TEACHING THANATOLOGY IN A FOREIGN COUNTRY: IMPLICATIONS FOR DEATH EDUCATORS

Although an increasing number of death educators will have the opportunity to teach abroad, many may not be fully aware of the issues that arise in intercultural instruction and are not prepared to handle the pedagogical challenges associated with teaching thanatology in a foreign country. On the basis of experience of teaching in China, the author describes the challenges of intercultural teaching, strategies for adapting instruction to address the pedagogical obstacles, and the ways an international teaching experience can enrich instruction.     

消毒灭菌质量连续5年监测结果报告

调查了解医院消毒灭菌质量,以更有效控制医源性感染,采用抽样检测方法,对医院的医疗器械处理质量及压力蒸汽灭菌器性能进行随机抽样监测。结果,使用后医疗器械清洁处理合格率86.8%～98.6%;器械灭菌效果合格率92.5%～100%;一次性使用医疗器械无菌合格率90.6%～98.2%;压力蒸汽灭菌器性能检测合格率98.2%～99.1%。结论,该医院医疗器械清洁和灭菌效果合格率呈逐年升高趋势,但仍需要进一步加强管理。     

DEATH EXPERIENCES AND HOSPICE: PERCEPTIONS OF COLLEGE STUDENTS

The purpose of this study was to investigate college-age students awareness of and involvement in hospice and to ascertain information regarding their own experiences with death and their preferences about death and dying. Our data were gathered through a mailed survey to 521 biology majors at an undergraduate college in the southeastern United States (122 responded or 23%). The majority of respondents were aware of hospice, yet less than 25% had any involvement with hospice. Over 90% of the respondents had seen a dead body, and one-third had witnessed a death. Statistically significant differences by gender were found only with awareness of hospice, with women being more knowledgeable. With health professions as the goal for most of these students, a similar study with a cohort of non-college students, or even non-health-profession-bound college students, would serve as an interesting control group.     

循证医学教学模式在研究生神经病理性疼痛教学中的应用研究

目的:探讨循证医学教学模式在研究生神经病理性疼痛教学中的可行性和效果分析。方法:选取神经内科实习的研究生40名,随机分为对照组和实验组(每组各20名)。分别采取传统医学教学模式和循证医学教学模式。通过调查问卷和临床技能考核方法探讨循证医学教学模式的可行性和教学效果。结果:(1)对照组和实验组入科时对神经病理性疼痛感兴趣百分比分别为35%和40%;出科时实验组与对照组相比兴趣增加(P<0.05);实验组出科时比入科时兴趣也明显提高(P<0.05)。(2)对照组入科时认为循证医学教学模式有利于临床实践和就业的占30%,实验组占35%;出科时实验组与对照组相比重要性认识上提高(P<0.05);实验组出科时比入科时相比重要性认识上同样提高(P<0.05)。(3)实验组与对照组相比,在病史采集、体格检查、病历书写、基本操作和病例分析方面均有提高(P<0.05),尤其在病历书写和病例分析方面明显提高(P<0.01)。结论:开展研究生神经病理性疼痛循证医学教学模式具有可行性和必要性。     

压力蒸汽灭菌化学指示卡研制试验初步报告

<正> 目前国内对压力蒸汽灭菌效果监测使用的硫磺管或苯甲酸管只能指示温度,不能指示维持时间,采用纸片型生物指示剂,不仅培养所需时间较长,实际使用亦多不便。为     

SHOESTRINGS AND BRICOLAGE: SOME NOTES ON RESEARCHING THE IMPACT OF A CHILD'S DEATH ON FAMILY RELATIONSHIPS

An earlier version of this paper appeared as the appendix to our recent book, An Intimate Loneliness: Supporting Bereaved Parents and Children (G. Riches & P.Dawson, 2000). In it, we attempt to offer a brief history of the processes we have gone through in taking a simple research question, developing it into a practical proposal, experiencing how it shifted as we explored it, accounting for the changes that our broader reading imposed on our perceptions of what we were doing, and, finally, how the data itself and our efforts to understand it, resulted in a set of broad theoretical propositions rather than any tight conclusions.     

