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81.
We evaluated the effects of a behavioral treatment on the safe passing of sharp instruments using the hands-free technique among hospital operating room personnel during surgical procedures. Treatment consisted of participative goal setting, task clarification, and feedback. The average percentage of sharp instruments passed safely increased from 32% to 64% and 31% to 70% between baseline and treatment phases in the inpatient and outpatient surgery units, respectively. Five-month follow-up data suggested maintenance of treatment effects. These findings suggest the utility of organizational behavior management strategies in reducing risky behavior in hospital settings. 相似文献
82.
淡化糖尿病的分型为我们提供了一个全新的思维空间。即传统的1型和至少部分2型糖尿病可能都是一种自身免疫性疾病,而目前流行的炎症学说可能是对认可免疫损伤是糖尿病发病理论的一个过渡,我们应该重新审视糖尿病的早期治疗和研究其慢性并发症的发病机理。我们则采用小别量、长时间的治疗理念,早期接受这种免疫治疗的患者出现低血糖的症状,遂减少胰岛素的剂量;再次出现低血糖,我们就继续减少胰岛素的剂量。结果,有部分患者完全摆脱了胰岛素。我们对糖尿病的再认识是建立在对多脏器活检的基础之上。我们的活检结果表明,糖尿病肾病存在着免疫损伤。糖尿病眼底病变是使患者致盲的主要病因,糖尿病患者的眼底病变是一种自身免疫损伤的结果。我们尝试用小剂量的免疫抑制剂环孢菌素A(25mgbid)治疗糖尿病眼底出血,取得了不错的疗效,也证实糖尿病眼底病变是一种血管炎,与自身免疫病变有关。其他的器官还包括垂体、大脑的血管、糖尿病足、冠心病、皮肤的病变和肌肉活检的免疫组化也均有证据表明,免疫损伤是导致多种慢性并发症的罪魁祸首,是一种多器官免疫损伤的结果无论是1型糖尿病,还是2型糖尿病,肌细胞表面或多或少均有免疫复合物沉积。这些免疫复合物的存在势必会影响胰岛素与肌肉细胞表面的胰岛素受体结合,即胰岛素抵抗的存在。为此,我们在临床上广泛采用了免疫抑制治疗的理念治疗糖尿病。应用小剂量胰岛素和小剂量环孢素A治疗早期发现的糖尿病取得了不错的疗效。唯一担心的副作用发生在肝脏,即部分糖尿病患者会出现总胆红素升高,而也有一部分患者总胆红素不升高。 相似文献
83.
药物性肝损伤的诊断思维 总被引:5,自引:0,他引:5
药物性肝损伤(DILI)是指由于药物或其代谢产物引起的肝脏损害。DILI的诊断尚无金标准,目前国际上比较常用的诊断标准分别从数个不同方面各自进行量化评分,根据得分情况做出诊断。本文归纳DILI的产生机制、诊断标准、临床分型及病理类型,总结推论其临床诊断思维与决策,以供临床医生参考,提高诊断水平。 相似文献
84.
Megan R Heinicke James E Carr Michael P Mozzoni Henry Roane 《Journal of applied behavior analysis》2009,42(4):861-865
The present study investigated the effects of contingency‐specifying rules and a token economy to decrease the latency to comply with academic instructions by a 16‐year‐old girl with acquired brain injury. Results showed that treatment was successful in reducing academic response latencies. These results replicate previous research in which differential reinforcement was used to decrease slow responding to academic tasks. 相似文献
85.
Motor disorders are a frequent consequence of acquired brain injury (ABI) in children and much effort is currently invested in alleviating these deficits. The aim of the present study was to test motor imagery (MI) capabilities in children with ABI (n=25) and an age- and gender-matched control group (n=25). A computerized Virtual Radial Fitts Task (VRFT) was used to investigate the speed-accuracy trade-offs (or Fitts' law) that occur as target size is varied for both executed and imagined performance. In the control group, the speed for accuracy trade-off for both executed and imagined performance conformed to Fitts' law. In the ABI group, only executed movements conformed to Fitts' law. These findings suggest that children with ABI show an inferior ability to imagine the time needed to complete goal-directed movements with differential difficulty levels. 相似文献
86.
Renu Sharma Persaud 《International Journal of Children's Spirituality》2009,14(2):129-149
This paper introduces the topic of spiritual injury and the possible influences and relationships it might share with education‐to‐work transitions of young adults. Students of both dominant and minority cultural backgrounds were interviewed to gain a detailed understanding of how perceptions of transitions came about. Further, I sought to understand what role spirituality and experiences of spirit injury have in the decision‐making processes. 相似文献
87.
Jonathan Cole 《Phenomenology and the Cognitive Sciences》2009,8(3):343-360
This paper considers the importance of the body for self-esteem, communication, and emotional expression and experience, through the reflections of those who live with various neurological impairments of movement and sensation; sensory deafferentation, spinal cord injury and Möbius Syndrome (the congenital absence of facial expression). People with severe sensory loss, who require conscious attention and visual feedback for movement, describe the imperative to use the same strategies to reacquire gesture, to appear normal and have embodied expression. Those paralysed after spinal cord injury struggle to have others see them as people rather than as people in wheelchairs and have been active in the disability movement, distinguishing between their medical impairment and the social induced disability others project onto them. Lastly those with Möbius reveal the importance of the face for emotional expression and communication and indeed for emotional experience itself. All these examples explore the crucial role of the body as agent for social and personal expression and self-esteem. 相似文献
88.
道德韧性是成功应对道德逆境的高尚道德操守。面对新型冠状病毒感染的肺炎疫情,中华民族的道德韧性得以彰显,有效地遏制了道德创伤的发生;但社会个体道德韧性的缺失,也使得部分道德创伤不容忽视,如果任其恣意蔓延必将消解和冲击人们抗击疫情的道德情感和道德意志。抵御疫情中的道德创伤,必须在坚定文化自信中传承道德韧性,在应对道德逆境中塑造道德韧性,在探寻生命意义中升华道德韧性,在领导和权威人士履职尽责中激发道德韧性。 相似文献
89.
总结提高胰头癌手术切除率、手术技巧和治疗效果的经验。回顾性分析自2003年9月起收治的39例胰头癌病人的临床资料,术中采用解剖性探查、蚊式钳勾划技术,对36例病人全部一次性行胰十二指肠切除术(PD)。手术切除率92.31%,剥离出的癌灶侵犯血管壁的断缘组织中镜下见到癌细胞25.93%,淋巴结转移率47.22%;胰周神经节、丛侵犯率55.56%,并发症发生率25.00%。解剖性探查、蚊式钳勾划技术的应用显著提高胰十二指肠切除率。 相似文献
90.
中学生心理危机分类模型属于复杂数据模型,本文采用分类树算法探究家庭、校园、同伴和个体因素在中学生心理危机分类中的相对重要性差异,尤其是心理痛苦三因素对致死性危机的独特作用。结果显示:(1)中学生自杀危机和非致死性危机分类树的分类效果良好,自伤危机分类树的分类效果欠佳;(2)中学生自杀危机中,痛苦逃避最为重要,痛苦唤醒次之,之后为痛苦体验和学校满意度;(3)中学生自伤危机中,同伴问题行为最为重要,之后为父母陪伴和家庭监督;(4)中学生非致死性危机中,歧视知觉最为重要,之后为痛苦唤醒和同伴支持。提示中学生不同心理危机的促发机制存在差异,心理痛苦三因素模型在自杀分类模型中作用显著,但并非自伤危机和非致死性危机的关键变量。 相似文献