自我保护性医疗的伦理扫描--论患方知情同意与医方规避风险

自我保护性医疗是近年来医方为应对医患关系重构而采取的一种行为模式,其本身和影响具有全新特点,充满价值冲突;这种行为模式,客观上是对应医疗风险尤其是重大医疗风险的;主观上同医方免责期待的张扬以及对知情同意的解读直接相关;因而,正当的自我保护性医疗既取决于医方合理的免责期待,以及改变对知情同意的误读,更依赖于自身的医学伦理综合素质的打造和完善。     

Adverse caregiving in early life: The trauma and deprivation distinction in young children

Knowledge and understanding about the impact of cumulative adverse experiences on the health and wellbeing of children, adolescents, and adults has rapidly expanded over the past 30 years. Despite the invaluable attention and support this proliferation has drawn to the importance of early childhood experiences, we believe that it is time to move beyond broad indices of risk and toward more specific and individualized understanding of how risk exposures are linked to clinical outcomes in young children. Within infant and early childhood mental health, there is a need for greater specificity in linking adverse caregiving experiences in early life to psychopathology in children. We highlight a framework distinguishing experiences of trauma from experiences of deprivation and use the examples of posttraumatic stress disorder and reactive attachment disorder to demonstrate how greater specificity in our understanding of early adverse caregiving can lead to more accurate and targeted diagnosis and treatment for young children. Both researchers and clinicians benefit from an approach to gain a greater appreciation of the links between specific types of experiences and outcomes in the children that we serve.     

Why Young Men Drive Dangerously: Implications for Injury Prevention

Why is risk consistently underestimated, and why do young men in particular take exceptionally high risks and think of themselves as invulnerable? Two explanatory paths are proposed. The first is that risk taking in young males has been shaped by evolutionary forces to provide a fitness value. The second pathway is through myth and the other narrative forms that affirm the ego's immortality and invulnerability. Because of its evolutionary base, risk taking is emotionally driven: Emotions are preverbal and irrational, which means that persuasive prevention cannot be more than weakly successful. Three prevention challenges emerge from this analysis: to determine what it is that young drivers fear, to attach affectively experienced fears to defined driving behaviors, and to devise injury-prevention programs that acknowledge that young males' risk taking is not "stupid," but driven by adaptive needs that are as significant to today's young adults as they were to our distant ancestors.     

累积生态风险与高职生学习倦怠：消极自我图式和网络成瘾的中介作用

采用累积生态风险问卷、消极自我图式问卷、网络成瘾问卷以及学习倦怠问卷对湖南省4所高职院校的664名高职生进行调查,考察累积生态风险与高职生学习倦怠的关系以及消极自我图式、网络成瘾的中介作用。结果发现:(1)高职生累积生态风险、消极自我图式、网络成瘾和学习倦怠均呈显著正相关;(2)高职生累积生态风险对学习倦怠的直接效应和间接效应均显著。间接效应包括了三条路径:通过消极自我图式的中介作用、通过网络成瘾的中介作用以及通过消极自我图式和网络成瘾的链式中介作用。这一结论有助于理解累积生态风险对学习倦怠的作用机制,为降低高职生的学习倦怠提供参考建议。     

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。     

Salience Versus Proportional Reasoning: Rethinking the Mechanism Behind Graphical Display Effects

Two experiments examined predictions from two separate explanations for previously observed display effects for communicating low‐probability risks: foreground:background salience and proportional reasoning. According to foreground:background salience, people's risk perceptions are based on the relative salience of the foreground (number of people harmed) versus the background (number of people at risk), such that calling attention to the background makes the risk seem smaller. Conversely, the proportional reasoning explanation states that what matters is whether the respondent attends to the proportion, which conveys how small the risk is. In Experiment 1, we made the background more salient via color and bolding; in contrast to the foreground:background salience prediction, this manipulation did not influence participants' risk aversion. In Experiment 2, we separately manipulated whether the foreground and the background were displayed graphically or numerically. In keeping with the proportional reasoning hypothesis, there was an interaction whereby participants given formats that displayed the foreground and background in the same modality (graphs or numbers, thereby making the proportion easier to form) saw the probability as smaller and were less risk averse than participants given the information in different modalities. There was also a main effect of displaying the background graphically, providing some support for foreground:background salience. In total, this work suggests that the proportional reasoning account provides a good explanation of many display effects related to communicating low‐probability risks, although there is some role for foreground:background salience as well. Copyright © 2018 John Wiley & Sons, Ltd.     

