我国全科医学的学科定位与社区卫生建设的关系

随着许多医学院校定向培养到基层医疗机构工作的医生,基层医疗机构与全科医学紧密联系起来.从我国全科医学的学科定位、全科医学与社区卫生建设的关系、全科医学教育的社区实践三方面进行论述,指出全科医学在当今世界已成为一门标准化科学,属于临床医学,而目前我国全科医学不具有学科的独立性;全科医学人才的培养目标模糊,出现"全科是退而求其次"的状况;社区卫生建设跟不上人才培养的需要.因此,需要促进我国全科医学独立性的形成,专门培养全科医学人才,加强社区卫生建设.     

人文医学学科建设之我见

学科建设的状态及其指标体系的完满程度,是学科发展水平的重要标志。当前我国人文医学的建设,需要从反映学科的时代精神,明确学科的性质,落实学科的归宿,夯实学科的基础,即一方面是人文医学学科的理论基础,另一方面是人文医学的医学基础,完善学科的结构和知识体系,以及加速人才队伍建设,特别是学科带头人的培养,以及开展学科相关重要课题的研究几方面着手。人文医学学科的建设,应当紧密围绕培养优秀医学人才的目标进行。     

当下高等医学人文教育的困境与出路

医学人文教育是医学教育不可或缺的重要组成部分,医学科学精神与医学人文精神的融合是医学学科发展的目标和方向.当下医学人文教育的困境在于:医学人文教育与政治教育混谈,人文教育目标不明;医学人文教学与社会现实脱节,人文教学效果不佳.破解医学人文教育的困境,必须从顶层设计,跳出医学人文教育看教育,实施医学人文教育发展战略,实现医学教育的全面、协调、可持续发展.     

临床决策:医学哲学研究的一个重要领域

临床决策研究已成为临床医学中的一个重要领域.当下的临床决策问题涉及到医学信息学、循证医学、费用-效益评估、卫生技术评估、医学伦理与法律等学科领域.因此在临床决策中单一的经验-描述的研究纲领已不适应当代医学发展的需要,需要引入综合的决策方法.临床决策问题也为医学哲学研究提供了一个极佳的思想实验场所.临床决策的多维度研究,对于打通学科之间的壁垒,架构科学与人文之间的桥梁,更深刻地理解和把握医疗保健的整体性,使临床医疗达到最佳疗效具有重要意义.     

循证烧伤医学与烧伤医学的发展

循证医学是以证据为基础的医学,其在烧伤医学的应用即为循证烧伤医学.循证医学主要实施策略是发现和提出问题;寻求烧伤医疗实践中或者文献中的有价值证据;进行实验或方法学的评价;应用于临床检验的实践中;评价实践结果.循证烧伤医学和循证医学对烧伤医学的学科发展和临床工作的开展具有重要的意义,烧伤医学今后的发展方向是循证烧伤医学.     

论流行病学与医学创新

流行病学随医学的发展而发展,同时,它的发展对整个医学学科的发展也产生了重大的影响。从流行病学对医学思维、医学研究方法、医学模式及医学目的的实现等几个方面讨论了该学科在现代医学发展中的作用和地位。     

医学发展中的整体观念与学科综合

以器官为中心的"器官医学"忽略了人的整体性.随着医学模式的转变,以器官为研究重点的单个学科因其自身的劣势,已越来越不适应医学的发展.在疾病诊治中的对整体观念的要求更加突出,要以疾病为中心转向以病人为中心.注重整体观念和新的学科模式即学科综合将是医学发展的必由之路.     

美学观念在当代中国医学领域里的三次“飞跃”——当代中国美容医学整体学科的发展

探寻医学美学与美容医学整体学科在我国形成与发展的历程,总结了近30年来美学观念在我国医学领域的三次“飞跃”:从学科的孕育到学术组织的建立;国内整体学科建设的成功;学会和学科成功迈步世界.明确了我国美容医学已经迎来进一步向世界作出贡献的新机遇.     

写在《医学与哲学》办刊30周年之际

<医学与哲学>从1980年创刊到现在已30年,出版390多期,是探讨医学与哲学关系,医学哲学领域最权威的理论阵地,也是指导医学人文学发展的理论源泉,成为了当前我国医学哲学界的一本重要学术期刊和代表性的期刊.     

论医学人道主义的三个历史形态

医学从原始社会发展到现在经过了漫长复杂的道路。在它的发展过程中,医学人道主义经历了三个历史形态,即古代朴素的医学人道观念,一般的医学人道主义;革命人道主义。医学人道主义的三个历史形态,反映了医德由低到高的客观发展进程。加强对医学人道主义的研究,对于建设社会主义医德是十分重要的。     

Seeing and hearing and space and space and time

A previous experiment had shown spatial location to be judged in terms of the framework provided by the modality in which stimuli were presented. In the present study, digits were either auditorally or visually presented, and in either form the three digits appeared successivly to the left, in the center, and to the right of the S. The digit which occurred temporally in the middle of the sequence was never central from the spatial viewpoint. The S was asked to indicate which digit was the middle one. Ss were blind, deaf, or normal. The deaf and two control groups saw visual displays, and the blind and their controls heard auditory displays. The former groups predominantly chose the spatially middle digit and the latter groups the temporally middle. It was concluded that modality of presentation was the trigger which switched in the coding dimension of time or space.     

