告知患者癌症诊断的利弊分析及有效告知的方法

告知患者癌症诊断是肿瘤科的核心问题。法律和医学伦理原则要求医务人员应掌握肿瘤患者的心理和其他方面的特殊性,及时、充分地与患者及家属进行沟通,严格履行肿瘤患者的知情同意原则。本文旨在对告知患者癌症诊断的利弊及有效告知癌症诊断的方法进行分析,以期为临床肿瘤医疗、护理工作提供指导。     

Why is a truth-predicate like a pronoun?

I begin with an exposition of the two main variants of the Prosentential Theory of Truth (PT), those of Dorothy Grover et al. and Robert Brandom. Three main types of criticisms are then put forward: (1) material criticisms to the effect that (PT) does not adequately explain the linguistic data, (2) an objection to the effect that no variant of (PT) gives a properly unified account of the various occurrences of “true” in English, and, most importantly, (3) a charge that the comparison with proforms is explanatorily idle. The last objection is that, given a complete semantic account of pronouns, proadjectives, antecedents, etc., together with a complete (PT), the essential semantic character of “true” could be deduced, but then, the idleness of the comparison with pronouns would be apparent. It turns out that objections (2) and (3) are related in the following way: the prosentential terminology is held to conceal the lack of unity in (PT), by describing the different data in the same terms (“proform”, “antecedent”, etc.). But this, I argue, is only a way of truly describing, rather than explaining, the data, these being certain relations of equivalence and consequence between sentences. I consider a language for which (PT) would be not only true, but also explanatory, but note that this language is very different from English. I end by showing that Robert Brandom’s case that “is true” is not a predicate fails, and that his motivation for saying so is based on fallacious reasoning (namely, Boghossian’s argument against deflationism).     

A confusion of tongues between psychoanalysis and philosophy: Is the controversy over drive versus relational theory a philosophical one?

In recent years the controversy over Drive versus Relational models of the psyche has become entangled in a philosophical controversy over epistemology. Some have argued that the Drive model was a relic of an age of positivistic science, while Relational models are a product of a postmodern condition. This paper argues that the controversy need not be a philosophical one, and that Relational views are not, in fact, a product of postmodernism, nor are they necessarily dependent on a postmodern epistemology. Separating the epistemological from the psychological more carefully may help return the debate to its proper, psychoanalytic domain, and perhaps contribute to a more fruitful dialogue across what, at times, seems like an abyss between Relational views and Drive theory.     

Science,spirituality and truth: acknowledging difference for spiritual dialogue and human well‐being

This article seeks to explain why spiritual education must be clear about the nature of spiritual knowledge and truth and how it differs from the knowledge and truth generated by science. The author argues this is important in order that spirituality and science are equally valued, and in order that spiritual pedagogy appropriately reflects the nature of spiritual truth in the context of spiritual diversity and commitment. Based on these arguments, and inspired both by the ideas of inter‐faith dialogue and the philosophy of Michael Bakhtin, the author then suggests a dialogical approach to spiritual pedagogy for spiritual development and wellbeing. The article suggests education will best enhance human wellbeing if it is positive about the contributions of both science and spirituality, and if it promotes understanding of spiritual difference and commitment.     

Projection of a binary criterion into a model of hierarchical classes

A formal analysis is made of how to project an attribute criterion into the hierarchical classes model for object by attribute data proposed by De Boeck and Rosenberg. The projection is conceptualized as the prediction of the attribute criterion by means of a logical rule defined on the basis of attribute combinations from the model. Eliminative and constructive strategies are proposed to find logical rules with maximal predictive power and minimal formula complexity. Logical analyses of a real data set are reported and compared with a logistic regression to demonstrate the usefulness of the logical strategies, and to show the complementarity of logical and probabilistic approaches.The first suthor is Senior Research Assistant of the National Fund for Scientific Research (Belgium). We would like to thank the Editor, the reviewers, Seymour Rosenberg, and Luc Delbeke for their helpful comments on earlier drafts of this article.     

Correspondence in children's self-report: Tacting and manding aspects

Four boys and 4 girls (3 to 5 years old) played with as many as three toys chosen from a set of six, and were then asked whether they played with each of the toys. After a baseline in which all children showed high levels of correspondence between reported and actual behavior, reports of play were differentially reinforced, first in an individual and then in a social context. Two children in the individual condition began to report play with all six toys, even though no more than three toys had been played with. When reports of play were reinforced in a group context, 5 children reported play with all six toys. When correspondence was subsequently reinforced, virtually complete correspondence returned and was maintained in a third noncontingent reinforcement condition. Correspondence and lack of correspondence were discussed in terms of self-tacting and distorted tacting or manding.     

求真与致善——荀子正名理论新探

荀子的正名理论不仅接续孔子的正名传统,也有对诸子之学的扬弃,在正名理论中荀子借鉴了名家、墨家的理论,丽他们也是萄子批评最多的。荀子的正名理论主要体现在《正名》篇中。其中他讨论了名的分类、名的作用、制名的原则等,并对“三惑”等不正之名进行了批判。他认为名的主要作用在于“明贵贱”与“辨同异”,“贵贱”关乎价值,“同异”关乎事实,萄子就通过名联接了事实与价值。“辨同异”在乎求“真”,“明贵贱”在乎求“善”,而荀子又认为“明贵贱”高于“辨同异”,从而把名学引向伦理、政治之域。     

又有一项生物学信条受到挑战

生物学上的一条新发现———终末分化的神经细胞和心肌细胞具有分裂增殖的能力,向传统理论提出了挑战。指出了真理受一定时代和范围的限制,具有相对性,我们不能超越客观事实去片面追求完善的真理,又要敢于在新技术手段的支持下,提出新观点,勇于向传统观念挑战     

中国农村合作医疗微观要素机制的演进和变迁

作为中国特色的农民医疗保障制度,中国农村合作医疗70年制度变迁,是适应中国宏观体制机制变迁的结果,是城乡二元经济社会政治体制向一元化体制机制战略转型的“活化石”。合作医疗的参保主体、基金筹集、管理经办和待遇支付等微观要素机制,分别与经济、社会和政治体制的变革耦合与适应,从要素制度的“渐进性”变革起始,牵一发而动全身,带动合作医疗实现整体性制度创新和变迁,构成了合作医疗制度演进和变迁的微观图景,并依此形成了中国农村合作医疗制度变迁的特色逻辑,为解决当下新农合与城居保制度“整而不合”的实践难题提供借鉴路径。