301例中枢神经系统感染的临床分析

回顾性研究301例中枢神经系统感染病例的临床资料,分析其临床特点,将符合临床诊断标准的病例按病原种类分为病脑组、结脑组、化脑组及隐脑组4个组,应用相关的统计描述分析其临床特征。结果发现病毒性脑（膜）炎是最常见的中枢神经系统感染性疾病,而中枢神经系统感染性疾病一年四季均可发病,其中病毒性脑（膜）炎高发于5月及7月,结核性脑膜炎则高发于1月与3月,有明显的季节性。中枢神经系统感染的临床首发症状依次表现为发热、头痛、意识障碍、精神症状、抽搐及神经系统定位症状。     

医学人文教育功能简论

医学人文教育功能是医学人文教育这一特殊的社会现象和社会活动能够引起个体或其他社会系统发生变化的作用或能力,是医学人文教育自身固有的根本属性和重要特征的外在表现,主要用来回答“医学人文教育为什么能够存在和它对外界能产生何种影响”的问题。发展、认识、文化、享用、激励等诸多功能都是医学人文教育功能的现实表现,因此,医学人文教育功能是医学人文教育得以存在和发展的本体依据和坚实基础,必须从多重维度出发去促成医学人文教育功能的充分发挥和完全实现。     

Shifts of the psychometric function: Distinguishing bias from perceptual effects

Morgan, Dillenburger, Raphael, and Solomon have shown that observers can use different response strategies when unsure of their answer, and, thus, they can voluntarily shift the location of the psychometric function estimated with the method of single stimuli (MSS; sometimes also referred to as the single-interval, two-alternative method). They wondered whether MSS could distinguish response bias from a true perceptual effect that would also shift the location of the psychometric function. We demonstrate theoretically that the inability to distinguish response bias from perceptual effects is an inherent shortcoming of MSS, although a three-response format including also an “undecided” response option may solve the problem under restrictive assumptions whose validity cannot be tested with MSS data. We also show that a proper two-alternative forced-choice (2AFC) task with the three-response format is free of all these problems so that bias and perceptual effects can easily be separated out. The use of a three-response 2AFC format is essential to eliminate a confound (response bias) in studies of perceptual effects and, hence, to eliminate a threat to the internal validity of research in this area.     

The role of componential analysis,categorical hypothesising,replicability and confirmation bias in testing for bilingual advantages in executive functioning

Kroll and Bialystok assert that managing two languages leads to a reorganisation of the neural circuits involved in language and cognitive processing and to bilingual advantages in executive functioning. This commentary documents that bilingual advantages in inhibitory control, switching and monitoring are difficult to replicate. Kroll and Bialystok argue that the use of componential analyses and categorical hypothesising are often responsible for the null results and that these research practices have created a false controversy surrounding the existence of bilingual advantages. An alternative perspective is presented suggesting that the appearance of a steady stream of published reports has been exaggerated because of the frequent use of risky small n's, a confirmation bias to report positive findings and a reluctance to conduct and report exact replications.     

Auditory sensory gating and performance on the Delis–Kaplan Executive Function System

Sensory gating is a neurological mechanism that inhibits redundant sensory information. Impaired sensory gating is not uncommon in otherwise healthy individuals, but its relationship with higher level cognitive function is poorly understood. It is plausible that cognitive fragmentation associated with poor sensory gating may affect an individual's higher level executive functioning. Fifty-one participants (Mean age?=?22.02; 24 males) were administered an electroencephalogram with a paired-tone paradigm to measure sensory gating as well as a comprehensive executive functioning battery—the Delis–Kaplan Executive Function System. Overall, better performance on the D-KEFS was related to more effective sensory gating. Also, tasks that measured cognitive flexibility predicted P50 latency as well as P200 amplitude and sensory gating. Understanding the relationship between sensory gating and cognitive processing has implications for healthy individuals and clinical groups alike.     

Teaching Approaches and Occupational Therapy Psychoeducation

Abstract

Patient education has become an important feature of any treatment program. Psychoeducational procedures dominate the treatment used by occupational therapy practitioners in psychiatric rehabilitation. Occupational therapy literature frequently describes the content of psychoeducational programs but rarely examines the teaching approach therapists use in them. It is necessary, therefore, to begin carefully questioning how we are approaching psychoeducation and justifying it as a method compatible with our basic philosophical principles and our growing understanding of occupation. Three approaches to teaching are examined and contrasted with occupational therapy values: the executive approach, the therapist approach, and the liberationist approach. Each of these approaches points to dramatically different outcomes of the therapeutic process. Ultimately, they bring into question the way in which we build a relationship with our clients. The liberationist approach is proposed as the best guide of how and why to use psychoeducation in the quest for providing authentic occupational therapy.     

