道家人格的测量

以对道家人格的界定及道家人格结构理论模型为基础,从道家经典著作中收集到486个描述人的词汇,经由意义分析和初测保留了45个项目,选取了中国人整体思维方式量表作为对道家认知思维方式的测量。道家人格量表在四个不同年龄样本中的探索及验证性因素分析均支持了一阶十维、二阶＂真＂、＂伪＂的二维结构。道家人格量表内部一致性系数和重测信度系数分别介于0.63～0.88之间和0.66～0.89之间。各题项与其所属维度间及各维度间的相关分别介于0.48～0.89之间和-0.11～0.53之间。未来研究需要进一步探究道家人格各维度的丰富内涵并编制具有针对性的道家认知思维方式量表。     

The Many Faces of Malingering and Participant Response Strategies: New Methodologies in the Attachment and Clinical Issues Questionnaire (ACIQ)

Four studies created malingering and response bias scales for a new test battery, the Attachment and Clinical Issues Questionnaire (ACIQ). In the first calibration study, a new approach to identifying fake good and fake bad respondents was outlined. In Study 2, this scale was cross validated in a within-subjects design that also found only weak correlations between the scales of the ACIQ and measures of social desirability. The third study developed a method violator scale (one who responds randomly to the content of the scales due to carelessness, low IQ, etc.). It was tested by Monte Carlo and empirical studies. The fourth study combined the two cross validation studies to offer clear cutoffs for the practitioner. These studies successfully led to the creation of malingering and response bias scales for the ACIQ and also introduced new methods that could be adapted to other instruments.     

Curriculum-based measurement of oral reading (R-CBM): A diagnostic test accuracy meta-analysis of evidence supporting use in universal screening

A great deal of research over the past decade has examined the appropriateness of curriculum-based measurement of oral reading (R-CBM) in universal screening. Multiple researchers have meta-analyzed available correlational evidence, yielding support for the interpretation of R-CBM as an indicator of general reading proficiency. In contrast, researchers have yet to synthesize diagnostic accuracy evidence, which pertains to the defensibility of the use of R-CBM for screening purposes. The overall purpose of this research was to therefore conduct the first meta-analysis of R-CBM diagnostic accuracy research. A systematic search of the literature resulted in the identification of 34 studies, including 20 peer-reviewed articles, 7 dissertations, and 7 technical reports. Bivariate hierarchical linear models yielded generalized estimates of diagnostic accuracy statistics, which predominantly exceeded standards for acceptable universal screener performance. For instance, when predicting criterion outcomes within a school year (≤ 9 months), R-CBM sensitivity ranged between .80 and .83 and specificity ranged between .71 and .73. Multiple moderators of R-CBM diagnostic accuracy were identified, including the (a) R-CBM cut score used to define risk, (b) lag in time between R-CBM and criterion test administration, and (c) percentile rank corresponding to the criterion test cut score through which students were identified as either truly at risk or not at risk. Follow-up analyses revealed substantial variability of extracted cut scores within grade and time of year (i.e., fall, winter, and spring). This result called into question the inflexible application of a single cut score across contexts and suggested the potential necessity of local cut scores. Implications for practices, directions for future research, and limitations are discussed.     

Assessment Use by Counselors in the United States: Implications for Policy and Practice

Although assessment use is a professional activity recognized by every major counseling organization, little is known about which assessments are used in counseling. In this study, 926 respondents from a random national sample of counselors reported their use of personality, projective, career, intelligence/cognitive, educational/achievement, clinical/behavioral, and environmental/interpersonal tests. Test rankings by frequency of use and comparisons by type of counselor and type of test are reported. Implications for policy and practice are discussed.     

