1989年～2008年中国卫生人力资源配置的公平性评价

资源分配的公平性是卫生事业发展普遍关注的重要命题.基于基尼系数和洛伦兹曲线的变化评价了过去20年我国卫生人力配置公平性的变动情况,得出中国卫生人力分布公平性正逐年优化,但受经济发展不均影响仍待改善.今后应吸引和鼓励高质童的卫生人力向经济不发达地区转移,并增大对不发达地区的资金支持.     

Evaluating the performance of different procedures for constructing confidence intervals for coefficient alpha: A simulation study

Reliability is one of the most important aspects of testing in educational and psychological measurement. The construction of confidence intervals for reliability coefficients has important implications for evaluating the accuracy of the sample estimate of reliability and for comparing different tests, scoring rubrics, or training procedures for raters or observers. The present simulation study evaluated and compared various parametric and non-parametric methods for constructing confidence intervals of coefficient alpha. Six factors were manipulated: number of items, number of subjects, population coefficient alpha, deviation from essentially parallel condition, item response distribution and type. The coverage and width of different confidence intervals were compared across simulation conditions.     

The Compromise Effect in Choosing for Others

Most research into the compromise effect focuses on cognitive factors related to choosing for oneself. However, there are daily opportunities to make choices for others, from helping friends to buy merchandise to choosing souvenirs for relatives. Although it is a common practice, choosing for others is rarely discussed in the literature. Hence, this research is directed to determine whether (i) the compromise effect is greater for people choosing for others with whom one has a distant relationship compared to choosing for themselves, (ii) the decision maker's susceptibility to interpersonal relationships, accountability, and anticipated regret moderate the relationship between choosing for others versus choosing for themselves and the compromise effect, and (iii) the confidence of the decision maker mediates the relationship between deciding for others and the compromise effect. Five hypotheses are proposed and they are supported by the results from four experiments. Copyright © 2011 John Wiley & Sons, Ltd.     

循证护理在ICU人工气道患者意外拔管中的应用

探讨循证护理在人工气道患者意外拔管中的应用.通过对123例ICU人工气道患者气管导管进行临床评估,应用循证护理的概念和实施步骤,制定护理干预措施.通过循证护理的干预,患者意外拔管发生率降低.循证护理改变了临床护士以往以经验和感觉为主的习惯和行为,有效地降低了ICU人工气道患者意外拔管的发生率,提高患者生存质量.     

APC及p63在人口腔鳞状细胞癌发生中的表达及病理意义

为了探讨抑癌基因APC及p63在口腔鳞状细胞癌中的蛋白表达水平和病理意义,实验收集46例人口腔鳞癌石蜡包埋组织,采用elivision染色法检测口腔正常黏膜上皮、上皮异常增生和口腔鳞癌组织中的APC及p63的表达变化,最后将各组份的免疫组化结果与各病例的临床病理学资料使用Kruskal- Wallis检验或Spearman相关性检验,进行统计学处理.结果显示APC蛋白胞浆表达水平与口腔鳞癌的分化呈正相关(P＜0.05),p63蛋白胞核表达水平与口腔鳞癌的分化呈负相关(P＜0.05).APC与其淋巴结有否转移无相关性,而p63与其淋巴结转移有否呈负相关(P＜0.05).因此,APC及p63的表达与口腔鳞癌的发生密切相关,而且与口腔鳞癌的分化程度有关,提示APC和p63可作为口腔鳞癌的发生和预后的检测指标.     

Alerting and orienting of attention without visual awareness

Two types of the attentional network, alerting and orienting, help organisms respond to environmental events for survival in the temporal and spatial dimensions, respectively. Here, we applied chromatic flicker beyond the critical fusion frequency to address whether awareness was necessary for activation of the two attentional networks. We found that high-frequency chromatic flicker, despite its failure to reach awareness, produced the alerting and orienting effects, supporting the dissociation between attention and awareness. Furthermore, as the flicker frequency increased, the orienting effect attenuated whereas the alerting effect remained unchanged. According to the systematic decline in temporal frequency sensitivity across the visual hierarchy, this finding suggests that unconscious alerting might be associated with activity in earlier visual areas than unconscious orienting. Since high-frequency flicker has been demonstrated to only activate early visual cortex, we suppose that neural activation in early visual areas might be sufficient to activate the two attentional networks.     

Use of the estimated intraclass correlation for correcting differences in effect size by level

In a meta-analysis of intervention or group comparison studies, researchers often encounter the circumstance in which the standardized mean differences (d-effect sizes) are computed at multiple levels (e.g., individual vs. cluster). Cluster-level d-effect sizes may be inflated and, thus, may need to be corrected using the intraclass correlation (ICC) before being combined with individual-level d-effect sizes. The ICC value, however, is seldom reported in primary studies and, thus, may need to be computed from other sources. This article proposes a method for estimating the ICC value from the reported standard deviations within a particular meta-analysis (i.e., estimated ICC) when an appropriate default ICC value (Hedges, 2009b) is unavailable. A series of simulations provided evidence that the proposed method yields an accurate and precise estimated ICC value, which can then be used for correct estimation of a d-effect size. The effects of other pertinent factors (e.g., number of studies) were also examined, followed by discussion of related limitations and future research in this area.     

重复知盲效应产生的机制——来自汉语叠词加工的证据

以汉语中的叠词为实验材料,对重复知盲产生机制的类型标记个体化理论和建构理论进行检验。采用RSVP研究范式,在两个实验中让178名被试口头报告列表中出现的所有汉字（全部报告）或列表中最后两个字（部分报告）。结果发现：（1）在呈现速率为128ms和198ms时,完全重复的汉字在全部报告和部分报告任务中均存在RB效应,但在部分报告任务下出现的RB相比全部报告任务的减少了,符合建构理论的假设。（2）在全部报告条件下,不仅重复刺激的正确报告率会降低,而且与重复刺激相关的非重复刺激的正确报告率也会降低。研究表明建构理论比类型标记个体化理论更能解释RB效应的产生机制。     

流动人口对结核病相关知识和政策的认知及态度研究

对229例流动人口结核病疑似患者采用问卷调查,开展多次专题小组讨论和个人深入访谈。结果发现,流动人口对结核病相关知识和免费治疗政策了解有限,看法不一。对结核病治疗转归情况有不同程度的担心,且对结核病人持谨慎态度。建议加大流动人口健康教育的力度,以减少对结核病人的社会歧视,并探索建立传染病专项保险制度以提高全国性减免方案的效果。     

西医——中医挥之不去的他者

中西医的论证是医学哲学与医学史研究的热点问题。后现代哲学可以为理解两种医学之间的关系提供一个新的视角。本文运用后现代哲学中的“他者”观念回顾了中西医之间张力的演变,指出在整个过程中“中医”未能摆脱“西医”作为“他者”的注视。并从后现代医学的角度对这种张力的未来进行展望。