The Perceptions of Lutheran Pastors Toward Prenatal Genetic Counseling and Pastoral Care

The purpose of this study is to explore a theological perspective toward genetic counseling. A survey was sent to 207 ministers within the Evangelical Lutheran Church of America (ELCA), to determine their perspectives toward four different scenarios in a prenatal genetic counseling setting. The four different scenarios included situations involving Huntington disease, Down syndrome, trisomy 18, and anencephaly. Nearly all ELCA Lutheran pastors perceived genetic counseling as beneficial and useful and wanted to be involved in the decision-making process for whether or not to terminate the pregnancy. Their views toward termination of pregnancy varied depending on the severity of the genetic abnormality. Severity in this study was based upon life compatibility. As the severity of the genetic abnormality increased, the percentage of Lutheran pastors who viewed termination as an option increased from 23% (Down syndrome) to 62% (anencephaly). A better understanding of how spiritual leaders view genetic counseling would provide an insight into how genetics and religious beliefs together play a significant role in shaping the decisions of those faced with abnormal pregnancies.     

Antenatal Genetic Testing and the Right to Remain in Ignorance

As knowledge increases about the human genome,prenatal genetic testing will become cheaper,safer and more comprehensive. It is likelythat there will be a great deal of support formaking prenatal testing for a wide range ofgenetic disorders a routine part of antenatalcare. Such routine testing is necessarilycoercive in nature and does not involve thesame standard of consent as is required inother health care settings. This paper askswhether this level of coercion is ethicallyjustifiable in this case, or whether pregnantwomen have a right to remain in ignorance ofthe genetic make-up of the fetus they arecarrying. While information gained by genetictesting may be useful for pregnant women whenmaking decisions about their pregnancy, it doesnot prevent harm to future children. It isargued that as this kind of testing providesinformation in the interests of the pregnantwomen and not in the interests of any futurechild, the same standards of consent that arenormally required for genetic testing should berequired in this instance.     

产前超声检查的相关伦理学思考

超声检查是产前诊断的一项主要检查技术,应坚持将患者的利益放在首位的原则,并且在检查前充分告知孕妇超声检查的安全性及局限性。对知情同意、人工流产及性别鉴定等伦理问题进行了分析。医生应告知孕妇胎儿的异常情况。以便其做出决定。     

糖皮质激素治疗脓毒血症的策略

脓毒症是由感染所致的破坏性的全身炎症反应综合征,进一步发展可导致多器官功能障碍综合征,甚至休克,成为危重患者最主要的死亡原因之一。糖皮质激素是脓毒症的重要辅助药物,其治疗机制在于其抑制机体的炎症反应,但其使用剂量、疗程、时间一直存在争议。本文通过回顾糖皮质激素在治疗脓毒症的发展历程,深入探讨糖皮质激素治疗脓毒血症的治疗策略。     

THE IMPACT OF DEPRESSION ON MATERNAL RESPONSES TO INFANT FACES IN PREGNANCY

Research has suggested that prenatal depression may be associated with disrupted maternal responses to infant stimuli, with depressed pregnant women not showing the bias toward distressed infants as that observed in nondepressed pregnant women. The current study examined the effects of depression on self‐ reported responses to infant stimuli, in early pregnancy. Women with clinical depression (n = 38), and nondepressed women (n = 67) were recruited from a wider cognitive behavioral therapy trial. They completed Maternal Response Scales in which they were presented with images of distressed, neutral, and happy infant faces, with no time limit. The women rated their responses to these images along three dimensions—wanting to comfort, wanting to turn away, and feelings of anxiety—using Likert scales via a computerized task. There was evidence that women with depression in pregnancy showed different responses than did women without depression. Women with depression were substantially more likely to be in the highest quartile for ratings of wanting to turn away, odds (OR) ratio = 4.15, 95% confidence intervals (CIs) = 1.63–10.5, p = .003, and also were substantially less likely to be in the highest quartile for wanting to comfort a distressed infant face, OR = 0.22, 95% CIs = 0.09–0.54, p < .001. Findings are consistent with there being both a heightened avoidant and a reduced comforting response toward distressed infants in depressed pregnant women, providing some support that depression disrupts maternal preparations at a conscious level.     

也论朱子对《周易参同契》的整理

本文系对"朱子删改《参同契》文本说"的回应。该说法认为,朱子以宋代之后才出现的"先天方位"思想作为诠释《参同契》思想的基本方向,为弥合其注释与正文之间的矛盾,朱子有选择地删改了《参同契》的文本。本文对该说的几个主要论据做出回应:针对在朱子之前《参同契》文本不稳定的观点,本文指出,《参同契》文本在唐代已经基本稳定,而唐宋之际阐发《参同契》的文献大量出现,导致了《参同契》与之相混同的现象;针对朱子首次把《参同契》所本无的"先天方位"思想强加到对《参同契》的解释中的说法,本文指出,在朱子之前已有先例以"乾坤坎离"释《参同契》的"牝牡四卦"的说法,而《参同契》本身也是陈抟、邵雍"先天方位"说的思想来源之一;最后,本文还就"朱子删改《参同契》文本说"的具体条目做出了分析,指出其判断多有失误。     

The Association of Children's Nonverbal Decoding Abilities With Their Popularity,Locus of Control,and Academic Achievement

The present study examined the relation between children's abilities to decode the emotional meanings in facial expressions and tones of voice, and their popularity, locus of control or reinforcement orientation, and academic achievement. Four hundred fifty-six elementary school children were given tests that measured their abilities to decode emotions in facial expressions and tones of voice. Children who were better at decoding nonverbal emotional information in faces and tones of voice were more popular, more likely to be internally controlled, and more likely to have higher academic achievement scores. The results were interpreted as supporting the importance of nonverbal communication in the academic as well as the social realms.     

NR3C1基因多态性及单倍型、父母教养方式对青少年焦虑障碍的影响

NR3C1参与HPA轴调节,与应激相关的身心疾病关系密切。以往针对NR3C1与焦虑障碍的研究基本以成人为考察对象,且大多关注负性生活事件等个体层面环境变量。本研究采用病例-对照设计,以238名青少年为被试(焦虑障碍117人,对照121人),旨在考察NR3C1常见位点rs6191、rs6196、rs41423247的多态性、单倍型以及父母不同类型教养方式对焦虑障碍的影响。结果表明rs6191 GG基因型、rs6196 AA基因型、rs41423247 GG基因型与低焦虑障碍风险相关。父母过多的过度保护与冷漠拒绝、父亲过少的温暖关怀可预测较高的焦虑障碍风险。rs41423247多态性与母亲温暖关怀存在交互作用:rs41423247 GG基因型只在母亲温暖关怀较多时能降低焦虑障碍风险,在母亲温暖关怀较少时与焦虑障碍并无显著相关。此外,rs6191-rs6196-rs41423247构成的单倍型GAG与低焦虑障碍风险显著关联,TGC与高焦虑障碍风险显著关联,且二者与母亲温暖关怀、母亲过度保护分别存在交互作用。未来可采用追踪研究,从表观遗传层面探讨教养方式与NR3C1影响焦虑障碍的内在机制。