冠脉介入治疗合理临床应用的思维基础

冠心病的发病率逐年升高,死亡率居高不下,成为威胁人类健康的重要疾病。人们为了攻克这一难题进行了不懈的工作,溶栓、监护及介入治疗的出现挽救了众多生命。随着冠状动脉介入治疗方法的不断完善和广泛开展,冠状动脉介入治疗越来越成为冠心病治疗的主要临床手段。但随之而来的手术并发症、支架在狭窄等问题成为不得不考虑的问题。治疗策略的选...     

谈谈个人对智力落后儿童早期干预的看法

本文作者根据从事智力落后儿童的早期干预教学研究的实践经验对当今在我国开展早期干预的必要性以及早期干预的目的、设置的理由、内容、方式、对象、教师的条件、效果的评价以及开展的步骤等9个问题,提出了自己的看法。     

THE WORLDWIDE BURDEN OF INFANT MENTAL AND EMOTIONAL DISORDER: REPORT OF THE TASK FORCE OF THE WORLD ASSOCIATION FOR INFANT MENTAL HEALTH

Children worldwide experience mental and emotional disorders. Mental disorders occurring among young children, especially infants (birth –3 years), often go unrecognized. Prevalence rates are difficult to determine because of lack of awareness and difficulty assessing and diagnosing young children. Existing data, however, suggest that rates of disorders in young children are comparable to those of older children and adolescents (von Klitzing, Dohnert, Kroll, & Grube, 2015 ). The lack of widespread recognition of disorders of infancy is particularly concerning due to the unique positioning of infancy as foundational in the developmental process. Both the brain and behavior are in vulnerable states of development across the first 3 years of life, with potential for enduring deviations to occur in response to early trauma and deprivation. Intervention approaches for young children require sensitivity to their developmental needs within their families. The primacy of infancy as a time of unique foundational risks for disorder, the impact of trauma and violence on young children's development, the impact of family disruption on children's attachment, and existing literature on prevalence rates of early disorders are discussed. Finally, global priorities for addressing these disorders of infancy are highlighted to support prevention and intervention actions that may alleviate suffering among our youngest world citizens.     

Fostering networking behavior,career planning and optimism,and subjective career success: An intervention study

The present study evaluated personal resource-oriented interventions supporting the career development of young academics, working at German universities within the STEM fields. The study sought to foster subjective career success by improving networking behavior, career planning, and career optimism. The study involved a quasi-experimental pre-post intervention with two intervention and two control groups (N = 81 research associates). Participants of the first intervention group received networking training; participants of the second intervention group received the same networking training plus individual career coaching. Participants of both intervention groups were female. Participants of the control groups (i.e., male vs. female group) did not participate in any intervention. As expected, path analyses, based on mean differences from pre-test to post-test, revealed an increase in career planning and career optimism within the networking plus career coaching intervention group, that was indirectly positively related to changes in subjective career success. Contrary to our expectations, the networking group training alone and in combination with the career coaching showed no effectiveness in fostering networking behavior. Results are discussed in the context of career counseling and intervention effectiveness studies.     

One-to-one support for crisis intervention using online synchronous instant messaging: evaluating working alliance and client satisfaction

Young people are increasingly turning to online support, especially when traditional mental health services are not immediately available. Using a cross-sectional design, sociodemographic information and self-reported perceptions of the strength of the working alliance and client satisfaction were collected from a sample of participants (n = 78) who were users of a service providing free online support using synchronous instant messaging. The results reported a significant positive relationship between the strength of the working alliance and client satisfaction, suggesting that the strength of the working alliance remains a key component in counselling, even online. Participants, however, scored significantly lower on both the strength of the working alliance and client satisfaction, compared to participants in offline settings as reported in past studies.     

Using Small-Group Instruction to Improve Students' Reading Fluency: An Evaluation of the Existing Research

Reading fluency is necessary for reading comprehension, but approximately 40% of U.S. fourth-grade students have inadequate reading fluency skills. Because small-group (SG) instruction is often used as a first line of intervention for struggling readers, SG instruction targeting deficiencies in text reading fluency ought to be part of every school's intervention toolbox. The authors summarize the existing research on instruction and interventions that specifically targets reading fluency and is implemented by an adult with 3 or more students at once. Key findings revealed that most studies used a single-case design, nearly all studies were rated positively in terms of methodological quality, and the majority of participants significantly improved as a result of receiving SG intervention. Furthermore, of the five studies examining comparable SG and 1-on-1 interventions, 79% of the students performed equally well from both interventions. Implications and several recommendations for future research are discussed.     

Interventions for Midlife Smoking Cessation: A Literature Review

Midlife smoking continues to be a problem in Australia, with substantial personal, social, and financial costs. Yet the specific characteristics and needs of this group have been largely overlooked. Here we review the literature for the purposes of (1) profiling the characteristics of midlife smokers and (2) assessing the effectiveness of interventions for this group. This review shows midlife smokers differ from younger smokers in important ways: they underestimate the costs of smoking and overestimate the benefits, and are less confident in their ability to quit. The few studies investigating age‐tailored interventions have shown these to be effective in reducing midlife smoking. Still, research in this area is limited, with only one study conducted during the past decade that investigated smoking interventions for those in midlife. Clearly there is a need for smoking cessation interventions for midlife smokers that are tailored to the specific beliefs and needs of this unique group. Future research should focus on establishing the best methods for interventions for those individuals who are resistant to earlier interventions and still continue smoking into midlife. Interventions may benefit from incorporating recent evidence about the less obvious costs associated with midlife smoking, including later‐life neurological disease.     

What is the Accordion Effect?

In "Action and Responsibility,' Joel Feinberg pointed to an important idea to which he gave the label "the accordion effect.' Feinberg's discussion of this idea is of interest on its own, but it is also of interest because of its interaction with his critique, in his "Causing Voluntary Actions,' of a much discussed view of H. L. A. Hart and A. M. Honoré that Feinberg labels the "voluntary intervention principle.' In this essay I reflect on what the accordion effect is supposed by Feinberg to be, on differences between Feinberg's understanding of this idea and that of Donald Davidson, and on the interaction between Feinberg's discussion of the accordion effect and his critique of the voluntary intervention principle.     

A cognitive behavioral workshop for subclinical obsessions and compulsions

The present study investigates the effectiveness of a 3-h cognitive behavioral workshop for individuals, ages 18-22, with subclinical obsessions and compulsions. It was hypothesized that, compared to individuals in an assessment-only waitlist group (n = 42), individuals assigned to the workshop group (n = 43) would experience a significant decrease in obsessive-compulsive (OC) symptomatology, comorbidity, and thought action fusion endorsement at 1-month and 5-month follow-up assessments. An additional outcome of interest was the number of incident cases of obsessive-compulsive disorder (OCD) over the course of the study. The results indicated that the workshop group reported a significantly fewer number of OC symptoms at 5-month follow-up and endorsed significantly less thought action fusion at both follow-up points. However, there were no differences between groups in severity of OC symptoms and number of comorbid diagnoses endorsed. Only one incident case of OCD was observed during the study, from a participant in the waitlist group. These results are discussed in reference to treatment of subclinical anxiety symptoms.