坚持科学的良知努力创新

当前,国家非常重科技术创新.2006年1月9日在北京召开的全国科技大会上,胡锦涛同志代表党和国家提出要建立创新型国家的目标.进入21世纪以来,以新的科技革命浪潮和知识经济崛起为标志,人类社会正在加速从工业社会向知识社会演进的历程,而其中科技创新实为这一演变过程的关键环节.就我们医学战线而言,也是如此.如何加速医学创新的步伐,是我们医学科学工作者面临的重要而又紧迫的任务.     

癌症姑息治疗的临床意义和社会伦理思考

姑息医学作为医学学科之一,内容包括癌痛控制,处理缓解其他症状.癌症姑息治疗缓解了紧张的医患关系,有效的防止有限医疗资源的浪费及分配不公,同时姑息治疗给人们留下诸多社会伦理思考.如告知、癌痛控制等问题.如何将姑息治疗扩展到其他非恶性疾病面临着巨大挑战.     

组织工程学技术与医学科技伦理的相互关系——矛与盾还是剑与鞘

组织工程学技术为人类疾病治疗带来希望的同时,也提出了严峻的医学科技伦理问题.组织工程学产生和发展是必然的,与医学科技伦理的矛盾也是必然的,两者间如何找到平衡,是值得探索的.旨在阐明二者间矛盾的必然性,分析相互关系,是制约对立的矛与盾,还是和谐统一的剑与鞘,并提出如何实现双赢,找到平衡的若干设想.     

医学哲学是临床医学创新的不竭动力

受诸多复杂因素的影响,现代医学在取得巨大成就的同时,也有自身的局限与不足.医学哲学是医学精神的精华.哲学的本质是批判,是创新,是全面地、发展地认识问题,促进事物前进、发展.哲学是医学创新的不竭动力,确定医学的历史方位,引导医学的未来发展方向,是解决当代医学前沿中难点、热点问题的钥匙,促进临床医学模式"以疾病为中心"向"以病人为中心"和"以健康为中心"模式转变.     

中医诊断和治疗疾病的现代医学原理

1 医学模式和病与证的统一性原理 医学作为研究和认识人类生命现象本质的科学理论体系,其根本宗旨是阐明人类疾病过程的本质及其变化规律,探索出诊治疾病的有效方法.从理论上分析,研究和认识人类生命现象和疾病过程本质的科学理论体系只会有一种模式--医学,而不会有西医和中医等之分,即医学模式的惟一性原理.中医学的产生和存在是医学发展初级阶段内存在的过渡性医学理论体系,一旦人类破译出生命现象的本质、阐明疾病发生发展的规律,各种医学模式的精髓就会真正结合在一起,届时,就只会有一种医学模式.     

为医学创新创造良好的环境条件

医学创新和其他一切科技创新一样,首先是科学家智力奋进的集中表现,是知识积蓄过程中一种质的变革.任何医学创新,都是以创新者的创造性的旺盛智力活动为基础的.离开了创新的积极性,创新从何谈起?但是,大量的事实也同样证明,任何创新者的智力创造,总是在一定的环境条件下实现的.良好的环境条件,催生和哺育着创新者的心灵,鼓舞着创新着的进取意志,为创新者开启一切方便之门,使创新者的智慧有如江河入海,一泻东流.     

始终关注医学、健康与社会的《医学与哲学》

1 一个重要的决策 <医学与哲学>杂志创刊30周年.我仪致以热烈的祝贺.在<医学与哲学>杂志30年的办刊历史中,一直重视"医学、健康与社会"关系的研究.杂志刚刚创办的次年,即1981年第3期,就开始设置了"医学与社会"的专栏,并发表了时任副主编杜冶政撰写的"一个重要的研究课题医学、健康与社会"的文章.认为"把医学和整个社会发展联系起来,从整个丰十会的发展水平和需要去认识医学和医药卫生事业,对于确定医学和医药卫生事业的战略目标,有着十分重要的意义".提出要重视医学与社会关系的研究,并同时发表了"论卫生事业的经济地位和经济作用"(杜乐勋)、"水利工程的兴建与疾病的兴衰"(李友松)和"医学社会学初探"(李恩吕)等3篇文章.     

论实现医学模式转变的理论与实践

医学模式实现转变是一场深刻的医学变革.途径和标志是什么?实现模式转变的基本途径是创新建立一个医学新理论体系;实现新旧模式转变的客观标志,主要体现在医学理论、医学主体、教育培训体系、医院组织结构、医疗方式、技术体系、管理模式、医学目标等的转变.微创医学(或整体医学)理论是笔者于2003年提出的一个医学新体系.     

