人文医学的视角：裘法祖误诊误治思想初探——兼论医学伦理道德

本文结合裘法祖的相关论述,对裘法祖的误诊误治思想进行梳理勾连。认为裘法祖这一重要医学思想内涵是要勇于总结医学当中的误诊误治、老专家要“真心帮助青年人”,要学习国外经验,但也不能枉自菲薄,这一思想在当代医学医德教育当中有重要的启示意义。     

错误正波的神经发生源与功能意义解释

错误正波(error positivity, Pe)是指在错误反应后200~600ms后出现的事件相关电位(ERP)的正偏转, 对Pe的研究有助于揭示人类错误加工机制的全貌。现有研究表明Pe主要产生于前扣带回喙部, 但不同的研究对其精细神经发生源并没有达成一致。Pe的功能意义解释主要有错误意识假说、行为适应假说、情绪评估假说。当根据有关P3的理论来解释Pe的功能意义时, Pe可能反映了对错误背景的刷新。然而上述每一种对Pe的功能意义的解释都还受到了一些研究结果的质疑和挑战。基于此, 作者对现有研究存在的问题进行了总结和分析, 并对今后如何对Pe的神经发生源和功能意义的进一步研究提出了建议。     

年幼儿童的尺寸匹配误差现象

近十年来,尺寸匹配误差作为年幼儿童生活中的一种常见的尺寸误用现象逐渐受到了一些研究者的关注。现有研究主要集中在尺寸匹配误差的特点、出现频率和产生原因等方面。抑制控制的失败、神经通路的协调失败、“计划-控制”模型和“感觉-行动”模型、功能性推理偏好以及身体意识发展的不成熟等观点能够对某些类型的尺寸匹配误差现象做出解释。未来的研究应从进一步深入探讨尺寸匹配误差与假装的区别、完善研究方法以及跨文化研究的开展几方面进行。     

Reducing Measurement Error in Student Achievement Estimation

The achievement level is a variable measured with error, that can be estimated by means of the Rasch model. Teacher grades also measure the achievement level but they are expressed on a different scale. This paper proposes a method for combining these two scores to obtain a synthetic measure of the achievement level based on the theory developed for regression with covariate measurement error. In particular, the focus is on ordinal scaled grades, using the SIMEX method for measurement error correction. The result is a measure comparable across subjects with smaller measurement error variance. An empirical application illustrates the method.     

Grammatical Gender in Speech Production: Evidence from Czech

Three experiments demonstrate gender congruency effects (i.e., naming times of a picture are faster when the name of the target picture and a distractor noun are gender congruent) in Czech. In the first experiment, subjects named the pictures by producing gender-marked demonstrative pronouns and a noun. In the second and third experiments, subjects produced a gender-marked numeral (marked with a suffix) plus a noun. Two types of such suffixes exist in Czech. Some numerals vary in nominative singular with gender, others do not. The results show significant gender congruency effects in all experiments. They suggest that gender congruency effects can be obtained not only with free, but also with bound morphemes. In the second and third experiment the effect only emerged when the suffix was gender-marked (as opposed to gender-invariant), supporting the view that the gender congruency effect is due to competition at the level of phonological forms rather than at the grammatical level.     

Syntax as a reflex: neurophysiological evidence for early automaticity of grammatical processing

It has been a matter of debate whether the specifically human capacity to process syntactic information draws on attentional resources or is automatic. To address this issue, we recorded neurophysiological indicators of syntactic processing to spoken sentences while subjects were distracted to different degrees from language processing. Subjects were either passively distracted, by watching a silent video film, or their attention was actively streamed away from the language input by performing a demanding acoustic signal detection task. An early index of syntactic violations, the syntactic Mismatch Negativity (sMMN), distinguished between grammatical and ungrammatical speech even under strongest distraction. The magnitude of the early sMMN (at <150ms) was unaffected by attention load of the distraction task. The independence of the early syntactic brain response of attentional distraction provides neurophysiological evidence for the automaticity of syntax and for its autonomy from other attention-demanding processes, including acoustic stimulus discrimination. The first attentional modulation of syntactic brain responses became manifest at a later stage, at approximately 200ms, thus demonstrating the narrowness of the early time window of syntactic autonomy. We discuss these results in the light of modular and interactive theories of cognitive processing and draw inferences on the automaticity of both the cognitive MMN response and certain grammar processes in general.     

