Learning from errors versus explicit instruction in preparation for a test that counts.

BACKGROUND: Although the generation of errors has been thought, traditionally, to impair learning, recent studies indicate that, under particular feedback conditions, the commission of errors may have a beneficial effect. AIMS: This study investigates the teaching strategies that facilitate learning from errors. MATERIALS AND METHODS: This 2-year study, involving two cohorts of ~88 students each, contrasted a learning-from-errors (LFE) with an explicit instruction (EI) teaching strategy in a multi-session implementation directed at improving student performance on the high-stakes New York State Algebra 1 Regents examination. In the LFE condition, instead of receiving instruction on 4 sessions, students took mini-tests. Their errors were isolated to become the focus of 4 teacher-guided feedback sessions. In the EI condition, teachers explicitly taught the mathematical material for all 8 sessions. RESULTS: Teacher time-on in the LFE condition produced a higher rate of learning than did teacher time-on in the EI condition. The learning benefit in the LFE condition was, however, inconsistent across teachers. Second-by-second analyses of classroom activities, directed at isolating learning-relevant differences in teaching style revealed that a highly interactive mode of engaging the students in understanding their errors was more conducive to learning than was teaching directed at getting to the correct solution, either by lecturing about corrections or by interaction focused on corrections. CONCLUSION: These results indicate that engaging the students interactively to focus on errors, and the reasons for them, facilitates productive failure and learning from errors.

Does price deregulation increase drug price in China? An interrupted time series analysis.

BACKGROUND: The Chinese government removed the price ceiling of most drugs in June 2015 to establish a market-driven pricing system. The purpose of this study is to examine the impact of the elimination of drug ceiling price (EDCP) policy on drug prices. METHODS: Using a national macro-level dataset, we employed an interrupted time series method to study the abrupt level and gradual trend changes of Chinese and Western medicine consumer price index (CPI) between June 2014 and June 2017. RESULTS: The policy exerted level change on Chinese medicine CPI, increasing 0.201% (95% CI 0.026% to 0.376%, p = 0.026). And the trend in Chinese medicine CPI was still decreased nonsignificantly after the EDCP policy. However, there was no significant price change in Western medicine. CONCLUSION: The EDCP policy has different effects on the prices of Chinese and Western medicines. Therefore, we need to pay more attention to the drug pricing mechanism in the future.

Assessing the reliability and validity of the ICECAP-A instrument in Chinese type 2 diabetes patients.

PURPOSE: We aimed to conduct psychometric tests for the Chinese version of ICECAP-A and compare the differences between ICECAP-A and EQ-5D-3L for patients with T2DM and explore the relationship between clinical conditions and ICECAP-A through diabetes-related clinical indicators. METHODS: Data were collected from a sample of 492 Chinese T2DM patients. The reliability and validity of the ICECAP-A were verified. Exploratory factor analysis (EFA), correlation analysis and regression analysis were conducted for both the ICECAP-A and EQ-5D-3L. RESULTS: Our results show that the Chinese version of ICECAP-A has good internal consistency with an overall Cronbach's Alpha coefficient of 0.721. The mean scores of ICECAP-A and EQ-5D-3L are 0.85 vs. 0.94. A weak correlation (r = 0.116) was found between the ICECAP-A tariff and EQ-5D-3L utility. EFA showed that although the five dimensions of the ICECAP-A and EQ-5D-3L scales were loaded into two different factors respectively. However, the two scales captured different dimensions of quality of life and can complement each other. The ICECAP-A, EQ-5D-3L, and EQ-VAS scores showed differences across different socio-demographic characteristics and clinic conditions groups. CONCLUSION: The Chinese version of the ICECAP-A capability instrument can be for assessing outcomes in adults with T2DM. It may capture more dimensions of QoL than traditional Health-related QoL (HRQoL) instruments and may be useful for economic evaluations of health care and social care for people with T2DM or other chronic diseases.

Tip-of-the-tongue states predict enhanced feedback processing and subsequent memory.

