;益气涤痰、开窍通络;温阳散寒、化瘀通脉;健脾补肾、温阳通脉;补肾益精、养血通脉;活血化瘀、疏经通络;回本扶元、气血双补等方法论治多发性大动脉炎.     

5.12地震绵阳地区医疗救护经验和体会

[目的]探讨如何在医疗救护中采取有效的措施. [方法]应用回顾性分析调查受5.12地震影响的绵阳地区开展的医疗救护情况. [结果]采取及时,有序,高效的措施和进一步的治疗能够很大程度地降低5.12地震引起的伤残和死亡.[结论]快速,有序的医疗救护能够有效地降低地震地区的伤亡.     

詹文涛治未病理念救治危重症经验

治未病理念在中医防治疾病过程中体现为4个方面:无病先防(养生)、已病防传、已传防变、已变防坏.虚虚实实恶性因果转换链是危重症发生发展及转归的主导环节,而截断其恶化因果转换链则成为中医救治危、急重症的技术关健.詹文涛教授认为,治未病的理念要贯穿救治危重症全过程,就是要辨识和抓住危重症病程演进中恶性因果转换链的主要矛盾和矛盾主要方面,采用病因学预防与发病学预防相结合,病因学治疗与发病学治疗相结合的方法,促使罹病机体尽快脱离危急状态,趋向好转与康复.     

秦国政教授治疗前列腺增生临床经验

导师秦国政教授在治疗前列腺增生时，采用辨病论治与辨症论治相结合，通过虚实辨证，采取经方与专药同治，临床疗效较佳。根据笔者跟师体会，从治疗经验、用药经验、典型病例三方面总结导师秦教授对前列腺增生的治疗经经验。     

钝性肝损伤33例诊断治疗体会

目的:探讨钝性肝损伤的诊断措施和治疗方案。方法:回顾分析33例钝性肝损伤的临床资料。结果:Ⅰ级~Ⅱ级19例中除4例因合并脾脏破裂中转手术外均非手术治疗;Ⅲ级手术治疗9例,非手术治疗2例中转手术;Ⅳ级以上均手术治疗。结论:循环稳定的Ⅰ级~Ⅱ级单纯肝损伤非手术治疗成功率较高;循环不稳定、有明显腹膜炎体征者、Ⅳ级以上手术治疗较为稳妥。