儿童支气管异物32例误诊分析

支气管异物系儿科常见病,误诊原因很多,如病史陈述不详细、辅助检查的干扰等,更重要的一个原因就是异物的不典型位置。传统观念中,右下肺异物高发,实际上,受气流及异物体积的影响,轻而小的塑料可被回吸进入左上肺,而较大的异物受自身重力影响多进入右下肺。异物进入体内,引起的·临床表现多种多样,咳嗽、咯血、喘息甚至呼吸困难等,诸类症状在呼吸系统疾病中较为常见,因此这些症状的鉴别就显得尤为重要。在治疗方面,突破传统的支气管镜技术,提倡可以首先采取保守治疗,给予拍背、体位引流等手段,部分患儿可自行咳出异物,这样就避免了手术的风险,在保守治疗无效的情况下可转入外科通过纤维支气管镜取出。     

‘You were not born here,so you are classless,you are free!’ Social class and cultural complex in analysis

The unconscious impact of differences in culture and social class is discussed from the perspective of an analyst practising in London whose ‘foreign accent’ prevents patients from placing her within the social stratifications by which they feel confined. Because she is seen by them as an analyst from both ‘inside’ and ‘outside’ the British psycho‐social fabric and cultural complex, this opens a space in the transference that enables fuller exploration of the impact of the British social class system on patients’ experience of themselves and their world. The paper considers this impact as a trans‐generational trauma of living in a society of sharp socio‐economic divisions based on material property. This is illustrated with the example of a patient who, at the point of moving towards the career to which he aspired, was unable to separate a sense of personal identity from the social class he so desperately wanted to leave behind and walk the long avenue of individuation. The dearth of literature on the subject of class is considered, and the paper concludes that not enough attention is given to class identification in training.     

How Irish Citizens Negotiate Foreign Policy: A Social Representations Approach to Neutrality

The present study investigates the relationship between the foreign policy orientation of Irish neutrality and national identity using a social representations approach (Elcheroth, Doise, & Reicher, 2011; Moscovici, 1961/76). In four focus groups conducted in the Republic of Ireland, 22 participants discussed vignettes in which hypothetical conflicts were described. The findings pointed towards the dynamic relationship between neutrality and Irish national identity and more generally to the importance of macropolitical phenomena for identity construction. The process of categorization was key to participants' decision making regarding the hypothetical conflicts; the decision to support or oppose the Irish state's involvement in the conflicts frequently revolved around a reconsideration of the boundaries of the ingroup. Furthermore, social representations were laden with the possibility of social change; the construction of neutrality as morally ambivalent, motivated by pragmatism rather than principles, opened up a space for younger participants to resist dominant, pragmatic interpretations of the policy and offer alternatives. Theoretical and empirical implications of the findings are discussed. Taken together, the findings demonstrate the critical potential of extending a social representations approach to issues of political psychological significance.     

Reflective practice and foreign language classroom anxiety: video-stimulated recall at work

Reflective practices have been shown to improve the effectiveness of learning and teaching processes. In this study, video-stimulated recall technique was employed as a method of motivating language learners to reflect on their oral production tasks. In this experimental study, the Foreign Language Classroom Anxiety Scale (FLCAS) was administered to control and treatment groups before and after an eight-week module during which video-stimulated recall interviews were conducted with students in the treatment group. Statistical analyses revealed that pre- and post-test FLCAS scores differed within the treatment group but not within the control group. The results also suggested that stimulated recall is an effective reflective tool which assists students in noticing and reflecting upon the symptoms and causes of anxiety in the classroom.     

Driving examiners’ views on data-driven assessment of test candidates: An interview study

