Diagnostic sequence of cocaine use disorder in relation to other mental health conditions among college students

Abstract

Objective: Cocaine use is increasing. Comorbidities and diagnostic sequencing are needed among college students to inform treatment of cocaine use disorder (CUD). Method: Using electronic medical records from the psychiatric clinic at the student health care center of a large, public university from 2005 to 2015, patients diagnosed with CUD were identified. Their top mental health conditions were identified and assessed to see whether the first diagnosis of these conditions was made (1) before, (2) at the same time as, or (3) after the first diagnosis of CUD. Results: Among the 50 CUD patients, their most common mental health comorbidities were alcohol use disorder, anxiety, depression, and cannabis use disorder. Anxiety and depression were likely to be diagnosed before CUD; alcohol and cannabis use disorders were likely to be diagnosed concurrently with CUD. Conclusion: Diagnostic sequencing can be used to inform screening, workup, and treatment for patients with CUD.     

论适应性表征及其方法论意义

适应性是主体适应其环境的特性,是物理演化系统和生物演化系统的本质属性,反映在认知上就是适应性表征。适应性表征也因此成为知识显现的方式和创造的核心,具有协调性、匹配性、互补性、模拟性和类比性,其表现方式有直接具象表征、间接具象表征、直接抽象表征和间接抽象表征,分别对应于经验主义、建构经验主义、理性主义和科学实在论。适应性表征的实现是通过科学理论核心概念的变化、定律的凝练、理论的更替、模型推理和世界观的改变展开的,具有经验上的适当性。这种经验适当性不仅是感知层次的体验,更是一种认知模式。在认知意义上,经验也是基于心理模型的,心理建模的路径有思想语言、心理表象、心理命题、思想实验和心理模拟推理。这种基于心理建模的适应性表征为科学认知和科学发现提供了有益的方法论。     

走自己的路:建党百年中国道路自信的生成逻辑及提升路径

自信是一种信念及精神,中国道路自信是中华儿女对中华民族发展能力及前途的信任,其形成与中国百年发展辉煌成就息息相关.中国道路自信源自中国道路的正确选择.建党百年来,中国共产党带领中华儿女历经千难万险,先后成功开辟新民主主义革命道路、社会主义改造及社会主义建设道路、中国特色社会主义道路.全国人民在百年磨砺中增强了中国道路自信.这种自信承载着中华儿女的无数梦想,是中华民族复兴的软实力.树立中国道路自信的理论前提,关键在于对中国道路优越性的彰显.只有将其置于不同参照系中进行多维度比较,才能使其优越性得以全面彰显,并愈加坚定不移地沿着这条道路阔步前行.显然,站在新时代历史方位上,通过梳理、总结建党百年来中国道路发展历程,将中国道路置于自身与"他者"之历史与现实中,进行共时态与历时态之比较,以唯物史观回望并厘清建党百年来中国道路自信生成逻辑,具有极其重大意义,既能彰显中国特色社会主义道路的优越性,又能激发全体中华儿女愈加自信地"走自己的路"——中国特色社会主义道路,筑牢中华民族共同体意识,阔步迈向全面建设社会主义现代化国家新征程.     

Staff and family attitudes to fences as a means of detaining people with dementia in residential aged care settings: The tension between physical and emotional safety

This study investigates staff and family attitudes towards the use of the fences that surround many aged care facilities in Australia, in the context of indefinite detention of people with dementia. This indefinite detention has been described in a report from an Australian Senate Inquiry as “a significant problem within the aged care context”, which “is often informal, unregulated and unlawful”. Five focus groups comprising direct care workers, family members, nurse unit managers and facility managers discussed the reasons for and their attitudes towards fences. The results show a tension between the provision of physical and emotional safety. This is to say that even while it is illegal to detain people with dementia against their will, and even while participants understood the negative impact of fences on the well‐being and emotional safety of people with dementia, they accepted and supported the presence of perimeter fences because they provided the perception that fences kept people with dementia physically safe. This has implications for redressing the balance between physical and emotional safety in policy and practice.     

