21世纪的中西医结合

自本世纪６０年代以来,中西医结合取得了重要进展,中西医结合的经验与成果已经引起国内外重视。２１世纪,在“中西医并重”的方针指引下,将会迎来更好的发展机遇。兼客、互补与结合创新是主要的三种结合形式,其中结合创新占有更重要的地位。我们应增强创新意识,选好创新目标,改善临床与研究工作条件,为取得更快的发展而努力。     

Democratic School Climate and Sense of Community in School: A Multilevel Analysis

This study examines individual- and school-level predictors of sense of community in school among adolescents. Hierarchical linear modeling was used to examine the relationships between individual (demographics, control and monitoring by parents, and perception of democratic school climate), class, and school characteristics (mean democratic school climate, demographics, activities, school size, public/private governance of the school, and facilities) and students' sense of community in the school. Data were analyzed using a three-level model based on 4,092 10- to 18-year-old students nested within 248 classes (across three grade levels: 6th, 8th, and 10th grade level, where the median age was 11, 13, and 15, respectively) in 134 schools in the Veneto region of northeast Italy. Individual and contextual measures of the perception of a democratic school climate, modeled at the individual, class, and school levels simultaneously, were each significant predictor of school sense of community. More parental monitoring and less parental control were also predictive at the individual level. School-level SES predicted between school variation in sense of community, controlling for individual student SES and other student and school-level predictors. School size, facilities (physical spaces resources), level of interaction of the school with the community, public, or private governance, and number of extracurricular activities offered were all nonsignificant. The study demonstrates significant variation in school sense of community at the student, class, and school levels and the important role played by democratic school practices, such as student participation in making rules and organizing events, freedom of expression, and the perceived fairness of rules and teachers, in determining this variable.     

The Alien-Hand Experiment

This article reintroduces a phenomenological experiment designed in the early 1960’s, The Alien-Hand Experiment (TAHE), and it illustrates how phenomena denoted by theoretical concepts like body image, body schema and agency can be studied via the experiment. An analysis of the verbal reports from 26 subjects who participated in TAHE is presented in this article. Subjects were divided into three groups: A group of non-bulimic men, a group of non-bulimic women and a group of female bulimics. The group of (female) bulimics was studied due to the widely spread notion that subjects suffering from eating disorders have a distorted body image. TAHE can be thought of as both a qualitative and quantitative way to study the phenomena arising when the normal relationship between motor behaviour and body experience is disrupted. The present investigation is not an operational definition of body schema and body image, but the two concepts offer a useful interpretive framework.     

Childhood psychological maltreatment,sense of self,and PTSD symptoms in emerging adulthood

This study outlines the relationships among childhood psychological maltreatment (CPM), an understudied form of maltreatment, sense of self (SOS), a developmental construct negatively impacted by trauma, and post-traumatic stress disorder (PTSD) symptoms in emerging adults. Results from regression analysis on a sample of emerging adults (N = 358) indicated CPM to be the greatest predictor of a weaker SOS, even when considered alongside other types of child maltreatment. Among those exposed to CPM, SOS was a significant predictor of PTSD symptoms, explaining 34.1% of the variance in the outcome. Counseling interventions that focus on SOS during emerging adulthood are recommended as one important consideration for survivors of CPM who experience PTSD symptoms. Specific counseling practice and research implications are included.     

The effects of response cost and response restriction on a multiple-response repertoire with humans

In two experiments a multiple-response repertoire of four free-operant responses was developed with university students as subjects using monetary gain as reinforcement. Following baseline, one of the responses was reduced either by making monetary loss contingent upon it (response cost) or by removing it from the repertoire (response restriction). In Experiment 1 a multielement baseline design was employed in which baseline and restriction or response-cost contingencies alternated semirandomly every 3 minutes. In Experiment 2 a reversal design was employed (i.e., baseline, restriction or response cost, then baseline), and each response required a different amount of effort. Both experiments had the following results: (a) The target response decreased substantially; (b) most nontarget responses increased, and the rest remained near their baseline levels; and (c) no support was found for Dunham's hierarchical, most frequent follower, or greatest temporal similarity rules. For several subjects, the least probable responses during baseline increased most, and the most probable responses increased least. Furthermore, in Experiment 2, responses with the lowest frequency of reinforcement increased most (for all 7 subjects), and those with the greatest frequency of reinforcement increased least (for 5 subjects).     

