中医院市场定位的两难选择及其对策

中医院的市场定位处于两难选择之中:中医药技术的潜在优势与现实局限性的矛盾、中医院管理者的价值取向与现实窘况的矛盾、中医院发展历史沉淀与市场竞争的矛盾、政府的中医药政策自身存在的矛盾等。这些矛盾涉及多方行为和利益主体,必须深化改革,以实现中医院的良性发展。     

Cumulative parenting stress across the preschool period: relations to maternal parenting and child behaviour at age 5

Despite increasing interest in the effects of parenting stress on children and families, many questions remain regarding the nature of parenting stress and the mechanism through which stress exerts its influence across time. In this study, cumulative parenting stress was assessed across the preschool period in a sample of 125 typically developing children and their mothers. Indices of parenting stress included both major life events stress‐assessed annually from age 3 to 5, and parenting daily hassles assessed every 6 months across the same period. Naturalistic home observations were conducted when children were age 5, during which measures of parent and child interactive behaviour as well as dyadic pleasure and dyadic conflict were obtained. Mothers also completed the CBCL to assess children's behaviour problems. Results indicated that parenting daily hassles and major life stress are relatively stable across the preschool period. Both cumulative stress indices also proved to be important predictors of parent and child behaviour and dyadic interaction, although the predictions were somewhat differential. Despite meaningful relations between the stress factors and child well being, no evidence was found to support the premise that parent behaviour mediates the association between parenting stress and child outcomes. Results are discussed within a developmental framework to understand the stability and complexity of cumulative stress associations to early parent–child relationships. Copyright © 2005 John Wiley & Sons, Ltd.     

The relationships between parenting stress,parenting behaviour and preschoolers' social competence and behaviour problems in the classroom

Young children develop social and emotional competence through interactions with others in the two major contexts in which they spend time: home and preschool. This study examined whether parenting stress in the home context is related to the children's behaviour while in preschool. Previous research has suggested that parenting stress negatively influences parenting behaviour, which in turn has been shown to impact children's development. This study examined the direct relationship between parenting stress and children's behaviour in two types of preschool programmes: private day care centres and Head Start. Parenting stress was significantly related to teacher ratings of social competence, internalizing behaviours, and externalizing behaviours, and the effects of parenting behaviour do not appear to mediate this relationship. Parenting stress was most strongly related to children's social competence. Parents' reports of expectations for their child's behaviour appear to weakly moderate the relationship between externalizing behaviour and parenting stress. This study suggests that examination of a parent's level of stress, in addition to parenting practices, may be important in research and interventions with preschool children's behaviour and social competence. Copyright © 2005 John Wiley & Sons, Ltd.     

职前教师与在职教师在算术应用题上真实性思考的研究

采用由7道真实性算术应用题构成的测试材料研究了117名职前教师和72名在职教师,首先要求被试解答这些题目,然后评定学生的不同答案。结果表明：1）职前教师与在职教师表现出真实性思考的多重性。2）我国职前教师被试的真实性思考的人数比例为87．5％,高于国外研究所报告的比例。3）在职教师的真实性思考、真实性解答的人数比例都高于职前教师,但没有达到显著性差异;不确定的真实性解答的人数比例极显著地高于职前教师;常规性解答的人数比例显著地低于职前教师。在评定学生解答时、在职教师更愿意接受“不确定”这样一个解题的逻辑性结果,职前教师对常规性解答的态度更为宽容。     

医学实验室安全问题及其防范对策

提出了具有专业特殊性与复杂性的医学实验室安全问题,并据医学实验室的多种功用、自身特点,阐述了医学实验室安全问题的范畴,同时对可能发生的安全问题作了初步的分类,并着眼于多方位、多层面,较系统地论述了医学实验室安全问题的防范对策.     

