循证医学的辩证思维

随着临床医学的发展,临床医生面临着从理论知识加个人经验的医学模式向以科学证据为基础的医学模式转变。越来越多的卫生政策和诊疗指南的制定需要以高质量的研究结果为依据,如随机对照研究的结果,特别是随机对照研究的系统综述结论。循证医学模式要求医生在临床工作中不断提出问题并通过严格的科研设计来回答这些问题,同时强调不断进行知识更新,掌握最新研究证据以指导其临床工作。同时政府部门也鼓励发展循证医疗,因为它可通过研究有效的诊疗手段来提高卫生保健的效率。此外还有迹象表明法律决策过程中要参考是否遵循了研究证据和临床指南。知情的服务对象也促使临床工作者寻求研究证据作为依据,为了提高服务质量并且充分把握特殊专业领域的现状,临床工作者也需要不断了解新的依据信息。在众多的研究信息中,我们应对每项证据的研究方法、研究对象及观察的终点进行认真分析,确定该结论是否真实并适合我们的实际,从而制定有据可查的诊疗方案。     

Young Indigenous Australians' Sexually Transmitted Infection Prevention Practices: A Community‐based Participatory Research Project

National surveillance data indicate marked differences between Indigenous and other Australians in the prevalence of many sexually transmitted infections (STIs). Young Indigenous people bear a particularly high burden of these infections. A collaboration of university researchers, Indigenous health workers and young Indigenous people conducted 45 field interviews to examine how young Indigenous Australians keep themselves healthy and protected against STIs. Our findings emphasise the complexity of health behaviours, where individuals are rarely always ‘risky’ or always ‘safe’, as well as subtle gender differences in health practices. Preventive strategies employed by the young people were contingent on beliefs and knowledge about sexual partners, the type of relationship, the context of the sexual encounter and access to condoms. Tangible strengths such as young Indigenous people's commitments to condoms and STI screening should be celebrated and bolstered to enhance their ability to protect themselves against adverse health outcomes and enhance their resilience against STIs. Focusing on strengths helps to counter the deficit model of health commonly deployed in Indigenous health research and draws attention to health issues facing young Indigenous people and their communities, without reinforcing negative stereotypes or focusing solely on individual risk behaviour. We provide concrete recommendations for health promotion and education. Copyright © 2011 John Wiley & Sons, Ltd.     

When less is more: Consumer aversion to unused utility

A series of experiments demonstrates that consumers exhibit aversion to waste during forward-looking purchase. These experiments further reveal that such behavior is driven by distaste for unused utility, a reaction that is shown to be distinct from an aversion to squandering money. Waste aversion is especially pronounced when consumers anticipate future consequences and deprivation is salient. In addition to demonstrating robustness across consumers and marketing contexts, the results also demonstrate how waste aversion can lead to self-defeating behavior in which consumers forego desired utility. Finally, the present research demonstrates and discusses the implications of waste aversion for a variety of marketing issues, including buy-rent markets, bundling, and the fundamental distinction between goods and services.     

Post G20: The Challenge of Change,Implementing Evidence‐based Public Order Policing

In the wake of the 2011 ‘riots’, public order policing tactics in England and Wales have once again been brought into question. Yet, the riots came two years since police regulatory authorities in the UK called for fundamental reforms to the policing of public order. Questions are raised about why the change called for appears to have been so slow and what can be done to assist reform. This paper suggests that developing an evidence‐based policing approach within the field of public order policing to inform police decision‐making would provide the answers. By doing so, the paper addresses some of the possible barriers to implementing evidence‐based policing in public order and calls for police academic partnership to overcome these to make ‘change’ an ongoing reality. Copyright © 2012 John Wiley & Sons, Ltd.     

A computer-based program to teach braille reading to sighted individuals

Instructors of the visually impaired need efficient braille‐training methods. This study conducted a preliminary evaluation of a computer‐based program intended to teach the relation between braille characters and English letters using a matching‐to‐sample format with 4 sighted college students. Each participant mastered matching visual depictions of the braille alphabet to their printed‐word counterparts. Further, each participant increased the number of words they read in a braille passage following this training. These gains were maintained at variable levels on a maintenance probe conducted 2 to 4 weeks after training.     

What Is Legal Philosophy?

This article delineates some of the main issues that are debated by philosophers of law. It explores the connections between legal philosophy and other areas of philosophy, while also seeking to specify the distinctiveness of many of the concerns that have preoccupied philosophers of law. It illustrates its abstract points with examples focused on the separability of law and morality, the nature of the rule of law, the nature of rights, justifications for the imposition of punishment, and the identification of basic legal entitlements.     

计算机化分类测验终止规则的类别、特点及应用

计算机化分类测验(Computerized Classification Testing, CCT)能够高效地对被试进行分类, 已广泛应用于合格性测验及临床心理学中。作为CCT的重要组成部分, 终止规则决定测验何时停止以及将被试最终划分到何种类别, 因此直接影响测验效率及分类准确率。已有的三大类终止规则(似然比规则、贝叶斯决策理论规则及置信区间规则)的核心思想分别为构造假设检验、设计损失函数和比较置信区间相对位置。同时, 在不同测验情境下, CCT的终止规则发展出不同的具体形式。未来研究可以继续开发贝叶斯规则、考虑多维多类别情境以及结合作答时间和机器学习算法。针对测验实际需求, 三类终止规则在合格性测验上均有应用潜力, 而临床问卷则倾向应用贝叶斯规则。