循证医学及其在心血管疾病中的应用

循证医学作为一门新兴的学科,对医学的研究和实践将产生越来越大的影响。在循证医学的操作过程中,如何正确评价和应用所获得的证据极为重要。在短短的十几年间,循证医学给心血管疾病的临床实践带来了根本的变化。     

中医药学将走向何方

由于中医缺乏形态学,中医没有成熟的科学实验,中医的诊断很难标准化、客观化,理论逻辑的致命弱点,理论体系难以重构,所以中医药学在很长一段时间内将保留下来之后,随着中医药学的理论体系的缺陷无法克服,原有的中医药体系必然解体,其中有部分内容融入现代医学。中医药学的归宿就是逐渐融入现代医学。     

Intra‐sentential context effects on the interpretation of logical metonymy⋆

Verbs such as enjoy in the student enjoyed the book exhibit logical metonymy: enjoy is interpreted as enjoy reading. Theoreticalwork [Computational Linguistics 17 (4) (1991) 409; The Generative Lexicon, MIT Press, Cambridge, MA, 1995] predicts that this interpretation can be influenced by intra‐sentential context, e.g., by the subject of enjoy. In this article, we test this prediction using a completion experiment and find that the interpretation of a metonymic verb is influenced by the semantic role of its subject. We present a Bayesian model that accounts for the interpretation of logical metonymy and achieves a good fit on our experimental data. We show that the parameters of the model can be estimated from completion data or from corpus data.     

SOUTH DAKOTA AND ABORTION: A LOCAL STORY ABOUT HOW RELIGION,MEDICAL SCIENCE,AND CULTURE MEET

Telling the tale about South Dakota's recent legislative ban on nearly all abortions gets messy, complicated, and dirty. There are no innocent subjects and no simple plot lines. The story reveals other stories underneath and over the top of the others. Stories counter stories, revealing who is in the know and who does the telling. To “tell the old, old story,” as the song goes, is not as simple as it may seem. Religion and medical science are caught in the politics and cultural wars about abortion.     

Further extensions of precision medicine to behavior analysis: A demonstration using functional communication training

The potential applicability of concepts and methods of the paradigm of precision medicine to the field of applied behavior analysis is only beginning to be explored. Both precision medicine and applied behavior analysis seek to understand and classify clinical problems through identification of their causal pathways. Both aim to develop treatments directly targeting those causal pathways, which also requires an understanding of the mechanisms by which treatments produce change (treatment-action pathways). In the current study, we extend the data-analytic methods and concepts described by Hagopian et al. (2018) toward the identification of variables that predict response to functional communication training (FCT). We discuss emerging conceptual issues, including the importance of distinguishing predictive behavioral markers from predictor variables based on their purported involvement in the causal or treatment-action pathways. Making these discriminations is a complex undertaking that requires knowledge of these mechanisms and how they interact.     

微创治疗在胃肠道癌根治术中的几个问题的探讨

医学和哲学都是人类发展历史中的重要学科,随着医学模式的改变,微创医学作为医学的新兴理念迅猛发展.但是哲学作为最高科学,依然指导了微创医学的发展.手术范围的变迁、有所为有所不为、主要矛盾与次要矛盾的转变、否定之再否定等哲学理念都在微创医学的发展中得以体现.微创医学的发展,对外科医师提出更高的要求.     

A BEHAVIORAL SYSTEM FOR ASSESSING AND TRAINING CARDIOPULMONARY RESUSCITATION SKILLS AMONG EMERGENCY MEDICAL TECHNICIANS

Many deaths from cardiopulmonary arrest can be prevented by the prompt and effective administration of cardiopulmonary resuscitation (CPR). In this study, we examined the standard training program for teaching CPR to emergency medical technicians (EMTs). We developed an alternative experimental program whereby the behaviors involved in CPR were assessed easily and in greater detail. This assessment provided the basis for a system in which effective CPR skills were reinforced and problems were corrected. Subjects who were trained in CPR according to this experimental program performed more effectively than subjects in the standard program. In addition, retention (maintenance) measures indicated that experimental subjects continued to perform well, often more effectively than professionally employed EMTs.     

USING PARENTS TO MAINTAIN IMPROVED DENTAL FLOSSING SKILLS IN CHILDREN

An experimenter-administered intervention involving prompts, self-monitoring, permanent product collection, rewards for plaque reduction, and corrective feedback was used to improve the flossing skills of four 7- to 11-year-old children. Parents were subsequently trained in the reward and feedback procedures to facilitate maintenance. In a multiple baseline across subjects design, all four subjects snowed improvement in plaque between teeth during experimenter-administered intervention. Three subjects maintained low plaque levels during the 3- to 4-month parent-administered rewards and feedback follow-up condition. Improved plaque levels on nontargeted tooth surfaces also were observed. Pediatric dentistry applications are discussed.     

Psychological aspects of scuba diving injuries: Suggestions for short-term treatment from a psychodynamic perspective

Dive medicine is described as an area of practice in which psychologists may choose to expand their clinical service and research activities. The author argues that most research studying risk behavior and sports take into account biological, behavioral or cognitive approaches, while ignoring unconscious conflict in risk-taking and injury management. The present paper uses a psychodynamically-oriented, interview-based approach to studying psychological reactions to decompression sickness in three experienced scuba divers. Brief interventions and their outcomes are described.     

Building a primary care discipline: Notes from a psychologist in family medicine

Psychologists of a variety of emphases have actively participated in the growth of family medicine as an academic discipline. Rather than simply collaborate, they have shaped the very nature of the field. This paper describes a number of contributions from psychologists in family systems and educational arenas. In particular, physician-psychologist collaborative work is highlighted.