云南大理州白族初中生流行性癔症心理健康状况调查

目的：探讨大理州白族初中生流行性癔症人格特征与心理健康状况的关系,为有针对性地开展心理健康教育提供依据。方法2013年云南省大理州某初级中学癔症流行1周后对学生按班级展开症状自评量表和艾森克人格问卷测评。结果女生发病率显著高于男生（5．20％、1．11％）,其中男性发病者抑郁、焦虑、敌对、恐怖、总均分、阳性均分等项与未发病人群差异具有显著性（P＜0．05）。女性发病者九项因子及总分、总均分、阳性均分与未发病者差异性显著（P＜0．05）;发病学生艾森克人格问卷的N、E维度分值均高于未发病学生（ F＝4．48、5．38）;N量表与症状自评量表各因子分呈正相关（ r＝0．411、0．503、0．583、0．617、0．596、0．536、0．632、0．385、0．557）,P量表与人际敏感、偏执、敌对、抑郁、精神病性等呈正相关（ r＝0．527、0．477、0．491、0．512、0．4682）,E量表与人际敏感、抑郁等呈负相关（ r＝0．488、0．467）,L量表与焦虑呈负相关（ r＝0．370）。结论白族初中生流行性癔症患者的心理具有神经质和精神质倾向。     

台州市中小学生龋齿流行病学调查分析

目的了解台州地区中小学生龋齿患病情况,为制定口腔保健规划提供依据。方法抽取台州市2所中小学2502名学生,其中男生1501名,女生1001名；年龄7～17岁。口腔检查按照《全国学生常见病综合防治方案技术规范》进行；龋齿诊断采用世界卫生组织(WHO)龋病诊断标准。结果中小学生总患龋率为37．41%,初中生(25．51%)低于小学生(53．63%)和高中生 (31．01%),P＜0．05。患龋率最高的是9岁年龄组,达68．18%,后随年龄增加而逐渐下降,14岁以后略有回升。受检者龋均为0．86颗,患者龋均2．29颗。男女生息龋差异无统计学意义(P＜0．05)。龋齿总充填率为22．70%,小学生(7．00%)＜初中生(37．31%)＜高中生(48．00%),P＜0．05；女生 (26．23%)明显高于男生(20．30%),P＜0．01。结论学生龋齿患病率较高,龋齿充填率较低；口腔卫生知识的宣传教育和防治措施的落实需大力加强。应在学生中定期开展龋齿普查,做到早检查、早发现、早预防、早治疗。     

上海市闸北区初中生自我意识状况调查

目的：了解上海市闸北区初中生自我意识状况。方法抽取上海市闸北区2018名初中生采用Piers‐Harris儿童自我意识量表进行测评分析。结果入组初中生Piers‐Harris儿童自我意识量表总分为（52．83±12．62）分,自我意识偏低检出率为46．6％;不同性别初中生总分及行为、智力与学校、焦虑、合群因子分比较差异有极显著性（P＜0．01）,不同年龄总分及行为、智力与学校、焦虑、幸福与满足因子分比较差异有极显著性（P＜0．01）;男生自我意识偏低检出率显著高于女生（P＜ 0．01）,不同年龄初中生自我意识偏低检出率比较差异有极显著性（P＜0．01）。结论初中生自我意识偏低,存在性别及年龄差异,学校应予以有针对性的引导与教育。     

农村初中生厌学状况调查

目的调查农村初中生的厌学状况。方法对农村中学初二年级304名学生采用自制问卷调查其厌学状况，其中示范班142名，普通班162名。结果农村初中生的厌学率为49．01％；示范班学生厌学率（36．62％）低于普通班（59．88G），男生厌学率（66．10％）高于女生（38．17％），差异均有极显著性（P〈0．01）；示范班、普通班男生厌学率均显著高于女生（P〈0．01）。结论农村初中生的厌学问题较突出，男生厌学问题更严重，1／3的示范班学生存在厌学问题，学校、家庭及社会应多方配合，正确引导学生的学习兴趣，促进学生健康发展。     

新疆阿合奇县初中生癔症流行病学分析

目的：探讨阿合奇县初中生癔症流行病学特征。方法选取842例阿合奇县初中生为研究对象,分析癔症患病率及危险因素。结果经统计发现,阿合奇县初中生癔症发病率为9．01％。学生的年级、平时住哪里、多久见一次父母、曾目睹过同学有发作及家属有无发作病史均为在校学生癔症发作的高危因素。结论改善当地民众生活条件,缩小普通民众和县上生活条件的差距;学校老师多关爱学生的学习和生活;当地医院医护人员加强对于学生及其家属、老师进行癔症疾病的宣传能有效的减少癔症的发生。     

