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Effective communication between clinicians, patients, and families at end of life is associated with better clinical outcomes. A large body of literature describes the key skills needed for effective communication. We believe that clinicians could also benefit from communication skills more commonly associated with business or law negotiations. We will demonstrate via analogy (i.e. buying a house) how four key business/law negotiation techniques – 1. Determine your Reservation and Aspiration Value; 2. Separate People from their Positions; 3. Separate Positions from Interests; and 4. Logrolling of Interests – can be applied to a difficult family meeting in a home hospice patient.  相似文献   
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Introduction: There are at the minimum two major, quite different approaches to advance drug discovery. The first being the target-based drug discovery (TBDD) approach that is commonly referred to as the molecular approach. The second approach is the phenotype-based drug discovery (PBDD), also known as physiology-based drug discovery or empirical approach.

Area covered: The authors discuss, herein, the need for developing radiation countermeasure agents for various sub-syndromes of acute radiation syndromes (ARS) following TBDD and PBDD approaches. With time and continuous advances in radiation countermeasure drug development research, the expectation is to have multiple radiation countermeasure agents for each sub-syndrome made available to radiation exposed victims.

Expert opinion: The majority of the countermeasures currently being developed for ARS employ the PBDD approach, while the TBDD approach is clearly under-utilized. In the future, an improved drug development strategy might be a ‘hybrid’ strategy that is more reliant on TBDD for the initial drug discovery via large-scale screening of potential candidate agents, while utilizing PBDD for secondary screening of those candidates, followed by tertiary analytics phase in order to pinpoint efficacious candidates that target the specific sub-syndromes of ARS.  相似文献   

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1994年随机抽取广东省20个市315家街头食品经营户,按《广东省街头食品卫生检查评分标准》进行审评,结果,一类户占8.6%,二类户占43.8%,三类占47.6%.存在主要问题是饮食经营场所不卫生和设施简陋.食具消毒卫生质员不能有效得到保证.食品交叉污染因素较多,存在引发食物中毒潜在危险.食品从业人员个人卫生意识差.食品卫生监督力量薄弱,管不胜管.  相似文献   
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Cancer causes significatlt emotional distress to a considerable majority of patients. Many of these patients typically receive little formal psychological intervention. Support groups, however, have provided one forum from which patients can attempt to gain help and can use to overcome some psychological trauma that accompanies the cancer hagnosis, subsequent treatment and relapse. This article reviews past studies of professionally run cancer support groups as opposed to psychological intervention groups. These studies are considered in light of the proposed benefits and the methodological limitations frequently inherent in such studies.  相似文献   
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Anatomic bases of tongue flaps   总被引:2,自引:0,他引:2  
Summary The morphological structure of the lingual a. was studied in 50 dissected and 14 vascular cast specimens. The course of this artery is divided into 4 segments: the original segment, the segment within hyoglossus, the ascending and the horizontal segments of the deep lingual a. The root of the tongue is supplied by 2 to 3 root branches of the lingual a., the ascending palatine a. and the tonsillar a. The body of the tongue is nourished on average by 25 arterial branches from the deep lingual a. The ventral surface of the tongue, as well as the sublingual gland and the floor of the mouth, is supplied by the sublingual a. The termination of the lingual a. anastomoses with the submental branch of the facial a. to form the lingual frenal a. Except for a submucous arterial network on the dorsum of the tongue, all blood vessels are separated completely by the lingual septum, through which arterial anastomoses (2.0 mm in diameter) can be found occasionally.This work was supported by the National Natural Science Fund  相似文献   
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The danger management strategies of low‐income African American women who live in a public housing community characterized by chronic violence are examined. Based on qualitative interviews with 18 single mothers, we explored the violent community dangers with which women contend, the nature of this violence, the strategies used to deal with community violence, and their benefits and costs to family and community life. Findings show that multiple types of violence characterized life in the community and that this violence has specific physical locations, a particular set of actors, and a temporal rhythm. Women's responses to violence were nonconfrontational and family focused in nature. These efforts were effective in keeping women and their children safe, but did not reduce the prevalence of violence.  相似文献   
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通过对河南中医学院2003级医学班的131名研究生的测试,探讨英语听力训练的策略问题。研究表明,有意识地恰当地使用策略能提高外语学习成绩,因此在他们之中进行了策略使用情况问卷调查,结果发现策略使用的多少与成绩之间虽不呈线性相关关系,但也有一定相关,从而断定策略的掌握会对学生产生积极的影响。然而现在的听力教材中缺少这一内容,于是笔者将其加入到课文的具体内容之中。  相似文献   
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TOPIC: Psychological impact of adoption and resulting core issues for adopted children. PURPOSE: To raise awareness of the psychological impact of adoption. SOURCES: Published literature and personal observations. CONCLUSIONS: Adoption raises unique issues and challenges for the child and adoptive parents. Resolving the issues of adoption is a lifelong process. Through an awareness of the issues inherent in adoption, nurses and parents can use strategies that will enhance children's self-esteem and decrease their emotional vulnerability. Search terms: Adoption, intervention, loss, self-esteem, strategies  相似文献   
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