对疾病危险因素控制和癌症筛检的考量

目前各项疾病危险因素的“危险性”不够高, 所以通过药物控制单个危险因素来预防疾病的效益很低。癌症筛检虽然使检出的癌症病人增加, 但并不能降低死亡率。因此建议, 在控制慢性病危险因素时, 应首选安全、低成本的有效干预方式方法;采用药物控制手段时, 应优先在综合危险程度较高的人群使用;要努力寻找特异性更高的危险因素指标, 以缩小危险人群;要进一步加强临床研究, 根据国情确定我国自己的诊断与治疗标准。癌症筛检的目标是要检出真正可从治疗中受益的病人, 特别是鉴别出无需治疗的“停滞型”癌症。无论是对疾病危险因素的控制, 还是对癌症筛检, 在改进技术的同时, 更重要的是要从根本上树立正确的健康和医疗观念。     

试论《医林改错》中的实物观

清代医家王清任的《医林改错》自1830年刊行之时起即引起广泛关注, 究其原因不仅在于该书改正古人所记脏腑之错误, 关键在于其看待人体的视角及实践方法与传统中医不同——采用了实物观看待人体, 并且实施解剖观察实践, 这种革新举动挑战了传统中医的方法论。与西方近代科学相比较, 发现《医林改错》的思想萌芽和实践方法与之有相似处。结合医学史研习该著作, 看到中医学的方法论与历史环境不可分离, 随时代有所改变。《医林改错》的独特思维能够启发人们对中医方法论的认知。     

主流心理学科学观的来源与结构——经典物理学与主流心理学科学观比较分析

主流心理学僵化的科学观日益受到批判 ,但在其科学观的来源与结构问题上心理学家并未达成一致。本文通过比较经典物理学与主流心理学的科学观后认为 ,主流心理学的科学观来自于对经典物理学的模仿 ,且这一科学观有其内在的复杂结构。而目前对于主流心理学科学观的批判往往忽视或低估了这一结构的复杂性。     

Tactile order memory: evidence for sequence learning phenomena found with other stimulus types

We examine serial order memory for sequences of tactile stimuli and investigate whether established characteristics of order memory, namely serial position effects, error distributions, and Hebb repetition learning, are observed with tactile memory. Visually obscured participants received six tactile stimulations: one to each of six fingers. At test, participants lifted the six fingers in the order of stimulation. For every third trial participants received the same order of stimulation (i.e. the Hebb sequence). Serial recall accuracy produced the canonical bowed serial position function found for immediate serial recall. In addition, recall for the Hebb sequence improved relative to the filler sequences, providing the first demonstration of the Hebb repetition effect with tactile stimuli. Analysis of errors revealed close similarities to that reported with verbal and visual stimuli. This experiment further generalises established features of order memory to tactile memory, supporting the utilisation of an analogous order memory mechanism across stimuli.     

医疗保障制度改革过程中的价值取向问题及其影响

随着社会主义市场经济体制的建立,我国传统的劳保医疗制度和公费医疗制度已越来越不适应社会发展的要求,呈现出诸多弊端,亟待改革。作为一项公共政策,医疗保障制度在改革与完善的过程中应根据科学行政的要求对政策的价值取向进行深入分析,以便顺利实施改革的各项方案。分析医疗保障制度改革中所涉及的各方面的价值观及其对改革的影响,希望唤起政策制定者对不同群体利益的关注,从而保证政策体系的稳定。     

Comment on Björn Sahlberg’s paper

This paper is a comment on Björn Sahlberg’s paper on the function of training analysis in the Swedish psychoanalytic association and discusses some aspects of the candidates’ personal analysis and supervision. The paper further suggests some possible sources for inspiration and perspective on organizational and educational issues, for example taking an interest in the epistemology of professions, in what the concept of ‘reflection-in-action’ could mean in the training situation, or in empirical research about the educational models and the practice of psychoanalysis.     