This article investigates the relations among the tip-of-the-tongue (TOT) state, event related potentials (ERPs) to correct feedback to questions, and subsequent memory. ERPs were used to investigate neurocognitive responses to feedback to general information questions for which participants had expressed either being or not being in a TOT state. For questions in which participants were unable to answer within 3 s, they indicated whether they were experiencing a TOT state and then were immediately provided with the correct answer. Feedback during a TOT state, as opposed to not knowing the answer, was associated with enhanced positivity over centro-parietal electrodes 250-700 ms post-feedback, and this enhanced positivity mediated a positive relationship between TOTs and later recall. Although effects of increased semantic access during TOT states cannot be ruled out, these results suggest that information received during TOT states elicits enhanced processing-suggestive of curiosity-leading to enhanced learning of studied material.

Adaptation and assessments of the Chinese version of the ICECAP-A measurement.

BACKGROUND: This study adapts the ICECAP measure for Adults (ICECAP-A) to assess its capacity to measure the quality of life in China for economic evaluation. METHODS: Qualitative and quantitative methods were used to translate the ICECAP-A measure for wellbeing, established by the University of Birmingham, UK, to the Chinese cultural context. A focus group discussion solved the appropriateness and wording of the ICECAP attributes in Chinese; and a randomly selected sample of 1000 adults aged over 18 years were online surveyed. We conducted psychometric tests and compared the factors influencing the ICECAP-A measure with those influencing EQ-5D-3 L. RESULTS: Members of the focus group discussion agreed that the five attributes of the ICECAP-A measure are sufficient to evaluate wellbeing in China. However, the terms "being settled" and "friendship" were changed to "stability" and "kindness" for the Chinese cultural context. Our results show that the Chinese version of ICECAP-A has good internal consistency with an overall Cronbach's Alpha coefficient of 0.7999. The concurrent validity indicates that ICECAP-A is moderately correlated with EQ-5D-3 L (r ≤ 0.52). CONCLUSIONS: The ICECAP-A measure can be adapted to evaluate wellbeing in China, but cultural changes to the wording are necessary. It is a valid measurement of wellbeing and can complement the EQ-5D already used in China. However, further work is still needed to evaluate the sensitivity of the ICECAP-A measure in relation to public health and social care.

Attenuation of deep semantic processing during mind wandering: an event-related potential study.

Although much research shows that early sensory and attentional processing is affected by mind wandering, the effect of mind wandering on deep (i.e. semantic) processing is relatively unexplored. To investigate this relation, we recorded event-related potentials as participants studied English-Spanish word pairs, one at a time, while being intermittently probed for whether they were 'on task' or 'mind wandering'. Both perceptual processing, indexed by the P2 component, and deep processing, indexed by a late, sustained slow wave maximal at parietal electrodes, was attenuated during periods preceding participants' mind wandering reports. The pattern when participants were on task, rather than mind wandering, is similar to the subsequent memory or difference in memory effect. These results support previous findings of sensory attenuation during mind wandering, and extend them to a long-duration slow wave by suggesting that the deeper and more sustained levels of processing are also disrupted.

Learning from one's own errors and those of others.

Three experiments investigated the effects of making errors oneself, as compared to just hearing the correct answer without error generation, hearing another person make an error, or being "on-the-hook," that is, possibly but not necessarily being the person who would be "called-on" to give a response. In all three experiments, generating either an error of commission or generating the correct response, oneself, out loud, compared to being a person who heard another's commission errors (or correct responses), was beneficial for later recall of the correct answer. Experiment 1 suggested that the decrement in recall from self- to other-generation could be partially offset by being "on-the-hook." However, this benefit was fragile and did not hold up either at a delay or when the presence of the other participants was downplayed. The beneficial effect of self-generation, both of correct responses and of errors of commission is consistent with reconsolidation theory. That theory holds that retrieval has a special status as a memory process that renders the retrieved traces labile. If the person was correct, reconsolidating the correct trace results in strengthening. If wrong, the malleability of the retrieved trace implied by reconsolidation theory makes it open to enhanced modification and correction. If the person was not the agent who retrieved, though, such as when someone else retrieves information, or when nothing is retrieved as is the case with omission errors (which we argue is truly how the term "unsuccessful retrieval" should be used), the benefit conferred by the special malleability entailed by the postulated reconsolidation process does not obtain.

The choice and preference for public-private health care among urban residents in China: evidence from a discrete choice experiment.

