Using brief assessments to evaluate aberrant behavior maintained by attention

We examined the use of brief functional assessments to identify idiosyncratic variables associated with aberrant behavior maintained by positive reinforcement in the form of attention. Two participants with severe developmental disabilities and their parents were involved in the assessment and treatment evaluation process. A modified attention condition was introduced, which involved both parents interacting with a third person. Results of the assessment demonstrated that aberrant behavior occurred only in the modified attention condition for both participants. Treatment consisted of the parents delivering attention on a fixed-time schedule during this specific social context. Results indicated that the treatment reduced problem behavior. Follow-up evaluations with 1 participant indicated maintenance of treatment effects for up to 6 months.     

难治性丙型肝炎研究新进展

随着聚乙二醇化干扰素（IFN）的普及应用和慢性丙型肝炎规范化治疗的开展,其治愈率不断提高.但疗效不佳的慢性丙型肝炎患者不断积累,难治性慢性丙型肝炎患者成为临床医生必须面对的挑战.难治性丙型肝炎患者应当分为两类,第一类为“难治疗”性慢性丙型肝炎患者,该类患者由于宿主条件限制,不能耐受IFN联合利巴韦林（RBV）的标准治疗,如儿童和老年人、慢性肾功能衰竭患者等.第二类为“难治愈”性慢性丙型肝炎患者,该类患者可以耐受标准治疗方案,但按照应答指导的治疗原则（RGT）治疗后,效果仍然不佳或复发.本文就近年关于难治性丙型肝炎的研究进展,从难治性丙型肝炎的定义、机制、治疗诸方面作一综述.     

The Brief Cognitive Impairment Scale (BCIS): preliminary investigation of a severe-stage dementia test emphasizing cognitive processing and interpersonal tolerance

We describe the development and validation of The Brief Cognitive Impairment Scale (BCIS), a cognitive screening instrument designed for persons with severe-stage dementia. Psychometric analyses were performed on neuropsychological data from long-term care residents (N = 247) who completed a brief battery of tests, including the BCIS. A principle component analysis yielded three factors that provide insight into how persons with severe dementia cognitively process information and may tolerate specific aspects of social stimulation, such as during personal care. A BCIS cut score can be used to identify severe dementia with a sensitivity of .82, a specificity of .84, and an area under the curve of .89. It may be used by clinicians or caregivers when advanced dementia is suspected, as an alternative to measures with suspected floor effects, when residents cannot tolerate more demanding assessment tools, and as part of non-pharmacologic treatment plans for behavior disturbances associated with dementia.     

优化乙肝治疗方案真实评价治疗效果

目前乙肝治疗比较混乱,给患者带来许多损失,优化乙肝治疗方案,是从患者病情出发,实施个体化治疗,目标是安全、有效、经济和适度,处于抗病毒最佳时机的患者可以考虑使用干扰素或拉米夫定;乙肝病毒携带者暂时禁止使用药物治疗;急性乙肝只给与基本治疗,待其自愈.实施优化方案,杜绝各种各样的商业广告;凡是尝试性治疗,一律按照新药临床验证程序进行,一律实行免费.治疗乙肝的疗效最终取决于持久、完全效应,不应局限在病毒阴转或肝功正常上.     

中、西医治疗慢性乙型肝炎现状的分析与思考

分析了中、西医肝病临床治疗慢性乙型肝炎的现状,着重探讨了中医药在防治乙肝中的优势和不足.指出多数医生存在对乙肝发病机制认识模糊、不能提供合理的治疗方案和研究方法欠科学等三个误区.倡导用循征医学方法对中医药防治乙肝的疗效进行评价.     

2009年贵阳市住院儿童手足口病病原学及临床特点

为了解贵阳地区2009年4月~9月儿童手足口病的病原学及临床特点。从住院的820例手足口病患儿中采集部分伴有重症倾向的244例患儿的肛试子和咽试子标本进行RT-PCR技术检测,并进行临床观察。218例检测到肠道病毒,占89.34%,其中138例为EV71,占63.30%。72例为CA16,占33.02%,两者之比1.92:1。不同年龄组的病原构成差异有统计学意义(P0.01)。重症病例EV71感染明显高于轻症病例,两者在临床特征方面差异有统计学意义(P0.01)。2009年贵阳市住院儿童手足口病的主要病原是EV71和CA16;1岁~3岁的患儿EV71感染明显高于CA16,EV71比CA16更易引重症手足口病,重症病例与轻症病例在临床表现上有明显差异。     

When less is more: An exploration of psychoanalytically oriented hospital‐based treatment for severe personality disorder4

This paper discusses the main findings of a prospective study based at the Cassel Hospital, a centre dedicated to the psychoanalytically informed residential treatment of severe personality disorders. The results‐showing that significantly greater improvements on a number of outcome indicators were found in patients exposed to the psychoanalytically informed treatment programmes compared to a general psychiatric approach based on management and pharmacotherapy alone‐underscores the importance and the centrality of the psychoanalytic input in the treatment of severe personality disorders. However, the results of the study also suggested that some features of long‐term hospital treatment might carry the risk of iatrogenic and anti‐therapeutic effects for a sub‐group of patients with severe borderline core pathology. The authors present the clinical and psychodynamic implications of the study results based on an understanding of the internal and interpersonal mode of functioning of borderline patients.     

Constant vigilance: Heritage values and defensive pessimism in coping with severe acute respiratory syndrome in Singapore

The present study investigates the congruency of defensive pessimism in the Asian context and its role in coping with the severe acute respiratory syndrome (SARS) crisis in Singapore. Data collected from 174 Singaporeans supported the hypothesized relationships among Chinese values, defensive pessimism, SARS-related fears, compliance to preventive health-related behaviors and negative outcomes. Path analysis revealed that individuals' endorsement of Chinese value clusters − prudence, industry, and civic harmony − positively predicted their levels of defensive pessimism. The results also indicated that defensive pessimism had a direct positive effect on SARS-related fears and, SARS-related fears, in turn, were directly related to direct preventive health-related behaviors but not related to indirect preventive behaviors. In addition to the indirect effect of Chinese values on direct preventive health-related behaviors, Chinese values had a direct positive effect on both direct and indirect preventive health-related behaviors. Consistent with our contention that defensive pessimism has the potential for leading to particular negative outcomes, defensive pessimism was found to influence negative outcomes but this relationship was partially mediated by SARS-related fears.     

Biases in the perceived prevalence and motives of severe acute respiratory syndrome prevention behaviors among Chinese high school students in Hong Kong

In two studies conducted in Hong Kong during and immediately after the outbreak of severe acute respiratory syndrome (SARS), participants displayed several social cognitive biases when they estimated the prevalence of and inferred the motives underlying SARS preventive behaviors. First, participants who practiced preventive behaviors (practicers) consistently estimated that more people practiced such behaviors than did non-practicers (false consensus bias). Second, for some preventive behaviors, participants believed that their own behaviors were more motivated by prosocial concerns (relative to self-interest) than were other practicers (pluralistic ignorance). Finally, non-practicers underestimated the importance of prosocial concerns underlying some preventive behaviors (actor-observer bias). We discussed the relevance of these social cognitive biases to health education and to Hong Kong people's psychological reactions to SARS.