医疗风险与医疗事故的辩证思考

2002年9月1日开始实施的新《医疗事故处理条例》,在医务工作者中引起了巨大的反响,依法行医和按照规章制度、医疗护理操作常规进行医疗活动的意识在医务工作者中普遍得到加强。但是,随着医疗风险引起的医疗纠纷越来越多,也使一些医务工作者在医疗活动中缩手缩脚,对风险大的治疗由于担心可能引起医疗纠纷而放弃,本应得到治疗的疾病因风险大而不能及时救治。因此,探讨医疗风险与医疗事故的内涵和关系,有利于医疗活动健康发展,真正做到救死扶伤,为伤病员服务。     

过度医疗的原因及其应对策略探讨

近年来,过度医疗问题引起社会各界的广泛关注。过度医疗问题已不再是单纯的伦理问题,更深层次意义上已经变成一个重要的社会问题,其与医药卫生领域中的矛盾是紧密相关的。分析了过度医疗与现存的医疗体制、医疗经营机制、医生医疗实践和风险、医疗观念误区和疾病谱变化之间的关系及其影响,并提出了应对策略。     

过度医疗与医疗风险的关系

医疗风险导致医患立场日益分化,影响了正常的医疗秩序。就过度医疗与医疗风险的关系对医患立场的影响问题,从医疗风险的经济学因素、法律因素、人道主义因素和医疗技术因素4个方面阐述过度医疗的原因,并对此提出解决建议。     

句子完成与时间缓冲对信息整合的启动作用

探讨句子完成和时间缓冲因素在阅读过程启动背景信息整合的作用。包括3个实验,被试是华南师范大学198名一年级本科生。采用移动窗口技术,要求被试阅读14篇一致性版本与不一致版本的文章,然后对不同条件下目标句阅读时间或探测反应时进行统计分析。实验1重复Guzman和Klin的研究,并进一步探讨单纯的句子完成因素是否能即时启动整合。结果表明,在单纯的句子完成条件下,一致版本和不一致版本的目标句阅读时间和探测反应时有显著差异,说明目标句阅读时已经即时启动了背景信息的整合。实验2探讨Guman和Klin关于缓冲可以即时启动整合的研究是否混合了句子完成因素的作用,结果表明,当在目标句后面增加连接词时,会产生句子完成的暗示,从而可以即时启动整合,Guzman和Klin关于缓冲可以启动整合的结果是值得商榷的。实验3从Guzman和Klin的研究设计中分离出句子完成因素,探讨单纯的时间缓冲是否可以即时启动整合,结果表明,单纯的缓冲不能即时启动整合。研究的结果初步证明,句子完成是启动信息整合的充分必要条件,而单纯的时间缓冲不能起到这种即时启动作用。     

A Research Tool to Increase Attention to Experimental Materials: Manipulating Presentation Format

Experimental approaches require researchers in a variety of applied business disciplines to design experimental materials. This research is often busy and difficult to secure high-level professionals; thus, researchers must ensure sufficient attention to experimental materials to provide usable data. The current study suggests an experimental design feature to encourage participants to thoroughly process information contained in experimental materials. Based on Reynolds' (1992) selective attention strategy (SAS) model, variations in presentation format were expected to influence the relative salience of information presented. Two aspects of presentation format were manipulated to increase salience: display (paragraph vs. bullet point) and typeface (standard vs. bold underlined). Results indicate display improved ability to retrieve information, but typeface did not. Implications for the design of experimental materials are discussed.     

The influence of reasons on interpretations of probability forecasts

When providing a probability estimate for an event, experts often supply reasons that they expect will clarify and support that estimate. We investigated the possible unintended influence that these reasons might have on a listener's intuitive interpretation of the event's likelihood. Experiments 1 and 2 demonstrated that people who read positive reasons for a doctor's probability estimate regarding a hypothetical surgery were more optimistic than those who read negative reasons for the identical estimate. Experiment 3 tested whether a doctor's failure forecast for a surgery would result in differing levels of pessimism when the potential risk was attributed to one complication that had a probability of 0.30 versus three complications that had a disjunctive probability of 0.30. Overall, the findings are consistent with the argument that a probability estimate, albeit numerically precise, can be flexibly interpreted at an intuitive level depending on the reasons that the forecaster provides as the basis for the estimate. Copyright © 2003 John Wiley & Sons, Ltd.     

The role of competition and knowledge in the Ellsberg task

Ambiguity avoidance denotes people's preference for gambling situations with known over unknown, or ambiguous, probability distributions. In four experiments we provide evidence for the interaction between competitiveness and knowledge in Ellsberg's task, in which people have a choice between a risky box (distribution of balls known) and an ambiguous box (distribution of balls not known). If the situation is perceived as competitive (the experimenter or an opponent is responsible for composing the boxes) people avoid ambiguity by betting on the box with the known probability distribution. If the task is perceived as cooperative (a partner or friend is composing the boxes) people are indifferent toward ambiguity or even ambiguity seeking. In addition, we find that people expect their winning odds to be less than even in the ambiguous box. Copyright © 2003 John Wiley & Sons, Ltd.     

儿童社会信息加工的情绪－认知整合模型

回顾与总结了社会认知中情绪过程对儿童社会能力发展作用的研究成果,探讨了社会信息加工过程中情绪过程和认知的关系问题。发现就个人--社会决策活动而言,情绪过程具有核心作用。并且由此介绍了社会情绪--认知整合模型及其对情绪过程的理解。在此基础上,重点综述了情绪过程在社会情境中对儿童社会信息的线索编码与解释、目标分类、反应提取与决定及行为实施的影响。     

结构限制和作业难度对双重作业绩效的影响

通过对不同双重任务的呈现间隔时间和不同任务难度的双重任务的操作研究,探讨了结构限制与资源竞争对双重任务操作绩效的影响。实验结果表明：(1)两种作业呈现的间隔时间对双重任务操作绩效有明显的影响。间隔时间越大,双重任务的作业绩效越好。(2)作业难度对双重任务的操作有明显的影响。作业难度越大,双重任务的操作绩效越差。(3)两个作业呈现的间隔时间不同并不影响作业难度对双重任务操作绩效的作用。本研究的实验结果进一步证实了双重任务操作的三因素假设：结构限制、信息干扰和资源竞争是影响双重任务操作绩效的三个独立的原因。     

基于语境的预期推理构建的实验研究

两个实验用移动视窗技术,用目标句阅读时间和命名探测词两种指标来考察当文本中有两个情境模型时,读者是否会即时进行预期推理。结果表明,如果在支持性语境与引发推理的信息之间插入一个与支持性语境所描述的情境模型不同的,且与主人公目标有关的因果链上的情境模型的信息,则不管这个插入的情境模型在文本中的位置如何,也不管干扰信息的干扰水平高低,都会降低因果性预期推理在阅读中产生的可能性。