Mental Processes

心理过程
  • 文章类型: Editorial
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  • 文章类型: Journal Article
    背景:超重/肥胖儿童和青少年的执行功能经常发生改变,这对他们的学习和日常生活产生了负面影响。此外,研究表明,体育锻炼对提高认知能力有好处。该协议旨在以详细和结构化的方式定义将对旨在评估体育锻炼对超重/肥胖儿童和青少年(≤18岁)执行功能的影响的文献进行系统回顾的程序。
    方法:WebofScience,PubMed,Scopus,和EBSCO数据库将搜索纵向研究,至少有一个实验组和一个对照组使用执行功能的干预前后措施,包括工作记忆,抑制,以及超重或肥胖的儿科人群的认知灵活性。将使用CochraneRoB2和GRADE评估偏倚和证据确定性的风险,分别。此外,Simonian-Laird的随机效应模型将用于荟萃分析。效果大小将以95%的置信区间计算,p值<0.05表示干预前后各组执行功能各维度的统计学意义。
    结论:这篇综述的结果可能有助于教育和卫生专业人员为超重/肥胖儿童和青少年设计治疗计划,提供与该人群的学习和认知能力相关的潜在益处。PROSPERO注册号:CRD42023391420。
    BACKGROUND: Executive function is often altered in overweight/obese children and adolescents, which has a negative impact on their learning and daily life. Furthermore, research has shown the benefits of physical exercise in improving cognitive performance. This protocol aims to define in a detailed and structured manner the procedures that will be conducted for the development of a systematic review of the literature aimed at evaluating the effects of physical exercise on the executive functions of children and adolescents (≤18 years) with overweight/obesity in comparison with peers in control groups.
    METHODS: The Web of Science, PubMed, Scopus, and EBSCO databases will be searched for longitudinal studies that have at least one experimental and one control group using pre- and post-intervention measures of executive function, including working memory, inhibition, and cognitive flexibility in the pediatric population who are overweight or obese. The risk of bias and certainty of evidence will be assessed using Cochrane RoB2 and GRADE, respectively. Furthermore, Der Simonian-Laird\'s random effects model will be employed for meta-analyses. The effect sizes will be calculated with 95% confidence intervals, and p values < 0.05 indicate statistical significance for each dimension of executive function in the different groups before and after the intervention.
    CONCLUSIONS: The results of this review may be useful for education and health professionals to design treatment plans for overweight/obese children and adolescents, offering potential benefits related to the learning and cognitive abilities of this population. PROSPERO registration number: CRD42023391420.
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  • 文章类型: Journal Article
    虽然意识通常被认为等同于心理内容,某些冥想实践-包括开放监测(OM)-被认为可以实现独特的意识状态,在这种状态下,冥想者可以从去化的角度将心理内容体验为“正在进行的现象”。\"现象学上,这种状态被认为是故意减少,对心理内容的心理行为。我们假设这种去中心化状态的特征是提供对象的心理处理减少。我们招募了两组参与者,有长期培养脱实状态经验的冥想者,和人口统计学上匹配的新手冥想者。参与者在两种配置中使用图像执行任务-对象确实存在(高负担感),并且不暗示动作(低负担感)-遵循基线和OM诱导的去量化状态,以及脑电图记录。与基线期间的低示能图像相比,长期冥想者对高示能图像表现出优先处理,这种影响在OM状态下被废除了,如假设。对于新手来说,然而,在基线和OM期间,高示能表示配置优于低示能表示配置.物体在不同条件下的感知持续时间与µ节律去同步的程度呈正相关,表明供能的神经处理影响了知觉意识。我们的结果表明,OM的冥想风格可能有助于通过提供物体来使心理动作的自动认知过程在精神上解耦。
    While consciousness is typically considered equivalent to mental contents, certain meditation practices-including open monitoring (OM)-are said to enable a unique conscious state where meditators can experience mental content from a de-reified perspective as \"ongoing phenomena.\" Phenomenologically, such a state is considered as reduction of intentionality, the mental act upon mental content. We hypothesised that this de-reified state would be characterised by reduced mental actional processing of affording objects. We recruited two groups of participants, meditators with long-term experience in cultivating a de-reified state, and demographically-matched novice meditators. Participants performed a task with images in two configurations-where objects did (high-affordance) and did not imply actions (low-affordance)-following both a baseline and OM-induced de-reified state, along with EEG recordings. While long-term meditators exhibited preferential processing of high-affordance images compared to low-affordance images during baseline, such an effect was abolished during the OM state, as hypothesised. For novices, however, the high-affordance configuration was preferred over the low-affordance one both during baseline and OM. Perceptual durations of objects across conditions positively correlated with the degree of µ-rhythm desynchronization, indicating that neural processing of affordance impacted perceptual awareness. Our results indicate that OM styles of meditation may help in mentally decoupling otherwise automatic cognitive processing of mental actions by affording objects.
