医学伦理学概念之探究

医学伦理学的概念看起来很简单,一般情况下人们便习以为常地接受了作为应用规范伦理学的一个分支的科学地位,而忽视了医学对医学伦理学所起的作用。本文认为：医学伦理学的具体内容是医学科技与伦理道德两因素相互作用的产物,对其相互作用的形式和产物的具体分析和总结便可构成这门学科的理论体系。     

THE TREATMENT OF COVERT SELF-INJURY THROUGH CONTINGENCIES ON RESPONSE PRODUCTS

Assessment and treatment of covert self-injurious behavior are complicated because it is difficult to quantify and apply differential consequences to covert responses. In this study, both tangible and social reinforcers were identified using reinforcer assessment methods. These reinforcers were then provided contingent upon the absence of tissue damage identified during physical examinations, resulting in near 100% success in physical assessment checks that was maintained over 10 months.     

Sensitizing Medical Residents to Fantasies and Alignments in the Family: Mastering Psychosocial Skills in the Medical Encounter

In this paper, it is proposed that a) psychosocial medicine is best taught in a setting that provides technical and emotional support, while seizing for teaching only those moments when the learner is most receptive; and b) that the setting should avoid the development of a separate psychosocial skills curriculum, but should take the student where he or she is and integrate the psychosocial skills into his or her everyday biomedical practice. The paper gives specific case examples in which family based psychosocial issues were preeminent in the clinical problem-solving medical residents faced.     

国内外医学专业杂志发表医学人文相关文章情况分析

总结分析了201 2年1月～2013年5月国外4种医学专业杂志(BMJ、JAMA、LANCET和NEJM)医学人文相关文章的发表情况,并与国内4种知名医学专业杂志(《中华医学杂志》、《中国实用内科杂志》、《中华内科杂志》和《中华外科杂志》)发表的医学人文类文章的情况进行对比分析,结果发现,国外医学专业杂志医学人文类文章比重较大,而且涉及的领域较广,包括医疗卫生政策管理、医学社会学、对患者及医生的人文关怀、医疗风险告知和医疗差错告知的文章.而国内与国外杂志相比存在较大差距.     

Looking at remembering: Eye movements,pupil size,and autobiographical memory

To examine the relationship between visual imagery and autobiographical memory, eye position and pupil size were recorded while participants first searched for memories and then reconstructed the retrieved memories (Experiment 1), or only searched for memories (Experiment 2). In Experiment 1, we observed that, although recollective experience was not associated with the number of fixations per minute, memories that took longer to retrieve were linked to increased pupil size. In Experiment 2, we observed that directly retrieved memories were recalled more quickly and were accompanied by smaller pupils than generatively retrieved memories. After correcting for response time, retrieval mode also produced an effect, showing that decreased pupil size is not simply due to directly retrieved memories being recalled more quickly. These findings provide compelling evidence that objective measures, such as pupil size, can be used alongside subjective measures, such as self-reports, to distinguish between directly retrieved and generatively retrieved memories.     

From sport to eco: A case study of driver inputs on electric vehicle efficiency

This study focuses on driver-induced changes to vehicle energy and emissions performance by altering drivetrain configurations. It defines and examines the motivations for the use of drive modes in plug-in hybrid electric vehicles (PHEVs). Drive modes are defined as user-selectable drivetrain configurations that allow drivers to change vehicle performance aspects such as altering its propulsion status from electric to gas, changing the steering responsiveness, suspension stiffness, and regenerative braking strength. Despite the direct impact they have on the vehicle’s energy usage, greenhouse gas emissions, and local air emissions, the impact of drive modes are not traditionally measured as part of the vehicle’s performance and certification tests. The impact of drive mode choice can explain a portion of the discrepancy between PHEVs expected and on road performance as a recent study by the authors found that the use of certain modes can result in a 15–30% increase in total energy usage in a vehicle traveling at freeway speeds.This is the first study to examine the motivations for the use of these drive modes and provides an overview of PHEV drive modes, classifying them into two main mode categories (propulsion adjustment and driver experience) and eight different mode types based on their intended purpose. This is followed by a logistic regression of 11 indicators for mode usage taken from a survey of over 4,500 PHEV owning households, showing that gender and the number of long-distance trips were the most commonly associated with usage across mode types.     

调节模式对选择超载的影响及其机制：一个有中介的调节模型

当前,选择超载领域研究的焦点已从验证其是否存在,转向至其何时存在,即边界条件的探讨。本研究基于调节模式理论,分别以决策后悔和延迟选择作为选择超载的指标,开展两个实验探查选择超载存在的调节模式条件及所涉及的内在机制。实验1以决策后悔作指标,运用量表测试法操纵调节模式,初步探讨调节模式对选择超载的影响,结果发现调节模式调节了选项集与决策后悔的关系,即对评估模式的个体来说,面对大选项集比小选项集时体验到更强的后悔情绪,出现了选择超载,而对运动模式的个体而言,两种条件下的决策后悔无显著差异;实验2以延迟选择作指标,通过任务启动法操纵调节模式,进一步探讨调节模式对选择超载的影响及其机制,结果发现调节模式调节了选项集与延迟选择的关系,即对评估模式的个体来说,面对大选项集比小选项集时更倾向于延迟选择,出现了选择超载,而对运动模式的个体而言,两种条件下的延迟选择偏好无显著差异,进一步有中介的调节模型分析表明选择难度可以部分解释这种效应。总之,通过采用不同方法操纵调节模式,选取不同的选择超载指标,数据结果都一致支持：评估模式的个体比运动模式的个体更容易出现选择超载,选择难度在其中发挥着一定的中介作用。     

Effects of training and display content on Level 2 driving automation interface usability

IntroductionLevel 2 driving automation features, such as adaptive cruise control (ACC) combined with lane centering, primarily communicate their operating statuses through the instrument cluster. It remains unclear how interface-specific training and display content influence the ability to understand Level 2 activity in production vehicles.MethodsEighty participants viewed videos recorded from the driver’s point of view in a variety of driving scenarios with Level 2 activity displayed in the instrument cluster of a 2017 Mercedes-Benz E-Class. Half viewed one of two instrument cluster layouts (simple or complex), and half received an orientation to the interface before the experiment. After each video, they were asked about the scenario they had just seen. We then examined what information in the displays participants used to identify Level 2 activity and the usability of the displays.ResultsTraining improved recognition accuracy of when lane centering was temporarily inactive and understanding of why it was inactive. Neither training nor display content affected the ability to recognize when ACC had adjusted the vehicle’s speed or detected a vehicle ahead, or when ACC initially did not detect a lead vehicle and understanding of why it had not detected it. Both factors influenced which sources of information participants used to determine Level 2 activity. Recognition accuracy of system activity improved when participants used valid sources of information. Training, but not display content, improved lane centering usability, but not ACC usability.DiscussionBasic training improves detection of notifications that potentially require further driver action, but not of those that display persistent status information. Training does not result in full understanding of all system notifications or functional limitations, which reinforces the need for intuitive, salient communication about system behavior and its limitations.     

医疗信息的风险感知

从信息加工视角探究个体对医疗信息的风险感知过程, 通过医疗信息来源、医疗信息内容与呈现形式和信息加工主体三个方面归纳其影响因素, 并基于经验-分析式加工理论和字面-要义加工理论探讨医疗信息风险感知的认知机制。今后研究可更注重医疗信息风险感知的通用研究与特殊主题研究的平衡、风险感知测量工具的规范性与特异性的结合, 并立足于中国医疗体系建立具有循证依据的预防措施和配套政策。