住院医师规范化培训中辩证思维能力的培养

精湛的临床思维能力和良好的辩证思维能力是住院医师岗位胜任能力的根本要求。如何切实提升住院医师的辩证思维意识和思维习惯是现阶段住院医师规范化培训中一个亟待解决的现实难题。阐述了培养住院医师辩证思维能力的必要性和重要性,重点分析了住院医师规范化培训中应着力掌握的几种思维素养和能力。在规范化培训阶段,应以提升住院医师的辩证思维素养、强化辩证思维意识和思维习惯的养成教育、注重临床诊治实践能力的培养等为着力点培养住院医师辩证思维能力。     

Stopping the Nonadherence Cycle: The Clinical and Theoretical Basis for Dialectical Behavior Therapy Adapted for Adolescents With Chronic Medical Illness (DBT-CMI)

Most adolescents with chronic illness do not adhere to their regimen. A novel transdiagnostic adaptation of dialectical behavior therapy (dialectical behavior therapy for chronic medical conditions; DBT-CMI) is presented to improve medical adherence in adolescents. The authors describe the approach of DBT-CMI and the model’s conceptualization of nonadherence, with specific focus on the core concepts of non-adherence across illness in adolescence.DBT-CMI has been piloted in two disease groups with preliminary benefit. DBT-CMI lends itself theoretically as a transdiagnostic approach due to specific skills that target core concepts of nonadherence in adolescence. Future research is warranted on the applicability of DBT-CMI across other pediatric medical conditions to replicate findings and examine long-term outcomes.     

怎样看待和认识休克

哲学素质在现代医学实践中具有重要意义,它不仅是医务工作者的思维武器,更是了解医学前沿和解决医学难题的钥匙。本文就以休克这一临床上常见的危急重症为例,探讨休克发生发展过程中的哲学因素,旨在阐明自觉运用马克思主义哲学的思辨观来指导休克的诊疗过程实属必要,对医生及患者都大有益处。     

Consonances and controversies: Investigation and its discontents revisited

The author responds to the commentaries of 13 experts on his 1980 American Psychologist article, “Investigation and its discontents: On some constraints on progress in psychological research.” Among the themes addressed are the role of theory in psychological research, the meanings and implications of “productivity” by scholars and researchers, the role of grants, and of money in general, in directing research efforts, and the relation between psychological and neuropsychological research.     

Empathy and evaluation: Understanding the private meanings of behavior

This paper makes three points. First, empathy cannot be considered an epistemic basis for qualitative research and evaluation. Second, it is, however, a valuable method for understanding the private meanings of words and deeds. Third, this method is not completely reliable for purposes of what Popper called refutation, but is useful in what he dubbed scientific conjecture or the generation of theory. Basic researchers will need to take the necessary steps to subject empathetic hunches to critical examination. However, owing to the exigencies of action settings and decision-making, disciplined conjectures are sometimes the most that evaluators can hope to record.An earlier version of this paper was printed in the Proceedings of the Far Western Philosophy of Education Society, 1989. This version is published with permission of the Far Western Philosophy of Education society. The author is grateful for helpful comments and critisism made by members of the California Association for Philosophy Education. Remaining errors, of course, are the authors responsibility alone.     

Effectiveness of Dialectical Behavior Therapy for Treating Eating Disorders

This study evaluated the effectiveness of dialectical behavior therapy (DBT) for treating eating disorder episodes and co‐occurring depression symptoms among individuals diagnosed with eating disorders. Separate meta‐analytic procedures for between‐groups and single‐group studies were conducted and yielded large effect sizes, indicating that DBT may be efficacious for decreasing disordered episodes among women diagnosed with eating disorders; medium to large effect sizes were noted for treating depression symptoms. Implications for evidence‐supported practice and study limitations are discussed.     

Scientific Discovery on Positive Data via Belief Revision

A model of inductive inquiry is defined within a first-order context. Intuitively, the model pictures inquiry as a game between Nature and a scientist. To begin the game, a nonlogical vocabulary is agreed upon by the two players along with a partition of a class of structures for that vocabulary. Next, Nature secretly chooses one structure (the real world) from some cell of the partition. She then presents the scientist with a sequence of atomic facts about the chosen structure. With each new datum the scientist announces a guess about the cell to which the chosen structure belongs. To succeed in his inquiry, the scientist's successive conjectures must be correct all but finitely often, that is, the conjectures must converge in the limit to the correct cell. A special kind of scientist selects his hypotheses on the basis of a belief revision operator. We show that reliance on belief revision allows scientists to solve a wide class of problems.     

Philosophy for Children and the Reconstruction of Philosophy

In this paper I trace the dialogical and narrative dimensions of the philosophical tradition and explore how they are reconfigured in the notion of community of philosophical inquiry (CPI), the mainstay of the collection of novels and discussion plans known as Philosophy for Children. After considering the ontology and epistemology of dialogue, I argue that narrative has replaced exposition in our understanding of philosophical discourse and that CPI represents a narrative context in which truth comes to represent the best story, in a discursive location in which there are always multiple stories. Finally, I raise the issue of children's philosophical voice. Can children philosophize, and if they can, do they do so in a voice different from adults'? If so, what are the distinctive features of that voice? I assert that it is children's historical marginalization in the Western construction of rationality that now – as that rationality undergoes its crisis – makes of them, like women and other “natives,” privileged strangers to the tradition, who are, through CPI, enabled to enter it through dialogue and narrative.