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  • 文章类型: Journal Article
    背景:医学写作研讨会的普及凸显了对标准测量工具的需求,以评估此类研讨会对参与者的信心的影响:1-撰写标准文章,2-使用最佳英语语言。因为这样的仪器还没有,我们进行这项研究是为了设计和评估第一个评估这种可信度的测量工具.
    方法:我们通过搜索Medline创建了一个包含50个项目的项目池,Embase,和ClarivateAnalytics查找相关文章,利用我们以前的经验,接近关键线人。我们修改和编辑了项目池,多余的被排除在外。最后,36项工具包括两个域。我们在一组研讨会申请人中使用Cronbach'sα和Pearson相关性对内部一致性和时间可靠性进行了测试,并使用内容有效性指数和Pearson相关性对内容和收敛有效性进行了测试。
    结果:参与者的平均年龄为40.3岁,女性占主导地位(74.3%),和大多数教职员工(51.4%)。内部一致性显示出较高的可靠性(>0.95)。重测信度表现出很高的相关性(r=0.93)。域1的CVI为0.78,域2的CVI为0.73,整个仪器的CVI为0.75。
    结论:这种独特的,可靠,并且有效的测量工具可以准确地测量撰写标准医学文章以及为此目的使用适当的英语的信心水平。
    BACKGROUND: The popularity of medical writing workshops highlights the need for a standard measurement tool to assess the impact of such workshops on participants\' confidence in: 1- writing a standard article and 2- using optimal English language. Because such an instrument is not yet available, we undertook this study to devise and evaluate the first measurement tool to assess such confidence.
    METHODS: We created an item pool of 50 items by searching Medline, Embase, and Clarivate Analytics to find related articles, using our prior experience, and approaching the key informants. We revised and edited the item pool, and redundant ones were excluded. Finally, the 36-item tool comprised two domains. We tested it in a group of workshop applicants for internal consistency and temporal reliability using Cronbach\'s α and Pearson correlations and for content and convergent validity using the content validity index and Pearson correlations.
    RESULTS: The participants had a mean age of 40.3 years, a female predominance (74.3%), and a majority of faculty members (51.4%). The internal consistency showed high reliability (> 0.95). Test-retest reliability showed very high correlations (r = 0.93). The CVI for domain 1 was 0.78, for domain 2 was 0.73, and for the entire instrument was 0.75.
    CONCLUSIONS: This unique, reliable, and valid measurement tool could accurately measure the level of confidence in writing a standard medical article and in using the appropriate English language for this purpose.
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  • 文章类型: Journal Article
    病史对诊断的贡献约为80%,虽然体格检查和实验室检查增加了医生对医学诊断的信心。人工智能(AI)的概念最早是在70多年前提出的。最近,它在医学各个领域的作用显着增长。然而,尚无研究评估患者病史在AI辅助医疗诊断中的重要性.
