发音矫治在噪音疾病中的重要性

目的探讨发音矫治在噪音疾病中的重要性。方法对52例声带术后发音较差的患者经发音矫治后的疗效进行分析。结果声带术后发音较差的患者经发音矫治训练后声音均有明显恢复。结论发音矫治对声带术后声音恢复较差的患者有明显的效果,临床操作简单,值得推广。     

行为决策的评估理论构建研究

本研究构建了行为决策的评估理论,揭示人类行为发生、发展和改变的规律,为开展健康相关行为干预提供科学依据。本理论认为,所有的人类行为都是个体为了生存和发展,在对内、外部刺激进行评估后所做出的主动反应。个体以基因遗传、自我图式、群体规范和直觉为参照系,对内、外部刺激的重要性、安全性威胁和获益性,以及个体所拥有的行为资源进行感觉性评估和社会性评估,用以做出生理性反应和社会性行为决策,并通过感受器、中枢神经和效应器,形成“刺激-评估-行为决策-行为”循环。开展行为干预时,应通过与个体进行讨论和分析,帮助其发现和确认刺激的重要性、安全性、获益性及其拥有的行为资源。     

输血科实习生沟通能力的培养

随着患者和家属对医疗知识的了解和维权意识的增强,医患关系日趋紧张,医疗纠纷日渐增多.据报道,80％～90％的医疗事件其实并不构成医疗事故或医疗过失,只是沟通不够或不当所造成.沟通能力是现阶段医疗背景下医学生需要掌握的基本技能,笔者结合多年输血教学实践,针对输血医学自身特点及实习生沟通能力现状,提出实习生沟通能力培养的重要性及有效的策略.     

临床中护患沟通的重要性及技巧

护患沟通是指护士与患者及其家属、陪护人员之间的意见、观点、情感和信息的交流与传递。随着医学模式的转变,护理模式也从“疾病护理模式”向“整体护理模式”转变,这就深刻地影响了护理工作的重点和范围。护理工作的重点从以疾病与技术为中心转变到以服务对象为中心;护理照顾的服务对象从对个体扩展到团体、社会及整个未来社会。这些转变大大地丰富了护理教育的内涵,对未来护理人才综合素质提出了更高的要求,而具有良好的人际沟通能力是诸多素质中所必备的。良好的护患沟通有利与护患关系的和谐和护理质量的提高,可以减少和防范护惠纠纷的发生,提高患者满意度。     

护理质量管理在处理护理纠纷中的重要性

随着时代的发展、人们自我保护意识的不断增强,患者对自身利益的保护观念也随之增强,医疗纠纷案例逐年增多.护理人员工作在医疗战线的前沿,只要有护理活动,就存在着护理风险.护理质量缺陷是导致医疗纠纷发生的一个重要因素,因此加强护理质量管理,避免或减少护理纠纷的发生,保证患者安全十分重要,这成为了护理工作的一个重要课题.     

Why are we weighting? The role of importance ratings in quality of life measurement

Many Quality of Life (QoL) instruments ask respondents to rate a number of life domains in terms of satisfaction and personal importance, and derive weighted satisfaction scores by multiplying the two ratings. This paper demonstrates that this practice is both undesirable and unnecessary. QoL domains are selected on the basis of their inherent importance, rendering separate importance rating partially redundant. Weighted scores present difficulties in interpretation. Further, we show that multiplicative composites have undesirable psychometric properties. There is evidence that multiplicative composites have little or no advantage over unweighted ratings in correlational or predictive studies. Apart from the face validity and the intuitive appeal of multiplying satisfaction ratings by importance ratings, there appear to be no sound reasons for doing so, and several good reasons not to do so. This revised version was published online in June 2006 with corrections to the Cover Date.     

Evaluation of the relative importance of chemotherapeutic and antiemetic efficacy in various oncologic settings

Goals of work  This study investigated physician’s attitudes toward the relative importance of chemotherapeutic and antiemetic efficacy in different clinical scenarios. Materials and methods  Oncologists in the USA and four European countries completed an online stated-choice survey consisting of three hypothetical treatment choices for each of two patient types. Each hypothetical treatment alternative included both chemotherapy and antiemetic regimens. The two hypothetical patient types were (1) a 48-year-old woman with locoregional infiltrating ductal carcinoma of the breast and (2) a 78-year-old man with squamous cell carcinoma of the lung and multiple liver metastases. In each choice question, oncologists were asked to select the better combination of chemotherapy and antiemetic prophylaxis between two treatment alternatives. Main results  Five hundred fifty-seven oncologists completed the survey. For the adjuvant breast cancer patient, the most aggressive chemotherapy is consistently the most important treatment consideration in all countries. For the advanced lung cancer patient, the most aggressive chemotherapy, the less aggressive chemotherapy, and the most aggressive antiemetic prophylaxis are of similar importance in most countries. Conclusions  Physicians appear more likely to prescribe a more aggressive chemotherapy regimen for a younger patient with a perceived curable tumor, regardless of the emetogenic properties of the chemotherapy. Symptom management is more of a concern and chemotherapeutic efficacy relatively less of a priority in an older patient with advanced disease for whom chemotherapy is not curative.     

Simulated Maximum Likelihood Estimation in Transition Models

In this paper we analyse the problem of modelling individual transitions in the presence of an incomplete sampling scheme. This problem is particularly cumbersome when a continuous time-scale is used for the modelling and when the model incorporates unobserved heterogeneity. This problem arises, for instance, when the observation is made at fixed time points or stops on an interval of time. In order to take this phenomenon into account, we propose to maximize the simulated likelihood using an importance function. The method can be applied to general continuous-time discrete-state-space processes and a broad class of incomplete sampling schemes.     

减少酒精有害使用防控措施可及性评估

目的 评估我国减少酒精有害使用防控措施的可及性,为防控决策提供参考。方法 对488个国家慢性病综合防控示范区进行调查,具体措施库依据世界卫生组织推荐的措施构建。采用验证性因子分析和重要性-绩效分析,对我国减少酒精有害使用防控措施的可及性进行综合评估。结果 减少酒精有害使用措施可及性得分范围为（59.42～79.33）分,均值为66.55分,得分最高的措施为血液酒精浓度界限设定（79.33分）,其次为酒驾对策（75.94分）,得分最低的两项分别为禁止或限制价格促销（61.44分）和限制公共场所饮酒（59.42分）。验证性因子分析结果显示,对减少酒精有害使用干预措施总体可及性影响最大的措施为加强酒精饮品的消费税,其次为禁止或限制价格促销。重要性-绩效分析显示,20项具体干预措施中,血液酒精浓度界限设定、最小法定年龄、许可证制度、酒驾对策、（酒驾）其他措施、筛查和简短干预6项措施位于“区域1最高优先级”,综合性服务1项位于“区域2优先改进级”,其余13项措施位于 “区域4最低优先级”。结论 我国目前减少酒精有害使用防控措施的可及性不高,相对较好的主要为策略“加强对酒精供应的限制”下的干预措施,例如许可证制度;和策略“推进和实施酒后驾驶对策”下的干预措施,例如血液酒精浓度界限设定;应优先考虑改善筛查和简短干预及相关综合性服务的可及性。