医患沟通的三层"修炼"

良好的医患沟通能力可以避免或大大减少医疗纠纷的发生.医患沟通能力的提高需要不断地思考与实践.医患沟通需要经历三个阶段:技术沟通是指基础性的沟通内容及方式方法,用"心"沟通是指带着热忱、设身处地与无微不至的关怀与患者沟通,"忘记"沟通是指发自内心的、自然而然的沟通,才能达到高水平的沟通.     

价值驱动：当代企业管理伦理实现的重要方法

"价值驱动"是当代企业管理伦理实现的重要方法,意指企业管理要成功,必须进行以价值观的批判与建构活动为基础的管理,即以价值观指导经营管理活动、驱动管理行为,以使企业经营管理行为合乎伦理.它是当代管理发展到文化管理阶段的产物.企业管理活动需要价值观是因为价值观具有重要功能.当代企业所需要的价值观应该蕴含人类的基本价值,并具有"顾客导向"的纲领、"清晰简明"的特征和"知行合一"的目的等共性.     

论亚里士多德"自然"德性伦理学对德性伦理学复兴的启示

亚氏德性伦理学是以"自然"为基础的,"自然"是本体用意与现象用意的内在统一,统一于"人生"之中.在亚氏德性伦理学语境中,人的生命历程与呈明"自然"的德性之美是内在统一的过程.当代德性伦理学复兴缺乏本体论承诺,致使德性伦理学复兴缺乏统一的解释力度.这需要从亚氏"自然"德性伦理学中获得启示.     

《简·爱》的"语-图"关系研究

<简·爱>作为一部经典名著,曾被多次改编为电影.这些不同的改编对原著都有不同的认识和表现.仔细分析各部电影改编作品与原著之间一即"语言"与"图像"之间的关系会发现图像是语言之延伸.而语言是图像之本源.如何保持语言与图像之间合适的张力,是每个时代的改编者都需要面对的重要问题.     

幸福离我们有多远?

幸福(happiness)是一个我们熟悉得不能再熟悉的词,任何时代、任何地方,所有人都在不断地追求幸福.幸福是每个人与生俱来的权利.社会精英需要幸福,普通大众需要幸福;劳动者需要幸福,孤寡老人与留守儿童同样需要幸福;正常人需要幸福,残疾人同样需要幸福.多少时候我们拥有幸福,又有多少时候,我们迷失在寻找幸福的路上.2011年广东省委书记汪洋在广东省委十届八次全会上提出"加快转型升级,建设幸福广东"的社会发展目标,并指出"幸福广东是共建共享的过程".     

心房颤动的外科治疗策略

阵发性心房颤动(房颤)需要"局灶触发",其触发灶一般位于肺静脉开口附近,持续或永久性房颤同时需要"局灶触发"和心房的.异常基质"两个因素.也有人认为持续或永久性房颤根本不需要触发灶.因此.可靠的肺静脉隔离可以治愈绝大部分阵发性房颤的患者,而持续或永久性房颤则需要进行迷宫手术或与其相似的肺静脉隔离基础上的心房附加隔离线.近年来外科消融发展很快,其原因是该方法可达到与迷宫手术相似的高成功率,而并发症低以及手术时间短则明显优于迷宫手术.外科消融可采用的能量很多,有射频、微波、冷冻等.因为外科一般为永久性房颤的患者,肺静脉开口加左房后壁消融是其基本的消融线.考虑到没有心脏器质性疾病的房颤本身是一种良性心律失常,同时外科消融可能出现的某些重并发症,例如左房食管漏、冠状动脉损伤等,不推荐广泛应用外科消融来治疗孤立的房颤.但时需要进行心脏外科手术的患者合并房颤,无论是永久或阵发性房颠.均应常规进行外科治疗.     

以心代理：明代道德权威的缺失

道德权威是维护社会道德秩序的重要力量.在中国传统社会中,道德权威与政治权威是合二而一的,并通过王权合法性问题而展现出来.道德权威的确立需要坚实的理论基础,阳明心学的"以心代理"是导致明代中后期道德生活的混乱与失序的重要原因.     

食品与药品监督管理的反思

目前的劣质奶粉与假酒事件不能不让人触目惊心,悲愤不已,不能不引起我们的反思--究竟是法制或体制的不健全,还是"人治的失职"?每当某个方面出了问题,我们常说的就是法制或体制的不健全.我们不可否认法制和体制需要不断地建设与完善,需要与时俱进,但如果不从"人治的失职"去反思,将不会得到根本的治疗.所以二者皆不可忽视.     

深研经典,环顾宇内,振兴道家——在2008崂山论道暨首届玄门讲经活动上的讲话

非常荣幸能够参加2008崂山论道暨首届玄门讲经活动,这将是我学习道学的大好机会.佛门讲经,玄门论道,这是宗教自身生存和发展的需要,是建设社会主义和谐社会的需要,也是中国人民和世界人民一道消除"欧洲中心论",抵御"物质至上"、"科技迷信"等现代世界性疾病,共同建立适合人类未来发展需要的伦理观、世界观,促进世界和谐的需要.     

