论医学院校图书馆在学习型社会构建中的作用

学习型社会是一个终身学习、全民学习的社会。在医学院校构建学习型社会必须集医科师生个人与医学院校团体的力量,有效整合其机构的文化信息资源,充分发挥其效益。在阐述学习型社会的内涵与构建意义基础上,分析医学院校图书馆倡导自主学习的理念,拥有构建学习型社会需要丰富的学习资源,先进的信息传播技术应用及文献信息资源协同保障系统平台搭建,良好的学习环境、浓厚的学习氛围等优势,提出医学院校图书馆在构建学习型社会中有树立服务师生及员工的服务理念,开放常规服务,开展深层次信息服务等作用。     

The health implications of civic association in Russia

Can civic and political participation influence health outcomes, and if so, does the general aversion to joining community activities have some connection to poor health outcomes in Russia? Using data from surveys of 18,000+ urban Russians conducted from 2003 to 2005 and controlling for a wide range of variables, we find that individuals who join collective civic and political activities report better health than non-joiners and that living in a participatory community may enhance one’s health, regardless of one’s own participation.     

The Enigma of Japanese Ageing-in-Place Practice in the Information Age: Does Digital Gadget Help the (Good) Practice for Inter-Generation Care?

Against the background of Japanese demographic transition towards a very aged one: 22% (and 10%) of the population are aged 65 or above (and 75 or above) in mid-2008, the socio-familial reluctance for ageing-in-institutions, and the limited (already the inadequacy of) institutional care, ageing-in-place is both the socio-familial desirable and the policy solution. This paper examines the coping strategies of Japanese society, in the shortage of caring services, with socio-techno innovations derived from information and communication technologies (ICT), towards ageing-in-place. Mobile phone and e-communications promise for borderless, flexible and ubiquitous contacts: real time, round-the-clock, anytime and anywhere, making the geo-spatial conditions irrelevant and for all age groups, but are these offerings for the beneficiaries of an ageing society? Mobile communicative gadgets become social necessity for most Japanese and they are used for intensive social networking; for instance, the mobile phone's role in friendship-building among younger generations—but what about the senior adults for the place anchorage for active ageing? This paper examines and discusses the socio-familial-spatial (social networking, location and place) relevance of mobile communication, emphasizing the use of ICT and mobile communication by/with/for ageing population, for realizing the benefits of ageing-in-place. It especially considers elderly and their families, in the need for socially and geo-spatially fixed anchors (the essence of ageing-in-place), despite (or perhaps because of) the ‘mobility’ through ICT. Our key observations: the trend towards the intensification of ICT use, though affecting differential inter-personal relationship, evidently enables the practice for ageing-in-place in the information age.     

The Japanese society of alcohol-related problems

This paper presents an outline of the Japanese Society of Alcohol-Related Problems. The precursor of the Society was the Japan Alcoholism Treatment Research Group, inaugurated in 1979, by merging two local research groups in the Tokyo and Osaka areas, both of which were exclusive gatherings of psychiatrists associated with alcoholism clinics. The Research Group developed into the Society in 1992, as the number of participants including those from other medical professions increased yearly, and the subjects of the group widened to include all addictive behaviours. In reflecting the process of establishment, it is unique in many aspects as a scientific society. The Society is not a science-orientated body for presentation of new research findings. The main programme of the annual meeting is therefore a set of symposia in which members participate and discuss clinical and/or social problems arising from dependency on alcohol or drugs. Perhaps because of its content, the annual meeting is attended each year by the largest number of participants among all the societies in Japan concerned with alcohol and drugs. For the next several years, the Society's activities will be directed at (1) establishment of guidelines for early identification of and intervention in alcohol-related problems; (2) expansion of its membership to include those in related fields of medicine and non-medical professions; (3) improvement of the system of journal publication; and (4) creation of a system for timely adequate response to social problems associated with drugs and alcohol.     

Church mobilisation and HIV/AIDS treatment in Ghana and Zambia:a comparative analysis

This article compares Ghanaian and Zambian church mobilisation on HIV and AIDS. It analyses why long-term interest in HIV and AIDS has declined in Ghana but increased in Zambia, and why church involvement in promoting access to HIV/AIDS treatment has been less apparent in Ghana than in Zambia. The article uses three levels of analysis ― society, state, and international ― to explicate these different patterns. The analysis finds that continued HIV/AIDS stigma hampered Ghanaian church activities, while a decline in stigma opened up space for church-related HIV/AIDS responses in Zambia. The elite and professional nature of Ghana's churches promoted early HIV/ AIDS activities, but may have prevented these activities from responding to the needs of people with HIV or AIDS. Overlapping personal networks between civil society and state elites in Ghana urged early HIV/AIDS church-related actions, while state co-optation and civil-society divisions in Zambia limited early HIV/AIDS activities. As Zambian churches built ties to external actors, however, they gained autonomy in their HIV/AIDS responses. In contrast, the fact that Ghana was less incorporated into global HIV/AIDS responses (particularly, the global treatment movement) weakened the long-term interest in HIV and AIDS among the country's churches. The article is based on more than 50 semi-structured interviews with a range of participants affiliated with HIV/AIDS organisations (e.g. church, secular, government, donor) in Zambia and Ghana.     

Levosimendan: A retrospective single-center case series

Purpose

The purpose of this study is to describe the effect of levosimendan (without loading dose) on hemodynamics, inotropes/vasopressors, and mortality in acute heart failure (AHF).

Materials and Methods

Patients who received levosimendan for AHF were analyzed. Levosimendan dose, hemodynamic data, inotrope/vasopressor requirements, and fluid balance before commencement, at conclusion of, and 24 hours after levosimendan were collected. Mortality is also reported.

