冠脉介入治疗合理临床应用的思维基础

冠心病的发病率逐年升高,死亡率居高不下,成为威胁人类健康的重要疾病。人们为了攻克这一难题进行了不懈的工作,溶栓、监护及介入治疗的出现挽救了众多生命。随着冠状动脉介入治疗方法的不断完善和广泛开展,冠状动脉介入治疗越来越成为冠心病治疗的主要临床手段。但随之而来的手术并发症、支架在狭窄等问题成为不得不考虑的问题。治疗策略的选...     

THE WORLDWIDE BURDEN OF INFANT MENTAL AND EMOTIONAL DISORDER: REPORT OF THE TASK FORCE OF THE WORLD ASSOCIATION FOR INFANT MENTAL HEALTH

Children worldwide experience mental and emotional disorders. Mental disorders occurring among young children, especially infants (birth –3 years), often go unrecognized. Prevalence rates are difficult to determine because of lack of awareness and difficulty assessing and diagnosing young children. Existing data, however, suggest that rates of disorders in young children are comparable to those of older children and adolescents (von Klitzing, Dohnert, Kroll, & Grube, 2015 ). The lack of widespread recognition of disorders of infancy is particularly concerning due to the unique positioning of infancy as foundational in the developmental process. Both the brain and behavior are in vulnerable states of development across the first 3 years of life, with potential for enduring deviations to occur in response to early trauma and deprivation. Intervention approaches for young children require sensitivity to their developmental needs within their families. The primacy of infancy as a time of unique foundational risks for disorder, the impact of trauma and violence on young children's development, the impact of family disruption on children's attachment, and existing literature on prevalence rates of early disorders are discussed. Finally, global priorities for addressing these disorders of infancy are highlighted to support prevention and intervention actions that may alleviate suffering among our youngest world citizens.     

谈谈个人对智力落后儿童早期干预的看法

本文作者根据从事智力落后儿童的早期干预教学研究的实践经验对当今在我国开展早期干预的必要性以及早期干预的目的、设置的理由、内容、方式、对象、教师的条件、效果的评价以及开展的步骤等9个问题,提出了自己的看法。     

工作－家庭冲突的前因、后果及干预策略

随着劳动力结构与工作特点的巨大变化,工作－家庭冲突问题日益突出。国内外研究主要从工作、家庭与个体三个层面对工作－家庭冲突的前因变量、后果变量及干预策略进行了深入探讨。前因变量主要包括工作与家庭层面的压力、特点,性别等;后果变量主要涉及个体的工作家庭满意感、组织承诺、离职和心身健康;干预策略涉及家庭友好政策和个体应对方式等。作者认为今后研究可以在工作－家庭冲突积极面、跨文化研究等方面进行突破     

A cluster randomised controlled trial of an intervention based on the Health Action Process Approach for increasing fruit and vegetable consumption in Iranian adolescents

Objective: To evaluate an intervention programme based on the Health Action Process Approach and designed to increase the intake of fruit and vegetables (F&V) among Iranian adolescents aged 13 to 18.

Design: A randomised controlled trial with three arms examined the short- (1 month) and long-term (6 months) effects of the intervention. There were two intervention groups (one included adolescents only [A group; n = 510]; the second included mothers and adolescents [M + A group; n = 462]) and a control group (n = 483). All participants were recruited from schools.

Main outcome measures: Social cognitions, self-regulatory processes and F&V intake.

Results: The intervention led to an increase in F&V intake for adolescents in the short and long terms. Adolescents in the M + A group increased their F& V intake more than adolescents in the A group. Outcome expectancies, self-monitoring, intentions, action and coping planning, perceived social support and behavioural automaticity mediated the effect of the intervention on F&V intake.

Conclusion: The theory-based intervention led to an increase in F&V intake and promoted more positive social cognitions and self-regulatory processes among Iranian adolescents. The findings also provide evidence that involving mothers in an intervention can confer additional benefit.     

