血吸虫病低度流行区化疗对象筛查方法的比较及费用-效果分析

目的寻找血吸虫病低度流行区简便、有效、经济、适用的化疗对象筛查方法。方法分别以粪检、询检、间接血凝法 (IHA)及胶体染料试纸条法 (DSIA)对居民进行血吸虫病筛查 ,并分析和评价。结果各项评价指标 IHA均优于其它方法 ,与粪检总符合率为 93 .5 1 % ,阳性预告值为 2 4.49% ;DSIA各指标略低于 IHA;询检法相对较差。卫生经济学费用 -效果分析 ,IHA检出 1例感染者所需费用明显高于其他方法。结论 IHA具有简便、有效的优点 ,在感染率 <5 %的低度流行区是一种较可取的筛查方法 ,但所需费用仍较高 ;DSIA较 IHA更为简便、快速、廉价 ,且敏感性很高     

艾滋病相关话题人群访谈调查分析

目的通过对8类人群有关艾滋病(AIDS)话题的访谈调查,了解北京市东城区这8类人群对艾滋病的知晓程度。方法选择8类人群采取个别访谈、团体访谈的方式,按提纲进行访谈调查。结果艾滋病高危人群、传播途径等相关知识的知晓率达100%,不歧视率为78.8%。对艾滋病防治关怀和干预的可利用资源和可接受方法提出了多种思路,但对艾滋病疫情现状缺乏科学认识。流动人口缺乏必要的艾滋病预防知识。结论加强艾滋病防治的科学性教育,注重在流动人口中普及艾滋病防治知识。     

Youth at ultra high risk for psychosis: using the Revised Network Episode Model to examine pathways to mental health care

Aim: This paper aims to identify the ways in which youth at ultra high risk for psychosis access mental health services and the factors that advance or delay help seeking, using the Revised Network Episode Model (REV NEM) of mental health care. Methods: A case study approach documents help‐seeking pathways, encompassing two qualitative interviews with 10 young people and 29 significant others. Theoretical propositions derived from the REV NEM are explored, consisting of the content, structure and function of the: (i) family; (ii) community and school; and (iii) treatment system. Results: Although the aspects of the REV NEM are supported and shape pathways to care, we consider rethinking the model for help seeking with youth at ultra high risk for psychosis. Conclusions: The pathway concept is important to our understanding of how services and supports are received and experienced over time. Understanding this process and the strategies that support positive early intervention on the part of youth and significant others is critical.     

Introduction

Two paradigms have dominated psychoanalytic praxis: the classical model that views the impersonal analyst as objective mirror, and the interpersonal-relational model that views the analyst as intersubjective participant-observer. A shift in psychoanalytic consciousness, however, has been taking place, giving rise to coparticipant inquiry, a third paradigm that integrates the individualistic emphasis of classical theory and the social focus of participant-observation, avoiding the reductionism of each. This new perspective, which is rooted in the radical teachings and clinical experiments of Sandor Ferenczi and the early writings of Benjamin Wolstein, presents a significantly different concept of analytic data, technique, and process, and a different perspective on the nature of analytic participation. This essay articulates the seven guiding principles of coparticipant inquiry and reviews their implications for such analytic issues as transferernce and countertransference analysis, defense analysis, the therapeutic role of immediate experience, the uses of self-disclosure, and the curative effects of the living through process. The clinical dialectics of the interpersonal and the personal dimensions of the coparticipant self are examined. The inherent mutuality, bidirectionality, psychic symmetry, egalitarianism and dyadic uniqueness of coparticipant inquiry and its implications for analytic work are examined. In all this, the unifying theme is that of psychoanalytic inquiry as a personal encounter.     

中医问诊技能训练教学方法的探索与实践

中医问诊技能训练改变过去以问诊内容介绍为主的做法,编写问诊基本技能训练操作规范,分述重点步骤的具体要求和意义。结合中医问诊范例视频拍摄,规范问诊的具体运用过程。同时设计问诊病例,给出主要症状,要求学生根据主要症状进一步收集相关病史,使学生掌握问诊的基本过程和方法。通过规范问诊技能的训练过程,加强学生问诊技能的培养,使之能够较为熟练的应用于临床,提高教学质量。