实施临床路径管理 构建和谐医患关系

医患和谐是医患双方的共同需要,通过时单病种乳腺癌改良根治术等10个单病种临床路径与成本控制绩效分析,评价患者的满意效果。收集整理2006年7月至2007年12月10个单病种的统计信息,以其手术并发症发生率、平均住院天数、平均住院费用、患者满意率等作为评价指标,将实验组（应用临床路径和成本控制组）和对照组（未应用临床路径和成本控制组）进行对比分析。结果显示,应用临床路径和成本控制的患者与未应用这一方式的患者之间在手术并发症发生率、平均住院时间、平均住院费用、患者满意率方面有统计学显著差异。提示单病种临床路径和成本控制模式应用于临床管理,可以明显促进CQI（Continuous Quality Improvement持续性质量改进）,缩短平均住院时间,降低住院费用,提高患者满意率,并从根本上改善医患关系。     

No compelling evidence for a bilingual advantage in switching or that frequent language switching reduces switch cost

Participants completed three cued-switching tasks, responded to two category-fluency probes, two letter-fluency probes, and two probes to alternate between two targets. Correlations across the three cued-switching tasks were significant for both switching costs and mixing costs. The bilingual advantage hypothesis was tested both by forming language groups and treating bilingualism as a continuous variable. No bilingual advantages were observed. In verbal-fluency monolinguals generated more correct responses but the bilingual disadvantage on the category task was not reduced in the letter-fluency scores. The bilingual disadvantage was eliminated when the groups were matched on vocabulary size. The verbal-fluency measures obtained when participants alternated between targets weakly correlated with the switching-costs obtained in the cued-switching tasks.     

高危型人类乳头瘤病毒对子宫颈癌筛查的意义

高危型人类乳头瘤病毒（HR—HPV）感染是宫颈癌发生的必要条件,本文就是否将HR—HPV纳入宫颈癌筛查进行探讨。通过对我院行宫颈癌筛查的2505例患者资料分析,结果显示对于经济条件良好或有宫颈癌高危因素的女性,细胞学检查（TCT）联合HR—HPV检测做为宫颈癌的初筛,其临床效益大于成本收益。     

Casualties of war and sunk costs: Implications for attitude change and persuasion

The purpose of the present research was to gain greater insight into how people's support for an ongoing war might be influenced by providing information about recent casualties of war. On intuitive grounds, one might expect that such information might often decrease support for the war, especially when the war in question is relatively unpopular. However, research and theory on the “sunk cost effect” suggests, somewhat paradoxically, that highlighting such losses could actually increase, not decrease, support for the war, as driven by the goal to avoid wasting valuable resources. Across two experiments (one focusing on the war in Iraq, another focusing on the war in Afghanistan), we found that the effects of the war casualty information on attitudes were moderated by a recent use and activation of the relevant “don't waste” goal, which had been previously primed in a non-political context. The implications of our findings for theory and research on attitude change, as well as the judgment and decision making area, are discussed.     

围绕ICU的几个问题的思考

ICU是现代医学中的新兴事物,发挥着重要作用,但是围绕ICU方方面面问题,无论是业界还是公众还有许多争论及认识上的误区,有待研究探讨,比如ICU是否是一个真正意义上的独立学科?ICU的业态形式?ICU一定是高投入高装备吗?ICU注定是高消费?ICU有人文伦理缺失的特权吗?本文试图对这些问题给予一点作者的观察和己见。     

Sales manager cost control engagement: antecedents and performance implications

Many organizations face competing agendas by which they are expected to simultaneously grow sales output while controlling associated costs. At the interface of this organizational pressure and the sales force’s implementation of such initiatives is the sales manager. However, questions with significant implications remain regarding how a sales manager’s requisite engagement with cost control affects sales performance. To address this issue, the authors conceptualize and operationalize the notion of sales manager cost control engagement. Results from a survey of 178 business-to-business sales managers show the antecedent and consequence effects of sales manager cost control engagement. A variety of organizational factors are shown to effectively direct the sales manager’s attention to cost control, which in turn has a positive impact on cost-related sales performance. These findings add to an emergent body of research aimed at understanding key skills required of sales managers for driving sales performance as well as provide a novel perspective for sales managers to consider when balancing pressures between cost inputs and sales outputs. Several theoretical and managerial implications are offered, as are future research directions.     

Do egalitarians always help the disadvantaged more than the advantaged? Testing a value‐norm conflict hypothesis in Malaysia

Do egalitarians always express greater compassion toward the disadvantaged than toward the advantaged? A closer look at existing scholarship on the topic suggests that they likely do. Here, we investigated whether such tendency is also apparent within interdependent, high power distance cultures where the high‐status privilege prevails. Given the emphasis on harmony in social relations in interdependent cultures, we reasoned that egalitarians might experience a dissonance between their private equity values and a societal norm prescribing high‐status privilege, which we refer to as the value‐norm conflict. We therefore proposed and found evidence in Malaysia (N = 273) that egalitarians succumbed to the normative high‐status privilege in their culture: They displayed greater compassion towards higher than lower status victims, but only when the political cost of doing so was low. Interestingly, anti‐egalitarians displayed equitable levels of compassion for high‐ and low‐status victims, but only when the political cost for taking such action also was low. Hence, we show that even egalitarians can, at times, favor the privileged and that anti‐egalitarians can act equitably, so long as the political cost of doing so is trivial for them.     

Word order in sentence processing: an experimental study of verb placement in German

We examine the question of whether the human comprehension device exhibits word-order preferences during on-line sentence comprehension. The focus is on the positioning of finite verbs and auxiliaries relative to subjects and objects in German. Results from three experiments (using self-paced reading and event-related brain potentials) show that native speakers of German prefer to process finite verbs in second position (i.e., immediately after the subject and before the object). We will account for this order preference in terms of the relative processing costs associated with SV_fO and SOV_f. Our finding that word-order preferences play an important role in the on-line comprehension of German sentences is compatible with results from previous studies on English and other languages.     

The effects of response cost in the treatment of aberrant behavior maintained by negative reinforcement

Positive reinforcement contingencies can sometimes be used to decrease problem behavior maintained by negative reinforcement (e.g., escape). In the current study, we evaluated the extent to which response cost (i.e., contingent removal of a preferred stimulus) would compete with the negative reinforcer maintaining destructive behavior. The response cost contingency reduced destructive behavior by 87% from baseline levels even though the negative reinforcement contingency (i.e., escape) remained in place.     

Psychometric adaptation of the driving cost and benefit scale in Chinese drivers

The present study aimed to adapt the Driving Cost and Benefit Scale (DCBS, Taubman-Ben- Ari, 2008) to Chinese drivers and examine its relationships with driving style and traffic violations. Nine hundred drivers aged 18 to 60 years were asked to complete the DCBS and the Multidimensional Driving Style Inventory. The results of exploratory factor analysis (n = 429) and confirmatory factor analysis (n = 429) yielded a 36-item scale with satisfactory reliability. The Chinese version of the DCBS contains seven factors, including three driving cost factors (damage to self-esteem, life endangerment and distress) and four driving benefit factors (impression management, sense of control, thrill and pleasure). Significant associations between the DCBS-C factors and driving styles and traffic violations show that the discriminant validity of the scale is acceptable. Moreover, the driving cost factor of damage to self-esteem and the driving benefit factor of thrill both contributed to drivers’ traffic violations and crashes. The findings show that the reliability and validity of the Chinese version of the DCBS are acceptable, and it can be used as a tool to measure driving motivation in China.