Walter Bradford Cannon: Pioneer of stress research

Walter Bradford Cannon, M.D., made a significant contribution to psychology and medicine with the discovery of the stress response around 1915, setting the cornerstone for psychosomatic medicine. This brief, introductory article etches out the nature of his contribution and sets the stage for Dr. Bradford Cannon to reflect on his father's important professional contributions and personal life in the following article.     

Ethical reflections on the status of the preimplantation embryo leading to the German embryo protection act

Ethical conflicts have always been connected with new techniques of reproductive medicine such as in-vitro fertilization. The fundamental question is: When does human life begin and from which stage of development should the embryo be protected? This question cannot be solved by scientific findings only. In prenatal ontogenesis there is no moment during the development from the fertilized oocyte to a human being which could be recognized as an orientation point for all ethical problems connected with the question of the right to dispose of prenatal life (interruption of pregnancy, research on embryos). The protection of an individual human life must be valid for all in the same manner and from the very beginning on. It must not depend on value judgments or on stages of development, so-called grades of humanity, because these would then become selection criteria. Procreated life must have the right to be born. These were the essential ethical arguments which led to the German Embryo Protection Law.     

THE COSTS OF EATING: A BEHAVIORAL ECONOMIC ANALYSIS OF FOOD REFUSAL

Behavioral economic concepts were applied to the analysis and treatment of pediatric feeding disorders in a clinical setting. In Experiment 1, children who chronically refused food were presented with varying amounts of food on a spoon (empty, dipped, quarter, half, and level). Each child exhibited a different but orderly demand function of response (acceptance, expulsion, and mouth clean) by cost (increasing spoon volume) for a constant pay-off of toys and social interaction. In Experiment 2, physical guidance or nonremoval of the spoon for food refusal was initiated at the smallest spoon volume with low levels of acceptance, and was subsequently introduced at the largest spoon volume with moderate levels of acceptance. Treatment was effective in increasing acceptance, and these effects generalized hierarchically across untargeted spoon volumes. The results of both studies provide preliminary support that increasing spoon volume can be equated conceptually with increasing response effort, and that the change from differential reinforcement to physical guidance or nonremoval of the spoon appears to have altered the elasticity of each child's demand function.     

现代医学发展中人文精神归化必然性的思考

现代医学发展过程中,存在着与人文精神融合的思潮,本文从医学研究特殊性,如何由人文精神去克服“人－医疗科技”之间的异化,风代科学价值观转变等角度,思考、分析了医学向人文复归的必然性。     

USE OF TEXTURE FADING IN THE TREATMENT OF FOOD SELECTIVITY

Children with feeding disorders often display severe food selectivity. For many of these children, consuming highly textured foods may be aversive or potentially dangerous because of frequent gagging. The purpose of this study was to demonstrate the efficacy of texture fading in the treatment of food selectivity displayed by 4 children. Treatment involved the gradual addition of higher textures based on the results of periodic probes. In addition, food acceptance and swallowing were reinforced, while food refusal and food expulsion were placed on extinction. Results showed that all participants successfully advanced to consumption of age-appropriate texture and volume. The results suggest that texture fading with intermittent probes at higher textures may be an effective method for the treatment of food selectivity by texture.     

BEACHES: AN OBSERVATIONAL SYSTEM FOR ASSESSING CHILDREN'S EATING AND PHYSICAL ACTIVITY BEHAVIORS AND ASSOCIATED EVENTS

An integrated system for coding direct observations of children's dietary and physical activity behaviors was developed. Associated environmental events were also coded, including physical location, antecedents, and consequences. To assess the instrument's reliability and validity, 42 children, aged 4 to 8 years, were observed for 8 consecutive weeks at home and at school. Results indicated that four 60-min observations at home produced relatively stable estimates for most of the 10 dimensions. Interobserver reliabilities during live and videotaped observations were high, with the exception of “consequences” categories that occurred in less than 1% of observed intervals. Evidence of validity was provided by findings that antecedents were associated with respective dietary and physical activity behaviors. The five physical activity categories were validated by heart-rate monitoring in a second study. The Behaviors of Eating and Activity for Children's Health Evaluation System is appropriate for studying influences on diet and physical activity in children in a variety of settings.     

CURRENT TRENDS IN THE PHILOSOPHY OF MEDICINE

Abstract. The philosophy of medicine, a developing discipline, is defined as critical reflection on the activity of medicine. The clinical encounter is both its central aspect and the focus for philosophical analysis. The most systematic example of this discipline employs a mixture of empiricism and phenomenology. Systems thought presents an organizing schema by which the philosophy of medicine can move toward a more comprehensive and fundamental analysis of its own agenda, which includes four main topics: understanding the patient-physician interaction, concepts of health and disease, foundations of medical ethics, and the dialogue between medicine and the larger culture.     

21世纪医药卫生发展趋势

２１世纪是知识经济时代。以信息科学和生命科学为先导的信息革命贯穿整个时代,生物技术开创医学保健新纪元。人类基因组计划即将好成,基因奥秘即将被揭开。人们在基因水平上将阐明艾滋病,心血管病的发病机制。基础医学研究的前沿学科是：生物信息学及其带动的医学分子生物学,遗传学,免疫学、内分泌学、药理学和神经科学等。在临床和预防医学领域是：取代医学,器官移植,癌基因工程,老年医学,远程会诊等。预防医学则推动第三     

论中医的科学精神和人文方法

近十几年来中医现代化研究成效不显,以及发生许许多多的争论和困惑的重要原因在于我们对中医的基本性质缺乏一种共识。说中医就是一门科学或者不是科学,是一门经验医学或者是哲学医都会使我们陷于一个难堪的困境。中医具有科学精神,但不具有西方意义上的科学方法,而是用具有中国特色的人文方法实现科学精神的经验知识体系。具有科学精神是一回事,怎样实现这种精神却是另一回事,前者是无国界的,后者却是可以文化多元的。     

从心血管疾病的美国模式看肿瘤的中国模式

近年来,心脑血管疾病和癌症的死亡率在世界范围内已上升至前三位。自从美国通过改变生活方式,以控制心血管疾病的方针以来,心血管疾病的患病率减少了５０％,死亡率降低了２５％,人们称之为心血管疾病的美国模式。与此相应的是上海市癌症俱乐部提出了“群体抗癌”的新模式,倡导了“第四医学”和“第三人生”的新理论,１０年努力的结果,使癌症患者的５年生存率延长了３倍,１０年生存率延长了２－３倍,创造了癌症康复的中国模