神经外科高新技术应用中的人文问题

本文在分析医疗高新技术给神经外科带来发展的同时,阐述了其所带来的一系列人文问题。并对神经外科医务人员如何在临床中合理应用医疗高新技术,把握好医患关系,合理利用医疗资源,表现良好的医德医风提出了要求。     

四字谜问题解决中原型启发的时间抵消与位置效应

根据顿悟的原型启发理论,通过两个实验考察原型启发的时间抵消和位置效应。实验1采用2（字谜类型）×2（原型呈现时间）混合设计,结果发现：松组块字谜的正确率显著高于紧组块字谜;原型谜面消失的正确率显著大于谜面存在的正确率。实验2采用2（原型位置）×2（字谜类型）×2（原型呈现时间）混合设计,结果不仅证明了实验1,且原型位置、字谜类型、原型呈现时间的交互作用显著,原型在靶字谜之前时,紧组块字谜上谜面消失的正确率显著大于谜面存在的正确率;原型在靶字谜之后时,松组块字谜上谜面消失的正确率显著大于谜面存在的正确率。表明字谜顿悟问题解决中存在原型的时间抵消和位置效应,二者连同任务难度共同影响问题解决。     

Integrating Dimensional and Discrete Theories of Emotions: A New Set of Anger- and Fear-Eliciting Stimuli for Children

The selection of appropriate stimuli for inducing specific emotional states has become one of the most challenging topics in psychological research. In the literature there is a lack of affective picture database specifically suited to investigate emotional response in children. Here the authors present the methodology that led us to create a new database (called Anger- and Fear-Eliciting Stimuli for Children) of affective stimuli inducing experiences of 3 target emotions (neutral, anger, and fear) to use in experimental session involving children. A total of 84 children were asked to (a) indicate the perceived emotion and its intensity and (b) rate the three affective dimensions of the Self-Assessment Manikin (SAM). Based on concordance between labeled and expected target emotion, the authors decided to select 15 stimuli to be included in Multivariate modeling techniques were applied to evaluate the association between expected target emotion and SAM ratings. The authors found that the hit rate for the neutral pictures was good (greater than 81%), for fear-eliciting pictures it was greater than 64%, and for anger-eliciting pictures it was moderate (between 45% and 56%). The study results reveal also an age effect only in the arousal scale. However, the authors did not find significant gender-related differences in SAM ratings.     

A mixed-methods process evaluation of a goal management intervention for patients with polyarthritis

Process evaluations of newly developed interventions are necessary to identify effective and less effective intervention components. First aim of this study was to identify key components of a psychosocial goal management intervention from the perspective of participants, and second aim was to evaluate the intervention’s fidelity. A mixed-methods approach was applied to 24 interviews with participants post-intervention and 16 audio recordings of random training sessions. Participants experienced three key components: (1) the content, in which specific exercises helped to raise awareness and (intention to) change goal management behaviour, (2) person-focused approach, specifically, the nurse as trainer and personal fit of the approach, and (3) social mechanisms, including facilitating group processes and interpersonal processes. Adherence to the protocol by the trainers was high, while differences were found in the degree to which they were able to apply the intended collaborative approach and psychological communication skills. The applied design provided valuable insights into the processes that took place. Both the effects experienced by participants in relationship to the content, approach and social mechanisms as well as the strengths and weaknesses found with regard to fidelity provide insights that can inform the development and implementation of person-focused interventions.     

Torture in the Naked Public Square

Is torture ever ethically permissible? O’Donohue et al. (2014) argued that there are situations in which it is not only morally permissible but actually morally obligatory to torture a prisoner. Arrigo, DeBatto, Rockwood, and Mawe (2015) wrote a critical reply; O’Donohue et al. (2015) have responded. Yet to date, the specifically ethical weaknesses of the O’Donohue et al. position have not been examined; no argument against torture has been offered, nor have the lessons of the CIA’s secret program been taken into account. The present article moves the discussion forward on all three fronts. A case against torture is offered on pragmatic grounds.     

