“比较治疗学”与“循证医学”之比较

对比较治疗学与循证医学兴起的历史背景、基本内涵的差异以及在临床决策方法方面的关系进行了较为细致的比较。循证医学与比较治疗学分属于临床决策的两个不同的阶段,比较治疗学的内涵范围要大于循证医学,同时循证医学为比较治疗学提供主要的基础性决策依据,比较治疗学的决策方法是循证医学在临床决策方法上的新发展。两者对促进临床科学决策都具有重要意义。     

举证责任倒置与临床实践中证据的思考

医疗纠纷的举证责任倒置对医疗患双方产生广泛而深远的影响,也使医学与法律产生了碰撞,这就要求医务工作者在临床实践中既要为患者服务又要做到每个临床决策都必须有章可循,有法可依,有据可查以维护自己的合法权益,正确认识举证责任倒置的要求和掌握在临床实践中遵循证据的方法以避免陷入越来越多的医疗纠纷。     

循证医学及其在心血管疾病中的应用

循证医学作为一门新兴的学科,对医学的研究和实践将产生越来越大的影响。在循证医学的操作过程中,如何正确评价和应用所获得的证据极为重要。在短短的十几年间,循证医学给心血管疾病的临床实践带来了根本的变化。     

肺癌临床研究的方式、方法、方向

肺癌的临床研究,需要新的研究方式,新的研究方法和新的研究方向。系统评估方法、临床随机对照研究方式和临床指南的方式,正成为循证医学的最重要的临床研究方法。当我们的临床医学从经验医学到实验医学到循证医学时,肺癌的临床研究,需要迅速地进入一个新的领域。     

对心血管病学若干进展的反思

心电起搏的发展经历曲折的过程,反映出以技术和设备为本的缺陷,以人为本可弥补这些缺陷;对介入新技术的过热应用反映了以技术为本的弊端;临床试验证据只反映某种情况下的患者共性,对试验证据的僵化理解和运用违背了循证医学的本义,以人为本可较好地解决这一矛盾;预防为主是以人为本的最好体现,应得到广泛的重视和实施。以人为本是医学的核心价值和出发点。     

语义空间的研究方法

对于语义空间的研究一直是认知心理学研究的一个热点。由于对词汇语义系统的不同观点,科学家们试图从不同的角度采用不同的方法来进行研究。目前,有代表性的语义空间研究方法主要有两种:潜在语义分析(LSA)和语言的多维空间类比(HAL)。潜在语义分析是指利用奇异值分解的方法来探索文章中潜在的语义关系的方法;语言的多维空间类比则是利用多维量表(MDS)的方法来提取语义信息。     

The nature of clinical depression: symptoms, syndromes, and behavior analysis

In this article we discuss the traditional behavioral models of depression and some of the challenges analyzing a phenomenon with such complex and varied features. We present the traditional model and suggest that it does not capture the complexity of the phenomenon, nor do syndromal models of depression that dominate the mainstream conceptualization of depression. Instead, we emphasize ideographic analysis and present depression as a maladaptive dysregulation of an ultimately adaptive elicited emotional response. We emphasize environmental factors, specifically aversive control and private verbal events, in terms of relational frame theory, that may transform an adaptive response into a maladaptive disorder. We consider the role of negative thought processes and rumination, common and debilitating aspects of depression that have traditionally been neglected by behavior analysts.     

SCREEN MEMORIES: A NEGLECTED FREUDIAN DISCOVERY?

In 1899, Freud introduced the concept of screen memories. His insights were revolutionary: screen memories do not emerge into consciousness at the time of recall, he argued; they are formed at that time and, moreover, historical accuracy is not their prime concern. In this article, the author reviews two of Freud's screen memories, as well as two screen memories from a completed analysis of one of his own patients. He argues that, if screen memories are formed, a concept such as screen work must be invoked as the agent of their formation. While screen memories may theoretically be formed at any stage of life, adolescence may be a prime time for their formation.     

