临床药师问诊与实践体会

问诊是临床医师的基本技能之一.医师通过问诊可以获得病史资料,从而做出临床决策.随着医学模式从传统的生物医学模式向生物心理社会医学模式转变和临床药学的蓬勃发展,药学服务模式从传统的以保障药品供应为中心向以患者为中心模式转变.药师从药房逐步走向临床,参与合理用药和提供药学服务,问诊也应成为临床药师的基本技能之一.本文通过笔者问诊实践,阐述问诊对于临床药师的重要性、药师问诊的内容及其与医生问诊的区别.     

Personality Correlates of Psychological Flow States in Videogame Play

Psychological flow states experienced during videogame play was the topic of this study. Flow is defined as a pleasurable, immersive state experienced when engaged in a challenging task for which one has requisite skills, and has been suggested as the primary reward of videogame play. One hundred eighty-five adult videogame players completed a survey of videogaming patterns, experiences of flow states during videogaming, and a measure of personality traits. Results indicate that individual dimensions of flow were reported as moderately frequent during videogaming, and showed strong coherence in a factor analysis. Personality traits reflecting a high need to learn and low need for activity predicted weekly videogaming hours in a path analysis model. Traits reflecting high need to learn, high need to compete, and low need for activity predicted frequency of videogaming flow experiences. Participant sex predicted flow as well, favoring males. Weekly videogaming hours modestly predicted frequency of flow experiences in a positive direction. Results are generally consistent with previous research on trait and motivational predictors of videogaming as well as supporting theoretical proposals about game-induced flow experiences.     

Affective Expression in Children's Fantasy Play,Primary Process Thinking on the Rorschach,and Divergent Thinking

The relationships among expression of primary process thinking on the Rorschach, affective expression in fantasy play, and divergent thinking were investigated in first and second grade children. Sixty children received the Rorschach (Holt's scoring system), a play task (Affect in Play Scale), and the Alternate Uses Test. Major hypotheses were supported because the amount of primary process thinking on the Rorschach (frequency and percent) was significantly, positively related to amount of affective expression and primary process expression in play. Also, expression of affect in play (frequency, variety, integration, and comfort) was significantly, positively related to divergent thinking, independent of IQ for both boys and girls. On the Rorschach, percent of primary process was significantly related to divergent thinking for boys. The results suggest that the ability to think imaginatively in a free-association style and the ability to have access to affect-laden material are related processes.     

教学设计中的成绩表现和心流体验:基于认知负荷视角

教学设计是为优化教学效果而形成的教学实施方案。为提高学习表现,认知负荷理论认为在组织教学设计时需考虑内、外认知负荷两大因素,但少有研究关注学生在学习过程中的体验。本研究通过单词复合性操纵内在负荷,通过呈现方式操纵外在负荷,探究两类负荷对心流体验及表现的影响。结果发现,内在负荷对心流及表现均有影响,外在负荷仅在低水平组表现出对心流及表现的影响,另外内外负荷在低水平组的表现上存在交互作用。结果表明,教学设计中的内在负荷是影响心流及表现的稳定因素,外在负荷不仅受知识水平影响,其对表现的有效性还受内在负荷的调节。     

实践智慧与实践思维中的范畴错误——从杨国荣教授的实践智慧理论谈起

杨国荣教授在新作《人类行动与实践智慧》中提出一种形而上的实践智慧理论,将事实与价值、理论与实践、实然与应然等概念统一起来。尽管实践智慧的实际运作会综合地涉及诸多方面,但要清晰呈现其内在结构,须首先详尽分析每个方面在实践中的意义和作用。实践活动针对的是复杂异质的经验对象,根据对象的不同可将其大致分为三个最高范畴和六个次级范畴或类型。实践智慧的洞察与判断力就在于分析和判断实践对象应属哪个或哪些范畴,进而以适合该类型的方式筹划实践活动。范畴归属不当便是实践思维中的范畴错误,也就是实践判断的错误。只有以确切的经验分析和判断为前提,杨国荣教授所倡导的形而上的综合性实践智慧才有可能。     

