Response persistence: the effects of stimulus control on negatively reinforced problem behavior in a concurrent operant

In the context of instructional demands, compliance and problem behavior can be considered concurrent operants. Of applied interest is increasing one response (i.e., compliance) while decreasing the other (i.e., problem behavior). Strategic arrangement of reinforcement can alter response allocation accordingly. Such schedules can also influence response persistence and generalization. A case study is used to illustrate the effects of stimulus-reinforcer relations in a concurrent-operants arrangement involving an adult with developmental disabilities and problem behavior. Results are discussed in the context of basic operant research findings in the areas of stimulus control and behavioral persistence.     

腹内脂肪与胰岛素抵抗

腹内脂肪与胰岛素抵抗的关系密切,它在形态、脂解等方面不同于皮下脂肪。脂肪细胞分泌的细胞因子在胰岛素抵抗的发生发展中有着重要的作用。明确腹内脂肪致胰岛素抵抗的机制有益于代谢综合征的防治。     

细菌耐药性的产生及预防对策

细菌耐药性的产生是当今医学界所普遍面临的严重问题,危害着人类的健康和生存。通过透析细菌耐药的根源和机制,使人们认清细菌耐药性问题的实质,为制定出合理使用抗菌药物的原则和预防细菌耐药性的措施提供一些理论依据。     

慢性乙肝治疗路线图和HBV DNA、HBeAg、HBsAg定量的监测意义

慢性乙型肝炎病毒感染呈世界分布并且引起不良结局,是极为严重的健康问题。慢性乙型肝炎治疗最重要的目标是长期抑制病毒以改善预后,防止出现肝硬化、肝衰竭和肝癌。目前,抗病毒药物主要有干扰素和口服核苷（酸）类似物,核苷（酸）类似物的缺点主要在于长期治疗中出现耐药。路线图概念被用于监测耐药预测疗效。HBV DNA定量水平被作为路线图较好的监测指标。由于血清转换率及清除率过低,HBeAg、HBsAg定量检测不适合用于路线图监测,但对于使用聚乙二醇干扰素的慢性乙肝患者,可作为预测治疗应答的指标。     

内质网应激和胰岛素抵抗

2型糖尿病的发病机制主要涉及胰岛素抵抗,近年来研究表明内质网应激可诱导胰岛素抵抗的形成,并使与改善胰岛素受体敏感性相关的内质网应激标志物分子氧调节蛋白150和转录因子X盒结合蛋白-1表达增强,表明内质网应激对细胞具有双重作用,一方面可诱导胰岛素抵抗,另一方面激发对应激的适应反应。     

细菌耐药性与抗菌药物的合理应用

面对细菌耐药性的客观存在,分别从四个方面讨论抗菌药物的合理应用,即首先是人类如何对待细菌、真菌等微生物,第二是人类如何对待抗菌药物,第三是人类如何认识细菌耐药性,第四是临床医师如何合理应用抗菌药物以确保最佳疗效及遏制细菌耐药性。笔者提出“六化”,即做到用药适应证规范化,做到感染性疾病病原学诊断常规化,提倡感染性疾病病原学治疗选药合理化,逐步做到推广病原菌耐药性信息监测与反馈制度化,强调抗感染治疗用药方案个体化,评价疗效制度日常化。它是追求抗感染疗效最佳化,遏制病原菌耐药性有效化,力争抗菌药物不良反应最小化的基本措施。     

Cognitive And Self-Regulation Aspects Of Perfectionism And Their Implications For Treatment: Introduction To The Special Issue

The current article provides an overview of the papers included in this special issue on the cognitive and self-regulation aspects of perfectionism and their implications for treatment. Themes expressed in these papers include the association between perfectionism and deficits in cognitive self-management, the significant link between distress and automatic thoughts reflecting the need to be perfect, the importance of examining mediators and moderators of the association between perfectionism and psychological distress, and the specific role of perfectionism in suicidal tendencies and self-harm. It is also argued that certain core features of perfectionism and its associated correlates tend to impede treatment progress. Central factors associated with perfectionism that have a deleterious impact on treatment progress include the fear of failure and fear of embarrassment and exposure, a punishing orientation toward the self, pessimism and hopelessness about the possibility of recovery, and a rigid adherence to unrealistic goals and standards, including goals for treatment and recovery. We describe case studies illustrating treatment resistance among perfectionists and we reiterate the growing need for empirical research on the efficacy of clinical interventions designed for perfectionists. This article was supported by major research grants from Health Canada and the Social Sciences and Humanities Research Council (SSHRC) of Canada to the first two authors, and a Canada Research Chair in Personality & Health awarded to the first author.     

The Clinical Challenges of Assimilative Integration

S. B. Messer (1992) introduced the notion of assimilative integration in psychotherapy, theorizing that integrative practitioners adhere to their preferred theoretical paradigms while judiciously blending aspects from other models. His assimilative approach offers a conceptual and clinical middle ground between technical eclecticism and a grand, unified theory of psychotherapy. However, the practice of competent assimilative integration is fraught with many challenges, both theoretical and clinical. The goal of the present paper is to explore the challenges of implementing assimilative integration. First, the theoretical and clinical barriers to assimilative approaches are considered. Second, the use of assimilative integration to avoid therapeutic failures is discussed. Finally, a case example is presented to illustrate the author's attempt to assimilate narrative, interpretive interventions within his preferred cognitive–behavioral treatment paradigm.     

Negotiating Muslim–Christian Relations in Kenya through Waqfs, 1900–2010

Waqfs provided socio-economic security for the progeny of endowers and for other social welfare causes. Being thus guaranteed socio-economic well-being, these beneficiaries were antithetical to ruling elites in Muslim dynasties and Christian colonial powers, which led to the establishment of policies and institutions to control waqfs and check their growing influence. This development was not only counter to normative precepts but also set minority Muslims in predominantly Christian societies at odds with non-Muslim states. To what extent did civil policies and judgements influence waqfs? How did Muslims negotiate the secular state constructs vis-à-vis waqf practices? How did secular state control of waqfs influence the dynamics of Christian–Muslim relations? This discussion, based on ethnographic research in Kenyan coastal areas, employs two theoretical frameworks – Asad's ‘Islam as a discursive tradition’ and Scott’s concept of ‘symbolic (ideological) resistance’. The article draws mainly on the perspective of the Muslim minority in Kenya and argues that state control of waqfs in Kenya did not only interfere with normative practices but also partly laid the ground for the present-day economic and political marginalization and exclusion of Muslims, leading to suspicion and ambiguous relations with their Christian compatriots.     

Resisting the Devil: The Case of Edward Dynham (1626) and Options for English Protestant Dispossession

To the displeasure of many puritans, the Church of England canons of 1604 restricted the casting out of Devils to prayer and fasting. Yet after that date not all possession cases disappeared, nor were all dismissed as false. This article explores ways that long-standing general Protestant as well as puritan theology and practices (especially related to ‘resisting the Devil’) informed post-1604 anti-demonic activity. With a clear biblical basis, and primarily as an individual rather than collective practice, resisting the Devil was embraced by people from a wide range of religious positions and remained unrestricted by the religious establishment. There was variation; not everyone approved of how resisting the Devil was applied in particular cases. Yet ample evidence suggests that dispossessions led by lay people, and by means other than prayer and fasting, did in fact have a place within (and influenced the development of) Protestantism in early-modern England.