论药物治疗安全：药疗错误的科学定位与安保革新

面对越来越多的最普遍的一种医疗错误—药物治疗错误,以及由此带给患者的身体损害和经济损失,必须对药疗错误进行科学定位和对患者安全保障体系与措施的革新。本文不在于详尽地论述药疗错误和安保的革新,而是通过对药疗错误的科学定位,提出对药疗错误的预防优先和以医者与患者为中心的药疗安全保障,强调重在研究和应用与药疗安全问题相关的健康信息技术和改变认知与处理药。总的认为:关于药疗安全与药疗错误,执行安全措施的障碍和改善药疗管理的当前和可能的机制以及我们应当知道什么和可以怎样做为好。     

Partial report: iconic store or two buffers?

Selective recall of a subset of letters from a multiletter array declines systematically with increases in the delay of the partial report cue. The issues addressed were (a) whether such a decline is due to progressive loss of location information or to systematic loss of features and (b) whether partial report is the result of a select-then-identify or an identify-then-select process. Instructing the subjects to guess or not to guess had an effect of intra-array, displacement, and extra-array errors. Emphasizing on recall location affected both intra- and extra-array errors. The interstimulus interval manipulation had an effect on extra-array errors as well as on intra-array errors. These observations are contrary to the suggestions that intra-array errors are due to loss of location information and that extra-array errors are indicative of a joint effect on misidentification due to chance and the ratio of extra-array errors to intra-array errors. Some other results are difficult for a dual-buffer model but can readily be accounted for by the orthodox view of the iconic store.     

The selective impairment of phonological processing in speech production

We report the naming performance of a patient (DM) with a fluent progressive aphasia who made phonological errors in all language production tasks. The pattern of errors in naming was strikingly clear: DM made very many phonological errors that resulted almost always in nonword responses. The complete absence of semantic errors and the very low ratio of formal errors relative to nonword errors (1.6:30.3) in DM's performance are discussed in the context of recent claims about the nature of naming deficits in fluent aphasics. We argue that DM's performance makes highly improbable the claim that fluent aphasia results from global lesions affecting all levels of the lexical access system equally.     

Switching between spatial stimulus-response mappings: a developmental study of cognitive flexibility

Four different age groups (8-9-year-olds, 11-12-year-olds, 13-15-year-olds and young adults) performed a spatial rule-switch task in which the sorting rule had to be detected on the basis of feedback or on the basis of switch cues. Performance errors were examined on the basis of a recently introduced method of error scoring for the Wisconsin Card Sorting Task (WCST; Barcelo & Knight, 2002). This method allowed us to differentiate between errors due to failure-to-maintain-set (distraction errors) and errors due to failure-to-switch-set (perseverative errors). The anticipated age differences in performance errors were most pronounced for perseverative errors between 8-9 years and 11-12 years, but for distraction errors adult levels were not reached until 13-15 years. These findings were interpreted to support the notion that set switching and set maintenance follow distinct developmental trajectories.     

Dissociation of inflectional and derivational morphology

A patient is described who makes morphological errors in spontaneous sentence production and in repetition of single words. The great majority of these errors were substitutions of inflectional affixes. The patient did make some derivational errors in repeating derived words but almost never made such errors for nonderived words. The inflectional errors for adjectives and nouns occurred mostly on the plural forms for nouns and adjectives and on the feminine form for adjectives. For verbs, inflectional errors were produced for all tense, aspect, and mood forms. There were no indications that these latter verb features constrained the form of inflectional errors produced. The results are interpreted as support for the thesis that morphological processes are located in the lexicon but that inflectional and derivational processes constitute autonomous subcomponents of the lexicon.     

