我国公立医疗机构转型政策量化分析

分析我国城市一二级公立医院转型为康复医院、老年护理院等接续性医疗机构政策的内外部特征,为后续政策的制定与完善提供参考。通过构建政策工具、政策利益相关者、政策力度三维政策分析框架,对相关政策进行多维分类分析。得出相关政策发文量呈波动增长趋势;环境型政策工具使用过溢,供给型政策工具内部结构配置失衡,需求型政策工具应用匮乏;对不同政策利益相关方的关注度存在差异;政策顶层设计欠缺,整体政策效力不高。建议优化政策工具使用,平衡各利益相关方需求,完善政策体系内容。

     

系统性综述干细胞来源的生物材料采集的供者健康风险

通过检索国内外6个文献数据库以获取发表于2010年1月~2020年7月研究相关的文献,并对干细胞来源的生物材料采集的供者健康风险进行了系统性综述。50篇相关文献分析显示,在许多情况下,生物材料采集可使供者承受健康风险,包括麻醉、粒细胞集落刺激因子或促排卵药物使用、中心静脉导管放置、穿刺等带来的风险。此外,生物材料采集还可影响供者的心理健康。根据上述发现,建议干细胞来源的生物材料采集需要严格的伦理管控,以保障生物材料供者的健康权益。

     

不给予或撤除生命维持干预与安乐死、消极安乐死的概念辨析

不给予或撤除生命维持干预是临床实践中常见且棘手的伦理学问题。该问题的讨论应建立在清晰的概念之上,但不给予或撤除生命维持干预常与安乐死、消极安乐死和尊严死等概念混淆,引发误解。重新定义安乐死和消极安乐死具有理论和现实的紧迫性。基于汤姆•比彻姆和阿诺德•戴维森提出的安乐死定义,提出消极安乐死的定义。基于该定义,认为不给予或撤除生命维持干预与消极安乐死为交叉关系。鉴于安乐死概念的争议及其富含的感情色彩,强调讨论生命维持干预的使用时应区分事实与价值,并建议慎用或弃用安乐死与消极安乐死。

     

Factor analysis of Wechsler Adult Intelligence Scale-Revised in developmentally disabled persons

The results of previous studies on the factorial structure of Wechsler Intelligence Scales are somewhat inconsistent across normal and pathological samples. To study specific clinical groups, such as developmentally disabled persons, it is useful to examine the factor structure in appropriate samples. A factor analysis was carried out using the principal component method and the Varimax orthogonal rotation on the Wechsler Adult Intelligence Scale (WAIS-R) in a sample of 203 developmentally disabled persons, with a mean age of 25 years 4 months. Developmental disability ranged from mild to moderate. Partially contrasting with previous studies on normal samples, results found a two-factor solution. Wechsler's traditional Verbal and Performance scales seems to be more appropriate for this sample than the alternative three-factor solution.     

Adaptation in very old age: exploring the role of resources, beliefs, and attitudes for centenarians' happiness

When individuals reach very old age, accumulating negative conditions represent a serious challenge to their capacity to adapt and are likely to reduce the quality of life. By examining happiness and its determinants in centenarians, this study investigated the proposal that psychological resilience may come to an end in extremely old age. Data from the population-based Heidelberg Centenarian Study indicated high levels of happiness. Basic resources (i.e., job training, cognition, health, social network, extraversion) explained a substantial proportion of variance in happiness, but some resource effects were mediated through self-referent beliefs (e.g., self-efficacy) and attitudes toward life (e.g., optimistic outlook). Results challenge the view that psychological resilience reaches a critical limit or that the self-regulatory adaptation system loses its efficiency in very advanced age.     

Resources and life-management strategies as determinants of successful aging: on the protective effect of selection, optimization, and compensation

In this research, the authors investigated the specific and shared impact of personal resources and selection, optimization, and compensation (SOC) life-management strategies (A. M. Freund & P. B. Baltes, 2002) on subjective well-being. Life-management strategies were expected to be most relevant when resources were constrained, particularly in very old age. In Study 1 (N=156, 71-91 years), age-differential predictive patterns supported this assumption: Young-old individuals' well-being was predicted independently by resources and SOC, whereas SOC buffered the effect of restricted resources in old-old individuals. Study 2 replicated the findings longitudinally with resource-poor and resource-rich older individuals (N=42). In both studies, specific SOC strategies were differentially adaptive. Results confirm that resources are important determinants of well-being but that life-management strategies have a considerable protective effect with limited resources.     

