论药物治疗安全：药疗错误的科学定位与安保革新

面对越来越多的最普遍的一种医疗错误—药物治疗错误,以及由此带给患者的身体损害和经济损失,必须对药疗错误进行科学定位和对患者安全保障体系与措施的革新。本文不在于详尽地论述药疗错误和安保的革新,而是通过对药疗错误的科学定位,提出对药疗错误的预防优先和以医者与患者为中心的药疗安全保障,强调重在研究和应用与药疗安全问题相关的健康信息技术和改变认知与处理药。总的认为:关于药疗安全与药疗错误,执行安全措施的障碍和改善药疗管理的当前和可能的机制以及我们应当知道什么和可以怎样做为好。     

Assessing technology acceptance for skills development and real-world decision-making in the context of train driving

Advances in technology have improved operator performance and efficiency in transport but it is not uncommon for end users to resist technology in spite of its benefits. Operators may resist technology from genuine and legitimate concerns though it is often seen as unjustified. While beneficial, such resistance can have detrimental effects on operations and safety, and can result in the withdrawal of a technology. Theories relating to technology acceptance include elements such as perceptions about the purpose and use of the technology, personal impact, individual characteristics, peer influence, perceived equity, and organizational factors. Although considerable research into technology acceptance and resistance has been conducted in other domains, very little has been conducted in transportation. Findings from two Australian studies are reported which examined train driver attitudes to two state-of-the-art technologies aimed at enhancing skills development and real-world decision-making. The technologies were implemented in the form of in-vehicle information support and simulated learning. Analysis of interviews defined three overarching themes relating to technology resistance: task dynamics related to ways of working and safety; redundancy regarding the utility of the technology and the impact on job security; and personal impact with respect to effects on status and the drivers’ capacity to learn new skills. It is argued that domain-specific characteristics must be considered when designing and implementing new technologies to ensure that benefits of technologies are optimised. It is also argued that resistance should be seen as a positive element of the design and implementation process. This paper has high relevance for transport researchers, and practical application for rail organisations and policy makers.     

Evaluating the Effectiveness of an Abduction Prevention Program for Young Adults With Intellectual Disabilities

The purpose of this study was to evaluate the effectiveness of behavioral skills training (BST) and in situ training (IST) for teaching abduction prevention skills to young adults with intellectual disabilities. Four individuals, ages 18–24, participated. Five BST sessions were conducted for each participant. Following BST, in situ assessments took place at the participants’ school to assess acquisition of the skills. The data show that none of the participants reached criterion level following BST although some of the participants improved their score from baseline. IST was then implemented with two of the participants achieving criterion level and two participants exhibiting two of the three safety skills.     

Risky driving among young male drivers: The effects of mood and passengers

Young male drivers are at greater risk of automobile crashes than other drivers. Efforts to reduce risky driving in this population have met with mixed success. The present research was designed to examine the effects of induced mood and the presence or absence of passengers on risky driving in young male drivers. Male drivers (n = 204) aged 16–18 were tested in a driving simulator. This study employed a 2 (happy/sad mood) by 2 (passenger present/absent) between-subjects factorial design, and examined driving behavior in a simulator. Measures of risky driving were combined into two factors representing speed (e.g., exceeding the speed limit) and carelessness (e.g., crossing the center line). Findings indicated that driving with a passenger resulted in faster driving than driving alone. Although there was no significant main effect of induced mood on driving, results revealed a significant interaction of mood and passenger conditions: when in a happy mood, driving with a passenger significantly increased driving speed. There were no significant effects of passenger or mood on careless driving. In conclusion, both mood and passenger presence are important factors in fast driving among young male drivers. Results are discussed in the context of developing more effective countermeasures for this at-risk population.     

