现时代的生命伦理问题

结合现时代临床,提出医疗要回归“初心”,“初心”就是“人命贵”,这是医学伦理起点,也是医学的最高宗旨;而要贯彻“初心”,又应讲究医疗科技和医学人文及伦理之间形成合力。分析认为：现时代医学伦理可能以“生态伦理”更为合适;应区分重大疫情、急性抢救、慢性病纠治等不同情况,考虑“合力”所涉及的不同方面之轻重缓急;并针对生命伦理的有利原则,指出“有利”只是动机及出发点,还需深入思考,确立动机的基线和起点;就基线而言,要搞清楚是本然“有利”,还是科学“有利”,并做出一定区分;应在科学“有利”和本然“有利”之间保持适度的张力与平衡。

     

The Mediating Roles of Adolescent Disclosure and Parental Knowledge in the Association Between Parental Warmth and Delinquency Among Korean Adolescents

The purpose of this study was to examine the association between parental warmth and adolescent delinquency, the potential mediating roles of adolescent disclosure and parental knowledge, and gender differences in such association among Korean adolescents. We hypothesized that (1) parental warmth would be significantly and negatively associated with delinquency, (2) adolescent disclosure and parental knowledge would mediate the association between parental warmth and adolescent delinquency, and (3) the association between parental warmth and adolescent delinquency mediated through adolescent disclosure and parental knowledge would be stronger for adolescent girls than boys. Using a sample of 3125 Korean adolescents from nationally representative and longitudinal data (Korea Youth Panel Survey), results from path analyses demonstrated that findings were consistent with US samples, suggesting a negative association between parental warmth and adolescent delinquency. Further, when Korean adolescents perceived parents to be warmer, they were more likely to disclose personal information to their parents. In turn, higher levels of disclosure were associated with higher levels of parental knowledge about their adolescent children’s activities. Finally, tests of gender differences suggested that parental warmth was more closely associated with adolescent disclosure among girls than boys. Results supported a process model through which parents may shape adolescent children’s delinquency.     

医疗保障制度改革过程中的价值取向问题及其影响

随着社会主义市场经济体制的建立,我国传统的劳保医疗制度和公费医疗制度已越来越不适应社会发展的要求,呈现出诸多弊端,亟待改革。作为一项公共政策,医疗保障制度在改革与完善的过程中应根据科学行政的要求对政策的价值取向进行深入分析,以便顺利实施改革的各项方案。分析医疗保障制度改革中所涉及的各方面的价值观及其对改革的影响,希望唤起政策制定者对不同群体利益的关注,从而保证政策体系的稳定。     

高风险婴儿前瞻性纵向研究与孤独症谱系障碍早期识别

孤独症谱系障碍(Autism Spectrum Disorder, ASD)早期识别有助于早期诊断和早期干预的实施, 对于改善ASD儿童发育结果至关重要。高风险前瞻性纵向研究以高风险婴儿(ASD儿童的年幼同胞, 入组年龄小于12个月)作为主要研究对象, 通过对ASD高风险婴儿(24至36个月之间诊断为ASD的高风险婴儿)的早期发育轨迹的描绘和核心症状早期表现的识别, 为ASD早期识别提供了重要依据。未来可以增加被试数量、延长观察时间并密集观察时间点、关注伴发障碍、综合考虑遗传、环境和文化因素影响, 并结合早期干预研究进行深入探索。未来在中国开展相关研究具有重要的科学价值和临床意义。     

语义认知的习得、发展和老化及其神经机制

作为语言系统的重要组成部分, 探究语义认知发展机制及其神经机理对揭示人类语言发展、认知机制有着重要意义。以语义认知能力的习得、发展、老化认知机制为主线, 在系统阐释词汇-语义系统的习得、语义认知能力和策略发展的基础上, 进一步探讨了语义认知老化的认知机制及其神经机理。最后, 围绕儿童和成人的语义认知差异、句法和语义认知老化的差异、语义认知老化的影响因素等问题上进行了思考和展望。     

叙事医学模式下的临终关怀——以阿图·葛文德《最好的告别》为例

在临终阶段,帮助患者克服对死亡的恐惧,与患者建立心灵和情感上的沟通,帮助其提高生命质量,有尊严、有意义地度过生命最后的时光显得尤为重要。运用叙事医学理论,结合阿图·葛文德《最好的告别》一书中的案例,分别从医护人员、患者、患者家属三个视角,探讨叙事医学对临终关怀发展的指导意义。相较于传统医学模式,叙事医学模式下的临终关怀能够引导医护人员和患者正确对待衰老与死亡、促进医护人员叙事能力的提高、鼓励患者自我需求的叙事表达、关注家属面对亲人离世时的心理护理、改善家属在医疗决策中的辅助作用。叙事医学对临终关怀的发展具有指导意义,有望进一步推进临终关怀的应用进程。     

