Learning to Observe Relationships and Coping

Milieu relationships provide the critical background presence to staff's attempts to motivate, regulate, and teach patients how to cope with stress. Forging a connection with hospitalized children and adolescents demands attention to how they respond to adults and engage with staff around milieu expectations. Assessment guides that deal with these issues are presented. Important aspects of children's relatedness are presented in the context of their working models of adults and the influence of these representations on their response to staff. Coping skills are explained with particular emphasis on behavioral coping strategies. Tied to the assessment process are interventions that emphasize staff's role in helping patients manage strong affects and avoid the use of nonproductive behavior regulation strategies.     

The politics of interprofessional working and the struggle for professional autonomy in nursing

This study of interprofessional work relations in a Canadian mental health team examines how nursing deployed different forms of power in order to alter the mental health division of labour, to gain administrative, organizational and content control over its own work, expand its jurisdictional boundaries by expropriating the work of other professionals, and exclude others from encroaching on its old and newly acquired jurisdictions. This is set against the context of nursing's long-standing professional project to consolidate and expand its professional jurisdiction. Using an ethnographic study of a single interprofessional mental health team in a psychiatric hospital in Canada, the paper attempts to understand the politics and paradoxes involved in realizing nursing's professional project and how the politics of professional autonomy and professional dominance are actually conducted through micro-political struggles. The data demonstrates the effects of the political struggles at the organizational and work process levels, particularly in the forms of collaboration that result. Nurses gained substantial autonomy from medical domination and secured practical dominion over the work of non-medical professionals. New forms of interprofessional collaboration were accomplished through both simultaneous and sequential micro-political struggles with psychiatrists and non-medical professionals, and the formation of political alliances and informal agreements. Nursing solidarity at the elite level and substantial effort by the elite nurses and their committed colleagues to mobilize their less enthused members were fundamental to their success. The nurses deployed political (power) strategies and tactics to organize and reorganize themselves and other professionals on multiple levels (politically, organizationally, ideologically, socially and culturally). This study reveals the complexity and robustness of micro-political dynamics in the constitution of professional and collaborative interprofessional work relations.     

Risperidone and cognitive function in children with disruptive behavior disorders.

BACKGROUND: Effects of risperidone on cognitive function in children with disruptive behavior disorders (DBDs) and subaverage intelligence quotient (IQ) were assessed. METHODS: Data from two 6-week, double-blind, placebo-controlled studies (n = 228) were combined, as were three 1-year, open-label studies (n = 688). Patients with DBDs and subaverage IQ, 5 to14 years, received placebo or risperidone .02 to .06 mg/kg/day. Cognitive measures included the Continuous Performance Task (CPT) and Verbal Learning Test for Children (VLT-C). Efficacy was assessed using the Nisonger Child Behavior Rating Form (NCBRF). Adverse events were collected via spontaneous report; sedation was assessed using visual analog scale. RESULTS: Improvements on the NCBRF Conduct Problem subscale were significantly greater for risperidone- versus placebo-treated patients (-15.8 vs. -6.4, p < .0001) in short-term studies; significant reductions were observed in long-term studies (-16.3, p < .0001). No overall decline and some significant improvement in attention (CPT) and memory (VLT-C) were noted regardless of treatment in short-term studies. VLT-C improved significantly (p < .0001) for both groups, with no difference between treatment groups. Improvements in memory (VLT-C) and attention (CPT) were noted in long-term studies. Somnolence/sedation did not affect cognitive function. CONCLUSIONS: Cognitive function was not altered by risperidone in short-term studies and was maintained or improved with one year of treatment in children with DBDs and subaverage IQ, potentially representing age-appropriate gains.     