COLLEGE STUDENT BEREAVEMENT,SCHOLARSHIP, AND THE UNIVERSITY: A CALL FOR UNIVERSITY ENGAGEMENT

The prevalence of bereavement among traditional-aged college students should impel universities to assist bereaved students on their campuses. Dealing with bereavement can not only challenge a college student's completing the developmental tasks that our society sets for the later adolescent years, but also imperil the student's remaining in school and graduating. It is in the best interests of the university to develop and implement a variety of effective interventions to assist bereaved students. The author argues that universities are communities devoted to scholarly endeavors and should explicitly incorporate the dimension of compassion and caring. An abbreviated case study is used to illustrate the situations in which one grieving student found herself when she returned to school following the death of her father. A call is made for greater university engagement by forming a university-based bereavement center to coordinate and conduct coherent inquiry that fulfills the scholarly functions of discovery, application, and instruction. Four specific actions for a bereavement center are to train nonbereaved students to provide peer support, to provide structured interventions for college students at risk of bereavement complications, to raise consciousness about bereavement on the university campus, and to conduct research into various bereavement populations and bereavement topics.     

A CHILD'S DEATH AND DIVORCE: DISPELLING THE MYTH

In view of the commonly held assumption about a high divorce rate among bereaved parents, a thorough review of literature was conducted to determine what evidence exists. Evidence was found to indicate that a child's death can strain marital relationships, which may lead to separation and/or divorce in some cases; however, there is no conclusive evidence that bereaved parents are likely to divorce as a result of a child's death. On the contrary, it appears that the majority of marital relationships survive the strain brought about by a child's death and may even be strengthened in the long run. The time it takes for bereaved parents to restore their relationship to the level it was before the child's illness and /or death varies depending on the couple and the circumstances involved. The ultimate effects of a child's death on marriage may not be known until after several years have passed. The quality of marital relationship prior to the child's death, cause of death, and circumstances surrounding the death may produce differential outcomes for the marital relationship. In the process of conducting a literature review, a number of questionable or erroneous citations that professionals made were discovered. In addition to those mistakes, confusion between marital distress and divorce appears to be partially responsible for perpetuating the myth of a high divorce rate among bereaved parents. It is time for professionals to dispel the myth. Recommendations for future research are provided.     

A DECISION TREE AND CLINICAL PATHS FOR THE ASSESSMENT AND MANAGEMENT OF CHILDREN WITH ADHD

Attention Deficit/Hyperactivity Disorder (ADHD) is a common neurobehavioral disorder. Children with ADHD are disproportionately represented in pediatric populations characterized by school failure, criminal behavior, and substance abuse. Many children who present with ADHD symptomatology do not receive systematic assessments nor comprehensive treatment that is well coordinated across home and school environments. And yet, evidence suggests that early detection and appropriate treatment can alter the probability of a negative developmental trajectory. The Decision Tree and Clinical Paths for Assessment and Management of ADHD identify the critical components of care through a stepwise decision-making process involving the assessment, diagnosis, treatment, and outcome evaluation of children who present with ADHD symptomatology. Preliminary field testing supports the clinical utility and validity of the ADHD Decision Tree/Paths. In addition, cross-validation comparisons indicate consistency between the ADHD Decision Tree/Paths and recently released ADHD clinical guidelines issued by several national professional organizations.     

CLIENTS WITH MENTAL ILLNESS AND THEIR CHILDREN: IMPLICATIONS FOR CLINICAL PRACTICE

The problem of adults with severe mental illness parenting minor children is a growing concern. These clients suffer from concerns that negatively affect them and their children. This study showed many clients seeking services at public mental health agencies are parents of minor children and have had a history of family dysfunction. Prevalence rates, demographic characteristics, types of mental illness diagnoses, family background variables, and some current issues regarding these clients were examined. The study concludes with clinical implications for clients and their families and calls for a family focused approach.     

