循证医学及其在心血管疾病中的应用

循证医学作为一门新兴的学科,对医学的研究和实践将产生越来越大的影响。在循证医学的操作过程中,如何正确评价和应用所获得的证据极为重要。在短短的十几年间,循证医学给心血管疾病的临床实践带来了根本的变化。     

The relationship between performance-based self-esteem and self-reported work and health behaviors among Danish knowledge workers

Since knowledge intensive work often requires self-management, one might fear that persons who are dependent on work success for self-esteem will have difficulties in finding a healthful and sustainable balance between internal needs and external demands. Accordingly, we examined to what degree work-related performance-based self-esteem (PBS) was linked to work and health behaviors in 392 knowledge workers (226 women, 166 men). In the women group, multiple binary logistic regression analyses with repeated measurements showed that the PBS score was associated with 10 of the 17 examined work and health behaviors. For men the corresponding figure was 3 of 17. In both men and women, higher PBS scores were positively associated with reports of efforts and strivings for work as well as attending work while ill. In conclusion, statistically significant relationships between PBS and work and health behaviors were more clearly visible among women than men. Whether this gender difference is dependent on the study design, or on true inherent differences between women and men, cannot be concluded with any certainty. However, persons who described themselves as being relatively more dependent on work accomplishments for a high self-esteem, as expressed by the PBS score, seem to display work behaviors that may lessen their restitution time. In addition, they also seem to be more prone to work while sick.     

Disruption of writing processes by the semanticity of background speech

Previous studies have noted that writing processes are impaired by task-irrelevant background sound. However, what makes sound distracting to writing processes has remained unaddressed. The experiment reported here investigated whether the semanticity of irrelevant speech contributes to disruption of writing processes beyond the acoustic properties of the sound. The participants wrote stories against a background of normal speech, spectrally-rotated speech (i.e., a meaningless sound with marked acoustic resemblance to speech) or silence. Normal speech impaired quantitative (e.g., number of characters produced) and qualitative/semantic (e.g., uncorrected typing errors, proposition generation) aspects of the written material, in comparison with the other two sound conditions, and it increased the duration of pauses between words. No difference was found between the silent and the rotated-speech condition. These results suggest that writing is susceptible to disruption from the semanticity of speech but not especially susceptible to disruption from the acoustic properties of speech.     

A Study of Clinical Supervision Techniques and Training in Substance Abuse Treatment

Data from 57 clinical supervisors in licensed substance abuse treatment programs indicate that 28% had completed formal graduate course work in clinical supervision and 33% were professionally licensed or certified. Findings raise concerns about the scope and quality of clinical supervision available to substance abuse counselors.     

美国高等临床药学教育体系宏观结构变迁研究（1965年～2015年）

研究了1965年~2015年美国高等临床药学教育体系的层次结构、形式结构和分布结构等宏观结构的变迁情况。从临床药学实践、药师动态短缺、产业结构基础、办学经费来源、人口地理分布等方面,对半个世纪以来美国临床药学教育体系宏观结构变迁情况进行归因分析。在总结并肯定美国高等临床药学教育体系极高的市场敏感性和较强的结构优化灵活性的同时,探讨了美国高等临床药学教育体系宏观结构变迁过程中需要注意的问题。     

道德与良知：临床道德危机与德性伦理诉求

构建和谐医疗环境是广大民众的共识和愿望,但临床实践仍面临诸多困境。资本垄断医学导致道德沦丧;技术统治医疗导致伦理缺失;利益吞噬人性导致人性亏损,任何完善的机制、体制、规范也难以完全规范医生的诊疗行为。德性伦理兴起是化解道德危机的迫切诉求,也是医学道德建设永恒的主题。摆脱医学道德危机,不仅需要伦理规范的约束,更需要道德与良知的支撑。务必要重视德性伦理在临床实践中的作用,让道德的力量唤醒被麻醉的良知,从而超越资本逻辑、超越技术理性、超越自我意识,让现代医学真正为人类健康造福。     

干细胞研究中的多向立体思维方法

干细胞研究取得了里程碑式的进展,在临床疾病的预防和治疗中具有广阔的应用前景,这些研究成果凝聚了各国研究人员的集体智慧,多向立体思维方法得到了充分体现。     

驾驶经验和危险类型对驾驶员危险检测的影响

结合反应时和信号检测方法,考察不同危险类型下驾驶员危险检测的特点。35名新手和35名有经验驾驶员依次完成一个反应时测试和一个信号检测任务。结果发现：新手对明显和隐藏危险的反应时间比有经验驾驶员长。与隐藏危险相比,驾驶员对明显危险的敏感性高、判断标准低。驾驶员对两类危险的反应时间长是因为他们的判断标准严格。研究结果表明,驾驶员危险检测的特点随着危险类型不同而变化。     

负性情绪刺激对大学生多目标追踪能力的影响

探讨了负性情绪对大学生多目标追踪能力的影响以及其影响机制。实验要求被试在观看国际情绪图库中的负性或中性图片后,完成多目标追踪和点探测任务,同时设置基线条件作为对照。采用状态-特质焦虑量表和贝克抑郁自评量表考察不同情绪图片条件下被试的诱发情绪状态。研究结果发现：（1）被试观看负性情绪图片后状态焦虑程度和抑郁量表评分显著提高,观看情绪图片有效诱发了被试的负性情绪;（2）基线条件下的被试追踪正确率显著低于中性条件,基线条件和负性图片条件下的追踪正确率无差异,说明训练可以提高被试的多目标追踪能力,但负性情绪抑制了被试在基线追踪任务中的训练效果;（3）负性图片条件下的点探测觉察率显著低于中性图片条件,说明负性情绪影响了被试的注意资源分配。研究结果表明：负性情绪可能干扰了被试目标导向的注意系统,使得个体更易受刺激驱动的注意系统影响,并且在追踪过程中影响被试中央执行系统的抑制和转移功能。     

Forward inference in risky choice: Mapping gaze and decision processes

The study of cognitive processes is built on a close mapping between three components: overt gaze behavior, overt choice, and covert processes. To validate this overt–covert mapping in the domain of decision‐making, we collected eye‐movement data during decisions between risky gamble problems. Applying a forward inference paradigm, participants were instructed to use specific decision strategies to solve those gamble problems (maximizing expected values or applying different choice heuristics) during which gaze behavior was recorded. We revealed differences between overt behavior, as indicated by eye movements, and covert decision processes, instructed by the experimenter. However, our results show that the overt–covert mapping is for some eye‐movement measures not as close as expected by current decision theory, and hence question reverse inference as being prone to fallacies due to a violation of its prerequisite, that is, a close overt–covert mapping. We propose a framework to rehabilitate reverse inference.