Le problème de l’analyse des troubles de la pensée dans le discours avec la personne schizophrène : proposition méthodologique

ObjectiveWe are designing the beginnings of a methodology for the analysis of discursive disorders that will have the particularity of helping to pinpoint the discontinuous sequences that are most likely to signal the presence of thought disorders. We anticipate the development of a modeling system based on principles of pragmatic linguistics and formal semantics, which, applied to carefully selected discontinuous discourse sequences, will have a good chance of revealing the nature of the underlying thought disorders.MethodWe proceed to the analysis of the experimental literature in cognitive psychopathology that aims at identifying the cognitive processes, in this case related to semantic memory and executive functions, which are believed to define thought disorders. We confront this paradigm with other approaches in cognitive psychology and the philosophy of language that explore the language of thought. The combined theoretical and empirical findings allow us to arrive at a set of conjectures that anticipate the pragmatic and semantic properties of discourse transactions that are likely signs of disorders.ResultsWe compare these conjectures with the results of a previous study on the discovery of four “proven” types of discontinuous sequences; and we show which of these sequences can thus be considered as symptomatic of thought disorders. In continuity, we analyze some of these sequences by testing some principles of semantic modeling in order to identify the nature of the disorders and thought operations underlying the relevant discontinuous sequences.DiscussionWe show that discursive thought disorders should not be considered simply as an expression of a dysexecutive syndrome but also as a device that is likely to affect more complex thought operations, such as the inferences involved in the representation system of the conversational context, in the meaning calculus of the utterances, and in the speaker's meaning calculus. Improving the heuristics of formal systems for recognizing discourse disorders and interpreting thought disorders on the basis of more appropriate and accurate semantic modeling may lead to the development of more discriminating and effective diagnostic tools.ConclusionThe format of the formal systems that we have created will allow us to represent the interlocutory structure of the disorder in its natural context of expression with increasing precision, and should lead to the development of computerized tools to assist in diagnosis. Finally, the increased precision of formal modeling applied to communication disorders should also allow us to test the hypothesis according to which certain discursive configurations are based on thought disorders (in a broad sense) whereas others reveal cognitive dysfunctions that have to do, rather, with the conditions of possibility of discourse.     

Individual differences in resting heart rate variability moderate thought suppression success

Individual differences in heart rate variability (HRV) at rest are thought to represent an individual's capacity for self‐regulation, but it remains unclear whether HRV predicts control over unwanted thoughts. The current study used a thought suppression paradigm in which participants recorded occurrences of a personally relevant intrusive thought over three monitoring periods. Among those instructed to suppress, higher levels of HRV were associated with greater declines in intrusions across the monitoring periods; no such relationship was found among those assigned to a control condition. Resting HRV also interacted with spontaneous thought suppression effort to predict intrusive thought frequency. In both cases, these HRV‐related differences in thought suppression success predicted the generalized distress symptoms common to depression and anxiety. These findings enhance understanding of the relationships between HRV and cognitive control and highlight how individual differences in self‐regulatory capacity impact thought suppression success and emotion regulation.     

Differential roles of thought suppression and dispositional mindfulness in posttraumatic stress symptoms and craving

Exposure to traumatic events often results in severe distress which may elicit self-medication behaviors. Yet, some individuals exposed to trauma do not develop post-traumatic stress symptoms and comorbid addictive impulses. In the wake of traumatic events, psychological processes like thought suppression and mindfulness may modulate post-traumatic stress and craving for substances. We examined the differential roles of mindfulness and suppression in comorbid post-traumatic stress and craving among a sample of 125 persons with extensive trauma histories and psychiatric symptoms in residential treatment for substance dependence. Results indicated that thought suppression, rather than extent of trauma history, significantly predicted post-traumatic stress symptom severity while dispositional mindfulness significantly predicted both post-traumatic stress symptoms and craving. In multiple regression models, mindfulness and thought suppression combined explained nearly half of the variance in post-traumatic stress symptoms and one-quarter of the variance in substance craving. Moreover, multivariate path analysis indicated that prior traumatic experience was associated with greater thought suppression, which in turn was correlated with increased post-traumatic stress symptoms and drug craving, whereas dispositional mindfulness was associated with decreased suppression, post-traumatic stress, and craving. The maladaptive strategy of thought suppression appears to be linked with adverse psychological consequences of traumatic life events. In contrast, dispositional mindfulness appears to be a protective factor that buffers individuals from experiencing more severe post-traumatic stress symptoms and craving.     

