目前形势下临床教学问题的探讨与改革

当前医疗大环境的改变,社会评价的影响及病人的维权、自我保护意识等使临床教学工作发生了很大变化.需要我们采取相应的变革,注重病历的书写,基本功的培训,语言能力的指导和改变查房的方式,以完成培养新一代合格医生的任务.     

基督教伦理理论的两种类型

在西方基督徒中间,对与性、家庭生活和医学伦理问题相联系的个体道德问题,存在着严重的分歧.因为在今天的基督徒中间存在着两种伦理理论决定着他们的观点,第一种道德判断是"道义论",另一种道德判断叫做"后果主义".     

多维视野下的临床决策

临床决策是临床实践的重要组成部分之一,随着时代和科学技术的发展,临床决策的内涵和方法也发生了深刻的变化。有许多的因素影响或决定临床决策的质量,如何正确处理好循证医学证据与经验、传统方法和现代技术、创新与人文主义精神、技术与费用等关系是一个十分复杂的课题,需要从临床、经济、社会和法律等多方面加以研究和探索。     

医学研究者的经济利益冲突对临床试验的影响——美国的经验与启示

研究者的经济利益冲突对医学临床试验可能会产生消极影响。本文依据美国的研究成果,利用大量的统计数据和真实的案例,分析了研究者在临床试验中的主要经济利益,揭示了这些经济利益如何对研究的设计、执行和报告产生影响,以及可能造成的危害。     

Children's understanding of mental states as causes of emotions

Theory of mind studies of emotion usually focus on children's ability to predict other people's feelings. This study examined children's spontaneous references to mental states in explaining others' emotions. Children (4‐, 6‐ and 10‐year‐olds, n = 122) were told stories and asked to explain both typical and atypical emotional reactions of characters. Because atypical emotional reactions are unexpected, we hypothesized that children would be more likely to refer to mental states, such as desires and beliefs, in explaining them than when explaining typical emotions. From the development of lay theories of emotion, derived the prediction that older children would refer more often to mental states than younger children. The developmental shift from a desire‐psychology to a belief‐psychology led to the expectation that references to desires would increase at an earlier age than references to beliefs. Our findings confirmed these expectations only partly, because the nature of the emotion (happiness, anger, sadness or fear) interacted with these factors. Whereas anger, happiness and sadness mainly evoked desire references, fear evoked more belief references, even in 4‐year‐olds. The fact that other factors besides age can also play an influential role in children's mental state reasoning is discussed. Copyright © 2005 John Wiley & Sons, Ltd.     

The hybrid split ad technique and onsite rewards

With a ‘split ad’, information is presented as two distinct parts, such as when two short commercials for a given brand are separated by other television content. Two studies are presented in this paper which demonstrate the advantages of an emerging form of the split ad strategy, which is termed the ‘hybrid split ad’ technique. Using this approach, a message typically begins in a traditional medium and then concludes at a website. In Experiment 1, the hybrid split ad technique is shown to enhance attitudes towards an advertised product by increasing the perceived importance of favourable attributes provided at the website. Experiment 2 replicates this finding and also addresses an issue of managerial importance, namely, how to motivate consumers to pursue the second (web‐based) portion of the ad. Offering consumers an incentive at the website is useful in this regard, provided that the incentive is small enough not to undermine the positive effects of the hybrid split ad.     

POLANYI ON TELEOLOGY: ARESPONSETO JOHN APCZYNSKI AND RICHARD GELWICK

Abstract. Michael Polanyi criticized the neo‐Darwinian synthesis on two grounds: that accidental hereditary changes bringing adaptive advantages cannot account for the rise of discontinuous new species, and that a Ideological ordering principle is needed to explain evolutionary advance. I commend the previous articles by John Apczynski and Richard Gelwick and also argue, more strongly than they, that Polanyi's critique of evolutionary theory is flawed. It relies on an inappropriate notion of progress and untenable analogies from the human process of scientific discovery and the fact that in physical systems minimal potential energy is most stable. Yet within a life of commitment to transcendent values humans can directly experience purpose and meaning, and in developing this notion Polanyi makes his greatest contribution to teleology.     

THEOLOGY AND PHYSICS FORTY YEARS LATER

Abstract. Almost forty years later I look back on a 1966 article on theology and physics by Sanford Brown and my response published with it. I reflect on his hope that theological seminaries would give attention to the methods used in scientific inquiry. I compare our comments with subsequent thought on three issues: (1) the role of models in science and religion; (2) the relation of wholes to parts in physics and other sciences and the debate over reductionism and emergence; and (3) the implications of quantum physics for theology, including the possibility of divine action at the quantum level.     

Explaining after by before: Basic aspects of a dynamic systems approach to the study of development

The basic properties of a dynamic systems approach of development are illustrated by contrasting two simple equations. One, y_t+1 = f (y_t), is characteristic of dynamic systems models. The other, y_i = f (x_i), refers to what, for the sake of simplicity, is referred to as the standard developmental approach. We give illustrations from cognitive, language and social development to show the characteristic differences of these two types of models and show their complementarity. The article further compares the “Bloomington” with the “Groningen” approach to dynamic systems theorizing in developmental psychology. It continues with a discussion of two important questions. One involves the issue of measurement and the nature of developmental variables from the viewpoint of dynamic systems. The second concerns the question of short- and long-term time scales in developmental models, which is discussed on the basis of an example, namely dyadic interaction of young children in the context of different social statuses.     

Improving judgmental forecasts with judgmental bootstrapping and task feedback support

This study examines the utility of two widely advocated methods for supporting judgmental forecasts—providing task feedback and providing judgmental bootstrapping support. In a simulated laboratory based experiment that focused on producing composite sales forecasts from three individual components, we compared the effectiveness of these two methods in improving final judgmental forecasts. In the presence of cognitive feedback task, feedback led to better forecasts than providing judgmental bootstrap forecasts. Simply providing bootstrap forecasts was of no additional benefit over a control condition. This was true in terms of the Brunswik Lens model measures of achievement, knowledge, and consistency, and in terms of forecast accuracy. This occurred both in stable environments and when special events (unusual one‐time events requiring adjustments to the forecasts) arose. Copyright © 2005 John Wiley & Sons, Ltd.