Speech sound errors in patients with conduction and Broca's aphasia

Speech sound errors exhibited by three conduction and three Broca's aphasic patients on naming and word-repetition tasks were subjected to phonemic and subphonemic analyses. In the conduction aphasic patients, errors occurred equally often on consonants and vowels in both the naming and word-repetition tasks, while in the Broca's aphasic patients errors occurred selectively on consonants. Transposition errors occurred almost as often as substitution errors in the conduction aphasic patients, while substitution errors constituted the majority of errors in the Broca's aphasic patients. The Broca's aphasic patients, as compared to the conduction aphasic patients, exhibited a markedly higher number of substitution errors occurring between phonemes separated by a single subphonemic feature on the naming task. On the basis of these findings, it was hypothesized that the differences in the error patterns of the two types of aphasia reflected differences in the underlying mechanisms of the impairment in each type.     

Visuo-Proprioceptive Matching Errors Are Consistent with Biases in Distance Judgments

People make systematic errors when matching the location of an unseen index finger with that of a visual target. These errors are consistent over time, but idiosyncratic and surprisingly task-specific. The errors that are made when moving the unseen index finger to a visual target are not consistent with the errors when moving a visual target to the unseen index finger. To test whether such inconsistencies arise because a large part of the matching errors originate during movement execution, we compared errors in moving the unseen finger to a target with biases in deciding which of two visual targets was closer to the index finger before the movement. We found that the judgment as to which is the closest target was consistent with the matching errors. This means that inconsistencies in visuo-proprioceptive matching errors are not caused by systematic errors in movement execution, but are likely to be related to biases in sensory transformations.     

The frequency of simultaneous disfluency and phonological errors in children: A preliminary investigation

The frequency of simultaneous disfluency and phonological errors was examined in seven young English-speaking children exhibiting coexisting stuttering and phonological disorders. Data were gathered during 30 minutes of mother-child conversation and analyzed in three parts: (1) stuttering, (2) phonological errors, and (3) stuttering and phonological error co-occurrence. Results indicated that stuttering did not occur more frequently on syllables with phonological errors than on syllables without phonological errors. However, the frequency of disfluency on word-initial consonant clusters with phonological errors was significantly higher than on word-initial consonant clusters without phonological errors. Theoretical and clinical implications are discussed.     

个体完成系列回忆任务时错误类型发展的实验研究

本实验以小学一、三、五年级学生和大学生为被试,选择三种类型的汉字(普通字、形似字和同音字)为实验材料,要求被试完成系列回忆任务。结果发现：各组被试在完成系列回忆任务时,出现了四种错误,即遗漏错误、侵入错误、移动错误和重复错误。其中遗漏错误、侵入错误和移动错误随年级升高而降低;移动错误的相对比例最高,重复错误的相对比例最低。同时还发现同音字引起的错误率明显高于普通字和形似字。     

Sources of error in picture naming under time pressure

We used a deadline procedure to investigate how time pressure may influence the processes involved in picture naming. The deadline exaggerated errors found under naming without deadline. There were also category differences in performance between living and nonliving things and, in particular, for animals versus fruit and vegetables. The majority of errors were visuallyand semantically related to the target (e. celery-asparagus), and there was a greater proportion of these errors made to living things. Importantly, there were also more visual-semantic errors to animals than to fruit and vegetables. In addition, there were a smaller number of pure semantic errors (e.g., nut-bolt), which were made predominantly to nonliving things. The different kinds of error were correlated with different variables. Overall, visual-semantic errors were associated with visual complexity and visual similarity, whereas pure semantic errors were associated with imageability and age of acquisition. However, for animals, visual-semantic errors were associated with visual complexity, whereas for fruit and vegetables they were associated with visual similarity. We discuss these findings in terms of theories of category-specific semantic impairment and models of picture naming.     

