Quasi-Experimental Designs
学术英语(医学)课后问题答案
Unit11、Some factors that may lead to the complaint:·Neuron overload·Patients* high expectations·Mistrust and misunderstanding between the patient and the doctor2、Mrs. Osorio’s condition:·A 56-year-old woman·Somewhat overweight·Reasonably well-controlled diabetes and hypertension·Cholesterol on the high side without any medications for it·Not enough exercises she should take·Her bones a little thin on her last DEXA scan3、Good things:·Blood tests done·Glucose a little better·Her blood pressure a little better but not so great Bad things:·Cholesterol not so great·Her weight a little up·Her bones a little thin on her last DEXA scan 44、The situation:·The author was in a moderate state of panic: juggling so many thoughts about Mrs. Osorio’s conditions and trying to resolve them all before the clock ran down.·Mrs. Osorio made a trivial request, not so important as compared to her conditions.·Mrs. Osorio seemed to care only about her “innocent —and completely justified —request”:the form signed by her doctor.·The doctor tried to or at least pretended to pay attention to the patient whilecompleting documentation.5、Similarities:·In computer multitasking, a microprocessor actually performs only one task at a time. Like microprocessors, we human beings carft actually concentrate on two thoughts at the same exact time. Multitasking is just an illusion both in computers and human beings.Differences:·The concept of multitasking originated in computer science.·At best, human beings can juggle only a handful of thoughts in a multitasking manner, but computers can do much better.·The more thoughts human beings juggle, the less human beings are able to attune fully to any given thought, but computers can do much better.6、·7 medical issues to consider·5 separate thoughts, at least, for each issue·7 x 5 = 35 thoughts·10 patients that afternoon·35 x 10 = 350 thoughts·5 residents under the authors supervision·4 patients seen by each resident·10 thoughts, at least, generated from each patient·5 x 4 x 10 = anther 200 thoughts·350 + 200 = 550 thoughts to be handled in total·If the doctor does a good job juggling 98% of the time, that still leaves about 10 thoughts that might get lost in the process.7、Possible solutions:·Computer-generated reminders·Case managers·Ancillary services·The simplest solution: timeUnit21、The author implies:• Peoples inadequate consciousness about the consequence of neglecting the re-emerging infectious diseases·Unjustifiability of peoples complacency about the prevention and control of the infectious diseases·Unfinished war against infectious diseases2、Victory declarations:·Surgeon General William Stewart's hyperbolic statement of closing “the book on infectious disease”.·A string of impressive victories incurred by antibiotics and vaccines·The thought that the war against infectious diseases was almost overWhat followed ever since:·Appearance of new diseases such as AIDS and Ebola·Comeback of the old afflictions:» Diphtheria in the former Soviet Union» TB in urban centers like New York City» Rising Group A streptococcal conditions like scarlet fever·The fear of a powerful new flu strain sweeping the world3、Elaborate on the joined battle:·WHO established a new division devoted to worldwide surveillance and control of emerging disease in October 1995.·CDC launched a prevention strategy in 1994.·Congress raised fund from $6.7 million in 1995 to $26 million in 1997.4、The borders are meaningless to pathogenic microbes, which can travel from one country to another remote country in a very short time.5、TB:·Prisons and homeless shelters as ideal places for TB spread·Emerging of drug-resistant strain or even multi-drug-resistant strain·A ride on the HIV w^on by attacking the immunocompromisedGroup A strep:·A change in virulence·Mutation in the exterior of the bacteriumFlu:Constant changes in its coat (surface antigens) and resultant changes in its level of virulence6、Examples:·Experiment in England is seeing the waning immunity because of no vaccination. ·Du e to poor vaccination efforts, the diphtheria situation in the former Soviet Union is serious. '• The vaccination rates are dropping in some American cities, and it will lead to more diphtheria and whooping cough.7、The four areas of focus:·The need for surveillance·Updated science capable of dealing with discoveries in the field·Appropriate prevention and control·Strong public health infrastructure8、The infectious diseases such as TB, flu, diphtheria and scarlet fever will never really go away, and the war against them will never end.Unit31、Terry's life before·She loved practicing Tae Kwon Do·She loved the surge of adrenaline that came with the controlled combat of tournaments.·She competed nationally, even won bronze medal in the trials for the Pan American Games.·She attended medical school, practiced as an internal medicine resident, and became an academic general internist.·She got married and got a son and a daughter.2、The symptoms of MS and autoimmune disease:·Loss of stamina and strength·Problems with balance·Bouts of horrific facial pain·Dips in visual acuity3、Terry did the following before she self-experimented:·She started injections.·She adopted many pharmacotherapies.·She began her own study of literature:» She read articles on websites such as PubMed.» She searched for articles testing new MS drugs in animal models.» She turned to articles concerning neurodegeneration of all types — dementia,Parkinson's disease, Huntington's disease, and Lou Gehrig's disease.» She relearned basic sciences such as cellular physiology, biochemistry, and neurophysiology.4、Approaches Terry mainly used:·Self-experimentation with various nutrients to slow neurodegeneration based on literature reports on animal models·Self-experimentation with neuromuscular electrical stimulation which is not an approved treatment for MS·Online search to identify the sources of micronutrients and having a new diet ·Reduction of food allergies and toxic load5、Cases mentioned in the text:·Increased mercury stores in the brains of people with dental fillings·High levels of the herbicide atrazine in private wells in Iowa·The strong association between pesticide exposure and neurodegeneration ·The association of single nucleotide polymorphisms involving metabolism of sulfur and/or B vitamins·Inefficient clearing of toxins6、With 70% to 90% of the risk for diabetes, heart disease, cancer, andautoimmunity being due to environmental factors other than the genes, we can take many health problems and the health care crisis under our control, for example, optimizing our nutrition and reducing our toxic load.Unit41、Two concepts:·Complementary medicine refers to the use of conventional therapies together with alternative treatments such as using acupuncture in addition to usual care to help lessen pain. Complementary and alternative medicine is shortened as CAM.·Alternative medicine refers to healing treatments that are not part of conventional therapies —like acupuncture, massage therapy, or herbal medicine. They are called so because people used to consider practices like these outside the mainstream.2·TCM does not require advanced, complicated, and in most cases, expensive facilities.·TCM employs needles, cups, coins, to mention but a few.·Most procedures and operations of TCM are noninvasive.·The substances used as medicine are raw herbs or abstracts from them, and they are indeed all natural, from nature.·TCM has been practiced as long as the Chinese history, so the efficiency i s proven and ensured.·Ongoing research around the world on acupuncture, herbs, massage and Tai Chi have shed light on some of the theories and practices of TCM3、It may be used as an adjunct treatment, an alternative, or part of a comprehensive management program for a number of conditions: post-operative and chemotherapy induced nausea and vomiting, post-operative dental pain, addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma.4、A well-justified NO:·More intense research to uncover additional areas for the use of acupuncture ·Higher adoption of acupuncture as a common therapeutic modality not only in treatment but also in prevention of disease and promotion of wellness ·Exploration and perfection of innovative methods of acupuncture point stimulation with technological advancement·Improved understanding of neuroscience and other aspects of human physiology and function by basic research on acupuncture·Greater interest by stakeholders·An increasing number of physician acupuncturists5、·Appropriate uses of herbs depend on proper guidance:» Proper TCM diagnosis of the zheng of the patient»Correct selection of the corresponding therapeutic strategies and principles that guide the choice of herbs and herbal formulas·Digression from either of the above guidence will lead to misuses of herbs, and will result in complications in patient6、·Randomized controlled trialsAdvantages:»Elimination of the potential bias in the allocation of participants to the intervention group or control group» Tendency to produce comparable groups» Guaranteed validity of statistical tests of significanceLimitations:» Difficulty in generalizing the results obtained from the selected sampling to the population as a whole»A poor choice for research where temporal factors are anissue»Extremely heavy resources, requiring very large samplegroups• Quasi-experimentsAdvantages:» Control group comparisons possible»Reduced threats to external validity as natural environments do notsuffer the same problems of artificiality as compared to a well-controlledlaboratory setting.»Generalizations of the findings to be made about population since quasiexperiments are natural experimentsLimitations:» Potential for non-equivalent groups as quasi-experimental designs donot use random sampling in constructing experimental and controlgroups.»Potential for low internal validity as a result of not using random sampling methods to construct the experimental and control groups• Cohort studiesAdvantages:»Clear indication of the temporal sequence between exposure and outcome» Particular use for evaluating the effects of rare or unusual exposure» Ability to examine multiple outcomes of a single risk factorLimitations:» Larger, longer, and more expensive» Prone to certain types of bias» Not practical for rare outcomes• Case-control studiesAdvantages:» The only feasible method in the case of rare diseases and those with long periods between exposure and outcome» Time and cost effective with relatively fewer subjects as compared to other observational methodsLimitations:» Unable to provide the same level of evidence as randomized controlled trials as it is observational in nature» Difficult to establish the timeline of exposure to disease outcome• “N=1” trialsAdvantages» Easy to manage» InexpensiveLimitations:» Findings difficult to be generalized to the whole population» Weakest evidence due to the number of the subject7、• Synthesis of evidence is completely dependent on:» The completeness of the literature search (unavailable for foreign studies)» The accuracy of evaluation·There are situations in which no answer can be found for the questions of interest in RCTs and database analyses.·There's the requirement of using less stringent information rather than “hard data”8、·Assessment of the intrinsic value of traditional medicine in society·Research and education·Political, economic, and social factorsUnit51、·Dis-ease refers to the imbalance arising from:» Continuous stress» Pain» Hardships·Disease is a health crisis ascribable to various dis-eases.·Prompting elimination of dis-eases can alleviate some diseases.2、·Wellness is a state involving every aspect of our being: body, mind and spirit.·Manifestations of a healthy person:» Energy and vitality» A certain zip in gait» A warm feeling of peace of heart seen through behavior3、·Constant messages, positive and negative,are sent to our mind about the health of our body.·Physical symptoms are suppressed by people who go through life on automatic pilot.·Being well equals to being disease- or illness-free in the minds of them.·They confused wellness with an absence of symptoms.4、·People's minds are infected by spin:» Half-truth» Fearful fictions» Blatant deceit: some as a form of self-deceit·Spin is a result of unconscious living.·The kind of falseness is pandemic.5·Our body intelligence is suppressed or dormant from a lack of use.·There are tremendous amount of stress on a daily basis.·Our bodies are easily ignored for years because of a lack of recreation time. ·Limiting, self-defeating and even self-destructive behaviors undermine our wellbeing and keep them from achieving our full potential.6·We grow more reluctant to take risks.·We lose the ability to feel and acknowledge our deepest feelings and the courage to speak our truth.·We continue to deny and repress our feelings to protect ourselves.·Fear, denial and disconnection from our bodies and feelings become an unconscious, self-protective habit, a kind of default response to life.7·A multi-faceted process:» Looking for roots of and resolutions for the issues in different dimensions» Building our wellness toolbox slowly» Picturing our whole state of being·Attention to the little stuff:» Examining our lives honestly and setting clear intentions to change» Striving to maintain a balance of our mind, body and spirit» Taking small steps in the way to perceive and resolve conflict8·Try to awaken and evolve in order to live more consciously.·Get in touch with our genuine feelings and emotions.·Come to terms with the toxic emotions1、In the past, most people died at home. But now, more and more people are caredin hospitals and nursing homes at their end of life, which of course brings a new set of questions to consider.2、·Sixty-four years old with a history of congestive heart failure·Deciding to do everything medically possible to extend his life·Availability of around-the-clock medical services and a full range of treatment choices, tests, and other medical care·Relaxed visiting hours, and personal items from home3、Availability of around-the-clock medical resources, including doctors, nurses, andfacility.4、·Taking on a job which is big physically, emotionally, and financially·Hiring a home nurse for additional help·Arranging for services (such as visiting nurses) and special equipment (like a hospital bed or bedside commode)5、·Health insurance·Planning by a professional, such as a hospital discharge plaimer or a social worker·Help from local governmental agencies·Doctor's supervision at home6、·Traditionally, it is only about symptom care.