Compounding Vulnerability: Pregnancy and Schizophrenia

The predominant ethical framework for addressing reproductive decisions in the maternal–fetal relationship is respect for the woman's autonomy. However, when a pregnant schizophrenic woman lacks such autonomy, healthcare providers try to both protect her and respect her preferences. By delineating etic (objective) and emic (subjective) perspectives on vulnerability, I argue that options which balance both perspectives are preferable and that acting on etic perspectives to the exclusion of emic considerations is rarely justified. In negotiating perspectives, we balance the etic commitment to protect the vulnerable patient and her fetus from harm with the emic concern to empower a decisionally incapacitated woman. Equilibrium is best achieved by nurturing interdependent relationships that empower and protect the vulnerable woman. The analysis points to the need for better social support for mentally ill patients.     

A Cross-Cultural Comparison of Gender Factors Contributing to Long-Term Marital Satisfaction

Abstract

This article reports on the major findings of a cross-cultural study comparing long-term marital satisfaction between Caucasian couples and Chinese couples in Canada. The Dyadic Adjustment Scale was used to screen couples' marital satisfaction. In-depth qualitative interviews were conducted individually and jointly with the screened couples to explore their meanings and experiences of marital satisfaction. With the use of narrative analysis, the study illuminates how couples constructed their gender relationships to achieve marital satisfaction over a long course of thirty to thirty-six years according to their sociocultural contexts. The similarities and differences in how the two cultural groups' respondents constructed their long-term marital satisfaction are discussed in terms of: (1) household division of labour, (2) decision-making, (3) conflict and compromise, and (4) mutuality.     

Relationship between Trauma and Risky Behavior in Substance-Abusing Parents Involved in a Family Dependency Treatment Court

This exploratory study examined participants in a Family Dependency Treatment Court (FDTC), designed for substance-abusing parents whose children were removed from the home. Twenty-five participants were interviewed one year after FDTC enrollment to assess retrospectively the relationship between trauma history and risky behaviors. Treatment compliance rates were found to be high, and most participants had negative urinalysis results. Qualitative analyses revealed that approximately half of the participants attributed decreases in risky behaviors to the FDTC program. This study increases understanding of the effect of substance abuse and trauma on high-risk behaviors and might help to improve services for substance-abusing parents involved in the child welfare system. Finally, the future success of reducing child abuse and neglect and parental substance use could hinge on the partnership between judicial and substance abuse treatment through FDTCs. Findings from this exploratory pilot study should be replicated with more representative and larger samples.     

Predictors of student burnout and engagement among university students

This study investigated influences of core self-evaluation traits, career decision-making difficulties and social support on student burnout and engagement. A cross-sectional design was used with a non-probability quota sample. In the multiple regression analyses, self-efficacy, inconsistent information due to internal conflict and (lack of) parental support were significant predictors of exhaustion, cynicism, vigour and dedication. Self-esteem was also a significant predictor for the two engagement dimensions. In addition, lack of information about the self, lack of information about the occupations and inconsistent information due to external conflict predicted cynicism.     

青少年风险决策的时程加工机制：来自ERP的证据

采用事件相关电位（ERP）研究技术,运用剑桥风险任务的实验范式,考察了青少年风险决策的时程加工机制。行为结果表明,在高、中、低三种不确定性条件下,相对于效价,被试的决策更多的关注概率。脑电结果显示：1）不确定性的主效应在N400上表现显著,高不确定条件和中不确定条件的波幅要明显大于低不确定性条件的波幅,而高不确定条件和中不确定条件的波幅无显著差异;2）与中不确定条件相比,高不确定条件和低不确定条件诱发了一个新异正成分（LPC）,高不确定条件和低不确定条件的波幅要明显大于中不确定性条件的波幅,而高不确定条件和低不确定条件的波幅无显著差异。青少年在风险任务中的决策较多的是选择安全选项,表现出较为明显的风险规避倾向。N400的波幅可能反映了不确定性程度,而LPC的波幅大小可能反映了结果评价准确性程度的高低。     

薪酬体系框架与考核方式对个人绩效薪酬选择的影响

研究从行为决策视角, 采用情景实验法探讨了薪酬体系框架与绩效考核方式对个人绩效薪酬选择的影响。结果表明：(1)个体根据实际收入水平低于/高于内心预期收入参照点将分别形成损失/收益性的预期收入框架, 在损失性收入框架下选择风险性绩效薪酬的几率更高; (2)底薪加提成的薪酬支付模式会让个体形成收益框架, 薪酬打包的支付模式会让个体形成损失框架, 个体在薪酬打包模式下选择绩效薪酬体系的几率更高; (3)与封闭式目标的考核体系相比, 企业采用开放式目标的绩效考核会抑制预期收入框架和薪酬支付框架对个人绩效薪酬选择的影响。     

RISKY CHOICE IN PIGEONS: PREFERENCE FOR AMOUNT VARIABILITY USING A TOKEN-REINFORCEMENT SYSTEM

Pigeons were given repeated choices between variable and fixed numbers of token reinforcers (stimulus lamps arrayed above the response keys), with each earned token exchangeable for food. The number of tokens provided by the fixed‐amount option remained constant within blocks of sessions, but varied parametrically across phases, assuming values of 2, 4, 6, or 8 tokens per choice. The number of tokens provided by the variable‐amount option varied between 0 and 12 tokens per choice, arranged according to an exponential or rectangular distribution. In general, the pigeons strongly preferred the variable option when the fixed option provided equal or greater numbers of tokens than the variable amount. Preference for the variable amount decreased only when the alternatives provided widely disparate amounts favoring the fixed amount. When tokens were removed from the experimental context, preference for the variable option was reduced or eliminated, suggesting that the token presentation played a key role in maintaining risk‐prone choice patterns. Choice latencies varied inversely with preferences, suggesting that local analyses may provide useful ancillary measures of reinforcer value. Overall, the results indicate that systematic risk sensitivity can be attained with respect to reinforcer amount, and that tokens may be critical in the development of such preferences.     

The relation of social status to the career decision-making process

The relation of social status to individuals’ career decision self-efficacy (CDSE) and choice certainty was explored using a new, multifaceted measure of social status, the differential status identity scale (DSIS;, Brown, M. T., D’Agruma, H. D., Brown, A., Sia, A., Yamini-Diouf, Y., Porter, S., et al. (2002). Differential status identity: Construct, measurement, and initial validation. In Symposium presented during the annual convention of the American Psychological Association, Chicago, Illinois.). CDSE was also examined as a potential mediator between social class and career choice certainty. Pilot data and exploratory analyses supported the psychometric properties of the DSIS and the incremental utility of the DSIS over traditional, sociological indices of social class. Results for our college student sample indicated that greater access to economic resources, social prestige, and social power each related to higher levels of CDSE, but that the three facets did not contribute incrementally to CDSE. In addition, social status was related to career choice certainty, but this relation was fully mediated by CDSE.     

消化性溃疡的中西医结合辨治决策思路

面对消化性溃疡病人进行中西医结合辨治决策时,要掌握辨证型、辨病变、辨症状、辨病因等四个思维切入点,并在具体运用中处理好辨证与辨病、共性与个性、局部与整体、内因与外因等四个关系,才能作出正确的辨治决策。     

研究生临床技能测试制度与临床决策能力培养

医学研究生的生源不同、学制不同和培养方式等的差异,导致医学研究生毕业时的临床技能和临床决策能力参差不齐。建立医学毕业研究生临床技能测试制度,合理地评价医学研究生毕业时的实际临床能力,从而制定针对个体的临床技能培养方案,为快速培养和提高青年研究生的临床决策能力提供有力的措施。