呼吸机依赖患者撤机失败原因及对策

机械通气是近年来抢救呼吸衰竭患者的重要生命支持手段,但使用呼吸机的时间超过2周可导致撤机困难。本文详细分析了诸如心理障碍、营养不良、心肺功能不全以及撤机方法不当等各种可导致困难撤机的原因,并针对各个原因提出相应的治疗及护理对策,从而降低临床上困难撤机的发生率。     

An Experimental Analysis of the Effects of Reading Interventions in a Small Group Reading Instruction Context

The current study examined the effects of several combinations of instructional and motivational interventions on oral reading fluency in the context of small group reading instruction. A treatment package consisting of acquisition, fluency, and motivational components was examined and then dismantled. Results were evaluated individually for each participant using a multiple-probe design in order to identify the most effective, yet efficient reading intervention package for each member of the group. The results indicated that, although all potential combinations of the package were effective, the experimental analysis was able to identify an effective yet more efficient package that produced substantial increases in performance across all students. Results are discussed in terms of effective instructional components in small group instruction and how to adapt methods for the experimental analysis of behavior to make decisions about the effectiveness of small group instruction in reading.This study is based on a dissertation submitted by the first author in partial fulfillment of requirements for the doctoral degree.     

Fault Lines in the Great EST Debate

Three fault lines traverse inquiries into empirically supported therapies, along which pro and contra positions can be taken. First, failure to distinguish scientific from artistic properties of therapy has lead to neglect of pervasive personological and cultural variables that are implicated in this field of inquiry. Second, scientific anomalies result from focusing more on what ESTs are than on how they effect change. Psyche is portrayed as a humanistic Cartesian place-holder for an encroaching neuro-endocrinological and systemic understanding of human experiencing. Third, the EST movement is seen as a socio-political and business model, confounded with and eroding scientific objectives.     

TREATING SELF-INJURY: WATER MIST SPRAY VERSUS FACIAL SCREENING OR FORCED ARM EXERCISE

In three experiments, the effect of water mist spray on self-injurious and collateral behaviors was compared with either facial screening or forced arm exercise. Water mist spray was as effective as facial screening in suppressing face-slapping in Experiment 1. However, it was not as effective as facial screening for self-injurious finger-licking in Experiment 2 or forced arm exercise for excessive ear-rubbing in Experiment 3. These results suggest that while water mist spray is effective, it may be less so than alternative procedures. In Experiments 2 and 3 there was a consistent decrease in the occurrence of untreated maladaptive behaviors. In addition, there was a moderate increase in appropriate social interaction in Experiment 2 and a substantial increase in Experiment 3.