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ETHIC ASPECTS IN PALLIATIVE CARE
No full text倫理學是哲學之一分科，是研究道德義務之科學，是在研究人類行為的是非與試圖經由理性的探究，以求發現可以普遍適用的原理或規則，作為倫理判斷之指針，並使人類的行為有所規範。當今的醫事倫理已與以前不甚相同：(1)往前是採用規範式的方式來定義醫事倫理，而今對比較重大的醫事倫理問題；(2)往昔的醫事倫理幾乎都是出於絕對主義的義務論倫理體系，本質上是屬於個人主義倫理( personalist ethics)，當今有很多醫事上的倫理問題，醫師在作決定之前除了必須顧及病人的權益以外，也要把社會責任、醫藥資源是否充裕與使用的經濟效益，以及和現行的醫事法規是否有抵觸等外在因素一併列入考慮；(3)往昔醫師與病人在專業倫理上的相互關係很像父親與子女之間的關係，而今因為人權主張普遍獲得肯定，以及醫療傾向商業化等因素，愈來愈多人認為醫師有義務尊重病人的自主權 (autonomy)；當今社會，有不少臨床上所面臨的倫理問題，由於牽涉範圍較廣，常需非醫事專業人員如倫理學家、神學家、律師、社工人員等之協助或商議，才得確定對策或決定處理方針，這樣不僅可避免個人主觀的偏見與判斷上的錯誤，也可減輕醫師本人的心理負擔。緩和醫療稱為一種全方位的照顧，是一種多重科際配合的團隊工作，也是一種積極的治療，面對病人所有生理(身體)上、心理社會或心靈上的任何問題，醫療團隊都必須提供積極照護。醫療人員照護病人的基本倫理原則大致可以分為自主性、醫主、不傷害、行善與公平性。緩和醫療的倫理觀指的是一群terminal ill patients，而不是一群 incurably ill patients。照顧terminal ill patients我們可以分成兩方面來探討其照顧上的倫理原則：(1)在身體的照顧方面：對於個案的身體照顧，醫療團隊所給予的並不是"cure"，而是"care"，其中最主要的是止痛，不管是消除他身上的疼痛，或是設法將它減輕到可以忍受與不致影響病人睡眠的程度，也就是說，希望在其臨終之前，可以保持寧靜、安適與維持人性的尊嚴。(2)心理上的照顧：醫療團隊在進行緩和醫療之時，應知道病人除了希望在身體上的照顧能夠使其『善終』之外，也要隨時有家人和醫療人員感情上的支持。總之，醫療人員在強調醫事知識與技能的同時，亦應關心醫事倫理，強調全人照顧與holistic care的家庭醫師更必須具備此種觀念，尤其在提供緩和醫療照顧時，更應了解，緩和醫療的倫理觀不完全相同於一般醫療照顧的倫理觀，仍有一些值得探討與重視
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Crisis Management for National Infection Control System from the Experience of SARS and H5N2 Avian Influenza Outbreak
No full textSARS與H5N2禽流感同樣是令人聞之膽顫之傳染病，SARS是個已經發生且讓人印象深刻的世界級災難，雖然所造成的死亡人數沒有因為愛滋病所造成的那麼多，但是，所帶來的人民恐慌與經濟損失，卻遠比戰爭還令人害怕；H5N2是個隨時都可能發生、不知其後果之嚴重性的迷一般的傳染病，但其共同點是兩類病毒皆與動物有關。
防疫如同作戰，稍一不慎就有可能毀滅整個國家乃至整個世界；如何做好國家防疫系統的結構與流程的準備，以應付隨時可能發生在你我身邊的疫災，是一個嚴肅而重要的課題。衛生是一種專業，不容以政治手段操弄，才不致於造成民眾恐慌而無所適從，平時各部會乃至各級行政機關皆應有危機意識，隨時做好疫災的風險分析，隨時透過各種管道，包括媒體與專家討論會來教育民眾，並時常做好國際疫災資訊之溝通，並與媒體及國會議員，乃至地方民意代表等建立良好而通暢的溝通管道，才是應付疫災的最佳之道。疫災的控制不能靠個人英雄主義來解決，而是靠團隊的努力合作方能成功。
專責組織的建構與組織成員的定期教育訓練很重要，不適宜的法令也宜隨時修改，各種疫災之危機處理的標準作業程序必須隨時討論與修正，部會之間如何合作也宜趁著行政院組織再造的關鍵時刻進行溝通建置。面對中國大陸政治因素的困擾，與世界衛生組織間的關係存在某種程度的困難，我們有信心成功仍然操之在我。團結與團隊合作是防疫系統危機處理的成功關鍵因素。Both SARS and H5N2 avian influenza are terrible infectious diseases. SARS is a national and worldwide disaster. Although SARS caused deaths less than those caused by AIDS, it is more terrible than AIDS. H5N2 influenza could be present at anytime, the subsequent effects of its attack is unknown. Both SARS and H5N2 influenza are related to animals.
Infection control is like a war, infectious disease can ruin a whole world if we are not careful. It is a serious and important issue to prepare structures and procedures for infection control before it attacks. Health issue should not be manipulated by political methods. It is important to make risk analysis for infectious diseases outbreak and educate people through media and expertise conference, to make an international communication about infectious disasters, to construct an appropriate relationship with congress and local council.
A special team should be set up for infection control. It is important to educate and train the group regularly, to update the rules for infection control, to discuss and modify the standard procedures for the execution of the procedures of infection control, and to set a communication mechanism between different ministries. Facing the interference of Mainland China we are difficult to construct relationship with the World Health Organization. We still have confidence. Team work and cooperation is a key factor for the success of infection control
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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