Syntactic processing modulates the theta rhythm of the human EEG

Changes in oscillatory brain dynamics can be studied by means of induced band power (IBP) analyses, which quantify event-related changes in amplitude of frequency-specific EEG rhythms. Such analyses capture EEG phenomena that are not part of traditional event-related potential measures. The present study investigated whether IBP changes in the delta, theta, and alpha frequency ranges are sensitive to syntactic violations in sentences. Subjects read sentences that either were correct or contained a syntactic violation. The violations were either grammatical gender agreement violations, where a prenominal adjective was not appropriately inflected for the head noun's gender, or number agreement violations, in which a plural quantifier was combined with a singular head noun. IBP changes of the concurrently measured EEG were computed in five frequency bands of 2-Hz width, individually adjusted on the basis of subjects' alpha peak, ranging approximately from 2 to 12 Hz. Words constituting a syntactic violation elicited larger increases in theta power than the same words in a correct sentence context, in an interval of 300-500 ms after word onset. Of all the frequency bands studied, this was true for the theta frequency band only. The scalp topography of this effect was different for different violations: following number violations a left-hemispheric dominance was found, whereas gender violations elicited a right-hemisphere dominance of the theta power increase. Possible interpretations of this effect are considered in closing.     

Ethanol modulates cortical activity: direct evidence with combined TMS and EEG

The motor cortex of 10 healthy subjects was stimulated by transcranial magnetic stimulation (TMS) before and after ethanol challenge (0.8 g/kg resulting in blood concentration of 0.77 +/- 0.14 ml/liter). The electrical brain activity resulting from the brief electromagnetic pulse was recorded with high-resolution electroencephalography (EEG) and located using inversion algorithms. Focal magnetic pulses to the left motor cortex were delivered with a figure-of-eight coil at the random interstimulus interval of 1.5-2.5 s. The stimulation intensity was adjusted to the motor threshold of abductor digiti minimi. Two conditions before and after ethanol ingestion (30 min) were applied: (1) real TMS, with the coil pressed against the scalp; and (2) control condition, with the coil separated from the scalp by a 2-cm-thick piece of plastic. A separate EMG control recording of one subject during TMS was made with two bipolar platinum needle electrodes inserted to the left temporal muscle. In each condition, 120 pulses were delivered. The EEG was recorded from 60 scalp electrodes. A peak in the EEG signals was observed at 43 ms after the TMS pulse in the real-TMS condition but not in the control condition or in the control scalp EMG. Potential maps before and after ethanol ingestion were significantly different from each other (P = 0.01), but no differences were found in the control condition. Ethanol changed the TMS-evoked potentials over right frontal and left parietal areas, the underlying effect appearing to be largest in the right prefrontal area. Our findings suggest that ethanol may have changed the functional connectivity between prefrontal and motor cortices. This new noninvasive method provides direct evidence about the modulation of cortical connectivity after ethanol challenge.     

Test-retest reliability of EEG spectra during a working memory task

The inter-individual variation of EEG spectra is large even for the same cognitive task. We asked whether task-induced EEG spectra remain stable over more than a year.We recorded EEG in 41 healthy adults who performed a modified Sternberg task. In 20 subjects EEG was recorded in a second session with retest intervals 12–40 months. For electrodes AFz, Cz and Pz peak frequency and peak height were determined. We compared the curve shape of power spectra by regressing spectra pairwise onto each other and calculated a t-value. The t-value and pairwise differences in peak frequency and peak height between all sessions were entered into a generalized linear model (GLM) where binary output represents the recognition probability. The results were cross-validated by out-of-sample testing.Of the 40 sessions, 35 were correctly matched. The shape of power spectra contributed most to recognition. Out of all 2400 pairwise comparisons 99.3% were correct, with sensitivity 87.5% and specificity 99.5%.The intra-individual stability is high compared to the inter-individual variation. Thus, interleaved EEG-fMRI measurements are valid. Furthermore, longitudinal effects on cognitive EEG can be judged against the intra-individual variability in subjects.     