    本研究探讨了患者病史对AI辅助医疗诊断的贡献,并根据提供的病史评估了ChatGPT在临床诊断中的准确性。
    使用BMJ中确定的30例病例的临床插图,我们评估了ChatGPT诊断的准确性.我们将ChatGPT仅基于病史的诊断与正确的诊断进行了比较。我们还将ChatGPT在纳入其他体格检查结果和实验室数据以及病史后的诊断与正确诊断进行了比较。
    ChatGPT准确诊断76.6%(23/30)仅有病史的病例,与以前针对医生的研究一致。我们还发现,当包括其他信息时,这一比率为93.3%(28/30)。
    尽管添加附加信息可以提高诊断准确性,患者病史仍然是AI辅助医疗诊断的重要因素.因此,当在医疗诊断中使用人工智能时,纳入相关和正确的病史对于准确诊断至关重要。我们的发现强调了患者病史在这个年龄段的临床诊断中的持续重要性,并强调了将其整合到AI辅助医疗诊断系统中的必要性。
    UNASSIGNED: Medical history contributes approximately 80% to a diagnosis, although physical examinations and laboratory investigations increase a physician\'s confidence in the medical diagnosis. The concept of artificial intelligence (AI) was first proposed more than 70 years ago. Recently, its role in various fields of medicine has grown remarkably. However, no studies have evaluated the importance of patient history in AI-assisted medical diagnosis.
    UNASSIGNED: This study explored the contribution of patient history to AI-assisted medical diagnoses and assessed the accuracy of ChatGPT in reaching a clinical diagnosis based on the medical history provided.
    UNASSIGNED: Using clinical vignettes of 30 cases identified in The BMJ, we evaluated the accuracy of diagnoses generated by ChatGPT. We compared the diagnoses made by ChatGPT based solely on medical history with the correct diagnoses. We also compared the diagnoses made by ChatGPT after incorporating additional physical examination findings and laboratory data alongside history with the correct diagnoses.
    UNASSIGNED: ChatGPT accurately diagnosed 76.6% (23/30) of the cases with only the medical history, consistent with previous research targeting physicians. We also found that this rate was 93.3% (28/30) when additional information was included.
    UNASSIGNED: Although adding additional information improves diagnostic accuracy, patient history remains a significant factor in AI-assisted medical diagnosis. Thus, when using AI in medical diagnosis, it is crucial to include pertinent and correct patient histories for an accurate diagnosis. Our findings emphasize the continued significance of patient history in clinical diagnoses in this age and highlight the need for its integration into AI-assisted medical diagnosis systems.
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  • 文章类型: Journal Article
    背景:处方写作技巧对于医师实践至关重要。这项研究描述了课程干预的开发和实施,该课程干预的重点是利用跨专业教育模式提高实习医学生处方写作实践的知识和信心,专注于电子处方。
    方法:来自大型医学和药学学院,城市大学合作开发了研讨会的内容,并将模拟平台用于电子处方活动。二年级医学生参加了由四年级药学学生提供的强制性面对面研讨会。使用前和后知识测试和信心调查来评估学生的知识,信心,和满意度。知识测试的结果用配对样本比例测试进行了评估,在研究前后设计中,采用配对t检验和Wilcoxon符号秩检验对信心调查数据进行评估.
    结果:学生在完成研讨会后证明了处方书写知识和信心的显着增加。在预先测试中,7%的学生(21/284)正确完成了电子处方评估,51%的学生(149/295)在后期测试中正确完成了电子处方评估。信心调查的所有项目均显示调查前与调查后比较显着增加(p<0.001)。
    结论:这个由药学专业学生主持的跨专业处方书写研讨会显示出有望提高实习医学生对处方书写和电子处方实践的知识和信心。
    BACKGROUND: Prescription writing skills are essential for physician practice. This study describes the development and implementation of a curricular intervention focused on improving the knowledge and confidence of preclerkship medical students\' prescription writing practices utilizing an interprofessional education model, with a focus on electronic prescribing.
