超声心动图与心血管造影X线引导下先心病介入封堵治疗的比较

目前先天性心脏病介入治疗已成为介入心脏病学的新热点,而先心病介入治疗离不开影像学引导,目前临床上常用的影像学引导方式主要有超声心动图和心血管造影两种,本文针对两者优缺点,从治疗方式、疗效、费用等方面进行比较,为临床治疗思路提供借鉴。     

A Single-Session Workshop to Enhance Emotional Awareness and Emotion Regulation for Graduate Students: A Pilot Study

Emerging adults are at substantial risk for developing or worsening psychopathology and university students appear to be particularly vulnerable. Interventions targeted at these young adults that can mitigate transdiagnostic causal risk factors or burgeoning mental health problems have the potential to make a large impact. We aimed to develop and pilot test an accessible, single-session, transdiagnostic group intervention with the goals of enhancing emotion regulation skills and reducing risk for mental health problems in graduate students. The intervention included psychoeducation, skills instruction (e.g., mindful emotion awareness, cognitive flexibility, countering emotion-driven behaviors), group discussion, and supervised practice based on content from the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. The pilot program demonstrated strong feasibility and acceptability. Baseline, 1-month, and 3-month follow-up surveys also suggested benefits for reducing emotional avoidance and suppression, increasing use of cognitive reappraisal, and reducing symptoms of depression and neuroticism. Graduate students have seldom been the beneficiaries of university-based intervention and prevention research. Furthermore, most college and university mental health centers do not have the capacity to provide psychoeducation, preventative, or early intervention services to the many students who need or could benefit from them. Results suggest that future iterations of this intervention could address such barriers to meaningfully supporting emerging adults in graduate school.     

Anxiety Influences the Perceptual-Motor Calibration of Visually Guided Braking to Avoid Collisions

We investigated whether anxiety influences perceptual-motor calibration in a braking to avoid a collision task. Participants performed either a discrete braking task (Experiment 1) or a continuous braking task (Experiment 2), with the goal of stopping before colliding with a stop sign. Half of participants performed the braking task after an anxiety induction. We investigated whether anxiety reduced the frequency of crashing and if it influenced the calibration of perception (visual information) and action (brake pressure) dynamically between-trials in Experiment 1 and within-trials in Experiment 2. In the discrete braking task, anxious participants crashed less often and made larger corrective adjustments trial-to-trial after crashing, suggesting that the influence of anxiety on behavior did not occur uniformly, but rather dynamically with anxiety amplifying the reaction to previous crashes. However, when performing continuous braking, anxious participants crashed more often, and their within-trial adjustments of deceleration were less related to visual information compared to controls. Taken together, these findings suggest that the timescale and nature of the task mediates the influence of anxiety on the performance of goal-directed actions.     

Reducing emergency medical service use in patients with chronic psychotic disorders: results from the FAST intervention study

Patients with schizophrenia have disproportionately high rates of emergency medical service use, likely contributing to the high cost this illness places on society. The aim of this study was to examine the impact of a theory-based, behavioral intervention on immediate and long-term use of emergency medical services. Older patients with schizophrenia (n=240) were randomized to receive either a behavioral, skills-building intervention known as Functional Adaptation and Skills Training (FAST) or a time-equivalent attention-control condition (AC). Logistic regression analyses indicated that AC participants were nearly twice as likely to use emergency medical services in general (OR=2.54; p=0.02) and emergency psychiatric services in particular (OR=3.69; p=0.05) during the active intervention phase of the study. However, there were no differences between the interventions in terms of emergency service use during the long-term follow-up phase of the study (i.e., 6-18 months post-baseline). The FAST intervention appears efficacious for reducing the short-term risk of using emergency medical services. However, the long-term efficacy of the FAST intervention appears less clear. Future studies may want to provide more powerful maintenance sessions to encourage continued use of skills in patients' real-world settings.     