Vehicles are increasingly equipped with sensors that capture the state of the driver, the vehicle, and the environment. These developments are relevant to formal driver testing, but little is known about the extent to which driving examiners would support the use of sensor data in their job. This semi-structured interview study examined the opinions of 37 driving examiners about data-driven assessment of test candidates. The results showed that the examiners were supportive of using data to explain their pass/fail verdict to the candidate. According to the examiners, data in an easily accessible form such as graphs of eye movements, headway, speed, or braking behavior, and color-coded scores, supplemented with camera images, would allow them to eliminate doubt or help them convince disagreeing test-takers. The examiners were skeptical about higher levels of decision support, noting that forming an overall picture of the candidate’s abilities requires integrating multiple context-dependent sources of information. The interviews yielded other possible applications of data collection and sharing, such as selecting optimal routes, improving standardization, and training and pre-selecting candidates before they are allowed to take the driving test. Finally, the interviews focused on an increasingly viable form of data collection: simulator-based driver testing. This yielded a divided picture, with about half of the examiners being positive and half negative about using simulators in driver testing. In conclusion, this study has provided important insights regarding the use of data as an explanation aid for examiners. Future research should consider the views of test candidates and experimentally evaluate different forms of data-driven support in the driving test.     

Trauma,Emotions, and Memory in World Politics: The Case of the European Union's Foreign Policy in the Middle East Conflict

This article focuses on the impact of emotions on the European Union (EU)'s international identity and agency in the context of the memory of trauma. Emotions are understood as performances through which an actor expresses itself to others while constructing its identity, creating its agency, and potentially affecting the social order. It is argued that the memory of trauma is translated into EU foreign policy practice through emotional performances of EU representatives. Empirically, we explore this impact in relation to the EU's engagement in the Israel‐Palestinian prolonged conflict that has many underlying emotions linked with past traumatic experiences. By doing so, we aim to instigate a discussion between the emotions literature in International Relations and the European Union studies literature to nuance understanding of the politics of emotions that increasingly constrain what kind of a global actor the EU actually is or can become.     

Explaining the effects of a decision intervention on mammography intentions: The roles of worry,fear and perceived susceptibility to breast cancer

Objective: This study examines the effects of a mammography decision intervention on perceived susceptibility to breast cancer (PSBC) and emotion and investigates how these outcomes predict mammography intentions.

Design: Randomised between-subjects online experiment. Participants were stratified into two levels of risk. Within each stratum, conditions included a basic information condition and six decision intervention conditions that included personalised risk estimates and varied according to a 2 (amount of information: brief vs. extended) × 3 (format: expository vs. untailored exemplar vs. tailored exemplar) design. Participants included 2465 US women ages 35–49.

Main Outcome Measures: PSBC as a percentage, PSBC as a frequency, worry, fear and mammography intentions.

Results: The intervention resulted in significant reductions in PSBC as a percentage for women in both strata and significant increases in worry and fear for women in the upper risk stratum. Of the possible mediators examined, only PSBC as a percentage was a consistent mediator of the effect of the intervention on mammography intentions.

Conclusion: The results provide insight into the mechanism of action of the intervention by showing that PSBC mediated the effects of the intervention on mammography intentions.     

The Future Models of Arab Political Economy

Three distinct models of political economy are articulated in this article to chart out the possible politico-economic futures of the Arab World. Of these, the present predicaments of the revolutionizing Arab populace are argued to have been caused by the continuance of the wrong social choices. It depended for a long time now on the alienating model of differentiation and alienation of the Arab nations by their rulers, and by their uncritical immersing in the equally debilitating globalization agenda. Two models of the alienating and unfeasible types are formulated as the prevailing ones today. The arguments and empirical study of limited socioeconomic data with the examples of Egypt, Tunisia and Yemen, which are considered as exemplary of the revolutionary Arab World, point out that social factors based on the demand for participation and representation, self-reliant social change, and opportunities are the overwhelming factors of politico-economic change. These factors, as opposed to the purely economic factors, must be embedded in a synergistic way with the rest in a distinctive future model of Arab political economy. Three formal models of possible political economy of the future Arab World with their evolutionary futures are formalized. Necessary social and policy implications are drawn in reference to these three evolutionary Arab futures in political economy.     

Moral Stress in International Humanitarian Aid and Rescue Operations: A Grounded Theory Study

Humanitarian aid professionals frequently encounter situations in which one is conscious of the morally appropriate action but cannot take it because of institutional obstacles. Dilemmas like this are likely to result in a specific kind of stress reaction at the individual level, labeled as moral stress. In our study, 16 individuals working with international humanitarian aid and rescue operations participated in semistructured interviews, analyzed in accordance with a grounded theory approach. A theoretical model of ethical decision making from a moral stress perspective was developed. The practical implications of the study are discussed.