支持死后医疗数据捐赠：呼吁对个人健康数据的伦理利用

死后医疗数据捐赠对于科学研究的意义重大。但目前不存在有针对性的准则用于指导捐赠过程。如果死后医疗数据的使用缺乏监管可能会引发多种风险,一是给他人利益造成损害;二是造成数据的不规范使用。因此,应当类比现有捐献制度,允许并鼓励捐献死后医疗数据用于科学研究,并起草专门的捐赠准则。该准则的制定应当建立在遵循五大基本原则的前提下,主张以自愿参与的方式使用个人医疗数据,反对未经书面同意将数据用于以病例档案为基础的医学研究。

     

Cultural Considerations for Psychologists in Primary Care

Many health concerns in the United States (e.g., diabetes) are routinely managed in primary care settings. Regardless of the medical condition, patients’ health is directly influenced by factors such as healthcare providers and cultural background. Training related to how behaviors influence health, coupled with training on how cultural diversity intersects with mental health, allows psychologists to have the relevant expertise to assist in the development of primary care behavioral health interventions. However, many psychologists in primary care struggle with how to integrate a culture-centered paradigm into their roles as behavioral health providers. This paper provides an introduction on how three culture-centered concepts (providers’ cultural sensitivity, patient–provider cultural congruency, and patients’ health literacy) can be applied in primary care using the Five A’s Organizational Construct and a model of cultural competence. In addition, the paper includes a section on integration of cultural considerations into consultation and training and concludes with a discussion of how the three culture-centered concepts have implications for health equity.     

Patterns of emotional availability between mothers and young children: Associations with risk factors for borderline personality disorder

Emotional availability (EA) characterizes a warm, close relationship between caregiver and child. We compared patterns (clusters) of EA on risk factors, including those for borderline personality disorder (BPD). We sampled 70 children aged 4 to 7 years from low socio‐economic backgrounds: 51% of whose mothers had BPD. We coded filmed interactions for EA: mothers' sensitivity, structuring, non‐intrusiveness, non‐hostility, and children's responsiveness to, and involvement of, mothers. We additionally coded children's over‐responsiveness and over‐involvement. Using person‐centred analyses, we identified four clusters: high functioning, low functioning, asynchronous (mothers above average on two of four dimensions and children below), and below average. Mothers in the low‐functioning cluster had lower income, less social support, more of the borderline feature of negative relationships, and more depression than did mothers in the high‐functioning cluster. The children in the low‐functioning group had more risk factors for BPD (physical abuse, neglect, and separation from, or loss of caregivers, and negative narrative representations of the mother–child relationship in their stories) than did children in the high‐functioning group. The asynchronous group included older girls who were over‐responsive and over‐involving with their mothers in an apparent role reversal. Interventions targeting emotional availability may provide a buffer for children facing cumulative risks and help prevent psychopathology.

Highlights

• This paper investigated how mother‐child emotional availability (warmth and closeness) relates to risk factors for borderline personality disorder, including mother‐child role reversal.
• In filmed mother‐child interactions, low emotional availability was associated with risk for borderline personality disorder and role reversal was more likely for older girls.
• Findings support the cumulative risk hypothesis and may inform interventions to improve mother‐child emotional availability to prevent the development of psychopathology.

     

Isolated words enhance statistical language learning in infancy

Infants are adept at tracking statistical regularities to identify word boundaries in pause-free speech. However, researchers have questioned the relevance of statistical learning mechanisms to language acquisition, since previous studies have used simplified artificial languages that ignore the variability of real language input. The experiments reported here embraced a key dimension of variability in infant-directed speech. English-learning infants (8-10 months) listened briefly to natural Italian speech that contained either fluent speech only or a combination of fluent speech and single-word utterances. Listening times revealed successful learning of the statistical properties of target words only when words appeared both in fluent speech and in isolation; brief exposure to fluent speech alone was not sufficient to facilitate detection of the words' statistical properties. This investigation suggests that statistical learning mechanisms actually benefit from variability in utterance length, and provides the first evidence that isolated words and longer utterances act in concert to support infant word segmentation.     

Interactions between statistical and semantic information in infant language development

Infants can use statistical regularities to form rudimentary word categories (e.g. noun, verb), and to learn the meanings common to words from those categories. Using an artificial language methodology, we probed the mechanisms by which two types of statistical cues (distributional and phonological regularities) affect word learning. Because linking distributional cues vs. phonological information to semantics make different computational demands on learners, we also tested whether their use is related to language proficiency. We found that 22-month-old infants with smaller vocabularies generalized using phonological cues; however, infants with larger vocabularies showed the opposite pattern of results, generalizing based on distributional cues. These findings suggest that both phonological and distributional cues marking word categories promote early word learning. Moreover, while correlations between these cues are important to forming word categories, we found infants' weighting of these cues in subsequent word-learning tasks changes over the course of early language development.