A Video Life-world Approach to Consultation Practice: The Relevance of a Socio-Phenomenological Approach

This article discusses the [development and] use of a video life-world schema to explore alternative orientations to the shared health consultation. It is anticipated that this schema can be used by practitioners and consumers alike to understand the dynamics of videoed health consultations, the role of the participants within it and the potential to consciously alter the outcome by altering behaviour during the process of interaction. The study examines health consultation participation and develops an interpretative method of analysis that includes image elicitation (via videos), phenomenology (to identify the components of the analytic framework), narrative (to depict the stories of interactions) and a reflexive mode (to develop shared meaning through a conceptual framework for analysis). The analytic framework is derived from a life-world conception of human mutual shared interaction which is presented here as a novel approach to understanding patient-centred care. The video materials used in this study were derived from consultations in a Walk-in Centre (WiC) in East London. The conceptual framework produced through the process of video analysis is comprised of different combinations of movement, knowledge and emotional conversations that are used to classify objective or engaged WiC health care interactions. The videoed interactions organise along an active or passive, facilitative or directive typical situation continuum illustrating different kinds of textual approaches to practice that are in tension or harmony. The schema demonstrates how practitioners and consumers interact to produce these outcomes and indicates the potential for both consumers and practitioners to be educated to develop practice dynamics that support patient-centred care and impact on health outcomes.     

Bringing the Public Health Approach to the Problem of Suicide

Suicide and suicidal behavior are public health problems that should be addressed through a systematic public health approach. The need for such an approach can be found, for example, in Pierre, SD, where the suicide rate is 13 times the national rate; in the African American community, where the suicide rate among Black youths more than doubled between 1980 and 1995; and across the United States, where suicides outnumbered homicides in 1995. The U.S. Public Health Service is applying the public health approach to suicide by preparing the first-ever Surgeon General's Report on Mental Health, and by holding an October conference in Reno aimed at advancing a national strategy for suicide prevention.     

From the Heterogeneity Problem to a Natural-Kind Approach to Pleasure

The heterogeneity problem, which stems from the alleged difficulty of finding out what all pleasant experiences have in common, is largely considered as a substantial issue in the philosophy of pleasure, one that is usually taken as the starting point for theorizing about the essence of pleasure. The goal of this paper is to move the focus away from the heterogeneity problem and toward an alternative approach to pleasure. To do this, I first show that, although the approach stemming from the heterogeneity problem has led to an interesting discussion about the essence of pleasure, it has usually endorsed an introspectionist methodology and other problematic assumptions that have led to doubtful results. I thus propose a natural-kind approach to pleasure, which seeks to determine what, if any, the natural kind of pleasure would consist in. This approach broadens the investigation of pleasure by enabling the use of a larger range of methodological tools, thus opening new promising directions for research.     

A Sullivanian Approach to the Problem of Reading Disability: Theoretical Considerations and Empirical Data

Since reading disabilities resemble operationally hysterical disorders, the applicability of some of Sullivan's (1947, 1956) conceptions about hysteria in the understanding of this symptom was explored. To this end a measure was designed to assess the degree to which children are sensitive and selectively attentive to hypocritical, insincere, and plain “silly” aspects of the world around them and/or their readiness to understand the sincere precepts of their culture. The instrument was essentially a modification and extension of the Verbal Absurdities items and the Proverb items of the Stanford-Binet Test (Terman & Merrill, 1960). If Sullivan's notions were applicable, then youngsters with reading disabilities should do better than their adequately reading control subjects on the Absurdity items; the reverse relationship was expected on the Proverbs items. Twenty children with marked reading retardation and a matched control group of equal size and reading at grade level expectancy served as research populations. All measures calculated rendered results supporting the hypotheses advanced at better than the .05 level of confidence. The implications of these findings for the theoretical understanding of the reading disability symptom from a Sullivanian vantage point are discussed.     

