ICU谵妄患者病因分析以及处理

分析急诊ICU患者出现谵妄症状的原因以及处理对策。分析总结我院急诊ICU3年间所有患者的资料,发现20．2％的患者出现谵妄症状,原因为：（1）疾病相关;（2）药物相关;（3）监护环境等多种因素作用结果。经过调整治疗方案、加强心理护理后,需要镇静药物的仅为谵妄患者的19．7％。因此寻找谵妄原因很重要,治疗重点在于去除谵妄原因以及相关促发因素。     

The Effect of the Balance of Orthographic Neighborhood Distribution in Visual Word Recognition

The present study investigated whether the balance of neighborhood distribution (i.e., the way orthographic neighbors are spread across letter positions) influences visual word recognition. Three word conditions were compared. Word neighbors were either concentrated on one letter position (e.g.,nasse/basse-lasse-tasse-masse) or were unequally spread across two letter positions (e.g.,pelle/celle-selle-telle-perle), or were equally spread across two letter positions (e.g.,litre/titre-vitre-libre-livre). Predictions based on the interactive activation model [McClelland & Rumelhart (1981). Psychological Review, 88, 375–401] were generated by running simulations and were confirmed in the lexical decision task. Data showed that words were more rapidly identified when they had spread neighbors rather than concentrated neighbors. Furthermore, within the set of spread neighbors, words were more rapidly recognized when they had equally rather than unequally spread neighbors. The findings are explained in terms of activation and inhibition processes in the interactive activation framework.     

The role of exemplar distribution in infants'' differentiation of categories

Three experiments investigated how the frequency of exposure to particular exemplars influenced 10-month-old infants' differentiation of land and sea animals in an object-examining task. In Experiments 1 and 2, one category exemplar was presented more frequently than the others during familiarization (i.e., that exemplar was presented on 6 of 12 familiarization trials, and 3 other exemplars were each presented on 2 familiarization trials). For half of the infants, the frequent exemplar was similar to other category exemplars (e.g., a zebra if the familiarization category was land animals), and for half the frequent exemplar was not similar to many other category exemplars (e.g., a rabbit). Infants who frequently experienced the similar exemplar formed an exclusive category, and differentiated land and sea animals. Infants who frequently experienced a dissimilar exemplar, in contrast, formed an inclusive category, and failed to differentiate between land and sea animals. In Experiment 3, infants received frequent experience with a set of similar or dissimilar exemplars, and the same pattern was observed. Thus, 10-month-old infants are sensitive to the distribution of the exemplars to which they are exposed, and they form different category boundaries depending on that distribution.     

红细胞体积分布宽度与冠心病关系的研究近况

红细胞体积分布宽度是血常规检测报告的一部分,临床多用于各种贫血的诊断与鉴别诊断。近年国内外研究显示,其测量值的增高与冠心病的死亡等不良事件发生风险增加密切相关。本文对其生物学特性与检测原理、与冠心病关系、测量值的增高预测冠心病不良预后的可能机制的研究进行综述。     

True Context‐dependent Preferences? The Causes of Market‐dependent Valuations

A central assumption of neoclassical economics is that reservation prices for familiar products express people's true preferences for these products; that is, they represent the total benefit that a good confers to the consumers and are, thus, independent of actual prices in the market. Nevertheless, a vast amount of research has shown that valuations can be sensitive to other salient prices, particularly when individuals are explicitly anchored on them. In this paper, the authors extend previous research on single‐price anchoring and study the sensitivity of valuations to the distribution of prices found for a product in the market. In addition, they examine its possible causes. They find that market‐dependent valuations cannot be fully explained by rational inferences consumers draw about a product's value and are unlikely to be fully explained by true market‐dependent preferences. Rather, the market dependence of valuations likely reflects consumers' focus on something other than the total benefit that the product confers to them. Furthermore, this paper shows that market‐dependent valuations persist when – as in many real‐life settings – individuals make repeated purchase decisions over time and infer the distribution of the product's prices from their market experience. Finally, the authors consider the implications of their findings for marketers and consumers. Copyright © 2013 John Wiley & Sons, Ltd.     

