药价“虚高”:成因、结果分析与对策探讨

药品价格“虚高”已成为近年来药品市场中的一个突出问题。通过考量药价“虚高”的成因,并从实证的角度分析药价“虚高”的结果———“有效需求人数”和“消费者剩余”的减少,提出一些建议。     

Scientific Peer Review: A Case Study From Local And Global Analyses.

The dialog between Staddon (2001, 2004) and Baum (2004) raises general questions about the nature of scientific peer review. Their dialog displays effects on peer review of differences of opinion about the relative merits of local and global analyses. Baum (1995, 1997, 2001, 2002) favors global analyses as a paradigm different, newer, and better than the local, dynamic, real‐time approach that plays a significant role in Staddon (2001). According to the Kuhnian perspective (Kuhn, 1996) Baum advocates, we can better understand his review of Staddon (2001) by considering the implications for it of his commitment to the idea that a global analysis is a superior scientific paradigm. This commentary examines some characteristics of local and global analyses, as well as some of their possible implications for peer review in the context of a reviewer's belief in the Kuhnian idea of incommensurability: According to this idea, a reviewer who either is, or who believes he is, from one paradigm is unlikely, for better or worse, to understand or perhaps even tolerate work from a different paradigm. It is recommended that a process be developed to encourage “truth in peer reviewing” to reduce possible conflicts of interest embedded in the current conception of scientific peer review.     

Quantifying variability in phase portraits: application to gait ontogeny

We describe new Fourier- and shape-based methods for quantifying variation in phase-portraits, and re-analyze previously-published ontogenetic and adult data [Clark, J. E., & Phillips, S. J. (1993). A longitudinal study of intralimb coordination in the first year of independent walking: A dynamical systems approach. Child Development, 64, 1143–1157]. Results show considerable variation between individuals and through development, but after 6 months of walking some gait patterns stabilize.     

Comparative Evaluations

My response to Engelmann (2008) will be based on several questions that will allow both its author and the general reader to determine whether the assumptions I make as an interpreter of this complex paper are congruent or incongruent with their own interpretations of the text. The interpretations by the writer, by any commentator, and the diverse interpretations of a general audience together with my own interpretations will, I hope, facilitate some fruitful ‘comparative evaluations.’ I articulate my inferences of the most dense part of the paper, namely the ‘concrete immediate Consciousness and the developing absent outside.’ My hope is to address Engelmann’s question: “Am I in a better disposition to judge modern theories of consciousness?” The last section of my response spells out more personal comments to my all too brief and single encounter with Arno Engelmann. It is there that Arno Engelmann’s fascinating statement “I am a citizen of the world” is addressed through its counterparts in my life.     

Origins of submovements during pointing movements

Submovements that are frequently observed in the final portion of pointing movements have traditionally been viewed as pointing accuracy adjustments. Here we re-examine this long-lasting interpretation by developing evidence that many of submovements may be non-corrective fluctuations arising from various sources of motor output variability. In particular, non-corrective submovements may emerge during motion termination and during motion of low speed. The contribution of these factors and the factor of accuracy regulation in submovement production is investigated here by manipulating movement mode (discrete, reciprocal, and passing) and target size (small and large). The three modes provided different temporal combinations of accuracy regulation and motion termination, thus allowing us to disentangle submovements associated with each factor. The target size manipulations further emphasized the role of accuracy regulation and provided variations in movement speed. Gross and fine submovements were distinguished based on the degree of perturbation of smooth motion. It was found that gross submovements were predominantly related to motion termination and not to pointing accuracy regulation. Although fine submovements were more frequent during movements to small than to large targets, other results show that they may also be not corrective submovements but rather motion fluctuations attributed to decreases in movement speed accompanying decreases in target size. Together, the findings challenge the traditional interpretation, suggesting that the majority of submovements are fluctuations emerging from mechanical and neural sources of motion variability. The implications of the findings for the mechanisms responsible for accurate target achievement are discussed.     

