基于叙事医学“细读”方法探讨中医医案叙事分析方法

医案作为叙事文本,可进行故事分析与叙事分析。叙事分析结果能够完善故事分析结果。叙事医学提出的细读方法是医学叙事分析方法的集大成者。为增加医案研读结果的完整度,借鉴叙事医学的细读方法,提出了分析医案“框架”、“形式”、“时间”、“情节”、“意愿”的方法,介绍了时间性、独特性、因果关系/偶然性、伦理性、主体间性特征等叙事医学概念对医案分析需求的启发。为了便于记录与规范医案叙事分析的过程,设计了医案叙事分析表。本研究丰富了医案研究方法,扩大了叙事医学细读方法的运用范围。     

Diagnostic Classification Models for a Mixture of Ordered and Non-ordered Response Options in Rating Scales

When developing ordinal rating scales, we may include potentially unordered response options such as “Neither Agree nor Disagree,” “Neutral,” “Don’t Know,” “No Opinion,” or “Hard to Say.” To handle responses to a mixture of ordered and unordered options, Huggins-Manley et al. (2018) proposed a class of semi-ordered models under the unidimensional item response theory framework. This study extends the concept of semi-ordered models into the area of diagnostic classification models. Specifically, we propose a flexible framework of semi-ordered DCMs that accommodates most earlier DCMs and allows for analyzing the relationship between those potentially unordered responses and the measured traits. Results from an operational study and two simulation studies show that the proposed framework can incorporate both ordered and non-ordered responses into the estimation of the latent traits and thus provide useful information about both the items and the respondents.     

论“二三九四”中西医结合慢性病管理模式

慢性非传染性疾病的急剧增加, 亚健康状态的出现, 不良生活方式的广泛存在, 对人们的健康产生了越来越显著的影响。研究认为, 科学的慢性病管理应当包括亚健康和不良生活方式在内的全人群的慢性病预防。从两种体检、三个状态、九种体质、四种干预方法出发, 提出以健康帮扶、健康促进、体质调理为特色的“二三九四”中西医结合慢性病管理模式。进一步联合企业和社区的初步实践证明, 该模式有利于降低亚健康的现患率, 可提高健康人群的比例, 为中西医结合防治慢性病提供了一定的参考。     

基于社会资本理论的社区慢性病防治管理策略浅析

慢性非传染性疾病对居民健康的威胁与日俱增。预防和控制慢性病的蔓延是卫生工作者和公共卫生系统面临的挑战, 也关系到国家社会经济能否持续健康的发展。在社会资本理论这一全新视角下, 分析如何构建社区慢性病防治体系, 整合社会资源, 改善人际网络关系。社区慢性病防治体系的建立将为社会资本的重组和再生形成助推器, 并有助于实现二者的相互促进, 同时, 对提高医疗资源的使用效率, 减轻患者及其家属的经济负担, 建立互信互利的社区慢性病防治平台具有重要的现实指导意义。     

大脑两半球功能不对称性与儿童学业成绩

本研究调查了 3 1 8名小学一至三年级学生大脑两半球优势情况 ,然后对不同优势半球学生的语文和数学成绩进行了比较。结果发现优势半球为右半球的学生人数较少 ,只有 3 .8% ,明显少于优势半球为左半球的学生 (χ2 =2 3 9.83 0 ,p<0 .0 0 1 )。对不同优势半球学生的语文和数学成绩的比较 ,未发现两者有显著差异 (语文 :F=1 .1 3 0 ,p>0 .0 5 ;数学 :F=0 .5 75 ,p>0 .0 5 )。     

Are All Kids Alike? The Magnitude of Individual Differences in Personality Characteristics Tends to Increase from Early Childhood to Early Adolescence

Do individual differences in personality traits become more or less pronounced over childhood and adolescence? The present research examined age differences in the variance of a range of personality traits, using parent reports of two large samples of children from predominantly the USA and Russia, respectively. Results indicate (i) that individual differences in most traits tend to increase with age from early childhood into early adolescence and then plateau, (ii) that this general pattern of greater personality variance at older childhood age is consistent across the two countries, and (iii) that this pattern is not an artefact of age differences in means or floor/ceiling effects. These findings are consistent with several (noncontradictory) developmental mechanisms, including youths' expanding behavioural capacities and person–environment transactions (corresponsive principle). However, these mechanisms may predominantly characterize periods before adolescence, or they may be offset by countervailing processes, such as socialization pressure towards a mature personality profile, in late adolescence and adulthood. Finally, the findings also suggest that interpreting age trajectories in mean trait scores as pertaining to age differences in a typical person may sometimes be misleading. Investigating variance should become an integral part of studying personality development. Copyright © 2017 European Association of Personality Psychology     

领导-部属交换（LMX）的回顾与展望

领导-部属交换理论从领导和部属的对偶关系中考察领导行为及其对下属的绩效、组织承诺等结果变量的影响。文章回顾了领导-部属交换的文献,对于它的概念、理论基础、结构、测量工具等进行了综合介绍,对不同测量工具的各自的特点以及它们之间的关系做了分析,接着总结了影响领导-部属关系的影响因素和结果变量以及与变革型领导的关系,最后提出未来研究应该加强从领导部属交换的发展阶段以及从部属或领导的角度来分析领导-部属交换理论     

Alteration of cingulate long-term plasticity and behavioral sensitization to inflammation by environmental enrichment

Exposure to an enriched environment (EE) has been shown to induce cortical plasticity. Considerable amount of research is focused on the effects of EE in the hippocampus; however, effects of EE on other brain regions and the mechanisms involved are not well known. To investigate this, we induced cortical plasticity by placing mice in an EE for one month and measured the effects of EE in the anterior cingulate cortex (ACC). Here, we show that EE enhanced the expression of the plasticity gene, egr-1, in the ACC of EE animals accompanied by enhanced cingulate long-term potentiation (LTP) and decreased cingulate long-term depression (LTD). The increased NMDA receptor NR2B/NR2A subunits current ratio is associated with the plasticity seen in the ACC while total protein levels remain unchanged. Furthermore, behavioral experiments show that these mice exposed to EE demonstrate enhanced responses to acute and long-term inflammation. Our findings suggest that exposure to EE alters physiological properties within the ACC which results in enhanced responses to inflammation.