The Construction of Doctor-patient Community with a Shared Future Based on Mencius’ Theory of Original Goodness of Human Nature / 中国医学伦理学

Since the first medical reform, China has carried out three reforms and improvements to the medical system. However, there are still some shortcomings, the problems at different levels are mainly reflected in the doctor-patient relationship. Doctor-patient conflict has become one of the hot topics of social focus. Under the development of the country and the joint efforts of all parties, doctor-patient conflict has been alleviated to a certain extent, and the doctor-patient relationship has been developing in a better direction. With the proposal of the concept of "doctor-patient community with a shared future", the joint construction of a community between doctors and patients has become a further goal. Mencius’ theory of original goodness of human nature echoes the construction of the contemporary doctor-patient community with a shared future. It criticizes the empirical theory of human nature and emphasizes the constructive and initiative of goodness in nature, that is, to achieve goodness in nature through preservation and expansion. In the doctor-patient relationship, goodness in nature is the construction of doctor-patient community with a shared future, which requires both doctors and patients to work together with firm confidence and gradually complete the construction of the community by continuous practice.

Prácticas de gestión humana en zonas de contacto cultural escolarizadas: co-construcciones / Human management practices in areas of schooled cultural contact, co-constructions / Práticas de gestão humana em zonas de contato cultural escolarizado, co-construções

Resumen (analítico) El objetivo de esta investigación es comprender los saberes que construyen los sujetos respecto a las prácticas de gestión humana en las zonas de contacto cultural escolarizadas, como co-construcciones de la investigación social. Los colaboradores fueron seleccionados por su condición de representación en los grupos sociales: presidente del consejo de padres, personera escolar y maestras representantes del consejo directivo. La opción metodológica fue la etnografía colaborativa precedida por dos supuestos antropológicos: colaboración y diálogo de saberes. Las categorías abordadas enfatizan en gestión, humanismo, cultura escolar e identificaciones sociales. La conclusión reconoce como prácticas de gestión humana, derivadas del conflicto y la diferencia social, a la sociología de la ontología política escolar y a los agenciamientos de los estudiantes para socavar o reforzar las identificaciones sociales.

Abstract (analytical) The objective of this investigation is to understand the knowledge that subjects build regarding human management practices in schooled cultural contact zones, as co-constructions of social research. The collaborators were selected for their representation status in the social groups: president of the parents' council, school representative and teachers representing the board of directors. The methodological option was collaborative ethnography preceded by two anthropological assumptions: collaboration and dialogue of knowledge. The categories addressed emphasize management, humanism, school culture and social identifications. The concluding part recognizes as human management practices derived from conflict and social difference, the sociology of the school political ontology and the assemblages of students to undermine or reinforce social identifications.

Resumo (analítico) O objetivo desta pesquiçã é compreender o conhecimento que os sujeitos constroem sobre as práticas de gestão humana em zonas de contato cultural escolarizado, como co-construções da pesquisa social. Os colaboradores foram selecionados pelo seu status de representação nos grupos sociais: presidente do conselho de pais, representante da escola e professores representantes da diretoria. A opção metodológica foi a etnografia colaborativa precedida por dois pressupostos antropológicos: colaboração e diálogo de saberes. As categorias abordadas enfatizam gestão, humanismo, cultura escolar e identificações sociais. A parte conclusiva reconhece como práticas de gestão humana derivadas do conflito e da diferença social, a sociologia da ontologia política escolar e os agenciamentos de alunos para minar ou reforçar identificações sociais.

Practice and reflection on the discipline co-construction in the trusteeship of a Grade Ⅲ traditional Chinese medicine with a district hospital / 中华医学科研管理杂志

Objective:The construction of public medical group is an important strategic measure to deepen the health reform in China. Taking Beijing Traditional Chinese Medicine Hospital as an example, the article introduces the measures, achievements, existing problems and possible development direction of the discipline co-construction in the entrusted district hospital.Methods:The article analyzes the measures of discipline co-construction and its implementation effect in detail.Results:It has effectively promoted the reasonable allocation of resources between " well-developed leading disciplines" and " disciplines to be nurtured" in the medical group, these disciplines entering a new rapid development phase through optimized organization and management, system construction, new research platform construction.Conclusions:" Disciplines to be nurtured" has been improved in medical service, scientific research capabilities, talent training, academic inheritance and quality of scientific research achievements, based on which, the goal of promoting the development of medical group through discipline co-construction was achieved.

