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141.
Challenging end-of-life encounters can be stressful and may lead to burnout. Monthly debriefing sessions are led by a physician and clinical social worker (LCSW). Sessions focus on experiences and emotional reactions rather than case details. Themes identified included; feeling unsupported after difficult deaths, identifying with patients emotionally, and conceptualizing a “good” versus “bad” death. Debriefing provides opportunities for residency physicians to reflect on the affective side of their work and helps promote resiliency.  相似文献   
142.
Abstract

Objective: To examine human immunodeficiency virus (HIV)–related knowledge, attitudes, and behaviors in at-risk college men who have sex with men (MSM), focusing on knowledge about acute HIV infection (AHI). Participants and Methods: A one-time anonymous survey was administered to college students attending a lesbian, gay, bisexual, transgender, and queer conference in February 2012. This article reports on a study subsample of MSM. Results: A total of 100 MSM completed the survey. Participants had an average age of 20.4 years. Sixty-six percent reported condom use the last time they had sex. Only 46% had ever heard of symptoms related to AHI. Forty-two percent would likely seek medical care when showing acute symptoms in a setting consistent with AHI. Conclusion: Despite having multiple risk factors for HIV infection, many MSM college students are unaware of AHI. HIV prevention programs should target this population and include information about signs, symptoms, and diagnosis of AHI.  相似文献   
143.
No abstract available for this article.  相似文献   
144.

The current system for the ethical oversight of clinical research suffers from structural, procedural, and performance assessment problems. Initially conceived primarily to handle local investigator-initiated single-site studies, the system of institutionally-based committee review has become progressively more inefficient given the increased prevalence of commercially or federally sponsored multi-center trials. To date, proposed solutions do not adequately address these problems.

Beginning with a review of these structural, procedural, and performance assessment problems, this article will then consider two proposals for addressing these deficiencies: (a) regional ethics organizations; and (b) IRBNet?, a newly developed web-based program for cooperative IRB review. The strengths and weaknesses of these two approaches will be evaluated in light of recent experience with centralized review. The proposal to establish a system of regional ethics organizations presents a comprehensive approach to many of the problems faced by the current system. However, IRBNet? offers an immediate and feasible solution to many of the problems faced by the review of multi-site clinical studies.  相似文献   
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147.
Molecularly targeted, genomic‐driven, and immunotherapy‐based clinical trials continue to be advanced for the treatment of relapse or refractory cancer patients, where the growth modulation index (GMI) is often considered a primary endpoint of treatment efficacy. However, there little literature is available that considers the trial design with GMI as the primary endpoint. In this article, we derived a sample size formula for the score test under a log‐linear model of the GMI. Study designs using the derived sample size formula are illustrated under a bivariate exponential model, the Weibull frailty model, and the generalized treatment effect size. The proposed designs provide sound statistical methods for a single‐arm phase II trial with GMI as the primary endpoint.  相似文献   
148.
Abstract

Development of accountability standards to demonstrate cause and effect relationships are gaining rapid advancement in the field of social sciences. Many governmental agencies, foundations, and other funders have developed approaches that require organizations to utilize science-based programs and incorporate evaluative methods to show improved outcomes and cost benefits to society. This article will examine the need for increased accountability in developing effective interventions by faith-based organizations in the delivery of social service interventions. Recently, there has been a strong movement toward governmental funding for faith-based institutions to provide social services, although there has been inadequate scientific data to demonstrate that approaches implemented are effective in meeting needs or yielding favorable outcomes. Similarly, many faith-based organizations provide innovative and effective programs that could serve as model programs if there was appropriate empirical evidence. This article will discuss how rigorous evaluative approaches such as randomized clinical control trials can produce scientific data on program effectiveness. We will use a case example in the field of drug and alcohol treatment to illustrate these points.  相似文献   
149.
中华女子学院法律诊所课程的建设与实践   总被引:1,自引:0,他引:1  
诊所法律教育在我国部分高校的引入和发展,一定程度上弥补了传统法律教育的不足。中华女子学院法律诊所课程的建设与实践,对培养学生,尤其是女大学生成为各具特色的现代应用型法律人才,有着积极的意义。  相似文献   
150.
ABSTRACT

There is an ongoing discussion regarding the role of psychologists in child custody relative to clinical vs. investigative roles. The issues revolve around how expansive or how limited a professional might be in addressing the concerns of families, adults and children in high conflict custody cases. In the article, the investigative or more maximalist role is discussed in the light of the alternative more clinical or minimalist stance. An argument is advanced that we may be limited to a more clinical/minimalist role if we are to stay within the confines of research informed practice standards.  相似文献   
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