Incomplete holism in pre-registration nurse education: the position of the biological sciences

There is an ongoing debate in nurse education concerning the role and delivery of the biological sciences in the nursing curriculum. One of the fundamental questions raised by this debate asks how best can teachers impart biological knowledge in a manner that can be readily applied by students and qualified nurses to inform their clinical practice. This paper will include a discussion of some of the features of pre-registration education that may have influenced the manner in which biological sciences are perceived, taught and used by nurses. It will be argued that nursing may have developed a form of incomplete holism and that this may be in part responsible for the challenges that remain to be met within this area of the nursing curriculum. As a response to incomplete holism an innovative approach within pre-registration education will be introduced. This development involves the use of linked teaching sessions which aim to develop the analytical skills necessary to apply physiological knowledge to nursing practice.     

中医证候及辨证施治复杂性研究的思路与方法

证候是中医认识疾病和临床诊疗的核心,辨证施治是中医治疗疾病的基本方法。由于证候具有整体性、非线性、动态性以及"不确定性"或"人为因素"等复杂性特征,使得基于整体论、系统论及控制论的"专家系统"成为中医证候复杂性研究的首要手段。并进一步运用还原论的思维方法进行"自上而下"的系统整合和集成,实现对中医证候复杂系统的控制。同时,利用动态模型探索复杂系统的关键特征,在整体观的指导下实现还原论、整体论和系统论的有机融合。基于上述思路,建立基于症候/证候分析、证素提取、证候辨识与分类以及标志物发现等中医证候的评价方法就成为中医证候复杂性研究的重要途径。此外,基于方证相应的中医用药特点,建立面向中医证候及中药复方疗效评价的新方法也是中医证候复杂性研究的重要内容。     

系统中医学指导下重振整体诊疗模式探讨

就中医学整体诊疗模式的临床探索进行理论总结及学术探讨。首先回顾了近年来经典中医学的整体诊疗及其异化,深刻认识到要打破和纠正现代分科诊疗的局限,必须认识和遵循人的生命及其病变的整体性,重振和发展中医学的整体诊疗模式。其次对重振中医整体诊疗的临床探索进行了理论总结,实践证明中医学整体观是中医整体辨证、诊断、调理、养护的理论基础。最后探讨了重振与复兴中医学整体诊疗模式的方法,认为要在系统中医学指导下以天生人观点、元整体观点、系统质观点为核心,发展中医学的现代整体观。并以此为基础,开拓和发展中医的现代化整体诊疗模式。     

Concepts of Localization: Balkanization in the Brain

A spate of recent anti-localizationist publications have re-ignited the old debate about the localization of function. Many of the recent attacks on localization, however, are directed at what I will argue to be a narrow and outmoded view of localization, and thus have little conceptual or empirical impact. What I hope to present here is an analysis of functional localization that more adequately reflects the sophistication and complexity of its use in neuroscientific research, both historically and recently. Proceeding first by way of contrast, I examine theanti-localizationist positions of holism andequipotentiationism. Then, I present a four-fold analysis of localization according to physical scope, physical kind, functional scope, and functional kind. Next, I turn to a discussion of the heuristic value oflocalization in deciphering structure-functionrelationships. Finally, I hope to show that the overall view of functional localization that emerges from these considerations constitutes a much more elusive target than its critics assume. It serves to mitigate, and insome instances even defeat, some forms ofanti-localizationist criticisms.     

Relationships that Heal: Beyond the Patient-Healer Dyad in Mayan Therapy

Biomedicine fosters particular styles of interaction and behaviors, with the therapeutic relationship seen as occurring between a doctor and patient. In contrast, where alternative modalities of healing are practiced, relationships go beyond a dyadic interaction and include wider social networks. In this article, we propose the existence of a ‘therapeutic unit’ in Maya healing practices in Guatemala that binds healer, wellness seeker, family, and community members, along with the spiritual and natural realms, into a coherent system requiring all of these elements to achieve success. Drawing on interviews with 67 Maya healers, we describe healers’ understanding of raxnaq’il nuk’aslemal (well-being), and show how these interactions activate wider networks that play crucial roles during treatments. We highlight how holism is expressed in relationships typical of indigenous healing systems, and how an appreciation of this is important for developing culturally appropriate health care provision systems.     