·Recently, it is a comprehensive approach to improving the quality of life for people who are living with potentially fatal diseases.·Stopping treatment specifically aimed at curing an illness equals discontinuing all treatment.·Choosing a hospice is a permanent decision.Unit71、·A dying patient·Decision whether to withdraw life-support machines and medication and start comfort measures·The family's refusal to make any decision or withdraw any treatments2、·The doctor as exclusive decision-maker·The patient as participant with little say in the final choice3、·Respect for the patient, especially the patient s autonomy·Patient-centered care·The patient as decision-maker based on the information provided by the doctor 4、·Patients are forced to make decisions they never want to.·Patients, at least a large majority of them, prefer their doctors to make final decisions.·Shifting responsibility of decision-making to patients will bring about more stress to patients and their families, especially when the best option for the patient is uncertain.5、Doctors are very much cautious about committing some kind of ethicaltransgression.6、·Shouldering responsibility together with the patient may be better than having the patient make decisions on their own.·Balancing between paternalism and respect for patients autonomy constitutes a large part of medical practice.Unit81、·Research:An activity to test hypothesis, to permit conclusions to be drawn, and thereby to develop or contribute to generalizable knowledge·Practice:Interventions solely to enhance the well-being of an individual patient or client and that have a reasonable expectation of success·Blurred distinction:» Cooccurrence of research and practice like in research designed to evaluate a therapy» Notable departures from standard practice being called “experimental” with the terms “experimenta l”and “research” carelessly defined2、·Autonomy:Individuals treated as autonomous agents .·Protection:Persons with diminished autonomy entitled to protection·A case in point:Prisoners involved in research3·“Do no harm” as the primary principle·Maximization of possible benefits and minimization of possible harms . ·Balance between benefits and potential risks involved in every step of seeding the benefits4、·“Do no harm” as a fundamental principle of medical ethics·Extension of it to the realm of research by Claude Bernard·Benefits and risks as a set “duet” in both medical practice and research5、·Unreasonable denial of entitled benefit and unduly imposed burden:Enrolment of patients in new drug trial: Who should be enrolled and who should not?·Equal treatment of equals:Determining factors of equality: age, sex, severity of the condition, financial status, social status6、·Definition:The opportunity to choose what shall or shall not happen to them ·Application:» A process rather than signing a written form» Adequate information as the premise» A well-informed decision as the expected result7、·Requirements for consent as entailed by the principle of respect for persons ·Risk/benefit assessment as entailed by the principle of beneficence·More requirements of fairness as entailed by the principle of justice: » At the individual level: fairness» At the social level: distinction between classes。
关于自闭症的英文
Movement of “evidence-based” into Education
Campbell Collaboration formed (in the US) in 1990 to conduct systematic reviews of educational and social policy practices What Works Clearinghouse funded by Institute of Education Sciences operates through CC Evidence for Policy and Practice Information Center (EPPIC) at the University of London Institute of Education was created in 1993 Center for Evidence-Based Practice at Orelena Puckett Institute in North Carolina
Superior to pill placebo or alternative treatment Equivalent to well established treatment
Large series of single-case design studies (n>9) that use good experimental design and compare the intervention to another treatment
States
New York Department of Health California Department of Human Resources National Academy of Sciences National Autism Center—National Standards Project National Academy of Pediatrics Rogers Dawson & Osterling Odom, Brown, et al. (2003)
准实验研究的英语
准实验研究的英语IntroductionExperimental research is a type of research design that involves manipulating one or more variables to observe the effect on another variable. However, in some situations, experimental research may not be feasible or ethical. In such cases, researchers may opt for quasi-experimental research, which is a type of research design that lacks the random assignment of participants to groups. This article explores quasi-experimental research, its types, advantages, and disadvantages.Types of Quasi-Experimental Research1. Pre-Experimental DesignsPre-experimental designs are the simplest type of quasi-experimental designs, and they involve measuring the dependent variable before and after an intervention. There are three types of pre-experimental designs: one-shot design, one-group pretest-posttest design, and static group comparison design.a. One-shot design: In this design, the researcher measures the dependent variable after the intervention. However, there is no control group, and hence, it isdifficult to determine whether the observed change is dueto the intervention or other factors.b. One-group pretest-posttest design: In this design,the researcher measures the dependent variable before and after the intervention. However, there is no control group, and hence, it is difficult to determine whether theobserved change is due to the intervention or other factors.c. Static group comparison design: In this design, the researcher compares the dependent variable in a group that received the intervention and a group that did not receive the intervention. However, the groups are not randomly assigned, and hence, there may be differences between the groups that may affect the results.2. Quasi-Experimental DesignsQuasi-experimental designs involve the manipulation ofan independent variable, but the participants are not randomly assigned to groups. There are four types of quasi-experimental designs: nonequivalent control group design,time-series design, interrupted time-series design, and regression-discontinuity design.a. Nonequivalent control group design: In this design, the researcher compares the dependent variable in a group that received the intervention and a group that did not receive the intervention. However, the groups are not randomly assigned, and hence, there may be differences between the groups that may affect the results.b. Time-series design: In this design, the researcher measures the dependent variable at multiple time points before and after the intervention. However, there is no control group, and hence, it is difficult to determine whether the observed change is due to the intervention or other factors.c. Interrupted time-series design: In this design, the researcher measures the dependent variable at multiple time points before and after the intervention. However, there is a control group, which allows the researcher to determine whether the observed change is due to the intervention or other factors.d. Regression-discontinuity design: In this design, the researcher selects participants based on a cutoff score on a continuous variable. Participants who score above the cutoff score receive the intervention, while those who score below the cutoff score do not receive the intervention. This design allows the researcher to determine whether the observed change is due to the intervention or other factors.Advantages of Quasi-Experimental Research1. Ethical ConsiderationsIn some situations, experimental research may not be ethical. For example, it may not be ethical to manipulate an independent variable that may harm participants. Quasi-experimental research provides an alternative to experimental research, which allows researchers to study the effect of an intervention without compromising the ethical considerations.2. Real-World SettingsQuasi-experimental research is often conducted in real-world settings, which enhances the ecological validity ofthe research findings. This means that the researchfindings are more likely to be applicable to real-world situations.3. Cost-EffectiveQuasi-experimental research is often less costly than experimental research. This is because it does not involve random assignment of participants to groups, which can be time-consuming and costly.Disadvantages of Quasi-Experimental Research1. Lack of ControlQuasi-experimental research lacks the control associated with experimental research. This means that there may be other factors that may affect the results, which may make it difficult to determine whether the observed change is due to the intervention or other factors.2. Selection BiasQuasi-experimental research may suffer from selection bias. This is because participants are not randomly assigned to groups, which may result in differences between the groups that may affect the results.3. Internal ValidityQuasi-experimental research may suffer from internal validity issues. This is because there may be other factors that may affect the results, which may make it difficult to determine whether the observed change is due to the intervention or other factors.ConclusionQuasi-experimental research is a type of research design that lacks the random assignment of participants to groups. It is often used in situations where experimental research may not be feasible or ethical. Quasi-experimental research has advantages such as being ethical, conducted in real-world settings, and cost-effective. However, it also has disadvantages such as lack of control, selection bias, and internal validity issues. Researchers should carefully consider the advantages and disadvantages of quasi-experimental research before deciding on the research design to use.。
quantitative 定量研究参考书
quantitative 定量研究参考书以下是一些定量研究的参考书籍:1. "Research Design: Qualitative, Quantitative, and Mixed Methods Approaches" by John W. Creswell - 这本书提供了对定性、定量和混合方法研究设计的详细介绍,适合初学者。
2. "Quantitative Social Science: An Introduction" by Kosuke Imai - 这本书介绍了社会科学中的定量研究方法和统计分析技术,并提供了实际应用案例。
3. "Applied Linear Statistical Models" by Michael H. Kutner, Christopher J. Nachtsheim, John Neter and William Li - 这本书介绍了线性统计模型及其在定量研究中的应用,包括回归分析、方差分析等。
4. "Designing and Conducting Survey Research: A Comprehensive Guide" by Louis M. Rea and Richard A. Parker - 这本书详细介绍了调查研究的设计和实施过程,包括样本策略、问卷设计、数据收集和分析等。
5. "Experimental and Quasi-Experimental Designs for Research" by Donald T. Campbell and Julian C. Stanley - 这本经典书籍介绍了实验和准实验研究设计的原理和应用,适合进行原因-结果推断的定量研究。
这些参考书籍都可以为进行定量研究的研究人员提供深入的理论基础和实用技巧。
(完整版)学术英语(医学)课后问题答案
Unit11、Some factors that may lead to the complaint:·Neuron overload·Patients* high expectations·Mistrust and misunderstanding between the patient and the doctor2、Mrs. Osorio’s condition:·A 56-year-old woman·Somewhat overweight·Reasonably well-controlled diabetes and hypertension·Cholesterol on the high side without any medications for it·Not enough exercises she should take·Her bones a little thin on her last DEXA scan3、Good things:·Blood tests done·Glucose a little better·Her blood pressure a little better but not so great Bad things:·Cholesterol not so great·Her weight a little up·Her bones a little thin on her last DEXA scan 44、The situation:·The author was in a moderate state of panic: juggling so many thoughts aboutMrs. Osorio’s conditions and trying to resolve them all before the clock ran down.·Mrs. Osorio made a trivial request, not so important as compared to her conditions.and completely justified ·Mrs. Osorio seemed to care only about her “innocent —:the form signed by her doctor.—request”·The doctor tried to or at least pretended to pay attention to the patient whilecompleting documentation.5、Similarities:·In computer multitasking, a microprocessor actually performs only one task at a time. Like microprocessors, we human beings carft actually concentrate on two thoughts at the same exact time. Multitasking is just an illusion both in computersand human beings.Differences:·The concept of multitasking originated in computer science.·At best, human beings can juggle only a handful of thoughts in a multitasking manner, but computers can do much better.·The more thoughts human beings juggle, the less human beings are able to attune fully to any given thought, but computers can do much better.6、·7 medical issues to consider·5 separate thoughts, at least, for each issue·7 x 5 = 35 thoughts·10 patients that afternoon·35 x 10 = 350 thoughts·5 residents under the authors supervision·4 patients seen by each resident·10 thoughts, at least, generated from each patient·5 x 4 x 10 = anther 200 thoughts·350 + 200 = 550 thoughts to be handled in total·If the doctor does a good job juggling 98% of the time, that still leaves about 10 thoughts that might get lost in the process.7、Possible solutions:·Computer-generated reminders·Case managers·Ancillary services·The simplest solution: timeUnit21、The author implies:? Peoples inadequate consciousness about the consequence of neglecting the re-emerging infectious diseases·Unjustifiability of peoples complacency about the prevention and control of theinfectious diseases·Unfinished war against infectious diseases2、Victory declarations:·Surgeon General William Stewart's hyperbolic statement of closing “the book on infectious disease”.