医患关系由“双输”到“双赢”

我国医患关系日趋紧张已是一个不争的事实,日趋恶化的医患关系使患者无奈、天使流泪、医院苦恼、政府尴尬,可谓"全盘皆输"。实现和谐医患关系达到"全赢",必须解决影响医疗服务水平的这一关键障碍,需要政府、医院、医务人员和患者多方的共同努力。     

The ontology of intentionality I: the dependence ontological account of order: mediate and immediate moments and pieces of dependent and independent objects

This is the first of three essays which use Edmund Husserl's dependence ontology to formulate a non-Diodorean and non-Kantian temporal semantics for two-valued, first-order predicate modal languages suitable for expressing ontologies of experience (like physics and cognitive science). This essay's primary desideratum is to formulate an adequate dependence-ontological account of order. To do so it uses primitive (proper) part and (weak) foundation relations to formulate seven axioms and 28 definitions as a basis for Husserl's dependence ontological theory of relating moments. The essay distinguishes between dependence v. independence, pieces v. moments, mediate v. immediate pieces and moments, maximal v. non-maximal pieces, founded v. unfounded qualities, integrative v. disintegrative dependence, and defines the concepts of the completion of an object, the adumbrational equivalence relation of objects, moments of unity which unify objects, and relating moments which relate objects. The eight theorems [CUT90]-[CUT97] show that relating moments of unity provide an adequate account of order in terms of primitive (proper) part and (weak) foundation relations.     

Comparing score tests and other local dependence diagnostics for the graded response model

Score tests for identifying locally dependent item pairs have been proposed for binary item response models. In this article, both the bifactor and the threshold shift score tests are generalized to the graded response model. For the bifactor test, the generalization is straightforward; it adds one secondary dimension associated only with one pair of items. For the threshold shift test, however, multiple generalizations are possible: in particular, conditional, uniform, and linear shift tests are discussed in this article. Simulation studies show that all of the score tests have accurate Type I error rates given large enough samples, although their small‐sample behaviour is not as good as that of Pearson's Χ² and M₂ as proposed in other studies for the purpose of local dependence (LD) detection. All score tests have the highest power to detect the LD which is consistent with their parametric form, and in this case they are uniformly more powerful than Χ² and M₂; even wrongly specified score tests are more powerful than Χ² and M₂ in most conditions. An example using empirical data is provided for illustration.     

Dual imputation model for incomplete longitudinal data

Missing values are a practical issue in the analysis of longitudinal data. Multiple imputation (MI) is a well‐known likelihood‐based method that has optimal properties in terms of efficiency and consistency if the imputation model is correctly specified. Doubly robust (DR) weighing‐based methods protect against misspecification bias if one of the models, but not necessarily both, for the data or the mechanism leading to missing data is correct. We propose a new imputation method that captures the simplicity of MI and protection from the DR method. This method integrates MI and DR to protect against misspecification of the imputation model under a missing at random assumption. Our method avoids analytical complications of missing data particularly in multivariate settings, and is easy to implement in standard statistical packages. Moreover, the proposed method works very well with an intermittent pattern of missingness when other DR methods can not be used. Simulation experiments show that the proposed approach achieves improved performance when one of the models is correct. The method is applied to data from the fireworks disaster study, a randomized clinical trial comparing therapies in disaster‐exposed children. We conclude that the new method increases the robustness of imputations.     

题组反应理论及其在中学英语考试中的应用研究

题组作为众多测验中的一种常见题型,由于项目间存在一定程度的依赖性而违背了局部独立性假设,若用项目反应模型进行参数估计将会出现较大的偏差.题组反应理论将被试与题组的交互作用纳入到模型中,解决了项目间相依性的问题.笔者对题组反应理论的发展、基本原理及其相关研究进行了综述,并将其应用在中学英语考试中.与项目反应理论相对比,结果发现：（1）题组反应模型与项目反应模型在各参数估计值的相关系数较强,尤其是能力参数和难度参数;（2）在置信区间宽度的比较上,题组反应模型在各个参数上均窄于项目反应模型,即题组反应模型的估计精度优于项目反应模型.     