Growing Together—Effects of a school-based intervention promoting positive self-beliefs and social integration in recently immigrated children

We present a school-based intervention geared to foster the social integration of recently immigrated (RI) primary school children by creating repeated positive contact situations with classmates brought up in the receiving society. Coaches encouraged groups of tandems, consisting of one RI and one child brought up in Germany each, to engage in cooperative activities designed to strengthen positive self-beliefs and perception of equal status. In a quasi-experimental control-group design (N = 318), we compared the 30 children (12 RI) who participated in our intervention between pre-test and post-test with a reference group. Self-beliefs were measured via self-reports, social integration via sociometric peer-nominations. The reference group (n = 288 children) included all children who did not participate in the intervention between pre-test and post-test: (a) 12 children (7 RI) of a waiting control group and (b) all classmates of both the students of the intervention and the waiting control group. Post-test self-beliefs were more positive in children having participated in the intervention. The intervention did not affect social integration: Neither the number of classmates nominating a student nor the number of peers the respective student nominated increased. Possibly, the intervention initiated self-reinforcing processes which support social integration over longer time periods.     

PROMOTING RECIPROCAL INTERACTIONS VIA PEER INCIDENTAL TEACHING

This study evaluated peer incidental teaching as a strategy for increasing reciprocal peer interactions by children with autism. Three typical preschoolers were trained as peer tutors for 3 young children with autism. During a classroom free-play session, peer tutors used incidental teaching to obtain verbal labels of preferred toys by children with autism. A multiple baseline across the 3 target children showed replicated positive effects of the intervention. Adult supervision and assistance were then faded systematically, with resulting maintenance of increased reciprocal interactions. Multiple measures of the extent and limits of generalization suggested that 1 child increased interactions in free-play periods throughout the day, but none of the children showed increases at lunch. Teacher and peer ratings supported the social validity of positive findings.     

Evaluating treatment effects in single-subject behavioral experiments using quality-control charts

Quality-control charts can be particularly useful in identifying treatment effects and patterns of behaviors in single-subject behavior-analytic experiments that cannot be determined by visual inspection of their graphs. Using an example from the behavior analysis literature the quality-control charts identified the presence of treatment effects across phases as well as the presence of trends within and between phases. The ease of their calculations suggest use of them by behavior analysts whenever the effects of particular interventions are questionable.     

A PROMPT PLUS DELAYED CONTINGENCY PROCEDURE FOR REDUCING BATHROOM GRAFFITI

This study assessed the effectiveness of posting signs for reducing graffiti in three men's restrooms on a college campus using a multiple baseline across settings design. During baseline, graffiti increased almost daily in each of the three settings. Immediately following the intervention, no marks were made on any of the three walls. Results were maintained at 3-month follow-up. A possible explanation for the results is that the signs specified an altruistic contingency.     

Effectiveness of a consultation intervention to promote tobacco control policies in Northwest Indian tribes: Integrating experimental evaluation and service delivery

A quasi-experimental replication of an intervention for promoting tobacco control policies in Northwest Indian tribes is described and the process of intervention including issues of collaboration among research institutions and Indian organizations is discussed. The policy intervention was evaluated using a pretest-posttest design wherein 20 tribes that had served as wait-list controls now received the intervention. The intervention comprised a tribal representative attending a kickoff orientation; follow-up visits to the tribes; distribution of tobacco policy workbooks; and phone call consultations. Policy status and stringency were assessed by means of telephone interviews with two key contacts per tribe, and by a count of enacted policies. There were significant pre-post changes in the primary outcome measure, a composite summary score of tobacco policy stringency, and changes were also reflected in enacted policies. The intervention effects observed were similar to those found in the prior randomized trial and suggest a robust, disseminable intervention. Much of the success achieved was attributed to the role of an Indian organization in planning the project and implementing the intervention and evaluation protocols.