Inverted U-Shaped Function Between Flow and Cortisol Release During Chess Play

This study focused on the salivary cortisol level and its relation to the two components of flow (flow absorption and flow fluency) in tournament chess players exposed to one of the skill-demand-level manipulations (underload, fit, and overload). The aims of this study were to investigate how skill-demand-level manipulations affect cortisol release and how flow and cortisol release are related in the context of an engaging task. Specifically, the task involved fifty-seven tournament chess players playing chess against a software in one of the experimental groups. We assessed flow after chess playing for 25 min via questionnaire and collected saliva before chess playing (T1), right after chess playing (T2), and 10 min after T2 (T3). Our findings show that cortisol levels were affected by the skill-demand-level manipulations. At T3, participants in the overload group showed higher cortisol levels than participants in the fit and underload groups. There were no differences in cortisol release between the experimental groups at T2. In addition, we found the expected inverted U-shaped relation between cortisol release and flow absorption at T2. A moderate level of cortisol was associated with a higher level of flow absorption. In contrast, a higher level of cortisol was associated with a lower level of flow absorption. Against our expectations, flow fluency was not related to cortisol release. We discuss practical and theoretical implications of our results as well as potential for future research.     

Cognitive Complexity Among Practicing Counselors: How Thinking Changes with Experience

The purpose of this study was to investigate whether years of experience in the counseling profession can help predict levels of cognitive complexity among practicing counselors. Results of a regression equation found that counselors with more years in the counseling profession had higher levels of cognitive complexity, with highest degree obtained in the counseling profession also contributing to the prediction equation. Years as a practicing counselor, age, gender, and race did not contribute significantly to the equation.     

Changes in Multidigit Synergies and Their Feed-Forward Adjustments in Multiple Sclerosis

The authors explored the changes in multidigit synergies in patients with multiple sclerosis (MS) within the framework of the uncontrolled manifold hypothesis. The specific hypotheses were that both synergy indices and anticipatory synergy adjustments prior to the initiation of a self-paced quick action would be diminished in the patients compared to age-matched controls. The MS patients and age-matched controls (n = 13 in both groups) performed one-finger and multifinger force production tasks involving both accurate steady-state force production and quick force pulses. The patients showed significantly lower maximal finger forces and a tendency toward slower force pulses. Enslaving was increased in MS, but only in the lateral fingers (index and little). Indices of multifinger synergies during steady-state force production were lower in MS, mainly due to the lower amount of intertrial variance that did not affect total force. Anticipatory synergy adjustments were significantly delayed in MS. The results show that MS leads to significant changes in multidigit synergies and feed-forward adjustments of the synergies prior to a quick action. The authors discuss possible contributions of subcortical structures to the impaired synergic control.     

产品设计领域的消费者审美体验

消费者从产品设计上获得的审美体验会影响他们对产品的感知和购买.审美体验的作用机制涉及神经科学研究、信息处理模型和情感反应过程三部分.具体图形与结构元素、一般化的设计要素、个体因素都会影响消费者对设计的审美体验,而审美体验会进一步通过溢出效应、感染效应和对比效应等方式影响产品性能感知、产品评价和购买意向.未来研究应解决已有研究结果间的矛盾并继续探索美学在消费者行为领域的理论和实践价值.     

网络游戏成瘾:沉浸的影响及其作用机制

本研究以491名男大学生为被试,考察了沉浸对网络游戏成瘾的影响、沉浸的前因变量和相关作用机制。结果发现:(1)网络游戏中的沉浸与网络游戏成瘾呈显著正相关,与控制、挑战呈显著正相关;挑战和控制与网络游戏成瘾呈显著正相关。(2)挑战通过沉浸的完全中介作用对网络游戏成瘾产生影响,挑战对网络游戏成瘾没有直接效应;控制除了通过沉浸的部分中介作用对网络游戏成瘾产生影响,还对网络游戏成瘾有直接效应。     