    METHODS: Medicine and Pharmacy Faculty from a large, urban university collaborated to develop the content of the workshop and a simulation platform was used for the e-prescribing activity. Second-year medical students attended a mandatory in-person workshop facilitated by fourth-year pharmacy students. A pre and post knowledge test and confidence survey were used to assess students\' knowledge, confidence, and satisfaction. Outcomes from the knowledge test were evaluated with paired-samples proportions tests, and confidence survey data was evaluated with paired t-tests and Wilcoxon signed-rank tests in a pre-post study design.
    RESULTS: Students demonstrated a significant increase in prescription writing knowledge and confidence after completing the workshop. On the pre-test, 7% of students (21/284) completed the electronic prescribing assessment correctly and 51% of students (149/295) completed it correctly on the post-test. All items on the confidence survey showed a significant increase in pre- versus post-survey comparisons (p < 0.001).
    CONCLUSIONS: This interprofessional prescription writing workshop facilitated by pharmacy students shows promise for improving the knowledge and confidence of prescription writing and electronic prescribing practices in preclerkship medical students.
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  • 文章类型: Journal Article
    自精神分析成立以来,有关分析师从患者分析中发表材料的问题一直困扰着精神分析领域。伪装不可避免地会扭曲临床材料,并且通常不足以保护患者免受识别。请求患者同意发表会侵犯并改变分析过程。尽管分析师在发表的材料中对匿名的必要性基本上达成了共识,在使用患者的材料发表时,是否有必要获得患者的同意仍存在相当大的争论。在本文中,我将追踪伪装的演变意义,特别是同意,在分析文献中。我将特别强调不同的理论信仰体系,这些理论信仰体系是分析师决定请求患者同意或不同意的基础,我会争辩说,尽管请求同意的决定仍然是一个复杂的问题,这种连贯的信念系统应该在分析师关于同意的决定中发挥重要作用。我将用简短的例子说明我的思维过程和一些临床情况,最后我会提出一些切实可行的建议,希望这些将激发分析界的进一步讨论。
    Questions concerning analysts\' publication of material from the analyses of their patients have troubled the field of psychoanalysis since its inception. Disguise inevitably distorts the clinical material and is often insufficient to protect the patient from recognition. Asking the patient\'s consent for publication intrudes upon and alters the analytic process. While analysts have largely reached a consensus about the need for anonymity in published material, there is still considerable debate about the necessity for obtaining patients\' consent when using their material for publication. In this paper, I will trace the evolving meanings of disguise, and particularly of consent, in the analytic literature. I will place a particular emphasis upon the differing theoretical belief systems that underlie the analyst\'s decision to ask consent from her patient or not to do so, and I will argue that, although decisions on asking consent remain a complex matter, such coherent belief systems should play an important part in analysts\' decisions regarding consent. I will illustrate my thought processes and some clinical situations with brief examples, and I will conclude with some practical recommendations, with the hope that these will stimulate further discussion in the analytic community.
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  • 文章类型: Journal Article
    作者描述并在临床上说明了他所说的精神分析的本体论维度(与形成有关)和精神分析的认识论维度(与认识和理解有关)。精神分析的这些维度都不是以纯粹的形式存在的;它们是不可分割地交织在一起的。认识论精神分析,弗洛伊德和克莱因是主要的建筑师,涉及达成对游戏的理解的工作,梦想,和联想;而本体论精神分析,温尼科特和比昂是主要建筑师,涉及创造条件,使患者可能变得更加完整和真实。作者提供了精神分析的本体论维度的临床插图,在该过程中,患者更充分地成为存在的过程是通过患者感到对他正在和正在成为的个体的认可来促进的。这发生在分析中,其中分析师和患者发明了一种独特的精神分析形式。
    The author describes and then clinically illustrates what he terms the ontological dimension of psychoanalysis (having to do with coming into being) and the epistemological dimension of psychoanalysis (having to do with coming to know and understand). Neither of these dimensions of psychoanalysis exists in pure form; they are inextricably intertwined. Epistemological psychoanalysis, for which Freud and Klein are the principal architects, involves the work of arriving at understandings of play, dreams, and associations; while ontological psychoanalysis, for which Winnicott and Bion are the principal architects, involves creating conditions in which the patient might become more fully alive and real to him- or herself. The author provides clinical illustrations of the ontological dimension of psychoanalysis in which the process of the patient\'s coming more fully into being is facilitated by the experiences in which the patient feels recognized for the individual he is and is becoming. This occurs in an analysis in which the analyst and patient invent a form of psychoanalysis that is uniquely their own.