BACKGROUND: Public health care dominated the services provision in China before 1980s. However, the number of private health care providers in China has been increasing since then. The growth of private hospitals escalated after a market-oriented reform was implemented in 2001. Through an experimental approach, this study aims to a better understanding of the dynamic change in preference of health care utilisation among the residents in urban China. METHODS: Based on a discrete choice experiment (DCE) from a random sample of respondents in urban China, the study evaluated preference over health care attributes affecting individuals' choice for the utilisation of hospital health care. The marginal willingness-to-pay for five health care attributes was estimated, including public/private provision of health care, by analysing mixed logit and latent class models. RESULTS: The results indicated a significantly negative marginal willingness-to-pay for private health care, which was interpreted as representing people's previous interactions with the health care system. The latent class model further suggested preference heterogeneity across our sample. We found that Hukou type, a typical indicator of socioeconomic background, was significantly related to respondents' preference for health care utilisation. Permanent urban residents (urban Hukou) valued private health care less; in contrast rural migrants (rural Hukou) were more likely to be indifferent between public/private provision. CONCLUSION: Urban residents in China showed a high disposition to obtain health care from the public providers of health care. Our results have implications in the context of the Chinese government attempts to expand the private health care sector in the short term. Policy makers need to consider residents' preference for health care in health policy development as the preference can only change in the long term.

Studying in the region of proximal learning reduces mind wandering.

Insofar as mind wandering has been linked to poor learning, finding ways to reduce the propensity to mind wander should have implications for improving learning. We investigated the possibility that studying materials at an appropriate level of difficulty with respect to the individual's capabilities-that is, studying in the region of proximal learning (RPL)-might reduce mind wandering. In Experiments 1 and 2, participants were probed for their attentional state while they studied blocks of English-Spanish word pairs that were (a) easy, (b) in the RPL, or (c) difficult. We found that studying materials in the RPL was associated with reduced mind wandering. Test performance on items studied while mind wandering was also poorer. In Experiment 3, we investigated the relation between differences in participants' mastery and mind wandering. We found that high performers mind wandered more when studying the easier word pairs, whereas low performers mind wandered more when studying the difficult items. These results indicate that the RPL is specific to the individual's level of mastery and that mind wandering occurs when people are outside that region.

People mind wander more during massed than spaced inductive learning.

This article investigates the relation between mind wandering and the spacing effect in inductive learning. Participants studied works of art by different artists grouped in blocks, where works by a particular artist were either presented all together successively (the massed condition), or interleaved with the works of other artists (the spaced condition). The works of 24 artists were shown, with 12, 15, or 18 works by each artist being provided as exemplars. Later, different works by the same artists were presented for a test of the artists' identity. During the course of studying these works, participants were probed for mind wandering. It was found that people mind wandered more when the exemplars were presented in a massed rather than in a spaced manner, especially as the task progressed. There was little mind wandering and little difference between massed and spaced conditions toward the beginning of study. People were better able to correctly attribute the new works to the appropriate artist (inductive learning) when (a) they were in the spaced condition and (b) they had not been mind wandering. This research suggests that inductive learning may be influenced by mind wandering and that the impairment in learning with massed practice (compared to spaced practice) may be attributable, at least in part, to attentional factors-people are "on task" less fully when the stimuli are massed rather than spaced. (PsycINFO Database Record

A comparison of outpatient healthcare expenditures between public and private medical institutions in urban China: an instrumental variable approach.

The growth of healthcare expenditure provokes constant comments and discussions, as countries battle the issues on cost containment and cost effectiveness. Prior to 1978, medical institutions in China were either state-owned or were collective public hospitals. Since 1978, China has been trying to rebuild its healthcare system, which was destroyed during the 'cultural revolution', allowing private medical institutions to deliver healthcare services. As a result, private medical institutions have grown from 0% to 28.57% between 1978 and 2010. In this context, we compare outpatient healthcare expenditures between public and private medical institutions. The central problem of this comparison is that the choice of medical institution is endogenous. So we apply an instrumental variable (IV) framework utilizing geographic information (whether the closest medical institution is private) as the instrument while controlling for severity of health and other relevant confounding factors. Using China's Urban Resident Basic Medical Insurance Survey 2008-2010, we found that there is no difference in expenditure between public and private medical institutions when IV framework is used. Our econometric tests suggest that our IV model is specified appropriately. However, the ordinary least square model, which is inconsistent in the presence of endogenous regressor(s), reveals that public medical institutions are more expensive.