Effects of behaviour change interventions on physical activity in people with spinal cord injury: A systematic review and meta-analysis

ObjectivesThis review investigated the effectiveness of behaviour-change interventions to improve physical activity (PA) participation in individuals with a spinal cord injury. Additionally, the review sought to analyse the change in PA behaviour that might be expected by utilising behaviour change in PA interventions and what specific intervention characteristics, application of behaviour change theories, and behaviour change techniques are most efficacious.MethodsThe protocol was prospectively registered on PROSPERO: CRD42021252744, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed in this review. Eight databases were comprehensively searched using a well-defined strategy developed in collaboration with an academic liaison librarian. Randomised, non-randomised controlled, and non-controlled studies were included in this review; however, controlled and non-controlled studies were analysed separately. Studies were included if participants were older than 16 years and had an SCI of any cause, level or severity, regardless of the time since injury. The behaviour change technique taxonomy version 1 was used to code the intervention characteristics for behaviour modification. The combined effects across studies were pooled in a meta-analysis, and the risk of bias was assessed using the Cochrane Risk of Bias 2 tool.ResultsThe search retrieved 10,155 titles and abstracts. After duplicate removal and screening against the eligibility criteria, 23 studies were included. The overall effect estimate of the change in PA participation in the controlled trials post-intervention was medium (d = 0.50, 95% CI = 0.31–0.70) in favour of behaviour-targeted interventions. The mean difference in PA volume between pre- and post-intervention was an increase of 22 minutes per week (95% CI = 5.96–38.90). Interventions that provided practical support (d = 0.81, 95% CI = 0.46–1.16), which were individualised (d = 0.62, 95% CI = 0.34–0.90) and that utilised monitoring (d = 0.59, 95% CI = 0.34–0.83) had a greater effect on change to PA than those that were group-based and did not utilise those specific techniques.ConclusionsInterventions that target behaviour change to increase PA in people with SCI appear effective. Utilising behaviour change frameworks and specific behaviour change techniques augments PA uptake and levels, and interventions aimed at improving PA in people with SCI should incorporate a behaviour modification component. More research is needed on the isolated effect of intervention structure parameters and specific behaviour change techniques.     

The Transtheoretical model’s processes of change in the heart of a physical activity intervention: A series of n-of-1

The objectives were a) to test whether a Processes of Change (POC)-personalized Transtheoretical model (TTM)-based intervention could increase physical activity (PA) among inactive adults, and b) to examine whether the intervention increased the level of TTM theoretical constructs. The following hypotheses were formulated: 1) PA levels will be significantly higher during and after the intervention in comparison to baseline measures; 2) the level of targeted POCs will increase during the intervention; 3) non targeted POCs will stay stable, and 4) self-efficacy and decisional balance levels will increase during the intervention. A series of N-of-1 with A (1 to 2-week)-B(10-week)-A'(2-week) design were conducted with 12 inactive adults. Behavioral counselors used behavior change techniques to target TTM constructs and supervise PA. Interventions were individualized based on the 5 POCs with the lowest pre-intervention level. Device-based and subjective PA along with TTM measures were collected weekly online. PA data were analyzed with piecewise linear models. A visual analysis was run to examine the TTM constructs. Device, self-reported and TTM data were available for five, seven and five participants, respectively. A significant self-reported PA increase for six participants was found during the phase B and A2. A significant device-measured PA increase was observed in two participants during the study. A substantial increase of targeted POC from baseline for all participants with available data was observed. This study provides the first evidence of behavioral and psychological effects of a POC-personalized TTM-based intervention in inactive adults.     

Picturing the Wheatbelt: Exploring and Expressing Place Identity Through Photography

Community arts and cultural development is a process that builds on and responds to the aspirations and needs of communities through creative means. It is participatory and inclusive, and uses multiple modes of representation to produce local knowledge. ‘Voices’ used photography and photo elicitation as the medium for exploring and expressing sense of place among Aboriginal and non‐Indigenous children, young people and adults in four rural towns. An analysis of data generated by the project shows the diverse images that people chose to capture and the different meanings they afforded to their pictures. These meanings reflected individual and collective constructions of place, based on positive experiences and emotions tied to the natural environment and features of the built environment. We discuss community arts and cultural development practice with reference to creative visual methodologies and suggest that it is an approach that can contribute to community psychology’s empowerment agenda.     

Eliciting Intelligence Using the Scharff‐Technique: Closing in on the Confirmation/Disconfirmation‐Tactic

The current study examined interview techniques aimed at eliciting intelligence from human sources. We compared two versions of the Scharff‐technique to the Direct Approach (a combination of open and direct questions). The Scharff conditions, conceptualised into four tactics, differed only with respect to the ‘confirmation/disconfirmation‐tactic’. The participants (N = 90) received background information and took the role as a source in a phone interview. They were instructed to strike a balance between not revealing too little and too much information. As predicted, the Scharff‐technique resulted in more new information than the Direct Approach. Importantly, the sources interviewed by the Scharff‐technique perceived that they had revealed less new information than they objectively did, whereas the sources interviewed by the Direct Approach perceived that they had revealed more new information than they objectively did. Furthermore, the interviewer's information objectives were better masked with the confirmation‐tactic than with the disconfirmation‐tactic. The results highlight the Scharff‐technique as a promising human intelligence gathering technique. Copyright © 2014 John Wiley & Sons, Ltd.