临床整合医学的必要性及实施中存在的问题——以慢性阻塞性肺疾病及其合并症的诊治为例

近年来人们逐渐认识到慢性阻塞性肺疾病(COPD)是一种全身性疾病,即COPD不仅会影响到气道和肺,还会引起一系列合并症,包括心血管疾病、骨质疏松、焦虑和抑郁、癌症、感染、代谢综合征和糖尿病等。这些合并症会显著地影响COPD疾病严重程度和预后,因而必须对COPD进行整体防控,然而COPD的上述合并症的诊治分属不同学科,所以要做好COPD的整体防控就需要相关学科进行医学整合。     

The spatial distance rule in the moving and classical rubber hand illusions

The rubber hand illusion (RHI) is a perceptual illusion in which participants perceive a model hand as part of their own body. Here, through the use of one questionnaire experiment and two proprioceptive drift experiments, we investigated the effect of distance (12, 27.5, and 43 cm) in the vertical plane on both the moving and classical RHI. In both versions of the illusion, we found an effect of distance on ownership of the rubber hand for both measures tested. Our results further suggested that the moving RHI might follow a narrower spatial rule. Finally, whereas ownership of the moving rubber hand was affected by distance, this was not the case for agency, which was present at all distances tested. In sum, the present results generalize the spatial distance rule in terms of ownership to the vertical plane of space and demonstrate that also the moving RHI obeys this rule.     

Emotional inertia: A key to understanding psychotherapy process and outcome

The processes underlying psychotherapeutic change have increasingly been emphasized in both research and clinical practice. Nonlinear dynamical systems theory (NDS) offers a transdisciplinary scientific approach to the study of these processes. This paper introduces the NDS concept of “emotional inertia”, the property of human emotion by which it retains its course so long as it is not acted upon by an external force, as a key to understanding moment-by-moment and also longer-term change processes within psychotherapy. A testable mathematical model of emotional inertia is presented that represents specific impacts of psychotherapeutic processes on emotional dynamics over time. Emotional trajectories in phase space, treatment energy, and the interaction between them are the essential elements of the model, and a detailed explanation is provided. Procedures for testing this model are described, such as by tracking the movement of emotion in phase space within and across therapy sessions, along with clinical implications of the model, which can potentially help to make more clear the complementary roles of therapeutic force, timing, and leverage.     

NARCISSISTIC DEFENSES IN THE DISTORTION OF FREE ASSOCIATION AND THEIR UNDERLYING ANXIETIES

This paper examines particular distortions in the process of free association characteristics of patients with narcissistic personality disorders. The author proposes that the dominant narcissistic transference developments typical of the early and middle phases of the analytic treatment of these patients are reflected in these distortions of free association. This paper gathers the various patterns that these defensive distortions present, along with technical interventions geared to deal with them.     

How Neighborhood Poverty Structures Types and Levels of Social Integration

Social integration is fundamental to health and well‐being. However, few studies have explored how neighborhood contexts pattern types and levels of social integration that individuals experience. We examined how neighborhood poverty structures two dimensions of social integration: integration with neighbors and social integration more generally. Using data from the United States Third National Health and Nutrition Examination Survey, we linked study participants to percent poverty in their neighborhood of residence (N = 16,040). Social integration was assessed using a modified Social Network Index and neighborhood integration based on yearly visits with neighbors. We fit multivariate logistic regression models that accounted for the complex survey design. Living in high poverty neighborhoods was associated with lower social integration but higher visits with neighbors. Neighborhood poverty distinctly patterns social integration, demonstrating that contexts shape the extent and quality of social relationships.     