An Archival Study of Eyewitness Memory of the Titanic's Final Plunge

A handful of real-life studies demonstrate that most eyewitnesses accurately recall central details (i.e., the gist of what happened) from traumatic events. The authors evaluated the accuracy of archival eyewitness testimony from survivors of the Titanic disaster who witnessed the ship's final plunge. The results indicate that most eyewitness testimony (15 eyewitnesses of 20) is consistent with forensic evidence that demonstrates that the Titanic was breaking apart while it was still on the ocean's surface. Despite the methodological limitations of archival research, the authors provide evidence from a single-occurrence traumatic event (with a large-scale loss of life) that the majority of eyewitnesses accurately recall central details.     

A cognitive perspective on mindfulness

Mindfulness, the core teaching of the Buddhist tradition, has been receiving serious attention from the West in recent decades as evidence of the efficacy of mindfulness‐based interventions for emotional distress have become available. Although traditional Buddhist texts have described the mechanisms of mindfulness and the way to cultivate it in great detail, much is still not known from the perspective of Western science. In particular, there is no general agreement on the conceptualization and operationalization of mindfulness. Several conceptual models of mindfulness (referred to as “state” or “trait”) have been put forward to elucidate different aspects of this phenomenon, but none has gained sufficient empirical validation. This article proposes a new cognitive model of mindfulness. It has been our goal to describe and interrelate a relatively comprehensive group of determinants of a state of mindfulness, the consequences of its regular practicing, the mechanisms responsible for its beneficial effects, and the feedback mechanisms operating between the various constituents of the model. Within this model, the primary emphasis has been placed on understanding the cognitive processes shaping a state of mindfulness (i.e., the links between consciousness, meta‐awareness and the unconscious), and on their determinants (i.e., the executive functions of attention and the components of working memory). A metacognitive system promoting mindfulness, as well as the general capability of the central executive system, is suggested as a factor explaining individual differences in mindfulness, whereas decentering, self‐compassion, and reduction of self‐focused attention are proposed as mechanisms mediating beneficial changes. We hope that the model presented will encourage further discussion and orient future studies in the area of mindfulness.     

Aging of theory of mind: The influence of educational level and cognitive processing

Previous studies of theory of mind (ToM) in old age have provided mixed results. We predicted that educational level and cognitive processing are two factors influencing the pattern of the aging of ToM. To test this hypothesis, a younger group who received higher education (mean age 20.46 years), an older group with an education level equal to that of the young group (mean age 76.29 years), and an older group with less education (mean age 73.52 years) were recruited. ToM tasks included the following tests: the second‐order false‐belief task, the faux‐pas task, the eyes test, and tests of fundamental aspects of cognitive function that included two background tests (memory span and processing speed) and three subcomponents of executive function (inhibition, updating, and shifting). We found that the younger group and the older group with equally high education outperformed the older group with less education in false‐belief and faux‐pas tasks. However, there was no significant difference between the two former groups. The three groups of participants performed equivalently in the eyes test as well as in control tasks (false‐belief control question, faux‐pas control question, faux‐pas control story, and Eyes Test control task). The younger group outperformed the other two groups in the cognitive processing tasks. Mediation analyses showed that difficulties in inhibition, memory span, and processing speed mediated the age differences in false‐belief reasoning. Also, the variables of inhibition, updating, memory span, and processing speed mediated age‐related variance in faux‐pas. Discussion focused on the links between ToM aging, educational level, and cognitive processing.     

Developmental dissociation of visual dorsal stream parvo and magnocellular representations and the functional impact of negative retinotopic BOLD responses

Localized neurodevelopmental defects provide an opportunity to study structure–function correlations in the human nervous system. This unique multimodal case report of epileptogenic dysplasia in the visual cortex allowed exploring visual function across distinct pathways in retinotopic regions and the dorsal stream, in relation to fMRI retinotopic mapping and spike triggered BOLD responses.