癌症患者生存质量研究进展

随着癌症患者生存时间和生存人数的增加,生存者本人和家属更加重视生存质量。本文总结分析近年来国内外癌症患者生存质量的研究状况,以期在癌症治疗过程中,不仅关注躯体功能和疾病本身以及由治疗带来的症状和体征,同时注重心理和社会职能。     

Tests of behavioral-economic assessments of relative reinforcer efficacy: economic substitutes

This experiment was conducted to test predictions of two behavioral-economic approaches to quantifying relative reinforcer efficacy. According to the first of these approaches, characteristics of averaged normalized demand curves may be used to predict progressive-ratio breakpoints and peak responding. The second approach, the demand analysis, rejects the concept of reinforcer efficacy, arguing instead that traditional measures of relative reinforcer efficacy (breakpoint, peak response rate, and choice) correspond to specific characteristics of non-normalized demand curves. The accuracy of these predictions was evaluated in rats' responding for food or fat: two reinforcers known to function as partial substitutes. Consistent with the first approach, predicted peak normalized response output values (Omax) obtained under single-schedule conditions ordinally predicted progressive-ratio breakpoints and peak responding. Predictions of the demand analysis had mixed success. Pmax and Omax were significantly correlated with PR breakpoints and peak responding (respectively) when fat, but not when food, was the reinforcer. Relative consumption of food and fat under single schedules of reinforcement did not predict preference better than chance. The normalized demand analysis is supplemented with the economic concept of diminishing marginal utility, to predict preference shifts across the range of food and fat prices examined.     

Disclosure of Genetics Research Results after the Death of the Patient Participant: A Qualitative Study of the Impact on Relatives

When a gene mutation is identified in a research study following the death of the study participant, it is not clear whether such information should be made available to relatives. We report here an evaluation of the impact on relatives of being informed of study results that detected pathogenic BRCA2 mutations in a male relative, now deceased, who had early onset (under the age of 55) prostate cancer. The breast and ovarian cancer risk was unknown to the living relatives. Qualitative analysis of interviews with thirteen relatives indicated that those who had a higher risk perception, resulting from an awareness of cancer family history or experiential knowledge of cancer in their family, tended to adjust more easily to the results. All participants believed that genetics research results of clinical significance should be fed back to relatives. Those who were fully aware of the BRCA2 results and implications for themselves felt they had benefited from the information, irrespective of whether or not they had elected for genetic testing, because of the consequent availability of surveillance programs. Initial anxiety upon learning about the BRCA2 result was alleviated by genetic counselling. Factors influencing those who have not engaged with the information included scepticism related to the relative who attempted to inform them, young age and fear of cancer. Those who had not sought genetic counselling did not attempt further dissemination, and some were not undergoing regular screening. Implications for informed consent in genetics research programs, and the requirement for genetic counselling when research results are disclosed, are discussed. Names have been changed to protect the privacy of study participants.     

文字与图片呈现形成想象空间记忆的比较

学习通过文字或图片方式显示的空间布局材料之后,采用空间定位任务．分别检验在不同朝向和相对位置的条件下,对想象空间方位判断的差异。结果表明,使用图片进行空间布局的学习,记忆后再各自以同样显示形式进行空间定位任务时,判断的速度比使用文字的反应时要快;同时,无论是文字还是图片形式呈现．在进行想象转向时．都会呈现朝向效应和相对位置效应。     

智商常态人群的智力个体差异研究述评

智力功能个体差异星正态分布有不同观点：g因素决定特殊能力分化程度差异论、因素搭配差异论;单一认知机能、认知机能系统中的一个或者几个认知机能缺陷影响智力功能差异论;认知发展理论的要素功能大小和要素关联关系强弱、结构差异论;文化活动结构差异和遗传进化的神经效率差异论;神经活动特性水平和神经活动区域效率差异、人格中介情景任务和人     

Reliability, diagnostic efficiency, and validity of the Millon adolescent clinical inventory: examination of selected scales in psychiatrically hospitalized adolescents

This study examined the internal consistency, diagnostic efficiency, and validity of selected scales of the Millon adolescent clinical inventory (MACI; Millon et al., Manual for the Millon Adolescent Clinical Inventory, National Computer Systems, Minneapolis, MN, 1993). 241 psychiatrically hospitalized adolescents were administered the MACI and a battery of established self-report measures and a multidisciplinary team independently assigned DSM-IV psychiatric diagnoses at the time of discharge. The internal consistency of MACI scales ranged from 0.71 to 0.93. Conditional probabilities (sensitivity, specificity, positive predictive power, and negative predictive power) were calculated for selected disorders using independently generated clinical diagnoses as the standard. The diagnostic efficiencies for the selected scales were variable, with adequate performance for predicting classes of diagnoses but not for specific diagnoses. The MACI showed good criterion validity for most disorders, with participants with a clinical diagnosis having a significantly higher corresponding MACI scale score than participants not assigned that diagnosis. Concurrent validity, tested by correlating MACI scale scores with those of relevant, validated measures, was generally good. The MACI appears to be a psychometrically sound self-report instrument and appears valuable as a screening instrument for many problems found in adolescent psychiatric inpatients.     