医德形成:外在强制与内在自觉

作为一种职业道德，医德的形成需要有一个过程。首先要以普通人或一般人的本质特性，即人是一个自由的有意识的存在者为前提条件。根据现代人的道德状况，将医德的形成分为两种路径，即医德形成的一般途径：靠制度约束的外在强制；医德形成的根本途径：对医生美德的内在自觉。     

Position of compression garment around the knee affects healthy adults’ knee joint position sense acuity

Athletes use compression garments (CGs) to improve sport performance, accelerate rehabilitation from knee injuries or to enhance joint position sense (JPS). The position of CGs around the knee may affect knee JPS but the data is inconsistent. The purpose of the present study was to determine the effects of CG position on healthy adults’ knee joint position sense acuity. In a counterbalanced, single-blinded study, 16 healthy young adults (8 female, age: 25.5 y) performed an active knee joint position-matching task with and without (CON) a below-knee (BK), above-knee (AK), or whole-knee (WK) CG in a randomized order on the dominant (CompDom) or the non-dominant leg (CompNon-Dom). We also determined the magnitude of tissue compression by measuring anatomical thigh and calf cross sectional area (CSA) in standing using magnetic resonance imaging (MRI). Subjects had less absolute repositioning error (magnitude of error) in BK compared with CON condition. On the other hand, the analysis of the direction of error (constant error) revealed that in each condition subjects tended to underestimate the target position (AK, BK and CON: 75%; WK: 94%). In WK condition there was a significantly larger negative error (−2.7 ± 3.4) as compared with CON (−1.6 ± 3.7) condition. There also was less variable error, in WK compared to BK and CON conditions, indicating less variability in their position sense using a WK CG, regardless of the underestimation. CG reduced thigh CSA by 4.5 cm² or 3% and calf CSA by Δ1.3 cm² or 1%. The position of CG relative to the knee modifies knee JPS. The findings helps us better understand how the application of a WK CG may support athletic activities.     

Practicing Elements Versus Practicing Coordination: Changes in the Structure of Variance

ABSTRACT

The authors explored effects of practice of a 2-finger accurate force production task on components of finger force variance quantified within the uncontrolled manifold (UCM) hypothesis, V_UCM, that had no effect on total force and V_ORT that affected total force. A variable task with graded instability was designed to encourage use of variable solutions. Two groups of subjects (n = 9 each) were tested prior to a 1.5-hr practice session, after the session, and 2 weeks later (retention test). Group 1 practiced 1 finger at a time, while Group 2 practiced the task with 2 fingers (index and middle) pressing together. Both groups showed comparable improvements in the performance indices. Both groups showed a decrease in V_ORT, while only Group 2 showed an increase in V_UCM. These effects persisted during the retention test. The results show that practicing elements and practicing redundant groups of elements may lead to similar changes in performance (i.e., in the variability of the total force produced by the set of fingers), accompanied by dramatically different changes in the structure of variance: A drop in V_UCM after the single-finger practice and an increase following the 2-finger practice. The strong retention effects promise applications of the method to rehabilitation.     

Loneliness and emotional intelligence

The possible associations of loneliness with Emotional Intelligence (EI), 2 of its correlates (life satisfaction and a sense of meaning), and several background variables were tested on a sample of 134 young adults attending college in northern Israel. Structural Equation Modeling (SEM) analysis provided support for the model, suggesting that the presence of meaning, EI, and size and availability of an individual's social network are the strongest correlates of loneliness. EI therefore emerges as a potentially important factor in our understanding of loneliness, and the model provides a framework for future studies. The results are discussed vis-à-vis existing findings in the literature and possible directions for approaching loneliness as a theoretical concept and a social phenomenon.     

Perceptions of Sense of Control,Relative Deprivation,and Expectations of Young Jews and Palestinians in Israel

Abstract

The author focused on the impact of personal deprivation, sense of control, and social context on the future expectations of advantaged and discriminated groups. Analysis of 6,430 Jewish and Palestinian high school students in Israel showed that Palestinian students had lower expectations and stronger feelings of deprivation than Jewish students. Also those who felt deprived had lower expectations regarding the prospects of marriage and the probability of owning a home and a car and of holding a permanent job. However, sense of control influenced these expectations more than did feelings of deprivation. The findings indicated that the processes by which future expectations are formed might be different for Jewish and Palestinian students and that these differences are—at least in part—related to long-term discrimination against Palestinians in Israel.