Involvement of cardiac,respiratory and gastrointestinal functions in neural responses to stressful events

In the stress concept, fight and flight situations as well as other CNS-controlled reaction patterns for alertness to danger have to be followed by or integrated with a restorative “build-up” process in order to maintain homeostasis. The “build-up” process can be studied physiologically for example after regular exercise or training. Under these conditions there is a decrease in resting sympathetic adrenergic activity and an increase in the parasympathetic vagal activity. A theoretical model for the “build-up” process in psychosomatic gastroenterology has previously been presented. The present paper deals with the “build-up” process in cardiovascular and respiratory tract diseases seen in athletes. Anorexia nervosa related to excess physical training is also discussed as well as the “build-up” process in severe obesity and psychosomatic gastroenterological disorders.     

BEHAVIORAL RESEARCH IN PREVENTIVE DENTISTRY: EDUCATIONAL AND CONTINGENCY MANAGEMENT APPROACHES TO THE PROBLEM OF PATIENT COMPLIANCE

This study examined the effects of reinforcement on compliance with an oral hygiene education program. Patients 18 years of age or older who enrolled in an ongoing program at a periodontal practice received 3–5 sessions of instruction in preventive dental care. Using a between-subjects design, patients who entered the program during alternating months also had a portion of their fees refunded contingent upon improvements in their dental plaque scores. Pre- and posttreatment data showed that all subjects exhibited lower plaque levels following the program, but that greater improvements were seen in patients who were exposed to the fee reduction contingency. Plaque scores taken at a 6-month follow-up revealed some relapse for the Fee Reduction subjects. However, their scores were still substantially better than pretreatment, and better than those of the Education only subjects, whose data differed little from untreated Controls. Methodological and practical issues related to behavioral research in preventive dentistry are discussed.     

The potential of medicine as a resource for philosophy

In addition to the neglect of philosophy by medicine, emphasized in a recent editorial in this journal, there has been an equally important neglect of medicine by philosophy. Philosophy stands to gain from medicine in three respects: in materials, the conceptual difficulties arising in the practice of medicine being key data for philosophical enquiry; in methods, these data, through their problematic character, being ideally suited to the technique of linguistic analysis; and in results, the practical requirements of medicine placing a direct demand for progress on philosophical theory. The future of the relationship between philosophy and medicine depends on the development of a positive two-way trade between them.     

Family Therapy and Alternative Medicine: Acupuncture as a Case in Point

Collaboration between family therapists and alternative medicine practitioners is recently cultivated ground that may prove to be fertile territory for the application of family therapy skills. Acupuncture and family therapy are two healing practices that differ in cultural tradition, language, and technique, yet they appear to share some underlying assumptions suggestive of a natural alliance in helping people with a variety of biopsychosociospiritual problems. This paper describes the process of interdisciplinary collaboration between an acupuncturist and family therapist via a clinical vignette, identifying different types of referral situations, and suggesting factors of effective collaboration that can synergistically enhance a patient and family's treatment.     

20世纪医学发展态势 21世纪医学发展预测--1901～1999年诺贝尔生理学/医学奖综合分析

通过对 190 1～ 1999年诺贝尔生理学 /医学奖综合分析 ,发现生物医学科学的发展规律。并对 2 1世纪医学发展的进行预测 :人类将完成庞大的人体基因组计划 ;攻克各种顽症 ;生产各种人造器官 ,以供移植所需。总结两种治疗疾病的思路 :一种是通过修正致病基因 ,另一种思路可通过器官移植 ,从根本上达到治病的目的     

The past,present, and future of the biopsychosocial model: A review of The Biopsychosocial Model of Health and Disease: New philosophical and scientific developments by Derek Bolton and Grant Gillett

Health psychology is a growing field generating exciting advances in theory, research, and applications that significantly improve the lives of individuals, shape the medical profession, and inform global public policy. For over 40 years, the field has been guided by the biopsychosocial model (Engel, 1977), an interdisciplinary and multifaceted model that posits the interrelations among the biological, psychological, and socio-environmental influences on health and disease. The theoretical implications and empirical research that it has generated have been vast. In The Biopsychosocial Model of Health and Disease: New philosophical and scientific developments, Derek Bolton and Grant Gillett (2019) present a summary of four decades of scholarship. They conclude that the model has fallen short clinically, scientifically, and philosophically. Although their book is timely, well-written, thought-provoking, and designed to highlight weaknesses that could drive science and practice forward, their criticisms are not fully convincing and are open to debate. The contributions this book could make may be to challenge a new generation of scholars and scientists to demonstrate that the biopsychosocial model is more relevant than ever, especially as areas such as social genomics, psychoneuroimmunology, health disparities, and global health become more important. Despite interesting philosophical challenges presented by Bolton and Gillett, theory, research, and practice focused on health, disability, illness, and wellness should remain grounded in the biopsychosocial model.     

Exploring emotions in dialog between health provider,parent and child. An observational study in pediatric primary care

IntroductionThis paper is part of the theoretical thread of health psychology and it presents a study aimed to recognize information useful to implement psychological interventions finalized to personalize medical treatments and engage users in pediatrics.ObjectiveIn this paper is presented an observational study aimed to explore doctor-patient dialog about worries in pediatric primary care; it has been carried out identifying dialogical interaction patterns, or typical dialog between health providers, parent and child.MethodWe documented conversations in 265 visits; we audio-recordered, transcribed and analyzed them with Verona Coding Definitions of Emotional Sequences. Dialogs between participants were analyzed one by one. Frequencies of emotions’ signals (cues/concerns) and responses were analyzed through Redundancy Analysis, aimed to establish a quantitative relationship between these pair of groups of variables considering the asymmetrical relationship between them.ResultsSix “Dialogical Interaction Patterns” were obtained by interpreting these relationships; they show dialogs mainly aimed at obtaining information useful for diagnosis and treatment, with a limited exploration of worries or issues related to the condition of the child. Pediatric conversations seem to be characterized by a very high attention to cognitive aspects of medical questions with a poor consideration of emotions as useful information to medical practice.ConclusionsThese dialogs seem to ensure the rapidity and the efficiency of medical visits. Nevertheless, it could be useful to implement psychological interventions to achieve an enrichment of the dialog between participants, helping them to recognize users’ emotions as useful to define shared medical strategies.     

Toward a more natural medicine

Modern science and culture attempt to dominate and control nature. Unfortunately contemporary medicine has followed this lead. Traditionally religion has recognized the order and goodness in the natural order and has encouraged followers to comply with the rules of nature. Medicine, from Hippocratic times, has viewed the physician as an assistant to nature. Contemporary medicine, while employing modern science, would be well advised to also recognize the healing effects of religion's admonition to acknowledge and respect the wisdom of nature.     

Response to John Polkinghorne

In this statement, the author poses a number of questions that he believes John Polkinghorne left untouched in his response to Pannenberg's article "God as Spirit—and Natural Science." These questions include the role of philosophy in the interaction between theology and science, the concepts of space and time as prior to measurement, the relation between top-down and bottom-up thinking, and the concept of field.