医疗信息共享对患者转移数量和服务质量水平影响研究

当前我国医院间存在严重的"信息孤岛"，医院参与医疗信息共享意愿不高，患者的诊疗信息被静态碎片化储存而无法充分有效地利用。考虑到医院进行医疗信息共享将降低患者转移成本，本文构建一个多阶段双寡头动态博弈模型研究医疗信息共享对医院竞争过程中患者转移数量和服务质量水平决策的影响。首先，根据是否存在转移成本，将患者分为新患者和经验性患者，借助Hotelling模型刻画患者的效用函数，分析患者就诊决策。然后，在政府价格规制和不考虑医院利他性情景下，构建了医院累积期望收益目标函数，使用动态规划方法，求解实现医院累积期望收益最大化的服务质量水平，获得了实现患者相互转移且医院在市场中共存的马尔可夫完美均衡。最后，根据医院参与医疗信息共享后患者转移成本降为零，分析与比较信息共享前后患者转移数量和服务质量水平变化。研究发现：在不同医院间本身存在患者转移背景下，医院参与信息共享后，患者转移数量增加但存在一个上限，增加的转移量与患者在医院间的转移成本呈正相关，与初始感知效用的差值范围呈负相关；医院参与信息共享后，均衡状态下的医院服务质量水平高于信息共享前的服务质量水平。因此，在不改变当前医保支付方式下，要加快推进医疗信息共享，政府部门可以根据医院的患者数量和服务质量水平变化对其进行定期补贴，以激励医院积极参与医疗信息共享，本文给出了这个补贴的量化表达。     

Breakthroughs on Fundamental Issues of Socialist Political Economy in China’s Economic Reform

How to effectively integrate the basic economic system of the primary stage of socialism in which public ownership is the dominant and diverse economic sectors develop side by side with a resource allocation model in which the market plays a decisive role is a fundamental issue in building a socialist political economy with Chinese characteristics. Western bourgeois economics and the traditional understanding of Marxist classical writers reject the possibility of such integration. In the transitional countries of Central and Eastern Europe, the practice and theoretical exploration of combining the two ended by abandoning public ownership. The fundamental feature of socialist economic reform practice with Chinese characteristics is to uphold their organic unity. This approach has already achieved great progress but at the same time is confronting a series of new problems.     

疫情防控期间大学生焦虑水平及其影响因素研究

为了解大学生在新型冠状病毒肺炎疫情防控期间的焦虑状况，采用汉密顿焦虑量表（HAMA），对四川、云南、重庆三省（直辖市）的3 178名大学生进行在线问卷测试。结果发现：新冠肺炎疫情防控期间大学生焦虑水平高于常模，并且与大学生的性别、就读学历层次、就读学科、每日上网时间等存在显著相关性。其中，28.48%的大学生还可能有严重焦虑；女性、专科层次、尚不清楚就读学科的大学生群体焦虑水平更为明显；精神性焦虑是新冠肺炎疫情防控期间大学生焦虑的主要特质；每日上网时间与大学生精神性焦虑水平呈显著正相关。在公共卫生事件突发时期，应积极关注大学生的心理健康状态，采取针对性措施加以有效疏导和干预，促进其心理健康发展。     

问题与路径:智库评价及中国特色智库评价体系构建

在中国智库朝气蓬勃发展的大背景下，构建具有中国特色的科学合理的智库评价体系，有助于引导各类智库切实深化体制机制改革、完善智库内部治理、推动智库提质增效，进而形成内外兼修健全发展的中国智库生态圈，以高质量的智库产品助推国家治理体系和治理能力现代化建设。笔者通过梳理国内外智库评价实践动态与学术研究现状，归纳总结我国智库评价工作存在的现实问题及其成因，并指出它们可能给中国特色新型智库建设带来的影响。由此建议：我国应基于中国经验、中国国情及智库发展建设的实际情况，以习近平新时代中国特色社会主义思想为指导，以时代背景为依托，构建中国特色智库评价体系，促进我国智库体系的整体发展。     

幼儿园教师虐童行为的特征、影响及对策

幼儿园教师虐童事件数次发生，已经成为全社会普遍愤慨和共同忧虑的焦点问题。幼儿园教师虐童具有隐蔽性强，儿童难以抗拒，施虐方式多样，越小儿童越易受到虐待等表现特征。虐童行为不仅伤及儿童身体，更给儿童心理和精神造成严重危害。为有效防止幼儿园教师虐童行为，需要从政府、幼儿园和家长层面采取具有针对性的防治措施。