Global Diversification in Medicine Regulation: Insights from Regenerative Stem Cell Medicine

ABSTRACT

Medicine regulation worldwide has undergone a process of regulatory diversification. The evidence-based medicine (EBM) paradigm, centered on multi-phase randomized controlled trials, is increasingly contested and replaced by new models of clinical validation. To explain these changes, STS research has cited just a few factors, e.g. growing pressure form health consumers; the role of pharmaceutical companies to lobby for fast, affordable drug development; the influence of neoliberal ideas and libertarian advocacy of deregulation; and the agency of national governments to enable domestic innovation opportunities in the context of global competition and inequalities. Those factors individually cannot account for the increasing variation in medicine regulation at both national and global levels. Instead it is helpful to integrate elements of existing explanations into a framework with four pairs of conflicting regulatory choices, which play a central role in the formation of medicine regulation. We use this framework to compare regulatory changes in the USA, European Union, China, India, Argentina, and Japan. Across these jurisdictions, the case studies illustrate four dynamics of diversification. Key regulatory concepts such as evidence, risk, safety, efficacy, responsibility and accountability acquire different meanings, reshaping medicine innovation in far-reaching and often contradictory ways. The boundaries between medical research and healthcare provision, commerce and humanitarian service, as well as state control and medical self-regulation are re-defined.     

Reducing the Tendency to Aggress: Insights from Social and Personality Psychology

The social and personality psychology literature on aggression has largely focused on the factors that are associated with an increase in aggression such as provocation, violent media exposure, and trait anger. This work has been quite important in developing models of aggression. Less emphasis, however, has been placed on examining the factors that reduce this harmful behavior. We use a widely researched model of aggression to examine some factors that are associated with aggression reduction including self‐control, pro‐social experiences, and appraisal processes. These variables reduce the tendency to aggress, and our review addresses some potential processes involved. We suggest that a stronger research focus on the factors that reduce aggression can aid our understanding of not only why aggression occurs but also how to control it.     

Rituals, Compulsions, and Other Syncretic Tools: Insights from Werner's Comparative Psychology

In line with theme of this special issue, this article speaks to a topic in developmental psychology from a Wernerian perspective. We take a Wernerian, comparative, and orthogenetic approach in addressing rituals and other compulsive behaviors in a variety of contexts: Ritual as cultural practice, as a part of pathologic behavior, and as a normative aspect of child development. We discuss the similarities and differences in these various forms of ritual, and conclude by incorporating recent advances in the study of obsessive-compulsive disorder to shed light on the normative variant of compulsive behavior. Our goal is to emphasize the continued relevance Werner's work in light of contemporary trends in developmental psychology, developmental psychopathology, and neuroscience.     

An Ecological Approach to Behavioral Development: Insights From Comparative Psychology

In this article, I review recent work from comparative psychology, highlighting several conceptual and methodological insights drawn from comparative research and exploring their value to an ecological approach to behavioral development. In particular, I consider examples of a major focus of comparative psychology, the search for developmental mechanisms and processes underlying the expression of species-typical behavior. This focus has provided several insights regarding behavioral development that have supported an ecological approach and provided a richness and depth of perspective on behavior complementary to that found in ecological psychology. Specifically, I review the related notions of probabilism, equifinality, nonlinearity, and distributed control and discuss their applicability to and support of ecological theory.     

从医生心理看医院对病人的人文关怀

现代社会的飞速发展给医学事业带来了空前的发展机遇,给广大的患者带来了实惠和希望的同时,也给医生的心理带来了一系列的问题,给患者人文关怀最终要由医生来完成.阐述了医生的心理现状,分析了产生的原因,并用马斯洛的需求层次理论提出了如何改变医生的不良心态,给患者文人关怀.     

社会支持对慢性病患者身心健康的影响

慢性疾病已经成为威胁现代人健康的头号问题.社会支持作为影响人们身心健康的重要因素,在减轻疾病压力、帮助人们应对压力以及减少心理不适、增进身体健康等方面发挥着重要的作用.从社会网络理论的视角,考察社会支持对慢性病患者身心健康的影响,提出相应的社会支持对策.     

The Future of Psychology in Family Medicine

Psychology has been integral to the field of family medicine since its inception as a medical specialty in the 1960s. Psychologists and other behavioral scientists contribute to family medicine in teaching clinical skills, in defining research questions, in developing research methodology, and in creating integrated physical/mental health care delivery systems. Future developments in the field of psychology in family medicine are likely to emphasize development and evaluation of screening measures which identify mental health problems in primary care, development of early intervention for those mental health problems, and more precise measurement of process and quality of care and health outcomes. Psychologists have an important role to fulfill in educating physicians on alternatives to pharmacologic and medical interventions for common presenting problems in primary care. However, current economic forces shaping the practice of medicine may work against further enhancing the efficacy of the physician in dealing with psychosocial issues. The future role of psychology in family medicine is not yet delineated, and while the move toward parity of reimbursement for mental and physical health care delivery may enhance this collaboration, there is a need to continue to evaluate how the psychological well-being of patients is influenced in the evolution of new models of care delivery.     

