医疗服务成本控制过程伦理范式的选择

不同伦理范式对医疗服务成本控制过程会产生不同的影响.运用经济伦理学及管理伦理学的原理和方法,结合医疗卫生服务机构的行业性质及特点,选择出现实可行的医疗服务成本控制过程的伦理范式.使医疗卫生服务机构在医疗服务成本控制过程中,从成本控制标准的确定、成本控制方法及途径的选择到成本控制结果的分析及考评等环节融入相关伦理内涵.使医疗服务成本控制更好地遵循恰当的伦理范式,更好地履行医疗卫生服务机构的宗旨和职责.     

Effective regulation of affect: An action control perspective on emotion regulation

The present review adopts an action control perspective on emotion regulation, contextualising the gap between emotion control goals (e.g., I want to remain calm) and emotional outcomes (e.g., anger, anxiety, and aggression) in terms of the broader literature on goal pursuit. We propose that failure to effectively regulate emotions can result from difficulties with the self-regulatory tasks of (i) identifying the need to regulate, (ii) deciding whether and how to regulate, and (iii) enacting a regulation strategy. Next we review evidence that a technique traditionally associated with regulating behavioural goals (forming implementation intentions or “if-then” planning) can help to overcome these difficulties. Meta-analysis indicated that forming implementation intentions is effective in modifying emotional outcomes, with a large effect relative to no regulation instructions (k = 21, N = 1306 d ₊ = 0.91, 95% CI = 0.61 to 1.20) and a medium-sized effect relative to goal intention instructions (k = 29, N = 1208, d ₊ = 0.53, 95% CI = 0.42 to 0.65). Our conclusion is that research on emotion regulation might benefit from an action control perspective and the interventions that this perspective offers.     

Forgoing Debriefing in Deceptive Research: Is It Ever Ethical?

The use of deception in research is generally permitted so long as participants are debriefed at the conclusion of their participation. Several authoritative research ethics guidelines allow investigators to omit debriefing under certain circumstances, however. Here we examine various justifications for forgoing debriefing in deceptive research, including concerns about subject pool contamination, the risk that revealing the deception will be harmful or distressing to participants, and issues of practicability. We conclude that, contrary to current practice, omitting debriefing is ethically acceptable only when debriefing is impracticable, the deception is innocuous, and no reasonable person would object to involvement in the research.     

Is risk-taking propensity associated with unethical behaviors? An experimental study

Are risk-takers more likely to engage in unethical behaviors? We examined the relationship between risk-taking propensity and cheating in two experimental studies. In Study 1, we examined the relationship between subjects’ risk-taking propensity and their actual self-serving dishonesty using a gambling-like task. The results suggested that risk-taking propensity, measured using a behavioral approach, was positively correlated with actual self-serving dishonest behavior. In Study 2, we measured participants’ performances using a matrices test and found that the positive correlation still held. We found that participants with high risk-taking propensity reported a lower perceived probability of being detected, which might drive their dishonest behavior.     

Unconscious task set priming with phonological and semantic tasks

Whether unconscious stimuli can modulate the preparation of a cognitive task is still controversial. Using a backward masking paradigm, we investigated whether the modulation could be observed even if the prime was made unconscious in 100% of the trials. In two behavioral experiments, subjects were instructed to initiate a phonological or semantic task on an upcoming word, following an explicit instruction and an unconscious prime. When the SOA between prime and instruction was sufficiently long (84 ms), primes congruent with the task set instruction led to speedier responses than incongruent primes. In the other condition (36 ms), no task set priming was observed. Repetition priming had the opposite tendency, suggesting the observed task set facilitation cannot be ascribed solely to perceptual repetition priming. Our results therefore confirm that unconscious information can modulate cognitive control for currently active task sets, providing sufficient time is available before the conscious decision.     