护理人员岗位需要和期望分析

目的:明确护理人员的岗位需求状况,探索提高满足护理人员需求的工作岗位设置和激励管理手段。方法:采用"Porter需要调查问卷"和自设问卷,调查综合性医院497位护理人员岗位需求状况和影响工作满意的主要因素以及对岗位设置的期望等。结果:护理人员总体需要未得到完全满足;不同职位、科室、护龄护理人员有统计学差异,不同学历无统计学差异。主要影响因素为缺乏足够人力资源、缺乏专业支持;期望繁忙、难度高、薪酬高的专业岗位。结论:护理人员与岗位相关的总体需求不能得到满足,满足内在性需要是护理工作的主要驱动力;如果外在性需要得不到满足将成为护理工作的阻力。     

Localizing epileptogenic regions in partial epilepsy using three-dimensional statistical parametric maps of background EEG source spectra

This preliminary study sought to localize epileptogenic regions in patients with partial epilepsy by analysis of interictal EEG activity utilizing variable resolution electromagnetic tomography (VARETA), a three-dimensional quantitative electroencephalographic (QEEG) frequency-domain distributed source modeling technique. The very narrow band (VNB) spectra spanned the frequency range 0.39 Hz to 19.1 Hz, in 0.39 Hz steps. These VNB spectra were compared to normative data and transformed to provide Z-scores for every scalp derivation, and the spatial distributions of the probable EEG generators of the most abnormal values were displayed on slices from a probabilistic MRI atlas. Each voxel was color-coded to represent the significance of the deviation relative to age appropriate normative values. We compared the resulting three-dimensional images to the localization of epileptogenic regions based on invasive intracranial EEG recordings of seizure onsets. The VARETA image indicated abnormal interictal spectral power values in regions of seizure onset identified by invasive monitoring, mainly in delta and theta range (1.5 to 8.0 Hz). The VARETA localization of the most abnormal voxel was congruent with the epileptogenic regions identified by intracranial recordings with regard to hemisphere in all 6 cases, and with regard to lobe in 5 cases. In contrast, abnormal findings with routine EEG agreed with invasive monitoring with regard to hemisphere in 3 cases and with regard to lobe in 2 cases. These results suggest that analysis of background interictal EEG utilizing distributed source models should be investigated further in clinical epilepsy.     

The expectation and reality of bank and agency nursing

We should all accept that temporary workers are here to stay and we should: Ensure that banks and agencies have thorough selection and pre-employment checking strategies, including professional registration and induction provision. Check what it costs to employ a particular nurse. A staffing agency will be highly profitable on a 10 per cent commission but may be charging much more. It may be cheaper to employ in-house staff on overtime. Accept that supply may not match demand and that this is not the fault of the nurses. Ensure nurses who take work outside their usual areas of expertise remember to tell other staff that they may need extra support when they arrive on duty. Ensure temporary staff are orientated to the clinical areas and are offered support by their colleagues. If and when things go wrong discuss them with clinical areas, as well as banks and agencies. It is vital that temporary staff are managed and patterns of unacceptable performance are monitored and acted upon. The growth in temporary working makes matching an increasingly difficult task and puts new challenges on monitoring performance. The effective bank or agency will offer education and appraisal and will have specific policies to ensure clinical governance. Not long ago that there were too few shifts to offer bank nurses. How things change--and how important it is for a service manager to ensure that temporary staff represent value for money and have professional integrity, and that staff realise that they are well supported. After all, they will be a value component of the workforce.     

