职业精神和医患关系

通过调查发现,外科医生在提供做决策的信息的问题上执行得较好;有些医生无论错误多么严重也不会把医疗错误披露出来;但是能够公开医生的经济奖励,这样医生的信任不但没有被损害,相反医生和医生团体的信任和忠诚却增强了。从知情决策、医疗错误的披露和利益冲突三个方面展示职业精神对医患关系产生的影响,并为职业精神的发展提供了新视角。     

Competencia conceptual y de procedimiento: comprensión de la propiedad conmutativa de la adición y estrategias de solución

Resumen

En esta investigación se analizan los factores implicados en la adquisición de la estrategia aditiva de contar desde el sumando mayor y su relación con el conocimiento de la propiedad conmutativa de la suma. Tres grupos de niños con edades comprendidas entre los 5 y los 8 años resuelven tres tareas (resolver sumas, comparar sumas y encontrar el sumando desconocido), en dos condiciones experimentales (presencia/ausencia del resultado) y con cuatro tipos de sumandos (1 + N; círculos + guarismos; hechos numéricos; y hechos numéricos superiores a la decena). En general, los resultados muestran que los factores grupo, tarea, presencia/ausencia del resultado y tipo de sumandos influyen en el rendimiento de los niños. Asimismo, el análisis de las estrategias y errores nos ha permitido constatar la existencia de diferencias evolutivas entre los grupos. Por último, nuestros datos ponen de manifiesto que las estrategias aditivas de contar desde el mayor se acompañan de un cierto éxito en las tareas de conmutatividad y que el fracaso en la tarea de sumar no implica fracaso igualmente en las tareas de conmutatividad.     

Age effects shrink when motor learning is predominantly supported by nondeclarative,automatic memory processes: Evidence from golf putting

Can motor learning be equivalent in younger and older adults? To address this question, 48 younger (M?=?23.5 years) and 48 older (M?=?65.0 years) participants learned to perform a golf-putting task in two different motor learning situations: one that resulted in infrequent errors or one that resulted in frequent errors. The results demonstrated that infrequent-error learning predominantly relied on nondeclarative, automatic memory processes whereas frequent-error learning predominantly relied on declarative, effortful memory processes: After learning, infrequent-error learners verbalized fewer strategies than frequent-error learners; at transfer, a concurrent, attention-demanding secondary task (tone counting) left motor performance of infrequent-error learners unaffected but impaired that of frequent-error learners. The results showed age-equivalent motor performance in infrequent-error learning but age deficits in frequent-error learning. Motor performance of frequent-error learners required more attention with age, as evidenced by an age deficit on the attention-demanding secondary task. The disappearance of age effects when nondeclarative, automatic memory processes predominated suggests that these processes are preserved with age and are available even early in motor learning.     

Health and adaptedness

The purpose of this paper is to give an explication of the concept of health which does not rely on the concept of disease. The explication is informed by a view of the human individual as an acting subject and it therefore places the abilities of agents in the centre. Abilities may be qualified in different ways. The qualification essential for understanding the dimension of health and illness relates abilities to environmental circumstances and high-ranking projects in the life plan. For this purpose generalized adaptedness is introduced as the overarching construction. The dimension of health and illness is characterized in terms of the adequacy of the repertoire for generalized adaptedness. Some immediate consequences concerning the notion of care are noted.     

A note on the asymptotic variance-covariance matrix of item parameter estimates in the rasch model

Lord and Wingersky have developed a method for computing the asymptotic variance-covariance matrix of maximum likelihood estimates for item and person parameters under some restrictions on the estimates which are needed in order to fix the latent scale. The method is tedious, but can be simplified for the Rasch model when one is only interested in the item parameters. This is demonstrated here under a suitable restriction on the item parameter estimates.     

Toward an empirically based parameter selection for time-sampling observation systems

The measurement error of time-sampling observation systems, used to estimate the frequencyof behavioral events, was analyzed by means of a five-factor design, computer simulation experiment. The first three factors represented response parameters: the relative frequency and duration of the behavior and the pattern of response distribution. For each combination of frequency, pattern, and duration, five simulated behavior events were generated within a simulated observation period of 900 sec. A total of 21 different time-sampling systems was employed. As a fourth factor three different observe and record lengths were included (6, 12, and 60 sec). In addition, there were seven different ratios of “observe” to “record” interval length (5∶1, 3∶1, 2∶1, 1∶1, 1∶2, 1∶3, and 1∶5) representing the fifth factor. Thus, 21 time-sampling systems scanned a total of 120 different behavior simulations from 24 types of behavior parameter combinations. The data were analyzed by means of a five-factor (2 × 3 × 4 × 3 × 7) analysis of variance with repeated measures on two factors. The study demonstrated that time sampling leads to high average measurement errors, which are determined by complex interrelationships among a variety of variables. Choosing a time-sampling system arbitrarily may lead to highly erroneous data. It was also shown, however, that time-sampling systems have the potential to yield very accurate results. An empirical selection procedure for time-sampling intervals is proposed to minimize measurement error. Exemplary tables are presented from which time-sampling parameters can be chosen given that the rate, duration, and pattern of occurrence of a behavior to be observed are known.     

Advances in experimental psychopatholinguistics: What can we learn from simulation of disorder-like symptoms in human volunteers?

For more than a century, work on patients with acquired or developmental language disorders has informed psycholinguistic models of normal linguistic processing in healthy persons. On the other hand, such models of healthy language processing have been used as blue-prints to gain further insights into the impairments of patients with language pathologies. Against the exemplary background of language production, the first part of this paper reflects this relationship and formulates a desideratum for naturalistic albeit controlled experimental settings. Two recent examples of behavioural and neurofunctional research are presented in which aphasia-like speech symptoms were elicited in healthy control subjects. In the second part, this idea to investigate disorder-like symptoms which are being experimentally induced for the course of the study is further pursued in the field of reading and dyslexia research. Here, it is argued, again on the basis of behavioural and neurofunctional data, that such an approach is advantageous in at least two respects:1. It allows a much more stringent control of experimental factors and confounds than could be potentially achieved in a clinical setting.2. It allows in-extenso piloting of experiments with healthy volunteers before actually recruiting selected (and sometimes rare) patients.It will be concluded that the experimental simulation of disorder-like symptoms in easily accessible healthy volunteers may be a useful approach to understand novel aspects of a language disorder on the basis of a human neurocognitive model of this disorder.