Chronic stable angina is associated with lower health-related quality of life: evidence from Chinese patients.

OBJECTIVES: To compare health-related quality of life (HRQoL) between patients with stable angina and the general population in China and to examine factors associated with HRQoL among patients with stable angina. METHODS: A cross-sectional HRQoL survey of stable angina patients recruited from 4 hospitals (n = 411) and the general population recruited from 3 Physical Examination Centers (n = 549) was conducted from July to December, 2011 in two large cities, Tianjin and Chengdu. HRQoL was assessed using the EQ-5D, EQ-VAS, and SF-6D instruments. The health status specific to patients with stable angina was assessed using the Seattle Angina Questionnaire (SAQ). Information on socio-demographic, clinical, and lifestyle factors were also collected. Nested regressions were performed to explore how these factors were associated with HRQoL in patients with stable angina. RESULTS: Compared with the general population (44.2 ± 10 years, 49.9% females), stable angina patients (68.1 ± 12 years, 50.4% females) had significantly lower HRQoL scores in EQ-5D utility index (0.75 ± 0.19 vs. 0.90 ± 0.20, p<0.05), SF-6D utility index (0.68 ± 0.12 vs. 0.85 ± 0.11, p<0.05), and EQ-VAS (71.2 ± 12.3 vs. 83.9 ± 10.9, p<0.05). The differences remained (-0.05 for EQ-5D, -9.27 for EQ-VAS and -0.13 for SF-6D) after controlling for socio-economic characteristics. SAQ scores showed that stable angina patients experienced impaired disease-specific health status, especially in angina stability (40.5 ± 34.6). Nested regressions indicated stable angina-specific health status explained most of the variation in HRQoL, among which disease perception, physical limitation, and angina stability were the strongest predictors. More physical exercise and better sleep were positively related with HRQoL. CONCLUSIONS: Compared to the general population, stable angina patients were associated with lower HRQoL and lower health utility scores, which were largely impacted by clinical symptoms. Further studies are needed to characterize the influence of geographic and cultural factors on the variations of health-related utility in stable angina patients.

I don't feel your pain (as much): the desensitizing effect of mind wandering on the perception of others' discomfort.

Mind wandering reduces both the sensory and cognitive processing of affectively neutral stimuli, but whether it also modulates the processing of affectively salient stimuli remains unclear. In particular, we examined whether mind wandering attenuates one's sensitivity to observing mild pain in others. In the first experiment, we recorded event-related potentials (ERPs) as participants viewed images of hands in either painful or neutral situations, while being prompted at random intervals to report whether their thoughts were on task or mind wandering. We found that the brain's later response to painful images was significantly reduced immediately preceding "mind-wandering" versus "on-task" reports, as measured via amplitude decreases in a frontal-central positivity beginning approximately 300 ms poststimulus. In a second, control experiment using behavioral measures, we wanted to confirm whether the subjective sense of pain observed in others does in fact decrease during mind wandering. Accordingly, we asked participants to rate how painful the hand images looked on a 5-point Likert scale, again while taking reports of their mind-wandering states at unpredictable intervals. Consistent with our ERP data, we found that the ratings for painful images were significantly reduced immediately preceding mind-wandering reports. Additional control analyses suggested that the effect could not simply be ascribed to general habituation in the affective response to painful images over time. Collectively, our findings demonstrate that mind wandering can directly modulate the cortical processing of affectively salient stimulus inputs, serving in this case to reduce sensitivity to the physical discomfort of others.

Pharmaceutical pricing: an empirical study of market competition in Chinese hospitals.

