医疗风险防范与化解新趋向

新的《医疗事故处理条例》实施以后,患者的自我保护意识不断增强、高精尖医疗器械的应用、新技术的不断开展等均增加了医疗行为的风险,医疗风险管理显示出日益重要的作用。新形势下医疗风险管理的新趋向是建立自愿的医疗责任保险、组织患者参加医疗风险保险、建立强制性医疗责任保险制度、卫生行政部门代理保险业务、建立医疗援助基金等方式,提出了在风险控制的基础上,加强风险融资的措施。     

Longitudinal interplay of young children's negative affectivity and maternal interaction quality in the context of unequal psychosocial resources

Interaction quality and child temperament predict early and later child development. Research hints at transactional interrelations of both aspects but lacks adequate data to examine this assumption. Maternal psychosocial resources are suspected moderators in this context but rarely taken into account. Drawing on data of the German National Educational Panel Study we conducted a cross-lagged panel analysis on the longitudinal interplay of maternal interaction quality and children's negative affectivity at 6–8, 16–18, and 25–27 months and compared mothers with and without accumulated strains. Both variables showed moderate to high structural and rank order stability over time and low but increasing connections. In the case of accumulated stress factors, interaction quality is clearly impaired and high negative affectivity acts as an additional burden while low negative affectivity helps strained mothers to maintain higher interaction quality but only in the first year of life.     

Risky behavior in young adult pedestrians: Personality determinants,correlates with risk perception,and gender differences

Based on the risk homeostasis theory, the aim of this study was to assess acceptable risk, measured by personality factors, and risk perception, measured by physiological arousal, as predictors of risky behavior in young adult pedestrians, as well as to assess for gender differences. Eighty-two young adults, aged 18–30, completed self-report measures about risky pedestrian behaviors and these personality traits: impulsiveness, conscientiousness and openness to experience. Sixty-four of these participants then took part in an experimental task designed to assess their perception of the level of risk in situations involving different interactions between cars and pedestrians. Risk perception was assessed by these physiological responses: heart rate, skin conductance level, and skin conductance response. Results showed that risky behavior had significant correlations with impulsiveness, conscientiousness, and skin conductance level. Gender differences also emerged in risky behavior, impulsiveness, conscientiousness, and skin conductance level. Finally, a structural equation model showed that impulsiveness, conscientiousness and the difference in skin conductance level between risky and neutral situations predicted risky pedestrian behaviors, and explained 23.6% of the its variance, after controlling the effect of gender. Implications for evaluation, prevention, and intervention for risky pedestrian behaviors are discussed.     

Driving construals: Personal Construct Theory in a reckless driving context

With research revealing low road safety campaign efficacy and links between reckless driving behaviors and crash frequency, further investigation into the foundations and composition of driver education and training is required. Through two studies, the current research aimed to develop a measure that utilized the principles of Kelly’s (1955) Personal Construct Theory to (a) elicit constructs, or construals, specific to selected elements of reckless driving behaviors, (b) pilot a method in which the elicited constructs could be measured by asking participants to choose those they deemed most important, (c) group participants based on their constructs, and (d) assess between-group differences in self-reported reckless driving behavior. Results suggest that drivers can be categorized based on the constructs they use, and that rates of self-reported past engagement in reckless driving behavior, and willingness to do so in the future, vary systematically between these construal-based driver categories. Continuing research is required to develop and test applications of these findings.     

Drawing to reconstruct: Pilot study on acknowledging prisoners' internal and external resources in a penitentiary institution

Since the first offender rehabilitation treatments, all theoretical approaches have been focusing on reducing risk factors that may influence recidivism, without satisfactory results. Recent resilience research has instead shown the important mediating or moderating role of protective factors and provided the theoretical principles for the Good Lives Model Comprehensive. This holistic model suggests the importance of integrating the reduction of risk factors with the reinforcement of protective factors in offenders' treatment programs. This combined action is considered the main condition through which offenders are motivated to change their life and develop a sense of agency on their current life conditions. This article presents a pilot study, aimed at analyzing the feasibility of a psychosocial intervention, based on graphic workshops. The purpose of the intervention is helping prisoners strive toward adaptation in jail, and facilitating the redesign of their life beyond bars. Drawing activities allowed prisoners to enhance their own internal and external resources, and recognize risk and protective factors that could influence their successful reintegration into society. The main limit of this study is directly linked to the setting of the penitentiary institution where the study was conducted, which is characterized by a high prisoners' turn over.     