他心问题的社会认知神经科学研究进路

作为当代心智哲学九大问题之一的他心问题,肇始于Descartes主义对心身关系的认识。问的是:我们能否知道以及怎么知道他人有心,亦即有思想、经验和情感等?对于他心问题的解决方案,20世纪90年代以来,随着现当代科学技术(尤其是神经生物学、认知神经科学和大脑测试技术等)的深入发展,哲学家与心理学家的知识联姻和交叉合作研究,提供了关于他心问题的若干重要成果和实证资料。他心问题不再成为"理论的死角"。当代社会认知神经科学的出现(social cognitive neuroscience,SCN,2000),在科学方法论上更加关注对社会性心智现象的神经机制考量,一系列研究成果都为揭示他心问题提供了科学旁证。这不仅说明了认识他心的可能性,而且表明了通向认识他心方式的多样性,物理学的方法并不是与他心相隔绝。本文尝试从社会认知神经科学的最新研究进展:镜像神经元系统,他知与自知、他心知觉和再认的社会标记、他心社会判断和归因入手来论证他心问题的可释性,为他心问题的论证提供一条多学科交叉研究的新进路。     

医疗保险实施中的新课题：构建合理的利益格局

大连市实施医疗保险制度6年来,在医疗保险制度改革中医保机构、医疗机构、医药行业及参职工在利益格局调整中,出现了一些问题。从有利于医疗保险制度改革和公平、公正、客观的角度,用辩证的方法分析了医疗保险制度改革过程中的几个主要矛盾,进而从改变利益观、完善政策、加快配套改革等方面提出了相应的建议。     

A Psychoeducational Approach to Hypochondriasis: Background,Content, and Practice Guidelines

Patients suffering from health anxiety are difficult to engage in a psychological treatment, although it has now been empirically established that cognitive behavioral treatments are beneficial for many of these patients. A first important step is to change their orientation from a biomedical to a biopsychosocial perspective. One way of promoting this change is to provide focused psychoeducation. A number of studies have shown that group psychoeducation for patients with health anxiety results in a reduction in anxious concerns, depression, and medical services utilization. The purpose of this paper is to describe the background, content, and implementation of a brief course entitled “Coping With Health Anxiety.” The empirical support as well as the potentially active ingredients of this approach are discussed.     

Creating Computer-Mediated Communities of Practice in Special Education

Summary

The convergence of theory and research on socially shared cognition represents a promising new direction for understanding how to enhance the intellectual growth of individuals. In this article, we draw upon the metaphor of “apprenticeship” to explain how individual cognitive development of children and adults alike can be enhanced by mentoring relationships within a particular educational “culture.” The view advanced here is that computers and related technologies can be instrumental in creating socially interactive and reflective learning communities. Within these communities there is active transmission of knowledge between individuals as they are guided from the periphery through to the center of the learning enterprise. Examples of communities of learners are provided to illustrate the process of socially shared cognition and development of knowledge networks. Principles for the creation of sustainable learning communities apply equally to traditional educational settings and on-line communities. The concept of the “collective zone of proximal development” is advanced here to explain how cognitive growth progressively occurs for community members who are operating within a socially interactive and reflective learning environment. Finally, principles and recommendations are offered on how to design communities so that all individuals can achieve their optimal functioning level through guided social participation.     

欲成义人,先做善人——康德对道德与宗教关系的处理

本文首先对"单纯理性界限内的宗教"这一说法进行了辨析,认为康德把宗教看作由两个部分的内容构成——理性的内容和经验性的内容;前者是宗教的道德内核,后者是用于承载或表现这个道德内核的宗教性外衣。康德强调真宗教必须是此二者的结合;对于人来说,道德与宗教都不可或缺:离开道德的内核,只把宗教的外衣当作宗教的全部内容,会走向宗教妄想;而离开宗教的表现、以为道德能够提供实践理性的终极目的的全部条件,这是道德狂热。康德对这两种思想倾向及实践都进行了批判。基于对康德宗教思想的这种认识,本文重新审视了把康德看作取消宗教的独立地位、将其化约为道德的看法,认为此种看法不符合康德对于道德与宗教关系的观点,因而是错误的认识。