The different types of limb apraxia errors made by patients with left vs. right hemisphere damage

Limb apraxia errors were compared among normal controls and right- or left-hemisphere-damaged patients as they imitated gestures with the ipsilateral hand. Both brain-damaged groups made similar errors on nonrepresentative and representative/intransitive movements. In contrast for pretended object use movements (transitive), the left-hemisphere-damaged group made more arm position and classical body-part-as-object errors while the right hemisphere group made as many partial errors and more less-primitive, body-part-as-object errors than the left-hemisphere-damaged group. These results help explain why a certain percentage of right-hemisphere-damaged patients are labeled apraxic, but also suggest that the left hemisphere is more important for integrating intrapersonal space and the “representation” of extrapersonal space.     

Morality and parenting: An ethical framework for decisions about the treatment of imperiled newborns

This essay is written in the belief that questions relating to the treatment of impaired and imperiled newborns cannot be adequately resolved in the absence of a general moral theory of parent-child relations. The rationale for treatment decisions in these cases should be consistent with principles that ought to govern the normal work of parenting. The first section of this paper briefly examines the social contract theory elaborated by John Rawls in his renowned book A Theory of Justice and extracts from it normative principles that can guide us in our attempt to lay a rational foundation for parenthood. The second section clarifies the implications of a Rawlsian theory for the problem at hand by examining several standards that have been proposed for the treatment of impaired newborns: the strict right-to-life standard, the medical decision standard, and the quality-of-life standard. A Rawlsian standard, by contrast, is autonomy-based. That is, it would have us base our treatment decisions on consideration of the child's capacity for developing critical rationality in making decisions on his or her own. This standard, it is suggested, avoids morally objectionable features of the others.     

Modes of understanding and mindfulness in clinical medicine

Beginning with a case vignette, this paper uses a semiotic approach to analyze several different kinds of understanding used in clinical medicine. By outlining semiotic structures, four distinct modes of understanding can be defined: (1) the representational mode, corresponding to scientific medicine; (2) the pragmatic mode, constituting the basic standpoint of medicine; (3) the hermeneutic mode, underlying the empathic, humanistic spirit of medicine; and (4) the ontologic mode, associated with both the ethical and ritual aspects of medicine. Clarifying the relationship between these modes avoids common confusions in clinical situations. Although experienced clinicians intuitively use these different modes, they do not necessarily reflect upon them. They are instead mindful of them, and this unique multi-modal consciousness, I suggest, provides a model for integrating theory and practice.This work was supported in part by the Robert Wood Johnson Clinical Scholars Program.     

School dropouts: Characteristics and prevention

Our nation's secondary school dropout rate of 17–25% is at a historic low. Nevertheless, considerable concern exists about the enormous losses to individuals, families, and society associated with not completing high school. School, race, gender, and economic and family qualities associated with dropouts are reviewed briefly. General prevention principals are proposed together with more specific strategies involving youth, schools, family, and community. The goals are two pronged: (a) to provide systems that enable adequate achievement and achievement motivation, passing grades, feelings of affiliation with school and peers, and a stable support systems from peers, family, and the community; and (b) to be free of impediments that diminish suitable educational outcomes, including unsuitable school qualities, premature entrance into adulthood, and qualities that adversely affect students' physical and mental health.     

论哲学思维在医学思维活动中的作用

医学思维活动离不开哲学思维的作用。医学思维和哲学思维的主要区别表现和思辨性和抽象性两个方面。虽然哲学思维不能代替医学思维,但是,哲学思维是医学思维的一般前提,医学思想往往由哲学思想过渡而来,医学认识的突破也以哲学思维为先导。医学家自觉运用哲学思维于医学认识之中,将会使医学思维更有效地进行。     

安乐死对象的界定

目前关于安乐死对象的界定,突出了医学要件,忽略了权利要件。为安乐死立法,必须对安乐死对象作出法律界定,应该满足两个条件：一是自然条件,即存在死亡痛苦;二是权利条件,即公民享得并行使安乐死的权利。不规定和具备权利条件,仅存在死亡痛苦,在法律上不能列为安乐死对象。     

Development of the Career Exploration Survey (CES)

The development, properties, and uses of the Career Exploration Survey (CES) are described. The CES is intended to (a) facilitate further theory development and empirical research on how exploration affects career decisions, development, and job outcomes, such as job satisfaction, commitment, and turnover; (b) provide a network of variables for investigating the dynamics of the exploration process; and (c) provide a set of criterion measures for examining the effects of personal characteristics and educational treatments on career exploration behaviors and beliefs. The CES is based on a conceptual framework derived from theories of exploration, stress, motivation, and career preference. It consists of seven measures of the career exploration process, three reactions to exploration, and six beliefs about exploration. Dimensionality, reliability, and validity data are presented for four studies comprising 680 observations across 601 individuals.     

Interpreting social-sexual behavior in a work setting

The influx of women into the work force, especially into nontraditional jobs, has facilitated interest in the topic of sexual harassment and, more generally, sexuality at work. Survey research data show disagreement about the interpretation of interactions between the sexes at work. This study was designed to learn more about the way people interpret ambiguous, but potentially sexual, interactions between the sexes in a work setting. Respondents were asked to evaluate a vignette depicting such an interaction. The vignettes were composed so that three dimensions were manipulated: the sex of the initiator of the behavior, the status of the initiator relative to the target, and the type of behavior. These manipulated dimensions, along with the sex of the respondent, were used as variables to examine the respondent's interpretation of the vignettes. Four-way ANOVAs showed that the independent variables were related to the evaluation of the relationship between the initiator and the target, the evaluation of the behavior, the appropriateness of the behavior, and the likelihood of the behavior. Men interpreted the vignettes more positively than did women. Incidents initiated by women were viewed more positively. Those initiated by persons with higher status than the target were seen less positively. Respondents, especially women, considered incidents that included touching to be negative. This was especially so when the touching was combined with a comment on work, and this effect was exacerbated when the behavior was initiated by a male and/or higher status person.     

Increasing achievement motivation and work productivity in a chronic psychiatric population

The major goal of this study was to determine if social reinforcement for behavior in a simulated work activity would increase achievement motivation, work interest, and simulated work activity production. Forty-five chronic psychiatric patients were randomly assigned to one of three groups: work sample with praise, work sample without praise, and a no-treatment control group. A 3 (between) × 2 (within) analysis of variance was run for each dependent measure, that is, achievement imagery, work interests, and simulated work production. The main effect for the interaction between trials and treatment was significant on each dependent measure. Follow-up Duncan Multiple Range Tests indicated that the praise group showed a significant improvement on each dependent measure, pre to post, as well as significantly greater improvement than the no-treatment control group and/or the work sample without praise group. These results are discussed in terms of the procedure used as a method for increasing motivation and in terms of possible generalization of results to other treatment situations.