门诊老年患者医疗服务中存在的问题及其改进

文章从门诊老年患者就医需求的角度对医疗服务进行思考,认为医护人员在服务理念、有效沟通以及主动服务等方面存在的问题亟需改进。提出医护人员应当确立以老年患者需求为中心的门诊医疗服务理念,做到主动关心、及时询问、有效沟通、合理安排,从而提高老年患者就诊的满意度。     

Pushing moral buttons: The interaction between personal force and intention in moral judgment

In some cases people judge it morally acceptable to sacrifice one person’s life in order to save several other lives, while in other similar cases they make the opposite judgment. Researchers have identified two general factors that may explain this phenomenon at the stimulus level: (1) the agent’s intention (i.e. whether the harmful event is intended as a means or merely foreseen as a side-effect) and (2) whether the agent harms the victim in a manner that is relatively “direct” or “personal”. Here we integrate these two classes of findings. Two experiments examine a novel personalness/directness factor that we call personal force, present when the force that directly impacts the victim is generated by the agent’s muscles (e.g., in pushing). Experiments 1a and b demonstrate the influence of personal force on moral judgment, distinguishing it from physical contact and spatial proximity. Experiments 2a and b demonstrate an interaction between personal force and intention, whereby the effect of personal force depends entirely on intention. These studies also introduce a method for controlling for people’s real-world expectations in decisions involving potentially unrealistic hypothetical dilemmas.     

A new argument for skepticism

The traditional argument for skepticism relies on a comparison between a normal subject and a subject in a skeptical scenario: because there is no relevant difference between them, neither has knowledge. Externalists respond by arguing that there is in fact a relevant difference—the normal subject is properly situated in her environment. I argue, however, that there is another sort of comparison available—one between a normal subject and a subject with a belief that is accidentally true—that makes possible a new argument for skepticism. Unlike the traditional form of skeptical argument, this new argument applies equally well to both internalist and externalist theories of knowledge.

Non-identity, self-defeat, and attitudes to future children

Although most people believe that it is morally wrong to intentionally create children who have an impairment, it is widely held that we cannot criticize such procreative choices unless we find a solution to Parfit’s non-identity problem. I argue that we can. Jonathan Glover has recently argued that, in certain circumstances, such choices would be self-defeating even if morally permissible. I argue that although the scope of Glover’s argument is too limited, it nevertheless directs attention to a moral defect in the attitudes that could motivate such procreative choices, attitudes that, properly characterized, turn out to be person-affecting in character. I conclude by arguing that prospective parents who want to create a child with an impairment face a dilemma. If they want to avoid the charge that their aim is morally defective, they must deny that the desired impairment is harmful. But this would commit them to endorsing the controversial claim that it is morally permissible or even required to turn normal children into impaired ones.

Effects of physical and verbal aggression,depression, and anxiety on drinking behavior of married partners: a prospective and retrospective longitudinal examination

In an ethnically diverse sample of 195 married couples, we conducted a latent factor growth analysis to investigate the longitudinal link (4 time points over 4½ years) between marital aggression (physical and verbal aggression self‐ and partner‐reports) and individual internalizing symptoms (depression and anxiety) as they relate to trajectories of alcohol use among husbands and wives. Alcohol use was operationalized as a latent factor with self‐ and partner reports of problem drinking as measured by the Michigan Alcoholism Screening Test and the Alcohol Dependence Scale. Verbal aggression by husbands or wives, by itself, has no effect on their alcohol use over time. In conjunction with depression, however, verbally aggressive husbands do have elevated drinking levels. The effects of husbands' and wives' physical aggression on their own and their partners' drinking behavior were also significant. This study is one of the first to examine the change over time in alcohol use for marital partners as related to marital aggression and internalizing symptoms. Our results shed light on areas of marital functioning (aggression, internalizing, alcohol use) that have not been investigated in conjunction with each other in a longitudinal design. Aggr. Behav. 35:296–312, 2009. © 2009 Wiley‐Liss, Inc.     

DESCRIPTIVE ANALYSIS OF TEACHERS' RESPONSES TO PROBLEM BEHAVIOR FOLLOWING TRAINING

The procedures described by Sloman et al. (2005) were extended to an analysis of teachers' responses to problem behavior after they had been taught to withhold potential sources of positive and negative reinforcement following instances of problem behavior. Results were consistent with those reported previously, suggesting that escape from child problem behavior may shape and maintain adult behavior that is potentially countertherapeutic.     

A Quintet,a Quartet,a Trio,a Duo? The Epistemic Regress Problem,Evidential Support,and Skepticism

In his topical article, Andrew Cling claims that the best extant formulation of the so-called epistemic regress problem rests on five assumptions that are too strong. Cling offers an improved version that rests on a different set of three core epistemic assumptions, each of which he argues for. Despite of owing a great deal to Cling’s ideas, I argue that the epistemic regress problem surfaces from more fundamental assumptions than those offered by Cling. There are ultimately two core assumptions—in fact two contradictory strands within the concept of epistemic support—which jointly create a powerful challenge for our pursuit of paramount epistemic values.

Weakly higher order cylindric algebras and finite axiomatization of the representables

We show that the variety of n-dimensional weakly higher order cylindric algebras, introduced in Németi [9], [8], is finitely axiomatizable when n > 2. Our result implies that in certain non-well-founded set theories the finitization problem of algebraic logic admits a positive solution; and it shows that this variety is a good candidate for being the cylindric algebra theoretic counterpart of Tarski’s quasi-projective relation algebras. Supported by the Hungarian National Foundation for Scientific Research grant T73601.