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51.
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。  相似文献   
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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.  相似文献   
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This commentary discusses causal estimands of same-age and same-grade comparisons for assessing grade-retention effects on student ability and performance. Using potential outcomes notation, we show that same-age and same-grade comparisons refer to different retention–promotion contrasts and therefore assess different causal questions. We also comment on deleting versus censoring records of students who dropped out of the study or do not belong to the treatment regimes under investigation. Whereas deleting entire student records potentially induces collider bias, censoring circumvents bias if censoring is ignorable given the observed pretreatment covariates.  相似文献   
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The Mini-Social Phobia Inventory (Mini-SPIN) is a brief, three-item measure designed as a screening tool for social anxiety disorder (SAD). This study investigated the Mini-SPIN’s psychometric properties in a series of trials of Internet-delivered treatment. Participants were 993 people seeking Internet-delivered cognitive behavioural therapy for a range of anxiety and mood disorders. Participants completed the Mini-SPIN, and were diagnosed using the Mini International Neuropsychiatric Interview Version 5.0.0 (MINI). They also completed measures of depression, general anxiety, panic, neuroticism and general impairment. The Mini-SPIN’s ability to discriminate between people with and without SAD, within a large sample of people seeking treatment for a range of psychological disorders, was assessed at initial assessment and three-month follow-up. The Mini-SPIN’s criterion group validity, internal consistency, test–retest reliability, construct validity and responsiveness to treatment were also examined. Results demonstrated that the Mini-SPIN has an excellent ability to discriminate between those with and without SAD in a highly comorbid clinical sample, and also has good criterion group validity. The Mini-SPIN also exhibited excellent internal consistency, good test–retest reliability, and was responsive to treatment. These results highlight the Mini-SPIN’s potential as an efficient and reliable measure of SAD in heterogenous populations.  相似文献   
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The current study examined the effects of bite placement with a flipped versus upright spoon on expulsion and mouth clean (product measure of swallowing) in the treatment of 3 children diagnosed with a pediatric feeding disorder and oral-motor deficits. For all 3 participants, extinction in the form of nonremoval of the spoon led to improvements in inappropriate mealtime behavior and acceptance of bites; however, re-presentation did not reduce expulsion or improve mouth clean. Results showed a lower level of expulsion and higher percentage of mouth clean during flipped spoon presentations and re-presentations for all participants. Findings from follow-up analyses supported transitioning back to an upright spoon in all 3 cases, although the time required for this to occur differed across participants.  相似文献   
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This commentary offers a critical reflection on the current status of evidence-based psychological treatments for psychological distress in dementia, with a particular emphasis on acceptance and commitment therapy (ACT).  相似文献   
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Participants with symptoms of depression received either eight sessions of therapist-delivered email cognitive behaviour therapy (eCBT; n=37), or eight sessions of computerised CBT self-administered treatment (cCBT; n=43). At post-treatment participants completed a questionnaire to determine what they found satisfying about their online treatment. Quantitative and qualitative analysis was employed to report outcomes. A sample of 25 participants(eCBT n=10; cCBT n=15) completed the satisfaction questionnaire. Both groups were satisfied with accessing and using an online treatment and that they had self-control over their treatment. Perceived anonymity was important for the eCBT group. For the cCBT group they found the treatment user-friendly, engaging and also a source of learning. Both groups disliked that the online treatment could at times be complicated and impersonal.  相似文献   
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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.  相似文献   
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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.  相似文献   
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