Factorial structure and diagnostic efficiency of DSM-IV criteria for avoidant personality disorder in patients with binge eating disorder

This study examined the factorial structure and diagnostic efficiency of the DSM-IV criteria for avoidant personality disorder (AVPD). Two hundred and twenty-eight consecutive outpatients (181 females and 47 males) with a primary diagnosis of binge eating disorder were reliably assessed with diagnostic interviews. Internal consistency of AVPD criteria was good, as suggested by coefficient alpha of 0.87, the pattern of inter-item correlations (range 0.41 to 0.64), and the lack of changes in alpha if any criteria are deleted. Exploratory factor analysis revealed a one-factor solution (56% of variance) supporting the unidimensionality of the AVPD criteria. Diagnostic efficiency indices (conditional probabilities, total predictive power, and kappa coefficients) were calculated for each AVPD criterion, for the entire study group and separately by gender. Overall, the best inclusion criterion was 'fears being ridiculed,' which was also the best predictor overall. These psychometric findings did not differ by gender. The findings support certain important aspects of the AVPD diagnosis.     

Measuring resistance to change at the within-session level

Resistance to change is often studied by measuring response rate in various components of a multiple schedule. Response rate in each component is normalized (that is, divided by its baseline level) and then log-transformed. Differential resistance to change is demonstrated if the normalized, log-transformed response rate in one component decreases more slowly than in another component. A problem with normalization, however, is that it can produce artifactual results if the relation between baseline level and disruption is not multiplicative. One way to address this issue is to fit specific models of disruption to untransformed response rates and evaluate whether or not a multiplicative model accounts for the data. Here we present such a test of resistance to change, using within-session response patterns in rats as a data base for fitting models of disruption. By analyzing response rate at a within-session level, we were able to confirm a central prediction of the resistance-to-change framework while discarding normalization artifacts as a plausible explanation of our results.     

Perceived quality of life in Taiwan and Hong Kong: an intra-culture comparison

Cross-society comparisons have become increasingly important to the study of the perceived quality of life. A major critique of these studies, however, is the lack of attention to intra-culture variation. This paper examines how subjective quality of life differs, at both societal and individual levels, between Taiwan and Hong Kong, two Chinese societies that share their cultural heritage but vary in their social and political systems. We draw upon data from synchronic surveys conducted in November 2000 in Taiwan (n=1222) and Hong Kong (n=1044). Ordinal regression analyses confirm that, for both societies, reported satisfaction at the societal level contributes to the variance in individuals quality of life. Moreover, the perceived fairness with regard to personal effort within the opportunity structure provided by the society also significantly affects an individuals quality of life. Different factors accounting for quality of life variation in Taiwan and in Hong Kong are discussed. This paper suggests that for the intra-cultural, cross-society comparisons on quality of life, inclusion of various societal level indicators is not only important, but the subjective perception of the fairness that society also contributes a significant effect.     

Updating the Baldwin effect : The biological levels behind Piaget's new theory

In 1964, Conrad Waddington (1905–1975) presented a paper in Geneva that led to an internal reassessment of the biological underpinnings of Jean Piaget's (1896–1980) theory. This in turn resulted in an overhaul of the theoretical framework upon which his stage theory of child development had been based, including his appeals to James Mark Baldwin's (1861–1934) “circular reaction.” In addition to leading to the emergence of what has elsewhere been called “Piaget's new theory,” this renovation also resulted in the update of the famous “Baldwin Effect.” Because aspects of the subsequent framework are of contemporary significance, this essay will review some of the work leading up to those updates. In reaching behind the translations to trace the sources of the arguments to which Piaget appealed, the resulting examination fills some of the gaps found in the secondary literature without quibbling over the “correct” English interpretation of translated French terms. We also go beyond how Piaget's writings have been understood in English and extract some useful additional ideas from his sources, including how to conceive of the social context in which development takes place. We see as a result how Waddington and his colleagues, including Paul Weiss (1898–1989), provided a constructive “existence proof” for the formal hierarchy of levels that Piaget had come to by other means.