传统时空观下“左阳右阴”在中医学的化用

“左阳右阴”理论作为一种思想文化,其形成和发展不可避免地受到经济、政治、科技、思想运动、地理环境等社会与自然多方面因素的影响。鉴于传统时空观对中医学生命观存在指导意义,以时空观为出发点,窥探“左阳右阴”思想形成的自然缘由。这一思想化用于中医领域,演变为中医学认识人体、辨治疾病的重要理论,在脏腑、气血、病证等方面均有体现。关于“左血右气”与“左阳右阴”的矛盾现象,认为原因在于阐述的角度差异,两种理论具体应用时彼此支持,这是中医学立足于整体,论述气血阴阳浑为一体的具体体现。     

Avoidance,induction, and the illusion of reinforcement

Environmental events that impact reproductive success may be called phylogenetically important events (PIEs). Some promote reproductive success, like mates and food; others threaten reproductive success, like predators and injury. Beneficial PIEs induce activities that enhance them, and detrimental PIEs induce activities that mitigate or avoid them. Free-operant avoidance relies on electric shock as a proxy for injury, a PIE. One theory takes avoidance behavior to be reinforced by its reducing shock rate. A more complete explanation is that avoidance both reduces shock rate and is induced by the PIEs it usually prevents. Shocks received act in concert with shock-rate reduction, in a feedback system. Four parametric data sets were analyzed to show that avoidance is induced by received shock rate according to power functions. Avoidance is not reinforced at all; avoidance is induced by its failures. Induction explains not only avoidance itself, but also phenomena unique to avoidance, like warmup and effects of unavoidable shock. Induction explains behavior more generally than reinforcement, because induction explains not only food-maintained operant and nonoperant behavior, but also shock-maintained behavior, including avoidance. Reinforcement fails to explain behavior when reinforcement is defined as strengthening by consequences. Induction erases the distinction between consequences and antecedents.     

Why Bayesian Psychologists Should Change the Way They Use the Bayes Factor

The discussion following Bem’s (2011 Bem, D. J. (2011). Feeling the future: Experimental evidence for anomalous retroactive influences on cognition and affect. Journal of Personality and Social Psychology, 100, 407–425. doi: 10.1037/a0021524[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) psi research highlights that applications of the Bayes factor in psychological research are not without problems. The first problem is the omission to translate subjective prior knowledge into subjective prior distributions. In the words of Savage (1961 Savage, L. J. (1961). The foundations of statistical inference reconsidered. In J. Neyman, (Ed.), Proceedings of the Fourth Berkeley Symposium on Mathematical Statistics and Probability, Volume 1: Contributions to the Theory of Statistics, pp. 575–586. BerkeleyCA: University of California. [Google Scholar]): “they make the Bayesian omelet without breaking the Bayesian egg.” The second problem occurs if the Bayesian egg is not broken: the omission to choose default prior distributions such that the ensuing inferences are well calibrated. The third problem is the adherence to inadequate rules for the interpretation of the size of the Bayes factor. The current paper will elaborate these problems and show how to avoid them using the basic hypotheses and statistical model used in the first experiment described in Bem (2011 Bem, D. J. (2011). Feeling the future: Experimental evidence for anomalous retroactive influences on cognition and affect. Journal of Personality and Social Psychology, 100, 407–425. doi: 10.1037/a0021524[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). It will be argued that a thorough investigation of these problems in the context of more encompassing hypotheses and statistical models is called for if Bayesian psychologists want to add a well-founded Bayes factor to the tool kit of psychological researchers.     

The Challenges of Extreme Moral Stress: Claudia Card's Contributions to the Formation of Nonideal Ethical Theory

This essay argues that Claudia Card numbers among important contributors to nonideal ethical theory (NET), and it advocates for the worth of NET. Following philosophers including Lisa Tessman and Charles Mills, the essay contends that it is important for ethical theory, and for feminist purposes, to carry forward the interrelationship that Mills identifies between nonideal theory and feminist ethics. Card's ethical theorizing assists in understanding that interrelationship. Card's philosophical work includes basic elements of NET indicated by Tessman, Mills, and others, and further offers two important and neglected elements to other nonideal ethical theorists: (i) her rejection of the “administrative point of view,” and (ii) her focus on “intolerable harms” as forms of “extreme moral stress” and obstacles to excellent ethical lives. The essay concludes that Card's insights are helpful to philosophers in developing nonideal ethical theory as a distinctive contribution to, and as a subset of, nonideal theory.