先天视觉经验缺失对颜色认知的影响：一项ERP研究

感觉与认知是否是相互独立的？本研究通过对比先天盲被试与明眼被试在进行物体颜色判断时的行为反应和神经电生理信号变化,探讨视觉经验缺失对颜色认知的影响。结果发现,先天盲被试具有一定的颜色知识,但其水平低于明眼被试;两组被试都出现了由颜色不匹配所诱发的N400效应,且都表现出左半球优势;但是盲人组的N400效应大于明眼组,盲人组的N400反应潜伏期小于明眼组。该结果说明,直接的视觉经验是颜色认知的充分条件而非必要条件。     

父母差别对待与青少年问题行为的关系：一个有调节的中介模型

通过问卷调查的方式,采用同胞不同经历问卷、关系网络问卷和问题行为量表对开封市1179名初高中学生进行研究。研究结果显示：（1）父母差别对待与外/内化问题行为呈显著正相关;同胞关系与外/内化问题行为呈显著负相关;父母差别对待和同胞关系呈显著负相关。（2）同胞关系在父母差别对待与外/内化问题行为之间起部分中介作用。（3）“父母差别对待→同胞关系→外/内化问题行为”这一中介路径的前半段受出生顺序调节;与年幼个体相比,父母差别对待对年长个体的同胞关系影响更大。出生顺序会调节父母差别对待对同胞关系的影响,提示二胎家庭要更关注年长个体的变化。     

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。     

抑郁个体对情绪面孔的返回抑制能力不足

探讨抑郁对情绪面孔返回抑制能力的影响。以贝克抑郁量表、自评抑郁量表、CCMD-3和汉密顿抑郁量表为工具筛选出了正常对照组、抑郁康复组和抑郁患者组各17名被试进行了真人情绪面孔线索-靶子任务的行为学实验和事件相关电位(ERP)实验。在线索靶子范式中, 靶子在线索消失后出现, 被试对靶子的位置作出反应。行为学实验显示线索靶子间隔时间(stimulus onset asynchronies, SOA)为14ms时, 正常对照组对中性面孔有返回抑制效应, 抑郁康复组对所有面孔均存在返回抑制效应, 患者组对愤怒、悲伤面孔和中性面孔存在返回抑制效应; SOA为250ms时三组被试均对悲伤面孔存在返回抑制能力不足, 以患者组最突出, 康复组对高兴面孔存在返回抑制能力不足; SOA为750ms时正常组对悲伤面孔存在返回抑制效应, 康复组对高兴和悲伤面孔存在返回抑制能力不足, 患者组对悲伤面孔存在返回抑制能力不足, 对愤怒面孔存在返回抑制效应。在SOA为750ms的条件下, ERP波形特点为正常组对高兴面孔线索P3波幅大于其他组, 对高兴面孔无效提示P1波幅小于其他面孔, 对悲伤面孔有效提示P1波幅小于高兴面孔, 对高兴面孔有效提示P3波幅大于患者组, 对悲伤面孔无效提示P3波幅大于其他组; 康复组对悲伤面孔线索P3波幅大于其他面孔, 对高兴面孔有效提示P3波幅大于患者组, 对悲伤面孔无效提示P3波幅小于正常组; 患者组对悲伤面孔线索P1波幅大于其他组、P3波幅大于其他面孔, 对悲伤面孔无效提示P3波幅小于正常组, 高兴面孔有效提示P3波幅小于其他组。提示抑郁患者对负性刺激有返回抑制能力不足, 这种对负性刺激抑制能力的缺失导致抑郁个体难以抗拒负性事件的干扰而受到不良情绪状态的困扰, 所以他们可能更多的体验到抑郁情绪, 并致使抑郁持续和发展。而抑郁康复个体对高兴、悲伤面孔均有返回抑制能力不足, 这让康复个体能同时感受到正、负性刺激, 从而能保持一种认知和情绪上特定的平衡。     

Parental Health and Children’s Functioning in Immigrant Families: Family Roles and Perceived Treatment at School

Although parents’ health condition is generally thought to be related to their involvement in their children’s functioning, the possible dynamics behind the scenes in school contexts with immigrant children has received little attention. This study examined the association between parents’ health condition and their children’s academic and behavioral functioning, as well as the mediation effects of parents’ school engagement and children’s perceived treatment at school among 607 immigrant families with 10- to 12-year-old children. Using structural equation modeling, the results indicated that parents’ poor health condition was associated with children’s increased behavioral problems. Parents’ school engagement fully mediated the association between parental health condition and children’s academic achievement and partially mediated the association between parental health condition and children’s behavior problems. Notably, higher levels of parents’ school engagement were associated with increased behavior problems, demonstrating a unique feature in these immigrant children’s developmental functioning. Higher levels of perceived harsh treatment by peers at school due to children’s immigrant identity were associated with these children’s greater risks of behavior problems. The results suggested what may lie behind the scenes in these children’s behavioral problems is that many of these children who act out and are brought to the school office for disciplinary issues may suffer from perceived discrimination and bad treatment by their peers. The findings provide important implications for researchers, healthcare practitioners, and educators seeking to understand this subpopulation and to design and implement family support and prevention programs for young adolescents from immigrant backgrounds.     

Parkinson’s Disease: Patients’ Knowledge,Attitudes, and Interest in Genetic Counseling

The objective of this study was to assess the genetics knowledge of patients with Parkinson’s disease (PD), and to explore their attitudes on genetic testing and interest in genetic counseling. We surveyed 158 patients from the University of Maryland Parkinson’s Disease and Movement Disorders Center. Patients averaged a score of 63% on general genetics knowledge and 73% on PD genetics knowledge. Participants had an overall positive attitude toward genetic testing: 80% believed that the use of genetic tests among people should be promoted, and 83% would undertake genetic test for PD if it was available. Patients reported a high interest to discuss the benefits, risks, and impacts of genetic testing for PD (mean sum score?=?26, range?=?9–35), and 43% patients expressed interest in meeting with a genetic counselor. Multivariate regression analysis showed that patients who had more positive attitudes toward genetic testing for PD were more interested in meeting with a genetic counselor (β?=?0.6, p?<?0.001). This study is the first to demonstrate an interest in genetic counseling among patients with PD. Our findings demonstrate a new niche for genetic counselors to support patients in clarifying gaps or misconceptions in knowledge about PD genetics as well as the possible risks, benefits, and limitations of genetic testing.     

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。     

医患会话不同研究方法进展

医患会话研究是研究医患矛盾和医患关系的关键,从社会学和语言学的视角,对国内外的医患会话研究进行了梳理。社会学和语言学视角对会话的分析有很大的差异。社会学家是研究如何进行会话,认为会话能透视社会生活,而语言学家则研究语言如何建构以产生会话,认为作为社会生活资源的会话可以帮助发现语言的本质。医患会话研究还应该拓展到认知神经科学、心理学和医学领域。只有更好地开展医患会话的研究才能指导医生的会话策略,提高医患沟通能力,改善医患关系。     

直觉思维在麻醉临床决策中的应用

围手术期麻醉医师面临问题的复杂性、动态性和模糊性,要求其在具备良好逻辑思维能力的同时,还要学会应用直觉思维来进行麻醉危机管理。通过决策判断的双加工理论模型探讨说明直觉思维在临床麻醉决策中的可应用性,并给出麻醉医师直觉思维的培养途径,提高麻醉医师的思考能力,增加应急处理课程和临床训练,重视临床经验的学习,营造良好的教学氛围。为了在围手术期更好地保证患者的安全,麻醉医师应重视直觉思维在临床麻醉决策中的应用。