浮针疗法对腕部腱鞘炎患者的疼痛治疗

浮针疗法是进针点选择在病痛局部周围,针体行进在皮下,针尖指向病灶,主要治疗局限性痛症的一种新型针刺治疗方法。本文运用该法治疗３７例腕部腱鞘炎,并与常规体针法进行比较,结果表明浮针疗法首次针刺镇痛效应显著好于常规针法,显效病例所需治疗次数少于常规疗法。表明浮针疗法有肯定,迅速的镇前作用。     

A CONTRIBUTION TO THE PATHOLOGY OF PRIMARY SPLENOMEGALY (GAUCHER TYPE), WITH THE REPORT OF AN AUTOPSY ON A MALE CHILD FOUR AND ONE HALF YEARS OF AGE

As a result of this study it may be stated that primary splenomegaly of the Gaucher type is a distinct disease, related in all probability to the blood diseases. It begins usually at an early age, frequently affects several members of a family, and runs a chronic course. The clinical manifestations are: pronounced hypertrophy of the spleen, subsequent enlargement of the liver, absence of palpable lymph nodes, absence of jaundice and ascites, absence of characteristic blood changes, discoloration or pigmentation of the skin, and a tendency to epistaxis or other hemorrhages. The lesions are found in the spleen, lymph nodes, bone marrow, and liver. These organs show the presence of iron-containing pigment, and large multinuclear cells with a characteristic cytoplasm. In the early cases peculiar large phagocytic cells arising from atypical large lymphocytes are found in the follicles (keimcentra) of the hemapoietic system. After leaving the follicles these cells possess phagocytic qualities for a certain period. As a result of the phagocytosisthe cells enlarge, the nature of the cytoplasm changes, and the cells acquire a characteristic vacuolated and wrinkled appearance. The cells are carried from the spleen through the portal system to the liver, where they are destroyed. The irritation produced by this destructive process gives rise to an increase in the intralobular connective tissue. The disease is eminently a chronic one, without any of the manifestations of malignancy, and always terminating as the result of some intercurrent affection. The etiology is unknown, although a family predisposition to some toxic agent which causes an irritability of the follicles in the hemapoietic system probably exists. The possibility of some protozoan infection as an etiological factor must not be overlooked.     

腹腔镜下肝胆胰脾手术40例的临床应用

目的：探讨腹腔镜下肝，胆道，胰，脾外科手术的可行性及适应证。方法：从1998年6月-2002年6月共行腹腔镜肝，胆道，胰，脾手术40例，其中肝脏手术21例，胆道手术14例，胰腺手术1例，脾脏手术4例。结果：40例手术中，37例在安全腹腔镜下手术，3例为腹腔镜辅助手术，全组手术均成功进行，无严重并发症发生。平均手术时间125min，平均术中失血85ml；术后平均住院天数7.3d。结论：腹腔镜外科手术应用于肝，胆道，胰腺是安全可行的，但应严格掌握适应证。     

PLACENTAL CHORIOANGIOMA: A CASE REPORT AND LITERATURE REVIEW

We report on a large asymptomatic placental chorioangioma, identified as an area of reduced echogenicity on ultrasound at 36 weeks' gestation. Despite the large size, it was not associated with the usual maternal or fetal complications expected with a chorioangioma of that size, possibly because of thrombosis and tumour degeneration.     

PARENTAL BONDING: A KEY FACTOR FOR MENTAL HEALTH OF COLLEGE WOMEN

The purpose of this study was to investigate the relationship of parental bonding to the mental health of college women aged 18 to 24 years. A cross-sectional study of a volunteer sample of 246 college women was conducted. Data on depressive symptoms, negative thinking, self-esteem, and parental bonding were collected via self-report. Maternal care was the strongest predictor of all four mental health indices. Paternal overprotection predicted scores of three of the four mental health measures. Women with optimal maternal and paternal bonding profiles (high care/low overprotection) had fewer depressive symptoms, less negative thinking, and higher self-esteem than women with other bonding profiles. The findings have implications for prevention, screening, and intervention to enhance the mental health of college women.