2012年诺贝尔生理学或医学奖对培养医学研究生科研思维的启示

约翰·格登和山中伸弥因在细胞核重编程研究领域的杰出贡献,获得2012年诺贝尔生理学或医学奖.介绍了科学研究的历程,探讨诺贝尔生理学或医学奖对培养医学研究生科研思维的有益启示.从培养敢于突破、科技创新精神、逆向思维能力、实事求是的科学态度和遵守学术道德、尊重医学伦理等方面加强研究生教育.塑造求真务实,坚韧不拔的科研素质,善于运用逆向思维,重视借鉴前人研究成果,鼓励尽早参与科研活动,培养研究生的科研思维,提高研究生的科研能力.     

医学创新教育面临的难题与对策

1医学创新教育面临的难题 1.1医学教育观念陈旧、培养目标单一 传统医学教育的目标是培养救死扶伤、治病救人的白衣天使,在这种医学本体功能单一性目标的影响下,医学的所有理论和法则都紧紧围绕着"战胜疾病"这一功利化的目的而展开.还没有从更高境界和更深层次上对"人为什么会生病,怎样才能不生病"等涉及人的全面本质问题的医学社会功能进行更加理性的价值评判[1].     

A case report of compensation in daily life of a person with memory problems: detailed functional use of memory aids over a five-year period

Numerous studies have been conducted on memory aids for memory-impaired people. However, it is not known how they use these memory aids in a functional, practical way. A 20-year-old patient (MH) was monitored for five years to identify what memory aids or other means she used and how she used them to compensate for her memory problems, e.g., forgetting what was said by others in a few minutes and getting lost or turning in the wrong direction on a walk or in a building. Results indicated MH did not necessarily always use memory aids such as a notebook or calendar to compensate for her memory problems, although MH and her mother reported that she frequently used them in daily life. She coped with memory problems by using various "resources" besides the memory aid. These facts suggest that it may be necessary to redefine functionally useful compensations, which include both memory aids and resources in daily life.     

Primary care providers' views regarding assessing and treating suicidal patients

Primary care providers (PCPs) usually do not explore patient suicidality during routine visits. Factors that predict PCP attitudes toward the assessment and treatment of suicidality were examined via an online survey of 195 practicing PCPs affiliated with medical schools in the United States. PCPs who perceived themselves as competent to work with suicidal patients were more willing to assess and more willing to treat suicidal patients, with the perception of competency fully explaining the relationship between training and willingness to treat. Female gender predicted lower self-perceived competency, while in-office access to professional mental health (MH) consultation predicted greater self-perceived competency. Higher self-perceived general competence predicted lower subjective valuation of access to MH consultation. Multiple linear regression analysis indicated a three-way interaction between training, gender, and valuation of MH consultation as predictors of perceived competency, with training generally being associated with greater perceived competency to treat suicidality. Relative to their male counterparts, female PCPs have lower confidence in assessing and treating suicidality. Perceived competence in risk assessment should be given more attention in medical training because of its role in PCPs' willingness to treat suicidality.     

诺贝尔医学奖计量研究及对我国医学创新的启示

通过统计诺贝尔生理学和医学奖获得者群体的年龄构成、学位结构、毕业院校和研究领域等基本信息,试图阐明杰出医学工作者成长及创造世界尖端医学科技成就可能遵循的基本途径,从而为我国在医学体系中的培养科研创新方面提供较为细致的新思路.     

A Linguistic Comparison of Letters of Recommendation for Male and Female Chemistry and Biochemistry Job Applicants

Letters of recommendation are central to the hiring process. However, gender stereotypes could bias how recommenders describe female compared to male applicants. In the current study, text analysis software was used to examine 886 letters of recommendation written on behalf of 235 male and 42 female applicants for either a chemistry or biochemistry faculty position at a large U.S. research university. Results revealed more similarities than differences in letters written for male and female candidates. However, recommenders used significantly more standout adjectives to describe male as compared to female candidates. Letters containing more standout words also included more ability words and fewer grindstone words. Research is needed to explore how differences in language use affect perceivers’ evaluations of female candidates. This research was supported by National Institute of Mental Health Grant #1R01MH071749 to the first author and a University of Arizona grant from the College of Science Millennium Report Oversight Committee awarded to the third author.     