Prefrontal direct current stimulation modulates resting EEG and event-related potentials in healthy subjects: a standardized low resolution tomography (sLORETA) study

Prefrontal transcranial direct current stimulation (tDCS) with the anode placed on the left dorsolateral prefrontal cortex (DLPFC) has been reported to enhance working memory in healthy subjects and to improve mood in major depression. However, its putative antidepressant, cognitive and behavior action is not well understood. Here, we evaluated the distribution of neuronal electrical activity changes after anodal tDCS of the left DLPFC and cathodal tDCS of the right supraorbital region using spectral power analysis and standardized low resolution tomography (sLORETA). Ten healthy subjects underwent real and sham tDCS on separate days in a double-blind, placebo-controlled cross-over trial. Anodal tDCS was applied for 20 min at 2 mA intensity over the left DLPFC, while the cathode was positioned over the contralateral supraorbital region. After tDCS, EEG was recorded during an eyes-closed resting state followed by a working memory (n-back) task. Statistical non-parametric mapping showed reduced left frontal delta activity in the real tDCS condition. Specifically, a significant reduction of mean current densities (sLORETA) for the delta band was detected in the left subgenual PFC, the anterior cingulate and in the left medial frontal gyrus. Moreover, the effect was strongest for the first 5 min (p<0.01). The following n-back task revealed a positive impact of prefrontal tDCS on error rate, accuracy and reaction time. This was accompanied by increased P2- and P3- event-related potentials (ERP) component-amplitudes for the 2-back condition at the electrode Fz. A source localization using sLORETA for the time window 250-450 ms showed enhanced activity in the left parahippocampal gyrus for the 2-back condition. These results suggest that anodal tDCS of the left DLPFC and/or cathodal tDCS of the contralateral supraorbital region may modulate regional electrical activity in the prefrontal and anterior cingulate cortex in addition to improving working memory performance.     

护理服务质量的感知与期望分析

护理服务质量是一个多维的评价指标。它即有质量部分(技术性、定量),又有非质量部分(功能性、定性),前者是指护理专业的技术水平以及护理工作结果的服务质量,后者是指服务过程的质量,因此护理服务质量不仅取决于医院护理者提供的技术性、定量的技术质量,而且还取决于病人在护理服务过程中感知与期望之间的对比。病人在住院之前对医院护理服务的质量有一个期望,接受了护理服务之后就有了感知,如果病人感知到的护理服务符合期望的护理服务,就会感到满意,如果病人感知到的护理服务高于期望的护理服务,就会感到欣喜,这就是优质护理服务,如果感知…     

患者对护理服务质量感知与期望的调查研究

目的了解不同等级医院患者对护理服务质量感知与期望。方法采用服务质量测评量表对350例住院患者进行问卷调查。结果患者对护理服务质量感知得分为(4.13±0.54)分,期望得分为(4.34±0.45)分。不同等级医院患者护理服务质量期望值均高于感知值,不同等级医院护理服务质量在有形性、反应性2个维度评分上存在差异(P<0.05)。结论各医院的护理服务质量还未能达到患者的期望,二级医院应重点加强医院设施建设,并鼓励护理人员及时为患者提供服务,以满足患者需求。     

乳腺病灶超声学检查方法的现状与展望

乳腺癌是女性生殖系统第二大恶性肿瘤。随着现代医学影像技术的发展,常规超声、乳腺X线摄影是乳腺体检和肿瘤筛查的主要检查手段,CT、MRI、核医学检查是辅助手段,此外,对缺乏影像特征的病灶可行CEUS及穿刺活检。本文对各种影像学检查方法对乳腺病灶的诊断价值及现状进行综述。     

护理服务质量的感知与期望分析

护理服务质量是一个多维的评价指标。它即有质量部分（技术性、定量），又有非质量部分（功能性、定性），前者是指护理专业的技术水平以及护理工作结果的服务质量，后者是指服务过程的质量，因此护理服务质量不仅取决于医院护理者提供的技术性、定量的技术质量，而且还取决于病人在护理服务过程中感知与期望之间的对比。病人在住院之前对医院护理服务的质量有一个期望，接受了护理服务之后就有了感知，如果病人感知到的护理服务符合期望的护理服务，就会感到满意，如果病人感知到的护理服务高于期望的护理服务，就会感到欣喜，这就是优质护理服务，如果感知到的护理服务质量不如期望的护理服务，就会不满，这就是不良的护理服务，也就是护理服务质量与病人的感知与期望之间的距离密切相关，差距越大，病人感知的护理服务质量就越差。     