Words fail: Lesion-symptom mapping of errors of omission in post-stroke aphasia

Impaired object naming is a core deficit in post-stroke aphasia, which can manifest as errors of commission – producing an incorrect word or a non-word – or as errors of omission – failing to attempt to name the object. Detailed behavioural, computational, and neurological investigations of errors of commission have played a key role in the development of neurocognitive models of word production. In contrast, the neurocognitive basis of omission errors is radically underspecified despite being a prevalent phenomenon in aphasia and other populations. The prevalence of omission errors makes their neurocognitive basis important for characterizing an individual's deficits and, ideally, for personalizing treatment and evaluating treatment outcomes. This study leveraged established relationships between lesion location and errors of commission to investigate omission errors in picture naming. Omission error rates from the Philadelphia Naming Test for 123 individuals with post-stroke aphasia were analysed using support vector regression lesion-symptom mapping. Omission errors were most strongly associated with left frontal and mid-anterior temporal lobe lesions. Computational model analysis further showed that omission errors were positively associated with impaired semantically driven lexical retrieval rather than phonological retrieval. These results suggest that errors of omission in aphasia predominantly arise from lexical–semantic deficits in word retrieval and selection from a competitor set.     

An event-related potential study on the observation of erroneous everyday actions

Recent experiments have demonstrated that error-related negativity (ERN) is not only elicited when people commit errors, but also when they observe others committing errors. The present study investigates whether this observed ERN is also present when participants observe execution errors in an everyday context. Participants observed short sequences of pictures showing steps of everyday actions ending either erroneously or correctly. Participants were instructed to indicate by a delayed response whether the observed action was correctly executed or not. The results showed a large P300 for execution errors compared with the observation of correct sequences, but no ERN activity was found. The present experiment indicates that the detection of execution errors in observation does not rely on the error processing mechanism responsible for generating the ERN. The increased P300 amplitudes suggest a more general monitoring process that signals that the occurrence of unexpected events is involved in the detection of execution errors.     

Running records and first grade english learners: An analysis of language related errors

The purpose of this study was to determine if first-grade English Learners made patterns of language related errors when reading, and if so, to identify those patterns and how teachers coded language related errors when analyzing English Learners' running records. Using research from the fields of both literacy and Second Language Acquisition, we analyzed 123 running records containing 649 errors. Over half (54%) of the errors were determined to be language related and 93% of the LR errors fell into five categories: Inflectional endings, irregular verb tenses, contractions, prepositions and teachers' use of tolds. Numbers of LR errors and non-LR errors were similar within text level bands, and both decreased over time as students became more proficient readers. It is difficult to infer how different types of LR errors influence comprehension. There was inconsistency in teachers' interpretation of language related errors, which underscores the need to increase teachers' understanding of second language acquisition in the service of literacy instruction, and to advance theory regarding English Learners' use of their linguistic resources in language and literacy acquisition.     

Beyond hypercorrection: remembering corrective feedback for low-confidence errors*

Correcting errors based on corrective feedback is essential to successful learning. Previous studies have found that corrections to high-confidence errors are better remembered than low-confidence errors (the hypercorrection effect). The aim of this study was to investigate whether corrections to low-confidence errors can also be successfully retained in some cases. Participants completed an initial multiple-choice test consisting of control, trick and easy general-knowledge questions, rated their confidence after answering each question, and then received immediate corrective feedback. After a short delay, they were given a cued-recall test consisting of the same questions. In two experiments, we found high-confidence errors to control questions were better corrected on the second test compared to low-confidence errors – the typical hypercorrection effect. However, low-confidence errors to trick questions were just as likely to be corrected as high-confidence errors. Most surprisingly, we found that memory for the feedback and original responses, not confidence or surprise, were significant predictors of error correction. We conclude that for some types of material, there is an effortful process of elaboration and problem solving prior to making low-confidence errors that facilitates memory of corrective feedback.     

Visual and haptic matching of perceived orientations of lines

In this study we investigated the perception and production of line orientations in a vertical plane. Previous studies have shown that systematic errors are made when participants have to match oblique orientations visually and haptically. Differences in the setup for visual and haptic matching did not allow for a quantitative comparison of the errors. To investigate whether matching errors are the same for different modalities, we asked participants to match a visually presented orientation visually, haptically with visual feedback, and haptically without visual feedback. The matching errors were the same in all three matching conditions. Horizontal and vertical orientations were matched correctly, but systematic errors were made for the oblique orientations. The errors depended on the viewing position from which the stimuli were seen, and on the distance of the stimulus from the observer.     

