器官移植手术中的医患利益冲突

我国的器官移植手术得到超常发展的重要原因是走了捷径,海归医学人士为我国器官移植手术的开展做出了贡献。但器官移植发展“喜忧参半”。手术背后有医患之间的利益冲突。科学利益和经济利益至上给器官移植的健康发展蒙上阴影。必须加强器官移植的法规建设和管理监督,使我国的器官移植更符合伦理的要求。     

The structure of the Hospital Anxiety and Depression Scale: Theoretical and methodological considerations

The Hospital Anxiety and Depression Scale (HADS; Zigmond - Snaith, 1983) is widely used; however, its factor structure is unclear, with studies reporting differing unidimensional, two-factor and three-factor models. We aimed to address some key theoretical and methodological issues contributing to inconsistencies in HADS structures across samples. We reviewed existing HADS models and compared their fit using confirmatory factor analysis (CFA). We also investigated methodological effects by comparing factor structures derived from Rasch and Principal Components Analysis (PCA) methods, as well as effects of a negative wording factor. An Australian community-dwelling sample consisting of 189 females and 158 males aged 17–86 (M = 35.73, SD = 17.41) completed the 14-item HADS. The Rasch Analysis, PCA and CFA all supported the original two-factor structure. Although some three-factor models had good fit, they had unacceptable reliability. In the CFA, a hierarchical bifactor model with a general distress factor and uncorrelated depression and anxiety subscales produced the best fit, but the general factor was not unidimensional. The addition of a negative wording factor improved model fit. These findings highlight the effects of differing methodologies in producing inconsistent HADS factor structures across studies. Further replication of model fit across samples and refinement of the HADS items is warranted.     

Verbal-manual time sharing in children as a function of task priority

Eighty-three normal, right-handed children performed (a) unimanual finger tapping, (b) recitation of a tongue twister, and (c) both tasks concurrently. Tradeoffs in dual-task performance were measured as the priority assigned to each task was manipulated. Irrespective of task priority, speaking interfered to a greater degree with right-hand tapping than with left-hand tapping, but the effect of tapping upon verbal production and speech errors was not lateralized. The asymmetric effect of speech upon tapping, which was seen in 85.5% of the children, cannot be attributed to the disparity between hands in baseline tapping rate. The findings suggest that time-sharing asymmetry reflects cerebral lateralization of speech, but only some of the results would be predicted on the basis of a functional distance principle of cerebral organization.