Differential effects of safety behaviour subtypes in social anxiety disorder

Clinical observations indicate that individuals with Social Anxiety Disorder (SAD) use a variety of safety behaviours; however, virtually no research has examined the functional effect of different safety-seeking strategies. Accordingly, we conducted two studies to address this issue. Study 1 measured global patterns of safety behaviour use in a large analogue sample. Factor analysis revealed two primary safety behaviour categories, avoidance and impression management. Study 2 assessed situational use of safety behaviours during a controlled social interaction in a clinical sample of 93 patients with Generalised SAD. Factor analysis again revealed support for avoidance and impression-management subtypes. Notably, the two types of safety behaviours were associated with different social outcomes. Avoidance safety behaviours were associated with higher state anxiety during the interaction and negative reactions from participants’ interaction partners. Impression-management strategies appeared to impede corrections in negative predictions about subsequent interactions. These findings suggest that it may be beneficial to consider the unique effects of different safety-seeking strategies when assessing and treating SAD.     

No decision‐maker is an Island: integrating expert advice with information acquisition

The present research examined the social context of information acquisition. The main purpose was to examine how decision‐makers' information acquisition processes changed when they were provided access to expert advice. Results indicated that all decision‐makers opted to acquire advice; however, they typically did so only after completing over 75% of their own information search. Decision‐makers agreed more with the advice as task complexity increased, but, in general, searched information in two stages—i.e., a pre‐advice “hypothesis generation” stage and a post‐advice “hypothesis testing” stage. To behave in an adaptive manner, decision‐makers could have used expert advice either to increase their decision accuracy or to reduce their effort expenditure (or both); they chose the former. Implications and further extensions are discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

The influence of parent-child relationship on young adolescents' use of safety equipment. The Norwegian Longitudinal Health Behavior Study

The purpose of this longitudinal study was to examine the extent to which the parent-child relationship, as perceived by young adolescents at age 13, may account for the use of various types of safety equipment at age 13 and 14 in terms of seat belts, bicycle helmets, motorcycle helmets when passenger, reflectors on the clothing when outside in the dark, and lifejackets when on board small boats. Parental influence was assessed in terms of three scales: Parental support, parental monitoring of the youngsters, and opposition towards the parents, with satisfactory internal consistencies (alphas >0.78). The results showed that each of the three constructs significantly accounted for an independent portion of the variance in the use of safety equipment measures. In sum they accounted for 20% of the variance in the use of safety equipment at age 13, and about 10% at age 14. The findings are discussed with regard to the implications for accident prevention measures aimed at young people.     

“医药分业”改革的经济学分析

目前,我国药品监督管理机构正在推行“渐进式的医药分业”政策,目标是将药品价格总体下降26%～30%,将每年469亿元～547亿元的药品毛利化作医疗服务收费标准的调整幅度,以后医疗服务收费标准按物价指数逐年调整。但在现有条件下执行这一政策,表面上医疗机构是直接的利益受损者,但事实上广大的药品消费者或支付者将为之埋单而成为利益受损者,药品生产者和流通渠道才是这一政策的真正受益者,政府也将面临提高医疗服务收费标准或增加医疗机构补偿的两难抉择。     

降低剖宫产率 维护母婴利益

剖宫产作为一种生产方式,其比率居高不下,已经引起医学界和卫生管理部门的重视。分析其原因,开展相应的对策研究,已成为当务之急。通过健康教育使产妇走出认识误区;加强医务人员职业道德建设;加强医疗卫生法制建设;完善医疗卫生管理体制;建立和谐的医患关系是降低剖宫产比率,维护母婴利益的重要保证。     

Can organisational safety climate and occupational stress predict work-related driver fatigue?

Road crashes are a significant cause of work-related injury and death. Driver fatigue is thought to cause 20–30% of fatal crashes. The current study utilised a survey to examine the relationship between safety climate, occupational stress and work-related driver fatigue. Drivers (n = 219) from two government organisations responded to items from the job-related tension scale [Kahn, R. L., Wolfe, D. M., Quinn, R. P., & Snoek, J. D. (1964). Organisational stress: Studies in role conflict and ambiguity. Malabar, FL: Krieger Publishing], safety climate questionnaire [Glendon, A., & Litherland, D. (2001). Safety climate factors, group differences and safety behaviour in road construction. Safety Science, 39, 157–188] and purpose-designed items on fatigue-related behaviour. Outcome measures were current self-reported, fatigue-related behaviour and self-reported ‘near (crash) misses’ during the previous 6 months. Together, occupational stress and safety climate predicted fatigue-related behaviour, accounting for 29% of the variance over and above that explained by control variables. Further, logistic regression revealed occupational stress and safety climate to be significant predictors of fatigue-related near misses. Safety climate emerged as a stronger predictor of both fatigue-related behaviour and near misses than occupational stress. Results suggest that organisations can play a part in improving the safety-related behaviours of their workforce through attention to safety climate and occupational stress.     

视觉标记：一种优先选择机制

视觉标记是与任务目标相关的自上而下的优先选择解释机制。视觉标记理论对preview效益——对后出现项目的视觉优先选择现象——提供了合理的解释：对先出现的项目自上而下的抑制提高了对后出现项目的优先选择等级。首先介绍视觉标记经典实验范式和preview效益,然后阐述研究者对视觉标记抑制机制的两种主要观点,进而介绍其他优先选择理论对preview效益的解释及其局限性,最后指出视觉标记研究中亟待解决的问题     

Threat of pain influences social context effects on verbal pain report and facial expression

Current theoretical models of pain catastrophizing have diverging predictions regarding the role of social context and perceived threat on pain expression. The communal coping model of catastrophizing predicts that high pain catastrophizers display more pain expression in the presence of another, regardless of the threat value of the pain, while a cognitive appraisal model predicts high pain catastrophizers to express more pain when pain has increased threat value, regardless of social context. A 2 × 2 factorial design was used to test the validity of both predictions. Healthy participants with varying levels of pain catastrophizing were exposed to a cold pressor task, consisting of a 60 s immersion and 60 s recovery period. Interestingly, the immersion results revealed that beyond and independent from the effects of pain catastrophizing, the effect of threat on verbal pain report and facial expression was dependent on social context and vice versa. In a threatening context, perceived threat of pain mediated the inhibitory effect of social presence on pain expression, suggesting that the observer acted as a safety signal. In the recovery period, social presence enhanced facial expression, but only when no threat was induced. The results are discussed in terms of the dynamic interaction between social context and threat appraisals.     

三维适形放疗治疗晚期腹部恶性肿瘤的临床受益和毒副反应

为观察三维适形放疗治疗晚期腹部恶性肿瘤的临床受益情况和毒副反应。对38例晚期腹部恶性肿瘤患者进行三维适形放疗,疗中和疗后进行临床受益情况和毒副反应的观察和评价。结果临床受益情况：有效为28．9％,稳定为42．1％,疼痛缓解率为28．9％;毒副反应主要为骨髓抑制、胃肠道反应、生化指标改变,除少数病例出现Ⅳ度生化指标改变外,其余均在Ⅲ度以下。结论三维适形放疗可以提高晚期腹部恶性肿瘤患者的生存质量,毒副反应轻微,是一种有效的姑息治疗手段。     

经济学评价在临床决策中的应用探讨

医生在临床工作中做出明确诊断,并据此给予有效的处理均属于决策过程。制定决策的整个过程,同时也是进行决策思维的过程。近年来,高新技术的迅猛发展以及医疗费用急剧增加,使制定决策更加复杂。如何进行正确的决策思维,做出最切实可行的和最佳的决策,对避免决策的盲目性具有重要的现实意义。