医院重点专科发展过程阶段论

讨论医院重点专科发展过程的阶段划分及特征,对于我们在重点专科建设中正确地把握方向、恰当地评估成效和有力地予以推进都有十分重大和现实的意义。本文把医院重点专科发展过程分为科室建设、学科建设、科学建设阶段,并从功能目标、效率效益、人才队伍、场地设施、技术设备、技术特色、教学培训、科学研究、文化氛围、能级水平十个方面对各阶段的特征进行归纳描述。三个阶段各具不同内涵特征,又存在相互内在关联,具有方向性、连续性、可加速性、交叉性和包涵性等规律。     

关于医疗、科研的一点认识

临床医疗是医院的根本使命,在权重上医疗自然重于科研.医疗实践是科研的出发点与归宿,决定了科研的基本走向.当前,科研工作受到前所未有的重视,科研作为医疗人员绩效考核的权重过大,偏离了医院的根本使命,会对科研、医疗、医护人员乃至整个社会造成伤害.SCI论文与临床关系不密切,不宜用来评价临床医师的水准.应该建立科学的考评机制,考核标准应细化、全面,对科研的奖励应适度.对于医护人员的考核应以医疗为主、科研为辅.     

The Human Mind in This World and the Next: Scientific and Early Theological Perspectives

The understanding of the mind usually adopted within the current science-theology dialogue is questionable. It fails to take into account something necessary to provide a non-reductionist understanding of religious faith: what in ancient and medieval theology was termed the nous. While this concept may require re-interpretation for our present age in terms of a different philosophical framework, any recognition of its reality will have a major impact on two aspects of current discussion: our response to philosophical idealism and our understanding of the eschatological state.     

Loss Aversion,Intellectual Inertia,and a Call for a More Contrarian Science: A Reply to Simonson & Kivetz and Higgins & Liberman

Higgins and Liberman (2018) and Simonson and Kivetz (2018) offer scholarly and stimulating perspectives on loss aversion and the implications for the sociology of science of its acceptance as a virtual law of nature. In our view, Higgins and Liberman (2018) largely complement our conclusion that the empirical evidence does not support loss aversion. Moreover, in alignment with our call for a contextualized perspective, they provide an excellent discourse on how a more nuanced view of reference points and consumers’ regulatory focus enriches our understanding of the psychological impact of losses and gains. Simonson and Kivetz (2018) approached our perspective with skepticism, and, while they retain some skepticism, they express agreement on the larger point that loss aversion has been accepted too uncritically. Both commentaries point to a need for a critical reevaluation of prevailing paradigms. Here, we build on these perspectives, as well as our experience working on the topic of loss aversion, to call for structural changes to facilitate scholarly debate on science's status quo.     

EMPIRICAL MINDFULNESS: TRADITIONAL CHINESE MEDICINE AND MENTAL HEALTH IN THE SCIENCE AND RELIGION DIALOGUE

As science and religion researchers begin to engage questions of mental health, mindfulness may prove to be a fruitful area of investigation. However, quantifying the physical effects of mindfulness on the brain is difficult because mindfulness deals with the problem of mental and physical interaction or, the mind/body problem. One system of understanding which may aid science and religion scholars in the pursuit of mindfulness is traditional Chinese medicine (TCM). Within TCM, heart Qi manages the body's present connection to time and space. If the “being in the moment” is disrupted, then the heart Qi is blocked and mental illness or various neurological disorders occur. Succinctly, within TCM, mindfulness is understood as a nonphysical phenomenon (Qi) which directly affects physical systems, resulting in empirical data. This is tracked and treated through the TCM understanding of Qi. The TCM view of Qi in mental health may therefore provide a helpful new paradigm to investigations concerning mindfulness and the human brain.     

BETWEEN KNOWING AND BEING: REFLECTIONS ON BEING TAUGHT SCIENCE AND RELIGION BY PROFESSOR CHRISTOPHER SOUTHGATE

It is a joy to be asked to contribute to this commemorative edition of Zygon, in honor of my friend Christopher Southgate. But a narrowly academic article seems not to fit the brief of writing a reflection on Southgate's teaching of science and religion, as one who has witnessed it, gladly, as both student and colleague. What follows, then, is deliberately reflective in tone, with little in the way of academic references apart from occasional links to Southgate's own work—though, I hope, enough of a strand of argument to justify inclusion in these pages. My argument is simply put: Southgate teaches by not teaching, but by drawing out knowledge from students and thereby empowering their growth. He is an exemplar, a kind man committed to the unfolding of understanding, interested too in forming dispositions in his students that will lead to their flourishing as thinkers and as people.     

Letting Go: Conceptualizing Intervention De‐implementation in Public Health and Social Service Settings

The discontinuation of interventions that should be stopped, or de‐implementation, has emerged as a novel line of inquiry within dissemination and implementation science. As this area grows in human services research, like public health and social work, theory is needed to help guide scientific endeavors. Given the infancy of de‐implementation, this conceptual narrative provides a definition and criteria for determining if an intervention should be de‐implemented. We identify three criteria for identifying interventions appropriate for de‐implementation: (a) interventions that are not effective or harmful, (b) interventions that are not the most effective or efficient to provide, and (c) interventions that are no longer necessary. Detailed, well‐documented examples illustrate each of the criteria. We describe de‐implementation frameworks, but also demonstrate how other existing implementation frameworks might be applied to de‐implementation research as a supplement. Finally, we conclude with a discussion of de‐implementation in the context of other stages of implementation, like sustainability and adoption; next steps for de‐implementation research, especially identifying interventions appropriate for de‐implementation in a systematic manner; and highlight special ethical considerations to advance the field of de‐implementation research.     

Ideology,inquiry, and antiquity: a critical notice of Lloyd's The Ideals of Inquiry: An Ancient History

A discussion of Lloyd's Tarner Lectures at Trinity College. The importance of Lloyd's previous scholarship is characterized and these sweeping, erudite lectures are placed in the context of that scholarship. In the broadest terms, the lectures are a call to culturally and historically comparative study of human reasoning. At their heart is a comparative history of scientific theorizing from the ancients through to modern science. Lloyd rejects the positivist picture, and the view of modern and ancient science as discontinuous; he urges scholars to undertake comparative work on the ancient sciences in different traditions. This critical notice evaluates Lloyd's view and raises several questions for further reflection.