浅谈用创新思维留住中小型公立医院知识型员工的做法和体会

目的 探究在21世纪的今天中小型公立医院如何尊重人才、引进人才,以人才立院,靠人才兴院,凭人才强院等,总结笔者所在医院的具体做法和体会,供同行参考.方法 将笔者所在医院5年来引进和辞职的高学历人才（硕士及博士毕业生）的来院意愿和离院原因进行对比研究.结果 来笔者所在医院的36名高学历人才中,5年来有5人因各种原因提出辞职离院.结论 在医疗市场的竞争中,最关键和最根本的是人才的竞争,只有牢固树立人力资源是第一资源,用创新思维来改革和完善人力资源管理机制,才能真正留住高学历的知识型员工,使医院得到发展.     

毛泽东医德思想的伦理意蕴

毛泽东医德思想是毛泽东思想不可分割的组成部分,也是我国社会主义医德的主要渊源。毛泽东医德思想是规范伦理与美德伦理的交融：规范伦理以实行革命人道主义为主要内容;美德伦理主要表现为倡导全心全意为人民服务和白求恩精神,二者内在统一于建设平等、公正社会的价值目标。     

临床输血相容性室间质评分析体会

[目的]通过室间质评来完善实验方法和提高检测水平,使实验结果更加可靠,为临床输血提供安全保障。[方法]依据卫生部临床检验中心对临床输血相容性室间质评的要求,每年3次,每次5个项目包括ABO血型正反定型和Rh(D)血型鉴定、受血者和献血者抗体筛检及交叉配血实验,每个项目有5个被检测标本;对影响检测质量的标本、检测方法、试剂、操作过程及结果分析等诸多因素进行评估。[结果]2008年081批次结果较差,仅ABO正定型,Rh(D)血型鉴定两项为100%;082批次交叉配血较差为40%。2008年083批次及2009年091、092、093批次结果较为满意。[结论]临床输血相容性室间质控工作是临床输血质量管理体系中的重要环节,室间质评可增加临床实践经验,增强鉴别判断能力,规范临床输血相容性检测工作,达到安全输血的目的。     

Introduction: Philosophy in and Philosophy of Cognitive Science

Despite being there from the beginning, philosophical approaches have never had a settled place in cognitive research and few cognitive researchers not trained in philosophy have a clear sense of what its role has been or should be. We distinguish philosophy in cognitive research and philosophy of cognitive research. Concerning philosophy in cognitive research, after exploring some standard reactions to this work by nonphilosophers, we will pay particular attention to the methods that philosophers use. Being neither experimental nor computational, they can leave others bewildered. Thought experiments are the most striking example but not the only one. Concerning philosophy of cognitive research, we will pay particular attention to its power to generate and test normative claims, claims about what should and should not be done.     

The effects of cognitive defusion and thought distraction on emotional discomfort and believability of negative self-referential thoughts

Previous research has shown that rapid vocal repetition of a one-word version of negative self-referential thought reduces the stimulus functions (e.g., emotional discomfort and believability) associated with that thought. The present study compares the effects of that defusion strategy with thought distraction and distraction-based experimental control tasks on a negative self-referential thought. Non-clinical undergraduates were randomly assigned to one of three protocols. The cognitive defusion condition reduced the emotional discomfort and believability of negative self-referential thoughts significantly greater than comparison conditions. Favorable results were also found for the defusion technique with participants with elevated depressive symptoms.     

基于案例对门诊护理安全管理的思考

护理安全是门诊护理管理永恒的主题。文章结合典型案例就门诊护理工作中存在的安全问题和隐患进行分析,并举一反三提出改进对策,通过管理活动达到提高护士的法律意识和护理安全水平的目的。实践证明,案例分析与临床工作结合的教育形式是培养法律和护理安全意识的有效方法,不仅受到护士们的普遍欢迎,而且对护理管理实践具有指导意义。