实验室检验失血与医源性贫血——ICU的潜在危机

所有的住院患者均需采血进行实验室检测,而ICU中的危重患者则更为频繁。有很多原因促使医生开立检验单,以明确疾病的诊断和治疗,但由此而产生的失血却往往易被忽视。病情的危重程度和器官功能障碍程度是检验失血量的主要影响因素,但同时采血技术、检验分析仪性能以及医生开立检验单的目标和规范性等欠佳会增加血液标本的浪费。积极地进行规范的医疗管理和实验室仪器设备的改进等,在满足患者病情治疗需要的前提下尽量降低检验性失血,需要全社会的努力。     

耳聋基因治疗进展及评价

基因治疗为感音性聋的治疗提供新的生物治疗模式,通过预防毛细胞死亡、调控毛细胞分化和再生、基因操纵、干细胞移植、RNA干扰等手段而恢复内耳功能。耳聋基因治疗体现了多学科联合发展的要求及求异性思维的重要性,但仍面临诸多问题,从哲学的角度思考及正确对待耳聋基因治疗,必将有利于促进该技术最终服务于人类。     

Type of Job Loss and its Impact on Decision Control,Mastery, and Depression: Comparison of Employee and Company-Stated Reasons

In the present study, we explore agreement between company versus self-reported reasons for job loss and the degree of perceived control employees report over the job loss, looking to see if either job loss type or perceived control is related to subsequent levels of mastery and depression. Two thousand two hundred seventy-nine of 3,700 (61%) employees responded to a survey at Time One; of these participants, 310 later lost their jobs and were mailed a Time Two survey. Comparison of self- versus company-reported reasons for the job loss from the 171 usable surveys (55% response rate) revealed relatively good agreement. Roughly one third of the former employees, however, categorized the job loss in more than one way. There was also a very strong tendency for employees to report that they had very high control over the decision to leave the company, and nearly all employees reported improvements to their levels of mastery and depression; exceptions to this pattern were observed for those losing their jobs due to “rule violation” or “involuntary layoff.” Control over the job loss was related to Time Two levels of mastery and depression, but only weakly related to changes in these outcomes moving from Time One to Time Two.     

A comparison of acceptance- and control-based strategies for coping with food cravings: an analog study

The present study utilized an analog paradigm to investigate the effectiveness of two strategies for coping with food cravings, which was theorized to be critical to the maintenance of weight loss. Ninety-eight undergraduate students were given transparent boxes of chocolate Hershey's Kisses and instructed to keep the chocolates with them, but not to eat them, for 48 h. Before receiving the Kisses, participants were randomized to receive either (a) no intervention, (b) instruction in control-based coping strategies such as distraction and cognitive restructuring, or (c) instruction in acceptance-based strategies such as experiential acceptance and defusion techniques. Measures included the Power of Food Scale (PFS; a measure of psychological sensitivity to the food environment), self-report ratings of chocolate cravings and surreptitiously recorded chocolate consumption. Results suggested that the effect of the intervention depended on baseline PFS levels, such that acceptance-based strategies were associated with better outcomes (cravings, consumption) among those reporting the highest susceptibility to the presence of food, but greater cravings among those who scored lowest on the PFS. It was observed that craving self-report measures predicted chocolate consumption, and baseline PFS levels predicted both cravings and consumption. Results are discussed in terms of the implications for weight loss maintenance strategies.     

Sibling loss, guilt and reparation: A case study

Psychoanalysis has shown that the death of a sibling is likely to have a long-standing impact on the character development of a surviving child. Among common adult manifestations are the identifi cation with the deceased sibling, repetitive self-punitive behaviors, and the development of masochistic trends. In treatment, these patients can become entrenched in a negative therapeutic reaction that compromises the outcome of their analysis. In this paper, the author discusses the analysis of a woman with a history of losses that included the loss of a sibling at an early age. A critical part of the treatment focused on helping this patient overcome a negative therapeutic reaction that emerged as she became aware of hostile and vengeful fantasies, not only as they related to her deceased brother but, more importantly, as they related to her parents.     

