Evaluation of a High School Peer Group Intervention for At-Risk Youth

The purpose of this paper is to examine the effectiveness of Reconnecting Youth, a prevention program for at-risk high school youth. Data are from a large, independently evaluated effectiveness trial in two diverse urban school districts. A total of 1,218 students participated; 50% were male; average age was 15. We tested whether positive efficacy trial effects could be replicated, and whether any negative behavioral effects occur when clustering high-risk youth. Although mixed program effects were observed at immediate post-intervention, only negative effects were found at 6-month follow-up. These effects included less optimal scores on measures of GPA, Anger, School Connectedness, Conventional Peer Bonding, and Peer High-Risk Behaviors. Overall, we found little support for the use of this social-influence—model intervention aimed at increasing school connectedness for high-risk youth. Further, this study provides evidence that clustering high-risk youth in preventive interventions has the potential for iatrogenic effects.     

Working Memory and Learning in Early Alzheimer’s Disease

Cognitive deficits associated with early Alzheimers disease (AD) have been recently operationalised in terms of an acquisition deficit and the research supporting this view is presented. However, there is still debate concerning the nature of this deficit and how underlying cognitive processes may be detrimentally affecting the ability to acquire new information in early AD. This review argues that the pattern of cognitive deficits contributing to the acquisition impairment in early AD patients may be readily interpreted within the context of a working memory model. Isolating the component processes of working memory that underlie the acquisition deficit in early AD patients will aid in the design of clinical applications that are focussed at enhancing the ability to acquire new information in everyday life.     

Musical and verbal memory in Alzheimer’s disease: A study of long-term and short-term memory

Musical memory was tested in Alzheimer patients and in healthy older adults using long-term and short-term memory tasks. Long-term memory (LTM) was tested with a recognition procedure using unfamiliar melodies. Short-term memory (STM) was evaluated with same/different judgment tasks on short series of notes. Musical memory was compared to verbal memory using a task that used pseudowords (LTM) or syllables (STM). Results indicated impaired musical memory in AD patients relative to healthy controls. The deficit was found for both long-term and short-term memory. Furthermore, it was of the same magnitude for both musical and verbal domains whether tested with short-term or long-term memory tasks. No correlation was found between musical and verbal LTM. However, there was a significant correlation between verbal and musical STM in AD participants and healthy older adults, which suggests that the two domains may share common mechanisms.     

再生障碍性贫血发病机制认识的发展与启示

再生障碍性贫血的发病机制已经突破了“种子”、“土壤”、“虫子”学说,并沿着“免疫异常”理论进入“自身免疫病”理论。同时这是一个科学思维付诸实践不断探索的过程。大量证据表明再生障碍性贫血是一种自身免疫病,它应该符合自身免疫病的共性,这一认识开阔了人们的视野,使人们能在更高的层面上考察原来的事物。     

冠心病理想治疗方式的选择

冠心病的治疗包括针对高危因素病因和临床并发症的综合治疗。其中,药物治疗主要包括：抗凝／抗血小板、控制血压和调脂等。血管重建术主要包括：介入、搭桥、“杂交”手术和分子生物学治疗。药物治疗是冠心病各种治疗方法的基础,而血管重建术是现代治疗冠心病的重要手段。如何合理地选择治疗方案是临床医师面临的重要课题。     

冠心病的外科治疗

首例成功的冠状动脉旁路移植术（CABG）手术完成于1960年,随着体外循环技术的成熟,CABG手术得以不断发展。20世纪90年代,以非体外循环下冠脉旁路移植术（0PCAB）为代表的微创冠脉搭桥手术逐渐应用于临床,并取得满意的临床效果。尽管冠脉介入技术（PCI）以其创伤小的优点在冠心病的治疗方面蓬勃发展,但是CABG在远期通畅性方面仍然占据优势地位,因此CABG仍然是冠心病治疗的效果确定的一种方法。     

Health behaviour change theory meets falls prevention: Feasibility of a habit-based balance and strength exercise intervention for older adults