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  • 文章类型: Journal Article
    感知信心被认为是由评估潜在感知决策证据的元认知过程产生的。我们调查了感知证据的元认知访问是否受到视觉皮层的分层组织的限制,在这种情况下,高级表示往往更容易被明确审查。我们发现,人类观察者评估其信心的能力确实取决于他们在相同的刺激下执行的是高级任务还是低级任务,但也受到感知决定后很久发生的操纵的影响。对低级感知决策的信心随着决策和响应线索之间时间的延长而下降,尤其是当存在反向掩蔽时。对高级任务的信心不受反向掩蔽的影响,并受益于额外的时间。这些结果可以通过一个模型来解释,该模型假设置信度在很大程度上依赖于随着时间的推移而退化的视觉刺激的决策后内部表示。其中高级表示更持久。
    Perceptual confidence is thought to arise from metacognitive processes that evaluate the underlying perceptual decision evidence. We investigated whether metacognitive access to perceptual evidence is constrained by the hierarchical organization of visual cortex, where high-level representations tend to be more readily available for explicit scrutiny. We found that the ability of human observers to evaluate their confidence did depend on whether they performed a high-level or low-level task on the same stimuli, but was also affected by manipulations that occurred long after the perceptual decision. Confidence in low-level perceptual decisions degraded with more time between the decision and the response cue, especially when backward masking was present. Confidence in high-level tasks was immune to backward masking and benefitted from additional time. These results can be explained by a model assuming confidence heavily relies on postdecisional internal representations of visual stimuli that degrade over time, where high-level representations are more persistent.
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  • 文章类型: Journal Article
    算术运算是根植于数字抽象概念的复杂心理过程。尽管意义重大,负责这些操作的神经架构在很大程度上仍然未知。在这项研究中,我们探索了猴子背侧运动前皮层中特定神经元活动的存在,这些活动致力于数字加法和减法。我们的发现表明,许多这些神经活动经历了转变,将他们的编码从算术转换为电机表示。这些运动表示包括有关使用哪只手以及动作中涉及的步数的信息。我们一致观察到与右手编码加法相关的细胞,而那些链接到左边编码的减法,这表明算术运算和电机指令是相互交织的。此外,我们使用了一种多变量解码技术,根据这些与算术相关的细胞的活动来预测猴子的行为。被训练来辨别算术运算的分类器,包括加法和减法,不仅预测了算术决策,而且还预测了右手和左手的后续运动动作。这些发现意味着运动皮层功能的认知扩展,其中固有的神经系统被重新利用以促进算术运算。
    Arithmetic operations are complex mental processes rooted in the abstract concept of numerosity. Despite the significance, the neural architecture responsible for these operations has remained largely uncharted. In this study, we explored the presence of specific neuronal activity in the dorsal premotor cortex of the monkey dedicated to numerical addition and subtraction. Our findings reveal that many of these neural activities undergo a transformation, shifting their coding from arithmetic to motor representations. These motor representations include information about which hand to use and the number of steps involved in the action. We consistently observed that cells related to the right-hand encoded addition, while those linked to the left-hand encoded subtraction, suggesting that arithmetic operations and motor commands are intertwining with each other. Furthermore, we used a multivariate decoding technique to predict the monkey\'s behaviour based on the activity of these arithmetic-related cells. The classifier trained to discern arithmetic operations, including addition and subtraction, not only predicted the arithmetic decisions but also the subsequent motor actions of the right and left-hand. These findings imply a cognitive extension of the motor cortex\'s function, where inherent neural systems are repurposed to facilitate arithmetic operations.
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