Computerized encounter registers in primary care research: Is there a gold standard?

Computer technology as well as the need to conduct research in primary care settings, has stimulated the creation in the U.S. of information networks linking private physicians' offices and other primary care practice sights. These networks give rise to several problems which have philosophic interest. One is a “numerator problem” created by the difficulty in primary care of using the more complicated or invasive diagnostic technologies commonly employed in tertiary care research. Another is a “denominator problem” arising from the difficulties in determining which and how many patients constitute the population from which a practice is drawn. Finally, this mode of research raises questions about the social construction of medical reality and how “objective” medical truth is actually based on carefully selected patient experience. All these questions combine to challenge the “gold standard” view on medical research: the idea that some sorts of medical knowledge are epistemologically privileged and can serve as a bench-mark to determine whether new data are valid.     

Biological substrates of empathy and facial modulation of emotion: Two facets of the scientific legacy of John Lanzetta

The impact of John Lanzetta's emotion research on our understanding of the interplay between psychological and physiological processes in emotion is examined. Lanzetta's work in two areas is reviewed along with related work by others. The first area concerns the biological substrates of empathy. Here Lanzetta studied emotional contagion, and in particular the conditions under which viewing another person's emotions can cause expressive and physiological changes in the observer. The second area concerns the facial modulation of emotion. Here Lanzetta studied the capacity of voluntary facial expression to alter the physiological and subjective aspects of emotion. The article closes with a personal reflection on Lanzetta as a scientist and as a person.The author's research reviewed in this article was supported by National Institute on Aging Grant AG07476 and National Institute of Mental Health Grants MH39895 and MH50841 to Robert W. Levenson.     

Giving voice to African thought in medical research ethics

In this article, I consider the virtual absence of an African voice and perspective in global discourses of medical research ethics against the backdrop of the high burden of diseases and epidemics on the continent and the fact that the continent is actually the scene of numerous and sundry medical research studies. I consider some reasons for this state of affairs as well as how the situation might be redressed. Using examples from the HIV/AIDS and Ebola epidemics, I attempt to show that the marginalization of Africa in medical research and medical research ethics is deliberate rather than accidental. It is causally related, in general terms, to a Eurocentric hegemony derived from colonialism and colonial indoctrination cum proselytization. I end by proposing seven theses for the critical reflection and appraisal of the reader.     

The self-perceptions and attributions of attention deficit hyperactivity disordered and nonreferred boys

Compared the self perceptions and attributions of attention deficit hyperactivity disordered (ADHD) and control boys. The ADHD boys viewed themselves as no worse than control boys on self-perceived competence and global selfworth, especially when internalizing symptomatology was taken into account statistically through covariance analyses. In terms of attributions, the ADHD boys were more likely to take responsibility for social successes and less likely to take responsibility for social failures than the control boys. Although the ADHD boys scored significantly higher on the Children's Depression Inventory, this difference was no longer significant when items dealing with behavior, school, and social problems were excluded. The results are discussed in terms of their implications for understanding how the attributions and selfperceptions of ADHD boys may mediate their performance in challenging academic and social situations.An earlier version of this paper was presented at the 1992 Annual Meeting of the Society for Research in Child and Adolescent Psychopathology, Sarasota, Florida. The first author was supported in part by grants from the National Institute of Mental Health (MH47390 and MH48157) and the Clinical Research Center (MH30915). The second author was supported in part by grants from the National Institute on Alcohol Abuse and Alcoholism (AA06267), the National Institute on Drug Abuse (DA05605), and the National Institute of Mental Health (MH48157). The fourth author was supported by a grant from the College of Arts and Sciences of the University of Kentucky.     

The Attitudes Toward Women Scale for Adolescents (AWSA): A study of reliability and validity

This study describes the development of the Attitudes Toward Women Scale for Adolescents (AWSA), an instrument based on the short form of the Spence-Helmreich Attitudes Toward Women Scale (AWS). The AWSA has been tested in four samples of adolescents. Internal consistency estimates and test-retest stability indicated high reliability. Hypotheses formulated to test the construct validity of the scale were largely supported. AWSA permits the examination of how boys' and girls' attitudes toward women influence the life paths that adolescent girls begin to pursue.This research was supported by grants to A. Petersen from the Spencer Foundation, the National Institute of Mental health (MH 30252/38142), and the Judith Baskin Offer Fund.