治疗决策十题

治疗决策是临床决策中的重要组成部分。为了提高治疗决策水平,临床医生可以从以下几个基本环节入手深究决策依据、明确治疗目标、坚持疗效优化、强调安全第一、注意条件约束、注重时效原则、突出救治重点、减损方案危害、分析失悔程度和了解敏感阈值。     

What Motivational and Awareness Variables are Associated with Adolescents’ Intentions to Go to Bed Earlier?

The aim of the study was to test the motivation and awareness variables of the I-change model as predictors of adolescent intention to go to bed earlier. Questionnaires regarding sleep related motivational and awareness variables were administered to 127 sleep restricted (determined by actigraphy) high school students (12–17 years old). The motivational variables positive attitudes towards sleep and parents setting wake time predicted higher intentions to go bed earlier. The awareness variable sleep related cues to action also predicted higher intentions to advance bedtime. Positive attitudes towards sleep partially mediated the effect of sleep related cues to action on intention to advance bedtime. Future sleep promotion programs should train adolescents to detect cues to go to bed earlier to increase their intentions to go to bed earlier. Adolescents should be assisted to develop positive attitudes towards sleep as to enhance their autonomous motivation to advance their bedtime.     

从认知逻辑视角看西方伦理学的发展

本文希望从认知伦理学的视角出发探讨伦理学的发展,以及人类对道德问题认知的过程与人类一般认知的逻辑之间的一致性。人类认知的逻辑是由概念到判断再到推论的过程,伦理学史由德性伦理学到规范伦理学再到话语伦理学、元伦理学和新德性伦理学的过程,实际上就是人类在道德认知上从概念伦理学到判断伦理学再到推论伦理学最后回归到概念伦理学的过程。     

启新、拓新与创新——论生态伦理学对伦理学的贡献

构建和谐社会,必须弘扬生态伦理,繁荣生态伦理学。生态伦理学对伦理学的贡献功不可没,主要体现为：开辟了伦理学研究的新领域,确立了处理人与自然关系的新原则,培育了人对自然的新态度,对传统思想展开了新的系统批判,明确了人类在自然生活中扮演的新角色,对伦理学基本观念进行了新阐释,制定了人类行为新规范。     

论生态学的马克思主义的人道主义

生态学的马克思主义基于对人类命运的关照,立足人道主义,反对以单纯保护生态为目的的生态中心主义和企图转嫁生态矛盾的生态帝国主义;认为资本主义的生产、分配和消费方式是引发生态危机的根源;要想摆脱已经上升为人和自然之主要矛盾的生态危机,不仅需要建立“无增长的”经济模式,倡导“劳动闲暇一元论”和日常生活的“简朴主义”,根除虚假需求,克服异化消费,使生产过程分散化、民主化和管理科学化,变控制自然为解放自然,提倡技术为全人类服务,使生态学充满人道主义,而且需要根除资本主义生产的利润动机,杜绝独裁主义的政治和生产逻辑,反对技术法西斯主义,最终废除资本主义制度,建立非极权的、更易于生存的、以实现生态与社会和谐发展为目标的“稳态社会主义”。     

The Tragedy of the Commons as an Essentially Aggregative Harm

This article identifies ‘the tragedy of the commons’ as an essentially aggregative harm and considers what agents in such a scenario owe to one another. It proposes that the duty to take reasonable precautions requires that agents make efforts to establish collective solutions to any essentially aggregative harm to which they would otherwise contribute. Baylor Johnson has argued that the general obligation to promote the common good requires that agents make efforts to establish a collective agreement to avert a potential tragedy of the commons. This article agrees with Johnson's analysis but argues that there are also negative duties, which give commons users additional moral reason to take collective action to prevent the destruction of the utility of the commons. These duties link commons users to resolving this particular problem and provide grounds to demand that they make greater efforts to prevent the destruction of the commons compared to bystanders. The article suggests that fulfilling negative duties can require establishing collective institutions with the power to regulate human action and interaction. This analysis could be applied to a range of social problems which result from the aggregation of actions and practices.     