对新调入护士进行专科知识教育的体会

目的探讨如何对新调入肿瘤科的护士进行专科教育的有关问题。方法帮助新护士尽快适应工作环境，进行必要的专科知识教育和专科技术传授，熟练掌握肿瘤病人的心理特点及健康教育技巧。结果新护士在调入1个月后能单独完成本职工作，未发生差错和事故，同事对新调入护士评价好，病人满意。结论护士长对新调入护士有目的地进行专科理论知识教育和专科技术操作传授，言传身教，对尽快提高新调入护士的工作能力，确保护理质量起着重要的作用。     

Further evidence of preserved memory function in Alzheimer's disease

Memory performance of elderly patients in the early stages of Alzheimer's disease (DAT) was compared with that of elderly control subjects. In explicit tests of recognition memory, which involve conscious recollection, the DAT patients were grossly impaired. In implicit tests of anagram solution and wordstem completion, which do not require conscious recollection, the DAT patients were not impaired. These findings further support the idea that a separate memory system, episodic memory, underlies conscious recollection, that it is this system which is most commonly damaged in amnesia, and that memory systems not involving conscious recollection may be spared in the early stages of Alzheimer's disease.     

神经节苷酯对老年性学习记忆减退鼠空间学习记忆能力的影响

目的研究神经节苷酯对老年性学习记忆减退鼠空间学习记忆的影响。方法用Ｍｏｒｉｓ水迷宫筛选老年性学习记忆减退昆明小鼠，腹腔注射神经节苷酯１４天，然后测试小鼠定位航行和空间探索能力。结果与老年学习记忆减退鼠对照组比较，治疗组平均逃避潜伏期缩短，原平台游泳距离和穿环数次却增大，但均未达到老年学习记忆正常组和青年组水平。结论提示神经节苷酯可改善老年性学习记忆减退鼠空间学习记忆能力。     

双侧壳核内侧区出血致记忆力、计算力减退1例报告

报告1例因双侧大脑壳核内侧区出血导致记忆力、计算力减退的特殊病例。患者3年前突发右侧大脑壳核内侧出血致左侧轻瘫,而无学习、记忆障碍;近来又发生脑出血,影像学检查证实出血部位在左侧大脑壳核内侧,本次除右侧上肢轻瘫外,还伴随近事记忆和记数障碍。这两次脑出血都损伤到脑内与学习记忆有关的新区———边缘区,从临床上证实边缘区参与脑的近事记忆和记数功能。     

Involvement of synthesis of brain cell structural proteins in the action of antitheines on long-term memory

Academician S. V. Anichkov Department of Pharmacology, Research Institute of Experimental Medicine, Academy of Medical Sciences, St. Petersburg. (Presented by Academician of the Academy of Medical Sciences A. N. Klimov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 113, No. 5, pp. 506–508, May, 1992.     

全身麻醉药物对学习记忆功能的影响

全身麻醉药物通过对中枢多种神经递质和受体系统的影响，调节神经突触传递可塑性的改变，从而对学习记忆功能产生广泛作用。深入考察全身麻醉药物对学习记忆功能的影响，将为合理解释术中残留记忆和术后认知功能障碍的发生机制，婴幼儿和老年痴呆患者手术期间选择合适的全身麻醉药物和方法提供借鉴。     

一次阿扑吗啡注射对大鼠视觉辨别学习和工作记忆的影响

目的探讨多巴胺受体激动剂 -阿扑吗啡对大鼠视觉辨别学习和工作记忆的影响。方法利用旋转T迷宫装置 ,通过食物强化 ,分别训练大鼠正常和逆反的视觉辨别学习任务。动物达到规定的标准次数后 ,腹腔注射 2mg/kg体重的阿扑吗啡 ,3 0分钟后观察药物对工作记忆的影响。 结果对于正常学习 ,阿扑吗啡注射组动物的正确次数与生理盐水对照组相比无显著性差异 ,且两组动物继续进行逆反学习训练 ,达到学习标准所需的总次数亦无显著性差异 ;对于逆反学习 ,阿扑吗啡注射组动物的正确次数较对照组显著降低。结论单独一次阿扑吗啡注射可能干扰大鼠逆反学习的工作记忆 ,但不影响正常学习的工作记忆和逆反学习的过程。