Discussion on design of clinical trial scheme for doctor-patient co-construction of traditional Chinese medicine and Western medicine under concept of narrative medicine / 中国中药杂志

With the continuous improvement of modern medical technology, medical practice has become more and more procedural. The medical process is often dominated by doctors, while the value orientation of patients is often ignored, lacking effective communication between doctors and patients. In response to this phenomenon, Charon R proposed the concept of narrative medicine, which has been recognized by all walks of life. In recent years, the value of medical humanism has attracted more attention, and the research on narrative medicine at home and abroad is increasing gradually. But at present, most of the research on narrative medicine is in terms of theory, lacking clinical research. How to make narrative medicine applied in the real world is the focus of current research. Following the concept of narrative medicine, and taking the study on doctor-patient parallel medical record to evaluate the real clinical efficacy of traditional Chinese medicine(TCM) and Western medicine(WM) in the treatment of digestive diseases as an example, this study is to explore the design contents and key points of the clinical trial scheme of doctor-patient co-construction of TCM and WM under narrative medicine, and discuss the activity form and clinical efficacy evaluation method under narrative medicine. Clinical trial design includes four aspects: medicine, ethics, statistics and trial management. This study explored the design of the doctor-patient co-construction clinical trial scheme under narrative medicine from both theoretical and practical aspects, providing reference for the design and research of future doctor-patient co-construction scheme, and expecting to establish a better efficacy evaluation method of TCM and WM.

La psicoterapia como una construcción conjunta del sentido de realidad: un acercamiento a los principios constituyentes de una interacción psicoterapéutica / Psychotherapy as a joint construction of the sense of reality: an approach to the constituent principles of a psychotherapeutic interaction

El desarrollo de una intervención psicoterapéutica compromete un encuentro interaccional, caracterizado por la necesaria conjunción de multiversos que convergen en una esfera dialógica, asociada a la resolución de una problemática o consecución de objetivos por parte de la figura consultante. Es en esta interacción dialógica, donde surgen las dudas sobre si la psicoterapia responde a un encuentro de miradas o bien, a una co-construcción de un sentido de realidad entre terapeuta y consultante, miradas que representan un posible descarte o complementariedad en su propia constitución. Una postura sobre la interacción en psicoterapia necesita establecer una posición activa respecto del rol del terapeuta, nutrida de una visión ontológica que repercuta directamente en un trabajo de interacción discursiva. Asimismo, estaría orientada hacia un propósito metódico que configure los quehaceres de los participantes, como elementos en continuo desarrollo, mas no en una respectiva predefinición. El presente artículo tiene como objetivo desarrollar una propuesta de modelo de integración comunicativa, resultando una oportunidad de convergencia en el encuentro de universos desde una dimensión lingüística de interacción en el desarrollo de un proceso psicoterapéutico.

The development of psychotherapeutic intervention engages an interactional encounter, characterized by the necessary conjunction of multiverses that converge in a dialogical sphere associated with the resolution of a problem or achievement of objectives by the consulting figure. It is in this dialogical interaction, where doubts arise as to whether psychotherapy responds to a meeting of views or, to a co-construction that comprises a sense of reality between therapist and consultant, views that represent a possible discard or complementarity in its own nature. An approach to the interaction in psychotherapy raises the need to establish an active position regarding the role of the therapist, nourished by an ontological vision that directly affects the constitution of a work of discursive interaction. In addition, this position should be oriented towards a methodical purpose that configures the tasks of participants, not as a respective predefinition but as elements in continuous development. The present article aims to propose a communicative integration model, resulting in an opportunity for convergence in the meeting of universes from a linguistic dimension of interaction in the development of a psychotherapeutic process

The Development Strategy and Mode of Co-construction and Sharing Base to Improve the Chinese Herbal Medicine Quality / 世界科学技术-中医药现代化

