医学伦理学与生命伦理学关系类型辨析——基于国内外文献的考察

医学伦理学与生命伦理学的关系在逻辑上有包容论、互异论和交叉论（延续论）三种可能的类型。包容论认为,后者关注范围更广,前者作为一个部分包括在生命伦理学当中。互异论主张,两个概念在跨学科特点方面不同,生命伦理学必须通过跨学科协作,以公共性为导向,而医学伦理学较为单一,以职业性为目标。交叉论（延续论）强调,医学伦理学经历了古代医德学,近现代医学伦理学和生命伦理学。包容论与互异论过于强调二者的相同或区别,割裂了二者内在联系,片面性显而易见。交叉论（延续论）看到了二者内在逻辑,反映了本体属性,是更为合理的评价。     

直觉思维在麻醉临床决策中的应用

围手术期麻醉医师面临问题的复杂性、动态性和模糊性,要求其在具备良好逻辑思维能力的同时,还要学会应用直觉思维来进行麻醉危机管理。通过决策判断的双加工理论模型探讨说明直觉思维在临床麻醉决策中的可应用性,并给出麻醉医师直觉思维的培养途径,提高麻醉医师的思考能力,增加应急处理课程和临床训练,重视临床经验的学习,营造良好的教学氛围。为了在围手术期更好地保证患者的安全,麻醉医师应重视直觉思维在临床麻醉决策中的应用。     

科学假说在揭示嗅觉奥秘中的作用——解读2004年度诺贝尔医学奖

通过分析2004年诺贝尔医学奖的发现过程,揭示假说对科学研究的指导意义。只有勤观察,多思考,大胆假设,小心求证,才能揭示自然规律。     

Contextual Integration in Multiparty Audience Design

Communicating with multiple addressees poses a problem for speakers: Each addressee necessarily comes to the conversation with a different perspective—different knowledge, different beliefs, and a distinct physical context. Despite the ubiquity of multiparty conversation in everyday life, little is known about the processes by which speakers design language in multiparty conversation. While prior evidence demonstrates that speakers design utterances to accommodate addressee knowledge in multiparty conversation, it is unknown if and how speakers encode and combine different types of perspective information. Here we test whether speakers encode the perspective of multiple addressees, and then simultaneously consider their knowledge and physical context during referential design in a three‐party conversation. Analyses of referential form—expression length, disfluency, and elaboration rate—in an interactive multiparty conversation demonstrate that speakers do take into consideration both addressee knowledge and physical context when designing utterances, consistent with a knowledge‐scene integration view. These findings point to an audience design process that takes as input multiple types of representations about the perspectives of multiple addressees, and that bases the informational content of the to‐be‐designed utterance on a combination of the perspectives of the intended addressees.     

Audience Design in Multiparty Conversation

How do speakers design what they say in order to communicate effectively with groups of addressees who vary in their background knowledge of the topic at hand? Prior findings indicate that when a speaker addresses a pair of listeners with discrepant knowledge, that speakers Aim Low, designing their utterances for the least knowledgeable of the two addressees. Here, we test the hypothesis that speakers will depart from an Aim Low approach in order to efficiently communicate with larger groups of interacting partners. Further, we ask whether the cognitive demands of tracking multiple conversational partners' perspectives places limitations on successful audience design. We find that speakers can successfully track information about what up to four of their partners do and do not know in conversation. When addressing groups of 3–4 addressees at once, speakers design language based on the combined knowledge of the group. These findings point to an audience design process that simultaneously represents the perspectives of multiple other individuals and combines these representations in order to design utterances that strike a balance between the different needs of the individuals within the group.     

患者和家属参与患者安全的概念演变及临床意义

运用Rodgers演化概念分析法对患者和家属参与患者安全概念的演化、替代术语和相关术语、前因变量、结果、概念属性、定义、典型案例进行分析。概念属性包含过程、行为及环境3个领域,4个重要特征分别为个性化、获取、投入及治疗联盟,其前因变量为患者的疾病、健康信息或护理协调的混乱、新政策号召的尝试。结果包括保障患者安全、减少医疗费用和确定最佳做法。澄清患者和家属参与患者安全的概念有助于提高医护人员对其的重视与了解,为临床的实践和研究提供参考和理论依据。