Safety behaviour: a reconsideration

There is ample evidence that the use of safety behaviour can interfere with the progress of therapy, particularly if exposure is involved. As a result, it is widely asserted that safety behaviour is anti-therapeutic. However, an unqualified rejection of safety behaviour should be reconsidered because we now have theoretical justification, experimental evidence and clinical observations showing that the judicious use of safety behaviour, especially in the early stages of treatment, can be facilitative. Experiments in which escape behaviour facilitated fear reduction, and others in which the use of safety gear facilitated fear reduction, are reviewed. It also appears that safety behaviour does not necessarily prevent disconfirmatory experiences. We propose that additional investigations of the judicious use of safety behaviour will help to elucidate therapeutic uses of safety behaviour in the treatment of anxious and related types of psychopathology.     

创伤截肢家庭护理与心理疏导

创伤截肢术后给患者带来不同程度的躯体残疾和缺陷,同时使患者产生巨大的心理压力,做好创伤截肢患者家庭护理与心理疏导非常关键。在慢性康复期,要关注患者的心理应激反应,纠正其认识偏差,减轻“自避”行为,消除“患肢痛”幻觉;在家庭康复护理过程中,要建立和谐的康复环境,训练其自我照顾及运动功能,预防各种并发症的发生。使患者尽快恢复身心健康,重新回归社会。     

阿司匹林抵抗及对策

阿司匹林广泛应用于心血管事件的预防,减少了心血管事件的发生。阿司匹林通过不可逆地和脂肪酸环氧化酶结合,抑制血小板聚集的激动剂血栓素A2的合成,发挥抗血小板聚集作用。但也有一些患者服用阿司匹林过程中有的血小板聚集能力和临床缺血事件不能被抑制。阿司匹林抵抗通常是指阿司匹林治疗未能引起预期的生物学效应抑制血栓素的生物合成或未能预防血栓事件的现象。导致这种现象的确切原因较复杂,包括不适当应用药物的相互作用,剂量不足,环氧化酶-1基因的多态性,及非血小板依赖血栓形成途径等有关。临床医生应该了解这些导致阿司匹林抵抗的因素,规范阿司匹林的应用剂量,适当地联合应用其他药物治疗。     

Taking old ideas seriously: Evolution, development, and human behavior

I argue that the roots of an adequate integration of evolution into psychology are not to be found in evolutionary psychology, but rather in evolutionary developmental biology (evo–devo). To this end, I provide an overview of evo–devo and explore the limited role that behavioral sciences have played in its genesis. I then motivate an evo–devo approach to psychobiology, and sketch desiderata for the success of this enterprise. In particular, I elucidate what it means to take both development and evolution seriously, and argue for the primacy of developmental analysis in the exploration of (human) behavior and its evolution.     

Rigorous Experiments on Monkey Love: An Account of Harry F. Harlow’s Role in the History of Attachment Theory

On the basis of personal reminiscences an account is given of Harlow’s role in the development of attachment theory and key notions of attachment theory are being discussed. Among other things, it is related how Harlow arrived at his famous research with rhesus monkeys and how this made Harlow a highly relevant figure for attachment theorist Bowlby.

The growth of developmental thought: Implications for a new evolutionary psychology

Evolution has come to be increasingly discussed in terms of changes in developmental processes rather than simply in terms of changes in gene frequencies. This shift is based in large part on the recognition that since all phenotypic traits arise during ontogeny as products of individual development, a primary basis for evolutionary change must be variations in the patterns and processes of development. Further, the products of development are epigenetic, not just genetic, and this is the case even when considering the evolutionary process. These insights have led investigators to reconsider the established notion of genes as the primary cause of development, opening the door to research programs focused on identifying how genetic and non-genetic factors coact to guide and constrain the process of development and its outcomes. I explore this growth of developmental thought and its implications for the achievement of a unified theory of heredity, development, and evolution and consider its implications for the realization of a new, developmentally based evolutionary psychology.