从"革命道德"到"和谐伦理"——和谐社会的伦理诉求

和谐伦理是在和谐哲学思维方法论的指导下关于社会交往和关系的协调理论及其规则体系.它是社会主义建设阶段的人际伦理准则,是为协调非对抗性的社会伦理关系,寻求伦理关系双方的共处和协作的伦理.和谐伦理具有与革命道德所不同的原则与要求.中国传统文化中的肯定"和而不同"的差异性、提倡"海纳百川"的包容性、强调"抑高举低"的互补性可以成为和谐伦理吸取的重要内容.中国社会从革命转向建设,就需要我们从革命道德转向和谐伦理.     

When Cheap Isn't the Same as Not Expensive: Generic Price Terms and Their Negations

Generic price terms such as cheap, not expensive, not cheap, and expensive are used frequently in marketing, but little is known about how consumers interpret them. In typical consumer contexts, in which lower prices are preferred, we find that not cheap means essentially the same as expensive (i.e., not cheap = expensive). In contrast, not expensive does not mean the same as cheap, in that cheap is associated with lower prices (i.e., cheap < not expensive). As an implication, in a consumer survey we find different response distributions for rating scales that are anchored with endpoint labels of not expensive versus expensive as compared to cheap versus expensive or cheap versus not cheap (the latter two are equivalent). Furthermore, although cheap is associated with lower prices than not expensive, this does not necessarily translate into higher preferences for options that are described as cheap (vs. not expensive), because cheap may also evoke negative quality perceptions. Finally, we demonstrate an interesting reversal in the way price terms are interpreted: when higher prices are preferred, cheap is equal to not expensive (i.e., cheap = not expensive), whereas not cheap is associated with lower prices than expensive (i.e., not cheap < expensive).     

Can a twelve-week intervention reduce barriers to bicycling among overweight adults in low-income Latino and Black communities?

This pilot study summarizes perceived barriers to bicycling among overweight adults in two low-income communities of color and evaluates the impact of a bicycling intervention on these perceived barriers. A randomized controlled trial with 38 total participants from one predominantly Latino and one predominantly Black neighborhood in Milwaukee, Wisconsin was conducted during summer 2015. The twelve-week intervention consisted of group bicycle rides and bicycling instruction. Several barriers identified prior to the intervention declined significantly among intervention group members soon after it was completed: not feeling healthy enough to bike, being physically uncomfortable while biking, not having a bicycle to use, not having other people to bicycle with, not knowing the best routes to use, not feeling safe from crime, not feeling safe from car traffic, and worrying that neighbors do not think it is normal for an adult to ride a bike. Eight weeks after completion, the intervention group reported significantly greater reductions than the control group with respect to the barriers of not feeling healthy enough to bike and not feeling safe from car traffic. In addition to decreasing barriers, qualitative analysis suggested that increasing support from family and friends as well as emphasizing personal health benefits could help motivate people to bicycle.     

A test of theory of planned behavior in Korea: participation in alcohol-related social gatherings

Two studies are reported using the theory of planned behavior (TPB) to predict and explain joining and not joining alcohol-related social gatherings among Korean undergraduates in various engineering majors. Specifically, considering that the attitudinal component of TPB is behavioral-outcome-based, the current study investigated whether the outcomes of engaging in a behavior and of not engaging in a behavior would similarly predict intentions to engage in a behavior and intentions to not engage in a behavior. The current study also examined whether intentions to engage and intentions to not engage would be significantly related to self-reported behavior a week later. Participants in Study 1 reported TPB components (attitudes toward behavior, subjective norms, perceived behavioral control, and behavioral intentions) concerning joining alcohol-related social gatherings. Participants in Study 2 reported TPB components concerning not joining alcohol-related social gatherings. Additionally, a week later, the participants in both studies reported their participation in alcohol-related social gatherings from the past week. Generally, the results showed that the TPB components were significantly associated with undergraduates' intentions to join and intentions to not join. Specifically, conversation-related attitudes and senior-junior relationship-related attitudes were significantly related to intentions to join, and only group-related attitudes were significantly related to intentions to not join. Intentions to join and intentions to not join were not significantly related to self-reported behavior of joining alcohol-related social gatherings a week later. The findings from the current research provide some evidence that joining or not joining alcohol-related social gatherings may not be mere behavioral opposites, predictable by the presence or absence of the same behavioral outcomes. These two aspects of the behavior may require assessment of different behavioral outcomes or different assessments of the same behavioral outcomes.     