Guidance systems across Europe: heritage,change and the art of becoming

Guidance systems exist within learning, working and welfare cultures, which are upheld by prevailing institutions and stakeholders. Implementing a lifelong approach questions rooted codes and idiosyncrasies of the sectors across which guidance is distributed. To support individuals' careers, unlock their potential and increase their contribution to the economy i.e. support their process of becoming, lifelong guidance must strive for effective systems' integration across policy fields, cultures and organisations. This article departs from national experiences and discusses how cultures and institutional contexts generate resistance to change, but can also be the departure point for the successful development of lifelong support to people's careers.     

Are Longshots Only for Losers? A New Look at the Last Race Effect

There is evidence that betting on longshots increases in the last race of a day of horse racing. Previous accounts have assumed that the phenomenon is driven by bettors who have lost money and are trying to recoup their losses. To test this assumption of “reference dependence,” three laboratory experiments simulated a day at the races: In each of several rounds, participants chose either (i) a gamble with a small probability of a large gain and a large probability of a small loss (the “longshot”) or (ii) a gamble with a moderate chance of a small gain or a small loss (the “favorite”). The first two experiments employed a game played for points, while a third experiment included monetary incentives and stimuli drawn from a real day of racing. These experiments provide a clear demonstration of the last race effect in a laboratory setting. However, the results indicate that the effect is largely reference independent: Participants were more likely to choose the longshot in the last round regardless of whether, and how much, they had won or lost in previous rounds. Winning or losing, bettors prefer to “go out with a bang” at the end of a series of gambles. Copyright © 2015 John Wiley & Sons, Ltd.     

The Relation Between Compulsive Sexual Behaviors and Aggression in a Substance-Dependent Population

Research supports a high comorbidity between compulsive sexual behaviors (CSBs) and substance use disorders (SUDs), which are both classified by increased impulsivity. Literature has also indicated that increased impulsivity and substance use are associated with aggression. However, no known research has examined the relationship between CSBs and aggression among a substance-dependent population. The purpose of this study was to examine this relationship. Participants included 349 male patients in treatment for SUDs. Results indicated that after controlling for alcohol and drug use and problems and age, CSBs were significantly associated with total aggression, aggressive attitudes, physical aggression, and verbal aggression. This is the first known study to examine this relationship; thus continued research is needed to extend and replicate these findings.     

初中生羞怯与手机依赖的关系:一个有调节的中介模型

为探讨初中生羞怯、疏离感、班级心理环境和手机依赖的关系,采用羞怯量表、青少年疏离感量表、班级心理环境量表和手机依赖指数量表对山东省两所学校的1077名初一至初三年级的学生进行调查。结果显示：（1）羞怯显著正向预测初中生手机依赖;（2）疏离感在初中生羞怯与手机依赖之间起完全中介作用;（3）班级心理环境对中介效应的后半段路径起调节作用,高班级心理环境会缓解疏离感对手机依赖的影响,但在极高疏离感水平下,高班级心理环境反而会加剧个体的手机依赖水平。研究有助于了解羞怯对手机依赖的复杂影响机制,对预防以及减少初中生手机依赖具有一定的现实意义。     

For the church community after COVID‐19

COVID‐19 is changing everyday life. COVID‐19 is also changing the look of the church. The church is a community of people who gather for worship, fellowship, and sharing. However, due to the coronavirus, the church is no longer able to gather and worship together. Moreover, because of the coronavirus, social distancing with as little as possible face‐to‐face contact has been recommended worldwide. If this situation is prolonged, the church community interactions will have difficulty in surviving. Therefore, this article seeks ways to maintain and strengthen the church community in and after the coronavirus era through insight into speech act theory.