医学人文精神培育路径的质性研究

在文献梳理和焦点小组访谈的基础上, 运用质性研究方法, 采用编码技术, 通过开放性编码、主轴编码和选择性编码, 识别出医学人文精神培育的主要路径, 即人文课程体系的构建与实践、医学专业课程中融入医学人文精神教育、临床实践中融入医学人文精神教育及其主要维度。提出了较为系统的、科学的医学人文精神培育路径体系。研究结论对医学院校人文教育具有重要的理论意义和应用价值。     

The Temporal Relations of PTSD Symptoms Among Treatment-Seeking Victims of Sexual Assault: A Longitudinal Study

This prospective study assessed the temporal relationships between the symptom clusters of PTSD in two nonprobability samples of treatment-seeking victims of sexual abuse: rape victims and adult survivors of childhood sexual abuse. Both groups were assessed at three time periods using self-report measures of PTSD symptomology. Findings from two cross-lagged panel analyses indicated weak temporal relationships between the symptom clusters of PTSD; however, avoidance and emotional numbing symptoms were found to exert the strongest cross-lagged effects. Avoidance and emotional numbing symptoms were also found to be the strongest predictor of subsequently meeting caseness for PTSD in both samples. Results suggest that there are minimal cross-lagged effects between the PTSD symptom clusters after three months from traumatic exposure.     

Is This Relevant? Physician Perceptions,Clinical Relevance,and Religious Content in Clinical Interactions

Despite wide support among physicians for practicing patient‐centered care, clinical interactions are primarily driven by physicians’ perception of relevance. While some will perceive a connection between religion and patient health, this relevance will be less apparent for others. I argue that physician responses when religious/spiritual topics come up during clinical interactions will depend on their own religious/spiritual background. The more central religion is for the physician, the greater his or her perception of religion's impact on health outcomes and his or her inclusion of religion/spirituality within clinical interactions. Using a nationally representative sample of physicians in the United States and mediated path models, I estimate models for five different physician actions to evaluate these relationships. I find that a physician's religious background is strongly associated with whether or not he or she thinks religion impacts health outcomes, which is strongly predictive of inclusion. I also find that not all of the association between inclusion and physicians’ religious background is mediated by thinking religion impacts health outcomes. Issues of religion's relevance for medicine are important to the degree that religious beliefs are an important dimension of patients’ lives.     

Levels of theory‐of‐mind reasoning in competitive games

The literature on recursive theory of mind (TOM) reasoning in interactive decision making (reasoning of the type “I think that you think that I think…”) has been pessimistic, suggesting that adults attribute to others levels of reasoning that are low and slow to increase with learning. In four experiments with college‐age adults playing sequential games, we examined whether choices and predictions were consistent with believing that others pursue their immediate self‐interest, or with believing that others reason through their own decision making, with fixed‐sum games that were simpler and more competitive. This manipulation led to higher‐level default TOM reasoning; indeed, reasoning against a lower‐level opponent was frequently consistent with assuming the opponent's reasoning to be higher‐level, leading to sub‐optimal choices. We conclude that TOM reasoning is not of a low level in all game settings; rather, individuals may display effective TOM reasoning, reflecting realistic assumptions about their opponents, in competitive and relatively simple games. Copyright © 2010 John Wiley & Sons, Ltd.     

局部表象产生中行为性别差异的神经基础

行为研究发现女性具有更好的局部表象产生能力, 但其神经基础尚不清楚。研究采用事件相关电位技术以及小世界网络分析方法, 探索局部表象产生中性别差异的大脑信息加工基础。结果显示在局部表象产生中, 女性行为反应较男性更快, 表象产生诱发的P300-650平均波幅更小, 且大脑功能网络的平均路径长度更短。深入分析发现, 反应时与脑网络的平均路径长度之间成正相关。该结果意味着低耗高效的大脑信息加工模式是女性具有更好的局部表象能力的神经基础。     

论临床医师创新能力的培养和人生道路的选择

临床医师创新能力培养的关键应该包括医学理论知识和实践经验的积累,但要更加注重培养独立思考和敢于纠错的精神;在基本理论融会贯通的基础上,广泛涉猎是创新思想产生的基础,要能够大道至简,抓住复杂系统中的关键问题,全面地了解科学发展史和发明史,积极谦虚地与他人交流;勤于动脑和善于思考,重视"再发明"训练和思想实验,克服跨专业创新的思想障碍;对临床医师的人生哲学和人生道路的选择提出了一些感悟。     

Figure-Ground Phenomena in the Perception of Physical and Social Stimuli

An instrument, the Grasha-Riechmann Student Learning Style Scales (GRSLSS), was developed to assess six student learning styles. These styles are Independent, Dependent, Avoidant, Participant, Collaborative, and Competitive. A “rational approach” was used to develop the GRSLSS and evaluate its construct validity. The process included professional and student inputs in special procedures for selecting scale items and designing criterion items. The utility of this approach is considered and problems critiqued. The rational approach yielded relatively high temporal reliability coefficients (range across scales r = .76 to r = .83; N = 269) and numerous meaningful correlations between criterion items and scale scores.     

The Relationship of Cognitive Tempo to Psychological Differentiation and Locus of Control

In this study, we investigated the relationship of cognitive tempo to psychological differentiation and locus of control. The 103 male and female undergraduate students who participated in this study were administered the adolescent and adult version of the Matching Familiar Figures Test, the Group Embedded Figures Test, and the Adult Nowicki-Strickland Internal-External Scale. Using multiple regression analyses, we found that field dependence and independence were significantly related to both cognitive tempo latency and cognitive tempo errors. Contrary to expectation, no relationship was found between locus of control and cognitive tempo. We concluded that psychological differentiation is highly useful in the direct prediction of cognitive tempo, although locus of control is not. Overall, the value of examining cognitive tempo latency and errors separately was upheld. The importance of these relationships is discussed.     

An Investigation of the Accuracy of Standardized Path Coefficients

The present study investigated potential sex differences in preferences for spicy, hot or unusual foods and in food aversions or neophobia. This study also reexamined the issue of a gender difference in preference for sweet foods. Questionnaires concerning past and current food use and preferences as well as food and condiment use in one actual meal were completed by 148 people between 17 and 32 years of age. Their responses clearly support the prediction that men tend to have a stronger preference than women for spicy, hot foods. The results also support the prediction that men are more likely than women to seek unusual and new foods. Both sexes showed the same degree of preference for condiment use.     

A tutorial on how to do a Mokken scale analysis on your test and questionnaire data

Over the past decade, Mokken scale analysis (MSA) has rapidly grown in popularity among researchers from many different research areas. This tutorial provides researchers with a set of techniques and a procedure for their application, such that the construction of scales that have superior measurement properties is further optimized, taking full advantage of the properties of MSA. First, we define the conceptual context of MSA, discuss the two item response theory (IRT) models that constitute the basis of MSA, and discuss how these models differ from other IRT models. Second, we discuss dos and don'ts for MSA; the don'ts include misunderstandings we have frequently encountered with researchers in our three decades of experience with real‐data MSA. Third, we discuss a methodology for MSA on real data that consist of a sample of persons who have provided scores on a set of items that, depending on the composition of the item set, constitute the basis for one or more scales, and we use the methodology to analyse an example real‐data set.