Chinese medicinal materials occupy an important position in China's health industry. However, its overall quality needs to be improved and it is in urgent need of regulation. Exploring the formation of effective organizational mechanisms and industry models has become an urgent need of the industry. In this context, the alliance of coconstruction and sharing Chinese herbal medicine base came into being. The alliance is based on the pursuit of the quality of Chinese herbal medicines and continues to promote the construction of Chinese herbal medicines. The Alliance provides a platform for economic and scientific cooperation in the industry. Its purpose is to guide the promotion of the standardization of local varieties and the construction of modern Chinese medicine agricultural enterprises based on the development needs of Chinese herbal medicine resources and the common interests of all members. As an important content, we will strive to expand the new pattern of coordinated development of traditional Chinese medicine agriculture and industry, explore the establishment of a new organizational system for modern Chinese medicine agricultural production with controllable quality, output and price under the link of production and demand. For the sustainable, stable and healthy development of the Chinese medicine industry, it will serve 1.3 billion people and serve humanity, provide high-quality sustainable Chinese herbal medicine resources. Since its establishment six years ago, the alliance has carried out work on key aspects such as standardized production of Chinese herbal medicines, plant protection, decoction processing, supply and demand docking, medicinal materials standards, poverty alleviation, breeding, and provided technical support to enterprises. During this period, the alliance also proposed the concept of"three-no and one- all"requires the members to take the lead in achieving the standards of"sulfur- free processing, no aflatoxin pollution, pollution-free, traceable throughout the whole", setting a benchmark for the industry.

Application effect of teachers-student co-construction of skills training team in teaching of nursing skills in higher vocational colleges / 现代临床护理

Objective To explore the effect of the teacher-student co-construction of skills training team in teaching of nursing skills for higher vocational nursing students. Methods About 129 students from grade 12 were enrolled in the control group, where the traditional teaching method was used. Another 136 nursing students from grade 13 were enrolled in the experiment group, where the teacher-student co-construction of skills training team was used. The two groups were compared in terms of test scores on nursing skills . Result The scores of the nursing skill in the experiment group were significantly higher than those of the control group (P < 0.05). Conclusion The implementation of teacher-student co-construction of nursing skills training team can improve the nursing skills of the nursing students, motivate students' initiative and creativity and enhance their sense of responsibility and other comprehensive quality.

Coconstrução da autonomia do cuidado da pessoa com diabetes / Co-constyruction of the healthcare autonomy for person with diabetes / Co-construcción de la autonomía del cuidado de la persona con diabetes

Trata-se de uma pesquisa qualitativa sobre a coconstrução da autonomia do cuidado da pessoa com diabetes, por meio das reflexões dos usuários diabéticos e profissionais de saúde de uma equipe de ambulatório especializado público, localizado num município de médio porte no sul do Brasil. Os dados foram coletados por intermédio de entrevistas semiestruturadas de pessoas com diabetes, profissionais de saúde e uma Roda de Conversa com os profissionais sobre as falas destes usuários. Os dados obtidos foram submetidos à análise de conteúdo, especificamente, a análise temática. A escuta, a clínica ampliada e a cogestão se afirmaram como estratégias potentes para compreender o viver e o lidar com diabetes como um processo singular e compartilhado entre adoecidos e profissionais de saúde, onde a doença faça parte da vida e não a vida parte da doença.

This is a qualitative research on the co-construction of the autonomy of care for individuals with diabetes through the reflections of diabetic users and health professionals in a team of a specialized public clinic, located in a medium-sized municipality in southern Brazil. Data were collected through semi-structured interviews of people with diabetes, health professionals and a conversation meeting with professionals about the discourses of these users. The analysis was guided by content analysis, specifically thematic analysis. Listening, expanded clinical approach and co-management proved to be key strategies to understand and live and copel with diabetes as a singular process by creating strategies shared between disease bearers and health professionals, where the disease is part of life, not life part of the disease.

Se trata de una investigación cualitativa sobre la co-construcción de la autonomía de la persona con diabetes por medio de las reflexiones de los usuarios diabéticos y profesionales de la salud de un equipo de una clínica pública especializada, ubicada en un municipio de tamaño medio en el sur de Brasil. Los datos fueron recolectados a través de entrevistas semiestructuradas a personas con diabetes, profesionales de la salud y una charla con profesionales sobre las narrativas de estos usuarios. El marco analítico de la presente investigación se basó en el análisis de contenido, específicamente el análisis temático. El acto de oír, la co-gestión y la clínica ampliada se colocaron como estrategias clave para entender y vivir con diabetes como un proceso singular que es posible alcanzar mediante la creación de estrategias compartidas entre los enfermos y los profesionales de salud, donde la enfermedad sea parte de la vida, y no la vida de la enfermedad.