运用文本挖掘技术研究形神一体观的理论

形神一体观是中医基础理论之一，在中医学的理论体系形成过程中发挥着重要的地位，具有指导临床实践的作用。文本挖掘技术能从大量的文本信息中发现潜在的有价值的信息，将文本挖掘技术运用到形神一体观的理论研究为中医的理论研究提供了一条新的思路。     

王国三临床用药经验

介绍著名中医临床家王国三教授临床用药特点。王老治病用药,务求从整体出发,四诊合参,审查病机,以法治之;强调攻邪而不伤正,正气是战胜邪气的决定因素;久病之人,注重扶正理念,顾护胃气,补养脾胃,补其正气,则病自愈。     

Doctor–patient-interaction is non-holistic

In recent philosophy of mind a non-holistic view on concept possession, originally developed by Tyler Burge, has emerged as an alternative to holistic analyses of language mastery. The article discusses the implications of this view for analyses of communication in doctor—patient-interaction. The central question Burge's theory gives an answer to is this: to what extent must a doctor and a patient understand a medical term in the same way in order to communicate in the sense that they express the same concept by the term? Many empirical studies have shown that patients do not, typically, understand medical terms in the same way as doctors they encounter. Holistic approaches therefore imply that doctors and patients seldom communicate. Burge's position, on the other hand, implies that it is sufficient that patients have a minimal understanding. In an important range of cases doctors can make sure that patients have a minimal understanding by being explicit about common dictionary definitions of the terms in question.

     

A comparison between the ethics of justice and the ethics of care

The parameters of the problem within which the principal aim of the present article will be addressed can be described as follows. When making ethical decisions there are different perspectives that health care professionals may use. This may lead to conflict and insufficient co-operation between the members of the health team. Two of these perspectives are the ethics of justice and the ethics of care. The ethics of justice constitutes an ethical perspective in terms of which ethical decisions are made on the basis of universal principles and rules, and in an impartial and verifiable manner with a view to ensuring the fair and equitable treatment of all people. The ethics of care, on the other hand, constitutes an ethical approach in terms of which involvement, harmonious relations and the needs of others play an important part in ethical decision-making in each ethical situation. To seek some sort of way of avoiding conflict and promoting a mutual understanding about ethical decisions in the health team, there is a need to examine the ethics of justice and ethics of care. In order to understand the ethics of justice and ethics of care, the purpose of this article is to compare the two ethical perspectives. It is argued that the ethics of justice and the ethics of care represent opposite poles. If the members of the health team were to use only one of these two perspectives in their ethical decision-making, certain ethical dilemmas would almost certainly remain unresolved. Both the fair and equitable treatment of all people (from the ethics of justice) and the holistic, contextual and need-centred nature of such treatment (from the ethics of care), ought therefore to be retained in the integrated application of the ethics of justice and the ethics of care.     

The holism of aesthetic knowing in nursing

In 1978, Carper identified 'four fundamental patterns of knowing' that became largely foundational to subsequent epistemological discourse within the nursing discipline. These patterns of empirical, personal, aesthetic, and ethical knowing were presented as conceptually distinct yet related patterns of knowing. In order to provide an alternative conceptualization of aesthetics in nursing, the main tenants of Carper's discussion of aesthetic knowing will be revisited, and the foundations for her arguments will be examined. Specifically, Dewey's Art as Experience will be examined in relation to the 'holism' of nursing, and an alternative position on pragmatic aesthetics in nursing will be offered. A preliminary reintegration of the four patterns of knowing will then be presented as will an example of a potential cultivation of aesthetics in nursing, through an example of Rodin's 19th century sculpture, the Burghers of Calais.