Patient participation in the clinical encounter and clinical practice guidelines: The case of patients’ participation in a GRADEd world

It is widely acknowledged that the patient's perspective should be considered when making decisions about how her care will be managed. Patient participation in the decision making process may play an important role in bringing to light and incorporating her perspective. The GRADE framework is touted as an evidence-based process for determining recommendations for clinical practice; i.e. determining how care ought to be managed. GRADE recommendations are categorized as “strong” or “weak” based on several factors, including the “values and preferences” of a “typical” patient. The strength of the recommendation also provides instruction to the clinician about when and how patients should participate in the clinical encounter, and thus whether an individual patient's values and preferences will be heard in her clinical encounter. That is, a “strong” recommendation encourages “paternalism” and a “weak” recommendation encourages shared decision making. We argue that adoption of the GRADE framework is problematic to patient participation and may result in care that is not respectful of the individual patient's values and preferences. We argue that the root of the problem is the conception of “values and preferences” in GRADE – the framework favours population thinking (e.g. “typical” patient “values and preferences”), despite the fact that “values and preferences” are individual in the sense that they are deeply personal. We also show that tying the strength of a recommendation to a model of decision making (paternalism or shared decision making) constrains patient participation and is not justified (theoretically and/or empirically) in the GRADE literature.     

Divergence of values and goals in participatory research

Public participation in scientific research has gained prominence in many scientific fields, but the theory of participatory research is still limited. In this paper, we suggest that the divergence of values and goals between academic researchers and public participants in research is key to analyzing the different forms this research takes. We examine two existing characterizations of participatory research: one in terms of public participants' role in the research, the other in terms of the virtues of the research. In our view, each of these captures an important feature of participatory research but is, on its own, limited in what features it takes into account. We introduce an expanded conception of norms of collaboration that extends to both academic researchers and public participants. We suggest that satisfying these norms requires consideration of the two groups' possibly divergent values and goals, and that a broad characterization of participatory research that starts from participants' values and goals can motivate both public participants’ role in the research and the virtues of the research. The resulting framework clarifies the similarities and differences among participatory projects and can help guide the responsible design of such projects.     

String theory,Einstein, and the identity of physics: Theory assessment in absence of the empirical

String theorists are certain that they are practicing physicists. Yet, some of their recent critics deny this. This paper argues that this conflict is really about who holds authority in making rational judgment in theoretical physics. At bottom, the conflict centers on the question: who is a proper physicist? To illustrate and understand the differing opinions about proper practice and identity, we discuss different appreciations of epistemic virtues and explanation among string theorists and their critics, and how these have been sourced in accounts of Einstein's biography. Just as Einstein is claimed by both sides, historiography offers examples of both successful and unsuccessful non-empirical science. History of science also teaches that times of conflict are often times of innovation, in which novel scholarly identities may come into being. At the same time, since the contributions of Thomas Kuhn historians have developed a critical attitude towards formal attempts and methodological recipes for epistemic demarcation and justification of scientific practice. These are now, however, being considered in the debate on non-empirical physics.     

States of ignorance and ignorance of states: Examining the Quantum Principal Principle

Earman (2018) has recently argued that the Principal Principle, a principle of rationality connecting objective chance and credence, is a theorem of quantum probability theory. This paper critiques Earman's argument, while also offering a positive proposal for how to understand the status of the Principal Principle in quantum probability theory.     

13-14世纪巴黎大学思辨式基础科学教育模式探析

伴随古希腊学术典籍,尤其是亚里士多德哲学和科学著作在13世纪巴黎大学艺学院的普及和流行,理性批判精神和辩证法思想汇入到传统七艺教学框架中,为思辨式基础科学教育模式的构建奠定了理论基础。注重逻辑思辨的教学理念渗透到讲授和辩论两大教学环节当中,形成了以究问和辩驳论证为典型特征的教学方法,重在培养学生的理性怀疑精神,崇尚自由开放的学术风气,有效地促进了科学研究与人才培养的协同发展。14世纪后半叶,在唯名论思潮的影响下,以布里丹为首的巴黎学派将词项逻辑应用于自然科学教育与研究,逻辑思辨与经验证据相结合的假说性论证成为艺学院自然哲学辩论命题的新导向。     

谁将数年泪高处哭途穷－论吴梅村诗中的明衰亡史

生活在明末清初的诗人吴梅村以诗人兼史家的眼光，诗史结合，给我们勾勒了一幅明亡图，并进行了反省总结。     

福司可林(FSK88)对HL60细胞抑增殖促分化的实验研究

研究了诱导分化剂FSK88对人白血病HL60细胞的抗肿瘤作用，将HL60细胞培养在含不同浓度FSK88的RPMI1640培养液中，测定FSK88对HL60细胞生长曲线、NBT阳性率、ANAE酶活性的影响，探讨了FSK88对HL60细胞裸鼠异种移植瘤体内抗肿瘤作用。结果表明，FSK88能诱导HL670细胞向单核／巨噬细胞方向分化，表现为生长抑制，NBT还原能力提高，酸性非特异性酯酶（ANAE）活性增加；流式细胞仪检测表明FSK88对HL60的诱导作用与细胞所处细胞周期的变化无明显相关性；FSK88可以有效的抑制白血病HL60的致瘤力，可见FSK88能抑制人白血病细胞的生长，促使其进入终末分化及凋亡。     

第六次科技革命的“核心专利争夺”已悄然展开——2001年以来第六次科技革命的十种前兆

2001年以来,关于第六次科技革命的十种前兆涉及自然人、网络人、仿生人和再生人等多个领域。而第六次科技革命的核心专利争夺,主要涉及信息转换器技术、人格信息包技术、仿生技术、创生技术、再生技术等。     

论高校思想政治工作与人本回归

高校思想政治工作存在偏离人本的现象,忽视大学生的主体性、个性发展、自身需要和价值,必须回归到"以人为本"的教育理念上来,科学理解把握高校思政工作"以人为本"的内涵要求,以大学生的需要为出发点,以大学生的发展完善为目的,转变思想观念,将服务主体与教育主体有机统一起来,建立个性化培养制度,引导学生全面发展.     

安全优质猪肉生产技术操作规程

猪肉是人们食物的重要组成部纷,安全优质猪肉是人们追求的目标。安全猪肉产品的产出受饲养、饲料和加工贮运等关键环节的制约,只有对影响其产出各环节的要素实施适当的控制,才能获得安全的猪肉产品。为提高猪肉的质量,开发安全优质猪肉产品,特制定《安全优质猪肉生产技术操作规程》。本标准的各项技术指标是在现有国家标准的基础上,结合猪肉生产和质量控制的实际情况而制定的。本标准的编写按GB/T1.1- 1993《标准化工作导则第1单元:标准的起草与表述规则第1部分:标准编写的基本规定》和GB/T1.1-1997《标准化工作导则第1单元:标准的起草与表述规则第3部分:产品标准编写规定》进行编写。