基于多层结构方程模型的情境效应分析—— 兼与多层线性模型比较

多层(嵌套)数据的变量关系研究, 必须借助多层模型来实现。两层模型中, 层一自变量Xij按组均值中心化, 并将组均值 置于层2截距方程式中, 可将Xij对因变量Yij的效应分解为组间和组内部分, 二者之差被称为情境效应, 称为情境变量。多层结构方程模型(MSEM)将多层线性模型(MLM)和结构方程模型(SEM)相结合, 通过设置潜变量和多指标的方法校正了MLM在情境效应分析中出现的抽样误差和测量误差, 同时解决了数据的多层(嵌套)结构和潜变量的估计问题。除了分析原理的说明, 还以班级平均竞争氛围对学生竞争表现的情境效应为例进行分析方法的示范, 并比较MSEM和MLM的异同, 随后展望了MSEM情境效应模型、情境效应无偏估计方法和情境变量研究的拓展方向。     

程序公正的测量及研究操纵

程序公正是指处理管理事务所依据的原则是否公正。普遍认可的程序公正原则包括一致性、避免偏见、准确性、可修正、代表性、道德与伦理原则。程序公正研究主要有测量和实验操纵两种研究范式。对程序公正的测量主要以单维为主,亦有少数多维测量量表;对程序公正的实验操纵主要以发言权为主,有少数研究对准确性、无偏性或综合几项原则进行操纵。未来研究应考虑程序公正的结构问题,对程序公正的操纵范围进行扩展、操纵方法考虑情景性,还需关注程序公正与程序不公正的差异。     

新医学模式在慢性前列腺炎临床中的应用

现代医学对慢性前列腺炎的认识已经经历了近200年,其发病机制、诊断和治疗等多方面存在很多疑惑和争议。慢性前列腺炎不能单纯视为躯体性疾病,其发生、发展和转归与精神心理和社会因素密切相关。新医学模式(生物-心理-社会医学模式)发展和医疗实践有机结合,将促进泌尿外科医师和患者对慢性前列腺炎疾病更深刻认识,这不仅为提高慢性前列腺炎诊断提供了新的视角、指标和工具,也为有效治疗提供了新的思路、技术和方法,为全面提高患者的生活质量提供了可能。     

囊虫病诊断技术的发展与临床应用

囊虫病是一种由猪囊尾蚴寄生于人体组织内主要引起脑、眼等重要器官或组织损害的常见寄生虫病。目前对其诊断的实验技术研究已发展到高层水平,但被临床应用的并不多。本文从多个方面较全面地分析和回答了出现此现象的原因,并提出了拟解决临床问题的见解与探索思路。     

肺结核患者的血糖控制

肺结核与糖尿病是两种严重危害人类健康的疾病。越来越多的研究证明,发生结核病的一个重要的危险因素为糖尿病,而且可能会影响肺结核患者的表现和治疗反应。另外,结核病可能会导致糖耐量异常,并使糖尿病患者的血糖控制不良。糖尿病引起肺结核发病增加,可能是因为持续的高血糖损害了针对结核杆菌的机体免疫。对结核病患者合并糖尿病者,药物治疗需考虑到药物动力学,监测血糖,谨慎用药。     

实施单病种临床路径缩短患者平均住院日

为研究单病种临床路径应用效果,对宫颈癌患者39例、输卵管妊娠患者29例实施,临床路径。结果显示,手术并发症发生率降低,平均住院日和住院费用、药品费、药占比均下降,并具有统计学意义（P〈0．05）。因此,应用单病种临床路径,能降低患者住院日和费用、提高医护工作效率、增加医院竞争力。     

转化医学——医学基础研究与临床应用间的桥梁

当前医学发展进程中,医学基础研究进展迅速,而临床医学则相对滞后。究其原因,大量基础研究成果不能及时有效地用于临床,使二者间产生了巨大的鸿沟。转化医学搭建了沟通二者的桥梁,为促进医学基础研究向临床的应用,同时为针对临床需要提出基础研究方向提供了有效途径。     

Developing an indicator of family function and a practicable outcome measure for systemic family and couple therapy: the SCORE

There is a need for a measure of outcome in systemic family and couples therapy (SFCT) that reflects current theory and practice. To meet the needs of SFCT practice the measure needs to use self‐report by family members, take a short time to complete and be easy to understand. The development of such a measure, called the SCORE, is reported in this article. Substantial piloting, consultation and review in terms of clinical judgement led to the construction of the SCORE 40 which has forty items about how the family functions, rated by family members over 11 years of age on a Likert scale, in addition to independent ratings of the family and its difficulties. The SCORE 40 is shown to be a viable instrument but is too substantial for everyday clinical use. In a research project to reduce and refine the measure and determine its psychometric properties the SCORE 40 was administered to 510 members of 228 families at the start of their first appointment for family therapy at clinics throughout the UK. The scale has good psychometric properties and could operate with either three or four dimensions. The analyses of these data, combined with data from a convenience sample of 126 non‐clinical families, allowed a reduction to fifteen items while retaining most of the information provided by the SCORE 40. This version is offered with three dimensions of: (1) Strengths and adaptability; (2) Overwhelmed by difficulties; and (3) Disrupted communication. It is hoped that the ready availability of the SCORE 15 will encourage routine evaluation of outcomes in clinics as well as the SCORE being used flexibly for both therapy and research.     

Attachment,emotional loneliness,and bullying behaviour: A study of adult and young offenders

This research addresses the question of whether or not offenders who bully others and/or are victimised themselves can be distinguished by their attachment styles and the level of emotional loneliness that they report. Adult and young male offenders (n = 220) were required to complete a self‐report behavioural checklist (DIPC: Direct and Indirect Prisoner behaviour Checklist: Ireland, 1999a) that addressed the level of bullying behaviour at their present institution. Offenders were also required to complete a measure of attachment, namely the Three Attachment Style Measure [Hazan and Shaver, 1987] exploring secure, avoidant and anxious/ambivalent styles, and a measure of emotional loneliness, namely the revised UCLA Loneliness scale [Russell, Peplaw and Cutrona, 1980]. Young offenders were more likely than adult offenders to report behaviours indicative of ‘bullying others’ and of ‘being bullied.’ With regards to attachment style and bullying behaviour, significant differences were restricted to avoidant attachment; bully/victims reported higher avoidant scores than the other bully‐categories, with pure bullies and those not‐involved reporting lower avoidant scores. Finally, when considering emotional loneliness and bullying behaviour, bully/victims reported higher scores on emotional loneliness than the other bully‐categories, with the not‐involved group reporting significantly lower scores. Aggr. Behav. 30:298–312, 2004. © 2004 Wiley‐Liss, Inc.     

Depression

Abstract— The theory of clinical depression presented here integrates etiological factors, changes in specific structural and cellular substrates, ensuing symptomatology, and treatment and prevention. According to this theory, important etiological factors, such as stress, can suppress the production of new neurons in the adult human brain, thereby precipitating or maintaining a depressive episode. Most current treatments for depression are known to elevate brain serotonin neurotransmission, and such increases in serotonin have been shown to significantly augment the ongoing rate of neurogenesis, providing the neural substrate for new cognitions to be formed, and thereby facilitating recovery from the depressive episode. This theory also points to treatments that augment neurogenesis as new therapeutic opportunities.