医院重点专科发展过程阶段论

讨论医院重点专科发展过程的阶段划分及特征,对于我们在重点专科建设中正确地把握方向、恰当地评估成效和有力地予以推进都有十分重大和现实的意义。本文把医院重点专科发展过程分为科室建设、学科建设、科学建设阶段,并从功能目标、效率效益、人才队伍、场地设施、技术设备、技术特色、教学培训、科学研究、文化氛围、能级水平十个方面对各阶段的特征进行归纳描述。三个阶段各具不同内涵特征,又存在相互内在关联,具有方向性、连续性、可加速性、交叉性和包涵性等规律。     

Neural correlates of inefficient filtering of emotionally neutral distractors from working memory in trait anxiety

Research has indicated that highly trait-anxious (HTA) individuals exhibit a specific deficit in filtering threat-related distractors from visual–spatial working memory (WM). Prior demonstrations of impaired inhibition control in HTA individuals have mainly focused on tasks that required the inhibition of prepotent response tendencies. Studies on the suppression of emotionally neutral distractors from WM in trait anxiety have also been minimal. In this article, we present a study on the manifestation of general inefficient filtering of neutral distractors during visual–spatial WM maintenance stages in HTA individuals. Female participants performed a visual–spatial WM task while event-related potentials were recorded. They were made to remember the orientations of red rectangles within half of the screen and to ignore all salient green rectangles. As predicted, no significant main effect of group and no interaction between group and condition were found in the N2pc component, suggesting that group differences did not manifest in the initial process of object individuation. During the subsequent WM maintenance phase, HTA individuals were highly inefficient at filtering the irrelevant items from WM, as reflected not only by parallel late contralateral delay activity (CDA; 450 to 900 ms) amplitudes for the distractor condition and the four red items, but also by a smaller filtering efficiency score in the HTA group than in the low-trait-anxiety group. Extending previous studies, our findings verify a general filtering impairment in HTA individuals for task-irrelevant salient distractors during a WM maintenance phase.     

Enhancing a Sense of Competence at Work by Engaging in Proactive Behavior: The Role of Proactive Personality

To understand how individuals’ senses of competence are cultivated, scholars have primarily focused on situational factors such as job autonomy and supervisor support. Against this backdrop, we propose that individuals can work as active agents and enhance their sense of competence by initiating actions that aim to master the environment. We adopt the behavioral concordance model and propose that people higher in proactive personality are more likely to engage in proactive behavior that elevates their senses of competence over time. We further propose that such behavioral concordance contributes to boosting a sense of competence is more prominent among those with higher proactive personality. Our predictions are supported by data from 172 employees and their direct supervisors in China, after controlling for the effect of job autonomy and supervisor support for autonomy. Specifically, only those higher in proactive personality engaged in more proactive behavior and increased their sense of competence over time. This study highlights both a self-initiated and a behavioral perspective on understanding the development of a sense of competence.     

The Mystery of Chinese People’s Happiness

The great improvement in economic wealth and social welfare over the decade doesn’t promote the Chinese people’s happiness. We construct a theoretical framework which covers economic wealth, social welfare, individual functional capability to explore the impact factors and determinants of the Chinese people’s happiness. Based on a national wide questionnaire survey in China, we test and modify the framework by the method of structural equation model. The empirical findings indicate that there are direct and indirect effects on the formation of happiness. For the direct effect, both the increasing of economic wealth and social welfare improves the national happiness, while the individual functional capability reduces it. For the indirect effect, the individual functional capability also reduces happiness by negatively affecting economic wealth and social welfare. The negative effect that played by individual functional capability overwhelms the positive effect played by economic wealth and social welfare. This causes the Chinese people’s happiness goes down while the economic wealth and social welfare are improving. Finally, we conclude that the Chinese people’s happiness is more about individual functional capability rather than social welfare or economic wealth.     

反馈类型和反馈时间对动作技能获得的影响

基于简单直线运动任务和复杂曲线追踪任务,在运动技能获得阶段考察不同反馈类型和反馈时间对操作绩效的影响。结果发现,在复杂曲线轨迹追踪任务中,接受运动轨迹反馈的被试组比接受偏差数值反馈组的成绩更好;即时反馈和延迟反馈组的操作绩效间没有显著差异。在简单直线运动任务中,提供落点偏差的图形反馈组成绩始终优于提供“近/远”信息的文本反馈组;在练习初期,即时反馈组成绩更好。说明,反馈信息的具体-抽象程度影响被试运动技能获得,提供具体直观的轨迹/图形反馈利于运动技能获得;反馈时间对运动技能的影响因任务难度而异。     

Cognitive diagnosis modelling incorporating item response times

To provide more refined diagnostic feedback with collateral information in item response times (RTs), this study proposed joint modelling of attributes and response speed using item responses and RTs simultaneously for cognitive diagnosis. For illustration, an extended deterministic input, noisy ‘and’ gate (DINA) model was proposed for joint modelling of responses and RTs. Model parameter estimation was explored using the Bayesian Markov chain Monte Carlo (MCMC) method. The PISA 2012 computer-based mathematics data were analysed first. These real data estimates were treated as true values in a subsequent simulation study. A follow-up simulation study with ideal testing conditions was conducted as well to further evaluate model parameter recovery. The results indicated that model parameters could be well recovered using the MCMC approach. Further, incorporating RTs into the DINA model would improve attribute and profile correct classification rates and result in more accurate and precise estimation of the model parameters.     

青少年亲子关系、消极社会适应和网络成瘾的关系:一个有中介的调节作用

为探讨亲子关系、消极社会适应和网络成瘾的关系,采用问卷法对六个城市共2324名中学生进行研究。结果表明：（1）冲突型青少年网络成瘾倾向得分最高,依恋型青少年网络成瘾倾向得分最低;（2）消极社会适应在亲子依恋和亲子冲突对网络成瘾的预测中均起部分中介作用;（3）消极社会适应的中介作用受到性别的调节。这一研究结果揭示了积极和消极亲子关系对网络成瘾的共同作用机制,为从家庭层面干预和预防青少年网络成瘾状况提供了参考。     

延迟间隔和提取条件对短时错误记忆的影响

采用短时DRM迫选任务,探讨提取条件和延迟间隔对短时错误记忆的影响,以进一步考察短时错误记忆的产生机制。结果发现,短时错误记忆的产生主要源于提取时对存贮细节通达的缺失。在无有效提取线索的条件下,延迟间隔能够增加错误记忆率;而有效提取线索存在时,真实记忆痕迹的可通达性增加能够极大避免错误记忆的产生,延迟间隔的作用则不显著。该实验的结果是对错误记忆理论解释的一种补充。     

论对精神障碍患者的医学保护性住院治疗——评《精神卫生法》第三十一条

《精神卫生法》将强制住院类型分为医学保护性住院和保安性住院。针对严重精神病患者,若已经发生伤害自身的行为或有伤害自身的危险,可以对其实施医学保护性住院治疗,但其具有限制人身自由的属性。而《精神卫生法》第三十一条却将医学保护性住院治疗的同意权单独授予监护人,患者出院也需要监护人的同意。此规定缺乏正当性,侵害了患者的正当权利。而这一规定存在的原因有多种,如医疗父权主义思想的影响,将精神障碍当然地视为无民事行为能力等。