Law and Gospel,and Youth and Family Ministry

Abstract : If “faith comes through hearing” the word of God comprised in law and gospel, how do the imperatives that characterize ‘Youth and Family Ministry’ make such hearing possible? Here, literature delineating ‘Youth and Family Ministry’ is analyzed in light of its biblical foundations. The primary lens implemented in this analysis is the law/gospel hermeneutic advocated by Martin Luther and other reformers.     

Extremes of self-esteem and narcissism and the experience and expression of anger and aggression

This study examined the level of self-esteem and narcissism as personality variables involved in the disposition to experience and express anger. Three hundred thirty-eight subjects were sampled across two higher education centres and one student teaching programme in the United Kingdom. It was reasoned that individuals with both high self-esteem and narcissism would report especially high tendencies to experience and express anger and aggression and that those with high self-esteem and low narcissism would report the lowest. These predictions were influenced by theories that emphasise the role of threats to high self-esteem in the production of aggression and violence. Results indicate that groups defined by their extreme scores on self-esteem and narcissism scales produced levels of anger expression in the predicted direction. The importance of considering extreme levels of self-esteem and narcissism (in conjunction with other factors) in an analysis of anger is discussed with reference to currently influential theories in the field. Aggr. Behav. 24:421–438, 1998. © 1998 Wiley-Liss, Inc.     

Bob and Carol and Tess and Ali

Conflicting religious experiences in different traditions do not necessarily defeat the rationality of conflicting beliefs sustained by those experiences in those traditions. The circularity that protects religious beliefs from such mutual defeat is not vicious. Moreover, the lack of ‘epistemological humility’ exhibited by such believers poses no threat to world peace. In fact, a campaign for compulsory humility would itself constitute a much greater threat.     

Yin and Yang,and the Hot and the Cold

Yin and Yang are important concepts in ancient Chinese philosophy.Western scholars have become more familiar with these two concepts recently,but for a long time almost no one considered comparing them with their own tradition such as the ancient Greek philosophy,and especially with the ideas of the Hot and the Cold in Presocratic philosophy.In this paper,I make an attempt to do exactly that,and especially make a detailed comparison between the thoughts of two ancient thinkers:Laozi and Anaximander.I discuss the thought of Yin and Yang in Laozi-who was the earliest philosopher making use of the concepts Yin and Yang-to express his cosmological thought in ancient Chinese philosophy.Comparatively,I discuss the ideas of the Hot and the Cold in Anaximander,the earlier among Presocratic philosophers referring to the Hot and the Cold as fundamental concepts used to establish his cosmological system.Through this comparison,I indicate that the similarity between ancient Chinese and Western traditions is far more significant than what people are used to imagining.     

Perversion and infancy and adolescence

Abstract

Studying the works of Freud and Lacan, the authors carried out research on perversion in childhood. Their work covered the perverse polymorphism of infantile sexuality and the perception of the anatomic difference between the sexes that leads the child to create sexual theories and fantasies. The phallic mother and the fetish are viewed as imaginary solutions directly related to the Oedipus and castration complexes. In perversion, a particular position is taken in relation to the Oedipus complex: a serious flaw occurs in the symbolization of the law, and the mechanisms of denial and disavowal take form. Sexuality requires a second “logical time,” separated from infancy by the latency period, in order to confirm (in action) that a fixed position of jouissance (enjoyment) has actually been established. This can only happen in a period after adolescent enhancement. The distinction between perverse traces and a perverse structure is made, taking into account the fact that, in the case of child analysis, the analyst should free the child from the family fantasy and help him/her to build his/her own fantasy.

Campos Santoro V. et al. Perversion und Kindheit und Adoleszenz.

Im Studium der Arbeiten von Freud und Lacan haben die Autoren Forschung über Perversion in der Kindheit gemacht. Die Studien behandeln den perversen Polymorphismus der infantilen Sexualität und die Wahrnehmung des anatomischen Unterschiedes zwischen den Geschlechtern, welche das Kind dazu führt, Sexual-Theorien und Phatasien zu schaffen.

