Effects of Approach and Avoid Mindsets on Performance, Self-regulatory Cognition, and Affect in a Multi-task Environment

Despite numerous studies of approach- and avoidant mindsets, relatively little research has addressed the impact of such motivational orientations on performance and emotion in a real-time, multi-task setting. A laboratory simulation is reported that examines the influence of an induced approach-centered, an avoidance-centered, and a “neutral” motivational mindset upon multiple aspects of task performance, self-regulatory cognition, and affect. Undergraduate females randomly assigned to one of three mindset conditions performed a simulated automobile drive across one practice and two experimental trials. Dependent measures included divided attention, behavioral indicators of driving “cautiousness” in relatively safe straight roadway sections as well as during more risk-filled driving, multiple aspects of self-regulatory thinking (including self-monitoring, intended effort, and self-administered consequences), and positive and negative affect. Results revealed that the avoidant mindset produced poorer executive attention (i.e., fewer correctly detected divided attention events), more “cautious” driving behavior and reduced performance variability (i.e., greater control) when driving on presumably safe, straight roadway sections, lower self-reports of intended effort, and greater negative affect relative to the approach mindset. Results are intepreted within a self-regulation-centered motivational framework. Implications of the multi-task simulation for the study of normal and disordered adjustment are considered.     

胸腰椎前路手术的新入路

目的：介绍一种胸腰椎前路手术的新入路。方法：通过横突前，沿横突、椎弓根和椎体腰部，严格的从骨膜下向前剥离，直达前纵韧带下方。结果：经155例临床应用，这种新入路，不需要结扎节段血管，切口短、出血少、缩短了手术时间。结论：手术方法简单、操作技术方便，比原来的腹膜后入路损伤小，也同样达到理想暴露的目的。     

经峡部径路行甲状腺手术的术式改进

目的探讨经峡部径路行甲状腺手术的临床价值。方法回顾性分析10年间575l例行甲状腺手术患者的临床资料。按手术方式分为两组：经峡部径路甲状腺切除术的3288例为改良组；同期施行传统切除术式的2463例为常规组。比较两种手术方式对手术时间、术中出血、术后引流及并发症的影响。结果改良组手术时间较常规组明显缩短（P〈0．01），术中出血量、喉返神经神经损伤率、术后气管局部不适及低钙血症的发生率明显减少（P〈0．01），术后引流量减少（P〈0．05），患者对手术耐受性好，术后出血发生率两组无统计学差异。结论经峡部径路行甲状腺手术可明显缩短手术时间；减少术中出血量，以及降低喉返神经损伤、术后出血、低钙血症等并发症的发生。     

The effects of distant and on-line visual information on the control of approach phase and step over an obstacle during locomotion

One of the goals of this study was to examine the nature and role of distant visual information sampled during locomotion in the feedforward control of leading and trailing limb while an individual is required to step over an obstacle in the travel path. In addition we were interested in whether or not on-line visual information available while the limb (lead or trail) is stepping over the obstacle influences limb trajectory control and whether the information provided during lead limb cross would be used to calibrate movement of the trail limb. Towards this end, we manipulated availability of vision following an initial dynamic sampling period during the approach phase in proximity to the obstacle and during the lead and trail limb stepping over the obstacle. Ten participants completed 40 trials of obstacle crossing in 8 testing conditions. Initial dynamic visual sampling was sufficient to ensure successful task performance in the absence of vision in the approach phase and during both lead and trail limb stepping over the obstacle. Despite successful task performance, foot placement of the lead and trail limb before obstacle crossing and limb elevation over the obstacle were increased after withdrawal of vision in the approach area. Furthermore, the correlation between toe clearance and foot placement was diminished. While both limbs require feedforward visual information to control the step over the obstacle, only lead limb elevation was influenced by availability of on-line visual information during obstacle crossing. Results were in agreement with the notion of primacy of information inherent in the optic array over those from static samples of the environment in guiding locomotion. It is suggested that the expected proprioceptive feedback information associated with the limb posture before the obstacle, reconstructed using visual memory from dynamic sampling of the environment, mismatched with those from the actual limb position. Accordingly, participants adopted a different strategy that enabled them to clear the obstacle with a higher safety margin.Financial assistance was provided by a grant from the Office of Naval Research, USA, NSERC/Canada, and CAPES/Brazil. We would like to thank Milad G. Ishac, Mike Greig, Zinat Shafaei-Shirazi, and Candida T. Goncalves for their assistance     