Detecting and correcting partial errors: Evidence for efficient control without conscious access

Appropriate reactions to erroneous actions are essential to keeping behavior adaptive. Erring, however, is not an all-or-none process: electromyographic (EMG) recordings of the responding muscles have revealed that covert incorrect response activations (termed “partial errors”) occur on a proportion of overtly correct trials. The occurrence of such “partial errors” shows that incorrect response activations could be corrected online, before turning into overt errors. In the present study, we showed that, unlike overt errors, such “partial errors” are poorly consciously detected by participants, who could report only one third of their partial errors. Two parameters of the partial errors were found to predict detection: the surface of the incorrect EMG burst (larger for detected) and the correction time (between the incorrect and correct EMG onsets; longer for detected). These two parameters provided independent information. The correct(ive) responses associated with detected partial errors were larger than the “pure-correct” ones, and this increase was likely a consequence, rather than a cause, of the detection. The respective impacts of the two parameters predicting detection (incorrect surface and correction time), along with the underlying physiological processes subtending partial-error detection, are discussed.     

Constraints upon word substitution speech errors

We explore the features of a corpus of naturally occurring word substitution speech errors. Words are replaced by more imageable competitors in semantic substitution errors but not in phonological substitution errors. Frequency effects in these errors are complex and the details prove difficult for any model of speech production. We argue that word frequency mainly affects phonological errors. Both semantic and phonological substitutions are constrained by phonological and syntactic similarity between the target and intrusion. We distinguish between associative and shared-feature semantic substitutions. Associative errors originate from outside the lexicon, while shared-feature errors arise within the lexicon and occur when particular properties of the targets make them less accessible than the intrusion. Semantic errors arise early while accessing lemmas from a semantic-conceptual input, while phonological errors arise late when accessing phonological forms from lemmas. Semantic errors are primarily sensitive to the properties of the semantic field involved, whereas phonological errors are sensitive to phonological properties of the targets and intrusions.     

Your mistake is my mistake . . . or is it? Behavioural adjustments following own and observed actions in cooperative and competitive contexts

A social speeded choice-reaction-time task was used to study adaptive behaviours following own and observed actions (errors and correct responses) in cooperative and competitive contexts. After making an erroneous response, the appropriate remedial action to avoid future errors in speeded reaction tasks is to slow down. Consistent with previous results, people indeed slow down following their own errors. Importantly, people who slow down most following own errors also slow down following observed errors in a cooperative situation. In a competitive context, a different pattern was found. People accelerated after errors from their opponent. The current findings demonstrate that the social context determines the way people respond to the errors of others, indicating that the neural systems that control remedial actions are highly flexible. These systems may underlie social adaptive behaviour, enabling people to respond flexibly to other people's actions in a wide variety of social contexts.     

Errors are aversive: defensive motivation and the error-related negativity

The error-related negativity (ERN) is a negative deflection in the event-related potential that is maximal approximately 50 ms after the commission of an error. The ERN is generated in the anterior cingulate cortex, a region of the medial prefrontal cortex implicated in both cognitive and emotional processing. Affective and motivational variables influence the magnitude of the ERN, which suggests that the ERN may relate to emotional or motivational aspects of error detection. In the present study, we evaluated the possibility that errors prime defensive motivational responses, and that the ERN may predict the magnitude of defensive reactivity after errors. We found that (a) the defensive startle response was larger following errors than following correct responses, and (b) the magnitude of the ERN predicted the degree of startle potentiation following errors. Thus, response errors prime defensive motivation-and the ERN predicts individual differences in the aversive response to errors.