认知能力对学业成绩的影响:有中介的调节模型

学业成绩是衡量学生掌握知识水平的重要指标,受到认知能力、社会支持和学习动机等多重因素的显著影响,而这多重因素间的关系及其对学业成绩的共同作用机制尚不明确。本研究采用标准化的认知能力测验、社会支持量表、学习动机量表对4,973名初中生进行测试,并以各科测验成绩总分的平均值作为学业成绩指标。结果表明：（1）认知能力、社会支持、学习动机均与学业成绩正相关;（2）社会支持在认知能力对学业成绩的影响中起调节作用,学生感受到的社会支持水平越高,学业成绩表现越好,且其认知能力对学业成绩的预测作用越强;（3）社会支持的调节作用部分通过学习动机这一中介变量实现。本研究构建了一个基于个体因素（认知能力和学习动机）和环境因素（社会支持）共同影响学业成绩的理论模型,有利于人们深入理解认知能力影响学业成绩的内在机制和边界条件,为提升学生学业成绩提供了理论依据和实证支持。     

The Influence of Family Socio-economic Status on Learning Burnout in Adolescents: Mediating and Moderating Effects

According to family investment theory, a family’s socio-economic status can have a noteworthy impact on the academic performance and future lives of adolescents. However, the mechanism for this remains poorly understood. We examined the mediating and moderating effects of family emotional and cultural environment on the relations between family socio-economic status and learning burnout. Specifically, we investigated whether different family emotional environments have a moderating effect on the relationship between family socio-economic status and learning burnout and on the mediating effect of family cultural environment. A sample of 1181 junior and senior high school students completed multidimensional measures of family socioeconomic status, family emotional and cultural environment, and learning burnout. A regression analysis showed that socio-economic status significantly predicted learning burnout. The achievement, cultural, and recreational dimensions of family cultural environment were all mediators of this relationship. Moreover, cultural dimension was moderated by the family conflicts factor of family emotional environment.     

Prevalence of depressive symptoms and its correlates among medical students in China: a national survey in 33 universities

We conducted a national survey among medical students in China to estimate the prevalence of depressive symptoms and explore associated risk factors based on an established questionnaire composed of demographic information, life events in the past four weeks before survey, and the validated Chinese version of the 21-item Beck’s Depression Inventory (BDI). The mean age of enrolled 9010 students was 20.7 (standard deviation: 1.6) years. BDI scores indicated that 19.9% had depressive symptoms based on the cut-off score of 14. Socioeconomic factors and student characteristics such as male sex, low monthly income per capita, father’s poor education background, and higher year of study were associated with higher prevalence of depressive symptoms among medical students. Students who studied in comprehensive universities were more likely to have depressive symptoms compared with those from medical universities. Habitual smoking and alcohol drinking, sleep deprivation, and hospitalization or medication for one week or more in the last four weeks also predisposed students to higher risk of depressive symptoms. Our results indicate that depressive symptoms are becoming a highly prevalent health problem among Chinese medical students. Primary and secondary prevention should be prioritized to tackle this issue based on potential risk factors.     

Does Cognitive Style Moderate Expected Evaluation and Adolescents' Creative Performance: An Empirical Study

Two studies investigated the effects of cognitive and school environmental factors on adolescents' creative performance. The first study tested the effects of expected evaluation and cognitive style on creativity among 89 high school students. The second study tested the effects of evaluation type and cognitive style on creativity among 92 high school students. Study 1 found main effects of expected evaluation and cognitive style on creativity. The interaction between expected evaluation and cognitive style was statistically significant. Under an experimental condition of expected evaluation, field‐dependent adolescents performed more creatively (i.e., higher originality) than those without expected evaluation. Study 2 uncovered main effects of expected evaluation type and cognitive style on creativity but no interactions between expected evaluation type and cognitive style. Adolescents performed better on the dimension of flexibility in a controlling evaluation condition, compared with adolescents in informational evaluation condition, and field‐independent adolescents showed more fluency and originality than field‐dependent adolescents. Together, this research provides a better understanding of the effects of expected evaluation and cognitive style on adolescents' creative performance. Implications for further research are discussed.