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.     

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.     

Identification With All Humanity: The role of self‐definition and self‐investment

Identification With All Humanity (IWAH) relates to higher levels of concern and supportive behavior toward the disadvantaged, stronger endorsement of human rights, and stronger responses in favor of global harmony. So far, IWAH has been conceptualized as a one‐dimensional construct describing the degree with which one identifies with all humans as a superordinate ingroup. However, recent group identification models suggest a multi‐dimensional model to provide a more differentiated approach toward the understanding of the highest level of social identification. Using principal axis (Study 1) and confirmatory (Study 2) factor analyses, we suggest that IWAH sub‐divides into two dimensions—global self‐definition and global self‐investment. Study 2 revealed that global self‐investment was a stronger predictor for both convergent measures (e.g., social dominance orientation and authoritarianism) and behavioral intentions than global self‐definition. Finally, in Study 3, we manipulated IWAH to test its causal effect on donation behavior. Participants in the experimental condition, compared with the control condition, showed higher global self‐investment, which in turn predicted greater giving to global charity. These findings suggest that two dimensions with different behavioral outcomes underlie IWAH.     

Validity of the German Test Anxiety Inventory (TAI‐G) in an Australian sample

Test anxiety (TA) is a prevalent issue among students that can result in deleterious consequences, such as underachievement. However, a contemporary measure that has been validated for use with Australian students seems to be lacking. This study, therefore, investigated the suitability of the German Test Anxiety Inventory (TAI‐G) for use with Australian university students. While the original TAI‐G contains 30 items and was designed to measure four factors (worry, emotionality, interference, and lack of confidence), differing factorial models have been supported in the literature using either the original or a shortened 17‐item version of the measure. These differing TAI‐G models were tested and compared in the current study via confirmatory factor analysis using 224 Australian university students. As expected, results supported the superior fit of the 17‐item four‐factor model. Additionally, the convergent validity of the measure was supported since measures of self‐esteem, self‐efficacy, and general anxiety were all found to correlate significantly with the TAI‐G in the hypothesised directions. Finally, the finding that all of the TAI‐G subscales had acceptably high reliabilities led to the conclusion that the 17‐item TAI‐G is a valid and reliable measure of TA in an Australian university population.     

The Self‐Care of Psychologists and Mental Health Professionals: A Review and Practitioner Guide

It has been documented in the professional literature that psychologists and mental health professionals in general tend to neglect their own mental health, despite serving in a field that promotes the health and well‐being of others. Numerous empirical studies support the need for psychologists and mental health professionals to be more conscientious of the effect that stress and the nature of their work has on them. This article reviews some of the recent literature and discusses the pertinent issues at hand. A number of interventions are suggested along with tips for professionals to consider in order to function in a more productive and ethical fashion.