Results

Eighty-seven patients were analyzed. The mean levosimendan dose (without loading) was 0.096 μg/kg per minute (± 0.014), and mean duration, 26 (± 7.2) hours. There was no change in heart rate (start, post, and 24 hours post) (92 [± 19], 92 [± 26], and 92 [± 15]) or mean arterial pressure (69 [± 10], 72 [± 8], and 72 [± 10] mm Hg, respectively). There was a significant reduction in median dobutamine from 7.27 to 0 μg/kg per minute and noradrenaline from 0.20 to 0.1 μg/kg per minute before and 24 hours after. There was a significant increase in both mean cardiac index from 2.38 ± 0.0.72 to 2.98 ± 0.0.77 L/min per square meter and in markers of perfusion: base excess from − 2.77 to 0.39 mmol/L, and lactate from 2.1 to 1.4 mmol/L before and 24 hours after infusion. Survival was 53%.

Conclusions

Levosimendan, without a loading dose, improved cardiac index and perfusion while allowing a reduction in inotropic/vasopressor requirements in patients with AHF.     

退变性腰椎侧凸合并类风湿性关节炎患者侧凸程度的影响因素分析

目的 :分析退变性腰椎侧凸(degenerative lumbar scoliosis,DLS)合并类风湿性关节炎(rheumatoid arthritis,RA)患者的发病特征和侧凸程度的影响因素。方法 :单中心纳入2013年1月～2018年4月61例合并RA拟行腰椎手术的患者,分为患有DLS者27例(DLS组)和无脊柱畸形患者34例(NDLS组)。提取信息包括人口统计学信息[如性别、年龄和体重指数(body mass index,BMI)等]、RA相关信息[如Steinbrocker分级、是否服用改变病情抗风湿药(disease-modifying anti-rheumatic drugs,DMARDs)等]、手术相关信息和DLS信息[如Cobb角、顶椎旋转角度、冠状位顶椎偏移距离、髂嵴连线高度、骨质疏松、全膝关节置换(total knee arthroplasty,TKA)史和膝关节功能评分(knee society score,KSS)],Steinbrocker分级用来评价RA活动性,Cobb角反映腰椎侧凸程度,KSS用以评价膝关节功能。结果:患者平均RA病程为16.8±12...     

中国当代和谐精神的内涵与建构

倡导和谐理念,培育和谐精神是建设和谐文化的首要任务,是构建社会主义和谐社会的灵魂工程。当下,建构与社会主义市场经济相适应、与社会主义和谐社会要求相吻合的中国当代和谐精神,必须坚持以真为魂、以人为本、理论建构与现实生长对接、继承传统与批判创新统一等基本原则,积极探索有利于和谐精神生成的现实路径。     

Globalization and perinatal medicine – How do we respond?

Globalization is both inevitable and usually desirable and contains advantageous and disadvantageous issues. It is a source of both hope and of apprehension and is an accelerating process in flow of information, technology, goods and services, and production means. Globalization has a complex influence on perinatal health. The bonds that link perinatologists together transcend geographic, political, religious, and lingual differences, resulting in a globalization that optimizes perinatal care. In this review, we will discuss some of the global problems facing modern perinatologists.

?Close to 1.5 billion people in the world, live in extreme poverty, a situation which is particularly stark in the developing world, where 80% of them live. Poor people have little or no access to qualified health services and education, and do not participate in the decisions critical to their day-to-day lives. Poverty cannot be defined solely in terms of lack of income. A person, a family, even a nation is not deemed poor only because of low economic resources. Little or no access to health services, lack of access to safe water and adequate nutrition, illiteracy or low educational level, and a distorted perception of rights and needs are also essential components of poverty. Expression of poverty in perinatal health care in developing countries are high maternal death and morbidity rates, huge perinatal and childhood losses, and high birth rates. There are good reasons to define it as a global tragedy in our time.

?Although the mankind has come quite far because the development of civilization and more advances in the health care were made during the past 100 years than in all previous human history, some inhabitants of our planet are not able to experience it. According to some data, every 3 s a newborn dies, and every minute a pregnant woman dies in the globalized world. All together over 10 million deaths every year, which indicates that health security is not strong enough. It is essential for improvement of these discouraging data to be aware that global health security is only as strong as its weakest link. The situation in perinatal health affected by the global crisis could be solved if the world community can agree on and enact comprehensive reforms in both economic and social areas, and on the national and international level.     

哲学论域中的自我

自我或“我”曾一再成为哲学沉思的对象。孔子曾提出“四毋”的要求 ,从认识论上看 ,“毋我”含有消除主观成见之意 ;就价值观而言 ,“毋我”则意味着超越小我。道家对于“我” ,也以有而无之为立场。道家的这种无己说 ,惟有联系其自然原则 ,才能得到较为具体的理解。相对于儒家对礼乐文明的礼赞 ,道家更多地表现出崇尚自然的趋向。佛教所说的“我” ,包括“人我”与“法我” ,前者与人的存在相联系 ,指作为个体的“我” ,后者则涉及人之外的一般对象 ,与之相应 ,无我亦包含“人无我”与“法无我”二重含义。相对于佛教 ,休谟通常所谓的“自我” ,不过是相继的“知觉的集合体 ,或一束知觉” ,作为实体的自我只是一种“虚构”。当自我被理解为“知觉的集合”时 ,它便失去了本体论上的实在性。从毋我、无我到质疑自我 ,对自我的消解和否定构成了其中共同的趋向。但作为具体的存在 ,自我既以意识与人格的综合统一为特点 ,又以感性生命为存在的前提 ;既有个体性的规定 ,又包含着社会的内容 ;既经历了形成与发展的阶段 ,又内含着时间中的绵延同一;在总体上表现为身与心、天与人、个体性与社会性、发展阶段与过程性的统一