BACKGROUND: High pharmaceutical prices and over-prescribing of high-priced pharmaceuticals in Chinese hospitals has long been criticized. Although policy makers have tried to address these issues, they have not yet found an effective balance between government regulation and market forces. OBJECTIVE: Our objective was to explore the impact of market competition on pharmaceutical pricing under Chinese government regulation. METHODS: Data from 11 public tertiary hospitals in three cities in China from 2002 to 2005 were used to explore the effect of generic and therapeutic competition on prices of antibiotics and cardiovascular products. A quasi-hedonic regression model was employed to estimate the impact of competition. The inputs to our model were specific attributes of the products and manufacturers, with the exception of competition variables. RESULTS: Our results suggest that pharmaceutical prices are inversely related to the number of generic and therapeutic competitors, but positively related to the number of therapeutic classes. In addition, the product prices of leading local manufacturers are not only significantly lower than those of global manufacturers, but are also lower than their non-leading counterparts when other product attributes are controlled for. CONCLUSION: Under the highly price-regulated market in China, competition from generic and therapeutic competitors did decrease pharmaceutical prices. Further research is needed to explore whether this competition increases consumer welfare in China's healthcare setting.

Traditional Chinese medicine in the Chinese health care system.

OBJECTIVES: This study examines the role and value of traditional Chinese medicine (TCM) in the current health care system in China. METHODS: Based on literature review and publicly available data in China. RESULTS: The study shows that TCM is well integrated in the Chinese health care system as one of the two mainstream medical practices. Also, the Chinese government is supportive of TCM development by increasing investment in TCM research and administration. However, there is downsizing of TCM utilization, a lack of TCM professionals with genuine TCM knowledge and skills, and limitations of and increasing public opinions on modernization and westernization. CONCLUSIONS: TCM is still facing many challenges in playing critical roles in improving public health in China. These challenges can be explained from different perspectives. In addition to the unique characteristics of TCM, economic, cultural, and historical evolution in China may also be major determinants.

Economic burden of cardiovascular diseases in China.

Cardiovascular diseases (CVD) have become the principle cause of death and disability among the middle-aged and elderly both in urban and rural areas of China. The objective of this study is to estimate the direct costs of CVD in China. Direct costs were estimated for the Chinese population with CVD in 2003 by sex, age, geography, type of medical condition and medical insurance, and then calculated based on the 2003 National Health Services Survey. The annual average direct medical cost and direct nonmedical cost were 4238.3 Yuan (US$529.8) and 153.9 Yuan (US$19.2) in urban areas, 2302.5 Yuan (US$278.1) and 416.4 Yuan (US$50.3) in rural areas, respectively. On average, only 23.9% of outpatient costs and 35.2% in-patient costs could be paid by various kinds of medical insurance. This disease burden led to 209.0 billion Yuan (US$26.1 billion) in direct costs in 2003. The strong positive association between CVD, and the economic burden to families and society, demonstrates the need for greater investment to prevent CVD in China.

The effect of mind power on HIV-1: a pilot study.

INTRODUCTION: Every human being has mind power, and it can directly affect our activities and behaviors. Furthermore, our minds can directly control our internal organs, tissues, and even cellular activity after we receive appropriate training. OBJECTIVE: This pilot study investigated how a person's mind power can directly influence the growth and infectivity of HIV type 1 (HIV-1) outside the human body. METHOD: In-vitro study of HIV-1 transfected 293T cell culture. INTERVENTIONS: "Inhibit growth intention" for 5 and 10 minutes, and "increase growth intention" for 5 minutes. OUTCOME MEASURES: HIV-1 growth and relative infectivity. RESULTS: The pilot study showed an interesting trend: compared to the control group, the amount of HIV-1 in the cell culture of the treatment groups with an "inhibit intention" decreased, whereas the amount of HIV-1 in the group with a "growth intention" increased. The multinuclear-activation galactosidase indicator (MAGI) analysis also showed that HIV-1 infectivity is influenced by different mind "intentions". Although the study is a pilot study, it sheds light on a new direction for HIV/AIDS research.

A general model of the impact of absenteeism on employers and employees.

Most studies on the indirect costs of an illness and the cost effectiveness of a medical intervention or employer-sponsored wellness program assume that the value of reducing the number of days employees miss from work due to illness is the wage rate. This paper presents a general model to examine the magnitude and incidence of costs associated with absenteeism under alternative assumptions regarding the size of the firm, the production function, the nature of the firm's product, and the competitiveness of the labor market. We conclude that the cost of lost work time can be substantially higher than the wage when perfect substitutes are not available to replace absent workers and there is team production or a penalty associated with not meeting an output target. In the long run, workers are likely to bear much of the incidence of the costs associated with absenteeism, and therefore be the likely beneficiaries of any reduction in absenteeism.