术后认知功能障碍和阿尔茨海默病相关的发病机制思考

术后认知功能障碍是手术麻醉后的并发症之一,阿尔茨海默病是一种常见的慢性进行性神经退行性疾病,在发病机制方面二者存在诸多的相似点,且目前在此方面对二者的研究都没有取得重大进展,有必要从发病机制角度对二者进行相关的辩证思考,以便更好地指导临床及基础研究。     

The myths of free association and the potentials of the analytic relationship

The author challenges the traditional and still prevalent view of 'free association', arguing that it entails three forms of denial (also formulated in terms of corresponding myths): 1) denial of the patient's free agency; 2) denial of the patient's and the analyst's interpersonal infl uence; and 3) denial of the patient's share of responsibility for co-constructing the analytic relationship. That responsibility includes some degree of consideration of the analyst's needs. Sometimes, the patient's good judgment to that end may be refl ected in what is automatically and mistakenly reduced to a form of 'resistance'. Attention to the patient's responsibility must be balanced against the effort to provide a uniquely safe environment for the patient's revealing of shame and anxiety-ridden feelings and attitudes. But the therapeutic action of psychoanalysis, ideally, includes the cultivation, through lived experience, of the dialectical interplay of self-expression, on the one hand, and caring relational engagement, on the other. Recognition of the patient's free agency does not preclude exploration of constraining structures laid down in the past. On the contrary, it deepens such exploration. At the same time, it opens the door to the possibility of explicit recognition, via challenge, criticism, or affi rmation, of the patient's contributions to the analytic work.     

Don’t say that!

According to pragma-dialectical methodology, a party in an argumentative discussion can be assumed to manoeuvre strategically between dialectical and rhetorical objectives. One confrontational form of strategic manoeuvring occurs when a critic charges an arguer with advancing a standpoint that has socially harmful consequences. In special situations this form of manoeuvring can be dialectically sound, for example when the standpoint is advanced in a way that damages the dialectical process. The boundary between fallacious and dialectically sound applications of this form of manoeuvring is examined by looking for the manoeuvring’s soundness conditions.     

特需医疗服务供方意向调查分析

剖析目前特需医疗服务供方所存在的主要问题,初步探讨在我国发展特需医疗服务适宜的承担主体。采用个别访谈和问卷调查的方法对来自不同性质的医院的医护人员和医院管理人员进行了意向调查。结果显示,医院发展特需医疗服务并不是解决医务人员收入问题的有效手段;公立医院发展特需医疗服务势必会对其普通医疗服务带来负面影响。建议在确保大部分公立医院只提供普通医疗服务的基础上,由私立医院和一部分公立医院作为特需医疗服务的承担机构。     

Is Science Neurotic?

Neurosis can be interpreted as a methodological condition from which any aim-pursuing entity can suffer. If such an entity pursues a problematic aim B but represents to itself that it is pursuing a different aim C and, as a result, fails to solve the problems associated with B which, if solved, would lead to the pursuit of aim A, then the entity may be said to be "rationalistically neurotic." Natural science is neurotic in this sense insofar as its basic aim is represented as improving knowledge of factual truth as such (aim C), when actually the aim of science is to improve knowledge of explanatory truth (aim B). Science itself does not suffer significantly from this neurosis, but philosophy of science does. Much more serious is the rationalistic neurosis of the social sciences and academic inquiry more generally. freeing social science and academic inquiry from neurosis would have far-reaching beneficial, intellectual, institutional and cultural consequences.     

John Dewey and the Role of Scientific Method in Aesthetic Experience

In this paper I examine a controversy ongoingwithin current Deweyan philosophy of educationscholarship regarding the proper role and scopeof science in Dewey's concept of inquiry. Theside I take is nuanced. It is one that issensitive to the importance that Dewey attachesto science as the best method of solvingproblems, while also sensitive to thosestatements in Dewey that counter a wholesalereductivism of inquiry to scientific method. Iutilize Dewey's statements regarding the placeaccorded to inquiry in aesthetic experiences ascharacteristic of his method, as bestconceived.     