Boundaries of American Identity: Relations Between Ethnic Group Prototypicality and Policy Attitudes

We sought to document that the extent to which different ethnic groups are perceived as embodying the American identity is more strongly linked to antiminority policy attitudes and acculturation ideologies among majority‐group members (European Americans) than among minority‐group members (Asian Americans or Latino/as). Participants rated 13 attributes of the American identity as they pertain to different ethnic groups and reported their endorsement of policy attitudes and acculturation ideologies. We found a relative consensus across ethnic groups regarding defining components of the American identity. However, European Americans were perceived as more prototypical of this American identity than ethnic minorities, especially by European American raters. Moreover, for European Americans but not for ethnic minorities, relative ingroup prototypicality was related to antiminority policy attitudes and acculturation ideologies. These findings suggest that for European Americans, perceptions of ethnic group prototypicality fulfill an instrumental function linked to preserving their group interests and limiting the rights afforded to ethnic minorities.     

青少年重复创伤暴露与创伤后应激障碍的关系:安全感与认知重评的中介作用

采用创伤暴露程度问卷、生活事件量表、安全感量表、情绪调节策略问卷和修订后的DSM-5的PTSD核查表对汶川地震8.5年后的1156名中学生进行调查,考察其重复创伤暴露、安全感和认知重评与PTSD之间的关系。结果发现,在控制初次地震暴露后,重复创伤暴露可以直接正向预测PTSD,也可以通过确定控制感和人际安全感分别间接地正向预测PTSD,还可以通过人际安全感经认知重评的多重中介作用来正向预测PTSD。不过,重复创伤暴露不能直接经过认知重评对PTSD发挥显著的预测作用,也不能通过确定控制感经认知重评来对PTSD发挥显著的多重间接预测作用。     

Migration Factors in West African Immigrant Parents’ Perceptions of Their Children's Neighborhood Safety

Immigrants make up large proportions of many low‐income neighborhoods, but have been largely ignored in the neighborhood safety literature. We examined perceived safety's association with migration using a six‐item, child‐specific measure of parents’ perceptions of school‐aged (5–12 years of age) children's safety in a sample of 93 West African immigrant parents in New York City. Aims of the study were (a) to identify pre‐migration correlates (e.g., trauma in home countries), (b) to identify migration‐related correlates (e.g., immigration status, time spent separated from children during migration), and (c) to identify pre‐migration and migration correlates that accounted for variance after controlling for non‐migration‐related correlates (e.g., neighborhood crime, parents’ psychological distress). In a linear regression model, children's safety was associated with borough of residence, greater English ability, less emotional distress, less parenting difficulty, and a history of child separation. Parents’ and children's gender, parents’ immigration status, and the number of contacts in the U.S. pre‐migration and pre‐migration trauma were not associated with children's safety. That child separation was positively associated with safety perceptions suggests that the processes that facilitate parent–child separation might be reconceptualized as strengths for transnational families. Integrating migration‐related factors into the discussion of neighborhood safety for immigrant populations allows for more nuanced views of immigrant families’ well‐being in host countries.     

An evaluation of the effectiveness of countermeasures for improving the safety of dilemma zones: A driving simulator study

The main objective of this driving simulator study is to analyze the behavior of the driver at the start of the yellow signal of a signalized rural intersection and identify the most effective countermeasures for tackling the dilemma zone, namely an area on the intersection approach where vehicles at the start of the yellow phase can neither safely stop before the stop line nor cross the intersection. The following countermeasures were tested in the study on a sample of 48 drivers: green signal countdown timers, GSCT (C₁); a new pattern of vertical and horizontal warning signs (C₂); and an advanced on-board driver assistance system based on augmented reality (AR) and connected vehicle technologies (C₃). These countermeasures were tested and compared to a baseline condition (B) where no countermeasures were applied. Based on the results of this study, the C₂ and C₃ countermeasures have proven to be valid tools for reducing driver indecision when approaching signalized intersections at the start of the yellow signal. In fact, using C₂ and C₃, the length of the dilemma zone was equal to 30 m and 36 m, respectively, with a reduction of about 50%, as compared to the baseline condition (B). Moreover, a reduced number of false behaviors was recorded, as well as a greater consistency in driver decision-making behaviors. Conversely, the C₁ countermeasure did not lead to a significant improvement in the dilemma zone: an unnecessary increase in early stop rates was recorded, resulting in reduced intersection efficiency and operations.