Ontogenesis and Phylogenesis in the Analysis of Chinese Classifiers： Remarks on Philosophical Method

Philosophical analysis is commonly assumed to involve decomposing the meaning of a sentence or an expression into a set of conceptually basic constituent parts. This essay challenges this traditional view by examining the potential semantic roles that classifier phrases play in Chinese. It is suggested that the conceptual resources necessary for justifying claims about the semantical status of natural language classifier phrases should be informed in part by methods that accommodate ontogenic and evolutionary contexts. Evidence is provided for the view that many Chinese classifiers （but not all） are features regimented in the grammar of Chinese that have no functional role in normal adult communication, but which play an ontogenetic role in the child＇s development of linguistic competency. Furthermore, it is suggested that this ontogenetic role has features in common with the phylogenetic processes by which Chinese or its classical variants came about, as a later product of mechanisms that evolved in the species in accordance with varying demands for successful communication.     

循证医学的辩证思维

随着临床医学的发展,临床医生面临着从理论知识加个人经验的医学模式向以科学证据为基础的医学模式转变。越来越多的卫生政策和诊疗指南的制定需要以高质量的研究结果为依据,如随机对照研究的结果,特别是随机对照研究的系统综述结论。循证医学模式要求医生在临床工作中不断提出问题并通过严格的科研设计来回答这些问题,同时强调不断进行知识更新,掌握最新研究证据以指导其临床工作。同时政府部门也鼓励发展循证医疗,因为它可通过研究有效的诊疗手段来提高卫生保健的效率。此外还有迹象表明法律决策过程中要参考是否遵循了研究证据和临床指南。知情的服务对象也促使临床工作者寻求研究证据作为依据,为了提高服务质量并且充分把握特殊专业领域的现状,临床工作者也需要不断了解新的依据信息。在众多的研究信息中,我们应对每项证据的研究方法、研究对象及观察的终点进行认真分析,确定该结论是否真实并适合我们的实际,从而制定有据可查的诊疗方案。     

临床方法依然是神经内科医师最重要的诊断法宝

通过7例疑难、危重患者的诊治过程说明临床方法的重要性,在神经科疾病研究中尤为突出。忽视细致的病史采集和体查,常导致了诊疗的失误;面对种目繁多的检查,更需要以临床方法选择之;临床逻辑思维能力非常重要,正确的临床思维出新知。在实验室检查方法越来越多的今天,临床方法是神经内科医师最重要、方便、快捷、有效的诊断法宝,具有不可替代性。     

Transference focused psychotherapy: overview and update

This paper describes a specific psychoanalytic psychotherapy for patients with severe personality disorders, its technical approach and specific research projects establishing empirical evidence supporting its efficacy. This treatment derives from the findings of the Menninger Foundation Psychotherapy Research project, and applies a model of contemporary psychoanalytic object relations theory as its theoretical foundation. The paper differentiates this treatment from alternative psychoanalytic approaches, including other types of psychoanalytic psychotherapy as well as standard psychoanalysis, and from three alternative non-analytical treatments prevalent in the treatment of borderline patients, namely, dialectic behavior therapy, supportive psychotherapy based on psychoanalytic theory, and schema focused therapy. It concludes with indications and contraindications to this particular therapeutic approach derived from the clinical experience that evolved in the course of the sequence of research projects leading to the empirical establishment of its efficacy.     

A Practical Guide to the Comparative Case Study Method in Political Psychology

The case study, as a method of inquiry, is particularly suited to the field of political psychology. Yet there is little training in political science, and even less in psychology, on how to do case study research. Furthermore, misconceptions about case studies contribute to the methodological barrier that exists within and between the two parent disciplines. This paper reviews the various definitions and uses of case studies and integrates a number of recent insights and advances into a practical guide for conducting case study research. To this end, the paper discusses various stereotypes of the case study and offers specific steps aimed at addressing these criticisms.