Positive affect and learning: exploring the “Eureka Effect” in dogs

Animals may experience positive affective states in response to their own achievements. We investigated emotional responses to problem-solving in dogs, separating these from reactions to rewards per se using a yoked control design. We also questioned whether the intensity of reaction would vary with reward type. We examined the response (behavior and heart rate) of dogs as they learned to gain access to different rewards: (1) food (2) human contact, and (3) dog contact. Twelve beagles were assigned to matched pairs, and each dog served as both an experimental and a control animal during different stages of the experiment. We trained all dogs to perform distinct operant tasks and exposed them to additional devices to which they were not trained. Later, dogs were tested in a new context. When acting as an experimental dog, access to the reward was granted immediately upon completion of trained operant tasks. When acting as a control, access to the reward was independent of the dog’s actions and was instead granted after a delay equal to their matched partner’s latency to complete their task. Thus, differences between the two situations could be attributed to experimental dogs having the opportunity to learn to control access to the reward. Experimental dogs showed signs of excitement (e.g., increased tail wagging and activity) in response to their achievements, whereas controls showed signs of frustration (e.g., chewing of the operant device) in response to the unpredictability of the situation. The intensity of emotional response in experimental dogs was influenced by the reward type, i.e., greatest response to food and least to another dog. Our results suggest that dogs react emotionally to problem-solving opportunities and that tail wagging may be a useful indicator of positive affective states in dogs.     

Zur Dynamik der Interaktion in der Supervision

The manifold functions of a supervisor in following the course of complex processes together with the trainee, are: ? to keep the goals of the supervision in view, ? to establish a teaching alliance and to support the wish and ambitions of the candidate to learn, ? to build a platform for the complex interactions with the trainee with regard to the dynamics of the training situation and keeping in mind the institutional influences, ? to lay down the setting for the work, ? to explore and to reflect how transference and counter-transference influence the interaction between patient and analyst as well as between trainee and supervisor, ? to examine these interactions together focussing continuously on the interaction between candidate and patient, and to encourage the candidate to do the same on his own, ? to continuously formulate hypotheses about the core conflict, the transference phenomena and resistance of the patient, ? to explore and reflect on the cooperative work.     

Observational learning of two visual discriminations by pigeons: a within-subjects design.

Pigeon's observational learning of successive visual discrimination was studied using within-subject comparisons of data from three experimental conditions. Two pairs of discriminative stimuli were used; each bird was exposed to two of the three experimental conditions, with different pairs of stimuli used in a given bird's two conditions. In one condition, observers were exposed to visual discriminative stimuli only. In a second condition, subjects were exposed to a randomly alternating sequence of two stimuli where the one that would subsequently be used as S+ was paired with the operation of the grain magazine. In a third experimental condition, subjects were exposed to the performance of a conspecific in the operant discrimination procedure. After exposures to conspecific performances, there was facilitation of discriminative learning, relative to that which followed exposures to stimulus and reinforcement sequences or exposures to stimulus sequences alone. Exposure to stimulus and food-delivery sequences enhanced performance relative to exposure to stimulus sequences alone. The differential effects of these three types of exposure were not attributable to order effects or to task difficulty; rather, they clearly were due to the type of exposure.     

推进新时代中国社区心理学新形态建设

建设中国特色的社区心理学是时代的呼唤和要求。在党的二十大精神指引下,新时代中国社区心理学需要坚持中国化时代化的马克思主义为指导以推进理论建设;以新时代社区心理建设为场域,助力社会主义核心价值观培育;构建新时代中国社区心理学服务路径,助推人民共同富裕。总体而言,中国特色社区心理学的理论建设与实践探索需要关注新时代社区发展中涌现出的新问题,提出解决中国社区发展问题的中国办法和中国方案,努力推进中国社区心理学新形态的建设。     

The Prevention of Reading Difficulties

The purpose of this article is to provide practical advice about methods to prevent reading failure that is grounded in the new knowledge we have acquired about reading and learning to read over the past 2 decades. Recent research on reading is used to establish a set of facts about reading and reading growth that is relevant to establishing instructional objectives and methods for the prevention of reading difficulties. Within the context of our current understanding of the reasons many children find it difficult to learn to read, the article also identifies the instructional conditions that need to be in place to prevent the development of reading difficulties in all but a very small proportion of children. The article concludes with a discussion of issues and procedures for the early identification of children who are likely to experience difficulties learning to read.     

