影响患者医疗知情权实现的细节因素分析

在医院细节文化的语境下,通过抽样问卷调查及结构式访谈法,提出在口语、书面语的医院方式文化中,影响患者医疗知情权实现的细节因素及其存在问题,并结合相关制度规定,分析存在问题的原因,进而寻找保障患者医疗知情权实现途径及对策,以期构建和谐医患关系。     

The role of variation in the perception of accented speech

Phonetic variation has been considered a barrier that listeners must overcome in speech perception, but has been proved beneficial in category learning. In this paper, I show that listeners use within-speaker variation to accommodate gross categorical variation. Within the perceptual learning paradigm, listeners are exposed to p-initial words in English produced by a native speaker of French. Critically, listeners are trained on these words with either invariant or highly-variable VOTs. While a gross boundary shift is made for participants exposed to the variable VOTs, no such shift is observed after exposure to the invariant stimuli. These data suggest that increasing variation improves the mapping of perceptually mismatched stimuli.     

What is the deficit in phonological processing deficits: auditory sensitivity, masking, or category formation?

Although children with language impairments, including those associated with reading, usually demonstrate deficits in phonological processing, there is minimal agreement as to the source of those deficits. This study examined two problems hypothesized to be possible sources: either poor auditory sensitivity to speech-relevant acoustic properties, mainly formant transitions, or enhanced masking of those properties. Adults and 8-year-olds with and without phonological processing deficits (PPD) participated. Children with PPD demonstrated weaker abilities than children with typical language development (TLD) in reading, sentence recall, and phonological awareness. Dependent measures were word recognition, discrimination of spectral glides, and phonetic judgments based on spectral and temporal cues. All tasks were conducted in quiet and in noise. Children with PPD showed neither poorer auditory sensitivity nor greater masking than adults and children with TLD, but they did demonstrate an unanticipated deficit in category formation for nonspeech sounds. These results suggest that these children may have an underlying deficit in perceptually organizing sensory information to form coherent categories.     

言语和非言语信号加工的早期分离——来自ERP研究的证据

利用128导事件相关电位技术,对19名正常被试在言语、峰鸣声和音乐刺激上产生的脑电早期外源性成分N1进行了考察。实验结果发现,在音素条件和蜂鸣声条件下,左侧额叶N1波幅显著高于右侧。偶极子溯源分析发现音素条件和蜂鸣声条件下的偶极子都位于左脑额叶,而音乐条件下的两个偶极子位于右脑额叶。证明范畴属性对信号加工大脑半球优势的影响在加工的早期就开始发挥作用。     

On the Constitution and the True Aim of The Joy of Heaven and Non-Speech： A Reinterpretation of the Debate at the Dam over the Hao River

The essay starts by questioning how the debate at the dam over the Hao River between Zhuang Zi and Hui Zi arose. It describes the source of ideas that led Zhuang Zi to speak on the enjoyment of the fish (yuzhile 鱼之乐) and points out that the meaning of the debate rests in bringing about the emergence of the true subject of “enjoyment.” It highlights this meaning by analyzing the essential content and value orientation of Zhuang Zi’s ideas on the joy of heaven (tian le 天乐) and perfect enjoyment (zhile 至乐). Following up on this thread, the essay goes further to analyze the true meaning of Zhuang Zi’s theory concerning the “great speech” of “non-speaking.” This essay holds that the debate is a parable, an external representation that unfolds an internal tension between two different levels contained within Zhuang Zi’s thought, rather than simply a debate between these two thinkers.     

失歌症者对音乐和言语音高的加工

音高是音乐和言语领域中一个重要维度。失歌症是一种对音乐音高加工的障碍。探讨失歌症者对音乐和言语音高的加工有助于揭示音乐和言语音高加工是否共享特定的认知和神经机制。已有研究结果表明, 失歌症者对音乐音高加工存在障碍, 这种音高障碍在一定程度上影响到言语音高加工。同时, 声调语言背景无法弥补失歌症者的音高障碍。这些研究结果支持了资源－共享框架(resource-sharing framework), 即音乐和语言共享特定的认知和神经机制(Patel, 2003, 2008, in press), 并可能在一定程度上为失语症临床治疗提供借鉴。     

