医学人文教育的关怀哲学基点探究

医学人文教育固然以提倡患者的自主存在性突破了医学技术主义形态,但若对患者自主地位的过度强调则会使其陷入二律背反的困境,于此之上的关怀哲学探究则把患者视为处于具体情境中的特殊他人,如此便能建立并维持医学人文情境中的医患和谐.透过耕犁“以患者自主为核心的医学教育限度”、“以关怀为始点的医学哲学诠解”与“关怀哲学在医学人文中的教育张力”三重意涵来突显关怀哲学在医学人文教育中的本位复归,期使医学教育能够透过关怀哲学的融汇从而在医疗临床过程中达成其效力显现的人文基点.     

制度伦理视阈中的护士职业倦怠问题

文献研究表明,国内护士职业倦怠现象相当普遍,其重要症结是制度非正义.这种制度非正义表现在三个方面,即护士的社会地位低;护士的劳动报酬低;护士的个人发展空间受限.因此,预防和消除护士职业倦怠现象应该从以下三个方面入手:尊重护士,提高其社会地位;提高劳动报酬,让护士生活得有尊严;拓展护士个人发展空间.     

老化刻板印象研究现状及展望

老化刻板印象是人们对老年人所持有的观念与预期,它能显著影响老化刻板印象持有者的生理功能、认知功能和行为结果。现有研究主要集中在老化刻板印象的机制、影响因素和中介变量方面。研究发现,老化刻板印象是通过内化形成的,刻板印象威胁理论和自我刻板化是解释老化刻板印象的两种作用机制。认知加工过程中的抑制能力、情境和文化差异是影响老化刻板印象的主要因素,而老化自我知觉和刻板期望则是老化刻板印象影响效果变量的中介因素。未来研究除了要继续探讨意识水平、情境因素、个体特征对老化刻板印象的影响以及老化刻板印象对不同年龄群体影响的特点以外,还应关注中介和干预研究,并进一步加强跨文化研究。     

自我不确定感对程序公正效应的调节作用:回顾与展望

自我不确定感是指个体怀疑“自我”,并且对其看法不稳定而产生的内隐与外显的主观感受及反应.其研究方法主要有自我报告法与情境实验法.自DeCremer和Sedikides首先通过实证研究验证了自我不确定感对程序公正效应的调节作用后,研究者们通过将自我不确定感分解为情绪自我不确定、地位不确定和归属不确定以及探讨程序公正认知机制,不断扩展了此领域的研究成果.未来可以通过自我不确定感调节效应的本土化研究,自我不确定感特质与情境成分交互作用的探讨,自我不确定感与自我肯定、信息不确定感等相关变量的关系研究,进一步深化此领域的研究.     

动物和人类的利他本性:共情的进化

共情指个体感知或想象其他个体的情感,并部分体验到其他个体感受的心理过程.利他指以增加其他个体的福利为最终目标的动机.共情起源于动物的亲代养育行为,其神经基础来源于古老的情感系统.共情从动物低水平的情绪感染逐渐进化到同情关注以及观点采择共情.另外,共情具有良好的环境适应性.未来可以进一步研究动物与人类的共情和利他行为的异同,加大研究动物的高级共情能力和利他行为以及深入研究共情受社会因素的调节机制.     

Victim-Defendants in Mandated Treatment: An Ethical Quandary

Battered women are being arrested and convicted of domestic violence-related crimes in higher numbers than ever before. In addition, battered women are being sentenced to treatment as primary perpetrators even though their aggression was in response to the violence perpetrated against them. Many service providers are presently ill-equipped to offer treatment and/or other services that will effectively serve these women in a manner that will truly reduce violence and is not re-victimizing. This article will present key issues surrounding the problem, and provide suggestions for effective advocacy and intervention approaches.     

从触摸的历史反思医学中触摸的应用

从触摸的定义、起源、应用发展演变阐明了其历史,并总结触摸在医学中的应用现状及特色。但由于历史、宗教、性别文化等因素的影响,触摸在医学中的应用存在一定障碍和困境,对这些应用困境进行反思,最终提出解决策略。     

慢性房颤的导管消融:时机已经成熟

心房解剖及电重构基础上的多发子波折返是慢性房颤的维持机制,支持线性消融策略;导管消融有关的操作逐渐标准化;盐水灌注导管和三维标测系统等新器械不断进展;慢性房颤消融策略的争议逐渐减少,采用肺静脉隔离加线性消融者越来越多;消融终点更多的以肺静脉隔离和线性阻滞为主,以直接终止心动过速为终点者减少.慢性房颤的导管消融时机已经成熟.     

慢性房颤导管消融：挑战与展望

随着对慢性房颤机制认识的深入以及消融方法不断探索,经导管消融在慢性房颤治疗的地位逐渐提高。尽管在适应证、消融策略、获益风险比及远期疗效等还存在一定争议,随着经验的积累和技术的进步,导管消融根治慢性房颤充满希望。     

Neural correlates of feigned memory impairment are distinguishable from answering randomly and answering incorrectly: an fMRI and behavioral study

Previous functional magnetic resonance imaging (fMRI) studies have identified activation in the prefrontal-parietal-sub-cortical circuit during feigned memory impairment when comparing with truthful telling. Here, we used fMRI to determine whether neural activity can differentiate between answering correctly, answering randomly, answering incorrectly, and feigned memory impairment. In this study, 12 healthy subjects underwent block-design fMRI while they performed digit task of forced-choice format under four conditions: answering correctly, answering randomly, answering incorrectly, and simulated feigned memory impairment. There were three main results. First, six areas, including the left prefrontal cortex, the left superior temporal lobe, the right postcentral gyrus, the right superior parietal cortex, the right superior occipital cortex, and the right putamen, were significantly modulated by condition type. Second, for some areas, including the right superior parietal cortex, the right postcentral gyrus, the right superior occipital cortex, and the right putamen, brain activity was significantly greater in feigned memory impairment than answering randomly. Third, for the areas including the left prefrontal cortex and the right putamen, brain activity was significantly greater in feigned memory impairment than answering incorrectly. In contrast, for the left superior temporal lobe, brain activity was significantly greater in answering incorrectly than feigned memory impairment. The results suggest that neural correlates of feigned memory impairment are distinguishable from answering randomly and answering incorrectly in healthy subjects.