Interdisciplinary Considerations in the Psychotherapy of Psychosomatic Patients

Abstract

Patients with psychosomatic conditions, who comprise a significant proportion of students seeking health care, demonstrate clearly the need for effective functioning of the health care team. These patients usually present themselves with problems of physical illness for practical, social, and psychodynamic reasons. Socially they seek to avoid the stigma attached to acknowledging psychological problems. Psychodynamically, such patients have transformed psychological problems into physical illness and need help in reversing this transformation. Attending only the physical illness or dismissing the patient because “it's all in your head” are inappropriate responses deeply embedded in popular culture. Case illustrations are used to show the need for careful diagnosis from physical and psychological standpoints, for skillful referral and interdisciplinary collaboration, and to show how psychotherapy can reverse the psychosomatic process and the underlying psychological determinants. The illustrations include cases of headache, asthma, ulcers, and disturbances of sleep and appetite. Both specific psychotherapeutic technique and overall theory are discussed.     

植病经济的内涵与研究方法评述

阐述了植病经济的概念、目标、任务、内涵,并对植病经济的研究方法进行摸索与探讨,其中部分研究方法用实例加以说明,以期为植病经济的深入研究提供借鉴与参考。     

Design and Evaluation of Prophylactic Interventions Using Infectious Disease Incidence Data from Close Contact Groups

Summary.  Prophylaxis of contacts of infectious cases such as household members and treatment of infectious cases are methods to prevent the spread of infectious diseases. We develop a method based on maximum likelihood to estimate the efficacy of such interventions and the transmission probabilities. We consider both the design with prospective follow-up of close contact groups and the design with ascertainment of close contact groups by an index case as well as randomization by groups and by individuals. We compare the designs by using simulations. We estimate the efficacy of the influenza antiviral agent oseltamivir in reducing susceptibility and infectiousness in two case-ascertained household trials.     

Reciprocal relations: The recognition and co-construction of caring with Alzheimer's disease

The literature on caring for people with Alzheimer's disease predominantly underscores the role of the care giver, largely ignoring the care receiver. Care is viewed as a service to mind someone rather than a compassionate act of shared relationship. Alzheimer's disease is portrayed as negatively influencing reciprocity in caring relationships, precipitating their gradual dissolution. We report findings from an ethnographic study that followed nearly 100 dyads of people with Alzheimer's disease and those who cared for them for more than 1 year. ‘Give and take’ in a relationship appears richer and more ambiguous than previously supposed; despite one party's cognitive losses, shared meanings can still be experienced by both people. In an in-depth examination of the narratives of co-carers, gathered during home visits, relationships were seen to be dynamic co-constructions built upon everyday events, interactions, environments and disease progression. Importantly, we show that people with Alzheimer's disease express insight and awareness despite decline.     

乌鲁木齐大气污染对呼吸系统疾病的影响

国内外大量流行病学研究证明大气污染影响人类健康,并与许多呼吸系统疾病间接或直接相关。针对乌鲁木齐冬季大气污染严重的现状,结合某医院呼吸系统疾病发病的门诊量和住院情况,分析了乌鲁木齐冬季呼吸系统疾病发病人数与大气污染的关系。     

简论近代中国民众卫生教育

由于近代中国疾疫猖狂为害 ,专业的医学教育又远不能满足社会的需要 ,使得开展民众卫生教育成为必要之举。民众卫生教育兴起后 ,多采用借助新闻媒体、发行卫生刊物或出版卫生书籍、开展各项卫生宣传等方式进行。其主要内容涉及普及卫生知识、研究和预防传染病、倡导民族健康运动等方面。     

心理疾患的社会文化因素探析

心理现象从来都不是孤立的 ,它有着深厚的文化背景。中国传统文化中光宗耀祖、望子成龙的亲子关系、性别角色观念和要面子的国民劣根性是影响当代人心理健康的重要因素 ;压抑自我的内向性格使人们不敢公开求助于心理医生 ,把心理疾患当成躯体疾患 ;心理治疗必须从社会环境和文化背景入手 ,才能有的放矢 ,收到良好效果     

探讨尿微量白蛋白与心血管疾病的关系

目的探讨尿微量白蛋白(AMU)与心血管疾病的关系。方法选择110例健康者为对照组,高血压组60例,冠心病组45例,分别测定血压、血脂、尿微量白蛋白浓度,分析比较其与心血管疾病的发生率。结果高血压组、冠心病组尿微量白蛋白明显高于对照组(P<0.001)。结论尿微量白蛋白是预测心血管疾病发生的具有重要意义的指标,临床医生应引起重视。     

A Method for Ascertaining and Controlling Representation Bias in Field Trials for Airborne Plant Pathogens

The basic premise of running a field trial is that the estimates of treatment effects obtained are representative of how the different treatments will perform in the field. The disparities between the treatment effects observed experimentally, and those that would be observed were the treatments applied to the field, we term 'representation bias.' When looking at field trials testing the efficacies of treatment sprays on plant pathogens, representation bias can be caused by positive and negative inter-plot interference. The potential for such effects will be greatest when looking at pathogens that are dispersed by wind. In this paper, a computer simulation that simulates plant disease dispersal under such conditions is described. This program is used to quantify the amount of representation bias occurring in various experimental situations. Through this, the relationships between field design parameters and representation bias are explored, and the importance of plot dimension and spacing, as well as treatment to plot allocation, emphasized.     

Quantitative Risk Assessment of Vibrio parahaemolyticus in Finfish: A Model of Raw Horse Mackerel Consumption in Japan

The aim of this study was to evaluate the effects of implemented control measures to reduce illness induced by Vibrio parahaemolyticus (V. parahaemolyticus) in horse mackerel (Trachurus japonicus), seafood that is commonly consumed raw in Japan. On the basis of currently available experimental and survey data, we constructed a quantitative risk model of V. parahaemolyticus in horse mackerel from harvest to consumption. In particular, the following factors were evaluated: bacterial growth at all stages, effects of washing the fish body and storage water, and bacterial transfer from the fish surface, gills, and intestine to fillets during preparation. New parameters of the beta‐Poisson dose‐response model were determined from all human feeding trials, some of which have been used for risk assessment by the U.S. Food and Drug Administration (USFDA). The probability of illness caused by V. parahaemolyticus was estimated using both the USFDA dose‐response parameters and our parameters for each selected pathway of scenario alternatives: washing whole fish at landing, storage in contaminated water, high temperature during transportation, and washing fish during preparation. The last scenario (washing fish during preparation) was the most effective for reducing the risk of illness by about a factor of 10 compared to no washing at this stage. Risk of illness increased by 50% by exposure to increased temperature during transportation, according to our assumptions of duration and temperature. The other two scenarios did not significantly affect risk. The choice of dose‐response parameters was not critical for evaluation of control measures.