创伤截肢后的假肢康复

5·12汶川地震使当地许多伤员肢体残缺,对伤者的生理和心理产生了重大的影响。帮助这些伤员尽快走出阴影,使他们在灾后能够最大程度的身心康复,重新回归社会,假肢的装配和使用是目前最有效的方法。为了使假肢能够更好地替代残缺肢体的功能,应当从截肢前着手,包括患者截肢平面的选择、残端的正确处理。术后早期对患者进行功能锻炼指导,防止畸形发生,尽可能早地根据患者自身情况选配合适的假肢,并指导患者正确使用和维护假肢,使其能够成功地回归社会,增强截肢者生活的信心。     

创伤性截肢的适应证与手术原则探讨

截肢是肢体严重损伤时的一个重要治疗方法,在决定截肢与肢体挽救时受到多方面因素的影响,但在相当程度取决于原发损伤的严重性。目前还没有一个明确的截肢适应证标准,需要一个客观的对肢体估价的方法以明确是否行截肢术,损毁肢体严重程度评分MESS（mangled extremity security score）有较大的临床指导意义。截肢虽是一种破坏性手术,也是一种重建与修复手术,同样遵守矫形外科手术的基本原则。当肢体损伤必须截肢时,要认真周密地设计、仔细地组织处理,在满足治疗的前提下,合理保存肢体长度,最大限度地保留患肢功能,获得较为理想的残肢,以使装配的假肢发挥最佳的功能。严格创伤截肢的标准,掌握截肢的手术原则,了解假肢的安装要求,与患者及家属的积极沟通,进行必要的会诊,是截肢手术医生必须要做到的。     

儿童创伤截肢

儿童意外伤害在国内外一直是受到普遍重视的问题,我国在这这方面的研究不多。严重肢体创伤的处理无论从专业理论还是在手术技巧上均要求很高,尤其对儿童肢体的毁损性创伤的治疗往往使临床医师常需在截肢与肢体挽救二者之间作出困难的选择。如何确定急诊截肢和保留肢体,国内外目前尚未有一个客观合理权威的标准。本文主要综述儿童截肢的标准和方法,以供参考。     

Attention in learning

Learners exhibit many apparently irrational behaviors in their use of cues, sometimes learning to ignore relevant cues or to attend to irrelevant ones. A learning phenomenon called highlighting seems especially to demand explanation in terms of learned attention. Highlighting complements the classic phenomenon of conditioned blocking, which has been shown to involve learned inattention. Highlighting and blocking, along with a wide spectrum of other perplexing learning phenomena, can be accounted for by recent connectionist models in which both attentional shifting and associative learning are driven by the rational goal of rapid error reduction.     

Adaptation of Reactive Saccades is Influenced by Unconscious Priming of the Attention Focus

The authors investigated whether the size of the attention focus can influence saccadic adaptation, and whether this influence changes in older age. Using the scrambled sentence task, young and older participants were either primed for a wide attention focus, or primed of a narrow attention focus, or were not primed for any specific attention focus. Subsequently, all participants underwent a double-step saccadic adaptation paradigm aimed at changing the direction of reflexive saccades. The authors found that compared to the nonprimed control group, priming for a wide attention focus enhanced saccadic adaptation in both age groups by a similar amount; the benefit persisted throughout the adaptation phase, but was absent during the deadaptation phase. In contrast, the authors found no effects of priming with a narrow attention focus on saccadic adaptation. From this the authors conclude that a wide attention focus is beneficial for workaround strategies but not for adaptive recalibration, and that those benefits are similar in young and older persons.     

高效率学习的选择性注意研究

本文回顾了视觉加工、双语学习、内隐认知、学习不能与专注力训练等领域的研究成果,从不同层面阐述了选择性注意对高效学习的贡献及其影响因素,为深入研究高效率学习的心理机制提供支持。     

创伤截肢家庭护理与心理疏导

创伤截肢术后给患者带来不同程度的躯体残疾和缺陷,同时使患者产生巨大的心理压力,做好创伤截肢患者家庭护理与心理疏导非常关键。在慢性康复期,要关注患者的心理应激反应,纠正其认识偏差,减轻“自避”行为,消除“患肢痛”幻觉;在家庭康复护理过程中,要建立和谐的康复环境,训练其自我照顾及运动功能,预防各种并发症的发生。使患者尽快恢复身心健康,重新回归社会。     

地震伤截肢纪实与感悟

笔者亲身经历了“5·12”四川汶川8．0级特大地震中救治地震伤员的医疗工作,结合相关的创伤性截肢的一些经验和一些感悟,初步分析了地震伤员的创伤性截肢的特点、原因以及创面处理的一些措施和原则,以期与同道共同探讨类似突发性、群发性伤害事件中更加有效的救治措施。     

内隐序列学习与注意的关系

内隐序列学习与注意的关系是内隐学习研究领域中的一个热点问题。“双注意机制”理论、“抑制表达”理论和“干扰外显学习成分”理论,从不同的角度阐释了内隐序列学习与注意的关系,但支持证据和反对意见并存,论争激烈。该文试图在一定程度上整合这三种理论,提出了“动态需求”假设,认为内隐序列学习任务对注意的需求是动态变化的,随着内隐序列学习任务中外显学习成分比重的变大,其对注意资源的需求也会随之增加     

情绪对学习不良青少年选择性注意和持续性注意的影响

以学习不良青少年为被试,采用成绩反馈法诱发情绪,考察了情绪对学习不良青少年选择性注意和持续性注意的影响,结果表明：（1）情绪会影响学习不良青少年的选择性注意,具有积极低唤醒情绪的学习不良青少年,他们的选择性注意的反应时显著短于消极情绪下的被试;(2)学习不良青少年的情绪会影响到他们的持续性注意能力,消极高唤醒的情绪能够增加虚报率,而积极高唤醒的情绪能够提高判断标准,降低虚报率     

