医疗体制改革应该以二级制为基础——评《哈佛报告》

香港特别行政区政府委托美国哈佛大学一个专家小组对香港的医疗制度作了一个全面评估,并就目前的融资安排（ｆｉｎａｎｃｉａｌａｒｒａｎｇｅｍｅｎｔ）提出改革方案。小组发表的报告对香港医疗制度作了很多中肯批评,但所提出的融资改革方案却极受争议。方案的主要缺点是违背医疗二级制的精神,令自由选择、关怀和社会公义（ｓｏｃｉａｌｊｕｓｔｉｃｅ）等价值难以得到实现。     

Choice vs. Preference: The Effects of Choice and No Choice of Preferred and Non Preferred Spelling Tasks on the Academic Behavior of Students with Disabilities

The effects of choice and no choice of preferred and non preferred instructional activities on the academic behavior of 3 students with disabilities were investigated. Participant preferences for spelling tasks were assessed and an ABCDEF design was used to examine choice and preference within 6 experimental conditions: a) choice of preferred tasks, b) choice of non preferred tasks, c) no choice of preferred tasks, d) no choice of non preferred tasks, e) no choice of preferred tasks (yoked-control), and f) no choice of non preferred tasks (yoked-control). Results indicate that all 3 participants had higher levels of task engagement when working with preferred tasks, regardless of a choice or no choice format. The findings from this investigation contribute to the growing body of research that focuses on developing interventions that are responsive to individual student preferences.     

How western scrub-jays (Aphelocoma californica) select a nut: effects of the number of options, variation in nut size, and social competition among foragers

Western scrub-jays (Aphelocoma californica) often visually assess and handle several whole (unshelled) peanuts before selecting one to transport and cache; this behavior is a search for a preferred heavy nut. I repeatedly video-taped individually identifiable jays as they landed on a feeding platform and chose from presentations of peanuts that varied in the number of items or in the distribution of sizes. I examined how differences among these presentations and a bird’s social status affected the amount of assessment and the economic consequences of choice. I also examined the specific patterns of handling peanuts, called sampling, to quantify the degree to which sampling sequences were typified by repeated comparisons among sampled peanuts (retrospective sampling), or sequential assessment and rejection of peanuts (prospective sampling). Peanut assessment was more extensive and prospective when there were many options from which to choose than when there were few. Peanut assessment was more extensive and retrospective when options were similar in size than when they varied. Scrub-jays were more likely to make repeated comparisons immediately before selecting a peanut than elsewhere in a sampling sequence. Subordinate scrub-jays, who were at the greatest risk of pre-emption by competitors, assessed peanuts less extensively and were more prospective in their sampling than dominants. Unless peanuts were very similar in size, jays were more accurate at selecting a high-quality peanut and achieved a higher rate of food storage than if they had not assessed. These results show that scrub-jays can adaptively modify how they search to improve their rate of food storage, and also suggest some of the specific search tactics used by jays when assessing peanuts. Received: 26 April 1999 / Accepted after revision: 10 October 1999     

结构对称性汉语成语的认知研究

运用命名作业,从识别和再认两个方面探讨了结构对称性汉语成语的认知特点,结果发现：（１）成语识别有显著的结构对称效应和熟悉度效应;结构对称性成语的识别明显快于非对称性成语,高熟悉度成语的识别明显快于低熟悉度的成语。（２）成语再认的反应时有显著的结构对称效应,熟悉度效应不显著;而反应错误率则有显著的熟悉度效应,结构对称效应不显著。上述结果都不存在结构对称性和熟悉度之间的显著的交互作用。现有的西方拼音文字认知模型不能恰当地解释汉语成语的认知特点。     

A comparison of presession and within-session reinforcement choice.

Single- and concurrent-operants procedures were used to evaluate the effects of two reinforcement conditions on the free-operant responding of 3 individuals with developmental disabilities and 1 with attention deficit disorder. In the presession choice condition, prior to each session the participant chose one item from an array of three different highly preferred stimuli. This item was delivered by the experimenter on each reinforcer delivery during that session. In the within-session choice condition, each reinforcer delivery consisted of placing an array of three different highly preferred stimuli in front of the participant, who was allowed to select one. Only one of the two reinforcement conditions was in effect for any particular session in single-operant phases. Buttons associated with each reinforcement condition were present, and the participant could allocate responses to one or the other in concurrent-operants phases. Data showed substantially more responding to the button associated with within-session choice than presession choice during concurrent-operants phases. This effect was not as apparent during single-operant phases, suggesting that a concurrent-operants procedure provided the more sensitive evaluation of within-session and presession reinforcer choice effects.     

