医疗保险费用控制的临床路径研究——胰腺炎医疗保险费用结算标准的确定

临床路径是现代医院管理的前沿技术之一,对于提高医疗服务质量和降低医疗费用具有现实意义。通过对急性胰腺炎病人的临床路径研究,探讨了我国临床实践中临床路径的实施方法,并在此基础上进一步研究了该疾病医疗保险费用结算标准的分类标准。     

Stereotypes and implicit social comparison: Shifts in comparison-group focus

Stereotypes affect how people understand implicit comparisons. In two studies, people judged the comparison implied by a statement (e.g., “Math is easy for me,” “I’m really aggressive”) made by an African-American, White, or Asian-American male. Counter-stereotypic comments, such as the African-American saying he was “bad” at basketball, caused participants to think the target was comparing himself to his narrow ingroup; stereotypic statements caused people to infer that the comparison group was broader. When compared to a fixed standard (all people in USA), evidence that people used stereotypes consistently emerged. Whether motivated or not, by narrowing the comparison standard when presented with a counter-stereotypic case, participants constructed an understanding of the target that protected the stereotype from challenge.     

Separation of conjoined twins and the principle of double effect.

This article examines the relationship between the principle of double effect and justification for separation surgeries for conjoined twins. First, the principle of double effect is examined in light of its historical context. It is argued that it can only operate under an absolutist view of good and evil that is compatible with the Bible. Given this foundation for application, scenarios for separating conjoined twins are considered against the criteria for the principle of double effect. It is concluded that the principle of double effect cannot be applied to cases wherein one of the twins must be killed. However, it is noted that this does not leave decision makers without options.     

耳机传送双重听觉信号的知觉特点研究

本研究探讨了耳机以叠加法和分离法传送双重听觉信号的知觉特点.实验结果表明(1)响度感觉是听觉中枢对同一信号的双耳输入强度加工整合的结果;(2)信号间的中枢干扰作用比外周干扰作用要小.前一论点在对三维虚拟听觉显示研究中也是应十分注意的.     

The relationship between Fisher's exact test and Pearson's chi-square test: A bayesian perspective

It is demonstrated in this paper that two major tests for 2 × 2 talbes are highly related from a Bayesian perspective. Although it is well-known that Fisher's exact and Pearson's chi-square tests are asymptotically equivalent, the present analysis shows that a formal similarity also exists in small samples. The key assumption that leads to the resemblance is the presence of a continuous parameter measuring association. In particular, it is shown that Pearson's probability can be obtained by integrating a two-moment approximation to the posterior distribution of the log-odds ratio. Furthermore, Pearson's chi-square test gave an excellent approximation to the actual Bayes probability in all 2×2 tables examined, except for those with extremely disproportionate marginal frequencies.     

态度及其与行为模式述评

态度一直是社会心理学的核心问题,态度对于预测行为具有重要作用。本文阐述了态度的界定、态度的结构模型及态度预测行为模型的各种理论,在这些理论的基础上,提出了态度预测行为的另一模型。     

Prepubertal social gender transitions: What we know; what we can learn—A view from a gender affirmative lens

ABSTRACT

?Background: This article provides a review and commentary on social transition of gender-expansive prepubertal youth, analyzing risks, and benefits based on a synthesis of research and clinical observation, highlighting controversies, and setting forth recommendations, including the importance of continued clinical research.

Methods: This article involved: (1) a review and critique of the WPATH Standards of Care 7th edition guidelines on social transition; (2) a review and synthesis of empirical research on social transition in prepubertal children; (3) a discussion of clinical practice observations; (4) a discussion of continuing controversies and complexities involving early social transition; (5) a discussion of risks and benefits of social transition; and (6) conclusions and recommendations based upon the above.

Results: Results suggest that at this point research is limited and that some of the earliest research on young gender-expansive youth is methodologically questionable and has not been replicated. Newer research suggests that socially transitioned prepubertal children are often well adjusted, a finding consistent with clinical practice observations. Analysis of both emerging research and clinical reports reveal evidence of a stable transgender identity surfacing in early childhood.

Discussion: The authors make recommendations to support social transitions in prepubertal gender-expansive children, when appropriate, as a facilitator of gender health, defined as a child's opportunity to live in the gender that feels most authentic, acknowledging that there are limitations to our knowledge, and ongoing research is essential.     

Scientific misconduct: The lessons of time

Conclusions Pascal’s paper indicates how far we have come. Now as then, however, there is a need to reflect from outside the cocoon of our agencies, institutions, and disciplines to behold the enterprise that shapes both our behavior and our interpretations of it. For the boundary separating propriety from impropriety continues to move. Just as science, and the knowledge it begets, continues to evolve, so must our collective standards. The lessons of time include this: ORI or biomedical research is no island; each is connected to a body of practitioners who are accountable to a society that is ever-more skeptical of expert knowledge and the institutions entrusted with its development. We are participants in a process of “continuous improvement”, not occupants of a state of grace. For the good of the enterprise we cherish, it is best that we all remember that. The views expressed here are the author’s own and reflect neither those of NSF nor of the National Science Board.     

Projection, Double Bind, and Demonic Possession: Some Common Elements in Three Theories of Psychosis

A desirable goal in science is to identify points at which theories converge. Three theories of psychosis are addressed with respect to three elements they share. The theories are (1) projection, (2) double bind, and (3) demonic possession. The points of convergence are (1) negative injunction, (2) persecutory belief, and (3) obedience to a transcendental command. Implications of the linkage between the elements and theories are drawn.     

Effects of training in the responsible conduct of research: A survey of graduate students in experimental sciences

In recent years, programs for training in research ethics have become widespread, but very little has been done to assess the effectiveness of this training. Because initial studies have failed to demonstrate a positive impact of research ethics training, this project defined two new outcome variables to be tested in a sample of graduate students at the University of California, San Diego. Trainees were surveyed to assess the role of ethics training in altering their perceptions about their own standards, or their knowledge of options available to them if faced with ethical problems that might arise in conducting and reporting research. In response to a mailing of 505 anonymous questionnaires, 283 replies were received. Similar to previous studies, perceptions of standards were not significantly affected by hours spent in informal discussions about research ethics, in attending courses on research ethics, or in discussions of case studies. However, self-reported knowledge of options for facing research ethics problems was significantly increased in association with increased hours of discussion, class time, or case study discussion. Taken together, this study emphasizes the need for increased attention to the definition and assessment of the goals of research ethics training.