缺血性脑卒中后血管性认知障碍的危险因素分析

目的：分析缺血性脑卒中后形成血管性认知障碍（VCI）的危险因素。方法选取开县人民医院神经内科2011年8月至2012年6月住院确诊为缺血性脑卒中的176例患者,对其可能发生的VCI危险因素进行统计分析。结果 VCI的发生与性别、吸烟史、饮酒史、冠心病、高血压等均无相关性（ P＞0．05）,与年龄、糖尿病、白质疏松症有显著相关性（P＜0．01）;VCI的发病与脑卒中的发病次数、发病部位、发病面积均有相关性。其中脑卒中发病次数超过2次的患者VCI发病率（66．7％）明显高于少于或等于2次的发病率（35．7％）,差异有统计学意义（P＜0．01）;大面积脑卒中患者VCI发病率（66．7％）明显高于小面积脑卒中患者发病率（8．2％）,差异有统计学意义（P＜0．01）;发病部位为额、顶、颞、枕和丘脑的患者VCI发病率（74．3％、47．9％、67．4％、42．9％、60．0％）明显高于基底核患者发病率（24．3％）,差异有统计学意义（P＜0．01）。结论缺血性脑卒中后VCI与发病次数、卒中面积、病灶部位、糖尿病、白质疏松症等多种因素有关,患者如有上述危险因素易发生VCI ,应及早予以防治。     

上海市闸北区初中生焦虑障碍状况调查

目的 探讨上海市闸北区初中生焦虑障碍状况,为制定有针对性的心理干预措施提供依据.方法 对2 058名初中生采用儿童焦虑性情绪障碍筛查表进行测评分析.结果 闸北区初中生焦虑障碍检出率为32.26%;不同年级初中生儿童焦虑性情绪障碍筛查表总分及各因子分差异均有极显著性(P＜0.01),焦虑障碍检出率差异有显著性(χ2=7.82,P＜0.05);女生儿童焦虑性情绪障碍筛查表总分及各因子分均显著高于男生(P＜0.01),焦虑障碍检出率显著高于男生(χ2=15.03,P＜0.01).结论 初中生焦虑障碍发生率高,尤其在初中预备班升至初中时;女生的焦虑程度及存在焦虑障碍的比例显著高于男生,应引起教育部门的重视,及时给予干预.     

护理专业本科男生压力源、压力强度及心理健康的调查

目的调查护理本科男生压力源、压力强度及心理健康状况。方法采用Beck—Srivastava压力量表（BSSI）和症状自评量表（SCL-90）,对129名护理专业本科男生进行测评,并与153名女生进行比较。结果男生的压力源集中在考试压力、同学竞争、感情问题、专业是否适合自己、个人习惯、经济状况、就业前景7个方面,与女生无差异（P〉0．05）。但男生压力强度得分高于女生（P〈0．01）,且在SCL-90量表的人际关系、焦虑、恐怖和偏执4个因子上得分高于女生（P〈0．01或P〈0．05）。结论护理本科男生的压力源与女生无明显差异,但压力强度高于女生,心理健康水平低于女生。应采取积极心理干预和疏导措施,缓解其心理压力．减轻压力造成的各种心理问题。     

225名医学生考试期间和非考试期间心理状态的调查研究

对225名三年级医学生考试期间和非考试期间15个心理症状出现率进行了调查。结果发现，考试期间心理症状出现率较非考虑期间为高，且男生心理症状发生率较女生高；害怕考试者心理症状出现率远高于不害怕考试者（P＜0．001，P＜0．01）。揭示考试期间心理症状的出现与考试这一应激源及学生心理素质有关。并对考试期间心理症状发生率高的原因及预防措施进行了讨论。     

网络成瘾与非成瘾大学生心理特征比较研究

目的探讨网络成瘾与非成瘾大学生的自我和谐、自尊水平和一般自我效能感状况,为大学生心理教育提供依据。方法采用Young网络成瘾诊断量表对河南省某3所大学827名在校大学生进行调查,共筛选出网络成瘾大学生48名设为成瘾组,抽取一般资料与成瘾组相匹配的非网络成瘾大学生60名设为非成瘾组。对两组大学生采用自我和谐量表、自尊量表和一般自我效能感量表进行评定分析。结果大学生网络成瘾检出率为5．8％,男生发生率为12．41％,女生为2．1％,男生网络成瘾发生率显著高于女生（χ^2=37．23,P〈0．01）。网络成瘾大学生自我和谐量表总分及自我与经验不和谐分量表分均显著高于非成瘾组（P〈0．01）,自尊量表总分显著低于非成瘾组（P〈0．05）;自我和谐量表自我灵活、自我刻板分量表分及一般自我效能感量表总分与非成瘾组比较无显著性差异（P〉0．05）。结论大学生网络成瘾与其自我和谐、自尊水平密切相关,应针对大学生的心理特征以及网络成瘾的原因和问题开展相应的心理健康教育和心理干预。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.