Information,Experience, and Divergent Thinking: An Empirical Test

ABSTRACT: Divergent thinking tests are often used to estimate the potential for creative problem solving. Scores on these tests may, however, reflect a kind of experiential bias. Similar biases once plagued IQ tests, the idea being that scores reflect the individual's background and information in long-term memory as much as ability per se. The investigation reported here attempted to assess the role of experience, knowledge, and memory in divergent thinking by comparing 2 kinds of tasks. One was a standard divergent thinking task (e.g., "list uses for a shoe," "uses for a brick," "uses for a newspaper"). The other allowed a number of responses but required that the examinee produce factual, knowledge- based responses. A second objective here was to compare standard- and knowledge-based ideation with tasks that shared 1 domain (e.g., transportation) with tasks that did not share a domain. Results indicated that there was a statistically significant correlation between the 2 types of tasks but only when they shared 1 domain. This was confirmed with product–moment correlations (r = .37, p = .025) and a canonical correlation (Rc = .69, p = 008). The correlations were not significant when the tasks represented different domains. It is interesting to note that both the knowledge-based and the standard divergent thinking tasks were unrelated to grade point average, which supports their discriminant validity. Limitations and directions for future research are suggested.     

现代胸腔镜外科实践中的科学思维

现代胸腔镜外科的出现开创了胸外科的新纪元,大大推动了现代胸外科的发展.但现代胸腔镜外科的出现毕竟是一个新鲜事物,主动运用科学的思维方法有助于我们更好地掌握这门先进技术,更充分发挥它的作用.结合自己在现代胸腔镜外科实践中的体会,阐述自觉掌握、运用科学思维方法的重大意义.     

Mother Positivity and Family Adjustment in Households with Children with a Serious Disability

Only limited attention has been given to parent coping resources in the positive adjustment of families of children with a disability. This study is the first to explore maternal positivity as a psychological coping resource related to family adjustment in these families. Consistent with broaden-and-build theory and prior positivity research, positivity was operationalized through a ratio of positive to negative affect scores. We employed longitudinal tracking over a 1 year interval. Children’s diagnostic categories included developmental conditions or impairments, mental health disorders, complex health conditions, physical/motor conditions or impairments, sensory impairments, and provisionally diagnosed conditions or impairments. We used a computer assisted telephone survey to gather psychological, family, and demographic information from 152 mothers in Alberta, Canada. Hierarchical regression analysis indicated mothers’ level of positivity and age, when controlled for family adjustment at Time 1, accounted for 46% of the variance in family adjustment at Time 2. That is, older mothers with higher positivity scores were found to live in households with higher levels of family adjustment after 1 year. These findings provide promising support for broaden-and-build theory, which posits that positive experienced emotions can offset and diminish the negative health and relationship impacts of chronic stress. Study findings support the salience of mothers’ positivity as a psychological coping resource, which is related to enhanced family adjustment in situations of childhood disability.     

浅谈口腔正畸学中临床思维与实践技能的并重

口腔正畸学对临床思维和实践技能均有较高的要求.在口腔正畸医生的成长和发展中,一方面要注意培养临床哲学思维,如整体与局部、理论-实践-理论、限度的问题、发展与联系等观点;另一方面应在临床实践中通过临床前基本技能培训及临床技能训练逐渐夯实其临床能力.通过开展临床病例讨论、专题讲课、病例总结等可进一步有效地将二者结合以提高口腔正畸医生的临床综合业务素质.     

Effects of Developmental Task Constraints on Kinematic Synergies during Catching in Children with Developmental Delays

Abstract

The aim of this study was to examine effects of a task intervention on kinematic synergies in catching. Participants were young children (5.58?±?0.52?years) with the lowest scores on two-hand catching, according to assessments with the Test of Gross Motor Development-2 (TGMD-2) and were allocated into two groups. The constraints group took part in an 8-week intervention, whereas the control group experienced a typical physical education. Both groups were assessed with motor development and kinematic coordination measures with a catching task with a ball thrown from 2?m distance. Kinematic variables were recorded using a wireless motion capture system. A principal component analysis (PCA) was used to measure the kinematic synergies formed among active body parts. Two synergies that emerged in catching were mainly utilised for “reaching” and “catching” the ball. The control group tended to re-organise the majority of active body parts into two functional units in all phases, whereas the constraints group adapted their active parts into functional units according to the requirement of the novel movement in the transfer task. The findings of this study suggested that task constraints could facilitate object control by re-organisation of active body parts into functional synergies to achieve successful performance.