知情同意的临床实践存在的问题及对策

临床医疗实践中贯彻实施知情同意原则旨在保护病人的权益不受侵犯,然而知情同意原则实施起来并不简单,它常常会受到主客体两方面种种因素的制约,陷入意想不到的困境。分析了知情同意原则在实施过程中可能出现的一些难以回避的问题,并针对这些问题探讨了若干对策。     

对肾移植输血问题的思考

就肾移植受者输血的几个问题进行了回顾和探讨。提出肾移植受者输血应该考虑的问题有：如何权衡输血对肾移植受者的有益作用与输血风险,输血医学的发展如何为肾移植提供更有力的保障,应该深入探讨输血有益于肾移植的机制,推进供者特异性输血在我国的应用。     

论庄存与的《公羊》学

庄存与的《公羊》学虽然受到赵《春秋属辞》的影响 ,但主要限于治学体例 ,而在治学立场上 ,二者其实有根本的歧异。庄存与克服了赵以策书之体说《春秋》的倾向 ,并注重《春秋》例辞背后的立场。这点直接上承汉代《公羊》学。不过 ,庄氏《春秋》学在某些具体的事例解释上与汉代《公羊》学也有差异。庄氏的特点在于对《春秋》变辞的引申与发挥 ,并补充了汉代《公羊》学未曾论述的诸多方面 ,为后人理解《公羊》大义提供了新的线索。     

孔子晚年心志蠡测--并为《莫春篇》作一新解

孔子晚年的心志如何,的确多费猜疑。作者发现其中最主要的关键在于如何对当今留下的史料作恰当的选取与解读而已。本文以《论语》为基准,通过《易传》与《春秋》来了解孔子晚年的思想。对《论语》里自古以来号称难解的《莫春篇》作出新的了解,显豁孔子晚年密契天道的意境,指出这正是孔子志存拨乱,推阐易道,作《春秋》运诸三世之苦心。后世实在不宜再忽视或过度怀疑《孟子·滕文公下》、《史记·孔子世家》及新近出土帛书《易传·要篇》等史料具有呈显孔子晚年思想实况的价值性.     

Countertransference and the female triangular situation3

This paper represents an attempt toward reconciling contemporary changes in psychoanalytic understandings of female development, particularly in respect to separation issues, with their clinical applications to female patients. Psychoanalytic thinking typically has categorized separation conflicts as pre‐oedipal, but the authors suggest that these are an integral part of the triangular situation of the girl. The authors argue that an allegiance to erroneous theory and/or individual blind spots have led to the infantilization, pre‐oedipalization or cultural stereotyping of females, which constrains the effectiveness of their analyses. The authors present a selected review of the literature on gender‐based countertransference biases in both male and female analysts, with reference to female ‘oedipal’ material. Analytic case material of two women is presented which demonstrates how theoretical misperceptions and countertransferences to triangular separation conflicts can produce an impediment to progression in analysis.     

Rejoinder to Harold Blum2

The author's main disagreement with Harold Blum is over Blum's contention that symptomatic improvement is directly linked to the recovery of memories. The idea that memories are laid down in childhood and preserved until the time of their later recovery flies in the face of what we now understand as the creation of memories by the neurobiological systems underpinning this aspect of mental function. No evidence directly links symptomatic improvement to reconstruction and thus to outcome; care should be taken to avoid confusing co‐occurrence with causality. While reconstruction of how things actually were in childhood can significantly contribute to therapeutic action, it is the process rather than the outcome of this reconstruction that is therapeutic, due to the opportunity thus afforded to rework current experiences in the context of other perspectives. The author clarifies his definition of transference to show some areas of agreement between his position and Blum's. He disusses contemporary neuroscientific views on memory and identifies a number of psychoanalytic writers who have used these productively.     

The puzzle of Freud's puzzle analogy: Reviving a struggle with doubt and conviction in Freud's Moses and monotheism

In this paper the author points to a puzzle raised by Freud's contradictory use of an analogy of a jigsaw puzzle. She shows how, through the attempt to resolve this puzzle, meanings and implications of Freud's difficult struggle with his search for truth in Moses and monotheism come alive, both in Freud's writing and in the author herself. Central to this struggle is an encounter with the sources of doubt and conviction that ultimately allows one to embrace ideas experienced as true, although they are not demonstrable evidentially. The paper sheds light on the importance of Moses and monotheism as a theoretical text that reflects on developments in Freud's thinking on truth, and the possibility, dangers and inherent difficulties of grasping it.     

Short-term visual memory for contour curvature in a delayed discrimination task

Abstract: A two-interval forced-choice of constant stimuli was used to measure the point of subjective equality (PSE) and discrimination threshold for standard contour curvature (1.91, 3.24 deg⁻¹) held in short-term visual memory (STVM). At both standard curvatures, the PSE for remembered curvature was nearly constant for standard curvature from 2 s to 16 s retention intervals, while the discrimination threshold increased as a linear function of retention interval. These results show that the decay in STVM for contour curvature is due to the noisy representation of curvature, neither to fading of the represented curvature nor to converging to the constant curvature. Furthermore, the Weber fraction was nearly constant for both standard curvatures at any delay from 2 to 16 s.     

Dropping out of school: A review of intervention programs

This article reviews the literature on dropout prevention for school-aged children. A review of dropout prevention programs identified in the literature highlights methodological concerns, with a discussion of design, sampling, statistical analysis, and implementation issues. The interventions employed with greatest frequency in the studies reviewed emphasized academic enhancement, psychosocial skill development, mentoring, and parent/teacher behavior management training. Programs that were academically oriented or those that were multi-component programs emerged with the most promising empirical base. However, at the present time, there is a lack of consistent and persuasive outcome evidence that meet Kratochwill and Stoiber's [Sch. Psychol. Q. 15 (2001) 233] criteria for empirically supported interventions. This deficiency leads to the conclusion that there is no one particular best practice or beneficial treatment currently available to address the problem of school dropout even though a number of intervention programs appear to hold promise. Implications for school psychologists include both practice and research applications.     

PEIRCEAN APPROACHES TO EMERGENT SYSTEMS IN COGNITIVE SCIENCE AND RELIGION

Cognitive science and religion provides perspectives on human cognition and spirituality. Emergent systems theory captures the subatomic, physical, biological, psychological, cultural, and transcendent relationships that constitute the human person. C. S. Peirce's metaphysical categories and existential graphs enrich traditional cognitive science modeling tools to capture emergent phenomena. From this richer perspective, one can reinterpret the traditional doctrine of soul as form of the body in terms of information as the constellation of constitutive relationships that enables real possibility.