医务人员对医患共同决策辅助工具的态度研究

循证医学实践要求在临床决策中整合最佳临床研究证据、医者经验、患者自身价值取向与所处具体临床情境。使用决策辅助工具进行医患共同决策可作为一种实践模式,有必要了解来自临床一线医务人员的态度。采用多阶段分层抽样方法,于国内11省及3个直辖市共32个城市的51所二级和三级医院发放问卷,探究使用决策辅助工具促进共同决策实施的可能性。对1 212份问卷的分析显示,73.2%的医务人员认可患者是高质量临床决策的参与主体;支持患者获知诊疗决策依据、认同患者决策辅助工具的积极效果与高学历等正相关。     

诉讼实践视野下病历真实性的认定

在医疗损害纠纷诉讼实践中,经常发生由于医疗机构提供的病历存在真实性问题导致鉴定不能,最后被法院直接推定存在过错的情形。该文在诉讼实践视野下,通过分析病历出现真实性问题的原因,厘清病历瑕疵与真实性问题的区别,并建议从证据学角度进行严格审查或委托专业机构对病历真实性进行鉴定,但同时可能会增加诉讼的成本,耗费诉讼的时间,使医疗损害案件的审理更加复杂、漫长,甚至会继续激化医患矛盾。从长远看,就需要国家相关部门对医疗机构病历真实性制定统一的规范及认定标准,既做到专业、公平、合法,又能简化诉讼程序。     

中国情境下的关系自我和群体自我区分研究

通过两个研究探索中国情境下关系自我和群体自我的区分。研究一通过问卷调查发现在外显层面被试的关系自我和群体自我是独立的结构;女性被试的关系自我水平要高于群体自我。研究二通过单靶内隐联想测验(Single Target Implicit Association Test,ST-IAT)发现在内隐层面,相对于群体自我,中国情境下的被试具更倾向从人际关系角度定义自我。同时,研究二也发现外显关系自我和内隐关系自我二者是独立的结构;外显群体自我和内隐群体自我二者是独立的结构。最后,文章讨论了研究对自我建构领域的贡献。     

浅析《太平经》中的"治国"思想

本文先引述了<太平经>的版本问题,进而简要分析了其成书时期、著者、思想来源以及其主要内容.在此基础上,提出了<太平经>中的"治国"所运用的"三"和"承负"两种思想,最后将其"治国"思想归结到君、臣、民"三合相通","立致太平"上.     

华西圣教书会的文字事工及其影响(1899-1919)

华西圣教书会于1899年初成立于重庆,存续40余年,于1941年关闭,是基督教在华西地区最重要的文字机构之一①.本文以清末民初为时限,考察华西圣教书会成立过程及其出版、发行状况,并分析基督教文字事业对华西社会变迁所起到的重大作用.     

Development and validation of a Coping with Discrimination Scale: factor structure, reliability, and validity

Four studies were conducted to develop and validate the Coping With Discrimination Scale (CDS). In Study 1, an exploratory factor analysis (N = 328) identified 5 factors: Education/Advocacy, Internalization, Drug and Alcohol Use, Resistance, and Detachment, with internal consistency reliability estimates ranging from .72 to .90. In Study 2, a confirmatory factor analysis (N = 328) provided cross-validation of the 5-factor model as well as evidence for validity of the scale. The validity evidence was similar across racial groups and for males and females. In Study 3, the estimated 2-week test-retest reliabilities (N = 53) were between .48 and .85 for the 5 factors. Education/Advocacy, Internalization, Drug and Alcohol Use, and Detachment were positively associated with active coping, self-blame, substance use, and behavioral disengagement, respectively, providing further support for validity of the CDS. Finally, incremental validity evidence was obtained in Study 4 (N = 220), where it was shown that the CDS explained variance in outcome variables (i.e., depression, life satisfaction, self-esteem, and ethnic identity) that could not be explained by general coping strategies.     

Determinants of Standard Errors of MLEs in Confirmatory Factor Analysis

This paper studies changes of standard errors (SE) of the normal-distribution-based maximum likelihood estimates (MLE) for confirmatory factor models as model parameters vary. Using logical analysis, simplified formulas and numerical verification, monotonic relationships between SEs and factor loadings as well as unique variances are found. Conditions under which monotonic relationships do not exist are also identified. Such functional relationships allow researchers to better understand the problem when significant factor loading estimates are expected but not obtained, and vice versa. What will affect the likelihood for Heywood cases (negative unique variance estimates) is also explicit through these relationships. Empirical findings in the literature are discussed using the obtained results.     

Application of the stagnant stage concept for monitoring Mn partitioning at the austenite-ferrite interface in the intercritical region for Fe–Mn–C alloys

The length of the stagnant stage during the new ferrite growth starting from a mixture of austenite and ferrite has been investigated for a Fe-0.17Mn-0.023C (wt%) alloy. It was found that the stagnant stage depends on the thermal path followed to create the mixture, and deduce that the tie-lines for austenite to ferrite transformation are quite different from those for ferrite to austenite transformation. The length of the stagnant stage is determined by the very local partitioning effect at the interface, and it can be used as a tool to monitor the Mn partitioning.     

Detrimental effect of cellular precipitation on the creep strength of Inconel740H

Cellular precipitation (also known as discontinuous precipitation) has been observed at the grain boundaries of a newly developed nickel-based Inconel740H alloy designed for use at 700?°C in advanced ultrasupercritical coal-fired power plants. By means of element mapping and selected area diffraction, the cellular precipitates were identified as Cr-rich M₂₃C₆ carbides. The onset of cellular precipitation was found to follow a pucker mechanism in Inconel740H. The cellular precipitates at the grain boundaries, even at low volume fractions, were severely detrimental to the creep strength at 750?°C. The creep rupture life of Inconel740H containing cellular precipitates at grain boundaries was only one-tenth of that for the alloy without cellular precipitates. The reason for the drastically decreased creep rupture life is attributed to the poor resistance of cellular precipitates to crack propagation during creep.