When do octopuses play? Effects of repeated testing, object type, age, and food deprivation on object play in Octopus vulgaris

Studying play behavior in octopuses is an important step toward understanding the phylogenetic origins and function of play as well as the cognitive abilities of invertebrates. Fourteen Octopus vulgaris (7 subadults and 7 adults) were presented 2 Lego objects and 2 different food items on 7 consecutive days under 2 different levels of food deprivation. Nine subjects showed play-like behavior with the Lego objects. There was no significant difference in play-like behavior corresponding to food deprivation, age, and sex of the octopuses. The sequence of behaviors, from exploration to play-like behavior, had a significant influence on the establishment of play-like behavior, as it occurred mostly on Days 3-6 of the 7-day experiment. The pattern of development of play-like activities after a period of exploration and habituation in this study agrees with the hypothesis that object play follows object exploration. A homologous origin of this behavioral trait in vertebrates and invertebrates is highly unlikely, as the last common ancestor might not have had the cognitive capacity to possess this trait.     

The validity of the hospital anxiety and depression scale and the geriatric depression scale in Parkinson's disease

We assessed the concurrent validity of the Hospital Anxiety and Depression Scale (HADS) and the Geriatric Depression Scale (GDS) against the Hamilton Rating Scale for Depression (Ham-D) in patients with Parkinson's disease (PD). Forty-six non-demented PD patients were assessed by a neurologist on the Ham-D. Patients also completed four mood rating scales: the HADS, the GDS, the VAS and the Face Scale. For the HADS and the GDS, Receiver Operating Characteristics (ROC) curves were obtained and the positive and negative predictive values (PPV, NPV) were calculated for different cut-off scores. Maximum discrimination between depressed and non-depressed PD patients was reached at a cut-off score of 10/11 for both the HADS and the GDS. At the same cut-off score of 10/11 for both the HADS and the GDS, the high sensitivity and NPV make these scales appropriate screening instruments for depression in PD. A high specificity and PPV, which is necessary for a diagnostic test, was reached at a cut-off score of 12/13 for the GDS and at a cut-off score of 11/12 for the HADS. The results indicate the validity of using the HADS and the GDS to screen for depressive symptoms and to diagnose depressive illness in PD.     

Place and summation coding for canonical and non-canonical finger numeral representations

Fingers can be used to express numerical magnitudes, and cultural habits about the fixed order in which fingers are raised determine which configurations become canonical and which non-canonical. Although both types of configuration carry magnitude information, it has been shown that the canonical ones are recognized faster and directly linked to number semantics. Here we tested whether this difference is a consequence of differences in the qualitative way of processing the two types of configurations. When participants named Arabic digits (Experiment 1) or verbal numerals (Experiment 2) primed by canonical and non-canonical finger configurations, qualitatively different priming patterns were observed for the two types of configurations. Canonical configurations activated a place coding representation, with priming spreading to close smaller and larger magnitudes as a function of the prime–target distance. Conversely, non-canonical configurations activated a summation coding representation priming smaller and equal magnitudes independently of the prime–target distance, and larger targets depending on this distance.     

Discrepancies Between Implicit and Explicit Motivation and Unhealthy Eating Behavior

ABSTRACT Many people change their eating behavior as a consequence of stress. One source of stress is intrapersonal psychological conflict as caused by discrepancies between implicit and explicit motives. In the present research, we examined whether eating behavior is related to this form of stress. Study 1 (N=53), a quasi‐experimental study in the lab, showed that the interaction between the implicit achievement motive disposition and explicit commitment toward an achievement task significantly predicts the number of snacks consumed in a consecutive taste test. In cross‐sectional Study 2 (N=100), with a sample of middle‐aged women, overall motive discrepancy was significantly related to diverse indices of unsettled eating. Regression analyses revealed interaction effects specifically for power and achievement motivation and not for affiliation. Emotional distress further partially mediated the relationship between the overall motive discrepancy and eating behavior.