A preventive intervention for enhancing resilience among highly stressed urban children

Describes the development and evaluation of a pilot 12-session, school-based preventive intervention designed to enhance resilience among inner-city children who have experienced major life stress. Thirty-six 4th–6th grade children participated in the intervention in groups of 5–8 co-led by school personnel. The curriculum focussed on understanding feelings in oneself and others, perspective-taking, social problem-solving, dealing with solvable and unsolvable problems, and building self-efficacy and esteem. Pre-post evaluation showed significant improvement among participants on teacher-rated indices of learning problems and task orientation and on child ratings of perceived self-efficacy, realistic control attributions and anxiety. Program limitations and factors that restrict generalization are considered and new directions for program development and research are proposed.     

Randomised trial comparing the upright and supine positions for the second stage of labour

Objective To assess the maternal and neonatal effects of upright compared with recumbent positions during delivery, in terms of defined outcome variables.
Design A randomised controlled trial.
Setting St Monica's Nursing Home, a midwife based maternity unit in Cape Town, South Africa.
Participants Five hundred and seventeen women of low obstetrical risk assigned to deliver at the nursing home.
Results The trial showed that women who adopted the upright posture for delivery experienced less pain, perineal trauma and fewer episiotomies than those who delivered in the supine position.
Conclusion The data suggest that in women of low obstetrical risk, choice of posture during delivery may be encouraged.     

低收入大学生一般自我效能感、主观幸福感研究

近年来 ,低收入大学生作为高校中的一个特殊群体逐渐受到研究者和教育者的关注。目前对低收入大学生的一般自我效能感 (generalself -efficacy)和主观幸福感的研究还不多见。一般自我效能感是指个体对各种挑战或新情境的应对能力的总体信心[1] 。一般自我效能感描述的是个体有效地应对各种紧张情境的广义而稳定的个人能力感 ,它与身心健康存在一定的关系[1- 2 ] 。主观幸福感 (subjectivewell-being)是指人们对于自己是否幸福的主观感受 ,是反应心理健康水平的重要指标之一。研究低收入大学生的一般自我效能感和幸福感的特点及其关系对于揭…     

Psychological reactions in patients with early rheumatoid arthritis

We report the interaction of RA and psychological factors over 2 years in a group of 89 patients with newly established disease. Short-time outcome regarding physical features was fairly good. Disease activity decreased, and disability evaluated by HAQ remained at a low level. Psychological distress as measured by the depression and anxiety subscales of SCL 90 (Symptom Check List) was not very pronounced and not related to disease state factors. A slight decrease of anxiety was recorded after 2 years. A new adjustment test was applied. It contained 13 items focused mainly on negative illness effects such as loss of independence, feelings of guilt, and change of social and leisure time activities. Three factors (regret of lost life values, dysphoric mood, and acceptance) explained 48% of the variance of the 13 items. The validity of the test was acceptable. The patients' degree of adjustment changed slowly or not at all during the 2 years.     

病人知情同意权的几个辩证法问题

以知情同意为核心的病人自主权是医疗服务和现代医患关系新的支撑点。在人体实验、放弃治疗等领域,充分尊重病人的知情同意权具有极大的现实意义。然而,医生的解释说明、医疗干预和亲属代理同意则构成了对知情同意的限制。因此,必须辩证理解和知情同意的内涵,以最大限度地保障病人利益。     

加强医学人才素质教育的探讨

笔者就高等医学院校培养高素质医学人才进行了探讨。首先分析了现行教育中存在的弱点,如教育模式、盲目扩大招生、课程设置未适应新的医学模式等的弊端。随后指出以提高学生的综合素质为切入点,抓好邓小平理论课教育、建立一支高素质的师资队伍、改革课程体系、强化实践环节、拓宽知识面、加强校园文化建设为着力点。