Stopping rule use during information search in design problems

Information search is critical in most decision-making tasks. An important aspect of information search is the stopping rule used by the decision maker to terminate information acquisition. Decision-making problems may be usefully decomposed into design problems and choice problems. The distinction is critical because the goals of stopping behavior in the two types of problems are quite different. In design problems, the focus is on the sufficiency of information obtained for problem structuring and generating alternatives, while choice problems focus on convergence toward a solution. While previous research has studied stopping behavior in choice problems, the present research is concerned with stopping rule use during information search in design problems. To build theory in this area, we conducted two experiments. In the first, we presented professional systems analysts with an information search problem in a systems development context and asked them to gather information for a proposed system. Protocols of the search sessions were analyzed, and stopping rules used and information gathered by the analysts were identified. Results indicated that the use of certain stopping rules resulted in greater quantity and quality of information gathered. Additionally, stopping rule use, rather than analyst experience, accounted for the quantity and quality of information elicited. Finally, stopping rule use differed between more experienced and less experienced analysts. To apply our findings about stopping rules from the first experiment, we performed a second experiment in which we investigated stopping rule use in a consumer information search task on the world wide web. Results indicated the use of the same stopping rules as in the first experiment, although in different proportions. Implications for information search theory and practice are discussed.     

Assessment of Parenting Practices Related to Conduct Problems: Development and Validation of the Management of Children's Behavior Scale

We report on the development and initial validation of the parent-report scale, Management of Children's Behavior Scale (MCBS), designed to evaluate parenting practices related to conduct problems in children. Children (N=396, ages 2-14) referred for outpatient treatment and their parents served as participants. We evaluated the composition and consistency of the scale and provided evidence pertaining to concurrent, predictive, and incremental validity. Evidence for each type of validity was consistent with the conceptualization of the scale and the pertinence to child conduct problems. The measure also was sensitive to therapeutic changes. Parenting practices targeted in treatment (parent management training) improved as predicted over time. The results suggest the measure may be useful in evaluating parenting practices known to relate to conduct problems and often targeted for intervention in parent- and family-based treatment.     

One night of sleep deprivation affects reaction time, but not interference or facilitation in a Stroop task

The Stroop color-naming task is one of the most widely studied tasks involving the inhibition of a prepotent response, regarded as an executive function. Several studies have examined performance on versions of the Stroop task under conditions of acute sleep deprivation. Though these studies revealed effects on Stroop performance, the results often do not differentiate between general effects of sleep deprivation on performance and effects specifically on interference in the Stroop task. To examine the effect of prolonged wakefulness on performance on the Stroop task, we studied participants in a 40-h "constant routine" protocol during which they remained awake in constant conditions and performed a Stroop color-naming task every two hours. We found that reaction time was slowest when the color and word did not match (incongruent), fastest when the color and word did match (congruent), and intermediate when participants named the color of the non-word stimulus (neutral). Performance on all three trial types degraded significantly as a function of time awake. Extended wakefulness did not significantly change the additional time needed to respond when the color and word did not match (Stroop interference), nor did it change the amount of facilitation when color and word matched. These results indicate that one night of sleep deprivation influences performance on the Stroop task by an overall increase in response time, but does not appear to impact the underlying processes of interference or facilitation. The results suggest that the degree to which an "executive function" is affected by sleep deprivation may depend on the particular executive function studied and the degree to which it is subserved by the prefrontal cortex.     

Lack of sleep and unethical conduct

We draw from the Ego Depletion model and research on sleep physiology to predict a relationship between lack of sleep and individuals’ unethical behavior. Laboratory studies showed that sleep quantity is positively related to self-control resources and negative associated with unethical behavior. In a cross-sectional field study examining unethical behavior in a variety of work settings, low levels of sleep, and low perceived quality of sleep, were both positively related to unethical behavior as rated by the supervisor, and cognitive fatigue mediated the influence of sleep quantity. In an experience sampling field study, we found similar effects within-individuals. We discuss the role of lost sleep in better understanding unethical behavior in organizations.     

Delivering Parent-Child Interaction Therapy in an Urban Community Clinic

Extensive evidence supports the efficacy of Parent-Child Interaction Therapy (PCIT) for reducing behavior problems in young children; however, little is known about the use of PCIT in a community mental health center (CMHC). This paper provides four clinical case examples of families who were referred to and successfully completed PCIT in an urban CMHC. The families were ethnically and socioeconomically diverse and presented with a wide range of treatment concerns and needs (e.g., autism, severe maternal psychopathology, involvement in child protective services, and complex family configurations) in addition to disruptive behavior. Our data and clinical observations suggest that PCIT decreased behavior problems, improved parent-child interactions, and, in some cases, reduced parental stress, with differing levels of change across families. Overall, the cases demonstrate that PCIT can be transported into a CMHC, and they illustrate supplemental services or minor accommodations to the established treatment protocol used to address individual family needs. Issues regarding the balance between fidelity and flexibility in transporting PCIT to a community setting are discussed, and future research topics are recommended.