·A string of impressive victories incurred by antibiotics and vaccines·The thought that the war against infectious diseases was almost overWhat followed ever since:·Appearance of new diseases such as AIDS and Ebola·Comeback of the old afflictions:? Diphtheria in the former Soviet Union? TB in urban centers like New York City? Rising Group A streptococcal conditions like scarlet fever·The fear of a powerful new flu strain sweeping the world3、Elaborate on the joined battle:·WHO established a new division devoted to worldwide surveillance and controlof emerging disease in October 1995.·CDC launched a prevention strategy in 1994.·Congress raised fund from $6.7 million in 1995 to $26 million in 1997.4、The borders are meaningless to pathogenic microbes, which can travel fromone country to another remote country in a very short time.5、TB:·Prisons and homeless shelters as ideal places for TB spread·Emerging of drug-resistant strain or even multi-drug-resistant strain·A ride on the HIV w^on by attacking the immunocompromisedGroup A strep:·A change in virulence·Mutation in the exterior of the bacteriumFlu:Constant changes in its coat (surface antigens) and resultant changes in its levelof virulence6、Examples:·Experiment in England is seeing the waning immunity because of no vaccination. ·Du e to poor vaccination efforts, the diphtheria situation in the former Soviet Union is serious. '? The vaccination rates are dropping in some American cities, and it will lead to more diphtheria and whooping cough.7、The four areas of focus:·The need for surveillance·Updated science capable of dealing with discoveries in the field·Appropriate prevention and control·Strong public health infrastructure8、The infectious diseases such as TB, flu, diphtheria and scarlet fever will never really go away, and the war against them will never end.Unit31、Terry's life before·She loved practicing Tae Kwon Do·She loved the surge of adrenaline that came with the controlled combat of tournaments.·She competed nationally, even won bronze medal in the trials for the Pan American Games.·She attended medical school, practiced as an internal medicine resident, and became an academic general internist.·She got married and got a son and a daughter.2、The symptoms of MS and autoimmune disease:·Loss of stamina and strength·Problems with balance·Bouts of horrific facial pain·Dips in visual acuity3、Terry did the following before she self-experimented:·She started injections.·She adopted many pharmacotherapies.·She began her own study of literature:? She read articles on websites such as PubMed.? She searched for articles testing new MS drugs in animal models.? She turned to articles concerning neurodegeneration of all types — dementia,Parkinson's disease, Huntington's disease, and Lou Gehrig's disease.? She relearned basic sciences such as cellular physiology, biochemistry, andneurophysiology.4、Approaches Terry mainly used:·Self-experimentation with various nutrients to slow neurodegeneration based on literature reports on animal models·Self-experimentation with neuromuscular electrical stimulation which is not an approved treatment for MS·Online search to identify the sources of micronutrients and having a new diet ·Reduction of food allergies and toxic load5、Cases mentioned in the text:·Increased mercury stores in the brains of people with dental fillings·High levels of the herbicide atrazine in private wells in Iowa·The strong association between pesticide exposure and neurodegeneration·The association of single nucleotide polymorphisms involving metabolism of sulfur and/or B vitamins·Inefficient clearing of toxins6、With 70% to 90% of the risk for diabetes, heart disease, cancer, andautoimmunity being due to environmental factors other than the genes, we cantake many health problems and the health care crisis under our control, for example, optimizing our nutrition and reducing our toxic load.Unit41、Two concepts:·Complementary medicine refers to the use of conventional therapies together with alternative treatments such as using acupuncture in addition to usual care to help lessen pain. Complementary and alternative medicine is shortened as CAM.·Alternative medicine refers to healing treatments that are not part of conventional therapies —like acupuncture, massage therapy, or herbal medicine. They are called so because people used to consider practices like these outside the mainstream.2·TCM does not require advanced, complicated, and in most cases, expensivefacilities.·TCM employs needles, cups, coins, to mention but a few.·Most procedures and operations of TCM are noninvasive.·The substances used as medicine are raw herbs or abstracts from them, andthey are indeed all natural, from nature.·TCM has been practiced as long as the Chinese history, so the efficiency i s proven and ensured.·Ongoing research around the world on acupuncture, herbs, massage and Tai Chi have shed light on some of the theories and practices of TCM3、It may be used as an adjunct treatment, an alternative, or part of a comprehensive management program for a number of conditions: post-operativeand chemotherapy induced nausea and vomiting, post-operative dental pain, addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma.4、A well-justified NO:·More intense research to uncover additional areas for the use of acupuncture ·Higher adoption of acupuncture as a common therapeutic modality not only in treatment but also in prevention of disease and promotion of wellness·Exploration and perfection of innovative methods of acupuncture point stimulation with technological advancement·Improved understanding of neuroscience and other aspects of human physiology and function by basic research on acupuncture·Greater interest by stakeholders·An increasing number of physician acupuncturists5、·Appropriate uses of herbs depend on proper guidance:? Proper TCM diagnosis of the zheng of the patient?Correct selection of the corresponding therapeutic strategies and principles that guide the choice of herbs and herbal formulas·Digression from either of the above guidence will lead to misuses of herbs, andwill result in complications in patient6、·Randomized controlled trialsAdvantages:?Elimination of the potential bias in the allocation of participants to the intervention group or control group? Tendency to produce comparable groups? Guaranteed validity of statistical tests of significanceLimitations:? Difficulty in generalizing the results obtained from the selected sampling to the population as a whole? A poor choice for research where temporal factors are anissue?Extremely heavy resources, requiring very large samplegroups? Quasi-experimentsAdvantages:? Control group comparisons possible?Reduced threats to external validity as natural environments do notsuffer the same problems of artificiality as compared to a well-controlledlaboratory setting.?Generalizations of the findings to be made about population since quasiexperiments are natural experimentsLimitations:? Potential for non-equivalent groups as quasi-experimental designs donot use random sampling in constructing experimental and controlgroups.?Potential for low internal validity as a result of not using random sampling methods to construct the experimental and control groups? Cohort studiesAdvantages:?Clear indication of the temporal sequence between exposure and outcome? Particular use for evaluating the effects of rare or unusual exposure? Ability to examine multiple outcomes of a single risk factorLimitations:? Larger, longer, and more expensive? Prone to certain types of bias? Not practical for rare outcomes? Case-control studiesAdvantages:? The only feasible method in the case of rare diseases and those with longperiods between exposure and outcome? Time and cost effective with relatively fewer subjects as compared to other observational methodsLimitations:? Unable to provide the same level of evidence as randomized controlled trialsas it is observational in nature? Difficult to establish the timeline of exposure to disease outcometrials? “N=1”Advantages? Easy to manage? InexpensiveLimitations:? Findings difficult to be generalized to the whole population? Weakest evidence due to the number of the subject7、? Synthesis of evidence is completely dependent on:? The completeness of the literature search (unavailable for foreign studies)? The accuracy of evaluation·There are situations in which no answer can be found for the questions of interest in RCTs and database analyses.·There's the requirement of using less stringent information rather than “hard data”8、·Assessment of the intrinsic value of traditional medicine in society·Research and education·Political, economic, and social factorsUnit51、·Dis-ease refers to the imbalance arising from:? Continuous stress? Pain? Hardships·Disease is a health crisis ascribable to various dis-eases.·Prompting elimination of dis-eases can alleviate some diseases.2、·Wellness is a state involving every aspect of our being: body, mind and spirit.·Manifestations of a healthy person:? Energy and vitality? A certain zip in gait? A warm feeling of peace of heart seen through behavior3、·Constant messages, positive and negative,are sent to our mind about the health of our body.·Physical symptoms are suppressed by people who go through life on automatic pilot.·Being well equals to being disease- or illness-free in the minds of them.·They confused wellness with an absence of symptoms.4、·People's minds are infected by spin:? Half-truth? Fearful fictions? Blatant deceit: some as a form of self-deceit·Spin is a result of unconscious living.·The kind of falseness is pandemic.5·Our body intelligence is suppressed or dormant from a lack of use.·There are tremendous amount of stress on a daily basis.·Our bodies are easily ignored for years because of a lack of recreation time. ·Limiting, self-defeating and even self-destructive behaviors undermine our wellbeing and keep them from achieving our full potential.6·We grow more reluctant to take risks.·We lose the ability to feel and acknowledge our deepest feelings and the courage to speak our truth.·We continue to deny and repress our feelings to protect ourselves.·Fear, denial and disconnection from our bodies and feelings become an unconscious, self-protective habit, a kind of default response to life.7·A multi-faceted process:? Looking for roots of and resolutions for the issues in different dimensions? Building our wellness toolbox slowly? Picturing our whole state of being·Attention to the little stuff:? Examining our lives honestly and setting clear intentions to change? Striving to maintain a balance of our mind, body and spirit? Taking small steps in the way to perceive and resolve conflict8·Try to awaken and evolve in order to live more consciously.·Get in touch with our genuine feelings and emotions.·Come to terms with the toxic emotionsUnit61、In the past, most people died at home. But now, more and more people are caredin hospitals and nursing homes at their end of life, which of course brings a newset of questions to consider.2、·Sixty-four years old with a history of congestive heart failure·Deciding to do everything medically possible to extend his life·Availability of around-the-clock medical services and a full range of treatmentchoices, tests, and other medical care·Relaxed visiting hours, and personal items from home3、Availability of around-the-clock medical resources, including doctors, nurses, andfacility.4、·Taking on a job which is big physically, emotionally, and financially·Hiring a home nurse for additional help·Arranging for services (such as visiting nurses) and special equipment (like ahospital bed or bedside commode)5、·Health insurance·Planning by a professional, such as a hospital discharge plaimer or a social worker·Help from local governmental agencies·Doctor's supervision at home6、·Traditionally, it is only about symptom care.·Recently, it is a comprehensive approach to improving the quality of life for people who are living with potentially fatal diseases.7、·Stopping treatment specifically aimed at curing an illness equals discontinuing all treatment.·Choosing a hospice is a permanent decision.Unit71、·A dying patient·Decision whether to withdraw life-support machines and medication and startcomfort measures·The family's refusal to make any decision or withdraw any treatments2、·The doctor as exclusive decision-maker·The patient as participant with little say in the final choice3、·Respect for the patient, especially the patient s autonomy·Patient-centered care·The patient as decision-maker based on the information provided by the doctor4、·Patients are forced to make decisions they never want to.·Patients, at least a large majority of them, prefer their doctors to make final decisions.·Shifting responsibility of decision-making to patients will bring about more stress to patients and their families, especially when the best option for the patient is uncertain.5、Doctors are very much cautious about committing some kind of ethicaltransgression.6、·Shouldering responsibility together with the patient may be better than havingthe patient make decisions on their own.·Balancing between paternalism and respect for patients autonomy constitutes alarge part of medical practice.Unit81、·Research:An activity to test hypothesis, to permit conclusions to be drawn, and thereby to develop or contribute to generalizable knowledge·Practice:Interventions solely to enhance the well-being of an individual patient or client and that have a reasonable expectation of success·Blurred distinction:? Cooccurrence of research and practice like in research designed to evaluate a therapy? Notable departures from standard practice being called “experimental” withl”and “research” carelessly definedthe terms “experimenta2、·Autonomy:Individuals treated as autonomous agents .·Protection:Persons with diminished autonomy entitled to protection·A case in point:Prisoners involved in research3·“Do no harm” as the primary principle·Maximization of possible benefits and minimization of possible harms .·Balance between benefits and potential risks involved in every step of seedingthe benefits4、·“Do no harm” as a fundamental principle of medical ethics·Extension of it to the realm of research by Claude Bernard·Benefits and risks as a set “duet” in both medical practice and research 5、·Unreasonable denial of entitled benefit and unduly imposed burden:Enrolment of patients in new drug trial: Who should be enrolled and who should not?·Equal treatment of equals:Determining factors of equality: age, sex, severity of the condition, financial status, social status6、·Definition:The opportunity to choose what shall or shall not happen to them·Application:? A process rather than signing a written form? Adequate information as the premise? A well-informed decision as the expected result7、·Requirements for consent as entailed by the principle of respect for persons ·Risk/benefit assessment as entailed by the principle of beneficence ·More requirements of fairness as entailed by the principle of justice: ? At the individual level: fairness? At the social level: distinction between classes。