“精选、精讲、精练”教学法在临床教学中的应用

临床医学是集多学科知识为一体的专业学科,具有基础知识与临床实践紧密结合的显著特性。为适应新世纪医学教育的系统性转型,配合器官系统为中心课程模式的有效运行,我院采用“精选、精讲、精练”的教学方法,通过系统性整合各专业学科课程,加强学科间的知识联系,实现基础向临床的转化、从而开辟专业课程综合化发展的道路,给学生提供最优化的教学内容,在掌握专业技术的同时,拓宽临床思维,履践医学人文精神,为培养医学生未来临床岗位胜任能力奠定坚实基础。     

内科实习医生医患沟通经历的调查分析

实习医生在医院里扮演着特殊角色,既要作为学生在临床实践中学习医学知识,又要作为医生在患者面前从事医疗工作。因此,培养医学生医患沟通能力,引导其建立和谐的医患关系,成为临床带教老师面临的一项严峻而又刻不容缓的任务。本研究针对内科实习医生在医院沟通中的典型案例进行了调查,从而了解实习医生在医患沟通中的经历,以及他们对原因的分析、处理方法及对自身的影响,进而了解实习医生对沟通技能培训的需求。     

应培养年轻医师的“逐本溯源”临床思维方式

近年来,疾病谱及其特点在悄然改变,伴随着无规可循、错综复杂的临床表现,甚至呈现为多系统综合征。这些变化对临床医师尤其是年轻医师而言,难以理清思路、把握重点,医生往往容易被直接呈现的各种表象所迷惑或满足于表象诊断,从而错过主要矛盾,在诊治过程中出现漏诊误诊情况,并可能增加患者就诊次数和成本,带来经济与精神上的压力。我们在临床实践中总结发现,“逐本溯源”临床思维方式对疾病诊治、避免漏诊误诊尤其是在病因诊断中具有较好的指导作用。     

降低医疗的二次伤害是医学人性化发展方向

医学是一种人性化的表达,然而,医学手段的伤害性特征也是现代医学本身无法回避的一个缺陷,忽视对医学技术本身的伤害性因素的认识,是当下医学人文衰退的一个重要原因,也是构建人性化医疗的一道障碍,面对越来越多的对医学伤害性的质疑,医学应该进行自我剖析,撕开医学手段的非人性化面纱,务必直面问题和解决问题,用医学的人性化关怀弥补医学手段的伤害性缺陷,并以医学技术本身的发展,促进医学向无伤害的人性化方向发展,这是现代医学发展的终极目标。     

创新药物埃克替尼临床研究进展及研究方向

晚期非小细胞肺癌（NSCLC）是全世界范围内主要的癌症死亡原因之一。晚期NSCLC的治疗主要是姑息性治疗和以铂类为基础的化疗,但上述治疗手段近几年已逐渐进入平台期。表皮生长因子受体酪氨酸激酶抑制剂（EGFR～TKIs）,如吉非替尼,厄洛替尼和阿法替尼的出现延长了患者的无进展生存期,与化疗相比具有较好的安全性,明显改善了患者生活质量,特别是对EGFR基因突变的晚期NSCLC患者获益更加明显。盐酸埃克替尼是我国自主研发的口服高选择性EGFR—TKIs抑制剂,属1．1类新药。其Ⅲ期注册性研究（ICOGEN）结果表明对于既往接受过化疗失败的患者,埃克替尼疗效与吉非替尼相似,且安全性更优。基于该研究,2011年6月CFDA批准埃克替尼用于既往化疗失败的晚期非小细胞肺癌。本文将探讨埃克替尼相关临床研究进展,以及其未来研发等几个方面。     

临床医学新趋势：语言作为一种治疗工具的复兴

在履践生物心理社会医学模式中,语言具有不可替代的重要作用。现代医疗设备和仪器的高度发达使医生逐渐脱离了患者;技术主体化倾向使医生的语言功能逐渐地退化,语言能力的欠缺不仅影响医患关系,也直接影响疾病的治疗效果。因此,履践语言的临床复兴,务必掌握语言的艺术、沟通的技巧,以建立和谐稳固的医疗环境和医患关系,良好的语言是缓解患者痛苦的有效良方,在当今诸多医学及复杂社会因素的影响下,语言作为一种治疗工具必将成为临床医疗的新趋势。