汉语口语韵律的作用及其神经机制

汉语是一种声调语言, 在口语韵律表达中存在独特的特点。本项目利用汉语不同于非声调语言的特点, 探讨已有研究中尚未澄清的问题, 即汉语声调在早期自动加工中对语义激活的作用, 以及在不同认知阶段中, 汉语声调和语调加工的神经机制。这些问题是当前的研究热点, 但仍存在着各种分歧和激烈的争论。本项目拟采用ERP方法, 结合LORETA源定位技术, 通过不同的实验范式考察以下内容：(1)在早期自动加工过程中, 汉语声调对词汇语义激活的作用; (2)在早期阶段, 汉语声调和语调加工的大脑激活模式; (3)在晚期阶段, 汉语声调和语调加工的大脑激活模式。对这些问题的考察将有助于澄清当前的激烈争论, 拓展以往基于非声调语言研究建立的口语加工理论的适用范围, 为完善言语认知加工的理论模型提供新的实验证据。     

口语句子产生中词汇选择的计划单元：来自大中小学生的比较研究

采用图-词干扰范式,要求被试口语产生包含三个名词的句子,通过检验句中不同位置的名词上的语义干扰效应, 探讨大中小学生言语产生中词汇选择的计划单元。结果发现,大学生和初中生都只在第一个名词上发现了言语产生潜伏期的语义干扰效应,表明其词汇选择的计划单元只限于第一个名词,支持了严格递进假设;小学生在三个名词上都没有发现潜伏期的语义干扰效应,表明小学生没有稳定地选择好第一个名词即开始发音。由此可见,词汇选择的计划单元大小是可变的,存在年龄上的个体差异,主要表现在小学生和初中生之间。     

Getting Vygotskian about theory of mind: Mediation,dialogue, and the development of social understanding

The ideas of Vygotsky [Vygotsky, L. S. (1987). Thinking and speech. In The collected works of L. S. Vygotsky, (Vol. 1). New York: Plenum. (Original work published 1934.)] have been increasingly influential in accounting for social–environmental influences on the development of social understanding (SU). In the first part of this article, I examine how Vygotskian ideas have to date been recruited to explanations of the development of SU. Next, I present a model of SU development which draws on two implications of Vygotsky’s ideas: the importance of semiotic mediation for mental functioning, and the dialogic nature of the higher mental functions. I then consider the value of the proposed model in accounting for evidence from three areas of enquiry: the typical development of SU in infancy and early childhood, relations between individual differences in SU and social–environmental variables, and atypical development. The model is suggested to be particularly helpful in understanding the transition from intentional-agent to mental-agent understanding, and the role of language in SU. Remaining challenges include a need to specify further the cognitive processes underlying internalization, and to gather more extensive evidence on the roles of typical and atypical social experience in SU development.     

Motor programming in apraxia of speech

Apraxia of Speech (AOS) is an impairment of motor programming. However, the exact nature of this deficit remains unclear. The present study examined motor programming in AOS in the context of a recent two-stage model [Klapp, S. T. (1995). Motor response programming during simple and choice reaction time: The role of practice. Journal of Experimental Psychology: Human Perception and Performance, 21, 1015–1027; Klapp, S. T. (2003). Reaction time analysis of two types of motor preparation for speech articulation: Action as a sequence of chunks. Journal of Motor Behavior, 35, 135–150] that proposes a preprogramming stage (INT) and a process that assigns serial order to multiple programs in a sequence (SEQ). The main hypothesis was that AOS involves a process-specific deficit in the INT (preprogramming) stage of processing, rather than in the on-line serial ordering (SEQ) and initiation of movement. In addition, we tested the hypothesis that AOS involves a central (i.e., modality-general) motor programming deficit. We used a reaction time paradigm that provides two dependent measures: study time (the amount of time for participants to ready a motor response; INT), and reaction time (time to initiate movement; SEQ). Two experiments were conducted to examine INT and SEQ in AOS: Experiment 1 involved finger movements, Experiment 2 involved speech movements analogous to the finger movements. Results showed longer preprogramming time for patients with AOS but normal sequencing and initiation times, relative to controls. Together, the findings are consistent with the hypothesis of a process-specific, but central (modality-independent) deficit in AOS; alternative explanations are also discussed.