方法论英语作文模板
方法论英语作文模板英文回答:Introduction.A research methodology provides a structured framework for conducting research. It outlines the steps involved in the research process, from problem formulation to data analysis and interpretation. A well-designed methodology ensures that the research is conducted systematically and rigorously, producing valid and reliable results.Components of a Research Methodology.1. Research Design:The research design determines the type of study to be conducted. Common research designs include experimental designs, quasi-experimental designs, non-experimental designs, and mixed-method designs.2. Data Collection Methods:Data collection methods are used to gather data from participants or sources. These methods include surveys, interviews, observations, experiments, and document analysis.3. Sampling:Sampling involves selecting a representative subset of the population to participate in the study. Sampling methods include random sampling, stratified sampling,cluster sampling, and convenience sampling.4. Data Analysis:Data analysis involves examining and interpreting the data collected. Statistical techniques, such as descriptive statistics, inferential statistics, and regression analysis, are often used for this purpose.5. Ethical Considerations:Researchers must adhere to ethical principles throughout the research process, including obtaining informed consent from participants, ensuring confidentiality, and avoiding any potential harm to participants.Conclusion.A research methodology provides a roadmap for conducting research that is methodologically sound and produces meaningful results. By following a structured approach, researchers can increase the validity and reliability of their findings, enhancing the credibility and impact of their research.中文回答:引言。
Quasi-experimental designs本
designs
– the differential research design – the posttest-only nonequivalent control group design – the pretest-posttest nonequivalent control group design
的被试,而是根据被试特点如性别、种族或人
格特征自然地分配各组被试,然后测量每一处 理条件下被试获得的一系列分数。研究的目的 是确定两组被试的分数是否存在差异。
区 分 性 研 究 与 相 关 研 究 的 对 比
3. Nonequivalent group designs
• 非等控制组后测设计(Post-test only
• 在很多情况下,研究者很难或不可能完全
满足真实验的要求,在自然情境下进行的
应用性研究尤其如此。
• 当可以操纵自变量、测量因变量但不能对
被试进行随机分配时,所使用的设计就是
准实验设计。
2. Introduction to the quasi experiment
• quasi-experimental research strategy
复习辅导
• • • 单项选择题(10) 研究案例分析(18) 图表分析或研究设计(12)
3. Nonequivalent group designs
• 非等控制组前测后测设计(Pretest-posttest
nonequivalent control group design):是指比较
两个非等组。一个组被测量两次——即对其实施 处理前后各测一次;另一组也被测量两次,但两 次之间不施加任何处理。
实验研究方法
其中C1=(YA1+YB1+YC1)/3, C2=(YA2+YB2+YC2)/3, C3=(YA3+YB3+YC3)/3。
实验结果为分别比较X1、X2、X3 各因素的作用效果之间的差异情 况,即比较C1-C2或C2-C3或C3 -C1之间是否存在差异。
实验研究方法
六、实验法的效度
内在效度。是指因变量产生的变化来自于自变量的程度。 如果一个实验设计,除了研究者所控制的实验变量外,还 有其它变量也影响反应变量的变化,使研究者无法正确解 释所得的实验结果,则该项实验设计的内在效度就很差。 内在效度的影响因素:生长和成熟;前测的影响;测量手 段;取样偏差等。 外在效度。是指实验结果的可推论性,即代表性问题,表 示实验结果是否适合于推广应用,能否做到对同类事物现 象作解析、预测和控制。如果实验结果只适用于某一范围 (如年龄、性别等)而不能推广到其他同类事物现象,则 表明其外在效度比较差。外在效度的影响因素:实验者的 主观因素;实验情境的过分人工化、因变量的侧量等 常见提高效度的方法:排除法、纳入法、随机法和循环法 等。
一项实验中,实验刺激对于实验对象和参与实验的观测人 员来说都是未知的。实验刺激是实验人员和实验对象以外 的第三方指定的。
新药实验、安慰剂效应
实验研究方法
五、实验法的基本模式
(一)单组实验
这种研究设计中只安排一个被试组,进行方法是:在一个时间 段中,按固定的周期对被试组成员进行一系列的某种测试,然 后让被试组接受实验处理(如某种与测试内容有关的训练或指 导等),之后又按原来的周期安排同样的一系列测试。单组前 测后测时间系列准实验设计程序模式如下表所示。
通过实验,比较Y1和Y2的差异性(相同或不同), 便可知道X所起的作用。 举例:霍桑实验、破窗效应、从众效应等
实验设计与数据处理相关参考文献
实验设计与数据处理相关参考文献实验设计和数据处理是科研工作中非常重要的环节,有很多经典的参考文献可以供我们学习和借鉴。
以下是一些与实验设计和数据处理相关的经典参考文献:1. Campbell, D. T., & Stanley, J. C. (1963). Experimental and quasi-experimental designs for research. This book provides a comprehensive overview of experimental and quasi-experimental research designs, and it is considered a classic in the field of research methodology.2. Kirk, R. E. (2016). Experimental design: Procedures for the behavioral sciences. This book offers a detailed and practical guide to experimental design, covering a wide range of experimental techniques and designs commonly used in the behavioral sciences.3. Montgomery, D. C. (2017). Design and analysis of experiments. This book provides a comprehensiveintroduction to the principles of experimental design andthe statistical analysis of experimental data, with a focus on practical applications in engineering and the physical sciences.4. Thabane, L., Mbuagbaw, L., Zhang, S., Samaan, Z., Marcucci, M., Ye, C., ... & Goldsmith, C. H. (2013). A tutorial on sensitivity analyses in clinical trials: the what, why, when and how. This article offers a detailed tutorial on the importance of sensitivity analyses inclinical trials, providing valuable insights into the handling and processing of experimental data in the medical and clinical research fields.5. Wickens, T. D. (2002). Elementary signal detection theory. This book provides a comprehensive overview ofsignal detection theory and its applications in theanalysis of experimental data, particularly in the fieldsof psychology and human factors.这些参考文献涵盖了实验设计和数据处理的基本原理和方法,涉及了多个学科领域,包括社会科学、工程学和医学等。
随机对比实验名词解释
随机对比实验名词解释随机对比实验是一种科学研究设计方法,旨在评估两个或多个处理条件之间的差异。
在随机对比实验中,参与者被随机分配到不同的处理条件中,以消除潜在的偏倚,并使得研究结果具有可靠性和有效性。
以下是对随机对比实验的详细解释和相关参考内容。
随机对比实验解释:随机对比实验是一种实验设计方法,用于比较两个或多个处理条件之间的效果差异。
在随机对比实验中,参与者被随机分配到不同的处理条件中,以确保分配的公平性和随机性。
通过使用随机分配,研究人员可以消除潜在的偏倚,并保证实验结果具有可靠性和有效性。
在随机对比实验中,研究人员通常会选择一个或多个处理变量,并对这些变量进行操作,以比较其对研究结果的影响。
随机对比实验的步骤可以按照以下顺序进行:1. 选择研究主题和目的。
2. 确定处理变量和响应变量。
3. 创建实验设计,包括比较组的数量和大小。
4. 随机分配参与者到不同的处理条件中。
5. 实施实验并收集数据。
6. 分析数据以比较不同处理条件的效果。
7. 从结果中得出结论,并将其推广到更大的总体中。
随机对比实验的优点:随机对比实验是一种强有力的研究设计方法,具有以下几个优点:1. 随机分配:通过随机分配参与者到不同的处理条件中,可以消除潜在的偏倚,确保实验组和对照组之间的比较是公平和随机的。
2. 可靠性和有效性:由于随机对比实验的严格设计和控制,实验结果具有较高的可靠性和有效性。
通过随机分配和大样本量的使用,可以减小随机误差,并提高结果的稳定性。
3. 因果关系:随机对比实验可以帮助研究人员确定处理变量和响应变量之间的因果关系,从而使得结论更具有说服力和可信度。
4. 推广性:随机对比实验可以使研究结果更具有推广性,因为可随机对比不同人群、不同地区和不同背景的结果。
参考内容:以下是一些与随机对比实验相关的参考内容,可以进一步了解该方法的细节和应用:1. "Experimental and Quasi-Experimental Designs for Generalized Causal Inference" - Donald T. Campbell and Julian C. Stanley (1963) - 这本教科书介绍了实验设计和因果推论的基本原理,并重点介绍了随机对比实验的原则和应用。
第五章 实验设计讲解
优点:能较好控制“成熟”因素、降低历史因素对内部效度的影响,可控
制测验因素的干扰,有时能控制统计回归的因素;
缺点:不能控制与实验处理同时发生的偶发事件的影响,不能排除与自变
量同时出现的附加变量的影响,不易控制测验与实验处理的交互作用,多
次施测可能降低或增加被试对实验处理的敏感性。
X
980
A
780
B
C
(二)实验组控制组后测设计
1.设计模式 2.数据统计检验 3.
1.设计模式
R1
X
O1
R2
-
O2
注意:独立样本T检验来进行差异判断。
差异?
例:观看暴力电视对攻击行为的影响.
实验组儿童 控制组儿童
看暴力电 视 -
攻击次 数 攻击 次数
差异?
2.数据的统计检验
独立样本平均数的t-检验:?O1 = O2 曼-惠特尼(Mann-Whitney)U-检验 或 中位数检 验(非参数检验)
被试内设计 被试间素与水平
因素:自变量, 可以是刺激变量,也可以是被试变量 水平:因素的特定值称为“水平”或称为“处理”
水平结合
一个因素的某一水平与另一因素的某一水平的结合,成为一个水平结 合,或者一个处理结合 例如:噪声强度两个水平:40分贝(A1)、60分贝(A2); 任务难度两个水平:高(B1)、低(B2) 包含的实验处理有2×2=4
3、三种分配区组被试的方式:
A、一名被试作为一个区组重复接受H种处理,即重复测量设计
B、采用配对法,把在某些特性相同的H个(或H的倍数)被试加 以配对,这时每个配对组为一个区组,H个被试随机分配到H个处 理中 C、区组内的基本单元是一个团体或一个子集,如一个年级为一 个区组,用随机分配的方法给予每个班的实验处理方面
实验设计 英语
实验设计英语Experimental Design (实验设计) is a method used to plan and conduct scientific experiments in order to obtain reliable and valid results. It involves identifying the variables that will be tested, determining the sample size, selecting the appropriate statistical analysis, and controlling for extraneous variables that may affect the outcome of the experiment.There are several types of experimental designs, including:1. Pre-experimental designs: These are the simplest designs and involve only one group of participants. Examples include one-shot case study, one-group pretest-posttest design, and static-group comparison.2. Quasi-experimental designs: These designs involve two or more groups of participants, but lack random assignment. Examples include non-equivalent control group design, time-series design, and interrupted time-series design.3. True experimental designs: These designs involve two or more groups of participants and include random assignment. Examples include randomized control trial, factorial design, and repeated measures design.Experimental design is important because it allows researchers to control for extraneous variables and determine causality. By carefully planning and conducting experiments, researchers can obtain reliable and valid results that can be used to make informed decisions and advance scientific knowledge.。
学术英语课后问题答案
Unit11、Some factors that may lead to the complaint:·Neuron overload·Patients* high expectations·Mistrust and misunderstanding between the patient and the doctor2、Mrs. Osorio’s condition:·A 56-year-old woman·Somewhat overweight·Reasonably well-controlled diabetes and hypertension·Cholesterol on the high side without any medications for it·Not enough exercises she should take·Her bones a little thin on her last DEXA scan3、 Good things:·Blood tests done·Glucose a little better·Her blood pressure a little better but not so great Bad things:·Cholesterol not so great·Her weight a little up·Her bones a little thin on her last DEXA scan 44、The situation:·The author was in a moderate state of panic: juggling so many thoughts about Mrs. Osorio’s conditions and trying to resolve them all before the clock ran down.·Mrs. Osorio made a trivial request, not so important as compared to her conditions.·Mrs. Osorio seemed to care only about her “innocent — and completely justified —request”: the form signed by her doctor.·The doctor tried to or at least pretended to pay attention to the patient while completing documentation.5、Similarities:·In computer multitasking, a microprocessor actually performs only one task at a time. Like microprocessors, we human beings carft actually concentrate on two thoughts at the same exact time. Multitasking is just an illusion both in computers and human beings.Differences:·The concept of multitasking originated in computer science.·At best, human beings can juggle only a handful of thoughts in a multitasking manner, but computers can do much better.·The more thoughts human beings juggle, the less human beings are able to attune fully to any given thought, but computers can do much better.6、·7 medical issues to consider·5 separate thoughts, at least, for each issue·7 x 5 = 35 thoughts·10 patients that afternoon·35 x 10 = 350 thoughts·5 residents under the authors supervision·4 patients seen by each resident·10 thoughts, at least, generated from each patient·5 x 4 x 10 = anther 200 thoughts·350 + 200 = 550 thoughts to be handled in total·If the doctor does a good job juggling 98% of the time, that still leaves about 10 thoughts that might get lost in the process.7、Possible solutions:·Computer-generated reminders·Case managers·Ancillary services·The simplest solution: timeUnit21、The author implies:• Peoples inadequate consciousness about the consequence of neglecting the re- emerging infectious diseases·Unjustifiability of peoples complacency about the prevention and control of the infectious diseases·Unfinished war against infectious diseases2、Victory declarations:·Surgeon General William Stewart's hyperbolic statement of closing “the book on infectious disease”.·A string of impressive victories incurred by antibiotics and vaccines ·The thought that the war against infectious diseases was almost overWhat followed ever since:·Appearance of new diseases such as AIDS and Ebola·Comeback of the old afflictions:» Diphtheria in the former Soviet Union» TB in urban centers like New York City» Rising Group A streptococcal conditions like scarlet fever·The fear of a powerful new flu strain sweeping the world3、Elaborate on the joined battle:·WHO established a new division devoted to worldwide surveillance and control of emerging disease in October 1995.·CDC launched a prevention strategy in 1994.·Congress raised fund from $ million in 1995 to $26 million in 1997.4、The borders are meaningless to pathogenic microbes, which can travel from one country to another remote country in a very short time.5、TB:·Prisons and homeless shelters as ideal places for TB spread·Emerging of drug-resistant strain or even multi-drug-resistant strain ·A ride on the HIV w^on by attacking the immunocompromisedGroup A strep:·A change in virulence·Mutation in the exterior of the bacteriumFlu:Constant changes in its coat (surface antigens) and resultant changes in its level of virulence6、Examples:·Experiment in England is seeing the waning immunity because of no vaccination.·D ue to poor vaccination efforts, the diphtheria situation in the former Soviet Union is serious. '• The vaccination rates are dropping in some American cities, and it will lead to more diphtheria and whooping cough.7、The four areas of focus:·The need for surveillance·Updated science capable of dealing with discoveries in the field ·Appropriate prevention and control·Strong public health infrastructure8、The infectious diseases such as TB, flu, diphtheria and scarlet fever will never really go away, and the war against them will never end.Unit31、Terry's life before·She loved practicing Tae Kwon Do·She loved the surge of adrenaline that came with the controlled combat of tournaments.·She competed nationally, even won bronze medal in the trials for the Pan American Games.·She attended medical school, practiced as an internal medicine resident, and became an academic general internist.·She got married and got a son and a daughter.2、The symptoms of MS and autoimmune disease:·Loss of stamina and strength·Problems with balance·Bouts of horrific facial pain·Dips in visual acuity3、Terry did the following before she self-experimented:·She started injections.·She adopted many pharmacotherapies.