On Nonequivalence of Several Procedures of Structural Equation Modeling

The normal theory based maximum likelihood procedure is widely used in structural equation modeling. Three alternatives are: the normal theory based generalized least squares, the normal theory based iteratively reweighted least squares, and the asymptotically distribution-free procedure. When data are normally distributed and the model structure is correctly specified, the four procedures are asymptotically equivalent. However, this equivalence is often used when models are not correctly specified. This short paper clarifies conditions under which these procedures are not asymptotically equivalent. Analytical results indicate that, when a model is not correct, two factors contribute to the nonequivalence of the different procedures. One is that the estimated covariance matrices by different procedures are different, the other is that they use different scales to measure the distance between the sample covariance matrix and the estimated covariance matrix. The results are illustrated using real as well as simulated data. Implication of the results to model fit indices is also discussed using the comparative fit index as an example. The work described in this paper was supported by a grant from the Research Grants Council of Hong Kong Special Administrative Region (Project No. CUHK 4170/99M) and by NSF grant DMS04-37167.     

Teaching Behaviour Modification Procedures to Parents of Retarded and Psychotic Children: Practical Problems and Issues

Abstract

Practical problems and issues which arise in training parents of retarded and psychotic children in the use of behaviour modification techniques are discussed. The discussion is based on both individual and group attempts at training parents over a two year period. It is concluded that much empirical research is needed to determine the conditions which must be present for 1/ maximally training parents on behaviour modification procedures, and 2/ generalizing their training to the treatment of new behaviour problems.     

Intuition and The Junctures of Judgment in Decision Procedures for Clinical Ethics

Moral decision procedures such as principlism or casuistry require intuition at certain junctures, as when a principle seems indeterminate, or principles conflict, or we wonder which paradigm case is most relevantly similar to the instant case. However, intuitions are widely thought to lack epistemic justification, and many ethicists urge that such decision procedures dispense with intuition in favor of forms of reasoning that provide discursive justification. I argue that discursive justification does not eliminate or minimize the need for intuition, or constrain our intuitions. However, this is not a problem, for intuitions can be justified in easy or obvious cases, and decision procedures should be understood as heuristic devices for reaching judgments about harder cases that approximate the justified intuitions we would have about cases under ideal conditions, where hard cases become easy. Similarly, the forms of reasoning which provide discursive justification help decision procedures perform this heuristic function not by avoiding intuition, but by making such heuristics more accurate. Nonetheless, it is possible to demand too much justification; many clinical ethicists lack the time and philosophical training to reach the more elaborate levels of discursive justification. We should keep moral decision procedures simple and user-friendly so that they will provide what justification can be achieved under clinical conditions, rather than trying to maximize our epistemic justification out of an overstated concern about intuition.     

统筹方法在胃癌根治性全胃切除术程序中的应用效果观察

探讨统筹方法在手术过程中的应用及对手术时间的影响.以2011年6月～2011年10月闻我科行胃癌根治性全胃切除术65例为具体研究对象,36例患者在开腹前、术中、关腹三个过程中应用统筹方法作为观察组,29例患者在上述三个过程中未应用统筹方法,作为对照组,比较两组患者的平均手术时间、平均手术出血量、术后吻合口漏及术后腹腔引流管的渗出量;分析统筹方法对手术进程的影响.观察组平均手术时间98.6 min,对照组平均手术时间150.4min.两组平均手术时间比较具有明显的统计学差异(t=5.647,P=0.028).两组平均手术出血量、术后吻合口漏及术后腹腔引流管的渗出量比较均无统计学差异.统筹方法在手术程序中的应用,能明显缩短手术时间,提高手术效率,降低手术风险.     

Acceptance of Labels for Behavioral Response-Reduction Procedures and the Users of Those Procedures

The Psychological Record - The acceptability of labels for behavioral response-reduction procedures and the users of those procedures was evaluated. Introductory psychology students read a lesson...     

医疗决策的程序公正

由于社会满足不了所有的医疗需求,医疗决策问题变成了确定医疗的限度问题.由于社会对于限度决定很难获得共识,医疗决策要通过公正的程序获得.医疗决策不能由某个人或某个团体或权力机构做出,而应该通过民主协商来做出.否则,人们会质疑医疗决策的合法性.     

医疗决策的程序公正

由于社会满足不了所有的医疗需求,医疗决策问题变成了确定医疗的限度问题。由于社会对于限度决定很难获得共识,医疗决策要通过公正的程序获得。医疗决策不能由某个人或某个团体或权力机构做出,而应该通过民主协商来做出,否则,人们会质疑医疗决策的合法性。     

Just Procedures with Controversial Outcomes: On the Grounds for Substantive Disputation within a Procedural Theory of Justice

Acts of civil disobedience and conscientious objection provide valuable indications of the congruence of political outcomes with citizens’ conceptions of justice and the good. As their primary concern is substantive, their logic seems extraneous to procedural approaches to justice. Accordingly, it has often been argued that these latter condemn citizens to a ‘deaf-and-blind’ acceptance of the outcomes of agreed procedures. A closer analysis of such acts of contestation shall reveal that although, for proceduralism, the outcomes of just procedures cannot be contested as unjust, they may be contested on the ground of values other than justice, such as someone’s religious/ethical allegiances. Proceduralism about justice will be thus shown to be consistent with the commitment to realising certain outcome-oriented values.     

