总结经验 推进新一轮卫生改革

着眼于实现为人人提供保健服务目标的医疗改革,要求卫生服务与医药购销制度的改革必须适应广覆盖、低成本的医疗保险制度;确保公共卫生、社区卫生与合作医疗在整个保健服务体系中的主体地位,在基本卫生保健服务机构与大医院之间建立合作、互补、互制的关系;坚定地对大医院实行调整和管理;构建医药分开的管理与流通体制;政府主导作用到位,投入方向合理,以顺利推进新一轮医疗改革。     

Item format and the structure of the buss-durkee hostility inventory

The Buss-Durkee Hostility Inventory is a widely employed multidimensional measure of aggression. Two studies, each involving the administration of both two-choice and seven-choice response format versions of the instrument, were conducted to determine if (1) the theoretical scales could be reproduced empirically, (2) the change in response format either changes or improves the structure, and (3) the structure of either response format replicates across administrations. The two-choice version provided some support for the present theoretical scoring but was not very stable across administrations. The seven-choice version resulted in a structure that was different from both the two-choice structure and theoretical scoring but was more stable across administrations.     

平滑滚动引导式和快速系列视觉呈现式中文文本阅读工效研究

本研究在机控速度条件下,考察了显示窗口大小(10字和20字)、显示速度(300字／分和600字／分)和文本显示方式(平滑滚动的引导式和快速系列视觉呈现)等因素对VDT中文文本阅读工效的影响。实验结果发现：(1)300字／分的显示速度有利于阅读理解;(2)在本实验条件下,平滑滚动引导式的可读性优于快速系列视觉呈现式。最后,作者结合有关中文眼动研究理论,对上述结果的成因进行了简要探讨。     

Questioning Children Who May Have Been Sexually Abused

Summary

This article derives from an Open Forum on Leading Questions sponsored by the American Professional Society on the Abuse of Children. It represents the thoughts of participants in the Open Forum, and the article attempts to integrate analogue research that relates to questioning children about past events into questioning practice with children who may have been sexually abused. It proposes a continuum of questions that includes four categories: most preferred, preferred, less preferred, and least preferred.     

放弃治疗后，以护理为主导的医学服务和人文关怀

剖析放弃治疗后死亡病案508例,分析放弃治疗的原因、疾病和形式,放弃治疗后护理工作存在的问题。提出在放弃治疗后,临床护理决策：对于护理工作发生的变化,应该提高认识,培养护理人员人文素质和法律意识,应该加强护理管理和规范,放弃治疗后,护理应该承担医学服务和人文关怀的主导作用。     

窗口大小、呈现速度和字号对引导式文本阅读的影响

使用EyeLink2000眼动仪,以30名大学生为被试,采用3（窗口大小：5字、10、15字）×2（呈现速度：300字/分、600字/分）×3（字号：24号、36号、48号）多因素混合设计,考察了窗口大小、呈现速度和字号对引导式文本阅读的影响。结果表明：（1）字号的主效应显著,字号越大,越有利于阅读;（2）呈现速度的主效应显著,慢速更有利于阅读;（3）呈现速度和字号的交互作用显著,慢速和中号、慢速和大号更有利于阅读。     

儿童在回答无意义问题时的反应倾向与年龄特征

研究设计了无意义问题来考察5、6、81、0岁共128名儿童在回答问题时的反应倾向。研究结果发现:(1)5~10岁儿童在回答无意义问题时,存在猜测答案的倾向,且受问题形式的影响。较开放问题,儿童在面对封闭问题时猜测答案的倾向更强烈。(2)在无意义的非比较问题上,随年龄的增长,儿童猜测答案的倾向更强烈。(3)5~10岁儿童回答封闭的非比较问题时存在否定反应倾向,但在封闭的比较问题上则不存在这种倾向。     

人格测验中作假的控制方法

被试很容易对人格测验作假,这严重影响了人格测验的有效性。目前测评专家已经提出了一些应对作假的方法,它们可被分为事前控制技术和事后识别技术两大类。前者包括迫选式量表,警告及假渠道技术等,后者包括作假识别量表,IRT及反应时识别技术等。目前,在人格测验中嵌套使用作假识别量表,以及在测验指导语中加入警告是比较有效的两种方法,迫选式量表的发展也值得期待。由于研究者对作假的内部发生机制了解较少,这制约了IRT与反应时识别技术的发展。     

儿童推断他人知识状态的知识偏差和无知偏差

采用“看见-知道”任务考察了儿童对他人知识状态推断的特点和可能存在的偏差效应。被试为90名3-5岁儿童。结果表明,3-5岁儿童已经理解他人看见即知道的关系;5岁儿童已经能准确地推断他人的知识状态,不存在偏差;但3、4岁儿童对他人知识状态的推断受到自身知识的影响且表现出自我中心的倾向：既存在知识偏差即因为自己知道而高估他人的知识,也存在无知偏差即因为自己的无知而低估他人的知识。4岁儿童的知识偏差程度与3岁儿童无异,但无知偏差低于3岁儿童,且4岁儿童的知识偏差程度大于其无知偏差,儿童克服无知偏差的时间可能早于克服知识偏差的时间。     

Probability judgment in hierarchical learning: a conflict between predictiveness and coherence

Why are people's judgments incoherent under probability formats? Research in an associative learning paradigm suggests that after structured learning participants give judgments based on predictiveness rather than normative probability. This is because people's learning mechanisms attune to statistical contingencies in the environment, and they use these learned associations as a basis for subsequent probability judgments. We introduced a hierarchical structure into a simulated medical diagnosis task, setting up a conflict between predictiveness and coherence. Thus, a target symptom was more predictive of a subordinate disease than of its superordinate category, even though the latter included the former. Under a probability format participants tended to violate coherence and make ratings in line with predictiveness; under a frequency format they were more normative. These results are difficult to explain within a unitary model of inference, whether associative or frequency-based. In the light of this, and other findings in the judgment and learning literature, a dual-component model is proposed.