肩胛骨前后联合入路治疗陈旧性浮肩损伤（附6例报告）

目的：探讨肩胛骨前后联合入路治疗陈旧性浮肩损伤的临床疗效。方法：采用肩胛骨前后联合入路对6例陈旧性浮肩损伤进行手术治疗。结果：根据Herscovici功能评估标准，其中优1例，良2例，可3例，无血管神经副损伤。结论：采用肩胛骨前后联合入路处理陈旧性浮肩损伤，术野显露清楚，易于操作与复位固定，可以有效地避开血管神经，安全可靠。     

加强人才队伍建设促进卫生事业发展的途径探索

在卫生事业的发展过程中,应该注重人才队伍的建设,强化人才队伍建设的创新改革力度,转变传统的人才管理工作思维与模式,遵循健康发展、协调发展的基本原则,借助人才队伍的建设促使卫生事业良好发展和进步,形成新时期背景下的卫生事业发展动力,彰显人才队伍的积极作用。该文就当前卫生事业人才队伍的现状,提出加强人才队伍建设促进卫生事业发展的指导思想,并且归纳总结卫生事业发展过程中人才队伍的建设经验、对策,争取可以采用有效的措施建设人才队伍,提升卫生事业发展过程中的核心力量,增强服务工作效果,满足当前的时代发展需求,达到预期的工作目的。     

Abdominal wall endometriomas. Should the approach vary based on its relationship to the fascia? A case report and review of the literature

IntroductionAbdominal wall endometrioma (AWE) is a rare encountered condition with a prevalence of 1–2%. Multiple diagnostic and treatment modalities are available; however, no clear guidelines exist. On occasions muscle and fascia excision might be necessary to achieve a clear margin. To avoid mesh complications, we believe the treatment should depend on tumor location in relation to the abdominal wall fascia. As far as we know this approach has not been previously discussed.PresentationA 29-year old female with a surgical history of 3 C-sections presented to us with 6 months of cyclical abdominal pain in the left lower quadrant. Imaging studies confirmed the presence of a mass overlying the left lower rectus abdominis muscle. After imaging studies, the mass was surgically excised. Pathology confirmed a benign endometrioma.DiscussionUnfortunately, the surgical literature has not established a consensus on the best approach for diagnosis and management of this condition. The purpose of this report is to not only to present another case of this rare phenomenon, but to address the need for guidelines and review the current diagnostic and treatment available options. We also attempt to increase the awareness of this condition, it’s unlikely malignant degeneration and potential morbidity of surgical excision.ConclusionSurgical excision remains the standard of care for AWEs. In those patients where the fascia and muscle must be excised, we recommend less invasive modalities to avoid mesh complications. The need for guidelines remains.     

经去颧弓扩大颞下入路切除海绵窦,岩尖,上斜坡肿瘤

本文介绍采用改进的去颧弓扩大颞下入路手术治疗８例位于或累及海绵窦、岩骨尖部、上斜坡、天幕游离前外缘肿瘤患者。该方法的要点是断去颧弓，扇形形成颞肌瓣，翻向颧弓断段以下，咬除蝶骨嵴外侧部分，形成低位颞额骨窗，仅轻度上抬颞叶，则可充分暴露病变范围。由于手术空间扩大，更利于肿瘤切除。本组８例均达到全部或大部分切除，患者术后均得以康复，原有体征不同程度改善。     

数据库规范设计

数据库设计既是一项涉及多学科的综合性技术,又是一项庞大的工程项目。人们努力探索,利用数据库规范设计方法设计出符合需要的数据库系统。