ObjectivesHabit formation is a proposed mechanism for behaviour maintenance. Very few falls prevention studies have adopted this as an intervention framework and outcome. Therefore, we tested feasibility of a theory-based behaviour change intervention that encouraged women to embed balance and strength exercises into daily life routines (e.g., eating, self-care routines).DesignThe EASY LiFE study was a mixed-methods, 4-month feasibility intervention that included seven group-based sessions and two telephone calls.Main outcome measuresWe obtained performance-based (i.e., Short-Physical-Performance-Battery) and psychological self-report measures (i.e., intention, self-efficacy, planning, action control, habit strength, quality of life) from 13 women at baseline (T1) and 4-month follow-up (T2). We applied the Framework-Method to post-intervention, semi-structured interviews to evaluate program content and delivery.ResultsIn total, 10 of 13 women completed the program (M_age = 66.23, SD = 3.98) and showed changes in their level of action control [mean difference_T1−T2 = 1.7, 95% CI (−2.2 to −0.8)], action planning [mean difference_T1−T2 = 0.8, 95% CI (−1.1 to −0.2)], automaticity [mean difference_T1−T2 = 2.5, 95% CI (−3.7 to −1.2)], and exercise identity [mean difference_T1−T2 = 2.0, 95% CI (−3.2 to −0.8)]. Based on the Theoretical Domains Framework we identified knowledge, behavioural regulation, and social factors as important themes. For program delivery, dominant themes were engagement, session facilitators and group format.ConclusionThe theory-based framework showed feasibility for promoting lifestyle integrated balance and strength exercise habits. Using activity and object-based cues may be particularly effective in generating action and automaticity.     

New Directions in the Cognitive-Behavioral Treatment of OCD: Theory,Research, and Practice

The beneficial effects of cognitive-behavioral interventions (particularly exposure and response prevention) for OCD are among the most consistent research findings in the mental health literature. Nevertheless, even after an adequate trial, many individuals experience residual symptoms, and others never receive adequate treatment due to limited access. These and other issues have prompted clinicians and researchers to search for ways to improve the conceptual and practical aspects of existing treatment approaches, as well as look for augmentation strategies. In the present article, we review a number of recent developments and new directions in the psychological treatment of OCD, including (a) the application of inhibitory learning approaches to exposure therapy, (b) the development of acceptance-based approaches, (c) involvement of caregivers (partners and parents) in treatment, (d) pharmacological cognitive enhancement of exposure therapy, and (e) the use of technology to disseminate effective treatment. We focus on both the conceptual/scientific and practical aspects of these topics so that clinicians and researchers alike can assess their relative merits and disadvantages.     

论神经哲学的兴起

人类心身问题的研究一直是科学界关注的热点。近年来,国外学者将神经科学与哲学研究统一起来,集合两门学科的研究方法、综合双方的研究成果,以此来共同推进人类心身问题的研究,因此诞生了一门介于神经科学和哲学之间的独立学科,它有着学科交叉的研究领域和特殊的跨学科研究方法,这门学科就是神经哲学。     

Use of Functional Magnetic Resonance Imaging in the Early Identification of Alzheimer's Disease

A growing body of evidence suggests that a preclinical phase of Alzheimer's disease (AD) exists several years or more prior to the overt manifestation of clinical symptoms and is characterized by subtle neuropsychological and brain changes. Identification of individuals prior to the development of significant clinical symptoms is imperative in order to have the greatest treatment impact by maintaining cognitive abilities and preserving quality of life. Functional magnetic resonance imaging (fMRI) offers considerable promise as a non-invasive tool for detecting early functional brain changes in asymptomatic adults. In fact, evidence to date indicates that functional brain decline precedes structural decline in preclinical samples. Therefore, fMRI may offer the unique ability to capture the dynamic state of change in the degenerating brain. This review examines the clinical utility of blood oxygen level dependent (BOLD) fMRI in those at risk for AD as well as in early AD. We provide an overview of fMRI findings in at-risk groups by virtue of genetic susceptibility or mild cognitive decline followed by an appraisal of the methodological issues concerning the diagnostic usefulness of fMRI in early AD. We conclude with a discussion of future directions and propose that BOLD-fMRI in combination with cerebral blood flow or diffusion techniques will provide a more complete accounting of the neurovascular changes that occur in preclinical AD and thus improve our ability to reliably detect early brain changes prior to disease onset.