注意在内隐序列学习中作用的研究述评

探索次级任务对序列学习的作用实质在对内隐序列学习的研究中占有重要地位。关于次级的计音任务对序列学习的干扰作用的实质 ,主要有四种主要的观点 :注意能量说、组织说、短时记忆说和抑制表现说。文章简要介绍了这些观点并对其各自的实验证据进行了总结和分析 ,并对最近可能进行的研究进行了展望。     

选择性注意中的客体与空间因素

注意选择理论可以分为空间选择和客体选择两大模型,文章首先介绍了这两类模型的观点,概述了客体选择和空间因素的关系与区别,也介绍了包括距离操纵和线索启动在内的客体选择和空间选择分离技术及其理论逻辑。     

线索在多媒体学习中的作用

线索在多媒体学习中作为一种重要的教学设计形式,具有引导注意、组织和整合信息的功能。综述已有研究发现,线索具有引导学习者加工特定位置信息、忽视无关信息干扰的功能;在特定条件下帮助学习者整合图-文信息,并且提高学习者的学习效果;但对于线索信息组织功能尚缺少充分而有力的证据。关于线索对学习效果的影响,大部分研究证实线索能够促进学习。但是由于线索的多样性以及学习材料的复杂性,线索能否有效地提高学习效果仍然存在争议。从认知负荷理论视角综述发现,线索加入并没有明显降低学习者感知到的主观认知负荷;从知觉加工视角而言,线索作为突显的刺激会吸引学习者的注意,从而简化学习者在知觉加工阶段的视觉搜索。未来研究仍然需要关注以下问题:(1)线索是否真的被学习者所注意和加工?(2)重视学习材料多样性比较和不同线索类型差异探讨,(3)关注学习者经验影响,(4)如何在教学设计上保证线索的有效性。     

Attention Is Required to Coordinate Reaching and Postural Stability during Upper Limb Movements Generated While Standing

Abstract

In the present study we investigated how attention contributes to the interaction between reach planning and execution, and postural control. Reaching movements were generated while standing and were performed either in isolation or in conjunction with a secondary reaction time (RT) task. In addition, to better understand how online movement control is affected by this interaction, the reaching movements could be unexpectedly perturbed medial-laterally. Postural kinetic, arm kinematic and RT, and secondary RT measures were used to characterize the responses. Results indicate task performance worsened when both the reaching and secondary tasks were completed simultaneously. Our results imply the generation of reaching movements while standing requires attentional resources to properly coordinate the interaction between the reaching task and postural control.     

参照性交流双方学习过程与选择性注意的比较

研究以大学生为被试,采用参照性交流范式,设计虚拟学习材料并创设功能预测和维度选择任务,探查比较参照性交流双方学习过程与选择性注意特点。结果发现：与低分组比较,高分组从学习阶段2开始得分显著更高;且维度选择整体结果显著优于低分组,这主要表现在对无关维度的抑制水平显著更高。结果表明：参照性交流双方的学习过程表现出不平衡性;参照性交流双方的选择性注意整体水平表现出不平衡性,具体表现于选择性注意的集中性水平。     

Prediction Errors and Attention in the Presence and Absence of Feedback

ABSTRACT— Contemporary theories of learning typically assume that learning is driven by prediction errors—in other words, that we learn more when our predictions turn out to be incorrect than we do when our predictions are correct. Results from the recording of electrical brain activity suggest one mechanism by which this might happen; we seem to direct visual attention toward the likely causes of previous prediction errors. This can happen very rapidly—within less than 200 milliseconds of the error-causing object being presented. It is tempting to infer that if learning is driven by prediction errors, then little can be learned in the absence of feedback. Such a conclusion is unwarranted. In fact, the substantial learning that is sometimes the result of simple exposure to objects can also be explained by processes of directing attention toward the likely causes of previous prediction errors.     

Higher visuo-Attentional Demands of Multiple Object Tracking (MOT) Lead to A Lower Precision in Pointing Movements

Multiple object tracking (MOT) requires visually attending to dynamically moving targets and distractors. This cognitive ability is based on perceptual-attentional processes that are also involved in goal-directed movements. This study aimed to test the hypothesis that MOT affects the motor performance of aiming movements. Therefore, the participants performed pointing movements using their fingers or a computer mouse that controlled the movements of a cursor directed at the targets in the MOT task. The precision of the pointing movements was measured, and it was predicted that a higher number of targets and distractors in the MOT task would result in a lower pointing precision. The results confirmed this hypothesis, indicating that MOT might influence the performance of motor actions. The potential factors underlying this influence are discussed.     

Assessment of Attention in Children with Attention Deficit Hyperactivity Problems in Primary Care Settings

Clinical child psychologists in primary care settings are often asked to evaluate children with suspected attention and learning problems. This paper will review some of the methods and assessments available to child psychologists to enable them to perform this task. Some problems with current practice will be described and some of the newer techniques will be introduced. A research-based understanding of areas of chronic impairment of children with Attention Deficit Hyperactivity Disorder (ADHD) will be discussed, and a new approach to the assessment of both executive functions and attention will be explored. This paper will primarily explore assessment in the primary care setting.     

中国古代心理学思想中的注意问题

本文根据古代思想家的有关言论,探讨了他们的注意心理思想,即注意的慨念。特征,分心与分散,分配与集中,注意与感知、记忆、思维的关系,注意在学习中的作用。