面对医疗高科技:领舞,还是伴舞——兼论肿瘤治疗中的高科技选择对策

人们在享受高科技带来的便利时,也注意到由其引起的困顿,但又无法避而不用。因此,面对医疗领域中层出不穷的高科技手段,不能只是"翩翩起舞",盲目跟进,而要多方注意,从容"领舞",为我所用。以肿瘤治疗为例,强调不能仅依靠高科技,更要用智慧PK肿瘤,人性化考虑第一,主张"基于效果的治疗",并阐述了肿瘤防治的GI4P模式。     

中外高等医学教育学制与学位的研究与思考

依据WHO《世界医学院指南》,研究了目前世界各国高等医学教育学制与学位的状况,在分析我国医学学制与学位现状及存在问题的基础上,提出了改革我国高等医学教育学制与学位的思考及建议     

Attitudes of high school students toward carrier screening and prenatal diagnosis of cystic fibrosis

The identification of the common mutations of the cystic fibrosis (CF) transmembrane conductance regulator gene has made it feasible to consider population-based CF carrier screening. However, the demand for such programs will depend largely on the attitudes and perceptions of the general public toward genetic testing. As part of a high school science project, we initiated studies to determine the attitudes of high school students toward carrier screening for CF and other genetic disorders. From a class of 120 biology students, 101 consented to participate in the study. Most of the students were of European ancestry and there were no known family histories of CF. Buccal swabs were obtained for PCR amplification and heteroduplex detection of the most common CF mutation (F508). The students and their corresponding buccal swabs were assigned random numbers and the results were kept confidential unless the student requested his/her test result. A questionnaire was used to assess the students' attitudes toward carrier screening and prenatal diagnosis. This questionnaire was given both before testing and after the class was informed that three individuals were carriers of the F508 mutation. Overall, the data indicate that high school students are receptive to the concepts of carrier screening and prenatal diagnosis. However, their attitudes changed considerably when informed of the possibility that they might actually be a F508 carrier, with marked increases in the level of indecision. At the conclusion of the study, very few students (5/101) requested information about their F508 carrier status.     

On Art and Intention

The author discusses a puzzle about the place of intention in art, a puzzle first articulated by Richard Wollheim in his well-known lecture 'On Drawing an Object'. The puzzle arises if we try to hold jointly three commonly-held claims, viz. (1) Art is intentional; (2) The artist, in making a work of art, needs to observe what he has done, in order to know what he has done; (3) A necessary condition of intentional action is that when an agent acts intentionally then he knows what he is (intentionally) doing without observation, or any need for it. Prima facie it would appear that we cannot hold all these claims together.
The author spells out the problem, discusses Wollheim's own solution to it (which he rejects) and seeks to dispel the puzzle by closer attention to intention and action in relation to artistic production.     

Reinventing the Self in the Face of Received Transgenerational Hatred in the African American Community

There are many clinical methods for understanding and transforming the impact of historical trauma, and reinventing the self in the clinical process. However, the approach advocated here requires that regardless of what clinical method of intervention is chosen, a particular strand must run through the process of treatment to produce durable and meaningful change. This strand must run through psychoanalysis, creative and expressive arts therapies, as well as many forms of intervention in aggrieved communities. The strand includes understanding human suffering, the way that particular suffering is mentalized by the victimized group and subsequently reenacted by generations to come. In technical terms there must first be many profiles of understanding of the historical injury. Then there must be an understanding of how the aggrieved community has stored in their communal memory those psychological hurts—those feelings of humiliation and changing historical accounts of the actual injuries. Subsequently those sendimentations of historical grievances are enacted within the transference in the clinical situation where the grievances are not only staged, but re-staged, distorted or extended. Then comes the most decisive obligation the clinician has towards the analysand, patient, client or community that is attempting to transform itself. That decisive obligation is to extract the errand or ambush towards extinction and to undergo the unpleasant drudgery of constantly engaging the mandate to die or destroy oneself in order to find new and more flexible forms of adaptation.     

Altering student responses through changes in teacher verbal behavior

Two experiments were conducted in a junior-high special-education class of eight pupils in an inner-city school. In the first experiment, the teacher doubled the number of words used by the pupils in answering questions by altering the type of questions asked. In the second experiment, the number of words used by students and the percentage of answers given in complete sentences, increased from less than 5% to approximately 90% when the teacher instructed the pupils to answer in complete sentences and asked another pupil to answer using a sentence if the first one did not do so. In both experiments, a brief return to baseline conditions brought a return to low levels of verbal responding. An analysis of which pupils were called on by the teacher, teacher praise, and in the second experiment the types of questions asked, indicated that these variables were not responsible for the increases in verbal responding.     

The Role of Psychological Factors in Medical Presentations

Research shows that a large number of medical presentations do not result in a medical diagnosis but rather are related to behavioral health problems. Factors such as age, lower education and economic status, health beliefs, and medical and psychological factors are linked to high medical service utilization. Research consistently shows that patients with psychological problems use more services than those without diagnosable psychological problems. The purpose of this paper is to provide a more detailed analysis of the roles of psychological factors in medical presentations. We present three kinds of pathways by which psychological factors lead to medical presentations. These include the (1) primary or direct medical presentation of a clinical problem, (2) secondary presentation or the impact of the clinical problem on patients general physical, psychological, or psychosocial health, and (3) the complex presentation or the impact of multiple diagnoses on the presentation of the clinical problem. Examples of each of these pathways are presented for each axis of the DSM-IV.     

Philosophy,writing, and liberation

In responding to the three creative interpretive discussions in the symposium on my book Philosophy and the Art of Writing, this paper explores the different styles of philosophical discourse and their role in the practice of philosophy as a way of life that extends beyond the discursive and that combines self-cultivation with care for others in the ethical-aesthetic pursuit of living beauty. In advocating this aesthetic model of philosophical life over a purely therapeutic model, I suggest how the former can incorporate the latter's concerns for spiritual health and liberation. In developing my response to the symposiasts while elaborating on the themes of my book, I consider issues of ineffability, creative performance, embodiment, truth, heroism, vulnerability, possession, art, spirituality, love, and liberation.     

Creativity: Celebrations and tensions

In 1950, the President of the American Psychological Association emphasised the economic and political importance of creativity for US society. His account of creativity exhibits a number of tensions that can be identified in other psychologists' theories and conceptualisations of creativity. This paper considers the tensions from the perspective of critical discursive psychology. In the terms of that approach, the tensions derive from multiple non-academic discourses around creativity, including popular discourses of creativity and art. The paper argues that conceptualisations of creativity from academic psychology have in turn entered wider discourses, invoked, for example, in recent celebrations of the global sector of the creative and cultural industries (CCI). The tensions within psychology's conceptualisations are significant, however, because they raise questions about the extent to which the psychology of creativity has a common reference and coheres around the study of a single phenomenon.