放弃治疗后,以护理为主导的医学服务和人文关怀

剖析放弃治疗后死亡病案508例,分析放弃治疗的原因、疾病和形式,放弃治疗后护理工作存在的问题.提出在放弃治疗后,临床护理决策:对于护理工作发生的变化,应该提高认识,培养护理人员人文素质和法律意识,应该加强护理管理和规范,放弃治疗后,护理应该承担医学服务和人文关怀的主导作用.     

Stanford-Binet and WAIS IQ differences and their implications for adults with intellectual disability (aka mental retardation)

Stanford-Binet and Wechsler Adult Intelligence Scale (WAIS) IQs were compared for a group of 74 adults with intellectual disability (ID). In every case, WAIS Full Scale IQ was higher than the Stanford-Binet Composite IQ, with a mean difference of 16.7 points. These differences did not appear to be due to the lower minimum possible score for the Stanford-Binet. Additional comparisons with other measures suggested that the WAIS might systematically underestimate severity of intellectual impairment. Implications of these findings are discussed regarding determination of disability status, estimating prevalence of ID, assessing dementia and aging-related cognitive declines, and diagnosis of ID in forensic cases involving a possible death penalty.     

Media Internalization and Social Comparison as Predictors of Eating Pathology Among Latino Adolescents: The Moderating Effect of Gender and Generational Status

Using a sociocultural framework, this cross-sectional study examined eating pathology among 235 Latino adolescents from the Southwestern U.S. who differed in generational status. Participants completed self-report measures of media pressures, internalization, social comparison, and eating pathology. Overall, results revealed stronger relationships between these sociocultural variables and eating pathology for girls. Girls reported greater social comparison, thin-ideal pressure and internalization, and eating pathology than boys. Generational status was positively correlated with these sociocultural variables and eating pathology for girls only. Moderated hierarchical regression analyses indicated that athletic-ideal internalization was a key predictor of eating pathology for girls but not boys. Discussion highlights gender, more than generational status, as critical to a sociocultural framework for eating pathology among adolescent Latino Americans.     

申遗成功后的五台山旅游业发展

五台山是属于全人类的宝贵遗产。作为世界文化景观遗产的价值体现在佛教圣地、艺术宝库、清凉胜境等方面。申遗成功后,五台山旅游发展要注意处理好遗产保护与利用的关系、宗教文化与旅游的关系,要建设完善的五台山旅游服务体系,科学开发五台山客源市场。为建设和谐五台山,仍须推进管理体制改革,探索旅游资源一体化的管理模式,转变产业发展方式,加强对旅游活动的管理,加强对本地居民的教育,关注他们的生存与发展。     

The role of the dorsal CA1 and ventral CA1 in memory for the temporal order of a sequence of odors

Memory for the temporal order of a sequence of odors was assessed in male rats. A sequence of five odors mixed in sand was presented in digging cups one at a time to each rat in a sequence that varied on each trial. A reward was buried in each cup. Following the fifth odor, two of the previous five odors were presented simultaneously and the rat needed to choose the odor that occurred earliest in the sequence to receive a reward. Temporal separations of 1, 2, or 3 were used which represented the number of odors that occurred between the two odors in the sequence. Once pre-operative criterion was reached, rats received a control, dorsal CA1 (dCA1), or ventral CA1 (vCA1) lesion and were retested on the task. On post-operative trials, only the vCA1 group was impaired relative to both control and dCA1 groups. All groups of rats could discriminate between the odors. The data suggest that the vCA1, but not dorsal CA1, is involved in separating sensory events (odors) in time so that one odor can be remembered separate from another odor.     

脂多糖激活所致大鼠抑郁样行为及对海马神经细胞钾电流变化的影响

采用细胞因子刺激剂脂多糖(lipopolysaccharide, LPS)为免疫激活手段, 研究LPS诱导的免疫激活产生的抑郁样行为及对海马神经细胞电压依赖钾电流变化的影响。应用膜片钳技术对海马神经细胞钾电流进行全细胞记录, 比较抑郁样行为大鼠与正常大鼠钾离子通道电流密度和激活特性的变化。结果发现, 与生理盐水对照组相比, 一次LPS注射后2 hr, 实验组动物产生抑郁样行为, 同时急性观察的海马神经细胞的钾离子通道的电流密度呈现显著升高(p<0.01); 而一次LPS注射后24 hr, 动物的抑郁样行为消失, 且急性观察的海马神经细胞的钾离子通道与对照组相比较, 其电流密度和激活曲线没有显著性变化。结论：LPS诱导的抑郁样行为, 与LPS诱导的海马神经细胞电压依赖钾电流的上调在时程上同步, 提示钾离子通道可能参与免疫激活所致的抑郁样行为。     