Reference-dependent expected utility with incomplete preferences

An important reason why people deviate from expected utility is reference-dependence of preferences, implying loss aversion. Bleichrodt [Bleichrodt H. (2007). Reference-dependent utility with shifting reference points and incomplete preferences. Journal of Mathematical Psychology, 51, 266-276] argued that in the empirically realistic case where the reference point is always an element of the decision maker’s opportunity set, reference-dependent preferences have to be taken as incomplete. This incompleteness is a consequence of reference-dependence and is different in nature from the type of incompleteness usually considered in the literature. It cannot be handled by existing characterizations of reference-dependence, which all assume complete preferences. This paper presents new preference foundations that extend reference-dependent expected utility to cover this case of incompleteness caused by reference-dependence. The paper uses intuitive axioms that are easy to test. Two special cases of reference-dependent expected utility are also characterized: one model in which utility is decomposed into a normative and a psychological component and one model in which loss aversion is constant. The latter model has been frequently used in empirical research on reference-dependence.     

Aided speech-identification performance in single-talker competition by older adults with impaired hearing

This study examined the effects of increased processing load on the closed-set speech-identification performance of young and older adults in a one-talker background. Since the older adults had impaired hearing, speech-identification performance was measured for spectrally shaped stimuli comparable to those experienced when wearing well-fit hearing aids. There were three groups of listeners: (1) 19 older adults with high-frequency sensorineural hearing loss; (2) 10 young adults with normal hearing who were assessed with the same spectrally shaped stimuli as the older adults; (3) 9 young adults with normal hearing who were assessed without spectral shaping and at a poorer target-to-competition ratio in an effort to equate overall performance to that of the older adults. In addition to this group factor, there were three within-participant repeated-measures independent variables designed to increase the demands on processing for the target and competing speech stimuli. These were: (1) competition meaningfulness (played in forward or reverse direction); (2) gender match between target and competing talkers (same or different gender); and (3) talker uncertainty (either the same target/competition talker pair or one of many such pairs on each trial). These three repeated-measures independent variables were examined in a 2 × 2 × 2 factorial design. They showed roughly independent and additive effects on speech-identification such that combinations of these variables decreased performance cumulatively. Older adults performed worse than young adults across the board, but also showed diminished relative improvement as the processing load was decreased. Individual differences in performance among the older adults were also examined.     

Income Volatility and Psychological Depression

Income volatility appears to be increasing especially among lower income workers. Such volatility may reflect the ongoing shift of economic risk from employers to employees as marked by decreasing job security and employer-provided benefits. This study tests whether absolute volatility or downward volatility in income predict depression controlling for prior depression. A sample (n = 4,493) from the National Longitudinal Survey of Youth (NLSY79) with depression (CESD) measured at age 40 and prior depression measured eight to 10 years earlier was utilized. Downward volatility (frequency of income loss) was positively associated with depression; adjusting for downward volatility and other covariates, absolute volatility was negatively associated with depression. An interaction indicated a positive association between downward volatility and depression only when absolute volatility was high. These findings apply to respondents in a narrow age range (30 s) and the results warrant replication to identify the mediators linking absolute volatility and income loss to depression.     

Loss and Resilience in the Time of COVID-19: Meaning Making,Hope, and Transcendence

This article addresses the many complex and traumatic losses wrought by the COVID-19 pandemic. In contrast to individually based, symptom-focused grief work, a resilience-oriented, systemic approach with complex losses contextualizes the distress and mobilizes relational resources to support positive adaptation. Applying a family resilience framework to pandemic-related losses, discussion focuses on the importance of shared belief systems in (1) meaning-making processes; (2) a positive, hopeful outlook and active agency; and (3) transcendent values and spiritual moorings for inspiration, transformation, and positive growth. Practice guidelines are offered to facilitate adaptation and resilience.