自然语言处理预测抑郁症的技术陷阱与道德风险

抑郁症患者倾向于在网络社交平台上发布带有抑郁信号的推文。基于这些文字信息，借助自然语言处理进行分析，提取归纳用户的语言特征，可以预测潜在用户的抑郁症状况。由于隐私信息的敏感、相关技术的不成熟等原因，出现了诸如信息获取与隐私侵犯、算法偏见与信息误判、信息权利与信息利益、责任界定与权限模糊等现实问题，成为进一步发展的掣肘。进行算法技术升级、完善法律法规、加强行业伦理约束等是避免道德风险的重要措施。     

The Effect of Genetic Counseling on Knowledge and Perceptions Regarding Risks for Breast Cancer

In 1994, a clinic for cancer risk counseling was opened at Hadassah University Hospital in Jerusalem. Most of the counselees have been women who had breast cancer and/or a relative with breast cancer. In order to evaluate the effect of this counseling on women's knowledge and perceptions regarding the risks for breast cancer, a questionnaire was given before and after the counseling session to 60 healthy women who came to the clinic because they have relatives with breast cancer. According to the genetic counselors' estimations, most of these women had a significantly increased risk (compared to the general population) of developing cancer. Before counseling, the women overestimated the population risk for breast cancer, the contribution of heredity to morbidity of cancer, and their own risks to get cancer. After counseling session, they gave reduced estimates, closer to the real ones. The subjective perceptions regarding these risks were reduced after counseling, except for the perceptions regarding their relativerisks which have not changed after the counseling. About 90% of the women who came to the clinic wanted to be tested for genetic predisposition to cancer. For most of these women, the expectations that the test can rule out a genetic predisposition to cancer became more realistic after the counseling. The option to first test an affected relative was offered to all families, and a test was actually conducted in 75% of the families.     

Psychological Interventions and Genetic Testing: Facilitating Informed Decisions About BRCA1/2 Cancer Susceptibility

Genetic testing for inherited cancer susceptibility, based on the recently identified. BRCA1 and BRCA2 genes, will soon be available on a large scale. However, at present, genetic test results do not lead to clearly indicated diagnostic or preventive measures, and the nature of the psychological impact of BRCA1/2 testing is still largely unknown. This uncertainty, combined with preliminary evidence suggesting significant individual differences in reactions to genetic susceptibility feedback, constitutes a unique challenge for any individual contemplating such testing. We outline the nature of this challenge and then propose an intervention strategy designed to help individuals make deeply processed and psychologically well-informed decisions with regard to their genetic susceptibility. The intervention is guided by recent research findings and theory on the cognitive–emotional processing of cancer-risk information. Specifically, the goal is to prepare the individual for genetic testing by (1) cognitively and emotionally activating, or preliving, the individual's potential reactions to testing feedback; (2) facilitating accurate appraisal of the individual's cognitive–emotional reactions; and (3) enabling the individual to process these reactions through the use of well-established clinical techniques.     

Concurrent validity and Holland's theory

This study was designed to explore two areas: (1) the concurrent validity of Holland's theory for employed men using four different operational definitions of vocational orientation, and (2) the relationships among all possible combinations of same named scales across the four inventories. Concurrent validity was studied by administering the Vocational Preference Inventory, the Self Directed Search, and the Holland Scales (Set I and Set II) to 153 male workers established in occupational environments consistent with Holland's six vocational environments. The results revealed that five scales of the VPI and of the Holland Scales (Set I and Set II) and four scales of the SDS successfully differentiated the occupational groups consistent with Holland's theoretical framework. The correlation coefficients for same named scales for all possible combinations of the four inventories were all found to be significant. In general, the findings of this study tend to support the concurrent validity of Holland's theory for employed men.     

Consistent occupational preferences,vocational maturity,and academic achievement

This study explored the differences in vocational maturity, academic aptitude, and achievement variables among female sorority students who made congruent, incongruent, and undecided occupational choices. The variables were operationally defined by the Career Maturity Inventory, the American College Test Battery, and a self-report questionnaire. Congruent, incongruent, and undecided current occupational choice groups were defined operationally using the Self-Directed Search. The analysis of variance revealed the main effect of groups to be significant for two variables. The findings suggest that students in the congruent female group tend to be more vocationally mature than students in the incongruent and undecided groups.