Cultural worldviews and climate change: A view from China

We investigated the association between cultural worldviews and climate change risk perceptions, support for climate friendly policies and climate change mitigation behaviours in a large Chinese sample. Items from Dake's cultural theory scales and Kahan's cultural cognition scale were presented to a Qualtrics online panel consisting of 515 Mandarin‐speaking residents of Beijing. A series of factor analyses revealed that the combined item sets were best represented by four‐dimensions: hierarchism, individualism, egalitarianism and fatalism. Mediation analysis revealed that respondents with egalitarian and non‐fatalist worldviews perceived greater risk associated with climate change, which in turn predicted greater support for policies to manage climate change and increased mitigation behaviour. In addition, respondents who scored high on individualism were less likely to support climate change policies, but this effect was not mediated by risk perceptions. Overall, our results suggest cultural worldviews may influence policy support both directly and indirectly through risk perceptions.     

判断与决策研究纵观:基于模糊痕迹理论的视角(英文)

模糊痕迹理论是用于解释记忆、判断与决策的综合性理论,该理论的提出和发展主要基于对信息存储、表征、提取和加工过程的研究。本文首先介绍了模糊痕迹理论的基本原则,在此基础上重点讨论了其要义(gist)如何发挥核心作用,使得模糊痕迹理论有别于其他传统的决策模型。该理论将高级直觉与原始冲动性进行了区分,并且预测决策误差来源于判断与决策的各种不同成分,如背景知识、信息表征、提取和加工过程等。模糊痕迹理论不仅可以解释诸如框架效应、合取谬误等传统决策与判断文献中常讨论的误差现象,同时基于该理论的研究还得到了一些与传统决策理论相悖的新发现。此外,对脑与行为如何发育性变化的研究为我们了解成人的认知过程提供了至关重要的新视角,这些对脑与行为的发育性研究和对特殊人群的研究结果也都支持了模糊痕迹理论对要义加工依赖的预测。     

Association of intimate partner violence with sociodemographic factors in married women: a population-based study in Iran

Intimate partner violence (IPV) is a neglected public health issue in Iran. This study was conducted among married women residing in urban Rasht (northern Iran), to estimate the prevalence and frequency of different forms of IPV from husband and their associations with socio-demographic factors. We carried out a population-based cross-sectional survey with cluster sampling design from February to October 2015. The samples consisted of married women aged ≥ 18 years with total household in Rasht city (north Iran) as the sample frame. We administered the Revised Conflict Tactics Scale (CTS-2) to estimate prevalence of past-year IPV. Of 2091 women, 57.1% had suffered psychological aggression, 27.6% physical abuse, 26.6% sexual abuse, and 6.9% injury. A significant association with IPV was found for women with, age ≤ 40 years, unemployed, low education, husband’s addiction and rented-householders. Women who experienced physical abuse, had less age at marriage than women without violence. Also women with sexual coercion had less length of marriage than other non-abused women. On logistic regression, the strongest predictor of psychological, physical and sexual abuse was unemployment of spouse, whereas for injury it was low educational level (<12 years) of women. Our findings suggest that risk of IPV is high in our population. There is an obvious need of preventive and treatment activities. Our findings point at that various forms of abuse are different from each other in terms of differing characteristics of the perpetrators and it might be that also different strategies are needed to reduce and prevent these violence. Confirmation by further research is needed.     

Childhood Exposure to Community and Domestic Violence: Prevalence,Risk Factors and Posttraumatic Outcomes in a South African Student Sample

The effects of exposure to direct and vicarious community and domestic violence on the posttraumatic adjustment of 323 South African students were examined. Data were collected using self-administered questionnaires, with the relationship between exposure to violence and posttraumatic outcomes being explored using binomial logistic regression analyses. Two hundred and sixty-two participants (81 %) reported that they had been exposed to some form of interpersonal violence during childhood. An analysis of risk factors for exposure to violence indicated that males were more than twice as likely as females to have experienced victimization by a community member. Direct exposure to domestic violence was the only form of violence which was found to be associated with Posttraumatic Stress Disorder (PTSD). Among participants who had experienced direct domestic violence, clinically significant levels of PTSD were significantly predicted by both gender (being female) and by abuse chronicity.