·She began her own study of literature:» She read articles on websites such as PubMed.» She searched for articles testing new MS drugs in animal models.» She turned to articles concerning neurodegeneration of all types —dementia, Parkinson's disease, Huntington's disease, and Lou Gehrig's disease.» She relearned basic sciences such as cellular physiology, biochemistry, and neurophysiology.4、Approaches Terry mainly used:·Self-experimentation with various nutrients to slow neurodegeneration based on literature reports on animal models·Self-experimentation with neuromuscular electrical stimulation which is not an approved treatment for MS·Online search to identify the sources of micronutrients and having a new diet·Reduction of food allergies and toxic load5、Cases mentioned in the text:·Increased mercury stores in the brains of people with dental fillings·High levels of the herbicide atrazine in private wells in Iowa·The strong association between pesticide exposure and neurodegeneration ·The association of single nucleotide polymorphisms involving metabolism of sulfur and/or B vitamins·Inefficient clearing of toxins6、With 70% to 90% of the risk for diabetes, heart disease, cancer, andautoimmunity being due to environmental factors other than the genes, we can take many health problems and the health care crisis under our control, for example, optimizing our nutrition and reducing our toxic load.Unit41、Two concepts:·Complementary medicine refers to the use of conventional therapies together with alternative treatments such as using acupuncture in addition to usual care to help lessen pain. Complementary and alternative medicine is shortened as CAM.·Alternative medicine refers to healing treatments that are not part of conventional therapies —like acupuncture, massage therapy, or herbal medicine. They are called so because people used to consider practices like these outside the mainstream.2·TCM does not require advanced, complicated, and in most cases, expensive facilities.·TCM employs needles, cups, coins, to mention but a few.·Most procedures and operations of TCM are noninvasive.·The substances used as medicine are raw herbs or abstracts from them, and they are indeed all natural, from nature.·TCM has been practiced as long as the Chinese history, so the efficiency proven and ensured.is·Ongoing research around the world on acupuncture, herbs, massage and Tai Chi have shed light on some of the theories and practices of TCM3、It may be used as an adjunct treatment, an alternative, or part of a comprehensive management program for a number of conditions: post-operative and chemotherapy induced nausea and vomiting, post-operative dental pain, addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma.4、A well-justified NO:·More intense research to uncover additional areas for the use of acupuncture ·Higher adoption of acupuncture as a common therapeutic modality not only in treatment but also in prevention of disease and promotion of wellness ·Exploration and perfection of innovative methods of acupuncture point stimulation with technological advancement·Improved understanding of neuroscience and other aspects of human physiology and function by basic research on acupuncture·Greater interest by stakeholders·An increasing number of physician acupuncturists5、·Appropriate uses of herbs depend on proper guidance:» Proper TCM diagnosis of the zheng of the patient» Correct selection of the corresponding therapeutic strategies and principles that guide the choice of herbs and herbal formulas ·Digression from either of the above guidence will lead to misuses of herbs, and will result in complications in patient6、·Randomized controlled trialsAdvantages:» Elimination of the potential bias in the allocation of participants to the intervention group or control group» Tendency to produce comparable groups» Guaranteed validity of statistical tests of si gnificanceLimitations:» Difficulty in generalizing the results obtained from the selected sampling to the population as a whole» A poor choice for research where temporal factors are anissue» Extremely heavy resources, requiring very large samplegroups• Quasi-experimentsAdvantages:» Control group comparisons possible» Reduced threats to external validity as natural environments donot suffer the same problems of artificiality as compared to awell-controlled laboratory setting.» Generaliza tions of the findings to be made about population since quasiexperiments are natural experimentsLimitations:» Potential for non-equivalent groups as quasi-experimental designsdo not use random sampling in constructing experimental and controlgroups.» Potential for low internal validity as a result of not using random sampling methods to construct the experimental and control groups• Cohort studiesAdvantages:» Clear indication of the temporal sequence between exposure and outcome» Particular use for evaluating the effects of rare or unusualexposure» Ability to examine multiple outcomes of a single risk factorLimitations:» Larger, longer, and more expensive» Prone to certain types of bias» Not practical for rare outcomes• Case-control studiesAdvantages:» The only feasible method in the case of rare diseases and those with long periods between exposure and outcome» Time and cost effective with relatively fewer subjects as compared to other observational methodsLimitations:» Un able to provide the same level of evidence as randomized controlled trials as it is observational in nature» Difficult to establish the timeline of exposure to disease outcome • “N=1” trialsAdvantages» Easy to manage» InexpensiveLimitations:» Findings difficult to be generalized to the wholepopulation» Weakest evidence due to the number of the subject7、• Synthesis of evidence is completely dependent on:» The completeness of the literature search (unavailable for foreign studies)» The accuracy of evaluation·There are situations in which no answer can be found for the questions of interest in RCTs and database analyses.·There's the requirement of using less stringent information rather than “hard data”8、·Assessment of the intrinsic value of traditional medicine in society ·Research and education·Political, economic, and social factorsUnit51、·Dis-ease refers to the imbalance arising from:» Continuous stress» Pain» Hardships·Disease is a health crisis ascribable to various dis-eases.·Prompting elimination of dis-eases can alleviate some diseases.2、·Wellness is a state involving every aspect of our being: body, mind and spirit.·Manifestations of a healthy person:» Energy and vitality» A c ertain zip in gait» A warm feeling of peace of heart seen through behavior3、·Constant messages, positive and negative,are sent to our mind about the health of our body.·Physical symptoms are suppressed by people who go through life on automatic pilot.·Being well equals to being disease- or illness-free in the minds of them.·They confused wellness with an absence of symptoms.4、·People's minds are infected by spin:» Half-truth» Fearful fictions» Blatant deceit: some as a form of sel f-deceit·Spin is a result of unconscious living.·The kind of falseness is pandemic.5·Our body intelligence is suppressed or dormant from a lack of use.·There are tremendous amount of stress on a daily basis.·Our bodies are easily ignored for years because of a lack of recreation time.·Limiting, self-defeating and even self-destructive behaviors undermine our wellbeing and keep them from achieving our full potential.6·We grow more reluctant to take risks.·We lose the ability to feel and acknowledge our deepest feelings and the courage to speak our truth.·We continue to deny and repress our feelings to protect ourselves.·Fear, denial and disconnection from our bodies and feelings become an unconscious, self-protective habit, a kind of default response to life.·A multi-faceted process:» Looking for roots of and resolutions for the issues in different dimensions» Building our wellness toolbox slowly» Picturing our whole state of being·Attention to the little stuff:» Examining ou r lives honestly and setting clear intentions to change » Striving to maintain a balance of our mind, body and spirit» Taking small steps in the way to perceive and resolve conflict8·Try to awaken and evolve in order to live more consciously.·Get in touch with our genuine feelings and emotions.·Come to terms with the toxic emotionsUnit61、In the past, most people died at home. But now, more and more people arecared in hospitals and nursing homes at their end of life, which of course brings a new set of questions to consider.2、·Sixty-four years old with a history of congestive heart failure·Deciding to do everything medically possible to extend his life·Availability of around-the-clock medical services and a full range of treatment choices, tests, and other medical care·Relaxed visiting hours, and personal items from home3、Availability of around-the-clock medical resources, including doctors,nurses, and facility.·Taking on a job which is big physically, emotionally, and financially ·Hiring a home nurse for additional help·Arranging for services (such as visiting nurses) and special equipment (like a hospital bed or bedside commode)5、·Health insurance·Planning by a professional, such as a hospital discharge plaimer or a social worker·Help from local governmental agencies·Doctor's supervision at home6、·Traditionally, it is only about symptom care.·Recently, it is a comprehensive approach to improving the quality of life for people who are living with potentially fatal diseases.7、·Stopping treatment specifically aimed at curing an illness equals discontinuing all treatment.·Choosing a hospice is a permanent decision.Unit71、·A dying patient·Decision whether to withdraw life-support machines and medication and start comfort measures·The family's refusal to make any decision or withdraw any treatments 2、·The doctor as exclusive decision-maker·The patient as participant with little say in the final choice3、·Respect for the patient, especially the patient s autonomy·Patient-centered care·The patient as decision-maker based on the information provided by the doctor4、·Patients are forced to make decisions they never want to.·Patients, at least a large majority of them, prefer their doctors to make final decisions.·Shifting responsibility of decision-making to patients will bring about more stress to patients and their families, especially when the best option for the patient is uncertain.5、Doctors are very much cautious about committing some kind of ethicaltransgression.6、·Shouldering responsibility together with the patient may be better than having the patient make decisions on their own.·Balancing between paternalism and respect for patients autonomy constitutesa large part of medical practice.Unit81、·Research:An activity to test hypothesis, to permit conclusions to be drawn, and thereby to develop or contribute to generalizable knowledge·Practice:Interventions solely to enhance the well-being of an individual patient or client and that have a reasonable expectation of success·Blurred distinction:» Cooccurrence of research and practice like in research designed to evaluate a therapy» Notable departures from standard practice being called “experimental”with the terms “experimenta l”and “research” c arelessly defined2、·Autonomy:Individuals treated as autonomous agents .·Protection:Persons with diminished autonomy entitled to protection·A case in point:Prisoners involved in research3·“Do no harm” as the primary principle·Maximization of possible benefits and minimization of possible harms .·Balance between benefits and potential risks involved in every step of seeding the benefits4、·“Do no harm” as a fundamental principle of medical ethics·Extension of it to the realm of research by Claude Bernard·Benefits and risks as a set “duet” in both medical practice and research 5、·Unreasonable denial of entitled benefit and unduly imposed burden:Enrolment of patients in new drug trial: Who should be enrolled and who should not?·Equal treatment of equals:Determining factors of equality: age, sex, severity of the condition, financial status, social status6、·Definition:The opportunity to choose what shall or shall not happen to them ·Application:» A process rather than signing a written form» Adequate information as the premise» A well-informed decision as the expected result7、·Requirements for consent as entailed by the principle of respect for persons ·Risk/benefit assessment as entailed by the principle of beneficence ·More requirements of fairness as entailed by the principle of justice:» At the individual level: fairness» At the social level: distinction between classes。
非实验设计
真实验设计、准实验设计& 非实验设计实验控制→实验控制→无实验控制严格一般Ture Experiment Quais-experiment Non-experimentCatalog1.非实验设计2.准实验设计一、准实验设计(quasi-experiment design)1.定义:指未对自变量实施充分控制,但使用真正实验的某些方法搜集、整理以及统计分析数据的方法。
它是介于非实验设计和真实验设计之间的实验设计,对额外变量的控制比非实验设计要严格一些,但不如真实验设计控制的充分和广泛。
通常情况下,准实验设计研究中不容易随机的挑选和分配被试,只能选择而不能改变。
由此可能产生额外变量与自变量的混淆。
这也称为现场研究(field study)。
现场研究是在实际工作,学习和生活情景中进行的研究。
实验室研究成果的推广与社会生活密切相关→→→→→→→→→→→适用范围的问题的研究受伦理限制的研究2.准实验设计的类型(1)单组准实验设计时间序列设计相等时间样本设计(2)多组准实验设计不相等实验组控制组前测后测设计不相等实验组控制组前测后测时间序列设计平衡设计1 时间序列设计(1)概念及模式指对一组被试或个体进行一系列周期性测量,并在测量的时间序列中引进实验处理(X),然后观测引进实验处理后的一系列测量结果,并与引入实验处理X前后的一系列测量结果想比较,研究插入实验处理前后测量结果的变化趋势,从而推断实验处理是否产生效果。
模式如下:O1 O2 O3 O4 X O5 O6 O7 O8时间序列设计所研究的是由O1-O8的总体趋势的结论,而不是仅考虑某一段的局部特征!(2)设计的显著性检验用统计方法考察实验处理前的回归直线与实验处理后的回归直线是否有显著差异,即确定O1~O4对应点的回归直线与O5~O8对应点的回归直线是否有显著差异。
(3)评价较好地控制“成熟”因素可能控制统计回归因素不能控制偶发事件的影响,也称为历史因素多次施测的影响2.相等时间样本设计(1)概念及模式在心理研究中,与选择两等价样本组(实验组和控制组)相对应,当只有一组被试时,常使用两相等的时间样本,在其中的一个时间样本中不出现实验变量,而采用常规安排X0。
学术英语(医学)课后问答规范标准答案