邻近效应对多媒体学习中图文整合的影响:线索的作用

在多媒体学习中图文排列的邻近或远离会影响学习的效果。本研究操纵了多媒体呈现的图文排列位置,采用颜色作为线索引导注意,探讨了线索有无和图片-文字的空间位置对多媒体学习图文整合的影响。结果发现:图文邻近呈现时的保持测验和迁移测验成绩好于图文远离呈现,图文邻近呈现时学习者对关键兴趣区的进出次数更多,体现出以文字为导向的阅读模式。线索并没有单独影响学习成绩和注意分配;但结合图文位置后,发现有线索时图文邻近学习材料的注视次数、进出关键兴趣区的次数显著多于图文远离。研究认为:图文的邻近效应不仅提高学习者对知识的识记和理解,同时也影响了学习者的注意分配过程,图文邻近呈现有助于图片和文本信息的注意联结和知识整合;线索能使邻近效应得到凸显,更好地促进图文信息的注视加工,但没有改进学习的效果。     

The Identity‐Location Binding Problem

The binding problem is fundamental to visual perception. It is the problem of associating an object's visual properties with itself and not with some other object. The problem is made particular difficult because different properties of an object, such as its color, shape, size, and motion, are often processed independently, sometimes in different cortical areas. The results of these separate analyses have to be combined before the object can be seen as a single coherent entity as opposed to a collection of unconnected features. Visual bindings are typically initiated and updated in a serial fashion, one object at a time. Here, we show that one type of binding, location‐identity bindings, can be updated in parallel. We do this by using two complementary techniques, the simultaneous‐sequential paradigm and systems factorial technology. These techniques make different assumptions and rely on different behavioral measures, yet both came to the same conclusion.     

The role of work–family role integration in a job demands–resources model among Chinese secondary school teachers

The current study examines an integrative demands–resources model of the work–family interface in a sample of 259 Chinese secondary school teachers. Participants completed questionnaires relating to job demands, job resources, work‐to‐family conflict, work‐to‐family enrichment, work–family role integration (WFRI) and burnout scale. Results show that: (i) job demands were strongly and positively associated with work‐to‐family conflict, which further led to an increase in burnout; job resources were strongly and positively associated with work‐to‐family enrichment, and consequently to a decrease in burnout. Job demands also had a significant direct impact on burnout; (ii) a newly proposed construct, WFRI, was found to partially mediate the relationship between job demands and work‐to‐family conflict, as well as between job resources and work‐to‐family enrichment. Theoretical and practical implications are discussed, and future research directions are provided.     

我是谁?——人际间多感觉刺激下的识脸错觉

识脸错觉是在人际间同步多感觉刺激下将他人面孔感知为自我面孔的一种主观体验。继Tsakiris报告了识脸错觉现象之后,研究者通过选取不同的刺激呈现方式、不同的被试,重点对被试的主观体验、行为反应两个方面进行了考察,并得到了大量新的研究成果;发现年龄、性别及内部敏感性是影响识脸错觉强度的重要因素,右侧颞顶联合区、顶内沟和枕下回的神经活动与被试主观报告的错觉体验强度相关。未来识脸错觉研究应侧重于研究策略的多样化并为生物特征识别中新模态的选择提供理论支持。此外,同步多感觉刺激技术的开发与应用将会对自我新面孔认同训练具有重要意义。     

Finnish Teachers’ Attitudes About Muslim Students and Muslim Student Integration

Although there is much discussion of educational needs and how to integrate Muslim students into modern Western contexts, there is a shortage of research on teachers’ attitudes about these issues. Finland offers a particularly interesting context for research, given its relatively new, small, yet rapidly growing Muslim population, its prominence of negative attitudes to visible religiosity, and its official policy of multiculturalism. This article presents the results of a quantitative study of Finnish teachers’ attitudes to Muslim students and to their integration into Finnish schools. A nonprobability sample of Finnish preservice and practicing teachers (N = 864) was surveyed and the resulting data analyzed with exploratory factor analysis, t‐tests, and ANOVA. The results indicate that Finnish teachers consider learning about general democratic values important, but their attitudes to dealing with Islam and Muslims are not quite as positive. However, previous involvement with other cultures indicated more positive attitudes among preservice teachers. Female teachers and practicing teachers were more oriented toward the teaching of commonality, and teaching at a more advanced level indicated more positive attitudes to Muslims and Muslim integration.