Lie-toe-tease: double negatives and unexcluded middles

Litotes, “a figure of speech in which an affirmative is expressed by the negative of the contrary” (OED) has had some tough reviews. For Pope and Swift (“Scriblerus” 1727), litotes—stock examples include “no mean feat”, “no small problem”, and “not bad at all”—is “the peculiar talent of Ladies, Whisperers, and Backbiters”; for Orwell (1946), it is a means to affect “an appearance of profundity” that we can deport from English “by memorizing this sentence: A not unblack dog was chasing a not unsmall rabbit across a not ungreen field.” But such ridicule is not without equivocation, given that litotes, or “logical” (non-concordial) double negation, may or may not be semantically redundant. When the negation of a logical contrary yields an unexcluded middle, it contributes to expressive power: someone who is not unhappy may not be happy either, and an occurrence may not be infrequent without being frequent. But if something is not possible, what can it be but possible? Why does Crashaw’s “not impossible she” survive rhetorically while Orwell’s “not unsmall rabbit” is doomed? How is Robbie being “not not friends” with Mary on 7th Heaven distinct from being friends with her, if not not-p reduces to p? The key is recognizing in litotes a corollary of MaxContrary, the tendency for contradictory (wide-scope) sentential negation ¬p to strengthen (at least) pragmatically to a contrary ©p, as when the formal contradictory Fr. “Il ne faut pas partir” (lit. ‘It is not necessary to leave’) is reinterpreted as expressing a contrary (‘one must not-leave’). Just as the Law of Excluded Middle can apply where it “shouldn’t”, resulting in pragmatically presupposed disjunctions between semantic contraries, so that “p v ©p” amounts to an instance of “p v ¬p”, the Law of Double Negation can fail to apply where it “should”. When not not-p conveys ¬©p, the negation of a virtual contrary, the middle between p and not-p is no longer excluded, rendering the Fregean dictum that “Wrapping up a thought in double negation does not alter its truth value” not unproblematic.     

在叙事中看到的医学景象——医学人文化的回归

疾病不仅仅是一个生物过程,而且还是一段经历,可能对人的一生都会产生影响。然而,在这样一个技术被广泛应用的时代里,医生通过与患者的对话——＂叙事＂去了解并缓解其疾痛已然成为一种奢侈。本文旨在通过综述叙事医学的起源及发展历史,探讨叙事与医学的相关性及可能的应用,并对叙事医学的发展方向及未来的医学景象作出展望。此外,还将＂叙事＂中折射出的临床医生角色功能归纳为五个要素：不只有循证,还说故事;不只谈疾病,还需整合;不只讲科学,还给关怀;不只能严谨,还会沟通;不只顾功能,还重意义。     

Christian Initiation,Apprenticeship in Prayer

Abstract

I confess to you, Lord, that I still do not know what time is. Yet I confess too that I do know that I am saying this in time, that I have been talking about time for a long time, and that this long time would not be a long time if it were not for the fact that time has been passing all the while. How can I know this, when I do not know what time is? Is it that I do know what time is, but do not know how to put what I know into words? I am in a sorry state, for I do not even know what I do not know!     

Not doing is not the opposite of doing: implications for attitudinal models of behavioral prediction

This study argues for and tests the prediction that cognitions about not performing a behavior are not simple opposites of cognitions about performing the same behavior because they rely on separate goals. Three behaviors (i.e., eating meat, doing vigorous physical activity, and breastfeeding) are examined, for which performing and not performing are means to different goals. In the context of the theory of planned behavior, the discriminant validity of constructs related to performing and not performing behaviors is tested. Moreover, the simultaneous validities of perceived behavioral control over doing and not doing for the prediction of both intentions and the incremental validity of both intentions in predicting behavior are investigated. Results show that the constructs related to performing and not performing a behavior independently contribute to the prediction of intentions and behaviors. Implications of considering separable motivational systems underlying doing and not doing are discussed.     

Mere formalities: fictional normativity and normative authority

It is commonly said that some standards, such as morality, are ‘normatively authoritative’ in a way that other standards, such as etiquette, are not; standards like etiquette are said to be ‘not really normative’. Skeptics deny the very possibility of normative authority, and take claims like ‘etiquette is not really normative’ to be either empty or confused. I offer a different route to defeat skeptics about authority: instead of focusing on what makes standards like morality special, we should focus on what makes standards like etiquette ‘not really normative’. I defend a fictionalist theory on which etiquette is ‘not really normative’ in roughly the same way that Sherlock is ‘not really a detective’, and show that fictionalism about some normative standards helps us explain the possibility of normative authority.     

Effects of paced respiration and expectations on physiological and psychological responses to threat.

While waiting to receive electric shocks, 105 males either (a) regulated their breathing at one half the normal rate, (b) regulated their breathing at the normal rate, or (c) did not regulate their breathing rate. Half of the subjects in each breathing condition were told that their breathing task would aid them in relaxing, whereas the other half were not given that expectation. Subjects in a no threat condition were not threatened with shocks, did not regulate their breathing, and were not provided with expectations. The results indicated that slowing respiration rate reduced physiological arousal as measured by skin resistance and finger pulse volume (but not heart rate) and reduced self-reports of anxiety. Expectations did not influence arousal. These data provide evidence for the effectiveness of paced respiration as a coping strategy, and they resolve the conflicting findings of previous investigations.