Congenital heart disease: A primer for the pediatric neuropsychologist

Congenital heart disease (CHD) affects millions of people worldwide, including over one million children in the United States. Approximately 25% of children born with CHD require intensive surgical intervention within the first year of life. Despite improved rates of survival into adulthood – rates that exceed 90% in the modern era – children and adolescents with CHD remain at risk for neurological injury and a range of neurobehavioral and psychosocial challenges that pose a threat to quality of life across the lifespan. Consequently, as experts in both clinical psychology and brain development, neuropsychologists are becoming increasingly involved in cardiac follow-up and monitoring to promote optimal developmental outcomes. The primary objective of this paper is to provide an evidence-based, clinically-oriented primer on CHD for pediatric neuropsychologists working with this growing population of survivors. Following an introduction to current standard-of-care guidelines for managing children and adolescents with CHD, we present an overview of brain development within the context of CHD, review neuropsychological outcomes, examine factors influencing variability in outcomes, and discuss implications and strategies for clinical assessment.     

Attachment patterns moderate the relation between coping flexibility and illness acceptance among kidney transplant recipients

Background and Objectives: Post-transplant kidney recipients may experience psychological concerns which have been associated with negative health behaviors. Illness acceptance might have an important role in this process. In line with the Conservation of Resources Theory (COR), the current study aimed to examine the relationship between coping flexibility, attachment patterns and illness acceptance among post-transplant kidney recipients, and to evaluate whether attachment patterns moderate the link between coping flexibility and illness acceptance.

Design: The study employed a cross-sectional design.

Methods: Ninety-four post-transplant kidney recipients completed questionnaires assessing demographic and medical characteristics, illness acceptance, coping flexibility and attachment patterns.

Results: Our results indicated that coping flexibility was positively associated with illness acceptance. Moreover, attachment moderated this link, as high coping flexibility was associated with increased illness acceptance among individuals with low levels of attachment anxiety, a finding which was not significant when high levels of anxiety were reported.

Conclusions: This study highlights the potential importance of building greater flexibility in order to enhance illness acceptance among kidney transplants recipients. Moreover, the role of insecure attachment patterns in health-related outcomes among kidney transplants recipients is emphasized.     

Walking versus biofeedback: a comparison of acute interventions for stressed students

Background: High rates of stress-related problems in college students and low utilization of treatment options demonstrate the need for effective stress-reducing interventions that can be self-regulated. This study compared the effect of brief paced-breathing with biofeedback and exercise interventions on heart rate variability, state anxiety and affect. Methods: Students (n?=?32) with high levels of perceived stress completed three 10-min interventions on separate days: paced-breathing with biofeedback (Biofeedback), a self-paced walk (Exercise), and an attention control condition of quiet studying (Quiet Study). Anxiety and affect were measured before (Pre), immediately after (Post0) and 15 mins after (Post15) the intervention. Heart rate variability was measured pre- and post-intervention using electrocardiogram. Results: Biofeedback reduced anxiety more than the exercise condition (Pre to Post0: Biofeedback d?=??0.48, Exercise d?=??0.13). Secondly, Exercise temporarily increased energy (Pre to Post0: d?=?0.67), whereas Biofeedback temporarily increased calmness (Pre to Post0: d?=?0.51). All conditions significantly increased total heart rate variability (p?Conclusions: Biofeedback and Exercise interventions improved emotional states in high-stress college students, but the type of change observed (i.e. energizing, calming or anxiety reducing) depended upon the condition.     

仿生学在移植免疫研究中的应用

世界正在进入仿生学时代。在生命科学领域中进行仿真学研究,将极大地促进人类对生命现象的认知,并揭示其普遍规律。运用仿生学原理在天然模型面前扬其利,避其害,将为科学工作者提供一个崭新的科研思维平台。从仿生角度洞悉并破解移植免疫奥秘将是一个具有广阔前景的创新源泉。     

左向右分流型先天性心脏病心力衰竭时神经内分泌失调及对策

左向右分流型先天性心脏病是引起小儿心力衰竭(心衰)主要病因之一。研究已证实神经内分泌紊乱与心衰之间有复杂的相关性。临床应用神经内分泌紊乱拮抗剂,如β-受体阻滞剂、洋地黄制剂、血管紧张素转换酶抑制剂(ACEI)能降低此类患儿心衰的病死率。就此类型先心病出现心衰时神经内分泌紊乱现象及治疗对策的综述。     

不同干预方式、不同应激源对血压、心率的影响

探讨不同干预方式、不同应激源对血压、心率影响的差异。被试为本科生48人,采取干预方式、应激源、实验间期的三因素混合实验设计。干预方式为放松训练和预知,应激源为心算和恐怖影片。实验间期包括基线期、干预期、应激期、恢复期。实验的因变量为每个实验间期的血压和心率。结果显示,心算应激引起的血压和心率升高显著高于恐怖影片应激引起的血压和心率的升高;放松训练组和预知组其干预期的血压和心率值都低于基线期;干预方式和应激源在血压和心率两个指标上交互作用不显著。结果表明,与恐怖情绪引起的紧张相比较,智力操作紧张更容易影响血压和心率;放松训练和预知对于对抗应激时血压和心率升高都起到了一定的作用;不同干预方式对于不同性质的应激源作用没有差别。     

防治血管剩留风险的决策探讨

针对冠心病和（或）2型糖尿病患者,已有许多有效的防治措施。然而,尽管接受了当前的标准治疗,这类患者仍会反复发生许多大血管和微血管事件,这种现象称之为血管剩留风险。有许多因素影响血管剩留风险的存在,其中最为重要的是致动脉粥样硬化性血脂异常。因此,采取积极的全面干预措施如改善生活方式、联合降脂以改善所有的脂质异常指标,是最大程度降低血管剩留风险的动向。     

干细胞移植治疗冠心病的现状与未来

冠心病仍然是全球的主要死亡原因。其所造成的心肌梗死及慢性心力衰竭对生活质量的影响和由此造成的高额医疗费用促使我们不断寻求新的医疗措施。近几年有关干细胞用于心肌梗死后心肌再生、心肌内新生血管形成,可能还会改善梗死后的心功能的研究成为心脏病学研究的最热门领域。尽管干细胞治疗有可能使心力衰竭的治疗得到彻底的革命,但仍有部分问题需要澄清。已发表的各个研究结果设计不尽相同,致使对该项治疗的效果较难得出一致的结论。但这些研究都强调干细胞治疗在未来心血管疾病的治疗中可能会发挥较大的作用。干细胞治疗与药学、外科及介入治疗的结合会显著改善冠心病患者的预后。     

奖惩线索对停止信号任务中抑制能力和心率、皮肤电的影响

采用不同类型强化刺激(中性刺激,奖励刺激,惩罚刺激,以及奖励、惩罚刺激并存)来改变可获得奖励和惩罚的强度和频度,分别考察不同类型强化条件对停止信号任务中抑制能力、心率和皮肤电的影响.结果显示:与奖惩混合条件相比,在奖励条件下,被试的反应速度快,但正确抑制率明显低于惩罚条件和奖惩混合条件;在奖励条件下,被试在任务完成过程中的心率明显高于反馈条件、惩罚条件和奖惩混合条件.四种条件下被试的皮肤电活动无差异.