对构建特色医院文化的思考

21世纪的医院是文化的医院,21世纪医院的竞争是文化的竞争,谁能构建出具有特色的医院文化,谁就能赢得竞争主动权。构建特色医院文化,核心是形成共同的理想和精神支柱;关键是打造“学习型”医院组织;根本是树立以人为本、诚信求实的服务理念;目标是树立良好的医院形象;基础是加快医院信息化建设。     

电子时代的医学图书馆馆员和循证医学

简要阐述了循证医学的概念及其基本特点,探讨了电子时代循证医学对于医学图书馆员的要求,同时提出了电子时代医学图书馆员应该具备的知识和技能.     

Effectiveness of an intensive stress intervention workshop for senior managers

This study investigates the efficacy of an intensive, integrated approach to stress reduction and coping enhancement directed towards an educated, upper level management population. Ninety‐five US governmental senior managers participated in a 35‐h stress management retreat held over a 3.5‐day period. The retreat combined didactic and experiential activities that were designed to increase participants' knowledge of stress liabilities and coping skills. Participants were encouraged to make positive lifestyle changes and to create specific action plans for the year following the workshop. Evaluations of participant satisfaction were completed at the close of the workshop. Eighty‐three participants completed baseline and follow‐up Stress and Coping Inventory (SCI) assessments in order to identify durable changes in these measures. Across 10 months, participants showed significant improvements in their overall Global Balance scores, psychological symptoms, depression symptoms, and all major coping scales, including Health Habits, Social Support, Responses to Stress and Life Satisfactions. Therefore, an intensive, multifaceted approach to stress intervention is a viable option for encouraging sustained behavioural change. Copyright © 2003 John Wiley & Sons, Ltd.     

强迫症含强迫思想和强迫行为者二重辨证施治在开放式心理病房的研究

目的 :探讨二重辨证施治对强迫症含强迫思想和强迫行为者的疗效 ,及其在开放式心理病房的适应情况。 方法:将 5 2例强迫症含强迫思想和强迫行为者按随机的原则在开放式心理病房分为研究组 (2 7例 )和对照组 (2 5例 )。研究组用二重辨证施治 ,对照组用认知疗法结合氯丙咪嗪、氟西汀等。研究时间共 5个月 ,头 2个月为积极治疗期 ,后 3个月为自由治疗期。采用临床疗效评定标准 ,耶鲁布朗强迫症量表 (Y -BOCS) ,x2 检验 ,t检验。 结果 :研究组和对照组 ,积极治疗期末痊愈差异有统计学意义 (x2 =19.94,P <0 .0 0 5 ) ,自由治疗期末痊愈差异有更大的统计学意义 (x2 =2 6.64 ,P <0 .0 0 5 )。耶鲁布朗强迫症量表 (Y -BOCS)总分 ,两组治疗前差异无统计学意义 (t =0 .75 6,P >0 .2 ) ;积极治疗期末 ,两组差异有统计学意义 (t=10 .3 2 4,P <0 .0 0 1) :自由治疗期末 ,两组差异有更大的统计学意义 (t=12 .66,P <0 .0 0 1)。 结论 :二重辨证施治对强迫症含强迫思想和强迫行为者有普遍卓越的痊愈功效和痊愈巩固功效 ,应积极推广。开放式心理病房可作为强迫症含强迫思想和强迫行为者二重辨证施治的医疗平台     

Learning and retention of movement sequences in Parkinson's disease.

The purpose of this study was to examine motor learning and retention given extensive practice in two fundamentally different movement sequences. One sequence was a memory-driven task (performing a series of whole body positions from memory) and the other a context-driven task (buttoning). Practice took place over 3 weeks, with performance measured weekly; retention was measured weekly for 3 weeks after practice. There were 7 people with Parkinson's disease (PD) and 7 age-matched neurologically healthy people who participated in this study. Both groups improved performance on both tasks with practice, with the majority of the change for the PD group occurring between 1 and 2 weeks of practice. Although those with PD did not necessarily perform as well as age-matched controls, they learned both sequences in a manner similar to age-matched controls, and exhibited retention across the 3-week retention interval. If people with PD are given sufficient practice they can learn and retain both memory-based and context-driven movement sequences as well as age-matched controls. The results provide support for maintaining physical activity and for intervention through movement therapy.     

