哈佛医学院医学人文课程体系设置探析

哈佛医学院医学人文课程体系较为完整系统.以描述哈佛医学院必修课课程设置为主体,从基础医学教育阶段的职业导论、病人—医生Ⅰ与病人—医生Ⅱ、社会与人口科学相关课程以及医学探索四大类课程和临床见习与实习阶段的病人—医生Ⅲ、临床管理相关课程以及凯普斯课程三大类课程出发,分别对各门课程的主要内容、课时安排、教学方法、评价方式等进行阐述.并以介绍十六大类五十余门选修课的课程设置为补充,剖析哈佛医学院医学人文课程体系发展现状.提出改革必修课程、完善选修课程、促进医学人文教育与专业教育整合的几点建议.     

基于伦理学视域的失能老人照护服务体系研究

研究失能老人照护服务体系问题,对于保障失能老人的生命尊严与生存权利、促进社会和谐发展等具有重要意义.基于失能老人生存需要的服务供给、人才培养、制度安排、组织监管等问题,是照护服务体系构建的基本元素.坚持人本理念以及资源配置的公平、公正与效益目标,是照护服务体系构建的伦理原则.     

The CARE System in Its Importance in Dealing with Today's Crises1

The CARE system is a gift from Mother Nature, we have it in our biological heritage; it enables us humans—as a basic gift—to help each other in a large, life-serving context, and thus also to counterbalance destruction. It is about a basic human ability, linked to typical behaviour, but also about a basic human need for connectedness. In this paper, I would like to show how the CARE system can be activated as a collective attitude. The CARE system is strengthened by positive emotions. We are currently being affected by many crises and this triggers fear. How can we deal with this better? Fear is countered with hope and the associated positive emotions such as joy, awe, kama muta and others. These emotions and feelings can be consciously encouraged and placed alongside the feelings of fear. But also, when we share the feelings of grief with each other, it triggers an attitude of CARE. We can grieve together for the various experiences of loss that we go through—but we can also imagine together how we envisage a future that is worth living for everyone. An attitude in the sense of CARING has been practised in friendship for thousands of years. It would therefore be possible to move away from an attitude of competing and outdoing, to an attitude not only of recognition, care, and solidarity in human interaction, but also in our connection with nature.     

动物和人类的利他本性:共情的进化

共情指个体感知或想象其他个体的情感,并部分体验到其他个体感受的心理过程.利他指以增加其他个体的福利为最终目标的动机.共情起源于动物的亲代养育行为,其神经基础来源于古老的情感系统.共情从动物低水平的情绪感染逐渐进化到同情关注以及观点采择共情.另外,共情具有良好的环境适应性.未来可以进一步研究动物与人类的共情和利他行为的异同,加大研究动物的高级共情能力和利他行为以及深入研究共情受社会因素的调节机制.     

当代中国临床医学伦理准则建设论纲

我国当代临床医学伦理准则亟待出台，建设时机现已水到渠成，为积极参与这项重要的建设工程，本文提出了找准现实生长点为根本课题的基本建设思路，并以病人中心准则为核心探索性地设计出了准则体系。     

Differential acetylcholine release in the prefrontal cortex and hippocampus during pavlovian trace and delay conditioning