超高龄患者外科手术治疗的思考

80岁以上需要手术的超高龄患者日益增多,但他们合并症多,手术风险大,手术后易发生并发症。做好围手术期的处理及选择简单、有效的手术方式是保证患者生命安全的重要因素。超高龄患者虽然有权利决定是否接受手术,但主要的决定权是由家属掌握。因此,医生与家属的充分沟通也非常重要。     

Non-LIFO Execution of Cognitive Procedures

Many current theories of human problem solving and skill acquisition assume that people work only on the unsatisfied goal that was created most recently. That is, the architecture obeys a last-in-first-out (LIFO) constraint on the selection of goals. This restriction seems necessary for the proper functioning of automatic learning mechanisms, such as production compilation and chunking. It is argued that this restriction is violated by some subjects on some tasks. In particular, 8 subjects (from a sample of 26) execute subtraction procedures in a way that violates the LIFO constraint. Although there is a great deal of between- and within-subject strategy variation in the 8 subjects' behavior, it can be simply explained by hypothesizing that (1) the goal selection is not necessarily LIFO, (2) goal selection knowledge is represented by explicit preferences, and (3) the 8 subjects have just a few preferences that are overgeneralized, overspecialized, or missing. The rest of their preferences are correct. On the other hand, LIFO-based models seem unable to explain the strategy variations in any simple way. Thus, it seems that part of the flexibility in human problem solving comes from having a choice of which goal to work on next. Fortunately, it is simple to ammend automatic learning mechanisms so that they will function correctly in a non-LIFO architecture.     

论个体差异与诊疗决策

诊疗决策最优化的过程,本质上是针对特定的患者,制定最适合其个体差异的决策过程.对个体差异认知方式,经验医学基于对个体的不完全归纳,循证医学基于对群体随机、双盲、对照、大样本,人类基因组学基于对人类基因的差异表达、单核苷酸多态和复制变异的研究.最优化的治疗方案应体现关注患者心理、社会差异、关注生命质量、远离趋利性等人文特征;体现针对个体病患生物学特性差异、个体病程病期和个体最佳疗效差异等科学特征.     

论个体差异与诊疗决策

诊疗决策最优化的过程,本质上是针对特定的患者,制定最适合其个体差异的决策过程。对个体差异认知方式,经验医学基于对个体的不完全归纳,循证医学基于对群体随机、双盲、对照、大样本,人类基因组学基于对人类基因的差异表达、单核苷酸多态和复制变异的研究。最优化的治疗方案应体现关注患者心理、社会差异、关注生命质量、远离趋利性等人文特征;体现针对个体病患生物学特性差异、个体病程病期和个体最佳疗效差异等科学特征。     

Procedures for computerized testing

The concept of tailored testing is defined in general terms and in terms of its major components: item calibration, item selection, and ability estimation. Each of the components is described and the available methods are summarized. The end result is a 12-category classification scheme based on the component parts. Four specific procedures are described. References are presented to suggest that the more adaptive procedures are capable of more precise measurement.     

超高龄患者外科手术治疗的思考

80岁以上需要手术的超高龄患者日益增多,但他们合并症多,手术风险大,手术后易发生并发症.做好围手术期的处理及选择简单、有效的手术方式是保证患者生命安全的重要因素.超高龄患者虽然有权利决定是否接受手术,但主要的决定权是由家属掌握.因此,医生与家属的充分沟通也非常重要.     

Modification of the Reactive Attitudes

In ‘Freedom and Resentment’ P. F. Strawson argues that reactive attitudes like resentment and indignation cannot be eliminated altogether, because doing so would involve exiting interpersonal relationships altogether. I describe an alternative to resentment: a form of moral sadness about wrongdoing that, I argue, preserves our participation in interpersonal relationships. Substituting this moral sadness for resentment and indignation would amount to a deep and far‐reaching change in the way we relate to each other – while keeping in place the interpersonal relationships, which, Strawson rightfully believes, cannot be eliminated.     

Selection Procedures in North America

The selection practices of organizations in Canada and the United States are reviewed. These practices are notable insofar as they rarely represent the most valid procedures, nor do they tend to be based on current research knowledge. Some reasons for the current state of selection and assessment procedures include knowledge of appropriate devices, professional competence, and client limitations. The challenge of complying with human rights legislation in North America is viewed by many practitioners as a selection constraint. It is argued, however, that legal requirements support valid selection practices by demanding professional accountability.     

介入手段与病人安全

卫生保健背景下,影响病人安全有4个基本要素或环节:规范做法、产品、操作和系统.这4个环节中任一出错,都会对病人安全带来直接的损害或不良影响,对它们进行有效控制就会使医疗错误降低到最低限度,使病人获得最大化的安全和收益.探讨介入诊疗手段在这4个方面对病人安全的潜在威胁.