Genetics Education for Health Professionals: Strategies and Outcomes from a National Initiative in the United Kingdom

The National Health Service (NHS) National Genetics Education and Development Centre was established by the Department of Health in 2004 to help drive and co-ordinate genetics education for health professionals working outside specialist genetic services. This paper reviews the experiences and lessons learned to date. At the outset, it was clear that understanding the learning ethos, preferred delivery methods and attitudes towards genetics of different NHS healthcare groups was vital. We collected evidence by undertaking needs assessments with educators, practitioners and patients. We have determined the genetics knowledge, skills and attitudes which they said were needed and translated these into learning outcomes and workforce competences in a continuum of education. Beginning with core concepts introduced (and examined) pre-registration, the continuum continues with development of concepts post-registration as appropriate for role, leading to practical application and assessment of competences in the workplace. These are supported by a portfolio of resources which draw heavily on patient based scenarios to demonstrate to staff that genetics is relevant to their work, and to convince educators and policy makers that genetic education is likely to result in real clinical benefit. A long term educational policy, inclusive of learners, educationalists and their institutions must be evidence based, flexible and responsive to changes in workforce structure, provision of clinical services and conceptual and financial commitments to education. The engagement of national policy, regulatory and professional bodies is vital ().     

THE INSULAR MOTHER: HER PROBLEMS IN PARENT-CHILD TREATMENT

Eighteen mother-child dyads were referred for psychological help because of the children's oppositional behaviors and the mothers' aversive reactions to the children. All dyads were from low income families in which the mothers reported themselves to be relatively isolated from social contact in their communities. Following a baseline phase, the mothers were trained to modify their children's oppositional behaviors through time out and a point system. Fourteen of the dyads were observed in three phases of the study: baseline, parent training or treatment, and a 1-year follow-up period. In Phases one and two, child opposition and mother aversive reactions to the children were measured twice weekly by professional observers in the home settings. During Phase three (follow-up), these observations occurred twice per month. In addition, the mothers' self-reported contacts with people in their communities were obtained immediately after each observation. Results showed significant improvement in the mother-child problems during the parent training or treatment phase. However, the problems returned to baseline levels of occurrence during the follow-up phase. The self-report findings indicated that number of mother contacts with friends was an inverse predictor of these problems. On days marked by high proportions of friend contacts, mother-child problems were lower in frequency than on days marked by low proportions of friend contacts. These correlational findings were taken to suggest that a mother's extra-family social contacts may influence her child interaction patterns at home. This possibility was discussed as a factor in the long-term success of parent training as a treatment strategy.     

德性自我意象、道德情绪与行为自我管理：对大学生的一项交叉滞后研究

研究采用交叉时序滞后设计,以问卷法对363名大学生进行了6个月的追踪调查,考察了德性自我意象、道德情绪（内疚/羞愧）与行为自我管理之间的相互预测关系。结果表明,德性自我意象、内疚和羞愧均能显著地正向预测道德行为自我管理,德性自我意象、内疚和羞愧可能是道德行为自我管理的前因变量。     

Structure of the Wechsler Adult Intelligence Scale – Revised in the Italian Normal Standardisation Sample

Six multifactor correlated traits models and a single-factor model of the WAIS-R's factor pattern were examined by confirmatory maximum likelihood factor analyses of a data matrix from the WAIS-R's Italian normative sample raw scores (N=2284). The main aim was to identify what model(s) best fit(s) the data for the different age groups considered. Analyses were designed to determine which of seven hypothesised factor solutions best explained the intellectual ability of four age bands (16 to 74 years of age) and of all samples. Results showed the same three-correlated-factors model (Verbal, Performance, and Freedom From Distractibility) for the younger (16 to 24 years of age) and for more aged (65 to 74 years of age), and two different three-factor models for the adult (band from 25 to 64 years of age) that had in common the presence of Digit Symbol loading on Freedom From Distractibility, that in the younger and aged band loaded on Perceptual Organisation. The individuals may use different strategies when performing a given task on the WAIS-R. Such differences in latent variability may represent real differences in neuropsychological functioning, and as such can account for some of the variability in results noted in the literature. Differences in latent variability across distinct demographic and clinical groups could provide important insight into brain–behaviour relationships.