Unit11、Some factors that may lead to the complaint:·Neuron overload·Patients* high expectations·Mistrust and misunderstanding between the patient and the doctor2、Mrs. Osorio’s condition:·A 56-year-old woman·Somewhat overweight·Reasonably well-controlled diabetes and hypertension·Cholesterol on the high side without any medications for it·Not enough exercises she should take·Her bones a little thin on her last DEXA scan3、Good things:·Blood tests done·Glucose a little better·Her blood pressure a little better but not so great Bad things:·Cholesterol not so great·Her weight a little up·Her bones a little thin on her last DEXA scan 44、The situation:·The author was in a moderate state of panic: juggling so many thoughts about Mrs. Osorio’s conditions and trying to resolve them all before the clock ran down.·Mrs. Osorio made a trivial request, not so important as compared to her conditions.·Mrs. Osorio seemed to care only about her “innocent —and completely justified —request”:the form signed by her doctor.·The doctor tried to or at least pretended to pay attention to the patient whilecompleting documentation.5、Similarities:·In computer multitasking, a microprocessor actually performs only one task at a time. Like microprocessors, we human beings carft actually concentrate on two thoughts at the same exact time. Multitasking is just an illusion both in computers and human beings.Differences:·The concept of multitasking originated in computer science.·At best, human beings can juggle only a handful of thoughts in a multitasking manner, but computers can do much better.·The more thoughts human beings juggle, the less human beings are able to attune fully to any given thought, but computers can do much better.6、·7 medical issues to consider·5 separate thoughts, at least, for each issue·7 x 5 = 35 thoughts·10 patients that afternoon·35 x 10 = 350 thoughts·5 residents under the authors supervision·4 patients seen by each resident·10 thoughts, at least, generated from each patient·5 x 4 x 10 = anther 200 thoughts·350 + 200 = 550 thoughts to be handled in total·If the doctor does a good job juggling 98% of the time, that still leaves about 10 thoughts that might get lost in the process.7、Possible solutions:·Computer-generated reminders·Case managers·Ancillary services·The simplest solution: timeUnit21、The author implies:• Peoples inadequate consciousness about the consequence of neglecting the re-emerging infectious diseases·Unjustifiability of peoples complacency about the prevention and control of the infectious diseases·Unfinished war against infectious diseases2、Victory declarations:·Surgeon General William Stewart's hyperbolic statement of closing “the book on infectious disease”.·A string of impressive victories incurred by antibiotics and vaccines·The thought that the war against infectious diseases was almost overWhat followed ever since:·Appearance of new diseases such as AIDS and Ebola·Comeback of the old afflictions:» Diphtheria in the former Soviet Union» TB in urban centers like New York City» Rising Group A streptococcal conditions like scarlet fever·The fear of a powerful new flu strain sweeping the world3、Elaborate on the joined battle:·WHO established a new division devoted to worldwide surveillance and control of emerging disease in October 1995.·CDC launched a prevention strategy in 1994.·Congress raised fund from $6.7 million in 1995 to $26 million in 1997.4、The borders are meaningless to pathogenic microbes, which can travel from one country to another remote country in a very short time.5、TB:·Prisons and homeless shelters as ideal places for TB spread·Emerging of drug-resistant strain or even multi-drug-resistant strain·A ride on the HIV w^on by attacking the immunocompromisedGroup A strep:·A change in virulence·Mutation in the exterior of the bacteriumFlu:Constant changes in its coat (surface antigens) and resultant changes in its level of virulence6、Examples:·Experiment in England is seeing the waning immunity because of no vaccination. ·Du e to poor vaccination efforts, the diphtheria situation in the former Soviet Union is serious. '• The vaccination rates are dropping in some American cities, and it will lead to more diphtheria and whooping cough.7、The four areas of focus:·The need for surveillance·Updated science capable of dealing with discoveries in the field·Appropriate prevention and control·Strong public health infrastructure8、The infectious diseases such as TB, flu, diphtheria and scarlet fever will never really go away, and the war against them will never end.Unit31、Terry's life before·She loved practicing Tae Kwon Do·She loved the surge of adrenaline that came with the controlled combat of tournaments.·She competed nationally, even won bronze medal in the trials for the Pan American Games.·She attended medical school, practiced as an internal medicine resident, and became an academic general internist.·She got married and got a son and a daughter.2、The symptoms of MS and autoimmune disease:·Loss of stamina and strength·Problems with balance·Bouts of horrific facial pain·Dips in visual acuity3、Terry did the following before she self-experimented:·She started injections.·She adopted many pharmacotherapies.·She began her own study of literature:» She read articles on websites such as PubMed.» She searched for articles testing new MS drugs in animal models.» She turned to articles concerning neurodegeneration of all types — dementia,Parkinson's disease, Huntington's disease, and Lou Gehrig's disease.» She relearned basic sciences such as cellular physiology, biochemistry, and neurophysiology.4、Approaches Terry mainly used:·Self-experimentation with various nutrients to slow neurodegeneration based on literature reports on animal models·Self-experimentation with neuromuscular electrical stimulation which is not an approved treatment for MS·Online search to identify the sources of micronutrients and having a new diet ·Reduction of food allergies and toxic load5、Cases mentioned in the text:·Increased mercury stores in the brains of people with dental fillings·High levels of the herbicide atrazine in private wells in Iowa·The strong association between pesticide exposure and neurodegeneration ·The association of single nucleotide polymorphisms involving metabolism of sulfur and/or B vitamins·Inefficient clearing of toxins6、With 70% to 90% of the risk for diabetes, heart disease, cancer, andautoimmunity being due to environmental factors other than the genes, we can take many health problems and the health care crisis under our control, for example, optimizing our nutrition and reducing our toxic load.Unit41、Two concepts:·Complementary medicine refers to the use of conventional therapies together with alternative treatments such as using acupuncture in addition to usual care to help lessen pain. Complementary and alternative medicine is shortened as CAM.·Alternative medicine refers to healing treatments that are not part of conventional therapies —like acupuncture, massage therapy, or herbal medicine. They are called so because people used to consider practices like these outside the mainstream.2·TCM does not require advanced, complicated, and in most cases, expensive facilities.·TCM employs needles, cups, coins, to mention but a few.·Most procedures and operations of TCM are noninvasive.·The substances used as medicine are raw herbs or abstracts from them, and they are indeed all natural, from nature.·TCM has been practiced as long as the Chinese history, so the efficiency i s proven and ensured.·Ongoing research around the world on acupuncture, herbs, massage and Tai Chi have shed light on some of the theories and practices of TCM3、It may be used as an adjunct treatment, an alternative, or part of a comprehensive management program for a number of conditions: post-operative and chemotherapy induced nausea and vomiting, post-operative dental pain, addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma.4、A well-justified NO:·More intense research to uncover additional areas for the use of acupuncture ·Higher adoption of acupuncture as a common therapeutic modality not only in treatment but also in prevention of disease and promotion of wellness ·Exploration and perfection of innovative methods of acupuncture point stimulation with technological advancement·Improved understanding of neuroscience and other aspects of human physiology and function by basic research on acupuncture·Greater interest by stakeholders·An increasing number of physician acupuncturists5、·Appropriate uses of herbs depend on proper guidance:» Proper TCM diagnosis of the zheng of the patient»Correct selection of the corresponding therapeutic strategies and principles that guide the choice of herbs and herbal formulas·Digression from either of the above guidence will lead to misuses of herbs, and will result in complications in patient6、·Randomized controlled trialsAdvantages:»Elimination of the potential bias in the allocation of participants to the intervention group or control group» Tendency to produce comparable groups» Guaranteed validity of statistical tests of significanceLimitations:» Difficulty in generalizing the results obtained from the selected sampling to the population as a whole»A poor choice for research where temporal factors are anissue»Extremely heavy resources, requiring very large samplegroups• Quasi-experimentsAdvantages:» Control group comparisons possible»Reduced threats to external validity as natural environments do notsuffer the same problems of artificiality as compared to a well-controlledlaboratory setting.»Generalizations of the findings to be made about population since quasiexperiments are natural experimentsLimitations:» Potential for non-equivalent groups as quasi-experimental designs donot use random sampling in constructing experimental and controlgroups.»Potential for low internal validity as a result of not using random sampling methods to construct the experimental and control groups• Cohort studiesAdvantages:»Clear indication of the temporal sequence between exposure and outcome» Particular use for evaluating the effects of rare or unusual exposure» Ability to examine multiple outcomes of a single risk factorLimitations:» Larger, longer, and more expensive» Prone to certain types of bias» Not practical for rare outcomes• Case-control studiesAdvantages:» The only feasible method in the case of rare diseases and those with long periods between exposure and outcome» Time and cost effective with relatively fewer subjects as compared to other observational methodsLimitations:» Unable to provide the same level of evidence as randomized controlled trials as it is observational in nature» Difficult to establish the timeline of exposure to disease outcome• “N=1” trialsAdvantages» Easy to manage» InexpensiveLimitations:» Findings difficult to be generalized to the whole population» Weakest evidence due to the number of the subject7、• Synthesis of evidence is completely dependent on:» The completeness of the literature search (unavailable for foreign studies)» The accuracy of evaluation·There are situations in which no answer can be found for the questions of interest in RCTs and database analyses.·There's the requirement of using less stringent information rather than “hard data”8、·Assessment of the intrinsic value of traditional medicine in society·Research and education·Political, economic, and social factorsUnit51、·Dis-ease refers to the imbalance arising from:» Continuous stress» Pain» Hardships·Disease is a health crisis ascribable to various dis-eases.·Prompting elimination of dis-eases can alleviate some diseases.2、·Wellness is a state involving every aspect of our being: body, mind and spirit.·Manifestations of a healthy person:» Energy and vitality» A certain zip in gait» A warm feeling of peace of heart seen through behavior3、·Constant messages, positive and negative,are sent to our mind about the health of our body.·Physical symptoms are suppressed by people who go through life on automatic pilot.·Being well equals to being disease- or illness-free in the minds of them.·They confused wellness with an absence of symptoms.4、·People's minds are infected by spin:» Half-truth» Fearful fictions» Blatant deceit: some as a form of self-deceit·Spin is a result of unconscious living.·The kind of falseness is pandemic.5·Our body intelligence is suppressed or dormant from a lack of use.·There are tremendous amount of stress on a daily basis.·Our bodies are easily ignored for years because of a lack of recreation time. ·Limiting, self-defeating and even self-destructive behaviors undermine our wellbeing and keep them from achieving our full potential.6·We grow more reluctant to take risks.·We lose the ability to feel and acknowledge our deepest feelings and the courage to speak our truth.·We continue to deny and repress our feelings to protect ourselves.·Fear, denial and disconnection from our bodies and feelings become an unconscious, self-protective habit, a kind of default response to life.7·A multi-faceted process:» Looking for roots of and resolutions for the issues in different dimensions» Building our wellness toolbox slowly» Picturing our whole state of being·Attention to the little stuff:» Examining our lives honestly and setting clear intentions to change» Striving to maintain a balance of our mind, body and spirit» Taking small steps in the way to perceive and resolve conflict8·Try to awaken and evolve in order to live more consciously.·Get in touch with our genuine feelings and emotions.·Come to terms with the toxic emotions1、In the past, most people died at home. But now, more and more people are caredin hospitals and nursing homes at their end of life, which of course brings a new set of questions to consider.2、·Sixty-four years old with a history of congestive heart failure·Deciding to do everything medically possible to extend his life·Availability of around-the-clock medical services and a full range of treatment choices, tests, and other medical care·Relaxed visiting hours, and personal items from home3、Availability of around-the-clock medical resources, including doctors, nurses, andfacility.4、·Taking on a job which is big physically, emotionally, and financially·Hiring a home nurse for additional help·Arranging for services (such as visiting nurses) and special equipment (like a hospital bed or bedside commode)5、·Health insurance·Planning by a professional, such as a hospital discharge plaimer or a social worker·Help from local governmental agencies·Doctor's supervision at home6、·Traditionally, it is only about symptom care.·Recently, it is a comprehensive approach to improving the quality of life for people who are living with potentially fatal diseases.·Stopping treatment specifically aimed at curing an illness equals discontinuing all treatment.