46例有刑事责任能力的法医精神病学鉴定案例分析

目的:探讨鉴定为有刑事责任能力的精神障碍者与所患精神疾病间的相关性。方法:收集我院2006-2010年46例鉴定为完全或限定刑事责任能力的法医精神病学鉴定案例进行统计分析。结果:被鉴定为完全或限定刑事责任能力者文化素质普遍较低,年龄多为青壮年,其中无精神病与有精神障碍者分别占17.39%、82.61%。结论:在法医精神病学鉴定中应明确诊断,谨慎评定刑事责任能力,维护司法公平正义,保护当事人的合法权利。     

首透责任制与提高血液透析患者生存质量探讨

目的探讨首透责任制护理在提高血液透析患者生存质量中所具备的重要意义。方法通过心理疏导、传授动静脉瘘管的观察,主动、系统地提供全方位的整体护理。结果与传统护理相比,首透责任制的认知度、生存质量均得到提高,差异有统计学意义（P〈0．01或P〈O．05）。结论实施首透责任制的患者对血透治疗的认知度、主动配合及依从性、治疗效果及服务满意度高,从而整体提高了患者的生存质量。     

Suicidality in Chinese adolescents in Hong Kong: the role of family and cultural influences

BACKGROUND: Adolescent suicidal ideation has found to predict suicidal behaviors and psychopathology in adulthood. Previous studies focused solely on the medical and environmental risk factors, which were insufficient to give a holistic picture of adolescent suicidality. OBJECTIVES: To assess the role of affective and cognitive attributes in the identification and prevention of adolescent suicidal ideation. METHOD: A community sample of 511 participants (age 15-19 years) were asked to indicate their suicidality in the 12 months and in their lifetime. Generalized estimating equation regression models were used to examine the effect of psychosocial and socio-environmental correlates in relation to adolescent suicidal ideation. RESULTS: The data show that perceived responsibilities for family was the only protective factor, while a coping mechanism by behavioral disengagement, severity of depressive symptoms, a history of deliberate self-harm, chronic physical illness or pain, media reporting of suicide news, and low household income were the risk factors for adolescent suicidal ideation. CONCLUSIONS: The results suggest that a multilayer effort for preventing adolescent suicide is needed by providing support for children in deprived families; enhancing life skills in the teens; strengthening family relationship; improving mental and health services; and promoting responsible media reporting on suicide.     

医学生责任感教育的实践及效果评价

为了分析当代医学生的责任感状况,以提高医学生责任感,让学生从内心认识到"责任"两个字的意义,把"责任"刻在心里,而不是流于形式,四川大学华西口腔医学院开展了医学生责任感教育的研究。通过设计各种环节,最终摸索出一条切实有效的培养医学生责任感的路径。经过调查研究,对教学效果进行详细评价,结果表明该课题的开展达到了预期效果,有开展的必要。     

医疗纠纷第三方调解处理——北京医疗纠纷第三方调解援助及探讨

北京卫生法学会医疗纠纷调解中心开展医疗纠纷第三方调解援助工作以来,从社会专业性调解援助工作模式的角度,对医疗责任争议进行调查、取证、定损、计赔、调处、防范等,取得了初步成效。本文介绍了该中心的工作概况、医疗纠纷第三方调解援助工作的模式和做法并提出建议。     

如何发挥医德资源作用来增强医院的社会责任

医患关系不协调所引发的医疗纠纷已成为社会关注的热点。充分发挥医德资源在医院管理、建设、发展中的作用,增强医院社会责任,强调与社会协调发展,可以提高医院在社会和公众中的良好形象,为医院可持续发展营造良好的发展空间。     

关于深化医学院校领导干部经济责任审计的思考

医学院校已广泛开展领导干部经济责任审计。深化领导干部经济责任审计必须加强几方面工作：领导重视是深化经济责任审计的前提条件;规范操作是深化经济责任审计的必要保证;落实措施是深化经济责任审计的长效体现。     

The virus stops with me: HIV-infected Ugandans' motivations in preventing HIV transmission

Few Positive Prevention interventions have been implemented in Africa; however, greater attention is now being paid to interventions that include messages of personal responsibility or altruism that may motivate HIV-infected individuals towards HIV prevention behaviors in Africa. We conducted 47 in-depth interviews in 2004 with HIV-infected men and women purposefully sampled to represent a range of sexual activities among clients of an AIDS support organization in Uganda. Qualitative interviews were selected from a cross-sectional survey of 1092 HIV-infected men and women. Clients were interviewed about their concerns around sexual HIV transmission, feelings of responsibility and reasons for these feelings, as well as about the challenges and consequences of actions to prevent HIV transmission. The reasons they provided for their sense of prevention responsibility revolved around ethical and practical themes. Responsibility toward sexual partners was linked to the belief that conscious transmission of HIV equals murder, would cause physical and emotional harm, and would leave children orphaned. The primary reason specific to preventing HIV transmission to unborn children was the perception that they are ‘innocent’. Most participants felt that HIV-infected individuals held a greater responsibility for preventing HIV transmission than did HIV-uninfected individuals. Respondents reported that their sense of responsibility lead them to reduce HIV transmission risk, encourage partner testing, disclose HIV test results, and assume an HIV/AIDS educator role. Challenges to HIV preventive behavior and altruistic intentions included: sexual desire; inconsistent condom use, especially in long term relationships; myths around condom use; fear of disclosure; gender-power dynamics; and social and financial pressure. Our finding that altruism played an important role in motivating preventive behaviors among HIV-infected persons in Uganda supports the inclusion of altruistic prevention and counseling messages within Positive Prevention interventions.     

公立医院政府健康责任实现方式与机制研究

政府承担着保护和促进公民健康的责任,公立医院作为政府举办的非营利性医疗机构,在政府履行健康责任中发挥着重要的平台作用?文章对政府通过公立医院来实现其健康责任的方式与机制进行了探讨和研究?     

指向质量与效率的医院流程化进阶管理

流程就是做事的程序。医院的工作一是医疗性的工作,二是非医疗性的行政、后勤等支持性工作。无论是哪部分工作,我们都强凋质量和效率,要求做精做细。唯有以程序为基础的科学化流程,才是保证质量、效率和精细化的前提。因此,我们提出了医院流程化进阶管理的模式。