The effects of exposure to political and domestic violence on preschool children and their mothers

The purpose of this study was to examine the effects of exposure to political violence on preschool children and their mothers. We explored whether these dyads are different from dyads with no known history of exposure to violence and from mother–child dyads with known exposure to domestic violence. Specifically, we explored differences in mothers' psychological status (depression and anxiety), dyadic emotional availability (EA), children's social information processing, and children's social behaviour, in a sample of 216 dyads divided into three groups (exposure to political violence, no exposure to violence, and exposure to domestic violence). We found evidence to support our hypotheses that children exposed to domestic violence exhibit the highest levels of social maladjustment with smaller but still significant differences between children exposed to political violence and children in the comparison group. As expected, the lowest EA scores were found in the exposure to domestic violence group, followed by dyads in the exposure to political violence group. Dyads belonging to the comparison group (no exposure) exhibited the highest levels of EA. These findings contribute to our understanding of the meaning of exposure to political violence, as well as sharpen the difference between exposure to political and domestic violence.     

Reasons-responsiveness and degrees of responsibility

Ordinarily, we take moral responsibility to come in degrees. Despite this commonplace, theories of moral responsibility have focused on the minimum threshold conditions under which agents are morally responsible. But this cannot account for our practices of holding agents to be more or less responsible. In this paper we remedy this omission. More specifically, we extend an account of reasons-responsiveness due to John Martin Fischer and Mark Ravizza according to which an agent is morally responsible only if she is appropriately receptive to and reactive to reasons for action. Building on this, we claim that the degree to which an agent is responsible will depend on the degree to which she is able to recognize and react to reasons. To analyze this, we appeal to relations of comparative similarity between possible worlds, arguing that the degree to which an agent is reasons-reactive depends on the nearest possible world in which given sufficient reason to do otherwise, she does so. Similarly, we argue that the degree to which an agent is reasons-receptive will depend on the intelligibility of her patterned recognition of reasons. By extending an account of reasons-responsiveness in these ways, we are able to rationalize our practice of judging people to be more or less responsible.     

“Bodyheartminding” (Xin 心): Reconceiving the Inner Self and the Outer World in the Language of Holographic Focus and Field

In this essay, inspired by the somatic turn in philosophy initiated by Richard Shusterman, I want to invoke the language of classical Confucian philosophy to think through the best efforts of William James and John Dewey to escape the mind-body and nature-nurture dualisms—that is, to offer an alternative vocabulary that might lend further clarity to the revolutionary insights of James and Dewey by appealing to the processual categories of Chinese cosmology. What I will try to do first is to refocus the pragmatist’s explanation of the relationship between mind and body through the lens of a process Confucian cosmology. And then, to make the case for James and Dewey, I will return to the radical, imagistic language they invoke to try and make the argument that this processual, holistic understanding of “vital bodyminding” is in fact what they were trying to say all along.     

Aristotle,Kant, and …Facebook? A Look at the Implications of Social Media on Ethics

The purpose of this study was to explore if and how social media might come to bear on people’s understanding of ethics. Participants were asked to complete online surveys regarding social media interaction and respond to 14 scenarios depicting ethical dilemmas. Our results suggest that social media and people’s perceptions of ethics do share a relationship. Specifically, we found that people who reported being exposed to ethical violations on social media were more likely to find our unethical scenarios to be personally unacceptable, to be of lower ethicality, and to react negatively to the content. These findings suggest that mere exposure to ethical violations is enough to produce awareness in people regarding ethical issues, which carries significant implications for ethics education.     

Cultural variations in optimistic and pessimistic bias: do Easterners really expect the worst and Westerners really expect the best when predicting future life events?

The authors compared levels of optimistic and pessimistic bias in the prediction of positive and negative life events between European Americans and Japanese. Study 1 showed that European Americans compared with Japanese were more likely to predict positive events to occur to self than to others. The opposite pattern emerged in the prediction of negative events. Study 2 replicated these cultural differences. Furthermore, positive associations emerged between predictions and occurrence of life events 2 months later for both European Americans and Japanese. Across both studies, results of within-groups analyses indicated that both groups expected negative events to be more likely to occur to others than to self (optimistic bias). In addition, Japanese expected positive events to be more likely to occur to others than to self (pessimistic bias). However, European Americans failed to show the expected optimistic bias for positive events.     

