公立医院体制改革的思考

公立医院体制改革给一些难以为继的中小医院带来一线生机,但是医院体制改革过程中存在的一些问题一直未得到妥善解决.通过对公立医院体制改革的益处及弊端的剖析,提出公立医院体制改革的建议,以保证改革的步伐健康有序地发展.     

Changing your mind about things unseen: Toddlers' sensitivity to prior reliability

The goal of this research was to investigate the extent to which young children use the past reliability of another person’s statements to make inferences about the accuracy of that person’s claims about a hidden toy. When children interacted with a previously reliable speaker, both 30- and 36-month-olds searched in the new location of the toy, in line with the speaker’s statement. When children interacted with an unreliable speaker, the 36-month-olds were less likely to rely on her false statement and instead searched either in the original location of the toy or in a neutral location. The 30-month-olds, however, searched in the location indicated by the speaker even when the speaker was unreliable. These results show that by 36 months of age, children begin to use reliability in processing a speaker’s episodic claims and can flexibly update their representations of absent objects depending on the reliability of the speaker.     

Traumatic Stress and Religion: Is there a Relationship? A Review of Empirical Findings

Based on a history of close conceptual link, empirical studies are beginning to accumulate that investigate the relationship between trauma and religion. A review of empirical studies that examined the relationship between religion/spirituality and PTSD showed mixed findings (n = 11). Though the direction of association varied among studies, all but one study reported significant associations between the two. Factors that might have contributed to the mixed findings are discussed (e.g., measurements, research design). Overall, these results appear to be encouraging toward confirming the conceptual link between religion and trauma. Further research investigating the direction of causation and possible moderators of the association may contribute to a better understanding of the relationship between trauma and religion.Yung Chen, Ph.D. was a research fellow at Duke University Medical Center, and is now an Assistant Professor in the Department of Behavioral Sciences and Leadership at the United States Military Academy at West Point.Harold Koenig, M.D. is a Professor of Psychiatry and Behavioral Sciences at Duke University Medical Center.     

肺动脉血栓栓塞症与凝血纤溶系统失衡

在生理状态下,凝血与纤溶处于动态平衡状态;当这种平衡失衡时,便可招致出血不止或形成栓塞。体内某些抗凝途径的蛋白缺陷会使机体处于高凝状态而导致静脉血栓栓塞性疾病(VTE),已经报道有多种栓塞因素与VTE的发生有关;人们通常认为,慢性栓塞性肺动脉高压(CTE-PH)是静脉系统栓子反复脱落至肺动脉所致,很自然的会想到CTE-PH的发病可能与以上多种栓塞因素有关,然而,目前研究更倾向于CTEPH和VTE并没有直接的关系或者说是两个独立的疾病。     

构建“医患沟通学”的思考与探索

中国医患关系紧张的原因涉及观念、国情、法制、政策、制度、医疗方式等。构建“医患沟通学”有重要的意义:医患迫切需要恢复和谐信任关系;新型医学模式变革、医学人才的培养及医学发展等更需要搭建“医患沟通”新的研究平台,并完善其理论。医患沟通实践与研究的过程,就是临床教师、医务卫生人员提高医学人文素质和实践能力的新途径。     

权力层级与团队绩效关系：权力与地位的一致与背离

本研究致力于探讨在权力与地位不一致的背景下, 权力层级与团队绩效研究的分歧。本研究提出权力层级与团队绩效的关系取决于团队的层级一致性——权力与地位的匹配度。具体地, 当层级一致(权力与地位匹配)时, 权力层级促进团队绩效; 当层级不一致(权力与地位不匹配)时, 权力层级抑制团队绩效。本研究结合问卷、实验和二手数据方法来验证假设, 研究1通过对46个大学生创业实践团队的两阶段问卷调查, 发现层级一致性对权力层级与团队绩效的关系具有调节作用。此后, 研究2通过一项涉及64个团队的实验来揭示因果关系, 发现权力争夺在权力层级和层级一致性的交互与团队绩效的关系中起中介作用。最后研究3通过203个观测值的互联网公司二手数据重复验证了层级一致性的调节作用, 并提升了本研究的生态效度。本研究为权力层级的研究做出了一定的贡献, 并为团队管理提供了启示。     

The effect of a psycho-educational intervention on weight management in obese military personnel

Obesity is a serious health problem for many population groups, including military personnel. Model-based health education programs have been shown to be effective in reducing weight. This study assessed the efficacy of an educational intervention based on a trans-theoretical model (TTM) targeting weight loss among active duty military. A single group experimental study using a before-after design was conducted in 49 military personnel with obesity. Constructs such as self-efficacy, decisional balance, stages of change, and processes of change as well as anthropometric measures including weight, waist circumference, and body mass index (BMI) were assessed at three times (baseline, 2 months after the intervention, and 4 months later). The intervention consisted of 10 educational sessions developed based on TTM constructs. At baseline, 30 (61%) and 19 (39%) persons were in the pre-action and action stages, respectively. By 2 months after the intervention, only 24 persons (49%) were in pre-action stages and 25 (51%) were in the action stages. Four months later, one (2%) and 43 (88%) were in pre-action and action stages. The mean changes in self-efficacy (25.7 ± 4.1 to 29.3 ± 2.4), decisional balance (9.2 ± 3.6 to 13.8 ± 1.9), total cognitive (74.7 ± 8.5 to 84.7 ± 6.3), and total behavioral change (60.8 ± 9.8 to 71.7 ± 7.8) were significantly different across the three time points. Reductions in weight (99.8 ± 10.4 to 93.0 ± 9.6), waist circumference (105.9 ± 14.2 to 100.2 ± 13.0), and BMI (32.5 ± 5.2 to 30.3 ± 4.5) from baseline to 4 months after the intervention were also significant (p < 0.05). An educational program based on TTM may be effective in reducing weight among obese military staff.     

发展性阅读障碍的噪音抑制缺陷

发展性阅读障碍的缺陷本质一直是研究者们关注和争论的焦点。近些年, 有研究者提出了一种新的理论假设——噪音抑制缺陷假设, 并得到了许多研究证据的支持。这种缺陷在视觉和听觉通道中均存在, 说明阅读障碍具有多感觉/一般性噪音抑制缺陷。但也有研究者指出知觉噪音抑制本质上反映了注意的功能, 因而这种缺陷可能是由注意缺陷导致的。目前还缺乏直接证据支持汉语阅读障碍存在噪音抑制缺陷。最后本文对该领域未来的发展方向做出展望。     

多维范式下神经组织行为学的哲学基础、理论框架和研究方法

神经组织行为学是指通过探究组织现象背后的生物学运作机理, 从神经生理视角发展并重构组织行为学框架的新兴多领域交叉学科。多维范式下的神经组织行为学包括从还原论到涌现论的哲学基础, 基于社会情境认知理论、跨层次研究和逆向推理的理论框架, 以及神经成像法和ANS测量法并行的研究方法。未来研究应注意神经组织行为学可能给组织理论带来的变革, 以及研究方法的未来走向。