Undergraduate and postgraduate dental students''reflection on learning'': a qualitative study

The aim of this study was to explore undergraduate and postgraduate dental students' understanding of a good learning experience by using 'reflection on learning' as described by Schon. Four groups of Year 4 BDS students and one group of postgraduate students in dental public health took part in a series of focus group discussions. The responses were grouped into four broad themes (a) active, practical and positive learning; (b) interactive/together learning; (c) personal learning; (d) theory into practice. Six educational models of good learning proposed by the students are described.     

Orthodontic undergraduate education: developments in a modern curriculum.

This paper explores some modern concepts of teaching and learning, including cognitive theory, the zone of proximal development, constructivism, andragogy and learning styles and describes how they have informed the development of an undergraduate orthodontic curriculum. The changes described include student-centred learning, guided self-learning, and the incorporation of problem-based learning concepts. The details of the problem-based learning programme are described together with results of student feedback on the change in teaching and learning style.     

Evidence for NMDA receptor involvement in environmentally induced dentate gyrus plasticity.

Research has demonstrated environmentally induced plasticity of hippocampal dentate gyrus-evoked potentials. Other research has shown a role of the NMDA receptor in dentate gyrus long-term potentiation (LTP). The authors tested the role of the NMDA receptor in one form of environmentally induced plasticity, in which transferring animals from their home cages to another environment results in significant excitatory postsynaptic potential (EPSP) enhancement and concomitant depression of the population spike. Rats were chronically implanted with stimulating electrodes in the perforant path and recording electrodes in the dentate gyrus bilaterally. Evoked potentials were recorded from freely behaving rats for four 20-minute sessions (1/wk), which took place immediately following an environmental transfer. Rats received 0.00, 0.05, 0.08, or 0.10 mg/kg MK-801 s.c. 30 minutes prior to recording sessions in either an ascending- or descending-dose series. Results showed that MK-801 produced a reduction of the EPSP enhancement, which takes place over the 20-minute session. The effects of MK-801 on spike depression varied as a function of dose series and time within a session, suggesting a long-term effect of MK-801 on spike depression. There was no detected effect of MK-801 on behavior. Results suggest a role of the NMDA receptor in this form of environmentally induced plasticity with different effects of NMDA receptor antagonism on EPSP enhancement and spike depression.     

Electrophysiological Signs of Neurocognitive Deficits in Long-Term Leukemia Survivors

The long-term effects of disease and treatment on electrophysiologicalmeasures of neurocognitive function were studied in childrenwho had survived acute lymphoblastic leukemia (ALL) for at least4 years and were currently in remission. We report here changesin cognitive processing time as shown by the latency of theP3 wave of the auditory event-related EEG potential (ERP). P3latency was significantly prolonged in long-term ALL surivors,as well as in patients successfully trreated for solid tumors(ST)outside the CNS who received similar chemotherapy but did notreceive prophylactic treatment to the CNS. P3 latencies werestrongly correlated with measures of school performance andIQ in these individuals. The similarity in P3 latency betweenthe ALL and ST groups suggests that the treatments used on thesepateints produce changes in electrophysiological responses thatare associated with mild, but significant, cognitive deficits.     

马来西亚寒邪致病及其证治初探

根据第一作者在马来西亚从事中医临床工作50余年的经验,以中医理论为指导,探讨了在炎热的马来西亚,寒邪致病的可能性、客观性以及寒邪致病的病因、病机、临床表现特征及其治疗方法。