浅谈产科镇痛与人文关怀

实施无痛分娩是对每位产妇最贴切的人文关怀,每位产妇都有享受这种关怀的权利,而在我国分娩镇痛仍未普遍采用.通过实际案例及产科镇痛发展史,论证了当今实施产科镇痛的必要性及技术条件的成熟性,剖析了当今实施此技术的人为及社会障碍,并提出了解决这一问题的方法和途径.     

公共卫生与全民的健康意识

SARS事件使公共卫生和全民的健康意识问题成为全社会的焦点问题,现在人们更加关注的是后SARS时代我国公共卫生建设和全民健康意识喜忧参半的现状,也许更有意义的是探讨公共卫生与全民健康意识的关系,明确健康意识的内涵,认清民众的健康误区,重视全民的健康教育.     

Social support,negative social exchange,and response to case formulation-based cognitive behavior therapy

We investigated associations between pretreatment social support, negative social exchange, and slope of weekly symptom change for depression, anxiety, and stress over the course of ideographic, case formulation-based, cognitive behavior therapy. Participants were 74 adults treated in a private practice setting. We used self-report measures to assess social support and negative social exchange at intake and to assess symptoms on a weekly basis. At pretreatment, a higher level of social support was associated with lower levels of depression, and a higher level of negative social exchanges was associated with higher levels of depression and stress. Pretreatment social support was not significantly associated with slope of symptom change. However, a higher level of pretreatment negative social exchanges was associated with steeper slope of change in symptoms of depression and stress during treatment. These findings suggest that the association between pretreatment negative social exchanges and subsequent symptoms may be stronger than that of social support and subsequent symptoms. Additionally, we discuss the possibility that having data on negative social exchanges at the start of treatment may benefit the outcome of ideographic, case formulation-based, cognitive behavior therapy.     

Psychodynamic Psychotherapy Process Research: A quick ride through what you should know about process (research)

This paper gives an overview of psychoanalytic process research, which brings to light the complexity of psychotherapy sessions. This complexity is so rich that many instruments intended to make the process measurable failed in the past because they initially used a strategy of complexity reduction. This method however did not help to further our understanding of the complexity involved. Three former presidents of the Society for Psychotherapy Research (Stiles, Hill, Elliot 2015) decided to solve the following equivalence paradox: many therapies work successfully though they all follow different theories, produce a heterogeneity of processes and often enough a misfit between what theories maintain to be a good process and their realization in the treatment room. As theories are often compared to maps, a driver would wonder which route to take. But therapists‐as‐drivers go undaunted ‐ and nevertheless achieve their goals together with their patients. Norcross and Wampold (2018) found that good therapists invent new therapies with every new patient. They hypothesize that it is because of conversation. This is in accord with the 3 former presidents’ proposal to return to detailed single case analyses including the micro‐analytic power of conversation analysis of which a few insights are outlined in this article.     

Evidence from masked‐priming that initial identification of brand names is via abstract letter identities

Although visual‐word recognition is often assumed to proceed on the basis of case‐invariant letter representations, previous research has shown a role for letter‐case in recognizing brand names. One recent study reported early effects of letter‐case in a brand‐decision task using masked primes (Perea et al., 2015, British Journal of Psychology, 106, 162). The present study attempts to replicate this finding using brand names typically presented in all lowercase (e.g., adidas), all uppercase (e.g., IKEA), or titlecase (e.g., Ford). Across three masked‐priming experiments, we found no advantage for case‐matched identity primes over case‐mismatched identity primes. This finding suggests that brand‐specific letter‐case information does not play a role in the early processing of brand names. However, we observed evidence that case may be used as a cue for making brand decisions, which may explain the effect reported by Perea et al. (2015, British Journal of Psychology, 106, 162).     

Developing Clear and Useful Scoring Procedures for Goal Attainment Scaling in Longitudinal Case Studies

This article examines scoring procedures for Goal Attainment Scaling (GAS) and suggests a new scoring procedure to communicate GAS outcomes in longitudinal studies. Analysis is based on longitudinal case studies that evaluate transitioning from psychiatric institutions to independent living. Five scoring methods are identified: raw scores; sum of score differences; mean scores; T-scores; and graphing raw scores. Graphing raw scores is presented as an alternative method of expressing GAS scores for studies with few participants and multiple time points. This enables easy interpretation of goal attainment, and allows for fluctuation in performance as is typical in clinical practice.     

Logical Argument Structures in Decision-making

Perelman and Olbrechts-Tyteca's practical reasoning theory has attracted a great deal of interest since its publication in 1969. Their most important assertion, however, that argument is the logical basis for practical decision-making, has been under-utilized, primarily because it was not sufficiently operationalized for research purposes. This essay presents an operationalization of practical reasoning for use in analyzing argument logics that emerge through group interaction. Particular elements of discourse and argument are identified as responding to principles put forward by Perelman and Olbrechts-Tyteca, and are viewed as fitting together in a kind of logical argument structure that is well suited to the study of practical arguments in decision-making. Both the content elements and the logical argument structure are illustrated using examples from two studies examining decision logics in public participation and jury decision-making. Advantages of this approach and proposed recognition of a new `filtered' type of argument structure are discussed.     

Computational aspects of the greatest lower bound to the reliability and constrained minimum trace factor analysis

In the last decade several algorithms for computing the greatest lower bound to reliability or the constrained minimum-trace communality solution in factor analysis have been developed. In this paper convergence properties of these methods are examined. Instead of using Lagrange multipliers a new theorem is applied that gives a sufficient condition for a symmetric matrix to be Gramian. Whereas computational pitfalls for two methods suggested by Woodhouse and Jackson can be constructed it is shown that a slightly modified version of one method suggested by Bentler and Woodward can safely be applied to any set of data. A uniqueness proof for the solution desired is offered.The authors are obliged to Charles Lewis and Dirk Knol for helpful comments, and to Frank Brokken and Henk Camstra for developing computer programs.     

Critiques of Casuistry and Why They Are Mistaken

Casuistic methods of reasoning in medical ethics have been criticized by a number of authors. At least five main objections to casuistry have been put forward: (1) it requires a uniformity of views that is not present in contemporary pluralistic society; (2) it cannot achieve consensus on controversial issues; (3) it is unable to examine critically intuitions about cases; (4) it yields different conclusions about cases when alternative paradigms are chosen; and (5) it cannot articulate the grounds of its conclusions. Two main versions of casuistry have been put forward, and the responses to these objections depend in part on which version one is defending. Jonsen has advocated a version modeled on the approach to casuistry used by moral theologians in the 15th and 16th century, involving comparison of the case at hand with a single paradigm and a lineup of cases. The present author has advocated another version, drawn from experience with cases in clinical ethics, which involves comparing the case at hand with two or more paradigms. Four of the five objections are unsuccessful when directed against Jonsen'sapproach, and all of them are unsuccessful when directed against the approach involving comparison with two or more paradigms.