IMPROVING THE PEER INTERACTIONS OF STUDENTS WITH EMOTIONAL AND BEHAVIORAL DISORDERS THROUGH SELF-EVALUATION PROCEDURES: A COMPONENT ANALYSIS AND GROUP APPLICATION

We conducted two experiments examining the effects of a self-evaluation package on the peer interactions of students described as emotionally or behaviorally disordered. Experiment 1 assessed the additive effects of various components of a self-evaluation package on the frequency of inappropriate and appropriate peer interactions. The components assessed were rewards alone, rewards plus discussion, and self-evaluation plus rewards. Results showed limited effectiveness when rewards alone and rewards plus discussion were implemented. However, substantial improvements in peer interactions were observed when the self-evaluation component was added. Experiment 2 examined the efficacy and feasibility of the procedures when implemented in a group setting. Students in three classrooms served as participants. Direct observation data collected for 8 of the participants showed the procedures to be effective in improving peer interactions when implemented in a group context.     

THE TREATMENT OF SEVERE BEHAVIOR PROBLEMS IN SCHOOL SETTINGS USING A TECHNICAL ASSISTANCE MODEL

We evaluated the feasibility of local school personnel conducting functional analysis and reinforcement-based treatment procedures within actual classroom settings. Following an initial in-service workshop on functional assessment and differential reinforcement procedures, on-site technical assistance was provided two to four times per month to local school personnel working in transdisciplinary teams. Overall results suggest that local school personnel were able to implement all procedures adequately with periodic technical assistance. In addition, functional analysis was effective in identifying individual maintaining contingencies, the derived treatments were effective, and the results were maintained throughout the approximate 18 months of this investigation.     

INCREASING ONE ASPECT OF SELF‐DETERMINATION AMONG ADULTS WITH SEVERE MULTIPLE DISABILITIES IN SUPPORTED WORK

We attempted to increase one aspect of self‐determination among 3 supported workers with multiple disabilities. Following Baer's (1998) self‐determination conceptualization, the workers were exposed to two conditions that involved working more versus less independently based on availability of assistive devices. Next, their condition preferences were assessed and honored. All participants consistently chose the more independent condition. Results reflect how self‐determination may be enhanced by giving workers increased control over work situations.     

Factors Predicting Attrition Within a Community Initiated System of Care

We designed this study to elucidate child, family, and service level characteristics that may influence attrition from a continuum of care developed and maintained by a community initiated collaboration of local clinics and agencies. Subjects included 117 children and adolescents referred to the Middlesex County system of care from 1992–1999. Data were collected through a retrospective case review. The strongest predictors of attrition from the system of care both before and after the establishment of an individualized service plan included depressed/isolated symptoms, substance abuse, general risk for psychiatric problems, number of referral reasons and urgency status at program intake. Among youth exiting residential placement, those completing recommended services were more likely to be returned home earlier or within the expected time frame than were dropouts. Our study presents important preliminary findings regarding characteristics related to treatment adherence within a community initiated systems of care.     

Using an Embedding Strategy to Teach Preschoolers with Significant Disabilities

The purpose of this study was two-fold. First, this study analyzed the effects of using response prompting procedures within an embedded skill approach on skill acquisition by 4 preschoolers with significant disabilities. Two target skills were identified from each student's IEP and taught during three preschool activities. A multiple probe across subjects design assessed the effects of the intervention. All students made progress above baseline performance. More importantly, there was consistency in performance of the target skills across at least two of the three activities for all children. Second, the reliability with which paraprofessionals in the preschool setting implemented response prompting procedures was evaluated. Data indicated that the paraprofessionals implemented the procedures with a high degree of accuracy. The impact of embedded skill instruction is addressed, as well as the impact of using non-degreed personnel to teach students with significant disabilities within inclusive preschool programs.     

乙肝治疗路线图与核苷类药物的耐药管理

慢性乙肝治疗的路线图介绍了对核苷类似物耐药的监测时间和处理方法。本文首先介绍了耐药评价的时间点,大多可以采用治疗后12周和24周的评估。如果出现耐药,针对不同情况可以采用换用或者加用没有交叉耐药的不同核苷类似物处理。     

亚低温在重型颅脑损伤患者救治中的应用与思考

重型颅脑损伤是致死、致残的主要原因之一。亚低温（MHT）的应用为重型颅脑损伤患者的救治提供了新的思路和方法,国内外多个临床试验证实了其在救治中的有效性和实用性。本文结合国内外相关诊疗指南、循证医学证据和文献,辩证探讨了MHT在重型颅脑损伤患者救治中的适应证及机制、操作方法及时间窗、并发症及临床决策问题。     

Phase transformation of germanium by processing through high-pressure torsion: strain and temperature effects

Germanium has been processed by high-pressure torsion (HPT) under a nominal pressure of 24 GPa at room temperature and cryogenic temperature. The samples processed at room temperature were composed of a diamond-cubic Ge-I phase and a metastable tetragonal Ge-III phase. The formation of Ge-III was significantly suppressed and Ge-I and an amorphous phase, in addition to a small amount of body-centred-cubic Ge-IV, appeared in the case of cryogenic HPT processing at 100 K. The Ge-IV phase gradually disappeared at room temperature. These results indicated that shear strain and thermal energy are important for promoting the formation of Ge-III.     

Family identity and severe mental illness: A thematic synthesis of qualitative studies

There is a growing amount of research showing that a shared social identity and the sense of belonging to a family have a potential effect on health. However, little is known about the effects of severe mental illness on family identity. The authors carried out this thematic synthesis based on a systematic review of literature on family narratives of severe mental illness and family identity. The main findings indicate that in many families (i) their identity—as a shared social identity—undergoes a transformation process by which the identity aspects of being a family are reinforced; (ii) family members often take on a caring role as their main family role; and finally, (iii) a cultural component shapes this transformation process. The authors describe implications for research and application in the mental health field. All in all, family identity is transformed by the experience of severe mental illness.     

早发型重度子痫前期的诊疗决策

早发型重度予痫前期可采取保守治疗恰当延长孕龄,减少因胎儿不成熟导致的围生儿死亡。但对妊娠28周～32周以前者的保守治疗,应采取非常慎重的态度,可以预期结局作为临床决策依据,恰当把握终止妊娠的时机与指征,达到提高胎儿有效成活率,避免孕产妇终末脏器不可逆损害,降低孕产妇病死率与婴幼儿死亡及病残率,减轻家庭和社会负担的目的。