Associative processes and strategies in disjunctive reaction time

Scaling analysis based on variable criterion theory has been applied to the c-reaction form of disjunctive RT. In addition to previously identified sensory growth functions, two associative processes have been identified and functions of time describing their growth have been obtained. Associative strength to the positive stimulus begins at about 200 msec, or after, and grows with initial positive and later negative acceleration. Associative inhibition to the negative stimulus begins earlier, shortly after the sensory detection functions, and grows rapidly with negative acceleration. Subjects may adopt strategies which emphasize the use of either of these associative processes. With the pure inhibitory strategy, they respond to the positive stimulus entirely on the basis of sensory detection, but associatively inhibit response to the negative stimulus. With either strategy, the speed-accuracy tradeoff was determined by the level of criterion adjustment.     

Toward a methodology for moral decision making in medicine

The failure of medical codes to provide adequate guidance for physicians' moral dilemmas points to the fact that some rules of analysis, informed by moral theory, are needed to assist in resolving perplexing ethical problems occurring with increasing frequency as medical technology advances. Initially, deontological and teleological theories appear more helpful, but critcisms can be lodged against both, and neither proves to be sufficient in itself. This paper suggests that to elude the limitations of previous approaches, a method of moral decision making must be developed incorporating both coherence methodology and some independently supported theoretical foundations. Wide Reflective Equilibrium is offered, and its process described along with a theory of the person which is used to animate the process. Steps are outlined to be used in the process, leading to the application of the method to an actual case.     

At the Heart of the Pregnancy: What Prenatal and Cardiovascular Genetic Counselors Need to Know about Maternal Heart Disease

In the last decade, an increasing number of cardiac conditions have been shown to have a genetic basis. Cardiovascular genetic counseling has emerged as a subspecialty aiming to identify unaffected at-risk individuals. An important sector of this at-risk population also includes expectant mothers, in whom unique clinical challenges may arise. Genetic counselors, especially those in cardiovascular and prenatal settings, have an opportunity to identify and assist women who may benefit from cardiovascular care during pregnancy. This paper provides basic management and genetic evaluation principles for affected women, as well as guidance on identifying those who are at risk. We provide considerations for cardiac surveillance in pregnancy and the post-partum period. Finally, key psychosocial issues that appraise how to best provide support to at risk women as they make informed decisions are discussed. We propose that a team approach including cardiology, maternal fetal medicine, and genetic counseling best serves this patient population. Ongoing questions addressing an evidence based approach to cardiovascular genetic conditions in pregnancy still remain. Thus, well-designed research protocols are essential to mark progress in this area.     

影响晚期胃癌患者生活质量的因素分析

分析晚期胃癌患者的生活质量情况及其影响因素,为晚期胃癌患者的临床护理干预提供科研数据.选择2010年5月至2011年5月在辽宁医学院附属第一医院胃肠外科及肿瘤科的晚期胃癌患者173名进行生活质量的乱查,并通过EORTC QLQ —C30,SSRS,MCMQ,SAS等量表和一般人口学资料及临床病例资料进行评估.晚期胃癌患者总体生活质量评分低,仅29.54±12.21;社会支持、医学应对方式、焦虑及患者临床资料(除放疗外)对晚期胃癌患者总体生活质量影响较明显(P＜0.05).晚期胃癌患者的生活质量较差,其影响因素是多方面的,临床上医务人员应采取必要的措施提高晚期胃癌患者的生活质量.     

Predicting Persistence of Nonsuicidal Self‐Injury in Suicidal Adolescents

Prospective predictors of persistent nonsuicidal self‐injury (NSSI) were examined in adolescents admitted to an inpatient psychiatric unit for suicidal behaviors and followed naturalistically for 6 months. Seventy‐one (77%) participants reported NSSI at baseline, and 40 (56%) persisted at the 6 month follow‐up. Those who endorsed automatic positive reinforcement (APR) as the predominant reason for NSSI were more likely to persist in NSSI. Depression over follow‐up, but not at baseline, also predicted persistence. These results suggest that helping high‐risk adolescents to identify alternative ways of generating emotion(s) to counter the effects of APR that may accompany NSSI should be a high priority treatment target.     

Impact of Applied Suicide Intervention Skills Training on the National Suicide Prevention Lifeline

We examined the impact of the implementation of Applied Suicide Intervention Skills Training (ASIST) across the National Suicide Prevention Lifeline's national network of crisis hotlines. Data were derived from 1,507 monitored calls from 1,410 suicidal individuals to 17 Lifeline centers in 2008–2009. Callers were significantly more likely to feel less depressed, less suicidal, less overwhelmed, and more hopeful by the end of calls handled by ASIST‐trained counselors. Few significant changes in ASIST‐trained counselors' interventions emerged; however, improvements in callers' outcomes were linked to ASIST‐related counselor interventions, including exploring reasons for living and informal support contacts. ASIST training did not yield more comprehensive suicide risk assessments.     

I Can Stomach That! Fearlessness About Death Predicts Attenuated Facial Electromyography Activity in Response to Death‐Related Images

Objective measures of suicide risk can convey life‐saving information to clinicians, but few such measures exist. This study examined an objective measure of fearlessness about death (FAD), testing whether FAD relates to self‐reported and physiological aversion to death. Females (n = 87) reported FAD and disgust sensitivity, and facial electromyography was used to measure physiological facial responses consistent with disgust while viewing death‐related images. FAD predicted attenuated expression of physiological death aversion, even when controlling for self‐reported death‐related disgust sensitivity. Diminished physiological aversion to death‐related stimuli holds promise as an objective measure of FAD and suicide risk.