·Choosing a hospice is a permanent decision.Unit71、·A dying patient·Decision whether to withdraw life-support machines and medication and start comfort measures·The family's refusal to make any decision or withdraw any treatments2、·The doctor as exclusive decision-maker·The patient as participant with little say in the final choice3、·Respect for the patient, especially the patient s autonomy·Patient-centered care·The patient as decision-maker based on the information provided by the doctor 4、·Patients are forced to make decisions they never want to.·Patients, at least a large majority of them, prefer their doctors to make final decisions.·Shifting responsibility of decision-making to patients will bring about more stress to patients and their families, especially when the best option for the patient is uncertain.5、Doctors are very much cautious about committing some kind of ethicaltransgression.6、·Shouldering responsibility together with the patient may be better than having the patient make decisions on their own.·Balancing between paternalism and respect for patients autonomy constitutes a large part of medical practice.Unit81、·Research:An activity to test hypothesis, to permit conclusions to be drawn, and thereby to develop or contribute to generalizable knowledge·Practice:Interventions solely to enhance the well-being of an individual patient or client and that have a reasonable expectation of success·Blurred distinction:» Cooccurrence of research and practice like in research designed to evaluate a therapy» Notable departures from standard practice being called “experimental” with the terms “experimenta l”and “research” carelessly defined2、·Autonomy:Individuals treated as autonomous agents .·Protection:Persons with diminished autonomy entitled to protection·A case in point:Prisoners involved in research3·“Do no harm” as the primary principle·Maximization of possible benefits and minimization of possible harms . ·Balance between benefits and potential risks involved in every step of seeding the benefits4、·“Do no harm” as a fundamental principle of medical ethics·Extension of it to the realm of research by Claude Bernard·Benefits and risks as a set “duet” in both medical practice and research5、·Unreasonable denial of entitled benefit and unduly imposed burden:Enrolment of patients in new drug trial: Who should be enrolled and who should not?·Equal treatment of equals:Determining factors of equality: age, sex, severity of the condition, financial status, social status6、·Definition:The opportunity to choose what shall or shall not happen to them ·Application:» A process rather than signing a written form» Adequate information as the premise» A well-informed decision as the expected result7、·Requirements for consent as entailed by the principle of respect for persons ·Risk/benefit assessment as entailed by the principle of beneficence·More requirements of fairness as entailed by the principle of justice: » At the individual level: fairness» At the social level: distinction between classes。
心理学研究方法第五讲准实验设计和比较研究
实验组 控制组
心理学研究方法
O1
X
O1
第五讲准实验设计和比较研究
O2 O2
11
(一)不等比较组设计(7)
由于实验组和控制组不是等组,所以, 不仅要比较实验组和控制组的后测成绩, 更重要的是要比较两组被试前测和后测 各自成绩的变化。
心理学研究方法
第五讲准实验设计和比较研究
12
(一)不等比较组设计(8)
心理学研究方法
第五讲准实验设计和比较研究
3
一、准实验设计(3)
准实验设计的主要优点是使用自然发生 的自变量,并且具有重要的实际意义。
准实验设计在吸收实验设计优点的同时, 又结合了观察法和相关研究的特点。
心理学研究方法
第五讲准实验设计和比较研究
4
一、准实验设计(4)
库克和坎贝尔(Cook & Campbell,1979)提出准实 验设计的各种变化形式,并应用这些设计来解决大量 的社会问题。
在这个例子中,设计模式中符号的下脚标是
指处理(辅导)期间的月数。假定因变量是
每组被试在假释期间违犯假释法律的频率,
辅导期的长短与因变量的分数有明显的负相
关,即辅导期越长,假释期间违犯假释法律
的次数越少。由于本设计中的被试并非随机
分配到不同的组,所以,我们对结果的解释
只能强调辅导期与假释期间违犯法律次数之
间的关系,而不能确定这两者之间的因果关
系。
心理学研究方法
第五讲准实验设计和比较研究
10
(一)不等比较组设计(6)
3、不等控制组实验设计(非处理比较组前测后 测设计 )
– 我们可以用以下符号表示该实验设计:
– O1和O2分别代表前测(pretest)和后测(posttest), X代表实验处理。表明两组被试都接受了前测(O1), 其中一组接受实验处理(X),另外一组不接受实验处 理,两组被试都接受后测(O2)。研究者最好以随机 方式决定哪一组接受实验处理。
quasi-experimental shift-share research designs
quasi-experimental shift-share researchdesignsShift-share designs are quasi-experimental designs used in economics and social sciences to assess the relative magnitude of different factors that produce change in a dependent variable. They allow researchers to disaggregate the overall amount of change in a variable into components reflecting changes due to the underlying macro drivers (like population growth or economic trends) and changes due to policy or programmes. In the basic shift-share design, the overall amount of change (or the “shift”) is partitioned between the “location effect”(i.e., the effect of the area's general characteristics, such as its population size) and the “compositional effect”(i.e., the effect of specific group characteristics). The “share”compares the actual change in the dependent variable to the expected change based on the location effect, providing a measure of the extent to which intervention programs have the power to affect change.A shift-share design typically begins with a baseline survey. This measures the amount of change in the dependent variable that is due to the location effect and compositional effect. Over time, additional surveys or measurements are taken, to measure the change in thedependent variable due to the policies or programs. By comparing these measurements with the baseline, the relative magnitude of the location effect and the compositional effect can be measured.Shift-share designs are advantageous for public policy evaluation and impact analysis because of their ability to separate the different effects and identify the areas that respond more to the intervention than the general trend. Additionally, they are relatively simpler and morecost-effective than other methods that can produce a similar analysis.。
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Fearon J D1991Counterfactuals and hypothesis testing in political science.World Politics43:169–95Goldberger A1983Abnormal selection bias.In:Karlin S, Amemyia T,Goodman L A(eds.)Studies in Econometrics, Time Series,and Multi ariate Statistics.Academic Press,New YorkGoldstein H1987Multile el Models in Educational and Social Research.Oxford University Press,New YorkHeckman J J1988The microeconomic evaluation of social programs and economic institutions.In:Chung-Hua Series of Lectures by In ited Eminent Economists no.14.The Institute of Economics,Academia Sinica,Teipei,ChinaHsiao C1986Analysis of Panel Data.Cambridge University Press,Cambridge,UKIsaac L W,Griffin L J1989A historicism in time-series analyses of historical process.American Sociological Re iew54: 873–90Jackman R1986The politics of economic growth in industrial democracies,1974–1980:Leftist strength or North Sea oil? 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randomly.Instead, quasi-experiments use a combination of design features,practical logic,and statistical analysis to show that the presumed cause is likely to be responsible for the observed effect,and other causes are not.The term nonrandomized experiment is synonymous with quasi-experiment;and the terms observational study and nonexperimental design often include quasi-experiments as a subset.This article discusses the need for quasi-experimentation,describes the kinds of designs that fall into this class of methods,reviews the intellectual and practical history of these designs,and notes important current developments.1.The Need for Quasi-experimentationGiven the desirable properties of randomized experi-ments,one might question why quasi-experiments are needed.When properly implemented,randomized experiments yield unbiased estimates of treatment effects,accompanied by known probabilities of error in identifying effect size.Quasi-experimental designs do not have these properties.Yet quasi-experiments are necessary in the arsenal of science because it is not always possible to randomize.Ethical constraints may preclude withholding treatment from needy people based on chance,those who administer treatment may refuse to honor randomization,or questions about program effects may arise after a treatment was already implemented so that randomization is im-possible.Consequently,the use of quasi-experimental designs is frequent and inevitable in practice.2.Kinds of Quasi-experimental DesignsThe range of quasi-experimental designs is large, including but not limited to:(a)Nonequivalent control group designs in which the outcomes of two or more treatment or comparison conditions are studied but the experimenter does not control assignment to conditions;(b)Interrupted time series designs in which many consecutive observations over time(proto-typically100)are available on an outcome,and treatment is introduced in the midst of those observa-tions to demonstrate its impact on the outcome through a discontinuity in the time series after treat-ment;(c)Regression discontinuity designs in which the experimenter uses a cutoffscore on a measured variable to determine eligibility for treatment,and12655Quasi-Experimental Designsan effect is observed if the regression line(of the assignment variable on outcome)for the treatment group is discontinuous from that of the comparison group at the cutoffscore;(d)Single-case designs in which one participant is repeatedly observed over time (usually on fewer occasions than in time series)while the scheduling and dose of treatment are manipulated to demonstrate that treatment controls outcome.In the preceding designs,treatment is manipulated, and outcome is then observed.Two other classes of designs are sometimes included as quasi-experiments, even though the presumed cause is not manipulated (and often not even manipulable)prior to observing the outcome.In(e)case–control designs,a group with an outcome of interest is compared to a group without that outcome to see if they differ retrospectively in exposure to possible causes in the past;and in(f) correlational designs,observations on possible treat-ments and outcomes are observed simultaneously, often with a survey,to see if they are related.Because these designs do not ensure that cause precedes effect, as it must logically do,they usually yield more equivocal causal inferences.3.The History of Quasi-experimental Designs Quasi-experimental designs have an even longer his-tory than randomized experiments.For example, around1,850epidemiologists used case–control meth-ods to identify contaminated water supplies as the cause of cholera in London(Schlesselman1982),and in1898,Triplett used a nonequivalent control group design to show that the presence of audience and competitors improved the performance of bicyclists. In fact,nearly all experiments conducted prior to Fisher’s work were quasi-experiments.However,it was not until1963that the term quasi-experiment was coined by Campbell and Stanley (1963)to describe this class of designs.Campbell and his colleagues(Cook and Campbell1979,Shadish et al.in press)extended the theory and practice of these designs in three ways.First,they described a large number of these designs,including variations of the designs described above.For example,some quasi-experimental designs are inherently longitudinal(e.g., time series,single case designs),observing participants over time,but other designs can be made longitudinal by adding more observations before or after treatment. Similarly,more than one treatment or control group can be used,and the designs can be combined,as when adding a nonequivalent control group to a time series. Second,Campbell developed a method to evaluate the quality of causal inferences resulting from quasi-experimental designs—a validity typology that was elaborated in Cook and Campbell(1979).The ty-pology includes four validity types and threats to validity for each type.Threats are common reasons why researchers may be wrong about the causal inferences they draw.Statistical conclusion validity concerns inferences about whether and how much presumed cause and effect co-vary;examples of threats to statistical conclusion validity include low statistical power,violated assumptions of statistical tests,and inaccurate effect size estimates.Internal validity con-cerns inferences that observed co-variation is due to the presumed treatment causing the presumed out-come;examples include history(extraneous events that could also cause the effect),maturation(natural growth processes that could cause an observed change),and selection(differences between groups before treatment that may cause differences after treatment).Construct validity concerns inferences about higher-order constructs that research operations represent;threats include experimenter expectancy effects whereby participants react to what they believe the experimenter wants to observe rather than to the intended treatment,and mono-operation bias in which researchers use only one measure that reflects a construct imperfectly or incorrectly.External validity concerns inferences about generalizing a causal relationship over variations in units,treatments, observations,settings,and times;threats include interactions of the treatment with other features of the design that produce unique effects that would not otherwise be observed.Third,Campbell’s theory emphasized addressing threats to validity using design features—things that a researcher can manipulate to prevent a threat from occurring or to diagnose its presence and potential impact on study results(see Table1).For example, suppose maturation(normal development)is an an-ticipated threat to validity because it could cause a pretest–post-test change like that attributed to the treatment.The inclusion of several consecutive pre-tests before treatment can indicate whether the rate of maturation before treatment is similar to the rate of change from during and after treatment.If it is similar, maturation is a threat.All quasi-experiments are combinations of these design features,thoughtfully chosen to diagnose or rule out threats to validity in a particular context.Conversely,Campbell was skep-tical about the more difficult task of trying to adjust threats statistically after they have already occurred. The reason is that statistical adjustments require making assumptions,the validity of which are usually impossible to test,and some of which are dubious (e.g.,that the selection model is known fully,or that the functional form of errors is known).Other scholars during this time were also interested in causal inferences in quasi-experiments,such