Separate time behaviors of the temporal and frontal mismatch negativity sources

It has been proposed that mismatch negativity (MMN) is generated by temporal and frontal lobe sources, the former being associated with change detection and the latter with involuntary switching of attention to sound change. If this switching of attention is triggered by the temporal cortex change-detection mechanism, one would expect that the frontal component of MMN is activated later than the temporal one. This was studied by using 64-channel electroencephalography (EEG) and 122-channel magnetoencephalography (MEG) with realistically shaped head models to determine the source current distribution in different lobes as a function of time. Minimum-norm estimation (MNE) was performed, constraining the solution to the reconstructed cortical sheet. The results support the hypothesis that the frontal MMN generator is activated later than the auditory cortex generator.     

癫痫患者与健康人脑电信息熵的对比研究

目的:为了获得癫痫脑电的某些非线性特征,研究了癫痫患者脑电的信息熵,并和健康人脑电的信息熵作比较。方法:采用基于相空间重构脑电信号的新方法来计算脑电信息熵。分别计算了100例癫痫患者和50例健康者的脑电样本。结果:癫痫脑电的平均信息熵为1.696。而健康者脑电的平均信息熵为1.920。值得注意的是,随着嵌入维数的增加,癫痫脑电的信息熵呈现出逐渐减小的趋势,而健康脑电却正好相反,呈现出逐渐增大的趋势。结论:癫痫脑电在低维空间的信息熵比高维空间的大,而健康脑电的情况正好相反。     

From hope and expectation to unexpected death after cardiac surgery

OBJECTIVE: Relatives of patients undergoing cardiac surgery expect successful outcome but sometimes complications cause death. The aim was to interview relatives of patients who have died in connection with cardiac surgery and describe their experiences of information, reception and care. METHODS: Data were obtained from semi-structured interviews with 18 relatives of deceased patients and then analysed using qualitative content analysis. RESULTS: Two main groups emerged: "Analysing the situation" with the sub-groups: knowledge of cardiac disease, the road to operation, hope and despair, information and choice and "The thin thread of life" with the sub-groups, reception, life is over, care, death as a relief, cause of death and support. CONCLUSION: Most relatives were satisfied with the information and care in connection with the operation and at the end of life. However, some aspects such as inadequate pain control and transportation of critically ill patients to other wards and hospitals could be improved. One way is to introduce a co-ordinator in order to better support patients, next of kin and colleagues without experience of cardio-thoracic surgery who need help during the patients' way from diagnosis and acceptance of cardiac surgery and through the treatment and postoperative care.     

护理管理人员的岗位培训现状及培训期望研究

目的 调查护理管理人员岗位培训的现状及管理人员对培训的期望。 方法 以湖南省全体护理管理人员为研究对象,通过网络发放和回收自设问卷。 结果 共回收有效问卷 5663 份。 结果显示,湖南省护理管理人员的结构质量良好,对管理岗位培训的官方要求认知充分,但仍需要接受培训,已开展的培训尚未普及所有管理人员,进一步提高受训率需要更多的人力和政策支持;在培训期望方面,管理人员希望可以理论与实践相结合,提供实用性课程并聘请与临床护理密切相关的护理专家进行授课。 结论 现有岗位培训模式已搭建了基本的架构,但仍需根据管理者的培训期望进行改进,以期建立系统化、常规化、形式灵活的护理管理人员培训体系。     

我国肿瘤专科护士培训现状与展望

本文通过对现阶段我国肿瘤专科护士的培训方式、培训内容、培训基地、资格认证及职能作用等方面进行综述,以期为肿瘤专科护士培训制度和培训基地的建立提供参考。