A normalização da cesárea como modo de nascer: cultura material do parto em maternidades privadas no Sudeste do Brasil / The normalization of c-section as a way of birth: material culture of birth in private hospitals in Southeastern Brazil

ResumoObjetiva-se discutir o desenvolvimento de uma cultura material em torno do parto e do nascimento em um contexto de utilização maciça de inovações tecnocientíficas e explorar a hipótese da normalização da cesariana como modo de nascer, através da análise de relatos de mulheres que realizaram cesáreas em maternidades privadas do Rio de Janeiro e São Paulo. O procedimento cirúrgico é reapresentado como um modo de nascer seguro, limpo, organizado e compatível com a vida moderna, com o trabalho produtivo intenso e com os impedimentos - sociais e biológicos - de se reproduzir nos modos "antigos", figurando como um evento de continuidade, e não de exceção. Outras necessidades concorrem para a cultura material da cesariana, entre elas a gestão da vida produtiva e reprodutiva, a dimensão sócio-afetiva e o consumo. As mulheres reivindicam para si o poder sobre as escolhas feitas no processo de nascimento dos seus filhos. Vê-se produzir um novo sistema de normas e valores, mais permeável às tecnologias, modelando um novo "natural" para o parto. No contexto mais amplo da biomedicalização da vida e da reprodução, a cesariana reapresenta o parto e o nascimento na sociedade, e reivindica-se como o modo normal de dar à luz.

AbstractThe objective is to discuss the development of a material culture on labor and birth in a context of massive use of technoscientific innovations and explore the possibility of cesarean normalization as a way of being born, by analyzing reports of women who underwent cesarean in private maternity hospitals in Rio de Janeiro and Sao Paulo. The surgical procedure is resubmitted as a way to be born safe, clean, organized and compatible with modern life, with intense productive work and impediments - social and biological - to reproduce the "old" ways, appearing as an event continuity, rather than exception. Other needs contribute to the material culture of cesarean section, including the management of productive and reproductive life, socio-affective dimension and consumption. Women claim for themselves the power over the choices made in the process of birth of their children. It is seen to produce a new system of norms and values, more permeable to technologies, modeling a new "natural" for delivery. In the broader context of biomedicalization of life and reproduction, caesarean delivery represents delivery and birth in society, and it is claimed as the normal way of giving birth.

Cantata a cinco voces: una experiencia de supervisión relacional / Cantata for five voices: an experience in relational supervision

El trabajo está dividido en tres partes. La primera hace un breve recorrido histórico de la supervisión. La segunda parte relata la experiencia personal de supervisión de 4 profesionales y su supervisora abordando algunas diferencias con su aprendizaje previo basado en un modelo neo-kleiniano. Las vivencias personales recorren las expectativas, dudas y angustias producidas por cada modelo y dan vida a través del relato a conceptos centrales del modelo relacional tales como: la emergencia de significado, la co-construcción, momentos de ruptura y reparación, el enactment y la develación además de la importancia del timing y el sostén por parte de la supervisora cuando existe un impasse en la díada de la supervisión. En la tercera parte se describe una situación de impasse entre la supervisora y una de las profesionales. Como sucede en la terapia analítica, dicho impasse ha sido transmitido por vías no verbales y ha involucrado a ambas, supervisora y supervisada. Vemos que en la resolución de dicho impasse, ha sido necesario tener cuidado de mantener el sostén necesario hasta el momento adecuado para poder abordarlo. Se finaliza con algunos comentarios que insertan la experiencia en un contexto de cambio social.

The experience of supervising and being supervised in a relational model setting is described by four psychologists and their supervisor, and compared to their previous training based on a neo-kleinian model. Their journey covers the expectations, doubts and anxieties produced in each period of their learning process and gives life to key concepts in the relational model such as: co-construction of meaning, rupture and repair, enactment and disclosure, as well as the importance of timing and holding during moments of impasse. The paper is divided into three parts. The first is a brief history of supervision. The second describes the experience of the supervisees and the supervisor past and present. The third analyzes a year long impasse involving one of the supervisees and the supervisor, in which timing and holding have been necessary until a better moment is found to disclose verbally what has been experienced in the body and through non verbal means. Concluding comments insert the experience of this supervision in a context of social change.

