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With increasing momentum for health care reform, attention is shifting to finance reform that will provide for direct methods for controlling health care spending. This article outlines the two principal paths to direct cost control and outlines a national plan that retains our multiple sources of payment, yet also contains a powerful direct cost control technique: a single fund to finance all health care.  相似文献   
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Semantic priming in a lexical decision task was investigated with concurrent pretarget and posttarget primes. The posttarget prime also served as a pattern mask of the lexical decision target. Forward priming is defined as the presence of a semantically related pretarget prime and an unrelated posttarget prime. Backward priming is defined as the presence of a semantically related posttarget prime and an unrelated pretarget prime. Forward and backward priming were compared both when the nonword foils were "legal" and when they were "illegal" with respect to English orthography. Predictions were derived for two general approaches to word recognition: spreading-activation and expectancy-set theories. Both approaches assume that word representations occupy distinct, nonoverlapping locations in memory. Backward-prime facilitation was equivalent to forward-prime facilitation when nonword foils were illegal; however, backward-prime facilitation was not significant when nonword foils were legal. These results challenge both approaches. The proposed solution uses semantic-space (distributed) representations that are functionally unitized by a resonant matching (verification) process.  相似文献   
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Just noticeable differences in orientation are smaller at principal standard orientations than at oblique standard orientations when they are measured with the method of single stimuli. We determined whether this oblique effect is due to an anisotropy in decision factors. A first series of experiments showed that the subjects compare the stimulus with an internal criterion, and that this decision rule is used at all standard orientations. A second series of experiments determined the influence on the oblique effect of nonsensorial variables related to criterion setting. The results strongly suggest that the effect is not due to a criterial noise anisotropy and that criterion-setting processes are similar at principal and oblique standard orientations. The latter conclusion was also supported by an analysis of the sequential stimulus and response dependencies in this task. Hence, it appears that the oblique effect in line orientation discrimination, when it is measured with the method of single stimuli, is due not to decision factors but to a sensorially based anisotropy.  相似文献   
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The main purpose of this paper is to account for the varying analysis and formalisations of a same advertisement text, Mir Rose, by Jean Michel Adam. First, we draw the methodological frame of this psycholinguistic approach of composing and understanding-memorizing texts. We refer to the notions of prototypical textual schema, semantic macrostructure and superstructure. Then we point out the differences between argumentative text and argumentative discourse. Last, we try to explain why it has been possible for Adam to analyse and formalise the same text first as a narrative one and a few years later as an argumentative one. We suggest that his narrative approach is not specific and textual narrative means here temporal-causative sequence or problem solving, i.e., deeper and more general psychological devices than those involved in processing narrative text per se. From Toulmin and van Dijk approaches of argumentation, we propose our own analysis and formalisation of Mir Rose, the psychological validity or plausibility of which should be tested in experimental tasks of reading-memorising.
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This study investigated the psychological and physical health status of 265 crew members on two U.S. Navy ships (a guided missile cruiser and a frigate on convoy escort duty for tankers under U.S. flag) during the Persian Gulf conflict at four time periods during combat-ready operations on a single day. Findings suggest that adaptation occurs to extreme stressors associated with sustained operations. Suggestions are made relative to measures that may minimize psychological and physical conditions that adversely affect performance under conditions of heavy stress. Report No. 89-18, supported by the Naval Medical Research and Development Command, Bethesda MD, Department of the Navy, under research Work Unit No. 63206N.M0096. The opinions expressed in this paper are those of the author and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government.  相似文献   
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The essay examines the argument advanced by E.D. Hirsch, Jr., for instituting ‘cultural literacy’ as a fundamental priority of schools. A number of confusions and equivocations in Hirsch's reasoning are identified, and the propensity of his project to indoctrinate is exposed. Among the features of Hirsch's argument shown to be troubling are his shifting construal of ‘language’, his inconsistency about the requirements of cultural literacy, and his uncritical relation to traditional images of the American past and present. The upshot is to raise the question why Hirsch's project has elicited wide support and praise.  相似文献   
19.
Medical expertise asa function of task difficulty   总被引:4,自引:0,他引:4  
This paper is concerned with factors that disrupt the pattern of forward reasoning characteristic of experts with accurate performance. Two experiments are described. In the first, the performances of cardiologists, psychiatrists, and surgeons in diagnostic explanation of a clinical problem in cardiology were examined. In the second, the performances of cardiologists and endocrinologists in diagnostic explanation of clinical problems within and outside their domains of expertise were examined. The performances of researchers and practicing physicians are also compared. The results of Experiment 1 replicated earlier results regarding the relationship between forward reasoning and accurate diagnosis. There were no differences in recall as a function of expertise. Experts did not show any bias toward using specific knowledge from their own areas of expertise. The results of Experiment 2 showed that the breakdown of forward reasoning was related to the structure of the task. In particular, nonsalient cues induced some backward reasoning even in subjects with accurate diagnoses. Some differences were also found between the types of explanation used by researchers and practitioners. The practitioners referred more to clinical components in their explanations, whereas the researchers focused more on the biomedical components.  相似文献   
20.
A total of 229 late adolescents (a large majority 15 to 19 years of age) completed a questionnaire that assesses a broad range of videogame-relevant experiences, preferences, and attitudes. Videogame playing was found to be a more popular, and a more highly regarded, activity among males than females. Gender differences were also found in participants' ratings of their motivations for playing videogames, their evaluations of particular characteristics of videogames, and their selection of their “most favorite” videogame. The differences between frequent and infrequent videogame players appeared to be limited to differences in the extent to which videogame playing is pursued and evaluated as a positive leisure activity, rather than reflecting broad differences in interest or personality. Some relations were found between participants' self-reported personality characteristics (i.e., self-esteem, empathy, conscientiousness, and introversion) and their attitudes toward videogames.  相似文献   
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