Selecting K of N alternatives

In some decision contexts (e.g. graduate admissions) the task to select a subset of k distinct alternatives from among the N > k > 1 options available. For moderate values of N and k, the number of possible subsets of size k becomes quite large. Assuming alternatives are evaluated using consistent, though not explicit weights, selecting k, rather than 1, empirically excludes a substantial proportion (more than 80%) of the subsets; unfortunately to the unaided decision maker it is not obvious which subsets should be excluded. The tendency of subjects to select excludable subsets can be called an ‘infeasibility’ bias. The experimental evidence surprisingly shows no ‘infeasibility’ bias, as subjects overwhelmingly chose non-excluded selections.     

Statistical inference for multiple choice tests

Finite sample inference procedures are considered for analyzing the observed scores on a multiple choice test with several items, where, for example, the items are dissimilar, or the item responses are correlated. A discrete p-parameter exponential family model leads to a generalized linear model framework and, in a special case, a convenient regression of true score upon observed score. Techniques based upon the likelihood function, Akaike's information criteria (AIC), an approximate Bayesian marginalization procedure based on conditional maximization (BCM), and simulations for exact posterior densities (importance sampling) are used to facilitate finite sample investigations of the average true score, individual true scores, and various probabilities of interest. A simulation study suggests that, when the examinees come from two different populations, the exponential family can adequately generalize Duncan's beta-binomial model. Extensions to regression models, the classical test theory model, and empirical Bayes estimation problems are mentioned. The Duncan, Keats, and Matsumura data sets are used to illustrate potential advantages and flexibility of the exponential family model, and the BCM technique.The authors wish to thank Ella Mae Matsumura for her data set and helpful comments, Frank Baker for his advice on item response theory, Hirotugu Akaike and Taskin Atilgan, for helpful discussions regarding AIC, Graham Wood for his advice concerning the class of all binomial mixture models, Yiu Ming Chiu for providing useful references and information on tetrachoric models, and the Editor and two referees for suggesting several references and alternative approaches.     

A simple multivariate probabilistic model for preferential and triadic choices

Multidimensional probabilistic models of behavior following similarity and choice judgements have proven to be useful in representing multidimensional percepts in Euclidean and non-Euclidean spaces. With few exceptions, these models are generally computationally intense because they often require numerical work with multiple integrals. This paper focuses attention on a particularly general triad and preferential choice model previously requiring the numerical evaluation of a 2n-fold integral, wheren is the number of elements in the vectors representing the psychological magnitudes. Transforming this model to an indefinite quadratic form leads to a single integral. The significance of this form to multidimensional scaling and computational efficiency is discussed.The authors would like to thank Jean-Claude Falmagne and Norman Johnson for suggestions and advice concerning quadratic forms.     

Choice and the dependability of stimuli that predict shock and safety

This study assessed whether choosing a signalled shock condition over an unsignalled one is controlled by a stimulus that predicts the presence of shock (Experiment I), or by a stimulus that predicts the absence of shock (Experiment II). The dependability of these stimuli as predictors of either the presence or the absence of shock was parametrically varied over a wide range, and subjects (rats) were given an option to change from an unsignalled to a signalled condition. In the first experiment, all shocks were preceded by signals; however, the probability of a signal being followed by shock varied from 1.0 to 0.02. The data obtained indicate that the dependability of the signal as a predictor of shock is unimportant. Rats changed to the signalled condition when the signal was completely dependable (all signals followed by shock) and when the dependability of the signal was systematically degraded. In the second experiment, all signals were followed by shock; however, some shocks were not preceded by a signal. The data show that the dependability of a stimulus predicting the absence of shock is important in that, as dependability decreases, changing to the signalled condition also decreases.     

Short-term memory in the pigeon: the previously reinforced response

Eighteen pigeons served in a discrete-trials short-term memory experiment in which the reinforcement probability for a peck on one of two keys depended on the response reinforced on the previous trial: either the probability of reinforcement on a trial was 0.8 for the same response reinforced on the previous trial and was 0.2 for the other response (Group A), or, it was 0 or 0.2 for the same response and 1.0 or 0.8 for the other response (Group B). A correction procedure ensured that over all trials reinforcement was distributed equally across the left and right keys. The optimal strategy was either a winstay, lose-shift strategy (Group A) or a win-shift, lose-stay strategy (Group B). The retention interval, that is the intertrial interval, was varied. The average probability of choosing the optimal alternative reinforced 80% of the time was 0.96, 0.84, and 0.74 after delays of 2.5, 4.0, and 6.0 sec, respectively for Group A, and was 0.87, 0.81, and 0.55 after delays of 2.5, 4.0, and 6.0 sec, respectively, for Group B. This outcome is consistent with the view that behavior approximated the optimal response strategy but only to an extent permitted by a subject's short-term memory for the cue correlated with reinforcement, that is, its own most-recently reinforced response. More generally, this result is consistent with “molecular” analyses of operant behavior, but is inconsistent with traditional “molar” analyses holding that fundamental controlling relations may be discovered by routinely averaging over different local reinforcement contingencies. In the present experiment, the molar results were byproducts of local reinforcement contingencies involving an organism's own recent behavior.