Motor programming in apraxia of speech

Apraxia of Speech (AOS) is an impairment of motor programming. However, the exact nature of this deficit remains unclear. The present study examined motor programming in AOS in the context of a recent two-stage model [Klapp, S. T. (1995). Motor response programming during simple and choice reaction time: The role of practice. Journal of Experimental Psychology: Human Perception and Performance, 21, 1015–1027; Klapp, S. T. (2003). Reaction time analysis of two types of motor preparation for speech articulation: Action as a sequence of chunks. Journal of Motor Behavior, 35, 135–150] that proposes a preprogramming stage (INT) and a process that assigns serial order to multiple programs in a sequence (SEQ). The main hypothesis was that AOS involves a process-specific deficit in the INT (preprogramming) stage of processing, rather than in the on-line serial ordering (SEQ) and initiation of movement. In addition, we tested the hypothesis that AOS involves a central (i.e., modality-general) motor programming deficit. We used a reaction time paradigm that provides two dependent measures: study time (the amount of time for participants to ready a motor response; INT), and reaction time (time to initiate movement; SEQ). Two experiments were conducted to examine INT and SEQ in AOS: Experiment 1 involved finger movements, Experiment 2 involved speech movements analogous to the finger movements. Results showed longer preprogramming time for patients with AOS but normal sequencing and initiation times, relative to controls. Together, the findings are consistent with the hypothesis of a process-specific, but central (modality-independent) deficit in AOS; alternative explanations are also discussed.     

Investigating speech motor practice and learning in people who stutter

In this exploratory study, we investigated whether or not people who stutter (PWS) show motor practice and learning changes similar to those of people who do not stutter (PNS). To this end, five PWS and five PNS repeated a set of non-words at two different rates (normal and fast) across three test sessions (T1, T2 on the same day and T3 on a separate day, at least 1 week apart). The results indicated that PWS and PNS may resemble each other on a number of performance variables (such as movement amplitude and duration), but they differ in terms of practice and learning on variables that relate to movement stability and strength of coordination patterns. These findings are interpreted in support of recent claims about speech motor skill limitations in PWS.

Educational objectives: The reader will be able to: (1) define oral articulatory changes associated with motor practice and learning and their measurement; (2) summarize findings from previous studies examining motor practice and learning in PWS; and (3) discuss hypotheses that could account for the present findings that suggest PWS and PNS differ in their speech motor learning abilities.     

Learning to fail: reoccurring tip-of-the-tongue states

This experiment looked at elicited tip-of-the-tongue (TOT) states to test the hypothesis that making an error once makes people more likely to make it again, via an implicit learning mechanism. We present a methodology that allows us to determine whether error reoccurrences are due to error learning or to the fact that some items tend to pose repeated difficulty to participants. We elicited TOTs by asking participants to supply the word that fitted a given definition. Each time participants indicated that they were experiencing a TOT they were randomly assigned a delay of either 10 or 30 seconds, during which they were asked to keep trying to retrieve the item. After the delay, the correct answer was supplied. We argue that this longer delay in a TOT state amounts to greater implicit learning of the erroneous state. A period of 48 hours later, participants returned to the laboratory and were asked to supply the words for the same definitions as those seen on Day 1. Results showed that TOTs were almost twice as likely to reoccur on words that had elicited a TOT and been followed by a long delay than on those that had been followed by a short delay.     

The developmental course of lexical tone perception in the first year of life

Perceptual reorganisation of infants' speech perception has been found from 6 months for consonants and earlier for vowels. Recently, similar reorganisation has been found for lexical tone between 6 and 9 months of age. Given that there is a close relationship between vowels and tones, this study investigates whether the perceptual reorganisation for tone begins earlier than 6 months. Non-tone language English and French infants were tested with the Thai low vs. rising lexical tone contrast, using the stimulus alternating preference procedure. Four- and 6-month-old infants discriminated the lexical tones, and there was no decline in discrimination performance across these ages. However, 9-month-olds failed to discriminate the lexical tones. This particular pattern of decline in nonnative tone discrimination over age indicates that perceptual reorganisation for tone does not parallel the developmentally prior decline observed in vowel perception. The findings converge with previous developmental cross-language findings on tone perception in English-language infants [Mattock, K., & Burnham, D. (2006). Chinese and English infants' tone perception: Evidence for perceptual reorganization. Infancy, 10(3)], and extend them by showing similar perceptual reorganisation for non-tone language infants learning rhythmically different non-tone languages (English and French).