关于完善我国医学教育体系的思考

当前我国社会经济的迅猛发展,已经对现行的医学教育体系提出了强有力的挑战。从医学教育自身特点出发,探讨我国现行医学教育体系的一些重要缺陷及其对策。建议全面引入医学教育国际标准,调整培养要求,积极稳妥地推行长学制医学教育,建立严格而规范的毕业后基本职业技能培训及职业准入制度,理顺高等教育体系内的医学教育统一管理体制,以完善我国医学教育体系。     

Decision-making competence in younger and older adults: which cognitive abilities contribute to the application of decision rules?

Older adults perform worse than younger adults when applying decision rules to choose between options that vary along multiple attributes. Although previous studies have shown that general fluid cognitive abilities contribute to the accurate application of decision rules, relatively little is known about which specific cognitive abilities play the most important role. We examined the independent roles of working memory, verbal fluency, semantic knowledge, and components of executive functioning. We found that age-related decline in applying decision rules was statistically mediated by age-related decline in working memory and verbal fluency. Our results have implications for theories of aging and decision-making.     

Primary Care Provider Familiarity with Binge Eating Disorder and Implications for Obesity Management: A Preliminary Survey

Current guidelines for the evaluation and treatment of obesity recommend referring individuals with binge eating disorder (BED) to a mental health professional. However, it is unclear how familiar primary care providers are with BED. The purpose of this study was to assess providers' familiarity with BED diagnosis and treatment. Providers in two primary care clinics completed a questionnaire, which assessed perceived familiarity with BED and demonstrated familiarity with BED diagnosis and treatment. Results indicated that 61% of respondents demonstrated familiarity with the essential symptoms of BED, and 80% reported familiarity with the diagnosis of BED. However, 35% of respondents who perceived themselves as familiar with BED did not demonstrate familiarity with the most basic symptoms. These results demonstrate that while many providers in primary care are familiar with BED, steps to improve provider familiarity with the disorder and provide appropriate mechanisms to address BED are warranted.     

Serotonin: Modulator of a drive to withdraw

Serotonin is a fundamental neuromodulator in both vertebrate and invertebrate nervous systems, with a suspected role in many human mental disorders. Yet, because of the complexity of serotonergic function, researchers have been unable to agree on a general theory. One function suggested for serotonin systems is the avoidance of threat. We propose and review evidence for an alternative hypothesis, that a phylogenetically primitive of function of serotonin is to oppose the activating neuromodulators (particularly noradrenalin and dopamine). The functional effect of this opposition can be seen as applying a drive to withdraw from dangerous, aversive or high stimulation environments. Proposing that serotonin is involved in a drive to withdraw and seek contentment, instead of a drive to avoid, may be compatible with several lines of evidence on serotonin function and may facilitate a better understanding of serotonergic neuromodulation in human psychopathology.     

Preferences for arthritis care among urban African Americans: "I don't want to be cut".

Despite greater disability from knee osteoarthritis among Blacks, Whites are 3-5 times more likely to have total knee replacement (TKR). The authors explored whether beliefs among Blacks about arthritis and surgery contribute to this disparity. Ninety-four Blacks, ages 50 to 89, with knee arthritis underwent semistructured qualitative interviews regarding disability, beliefs about arthritis, beliefs about TKR, and treatment preferences. Content analyses yielded 6 themes: preference for natural remedies, negative expectations of surgery, beliefs about God's control, preference for continuing in their current state, relationships with specialists, and fear of surgery or death. Given its high levels of disability, this cohort had low expectations of TKR. Culturally sensitive educational programs might improve patient altitudes and beliefs regarding TKR, ultimately increasing appropriate usage.     

Reprocessing as a recognition cue

The use of mental operations as recognition cues was investigated. Two experiments support the hypothesis that processing details are retained in memory and that a re-creation of those processing details can effectively cue recognition. Four subjects performed a mental arithmetic task that emphasized speed and accuracy while discouraging memorization of the numbers. Recognition was cued either by single numbers or by a pair of numbers that, when added, replicated an episode of the original task. Reprocessing an episode was the most effective recognition cue. Of the two single-number cues, the intermediate subtotals were recognized, whereas the numbers that had been physically displayed were not. The study suggests: (1) that the sequence of mental operations is retained in memory, (2) that reprocessing uses this trace to facilitate performance, and (3) that the detection of facilitated reprocessing aids recognition.     

A software system for the collection of retrospective protocols prompted by eye fixations

A software system is capable of recording eye position, reducing these data to a sequence of eye fixations, and immediately replaying this fixation sequence superimposed over the original stimulus. The replay can be controlled by the subject to produce various speeds, to pause, or to back up to earlier fixations. The purpose of the replay software is to enable the eye fixations to prompt a retrospective verbal protocol. Such a prompted protocol should reduce the forgetting and fabrication problems that are often associated with retrospective protocols. In a preliminary experimental test, the prompted protocol method yielded longer protocols and contained more words than those generated by either the concurrent or retrospective protocol methods.     

Grounding abstract object characteristics in embodied interactions

Recent studies in cognitive linguistics have demonstrated that objects are conceptualised in terms of the actions they afford, i.e., in terms of their spatial-functional meaning. Since our interactions are constrained by the structure of our body, these studies view conceptualisation as essentially embodied. In this paper we argue that an object's abstract/figurative meaning is also embodied in that it is grounded in patterns of recurrent interactions with our environment, referred to as image schemas. On the basis of the spatial, relational structure of three such image schemas, two everyday products, a jug and an alarm clock, were systematically varied on form dimensions. Experiment 1 showed that participants with a background in design relate abstract characteristics to the form changes in the way predicted. To rule out the possibility that the relations uncovered are due to learned associations, a replication of the experiment was conducted with nai ve participants (experiment 2), leading to highly similar results. In experiment 3, we tested the cross-cultural consistency of our findings by performing a second replication with Brazilian participants. The results of this experiment were only partly in line with our predictions, suggesting that cultural differences in interacting with the environment to some degree affect our understanding of the abstract meaning of objects.