Analogical reasoning as a tool of epidemiological investigation

Few, if any, scientific inquiries are conducted against a background of complete knowledge, a background in which inquirers are in possession of the full facts that relate to a particular question or issue. More often than not, scientists are compelled to conduct their deliberations in contexts of epistemic uncertainty, in which partial knowledge or even a total absence of knowledge characterise inquiry. Nowhere is this epistemic uncertainty more evident, or indeed more successfully controlled, than in the branch of scientific inquiry called epidemiology. In this paper, I examine how epidemiologists overcome the unique challenges to inquiry that are posed by epistemic uncertainty. In specific terms, I contend that epidemiologists employ analogical reasoning strategies in an attempt to advance their inquiries in situations that are epistemically uncertain. The context for my claims will be the early inquiries that were conducted into the emergence of HIV/AIDS in the United States. I argue that early scientific work in relation to HIV/AIDS was directly premised upon epidemiological investigations in which analogical reasoning with hepatitis B had featured significantly. I conclude that epidemiological investigations of AIDS exemplify the capacity of analogical reasoning to advance inquiry under conditions of epistemic uncertainty. To this extent, analogical reasoning should be a concern both to those who address practical problems of uncertainty management and to those who pursue theoretical debates within argumentation studies and epistemology.     

A Concept Divided: Ralph Johnson's Definition of Argument

Ralph Johnson's Manifest Rationality (2000) is a major contribution to the field of informal logic, but the concept of argument that is central to its project suffers from a tension between the components that comprise it. This paper explores and addresses that tension by examining the implications of each of five aspects of the definition of argument.     

Applying a relational lens to ethnographic inquiry: Storied insight into the inner workings of multicultural teams in men's elite football

ObjectiveTo examine the impact of transnational migration on the functioning of multicultural teams in men's elite football and to explore the cultural transition experiences of transnational players from the relational perspective of receiving football environments.Designand Method: This 26-month ethnographic study adopted a researcher-practitioner approach to investigate two elite European football clubs during the course of two complete seasons. Over 80 male participants from 18 different countries were involved in the approximately 1200 h of field observation (e.g., practices, games, closed-door meetings, etc.) and 50 h of transcribed interviews. Detailed field notes and interview data were thematically analyzed, followed by a narrative analysis of structure and form. Finally, the genre of ethnographic creative non-fiction was employed to present the findings.FindingsBy applying a relational lens to the study of cultural transitions, this investigation illuminates the centrality of relations in the daily functioning of multicultural teams embedded in transnational networks and spaces. The complex interactional dynamic between transnational players and members of the receiving environment as well as the structural constraints shaping footballing (sub)cultures and behaviours highlight the salience of restrained agency as a collective phenomenon in elite men's football. Moreover, the study explores the hows of cultural transition by engaging with temporality and proposing a complementary perspective that extends current understandings in the narration of cultural transition experiences.ConclusionsThe findings carry applied utility that can benefit stakeholders and practitioners working with culturally diverse teams in the deployment of culturally informed club management strategy, educational tools, and interventions.     

Adopting a student-led pedagogic approach within higher education: the reflections of an early career academic

The current paper presents a reflective account of the adoption of a student-led pedagogic approach, based upon the first author’s experiences of working within a new academic institution. Carl Rogers’ writings around student-centred learning and the role of the facilitator provide the theoretical underpinning for the reflections put forward, and contextual information regarding the institution’s learning and teaching strategy, and the first author’s teaching background are also provided. Observations and reflections relating to ‘power’ within teaching and learning, and the challenges (and successes) encountered when adopting the role of a ‘facilitator of learning’ are considered from a critical standpoint. The paper closes with some key questions and considerations surrounding the first author’s ongoing exploration of this innovative pedagogic approach.