晚期乳腺癌原发灶局部处理的若干问题

乳腺癌仍然是严重威胁女性健康的重大疾病。每年新发乳腺癌患者中约有6％为Ⅳ期乳腺癌,而这类患者5年生存率小于20％,局部处理（外科、放疗）可以根除局部病灶及微小转移灶,以延缓或者缓解症状,但是否可以带来生存获益尚无定论。本文对Ⅳ期乳腺癌原发灶的局部处理等方面的若干问题作一综述。     

原发灶切除在转移性乳腺癌治疗中的地位

无论是国内还是世界其他国家,乳腺癌近年来已成为女性常患恶性肿瘤之首。早期乳腺癌通过手术、化疗、放疗及内分泌治疗等综合治疗后可以达到长期生存。然而对于晚期乳腺癌,特别是伴有远处转移的乳腺癌,疗效却不尽如人意。对于转移性乳腺癌,目前治疗优先选择毒性尽可能小的全身系统性治疗方案;而对于需要缓解症状或避免即将发生并发症（如皮肤溃疡、出血、真菌感染以及疼痛等）的情况可于全身治疗后行相应手术。然而对于转移性乳腺癌是否手术切除原发灶以及是否可从手术中获益,仍然充满争议。     

The relationship between purpose and sources of meaning: A mixed methods study

This study examined the relationship between meaning and sources of meaning among a sample of South African university students (N = 139; female = 44 0.6%; mean age = 19.76, SD = 1.82). The students completed the Purpose in Life (PIL), the Sources of Meaning Profile-Revised (SOMP-R) measures, and naïve sketches. Results from the data analysis using correlational and regression analyses indicate the students’ purpose of life scores are accounted for by sources of meaning related to self-transcendence, collectivism, and individualism. The findings from the qualitative analysis highlights the importance of an individualist and collectivist focus during academic studies as a source of meaning. Students who report a more extensive network of meaningful sources are also more likely to indicate higher scores on purpose in life.     

Preventing Depression Among Early Adolescents in the Primary Care Setting: A Randomized Controlled Study of the Penn Resiliency Program

This study evaluated the Penn Resiliency Program's effectiveness in preventing depression when delivered by therapists in a primary care setting. Two-hundred and seventy-one 11- and 12-year-olds, with elevated depressive symptoms, were randomized to PRP or usual care. Over the 2-year follow-up, PRP improved explanatory style for positive events. PRP's effects on depressive symptoms and explanatory style for negative events were moderated by sex, with girls benefiting more than boys. Stronger effects were seen in high-fidelity groups than low-fidelity groups. PRP did not significantly prevent depressive disorders but significantly prevented depression, anxiety, and adjustment disorders (when combined) among high-symptom participants. Findings are discussed in relation to previous PRP studies and research on the dissemination of psychological interventions. An erratum to this article is available at .     

DELAYED REINFORCEMENT OF OPERANT BEHAVIOR

The experimental analysis of delay of reinforcement is considered from the perspective of three questions that seem basic not only to understanding delay of reinforcement, but, also, by implication, the contributions of temporal relations between events to operant behavior. The first question is whether effects of the temporal relation between responses and reinforcers can be isolated from other features of the environment that often accompany delays, such as stimuli or changes in the temporal distribution or rate of reinforcement. The second question is that of the effects of delays on operant behavior. Beyond the common denominator of a temporal separation between reinforcers and the responses that produce them, delay of reinforcement procedures differ from one another along several dimensions, making delay effects circumstance dependent. The final question is one of interpreting delay of reinforcement effects. It centers on the role of the response—reinforcer temporal relation in the context of other, concurrently operating behavioral processes.     

Kant's One World: Interpreting 'Transcendental Idealism'

The relationship between divine and created causality was widely discussed in medieval and early modern philosophy. Contemporary scholars of these discussions typically stake out three possible positions: occasionalism, concurrentism, and mere-conservationism. It is regularly claimed that virtually no medieval thinker adopted the final view which denies that God is an immediate active cause of creaturely actions. The main aim of this paper is to further understanding of the medieval causality debate, and particularly the mere-conservationist position, by analysing Peter John Olivi's neglected defence of it. The paper also includes discussion of Thomas Aquinas's arguments for concurrentism and an analysis of whether Olivi's objections refute his position.     

Descartes on the distinction between primary and secondary qualities

ABSTRACT

Descartes did not use the terms ‘primary’ and ‘secondary’ qualities, but a similar distinction emerges from his texts: certain qualities of objects (such as size and shape) are intrinsic properties of matter, whereas others (like colours and smells) are products of the interaction with a perceiver. A common interpretation states that the division between primary and secondary qualities is explained by the way in which we are acquainted with them: an idea of a primary quality is similar to its physical causes, and it is clearly and distinctly perceived by the intellect. An idea of a secondary quality is dissimilar to its physical causes and it is obscurely and confusedly perceived by the senses. This view receives the name of ‘bifurcation reading’ (Simmons, A. ‘Descartes on the Cognitive Structure of Sensory Experience’. Philosophy and Phenomenological Research, LXVII, no. 3 (November 2003)). While it integrates well some textual occurrences, it creates a problematic fragmentation within single acts of perception. This paper contends that this reading is incorrect. It presents several arguments for the claim that the distinction of qualities is due to the different ways in which our ideas of them misrepresent their physical causes. Then, Descartes’ dissimilarity thesis between physical objects and our ideas of them remains a structural feature of his theory of sensory perception and not a local phenomenon affecting only ideas of secondary qualities.     

学前教育年限与母亲受教育水平对农村一年级 小学生学校适应的影响

研究采用同伴提名法、教师和家长报告法,对农村135名一年级小学生进行了为期一年的追踪调查,在此基础上,考察了学前教育年限、母亲受教育水平与学校适应之间的关系。结果表明:(1)学前教育年限越长,小学生越多地表现出积极社会行为,但这种优势仅体现在小学入学初期;(2)母亲受教育水平越低,小学生越多地表现出敏感退缩行为和受拒绝同伴关系;(3)对于母亲受教育水平较低的小学生,学前教育年限越长,其攻击冒犯行为越多;而对于母亲受教育水平较高的小学生,学前教育年限越长,其攻击冒犯行为越少。可见,母亲受教育水平与学前教育年限相互作用,共同影响儿童发展结果,且母亲受教育水平的影响作用更为明显。     

Online Primary Sources in Religious Studies: Active Learning Exercises for Information Literacy Instruction

Online primary sources are a valuable resource for undergraduate students in religious studies courses. They provide firsthand, factual information about the beliefs and practices of religious traditions, movements, cults, and so on. In addition, they are readily and freely accessible online. Given their value as an information resource, undergraduate students need to be able to identify primary sources and understand how to use them in academic research. The purpose of this article is to describe activities for information literacy instruction that focus on primary sources in religious studies. These activities are intended as a resource for academic librarians who are teaching—or who plan to teach—undergraduate students how to identify and use primary sources.