as Cochran(1965)in statistics,Heckman(1979)in economics,and Hill(1953)in epidemiology.However, Campbell’s work was unique for its extensive emphasis on design rather than statistical analysis,for its theory of how to evaluate causal inferences,and for its sustained development of quasi-experimental theory12656Quasi-Experimental DesignsTable1Design elements used in constructing quasi-experimentsAssignment(Control of assignment strategies to increase group comparability)Cutoff-based assignment.Controlled assignment to conditions based solely on one or more fully measured covariates.This can yield an unbiased effect estimateOther nonrandom assignment.Various forms of‘haphazard’assignment that sometimes approximate randomization(e.g.,alternating assignment in a two condition quasi-experiment whereby every other unit is assigned to one condition,etc.)Matching and stratifying.Efforts to create groups equivalent on observed covariates in ways that are stable,do not lead to regression artifacts,and are correlated with the outcome.Preference is for pretreatment measures of the outcome itselfMeasurement(Use of measures to learn whether threats to causal inference actually operate)Post-test observationsNonequi alent dependent ariables.Measures that are not sensitive to the causal forces of the treatment,but are sensitive to all or most of the confounding causal forces that might lead to false conclusions about treatment effects(if such measures show no effect,but the outcome measures do show an effect,the causal inference is bolstered because it is less likely due to the confounds)Multiple substanti e ed to assess whether the treatment affects a complex pattern of theoretically predicted outcomesPretest observationsSingle pretest.A pretreatment measure on the outcome variable,useful to help diagnose selection biasRetrospecti e pretest.Reconstructed pretests when actual pretests are not feasible—by itself,a very weak design feature,but sometimes better than nothingProxy pretest.When a true pretest is not feasible,a pretest on a variable correlated with the outcome—also often weak by itselfMultiple pretest time points on the outcome.Helps reveal pretreatment trends or regression artifacts that might complicate causal inferencePretests on independent samples.When a pretest is not feasible on the treated sample,one is obtained from a randomly equivalent sampleComplex predictions such as predicted interactions.Successfully predicted interactions lend support to causal inference because alternative explanations become less plausibleMeasurement of threats to internal alidity.Help diagnose the presence of specific threats to the inference that A caused B such as whether units actively sought out additional treatments outside the experimentComparison groups(Selecting comparisons that are‘less nonequivalent’or that bracket the treatment group at the pretest(s))Single nonequi alent pared to studies without control groups,using a nonequivalent control group helps identify many plausible threats to validityMultiple nonequi alent groups.Serve several functions.For instance,groups are selected that are as similar as possible to the treated group but at least one outperforms it initially and at least one underperforms it,thus bracketing the treated groupparison groups chosen from the same institution in a different cycle(e.g.,sibling controls in families or last year’s students in schools)Internal( s.external)controls.Plausibly chosen from within the same population(e.g.,within the same school rather than from a different school)Treatment(Manipulations of the treatment to demonstrate that treatment variability affects outcome variability) Remo ed treatments.Showing an effect diminishes if treatment is removedRepeated treatments.Reintroduces treatments after they have been removed from some group—common in laboratory sciences or where treatments have short-term effectsSwitching replications.Reverses treatment and control group roles so that one group is the control while the other receives treatment,but the controls receive treatment later while the original treatment group receives no further treatment or has treatment removedRe ersed treatments.Provides a conceptually similar treatment that reverses an effect—e.g.,reducing access to a computer for some students but increasing access for othersDosage ariation.Demonstrates that outcome responds systematically to different levels of treatmentand method over four decades.Both the theory and the methods he outlined were widely adopted in practice during the last half of the twentieth century,and his terms like internal and external validity became so much a part of the scientific lexicon that today they are often used without reference to Campbell.12657Quasi-Experimental Designs4.Contemporary Research aboutQuasi-experimental Design4.1Statistics and Quasi-experimental Design Although work on the statistical analysis of quasi-experimental designs deserves separate treatment, several contemporary developments deserve mention here.One is the work of statisticians such as Paul Holland,Paul Rosenbaum,and Donald Rubin on statistical models for quasi-experimental designs(e.g., Rosenbaum1995).They emphasize the need to measure what would have happened to treatment participants without treatment(the counterfactual), and focus on statistics that can improve estimates of the counterfactual without randomization.A central method uses propensity scores,a predicted probability of group membership obtained from logistic regres-sion of actual group membership on predictors of outcome or of how participants got into treatment. Matching,stratifying,or co-varying on the propensity score can balance nonequivalent groups on those predictors,but they cannot balance groups for un-observed variables,so hidden bias may remain.Hence these statisticians have developed sensitivity analyses to measure how much hidden bias would be necessary to change an effect in important ways.Both propensity scores and sensitivity analysis are promising develop-ments warranting wider exploration in quasi-experi-mental designs.A second statistical development has been pursued mostly by economists,especially James Heckman and his colleagues,called selection bias modeling(Winship and Mare1992).The aim is to remove hidden bias in effect estimates from quasi-experiments by modeling the selection process.In principle the statistical models are exciting,but in practice they have been less successful.A series of studies in the1980s and1990s found that effect estimates from selection bias models did not match results from randomized experiments. Economists responded with various adjustments to these models,and proposed tests for their appropriate application,but so far results remain discouraging. Most recently,some economists have improved results by combining selection bias models with propensity scores.Although selection bias models cannot yet be recommended for widespread adoption,this topic continues to develop rapidly and serious scholars must attend to it.For example,other economists have developed useful econometrically based sensitivity analyses.Along with the incorporation of propensity scores,this may promise a future convergence in statistical and econometric literatures.A third development is the use of structural equation modeling(SEM)to study causal relationships in quasi-experiments,but this effort has also been only partly successful(Bollen1989).The capacity of SEM to model latent variables can sometimes reduce problems of bias caused by unreliability of measurement,but its capacity to generate unbiased effect estimates is hamstrung by the same lack of knowledge of selection that thwarts selection bias models.4.2The Empirical Program of Quasi-experimental DesignMany features of quasi-experimentation pertain to matters of empirical fact that cannot be resolved by statistical theory or logical analysis.For these features, a theory of quasi-experimental design benefits from empirical research about these facts.Shadish(2000) has presented an extended discussion of what such an empirical program of quasi-experimentation might look like,including studies of questions like the following:(a)Can quasi-experiments yield accurate effect estimates,and if so,under what conditions?(b)Which threats to validity actually occur in practice(e.g.,pretest sensitization,experimenter ex-pectancy effects),and if so,under what conditions?(c)Do the design features in Table1improve causal inference when applied to quasi-experimental design, and if so,under what conditions?Some of this empirical research has already been conducted(see Shadish2000,for examples).The methodologies used to investigate such questions are eclectic,including case studies,surveys,literature reviews(quantitative and qualitative),and experi-ments themselves.Until very recently,however,these studies have generally not been systematically used to critique and improve quasi-experimental theory.5.ConclusionThree important factors have converged at the end of the twentieth century to create the conditions under which the development of better quasi-experimen-tation may be possible.First,over30years of practical experience with quasi-experimental designs have pro-vided a database from which we can conduct empirical studies of the theory.Second,after decades of focus on randomized designs,statisticians and economists have turned their attention to improving quasi-experimen-tal designs.Third,the computer revolution provided both theorists and practitioners with increased ca-pacity to invent and use more sophisticated and computationally intense methods for improving quasi-experiments.Each in their own way,these three factors have taken us several steps closer to answering that great unanswered question with which this article began.See also:Campbell,Donald Thomas(1916–96); Comparative Studies:Method and Design;Exper-imental Design:Overview;Experimental Design:12658Quasi-Experimental DesignsRandomization and Social Experiments;Experi-mentation in Psychology,History of;Panel Surveys: Uses and ApplicationsBibliographyBollen K A1989Structural Equations with Latent Variables. 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Annual Re iew of Sociology18:327–50W.R.ShadishQueer Theory‘Queer theory’is a notoriously unstable phrase,and one much in contention.As a new theoretical move-ment with equally new political counterparts,it is in constantflux and development,and is charac-terized more by what it challenges and contests than by what it offers in the shape of a unified social theory. Drawing on the work of theorists such as Eve Sedgwick and Judith Butler,queer theory‘describes those gestures or analytical models which dramatise incoherencies in the allegedly stable relations between chromosomal sex,gender and sexual desire(Jagose 1996).In this sense,queer theory is a challenge to the ‘obvious categories(man,woman,latina,jew,butch, femme),oppositions(man vs.woman,heterosexual vs. homosexual),or equations(gender l sex)upon which conventional notions of sexuality and identity rely’(Hennessy1993).Queer theory argues instead that sexual desire and sexual practices are not reducible or explicable solely in terms of identity categories,such as gender,race,class,or sexual orientation.It is radically anti-essentialist,in that it challenges a notion of homosexuality as intrinsic,fixed,innate,and univer-sally present across time and space.Queer theorists reject any mode of thought that relies on a conception of identity as unified and self-evident(e.g.,I have sex with people of the opposite sex,therefore I must be heterosexual),and instead demonstrate that desires,sexual practices,and gen-dered identities are performances and enactments, rather than expressions of‘true’subjectivity.Hetero-sexuality is therefore challenged by queer theory not simply as a‘hegemonic’mode of identity,but as a false claim to unity and coherence that is constantly undermined by the incoherencies of sex and gender, incoherencies that the queer analytic hopes to expose and celebrate.1.Intellectual OriginsIn the broadest sense,queer theory emerged in what might be called the postmodern moment,when in-tellectual unease with unitary and cohesive frame-works of knowing reached a fever pitch.While impossible to summarize here,queer theory’s alle-giance to postmodern and\or poststructural modes of thought can be traced in its challenge to the notion of unitary identity(as in‘gay’or‘straight’),its refusal to understand sexuality through a singular and unified lens(homosexual desire,feminist theory,gender),a rejection of binary models(gay\straight,man\ woman,biological\social,real\constructed),and a more generic critique of identity-based theories and politics that,according to poststructuralist accounts, invariably reproduce the very conditions of repression they desire to challenge.For example,the term‘gay’or ‘homosexual’might be critiqued as a(fictional)cat-egory that shores up the binary opposition between ‘gay’and‘straight’that is itself part of the repressive logic of identity.To claim‘gayness’is therefore not simply or solely an act of self-revelation but is also a way of corralling sexuality within the framework of a category that only appears coherent but that,when opened up,reveals its instability(e.g.,Am I still gay if I sleep with a person of the opposite sex?Or if I sleep with those of the same sex but only in certain conditions and in certain ways?Or if my self-under-standing is of myself as‘straight?’).Queer theory,in that sense,has developed within and through the deconstructive impulse of poststructuralism,chal-lenging assertions of unitary identity and necessary linkages(between,say,sexual desire and gender orientation)and arguing instead for a more pro-visional,contingent,andfluid conception of the‘queer’in contemporary culture.While queer theory emerges as coterminous with postmodern impulses,it also traces its intellectual origins in lesbian\gay studies and feminist theory even12659Queer TheoryCopyright#2001Elsevier Science Ltd.All rights reserved.International Encyclopedia of the Social&Behavioral Sciences ISBN:0-08-043076-7。