超越启蒙心态

启蒙心态(the enlightenment mentality)作为人类历史上最具活力和转化力的意识形态,是现代西方崛起的基础。实际上,作为现代特征的,人们关注的所有主要领域,比如科学技术、工业资本、市场经济、民主政治等等,都从启蒙心态中受惠或汲取养分。而且,我们追求的那些被视为属于现代意识的价值,比如自由、平等和人权等等,如果不是在结构上,就是在起源上,与启蒙心态密不可分。     

Comparative effectiveness of CBT interventions for co-morbid chronic pain & insomnia: A pilot study

IntroductionChronic pain is difficult to treat and often precedes or exacerbates sleep disturbances such as insomnia. Insomnia, in turn, can amplify the pain experience. Both conditions are associated with inflammatory processes, which may be involved in the bi-directional relationship between pain and sleep. Cognitive behavioral therapy (CBT) for pain and CBT for insomnia are evidence based interventions for, respectively, chronic pain and insomnia. The study objectives were to determine the feasibility of combining CBT for pain and for insomnia and to assess the effects of the combined intervention and the stand alone interventions on pain, sleep, and mood outcomes compared to a control condition.MethodsTwenty-one adults with co-occurring chronic pain and chronic insomnia were randomized to either CBT for pain, CBT for insomnia, combined CBT for pain and insomnia, or a wait-list control condition.ResultsThe combined CBT intervention was feasible to deliver and produced significant improvements in sleep, disability from pain, depression and fatigue compared to the control condition. Overall, the combined intervention appeared to have a strong advantage over CBT for pain on most outcomes, modest advantage over both CBT for insomnia in reducing insomnia severity in chronic pain patients.DiscussionCBT for pain and CBT for insomnia may be combined with good results for patients with co-occurring chronic pain and insomnia.     

Socially Anxious and Peer-Victimized Preadolescents: “Doubly Primed” for Distress?

We examined independent and interactive associations linking preadolescents' socially anxious feelings and peer victimization experiences with their social behaviors (rated by parents and teachers) and psychophysiological arousal during lab simulations of salient peer stress situations in preadolescence (peer evaluation and peer rebuff). Sixty-three preadolescents and one parent per preadolescent participated. Respiratory sinus arrhythmia (RSA), skin conductance level (SCL), and heart rate (HR) were assessed during peer stress situations. Preadolescents provided reports of social anxiety; preadolescents and parents reported on peer victimization; and parents and teachers rated prosocial and aggressive behaviors. Peer victimization moderated associations between social anxiety and both physiological arousal and social-behavior problems. As hypothesized, social anxiety was more strongly associated with lower RSA, higher HR, and higher aggressive behavior among preadolescents who experienced higher levels of peer victimization, compared to preadolescents who experienced lower levels of peer victimization.     

The Content of the Threat Matters: the Differential Effects of Quantitative and Qualitative Job Insecurity on Different Types of Employee Motivation

Given the conceptual differences between different types of job insecurity, it is important to distinguish qualitative job insecurity from quantitative job insecurity when examining their motivational consequences. Building on the approach and avoidance framework, we expect that quantitative job insecurity influences avoid-performance goal orientation (avoidance form of motivation) via psychological safety, whereas qualitative job insecurity influences learning goal orientation (approach form of motivation) via psychological meaningfulness. We also examine the moderating role of organizational justice in such effects. Using two-wave data collected from 281 employees in China, we found that quantitative job insecurity had a positive indirect effect on employee avoid-performance goal orientation via decreased psychological safety, whereas qualitative job insecurity had a negative indirect effect on employee learning goal orientation via decreased psychological meaningfulness. In addition, organizational justice buffered the direct effect of quantitative job insecurity on employee psychological safety and the subsequent indirect effect on employee avoid-performance goal orientation. However, organizational justice did not moderate the influence of qualitative job insecurity on employee outcomes. Our findings provide new insights into the motivational implications of job insecurity.

     

A Class of Distribution-Free Models for Longitudinal Mediation Analysis

Mediation analysis constitutes an important part of treatment study to identify the mechanisms by which an intervention achieves its effect. Structural equation model (SEM) is a popular framework for modeling such causal relationship. However, current methods impose various restrictions on the study designs and data distributions, limiting the utility of the information they provide in real study applications. In particular, in longitudinal studies missing data is commonly addressed under the assumption of missing at random (MAR), where current methods are unable to handle such missing data if parametric assumptions are violated. In this paper, we propose a new, robust approach to address the limitations of current SEM within the context of longitudinal mediation analysis by utilizing a class of functional response models (FRM). Being distribution-free, the FRM-based approach does not impose any parametric assumption on data distributions. In addition, by extending the inverse probability weighted (IPW) estimates to the current context, the FRM-based SEM provides valid inference for longitudinal mediation analysis under the two most popular missing data mechanisms; missing completely at random (MCAR) and missing at random (MAR). We illustrate the approach with both real and simulated data.     

MIRT模型中多维能力及其相关矩阵估计的影响因素

多维项目反应理论因其模型本身的天然优势及其兼具因素分析与项目反应理论于一身的优点,而被广大研究者及应用者所重视.本研究在前人研究基础上,重点讨论MIRT多维能力及能力间相关矩阵的参数估计问题.研究采用Monte Carlo模拟方法进行,在三因素完全随机设计（4 ×3×3）下,使用MCMC算法,探讨测验维度数、维度间的相关大小和测验项目数三个因素对MIRT能力及其相关矩阵估计的影响.     

临床思维与决策能力是医学教育的重要组成部分

临床思维与决策能力培养是医学生不可或缺的一门必修课程,临床医生实际上每天处于临床决策之中,必须为疾病提供诊断和治疗的决策.而当前临床医学生在此方面训练甚少,临床工作具有很大的不可预知性和不可确定性,尤其是在手术室繁忙、变化的环境中,进行高效的临床决策就显得尤其重要.本文阐述了临床思维与临床决策在医学教育中的重要地位及其相互关系,分析当前医学生临床实践中的思维与决策方面存在的问题.并从临床实际角度出发,探讨如何提高医学生临床思维与决策能力的方法,对促进医学教育模式改革,提高医学教育质量具有重要推动作用.     

Modeling Concordance Correlation Coefficient for Longitudinal Study Data

Measures of agreement are used in a wide range of behavioral, biomedical, psychosocial, and health-care related research to assess reliability of diagnostic test, psychometric properties of instrument, fidelity of psychosocial intervention, and accuracy of proxy outcome. The concordance correlation coefficient (CCC) is a popular measure of agreement for continuous outcomes. In modern-day applications, data are often clustered, making inference difficult to perform using existing methods. In addition, as longitudinal study designs become increasingly popular, missing data have become a serious issue, and the lack of methods to systematically address this problem has hampered the progress of research in the aforementioned fields. In this paper, we develop a novel approach to tackle the complexities involved in addressing missing data and other related issues for performing CCC analysis within a longitudinal data setting. The approach is illustrated with both real and simulated data.