Personality disorders and psychosocial changes after intensive psychotherapy: A prospective follow-up study of an outpatient psychotherapy project, 5 years after end of treatment*

This report presents the results of a 7-year prospective outcome study designed to examine the psychosocial changes during and after therapy among 25 outpatients suffering from personality disorders and psychoses. The therapeutic approach was based mainly on object relations theory and psychodynamic self-psychology, and focused in particular on affect consciousness, parental images, self-image and interpersonal relations. Twenty patients completed the form which measured psychosocial changes during therapy, and 21 persons participated at follow-up. The data show statistically significant changes in the capacity to tolerate intimate relationships and actually establish such relationships, improved quality of contact in relationships with friends, a general raising of socioeconomic status and reduced use of ordinary health and social services. Both the global psychosocial outcome at follow-up as measured by HSRS and the general level of symptoms measured by SCL-90 suggest that 76% of the sample had reached a level of psychosocial functioning and adaptation that can be defined as “no-caseness”.     

Estimating latent distributions in recurrent choice data

This paper introduces a flexible class of stochastic mixture models for the analysis and interpretation of individual differences in recurrent choice and other types of count data. These choice models are derived by specifying elements of the choice process at the individual level. Probability distributions are introduced to describe variations in the choice process among individuals and to obtain a representation of the aggregate choice behavior. Due to the explicit consideration of random effect sources, the choice models are parsimonious and readily interpretable. An easy to implement EM algorithm is presented for parameter estimation. Two applications illustrate the proposed approach.     

Additive and multiplicative models for gamma distributed random variables,and their application as psychometric models for response times

A class of models for gamma distributed random variables is presented. These models are shown to be more flexible than the classical linear models with respect to the structure that can be imposed on the expected value. In particular, both additive, multiplicative, and combined additive-multiplicative models can be formulated. As a special case, a class of psychometric models for reaction times is presented, together with their psychological interpretation. By means of a comparison with existing models, this class of models is shown to offer some possibilities that are not available in existing methods. Parameter estimation by means of maximum likelihood (ML) is shown to have some attractive properties, since the models belong to the exponential family. Then, the results of a simulation study of the bias in the ML estimates are presented. Finally, the application of these models is illustrated by an analysis of the data from a mental rotation experiment. This analysis is preceded by an evaluation of the appropriateness of the gamma distribution for these data.     

With Hope and Imagination: Imaginative Moral Decision-Making in Neonatal Intensive Care Units

Although the role of imagination in moral reasoning is often neglected, recent literature, mostly of pragmatist signature, points to imagination as one of its central elements. In this article we develop some of their arguments by looking at the moral role of imagination in practice, in particular the practice of neonatal intensive care. Drawing on empirical research, we analyze a decision-making process in various stages: delivery, staff meeting, and reflection afterwards. We show how imagination aids medical practitioners demarcating moral categories, tuning their actions, and exploring long-range consequences of decisions. We argue that imagination helps to bring about at least four kinds of integration in the moral decision-making process: personal integration by creating a moral self-image in moments of reflection; social integration by aiding the conciliation of the diverging perspectives of the people involved; temporal integration by facilitating the parties to transcend the present moment and connect past, present, and future; and epistemological integration by helping to combine the various forms of knowledge and experience needed to make moral decisions. Furthermore, we argue that the role of imagination in these moral decision-processes is limited in several significant ways. Rather than being a solution itself, it is merely an aid and cannot replace the decision itself. Finally, there are also limits to the practical relevance of this theoretical reflection. In the end, it is up to care professionals as reflective practitioners to re-imagine the practice of intensive care and make the right decisions with hope and imagination.

Examples of real world engineering ethics problems

Nine examples are presented illustrating the kinds of problems encountered in actual practice by conscientious engineers. These cases are drawn fom the records of the IEEE Ethics Committee, and from the experience of the ethics help-line initiated recently by the Online Ethics Center for Engineering and Science. They range from situations in which companies try to cheat one another to those in which human health and safety are jeopardized. In one case, an engineer learned that even a quiet resignation can prove very costly in a personal sense. Some ways in which professional societies might make ethical practice of engineering somewhat easier are mentioned. An carlier, shorter version of this paper was presented at the International Conference on Ethics in Engineering and Computer Science, Case Western Reserve University, Cleveland, March 21–24, 1999, and can be accessed on line at http://onlineethics.org/cases/unger.html. In all cases described in this paper, the names of individuals and organizations have been suppressed or fictionalized. Professor Unger was Chairman of the IEEE (Institute of Electrical and Electronics Engineers) Ethics Committee (1997–1998).