Die phallische Mutter und der Fetisch werden als imaginäre Lösungen angesehen, die sich direkt auf den Ödipus- und Kastrations-Komplex beziehen. Bei der Perversion wird eine besondere Position in Bezug auf den Ödipus angenommen; ein ernsthafter Mangel tritt bei der Symbolisierung des Rechts auf; die Mechanismen der Verneinung und der Verleugnung bilden sich. Sexualität erfordert eine zweite “logische Zeit”, von der Kindheit durch die Latenz Periode getrennt, um (in der Handlung) zu bestätigen, daß eine fixierte Position der jouissance (Vergnügung) sich tatsächlich etabliert hat. Das kann sich nur in einer Periode nach der adoleszenten Verstärkung ereignen.

Es wird die Unterscheidung zwischen perversen Spuren und einer perversen Struktur gemacht, in Rechnung stellend, daß im Fall der Kinder-Analyse der Analytiker das Kind von der Familien-Phantasie befreien sollte und ihm/ihr helfen sollte, seine/ihre Phantasie auszubilden.

Campos Santoro V. Perversión e infancia y adolescencia.

Estudiando los trabajos de Freud y Lacan, los autores han investigado la perversión en la niñez. Los estudios cubren la sexualidad infantil perversa polimorfa y la percepción de la diferencia anatómica entre los sexos, que llevan al niño a crear teorías sexuales y fantasías.

La madre fálica y el fetiche son vistos como soluciones imaginarias relacionadas directamente con el complejo de Edipo y de castración. La perversión, toma una posición particular en relación al Edipo; un fallo importante tiene lugar en la simbolización de la ley; los mecanismos de negación y repudio toman forma. La sexualidad requiere un segundo “tiempo lógico” separado de la infancia por el periodo de latencia, para confirmar (en acto) que una posición fija de jouissance (goce) se ha establecido. Esto solo puede ocurrir en un periodo posterior a la intensificación adolescente.

La distinción entre las huellas perversas y la estructura perversa se ha hecho, teniendo en cuenta que, en el caso del análisis de niños, el analista debe librar al niño de la fantasía familiar y ayudar a el/ella a construir su propia fantasía.     

Human Dignity and the Ethics and Aesthetics of Pain and Suffering

Inasmuch as unmitigated pain and suffering areoften thought to rob human beings of theirdignity, physicians and other care providersincur a special duty to relieve pain andsuffering when they encounter it. When pain andsuffering cannot be controlled it is sometimesthought that human dignity is compromised.Death, it is sometimes argued, would bepreferred to a life without dignity.Reasoning such as this trades on certainpreconceptions of the nature of pain andsuffering, and of their relationships todignity. The purpose of this paper is to laybare these preconceptions. The duties torelieve pain and suffering are clearly mattersof moral obligation, as is the duty to respondappropriately to the dignity of other persons.However, it is argued that our understanding ofthe phenomena of pain and suffering and theirrelationships to human dignity will be expandedwhen we explore the aesthetic dimensions ofthese various concepts. On the view presentedhere the life worth living is both morally goodand aesthetically beautiful. Appropriate``suffering with' another can help to maintainand restore the dignity of the relationshipsinvolved, even as it preserves and enhances thedignity of patient and caregiver alike.     

自我刻板化及其影响因素与效果

自我刻板化是指个体自认为某群体的成员时,把伴随此种身份的刻板印象加诸于自己身上的过程。该文首先简要介绍了自我刻板化的理论基础——自我归类理论,然后从自我刻板化的行为效应、态度效应以及影响自我刻板化的因素等方面对以往的相关研究进行了回顾。最后,指出未来的研究还有必要加强对自我刻板化的应用研究等五方面问题的探讨     

Self-regulatory and narcissistic grandiosity and vulnerability: Common and discriminant relations

In three studies we examined the unique relations of narcissistic grandiosity and vulnerability with the self-regulatory factors of promotion, prevention, assessment, and locomotion. We found that grandiosity has unique positive relations with promotion, assessment, and locomotion but is unrelated to prevention (Study 1). We also found that vulnerability has a unique positive relation with assessment, a unique negative one with promotion, and is unrelated to locomotion and prevention (Study 2). Study 3 replicated these findings and demonstrated that they do not derive from the self-regulatory factors’ or grandiosity and vulnerability’s associations with self-esteem. The results indicate that grandiosity and vulnerability have self-regulatory underpinnings and provide evidence of their specific discriminant nature. Further, they indicate that the critical evaluations associated with strong assessment concerns are a significant vulnerability for both narcissism presentations.     

微生物与行为和精神疾病

病原微生物能够影响宿主的大脑和行为, 甚至诱发精神疾患。肠道细菌可影响小鼠的神经系统发育和行为模式的发展。慢性胃肠病、慢性疲劳综合征等生理疾病中的行为改变与微生物有关; 肝性脑病、多发性硬化等中枢神经系统生理疾病也可能由微生态改变引起; 抑郁症、孤独症等精神疾病与肠道细菌状态和比例有关; 卫生假说支持上述观点。建立良好的共生微生物平衡有利于人类身心健康。可以预期, 共生微生物与身心健康的关系将是今后心理学研究的关注热点。