Resilience concepts and findings: implications for family therapy

Resilience is a term used to describe relative resistance to psychosocial risk experiences. There is abundant evidence that there is enormous variation in children's responses to such experiences but research to determine the processes underlying the variations needs to take account of several crucial methodological issues. The findings emphasize that multiple risk and protective factors are involved; that children vary in their vulnerability to psychosocial stress and adversity as a result of both genetic and environmental influences; that family-wide experiences tend to impinge on individual children in quite different ways; that the reduction of negative, and increase of positive, chain reactions influences the extent to which the effects of adversity persist over time; that new experiences which open up opportunities can provide beneficial 'turning- point' effects; that although positive experiences in themselves do not exert much of a protective effect, they can be helpful if they serve to neutralize some risk factors; and that the cognitive and affective processing of experiences is likely to influence whether or not resilience develops. The implications of these findings for family therapy are considered in terms of the need for therapists to look carefully at the ways in which different risk factors interact; to assess and take account of individual differences in susceptibility; to consider the extent to which risk factors impinge on the individual and, in that connection, to note the importance of patterns of social interaction outside as well as inside the family; to appreciate the role of both the peer group and individual characteristics in the development of negative and positive chain reactions; and to pay attention to the ways in which individuals process their experiences.     

Sources of stimulus control during multiple discriminations

Pigeons learned to respond to the middle-sized member of six or seven sets of three stimuli differing in size. The sets were used successively, each serving as the discrimination problem from 10 to 16 times. After attaining criterion with one set, the birds received the others as probes. The number of responses in probes was related to the similarity of the probes to the prevailing discrimination problem. The birds responded either to the probe stimulus to which responding had most recently been reinforced, or to the probe stimulus closest in size to the positive member (S+) of the prevailing discrimination problem. Responses to a middle-sized probe-set stimulus occurred when it was the probe-set member most recently correlated with reinforcement, when it was one of two stimuli closest in size to S+, and when the stimulus closest in size to S+ was a negative member of the discrimination problem. All of the behavior could be explained in terms of control by the absolute sizes of the various stimuli.     

个人目标相关性对非临床抑郁者未来想象的影响

通过两个实验考查了非临床抑郁者未来想象的异常是否受到个人目标相关性的调节。实验1采用未来想象任务, 实验2采用可能性评估范式, 两个实验一致发现, 抑郁倾向者想象未来积极事件的异常, 受到了与个人目标相关性的调节：相对于非抑郁倾向者, 抑郁倾向者对未来与个人目标相关的积极事件的预期减弱, 而对未来与个人目标无关的积极事件的预期则没有表现出异常; 同时还发现, 抑郁倾向者表现出了对未来消极预期的普遍增强, 不受与个人目标相关性的影响。     

Natural sequence of recovery from child post-traumatic amnesia: A retrospective cohort study

The aim of this study was to determine the sequence of skills recovery during post-traumatic amnesia (PTA) in children with moderate to severe traumatic brain injuries (TBIs). Setting: Fifty children aged 8 to 15 years consecutively admitted to a children’s hospital with TBI and PTA>24 were tested in a retrospective cohort study where the main measure was the Westmead PTA Scale (WPTAS). The group analyses show that orientation to time took longer to recover than orientation to person and place, but not memory, while the individual analyses revealed that when orientation to time was grouped with memory, 94% of children recovered orientation to person and place before orientation to time and memory (examiner and pictures). Correlation coefficients between age and the number of days taken to recover skills were not found to be significant. It was established that, in terms of the natural sequence of skills recovery in children aged 8 to 15 years following moderate to severe TBI, recovery of orientation to time is more closely aligned to memory than to orientation to person and place. It was also established that WPTAS items are developmentally appropriate for children aged 8 to 15 years who have sustained TBI. These findings are clinically important because monitoring recovery from PTA both impacts the rehabilitation offered to individuals during acute care and aids discharge planning.