中医现代化的反思和中医的发展之路

讨论了当前所进行和提倡的中医现代化的结果不是在发展中医,而是导致了对中医的歧义的误解。认为中医的发展需要在继承的基础上,在遵循中医自身规律的前提下,在不断地纯中医方法的临床实践中,用开放的思维方式和开拓和精神发展中医的基础理论,加强中药生药的质控,用中医理论与西药匹配,加强中医的方证研究,使中医更适合社会的需要,为人类的健康事业做出应有的贡献。     

Patient and Family Descriptions of Ethical Concerns

Abstract

Ethically challenging situations routinely arise in the course of illness and healthcare. However, very few studies have surveyed patients and family members about their experiences with ethically challenging situations. To address this gap in the literature, we surveyed patients and family members at three hospitals. We conducted a content analysis of their responses to open-ended questions about their most memorable experience with an ethical concern for them or their family member. Participants (N?=?196) described 219 unique ethical experiences that spanned many of the prevailing themes of bioethics, including the patient-physician relationship, end-of-life care, decision-making capacity, healthcare costs, and genetic testing. Participants focused on relational issues in the course of experiencing illness and receiving medical care and concerns regarding the patient-physician encounters. Many concerns arose outside of a healthcare setting. These data indicate areas for improvement for healthcare providers but some concerns may be better addressed outside of the traditional healthcare setting.     

A preliminary investigation on improving functional communication training by mitigating resurgence of destructive behavior

Despite the effectiveness and widespread use of functional communication training (FCT), resurgence of destructive behavior can occur if the functional communication response (FCR) contacts a challenge, such as lapses in treatment integrity. We evaluated a method to mitigate resurgence by conducting FCT using a multiple schedule of reinforcement prior to extinction. After functional analyses of 2 boys’ destructive behavior and treatment with FCT (Study 1), we compared levels of resurgence during an extinction challenge either after a typical FCT sequence or after exposure to schedule thinning in the context of a multiple‐schedule arrangement (Study 2). Results for both participants suggested that schedule thinning using discriminative stimuli in a multiple schedule mitigated the resurgence of destructive behavior.     

Ability, breadth, and parsimony in computational models of higher-order cognition

Computational models will play an important role in our understanding of human higher‐order cognition. How can a model's contribution to this goal be evaluated? This article argues that three important aspects of a model of higher‐order cognition to evaluate are (a) its ability to reason, solve problems, converse, and learn as well as people do; (b) the breadth of situations in which it can do so; and (c) the parsimony of the mechanisms it posits. This article argues that fits of models to quantitative experimental data, although valuable for other reasons, do not address these criteria. Further, using analogies with other sciences, the history of cognitive science, and examples from modern‐day research programs, this article identifies five activities that have been demonstrated to play an important role in our understanding of human higher‐order cognition. These include modeling within a cognitive architecture, conducting artificial intelligence research, measuring and expanding a model's ability, finding mappings between the structure of different domains, and attempting to explain multiple phenomena within a single model.     

Personality attributes that predict cadet performance at West Point

Using data from the United States Military Academy at West Point (N = 1102 and N = 1049) from two successive years, we examined psychological measures of cadets and the correlations of those measures with consequential outcomes such as cadet performance and leadership potential. We examined four broad intelligences, two of which were thing-focused (spatial and mathematical) and two people-focused (verbal and personal intelligences) and their predictions to thing- and people-centered courses (e.g., chemistry versus psychology). We found support for a thing-people differential in reasoning. The broad intelligences and the Big Five personality traits also predicted academic and other performance criteria at consequential levels.     

Gathering Diverse Perspectives to Tackle “Wicked Problems”: Racial/Ethnic Disproportionality in Educational Placement

Among students receiving behavioral health and special education services, racial/ethnic minority students are consistently overrepresented in settings separate from general classrooms. Once separated, many young people struggle to improve academically and face significant difficulty upon trying to return to a general education setting. Given the complex, ongoing, and multifaceted nature of this challenge, racial/ethnic disproportionality can be identified as a “wicked problem,” for which solutions are not easily identified. Here, we describe our community-engaged research efforts, eliciting perspectives from relevant partners in an ongoing dialogue, to better integrate diverse stakeholders’ perspectives when attempting to address such disparities. We conducted focus groups and qualitative interviews with members of three stakeholder groups: community-serving organizations, individuals with lived experience of behavioral health conditions, and state-level policymakers, with a shared interest in addressing racial and ethnic disparities. Participant responses illustrated the “wickedness” of this problem and highlighted the need for additional supports for students, families, and school personnel, increased collaboration across relevant systems and agencies, and reduced barriers related to funding. Overall, this methodology bridged differing perspectives to develop, in concert with our partners, a shared language of the problem and a core set of issues to consider when seeking to effect change.     

A Qualitative Systematic Review of Youth Participatory Action Research Implementation in U.S. High Schools

This qualitative systematic review examined the context-specific factors that influence the implementation of youth participatory action research (YPAR) projects in high schools within the United States. Thematic synthesis was conducted to identify and analyze the YPAR implementation factors that were present in 38 peer-reviewed studies. Results indicate the following two analytic themes concerning YPAR implementation in high schools: (a) pedagogical strategies and (b) stakeholder dynamics and needs. The themes provide support for existing ecological frameworks of implementation factors and demonstrate that adult researchers’ project-specific decisions are nested within educational power structures. This paper will discuss the implications of these YPAR implementation themes in executing YPAR projects in high schools.