镇静与镇痛在ICU机械通气患者中的应用变化

探讨ICU内机械通气患者应用镇痛剂、镇静剂及肌松剂的情况及其对机械通气和预后的影响。回顾性分析我院中心ICU2006年、2007年收治的244例行有创机械通气治疗超过48h患者的临床资料,并将患者分为2006年组和2007年纽,用统计软件分析患者在年龄、性别、入ICU时APACHEⅡ评分、血糖、血浆白蛋白、基础疾病,气管插管时间、机械通气时间、ICU住院天数、镇痛与镇静剂应用的时间、机械通气时是否使用肌松剂、Ramsay评分及病死率方面是否存在差别。统计分析显示2006年组和2007年组在年龄、性剐、入ICU时APACHEⅡ评分、血糖、血浆白蛋白、是否使用肌松剂及基础疾病方面无差别;与2006年组相比2007年组患者气管插管时间、机械通气时间及ICU住院天数均缩短,镇痛与镇静剂应用时间均缩短,Ramsay评分降低,病死率下降。提示对机械通气的危重症患者应合理使用镇痛剂与镇静剂。     

Peer Experiences of Anxious and Socially Withdrawn Youth: An Integrative Review of the Developmental and Clinical Literature

Prior research indicates that both anxious youth and socially withdrawn youth tend to experience challenges and difficulties in various aspects of their peer relationships and social functioning. While clinical psychology researchers have examined how anxiety relates to peer experiences using normative and clinically anxious samples, developmental psychologists have focused primarily on the peer experiences of shy and withdrawn children. Research from these two fields has progressed on related yet separate paths, producing similar results despite using different terminology and assessment techniques. The purpose of this review is to bring together the developmental and clinical bodies of literature on the peer experiences of anxious and socially withdrawn youth by identifying common themes and unique contributions of each discipline. Studies reviewed focus specifically on the peer constructs of acceptance, friendship, peer victimization, social skills, and social-cognitive processes. Limitations including methodological inconsistencies and insufficient examination of age-, gender-, and ethnicity-related issues are identified. Recommendations for future collaborations between developmental and clinical researchers as well as implications for interventions targeting the peer relations of anxious and withdrawn youth are discussed.     

Multiple-interval timing in rats: Performance on two-valued mixed fixed-interval schedules

Three experiments studied timing in rats on 2-valued mixed-fixed-interval schedules, with equally probable components, Fixed-Interval S and Fixed-Interval L (FI S and FI L, respectively). When the L:S ratio was greater than 4, 2 distinct response peaks appeared close to FI S and FI L, and data could be well fitted by the sum of 2 Gaussian curves. When the L:S ratio was less than 4, only 1 response peak was usually visible, but nonlinear regression often identified separate sources of behavioral control, by FI S and FI L, although control by FI L dominated. Data were used to test ideas derived from scalar expectancy theory, the behavioral theory of timing, and learning to time.     

Acalculia: An historical review of localization

This article reviews the brain localization of calculation disorders (acalculia) beginning with Gall's claim in the early 19th century for a "center" of calculation. A renewed interest in the subject arose around the time of Henschen during the first quarter of the 20th century. A summary of the cases of acalculia since Henschen leads to the conclusion that regardless of the functional modular nature of calculation ability, there is neither a localized region nor a specific hemisphere uniquely underlying the disorder.     

Neighborhood & Family Effects on Learning Motivation among Urban African American Middle School Youth

Motivational theorists in psychology have moved away from individual-based approaches to socio-cognitive and socio-ecological models to explain student engagement and motivation for learning. Such approaches consider, for example, the influence of family and neighborhood environments as important constructs in youth behavior. In this study, links between neighborhood condition (e.g. external appearance of the blocks nearest to the respondents’ home), family dysfunction, and motivation for learning are investigated. Data were obtained from two hundred and sixteen (216) urban African American middle school children enrolled in a substance use prevention intervention. Analytic models show associations between poor neighborhood condition, and both family dysfunction and lower learning motivation, and poor neighborhood condition and lower learning motivation. Family dysfunction was also found to mediate the effect of neighborhood condition on motivated learning. Neighborhood and family characteristics are important determinants of urban schoolchildren’s motivation for learning.     

Linking Feedback Quality and Goal Orientation to Feedback Seeking and Job Performance

Contemporary feedback researchers have adopted theoretical perspectives in which personal characteristics interact with aspects of the feedback environment to influence feedback-related perceptions, feedback seeking, and job performance. To test these assertions, this study incorporates implicit person theory, uncertainty reduction theory, and Korman's theory of work motivation (2001) to develop a model that links a critical aspect of the feedback environment (feedback quality) and goal orientation to perceptions of feedback utility, feedback seeking, role clarity, and task performance and organizational citizenship behaviors. Results from supervisor–subordinate dyadic data (N?=?202) obtained from employed students largely support the hypothesized model. Implications are discussed.     

Scaling Estimates of Amplitude for Movements Without Visual Guidance

Three groups of subjects were involved in estimating movement amplitudes. Two of these groups used the method of estimation, labeling the amplitudes of simple linear movements in inches. One group made active movements, the other experienced passive movement of the arm. The third group, using the method of production, attempted to move the distance required by the experimenter’s label. Performance was described in terms of absolute, algebraic, and intrasubject variable error. No striking differences were noted between the three task groups, but males and females differed systematically. Females tended to over-estimate and males to underestimate the distances moved. Lack of evidence for any range effect suggests that subjects were operating from relatively stable perceptual traces, accessed by the verbal labels, rather than from memory traces of previous estimates of the same amplitudes.     

Essay review

C. W. A. Whitaker, Aristotle’s De Interpretatione. Contradiction and Dialectic. Oxford:Clarendon Press, 1996. x + 235 pp., £30. ISBN 0 19 823619 0

Ulrich Nortmann, Modale Syllogismen, mögliche Welten, Essentialismus. Eine Analyse der aristotelischen Modallogik (Perspektiven der Analytischen Philo-sophie/Perspectives in Analytical Philosophy, 9). Berlin and New York:Walter de Gruyter, 1996. x + 427 pp. DM 260.00 (for members of the Society for Analytical Philosophy DM 98.00). ISBN 3-11-014660-6