医学教育发展的困局与突破

受“大跃进”思维模式影响,我国高等教育由精英化快速过渡到大众化,医学教育呈现出急剧膨胀的发展态势,在教育理念、培养体系、办学模式、学制结构、专业设置、教育质量等方面出现了许多新情况、新问题,陷入了发展困局.面对困局必须更新教育观念,加强统筹协调,推动医学教育科学发展.     

The Council for Accreditation of Counseling and Related Educational Programs: Promoting Quality in Counselor Education

Much has changed for the counseling profession in the 30 years since the founding of the Council for Accreditation of Counseling and Related Educational Programs (CACREP). CACREP, the primary specialized accreditor for the counseling profession, has been an influential participant in the growing recognition and professionalization of counseling. This article offers an overview of CACREP and accreditation and addresses some primary issues confronting CACREP, counselor preparation programs, and, in some instances, overall U.S. higher education.     

The im-possibility of secular critique: The future of religion's memory

The legacy of secular critique, with its Greek, Christian, Kantian, modernist traces, constitutes an aporetic law (or contradiction). That law is this: a critical legacy, if it is critical, can affirm and sustain itself only by trying to separate it from itself (from the very crisis that it is). The legacy or history of ‘religion’ is always a history of such critique. Such a legacy always anticipates critiquing itself, its memory (of whatever kind – racist, sexist, colonialist, nationalist). Such a legacy of critique is always a legacy of crisis. However, the crisis of such a legacy cannot be resolved, because critique, as kairos/krisis (critical/decisive moment), can admit of no resolution. Yet the (secular) history of religion, if it is ever historical, can only be a history of such aporetic critique. Such an aporetic critique will be the heritage of religion's im-possible ¹ ?1. I write the word impossible/impossibility with and without a hyphen. When I hyphenate im-possible, I do so to remain true to Derrida's use of it. The im-possible is irreducible to either possibility or impossibility. Sometimes Derrida also writes the word without hyphenating it, but he still implies such irreducibility. future. It is an im-possible future because it will always be a promise, a promise to separate it from itself, a promise that will remain always deferred, always to come. Today, the promise of this secular critique is (in) democracy with its sovereign ‘decisive’ politics. We can no longer simply critique the (future) legacy of religion, understood this way. To do so is to fulfil that legacy's own messianic wish. This is the aporetic limit of secular critique. To think at the limits of the legacy of the critique of religion is to think the very question of the (secular) history of ‘religion’ and its others, that is, ‘religions’.     

Is there evidence for the use of art therapy in treatment of psychosomatic disorders,eating disorders and crisis? A comparative study of two different systems for evaluation

A comparative study of two different systems for evaluation. Scandinavian Journal of Psychology 53, 47-53. As with any type of treatment the requirement for evidence based practice (EBP) has also affected art therapy (AT) when used as an intervention. This review evaluates the available evidence for using AT for psychosomatic disorders, eating disorders and crisis. The search in Cochrane, Best Practice, AMED, CINAHL, PION, PsycINFO and PubMed from 1987 until now resulted in a huge number of articles but only 32 articles met our criteria for evaluations. The articles were assessed with two evaluation systems, the GRADE system used by the Swedish Council on Health Technology Assessment (SBU) and the US Preventive Services Task Force (USPSTF/Task Force). When comparing the results we found that the GRADE evaluation system rejected the quality in 84% of the 32 studies and the USPSTF/Task Force 41% of these studies. An evidence base for AT was found only according to the criteria of USPSTF/Task Force. Hence, the evidence concept is not explicit, which means that effective treatments run a risk of not being implemented in health care. We suggest a broader view of what constitutes evidence in order to make it possible to include different types of research designs and methods.     

Forging partnerships for mental health: The case of a prefecture in crisis ravaged Greece

Public health and in particular mental health have been severely affected by the multitude of socioeconomic crises experienced by people in Greece. The severe austerity programmes, have reduced access to health services and increased demand for publically funded health care. This paper presents a case study focusing on the impact of these measures on the lives of mental health providers in one prefecture in Crete. Focus group methodology was applied and the data were analysed using thematic analysis. Analyses revealed three superordinate themes that converge at many levels and appear to be going counter to the circumstances: firstly, ‘forging partnerships for mental health’; secondly, ‘extending our reach’; and thirdly ‘transformations in professional identity through praxis’. These themes are discussed using the words of the participants and the relevant literature.     

Bereavement anxieties and health amongst the Australian-Italian Catholic community

This article is based on survey of 269 households in the state of Victoria, Australia. It elicits some useful guidelines for professional caregivers in relation to eight cultural/religious groups including Australian-born Christians and Arab-born Muslims. The focus here is upon the relationships between the Australian Italian community and personal health outcomes during bereavement. The following sub-strata are examined: community differences in relation to grief and loss practices and traditions; the value of religious communal support and counseling; symptomatological differences from psychosocial and educational perspectives; psychopathological/psychiatric symptoms and beliefs and practice concerning the afterlife. Significant differences were revealed between the sexes on such matters as health problems, grief expressions, psychosomatic manifestations, communication with the dead, beliefs in the afterlife and interpretation of the meaning of loss. Differences in these findings will assist professional caregivers who deal with families experiencing personal death loss to broaden their own perspectives on bereavement, offering specific counselling strategies and care-giving interventions.     

THE INTERPLAY BETWEEN RELIGIOUS LEADERS AND ORGAN DONATION AMONG MUSLIMS

Bioethics and health researchers often turn to Islamic jurisconsults (fuqahā’) and their verdicts (fatāwā) to understand how Islam and health intersect. Yet when using fatwā to promote health behavior change, researchers have often found less than ideal results. In this article we examine several health behavior change interventions that partnered with Muslim religious leaders aiming at promoting organ donation. As these efforts have generally met with limited success, we reanalyze these efforts through the lens of the theory of planned behavior, and in light of two distinct scholarly imperatives of Muslim religious leaders, the ?ilmī and the islāhī. We argue for a new approach to health behavior change interventions within the Muslim community that are grounded in theoretical frameworks from the science of behavior change, as well the religious leadership paradigms innate to the Islamic tradition. We conclude by exploring the implications of our proposed model for applied Islamic bioethics and health research.     

Symposium Introduction: Reflexivity in Life Designing Interventions

This article introduces the Symposium on Reflexivity in Life Design Interventions. Eight articles report studies of counseling processes and client operations during life design interventions as well as client feedback during subsequent Interpersonal Process Recall interviews. The Symposium concludes with comments on and discussion of the studies.     

抗抑郁药应用选择的思考

目前市场上可供选择的抗抑郁药越来越多.从系统方法论、医学模式转变和矛盾重点论的角度来阐述临床上应该如何选择用药,才能使治疗效果和医疗费用更符合个体的情况,达到比较和谐的状态.     

医学人文社科系列课程的整合优化及教学模式改革

医学院校人文教育主要存在观念上的唯科学取向、内容上的唯知识取向、方法难输化和组织形式化等弊端。提出促进学科间的交叉融合是高校医学院校人文科学课程改革的根本目的之一.以学科为基础的实质性融合是人文学科体制改革的基本点。