The Section of Psychology: Psychology in an Academic Health Sciences Center's Department of Behavioral Medicine and Psychiatry

This paper describes the organization of the Section of Psychology, Department of Behavioral Medicine and Psychiatry, School of Medicine, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown. The organization of psychology is described in terms of the 10 organizational variables for psychology outlined by the Working Group on Governance and Administration from the 1995 Association of Medical School Psychologists, Georgetown Conference. Several aspects of the Department are highlighted that may account for the success of psychology section model including collegial relationship between the disciplines of psychology and psychiatry. The paper describes in detail how the section works, key successes, major obstacles encountered, and future challenges.     

佛教与中医心理学

佛教传入中国已有两千年的历史。在漫长的历史长河中,它已渐被中国古文明及人文习俗所接收,成为至今仍对中国民众思想、生活较有影响的一个宗教。它渗透于社会、生活的方方面面,其中也影响了传统医学的发展。     

Using Insights from Applied Moral Psychology to Promote Ethical Behavior Among Engineering Students and Professional Engineers

In this essay I discuss a novel engineering ethics class that has the potential to significantly decrease the likelihood that students (and professionals) will inadvertently or unintentionally act unethically in the future. This class is different from standard engineering ethics classes in that it focuses on the issue of why people act unethically and how students (and professionals) can avoid a variety of hurdles to ethical behavior. I do not deny that it is important for students to develop cogent moral reasoning and ethical decision-making as taught in traditional college-level ethics classes, but as an educator, I aim to help students apply moral reasoning in specific, real-life situations so they are able to make ethical decisions and act ethically in their academic careers and after they graduate. Research in moral psychology provides evidence that many seemingly irrelevant situational factors affect the moral judgment of most moral agents and frequently lead agents to unintentionally or inadvertently act wrongly. I argue that, in addition to teaching college students moral reasoning and ethical decision-making, it is important to: 1. Teach students about psychological and situational factors that affect people’s ethical judgments/behaviors in the sometimes stressful, emotion-laden environment of the workplace; 2. Guide students to engage in critical reflection about the sorts of situations they personally might find ethically challenging before they encounter those situations; and 3. Provide students with strategies to help them avoid future unethical behavior when they encounter these situations in school and in the workplace.     

Interrogating the Learning Sciences as a Design Science: Leveraging Insights from Chinese Philosophy and Chinese Medicine

Design research has been positioned as an important methodological contribution of the learning sciences. Despite the publication of a handbook on the subject, the practice of design research in education remains an eclectic collection of specific approaches implemented by different researchers and research groups. In this paper, I examine the learning sciences as a design science to identify its fundamental goals, methods, affiliations, and assumptions. I argue that inherent tensions arise when attempting to practice design research as an analytic science. Drawing inspiration and insight from Chinese philosophy and the practice of Chinese medicine, I propose that the learning sciences may better attain its claims to science through greater reliance on inductive synthesis rather than linear causal analysis. In so doing, I reposition the endeavor of science making within the metaphysics of process philosophy instead of classical Western philosophy. I suggest that theory building will be strengthened empirically and pragmatically by more careful observation and systematic generalization of the stability patterns of design related phenomena. It also needs to be more situated in its orientation.     

Aesthetics and Ethics in Engineering: Insights from Polanyi

Polanyi insisted that scientific knowledge was intensely personal in nature, though held with universal intent. His insights regarding the personal values of beauty and morality in science are first enunciated. These are then explored for their relevance to engineering. It is shown that the practice of engineering is also governed by aesthetics and ethics. For example, Polanyi’s three spheres of morality in science—that of the individual scientist, the scientific community and the wider society—has parallel entities in engineering. The existence of shared values in engineering is also demonstrated, in aesthetics through an example that shows convergence of practitioner opinion to solutions that represent accepted models of aesthetics; and in ethics through the recognition that many professional engineering institutions hold that the safety of the public supersedes the interests of the client. Such professional consensus can be seen as justification for studying engineering aesthetics and ethics as inter-subjective disciplines.     

Socialization: Insights from Social Cognition

Socialization is the process by which individuals are assisted to become members of their social groups. Findings from social cognition and cross-cultural psychology offer two major insights into the socialization process. First, basic social cognitive principles imply that the immediate environment functions as a socialization agent by activating and inhibiting knowledge structures and thereby shaping cognition and behavior. Second, because the immediate environment factors into cognition and behavior, socialization efforts should involve the modification of the environment for optimal effect. We discuss various examples of socialization through the configuration of the immediate environment, such as rituals and use of physical artifacts. Our review links basic social cognitive mechanisms to socialization processes, which are customarily treated at higher levels of analysis.     

人性化药学服务与我院药物咨询

为了解我院药物咨询工作情况,提高药学服务质量,随机抽取562例药物咨询记录,按患者咨询内容进行分析和总结.结果显示咨询对象以患者为主;咨询内容主要是药理作用与用途(占16.7％)、用法用量(占16.0％)、不良反应及注意事项(占12.5％)等.从而得知药物咨询是人性化药学服务的重要组成部分,对提高药学服务水平,保证药物疗效、保障患者用药安全及促进合理用药等有积极的推动作用.