个人化设计在临床研究中的应用——从个体角度研究个体差异

本文从有关研究证据的基础上,介绍了个人化设计的理论基础和实验设计,并在此基础上讨论了个人化设计在临床研究领域中的应用价值,总结出一种适合临床病人使用的研究程序。个人化设计允许对个体的个人价值进行分析,并能同时研究不同刺激信息的作用,在个体水平上分析个体差异。通过简化了的实验程序,个人化设计为解决临床研究中的问题提供了一种新的思维方式。文中还对相关研究法的局限进行了讨论。     

Aristotle and the tradition of rhetorical argumentation

The first part of this paper contends that argumentation is central and essential to Aristotle's Rhetoric, and recounts a number of arguments in support of that view, particularly the recognition that deliberative rhetoric or the rhetoric of counsel is the primary concern of Aristotle's work. The second part of the paper reviews the work that follows in this present volume to show that the other writers' views fit in perfectly with this thesis.     

Science and politics: Dangerous liaisons

In contrast to the opinion of numerous authors (e.g. R. Rudner, P. Kitcher, L. R. Graham, M. Dummett, N. Chomsky, R. Lewontin, etc.) it is argued here that the formation of opinion in science should be greatly insulated from political considerations. Special attention is devoted to the view that methodological standards for evaluation of scientific theories ought to vary according to the envisaged political uses of these theories.I wish to thank the Alexander von Humboldt Foundation for having supported the work on this paper.     

Work,leisure, and psychological well-being in a sample of young adults

This study of 20 ‘white-collar’ workers aged 20–30 measured motivation, enjoyment and access to various categories of experience in both work and leisure, and examined their relationship with psychological well-being on a number of dimensions. The method used a short questionnaire, psychological scales and the innovatory ‘experience sampling methodology’ (ESM) where respondents answer questions in a diary on the receipt of a signal from a pre-programmed watch or radio pager eight times a day for 1 week. The results show, in line with other studies, that intrinsic motivation in daily life is correlated with happiness but that, not previously reported, when motivation at work is examined both extrinsic motivation and instances where a person had to do the activity but did not wish to be doing something else, i.e. ‘positive motivational change’, are correlated with positive aspects of psychological well-being, while instances where a person wanted to do the activity but wished to be doing something else, i.e. ‘negative motivational change’, correlated with negative aspects. The results also show that enjoyment in both work and leisure correlates with aspects of psychological wellbeing; and that macro ‘flow’ experiences, where high skills and high challenges are perceived as equal, are enjoyable and interesting and come primarily from work. The study also shows that categories of experience considered important for psychological well-being and deemed to come primarily from work can be obtained in leisure. The results are discussed in the context of person—situation interactions and processes, and it is advocated that these should be studied in a variety of samples.     

Does the philosophy of medicine exist?

There has been a great deal of discussion, in this journal and others, about obstacles hindering the evolution of the philosophy of medicine. Such discussions presuppose that there is widespread agreement about what it is that constitutes the philosophy of medicine.Despite the fact that there is, and has been for decades, a great deal of literature, teaching and professional activity carried out explicitly in the name of the philosophy of medicine, this is not enough to establish that consensus exists as to the definition of the field. And even if consensus can be obtained as to what constitutes the philosophy of medicine, this does not mean that it exists as a field.     

Making peace in gestational conflicts

Mary Anne Warren's claim that there is room for only one person with full and equal rights inside a single human skin ([1], p. 63) calls attention to the vast range of moral conflict engendered by assigning full basic moral rights to fetuses. Thereby, it serves as a goad to thinking about conflicts between pregnant women and their fetuses in a way that emphasizes relationships rather than rights. I sketch out what a care orientation might suggest about resolving gestational conflicts. I also argue that the care orientation, with its commitment to the significance of the partial and the particular, cannot be absorbed within standard, impartialist moral theory.     

The utilization of genetic counselors within a newborn screening program

Genetic counselors have participated in the Michigan Newborn Screening Program on a contractual basis since 1988. Their role includes newborn screening education and training, newborn nursery site visits, and monitoring newborn screening in hospitals. Their impact has been to improve the quality of newborn screening services by reducing errors and increasing completion of data fields on newborn screening cards, improving hospital nursery cooperation and problem solving, and enhancing health department response to specific problems.     

Developmental sequences in the age of onset of disruptive child behaviors

Retrospective and prospective reports of the onset of disruptive child behaviors were analyzed in a sample of clinic-referred boys. The younger boys (ages 7–9 years), compared with the older boys (ages 10–12 years), showed the highest level of disruptive behavior and, judging from mothers' reports, had the fastest progression of onsets from less serious to more serious problem behaviors. Despite some overlap, developmental sequences in problem behavior within the domains of hyperactivity/inattention, oppositional behavior, and conduct problems were similar across the two age groups. This was also the case for developmental sequences of overt or confrontive problem behaviors and covert or concealing conduct problems. Sequences of the onset of oppositional behavior and conduct problems were validated through prospective data, based on the information from mothers, teachers, and boys themselves. The implications of the findings are discussed for the formulation of developmental pathways of behavior and the analysis of causal factors.     

Three intensive community-based programs for children and youth with serious emotional disturbance and their families

Systems of care for children with serious emotional disturbance and their families have generally lacked intensive community-based programs. We describe three types of newly established community-based programs in New York State and present a general evaluation plan for determining which programs work for various children and their families. The three community-based programs are Intensive Case Management, Family-Based Treatment, and Family-Centered Intensive Case Management. Process and outcome evaluations are being conducted for each of these programs. These evaluations make use of common intake and termination instruments, based on a minimum data set, standardized assessment instruments, and a common logic model, thus facilitating the comparison of findings across evaluations.     

Minimizing the number of observations: A generalization of the spearman-brown formula

A new method for determining the minimum number of observations per subject needed to achieve a specific generalizability coefficient is presented. This method, which consists of a branch-and-bound algorithm, allows for the employment of constraints specified by the investigator.