En primera persona: investigando mundos de los que somos partes / Em primeira pessoa: investigando mundos dos quais somos parte / Investigating worlds we are part of: in first person

El escrito propone algunas reflexiones en torno a los desafíos e interrogantes que se le presentan a los investigadores cuando se arriesgan a abandonar la ilusión de seguridad de colocarse “por fuera” de las dramáticas de su investigación. Los enfoques metodológicos de corte participativo y cooperativo cuestionan la posibilidad y el sentido de protegerse en la neutralidad u objetividad a fin de conseguir rigor y fiabilidad e invitan a considerar el encuentro de investigación sobre otras bases. En este escrito, revisamos algunos de los presupuestos epistemológicos y las dificultades metodológicas y técnicas que se presentan al investigador cuando intenta envolverse en la co-construccion de la investigación, arriesgándose a considerar a los “sujetos” como co-investigadores. Asimismo, se revisan algunas consecuencias de esta mirada sobre la formación de investigadores y se insinúan algunos caminos para cuidar - a la vez - del rigor metodológico y de una ética relacional

Esse trabalho propõe algumas reflexões acerca dos desafios e questões que se apresentam aos pesquisadores quando se arriscam a abandonar a ilusão de segurança de não estarem envolvidos nas tramas de suas investigações. Os enfoques metodológicos de tipo participativo e cooperativo questionam a possibilidade e o sentido de proteger-se na neutralidade ou objetividade a fim de alcançar rigor e confiabilidade e convidam a considerar o encontro entre “pesquisador/pesquisado” em outras bases. Nesse trabalho, revisamos alguns pressupostos epistemológicos e as dificuldades metodológicas e técnicas que se apresentam ao investigador ao tentar envolver-se na construção da investigação e considerar os “sujeitos” como partícipes dessa construção. Nesse sentido, buscamos discutir as conseqüências de tal perspectiva na formação de pesquisadores e indicamos alguns caminhos que articulam a um só tempo rigor metodológico e ética relacional

This article proposes some reflections around the challenges and questions that are presented to researchers when they take the risk to abandoning the illusion of security coming from positioning "outside" of their research. Participatory and collaborative methodological approaches questioned the possibility and the sense to protect the neutrality or objectivity in order to achieve accuracy and reliability and invited to consider the research encounter on other bases. In this paper, we review the basis of some epistemological, methodological and technical difficulties confronted for the researcher when he tries to get involved in the co-construction of research, taking the risk of considered the "subjects" as co-researchers. It also reviews some implications of this view on the training of investigators and we suggest some ways to look for a relational ethics and the methodological conditions

Co-construction and Sharing of Collection Resources among Medical University and Local Hospital Libraries / 医学信息学杂志

The paper discusses the necessity and the feasibility of co - construction and sharing of collection resources among medical university and local hospital libraries, proposes concrete measures of its implementing, including cultivating overall situation awareness, strengthening resources construction and highlighting the characteristics of collections and implementing unified library card.

Interação família-criança: possibilidades de negociação na co-construção da escrita / Interaction family-children: negotiation possibilities in the co-construction of the written

A abordagem sociocultural construtivista destaca a relevância dos processos de negociação presentes nas interações família-criança em contexto de leitura e escrita para a constituição do leitor. Este artigo, parte de um amplo estudo, pretende identificar nas interações família-criança possibilidades de negociação e sua contribuição para a construção do significado do ler e escrever pela criança. O material analisado originou-se de uma situação estruturada realizada com alunos iniciantes do ensino fundamental de uma escola pública do DF e seus familiares. Participaram dos episódios videogravados e selecionados para este trabalho, duas meninas - ambas com sete anos de idade - e suas mães. Uma microanálise dos dados foi realizada, considerando-se os aspectos comunicativos e metacomunicativos das interações entre as díades. Nessas interações observou-se divergências de objetivos que, por sua vez, conduziam a negociações positivas ou a impasses. Este aspecto faz refletir sobre a importância das qualidades das relações humanas para a co-construção da linguagem escrita.

The sociocultural constructivist approach shows the relevance of the negotiation process lived in interactions child-family in context of reading and writing to constitution of the reader. This paper, part of a wider research, tries to identify in the interactions child-family, possibilities of negotiation and its contribution in the construction the meaning of reading and writing by the children. The analyzed subject was extracted of a situation applied to students of the first year of the elementary level of a public school in DF, and with their relatives. Two girls, both with seven years old, and their mothers, were selected and videotaped for this paper. A microanalysis of the data was made, considering the communicative and metacommunicative aspects of the participants interactions. Conflicts on the goal orientation of dyads were observed. These conflicts promoted positive negotiations or real impasses to joint construction of the written language.