Pavlovian trace conditioning critically depends on the medial prefrontal cortex (mPFC) and hippocampus (HPC), whereas delay conditioning does not depend on these brain structures. Given that the cholinergic basal forebrain system modulates activity in both the mPFC and HPC, it was reasoned that the level of acetylcholine (ACh) release in these regions would show distinct profiles during testing in trace and delay conditioning paradigms. To test this assumption, microdialysis probes were implanted unilaterally into the mPFC and HPC of rats that were pre-trained in appetitive trace and delay conditioning paradigms using different conditional stimuli in the two tasks. On the day of microdialysis testing, dialysate samples were collected during a quiet baseline interval before trials were initiated, and again during performance in separate blocks of trace and delay conditioning trials in each animal. ACh levels were quantified using high-performance liquid chromatography and electrochemical detection techniques. Consistent with our hypothesis, results showed that ACh release in the mPFC was greater during trace conditioning than during delay conditioning. The level of ACh released during trace conditioning in the HPC was also greater than the levels observed during delay conditioning. While ACh efflux in both the mPFC and HPC selectively increased during trace conditioning, ACh levels in the mPFC during trace conditioning testing showed the greatest increases observed. These results demonstrate a dissociation in cholinergic activation of the mPFC and HPC during performance in trace but not delay appetitive conditioning, where this cholinergic activity may contribute to attentional mechanisms, adaptive response timing, or memory consolidation necessary for successful trace conditioning.     

Formation par alternance : expérience scolaire et rapport à l’apprendre chez des apprentis de niveau V et leurs maîtres d’apprentissage

This qualitative research in line with a socio-constructivist approach of the relation to knowledge aims at studying the conditions of efficiency of apprenticeship (training centre/working place) for wage-earning apprentices with a level V. The thematic analysis of 38 interviews (19 apprentices and 19 apprenticeship masters) reveals that apprentices and apprenticeship masters develop some similar schooling experience and relations to learning based on a massive rejection for any schooling form of transmission. We thus show that an apprenticeship based on work and study can offer young people the opportunity to reinvest their relation to learning but only under the conditions of finding ways to escape the circle of school condemnation. These young people must also be able to find in this system the necessary conditions which will give a meaning to their experience of apprentices.     

Recombinative reading derived from pseudoword instruction in a miniature linguistic system

A miniature linguistic system was used to study acquisition of recombinative symbolic behavior. Three studies evaluated the teaching conditions of conditional discriminations with printed and spoken pseudowords that could potentially generate recombinative reading. Fifty-four college students across all studies learned to match 12 printed pseudowords to 12 spoken pseudowords. Some also matched pictures to the same spoken words. Each two-syllable pseudoword was formed by symbols from an arbitrarily created alphabet composed of four vowels and four consonants. Letters had univocal correspondence with phonemes. Recombinative receptive reading, comprehensive reading, and textual responding to pseudowords were periodically assessed. Experiment 1 (n = 20) showed that recombinative reading increased as the number of trained words composed of the same symbols increased. Experiment 2 (n = 14) showed that overtraining the same two words did not produce recombinative reading for most participants. Experiment 3 (n = 20), in which training with pictures was omitted, showed that elemental control by within-syllable units can develop even when the trained pseudowords are meaningless (not related to pictures). The present results support the utility of the miniature linguistic system methodology for identifying and controlling environmental determinants of rudimentary reading skills.     

心理模拟在语言理解中的作用

心理模拟在语言理解中的作用逐渐受到人们重视。相关理论包括知觉符号系统理论、语言的神经理论和语言与情境模拟理论。行为研究发现感知觉运动信息与语言理解存在交互作用,而脑机制研究显示感知觉运动脑区参与语言理解。目前的研究对于心理模拟参与语言理解的机制仍缺乏细致探讨,导致结果存在矛盾之处。对隐喻语言里心理模拟作用的探讨也需加强。此外,心理模拟系统如何与语言学信息交互作用的相关假设也需要完善。     

Integrating personality, daily life events and emotion: Role of anxiety and positive affect in emotion regulation dynamics

We investigated the roles of anxiety and positive affect in emotion regulation, looking simultaneously at personality, daily life events, and affects. We hypothesized that individual differences in the temporal dynamics of affective experience related to trait anxiety would manifest themselves both in affective responsiveness to life events and in homeostatic regulatory forces. Data were collected from 49 adults, who rated their affective state three times a day over a 40-day period. Data were analyzed using a dynamical system model and graphical representations in the form of vector fields. Results showed that anxiety chiefly interacted with home base (attractor) positions as a function of life events. It also influenced the shape of positive affectivity trajectories in response to negative events.