利他惩罚的发生机制及其神经基础

利他惩罚是指个体为惩罚违反社会规范的人而自愿个人支付成本,它在人类合作演化过程中扮演着重要的作用。"认知控制"与"情绪满足"被用来阐述利他惩罚的产生机制。而神经层面的研究也发现,利他惩罚主要涉及以背外侧前额叶皮层为主的基于规则的系统和包括纹状体、内侧前额叶皮层以及脑岛等脑区在内的情绪驱动系统。此外,5-羟色胺、多巴胺等神经递质可能是利他惩罚行为发生的神经生化基础。未来研究除了需进一步深入探讨与整合利他惩罚的发生机制、神经机制、基因机制以外,还应注重利他惩罚在自然情境下的研究。     

奖赏预期调节局部注意干扰效应

局部注意干扰效应(Localized attentional interference, LAI)是指在视觉搜索任务中同时搜索在空间上分离的两个目标时, 或者目标周围存在一个无关奇异项时, 这两个关键刺激相距较近时产生的干扰现象。本实验采用视觉搜索范式, 探讨了奖赏预期对局部注意干扰效应的影响。实验1采用双目标搜索任务, 要求被试判断搜索画面中两个奇异项刺激的形状是否相同。结果显示奖赏条件和无奖赏条件都表现出显著的距离主效应, 随着目标间距离增大, 被试的正确率提高, 反应时下降。同时, 在远距离时, 奖赏条件下的正确率高于无奖赏条件, 而在近距离时, 奖赏条件下的正确率反而低于无奖赏条件, 即, 奖赏条件下局部注意干扰效应反而增大。高动机状态增强了两个目标的表征, 反而不利于解决局部注意干扰效应。实验2采用单目标搜索任务, 要求被试判断特定目标的方位并忽略另一无关奇异项刺激。与实验1不同的是, 实验2仅在无奖赏条件下观察到显著的距离主效应, 即被试行为表现在远距离时更好; 而在奖赏条件下, 被试在近距离和远距离的表现一样好, 即没有局部注意干扰效应。这说明在奖赏预期条件, 个体可以有效抑制分心物刺激的干扰, 将注意集中于目标刺激的加工, 从而对局部注意干扰效应产生调节。整个研究表明, 奖赏整体上能够提高对任务相关刺激的表征, 并抑制任务无关刺激, 虽然这并不总是能够提高任务表现。     

童年晚期亲社会行为与儿童的心理社会适应

对2097名六年级儿童(平均年龄12.27岁, 男生1093名)的亲社会行为以及多种心理社会适应指标进行测量, 主要运用个体定向的方法考察童年晚期亲社会行为与儿童心理社会适应之间的关系。结果发现:(1)亲社会行为与孤独感、攻击等不良适应呈中等程度负相关, 与同伴接纳、社交自我概念等积极适应呈中等程度正相关;(2)童年晚期儿童的心理社会适应表现为内化问题、外化问题、同伴拒绝与正常发展4种模式;(3)个体亲社会行为水平越高, 越可能属于正常发展组, 越不可能属于不良适应组;在各种不良适应组中, 个体亲社会行为水平越高, 更可能属于内化问题组, 而非外化问题和同伴拒绝组;(4)高亲社会组的儿童有6.8%存在内化问题;低亲社会组的儿童有50.2%适应良好;与普通儿童相比, 低亲社会组的儿童表现出更多的适应不良。     

家长投入对中小学生学业投入的影响:有中介的调节模型

以北京市12所中小学的4160名学生为调查对象,采用层次回归方法考察了家长投入对子女学业投入的影响以及家长自主支持/控制的教养风格和子女的学业心理需要满足在其中的作用。结果发现:(1)中小学生的家长投入程度随学段升高而降低;(2)家长注重在家辅导方面的投入,在参与社区及学校活动等方面的投入较为欠缺;(3)家长投入对子女的学业投入具有显著的正向预测作用;(4)家长自主支持/控制的教养风格在家长投入与子女学业投入的关系中起调节作用,且该调节效应部分地通过子女的学业心理需要满足这一中介变量产生作用。