Alcohol increases hypnotic susceptibility

One approach to hypnosis suggests that for hypnotic experience to occur frontal lobe activity must be attenuated. For example, cold control theory posits that a lack of awareness of intentions is responsible for the experience of involuntariness and/or the subjective reality of hypnotic suggestions. The mid-dorso-lateral prefrontal cortex and the ACC are candidate regions for such awareness. Alcohol impairs frontal lobe executive function. This study examined whether alcohol affects hypnotisability. We administered 0.8 mg/kg of alcohol or a placebo to 32 medium susceptible participants. They were subsequently hypnotised and given hypnotic suggestions. All participants believed they had received some alcohol. Participants in the alcohol condition were more susceptible to hypnotic suggestions than participants in the placebo condition. Impaired frontal lobe activity facilitates hypnotic responding, which supports theories postulating that attenuation of executive function facilitates hypnotic response, and contradicts theories postulating that hypnotic response involves enhanced inhibitory, attentional or other executive function.     

Adapting to an initial self-regulatory task cancels the ego depletion effect

The resource-based model of self-regulation provides a pessimistic view of self-regulation that people are destined to lose their self-control after having engaged in any act of self-regulation because these acts deplete the limited resource that people need for successful self-regulation. The cognitive control theory, however, offers an alternative explanation and suggests that the depletion effect reflects switch costs between different cognitive control processes recruited to deal with demanding tasks. This account implies that the depletion effect will not occur once people have had the opportunity to adapt to the self-regulatory task initially engaged in. Consistent with this idea, the present study showed that engaging in a demanding task led to performance deficits on a subsequent self-regulatory task (i.e. the depletion effect) only when the initial demanding task was relatively short but not when it was long enough for participants to adapt. Our results were unrelated to self-efficacy, mood, and motivation.     

Event-related potentials as brain correlates of item specific proportion congruent effects

The item-specific proportion congruency (ISPC) effect is consistent with the idea that control processes can be applied rapidly in accord with previously experienced conflict for a particular category. An alternative account of this effect is that it reflects item-specific learning processes unrelated to control at the level of the category. The accounts predict the same behaviour but differ in terms of electrophysiological predictions. Two experiments examined the ISPC effect with a particular focus on neural correlates that might reveal whether, and how early in processing, high and low proportion congruent items are treated as distinct classes of stimuli. For both tasks, the proportion congruency category was distinguished prior to the congruence of the specific stimulus, as early as 100 ms post-stimulus onset for the global/local identification task (Experiment 1) and 150 ms for the Stroop task (Experiment 2). The results support an on-line control account of ISPC effects.     

Effects of Backpack Carriage on Dual-Task Performance in Children During Standing and Walking

Primary school children perform parts of their everyday activities while carrying school supplies and being involved in attention-demanding situations. Twenty-eight children (8–10 years old) performed a 1-legged stance and a 10 m walking test under single- and dual-task situations in unloaded (i.e., no backpack) and loaded conditions (i.e., backpack with 20% of body mass). Results showed that load carriage did not significantly influence children's standing and walking performance (all p > .05), while divided attention affected all proxies of walking (all p < .001). Last, no significant load by attention interactions was detected. The single application of attentional but not load demand negatively affects children's walking performance. A combined application of both did not further deteriorate their gait behavior.     

The Impact of Strategic Trajectory Optimization on Illusory Target Biases During Goal-Directed Aiming

During rapid aiming, movements are planned and executed to avoid worst-case outcomes that require time and energy to correct. As such, downward movements initially undershoot the target to avoid corrections against gravity. Illusory target context can also impact aiming bias. Here, the authors sought to determine how strategic biases mediate illusory biases. Participants aimed to Müller-Lyer figures in different directions (forward, backward, up, down). Downward biases emerged late in the movement and illusory biases emerged from peak velocity. The illusory effects were greater for downward movements at terminal endpoint. These results indicate that strategic biases interact with the limb-target control processes associated with illusory biases. Thus, multiple control processes during rapid aiming may combine and later affect endpoint accuracy (D. Elliott et al., 2010 Elliott, D., Hansen, S., Grierson, L. E. M., Lyons, J., Bennett, S. J., &; Hayes, S. J. (2010). Goal-directed aiming: two components but multiple processes. Psychological Bulletin, 136, 1023–1044.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]).