HIE恢复期患儿家长情绪与家庭亲密度适应性的相关性研究

[目的]探讨新生儿缺氧缺血性脑病(HIE)恢复期患儿家长情绪与家庭亲密度、适应性的关系,并分析其情绪的影响因素,为进一步的干预研究提供参考依据。[方法]以方便取样的方法选取176名HIE恢复期患儿家长,采用一般资料调查问卷、医院焦虑抑郁量表(HAD)、家庭亲密度与适应性量表(FACESⅡ)调查其情绪、家庭亲密度适应性状况。[结果]约70%的患儿家长存在焦虑、抑郁情绪倾向;除患儿家长家庭实际亲密度与国内常模相比,差异无统计学意义外(P0.05),其余差异均有统计学意义(P0.01);患儿家长焦虑、抑郁情绪得分均与实际亲密度、实际适应性呈负相关(P0.01),均与亲密度不满意度、适应性不满意度呈正相关(P0.01);自我感觉压力、实际亲密度、HIE程度、性格特征、居住地是患儿家长焦虑情绪的主要影响因素;自我感觉压力、实际适应性、康复疗程及居住地是患儿家长抑郁情绪的主要影响因素。[结论]HIE恢复期患儿家长的情绪应受到关注,干预对象应扩展到患儿家长,乃至整个家庭,从家庭功能的角度出发,改善患儿家长焦虑抑郁状况。     

缺氧缺血性脑病恢复期患儿家长家庭亲密度适应性与负性情感的相关性

[目的]探究缺氧缺血性脑病恢复期患儿家长的家庭亲密度适应性与其负性情感的相关性及其影响因素。[方法]选取2016年5月—2017年5月收治的缺氧缺血性脑病恢复期患儿家长188人,采用医院焦虑抑郁量表(HAD)、家庭亲密度及适应性量表(FACESⅡ)调查患儿家长的负性情绪、家庭亲密度适应性情况。[结果]新生儿缺氧缺血性脑病恢复期患儿家长的理想亲密度、亲密度不满意度、适应性不满意度评分高于国内常模,理想适应性、实际适应性评分低于国内常模,两者比较差异有统计学意义(P0.05)。患儿家长焦虑、抑郁评分与亲密度不满意度、适应性不满意度呈正相关,与实际适应性、实际亲密度呈负相关。不同患儿月龄、患儿病情程度、康复疗程、患儿家长学历、性格特征、居住地、自我感觉压力家长焦虑、抑郁评分比较差异有统计学意义(P0.05)。患儿病情程度、患儿家长性格特点、患儿家长自我感觉压力、患儿家长居住地、患儿家长实际亲密度是影响新生儿缺氧缺血性脑病恢复期患儿家长焦虑的主要因素(P0.05);患儿康复疗程、患儿家长居住地、患儿家长自我感觉压力、患儿家长实际适应性是影响新生儿缺氧缺血性脑病恢复期患儿家长抑郁的主要因素(P0.05)。[结论]应重视新生儿缺氧缺血性脑病恢复期患儿家长的心理状况及家庭功能,对其展开有效的心理干预,从而尽快帮助患儿机体康复。     

家庭亲密度适应性与脑梗死患者自尊的关系

目的 探讨家庭亲密度适应性与脑梗死患者自尊的关系.方法 采用家庭亲密度适应性量表和Rosenberg自尊量表对253例脑梗死患者进行横断面调查,并进行相关性分析.结果 自尊与实际亲密度实际适应性均显著正相关;自尊与亲密度不满意程度、适应性不满意程度均显著负相关;自尊与理想亲密度和理想适应性的相关性无意义.年龄、家庭收入和病程为家庭亲密度适应性和自尊的影响因素.结论 脑梗死患者自尊与家庭亲密度和适应性有关,受年龄、家庭收入及病程影响.     

大学生家庭亲密度和适应性与领悟社会支持关系的研究

目的调查大学生家庭亲密度和适应性与领悟社会支持的关系。方法采用家庭亲密度和适应性量表（FACESⅡ-CV）与领悟社会支持量表（PSSS），对宁波市4所不同录取批次高校400名04级大学生进行了社会支持情况的调查分析。结果和结论家庭亲密度和适应性与领悟家庭内支持和领悟家庭外支持得分呈显著正相关；领悟家庭内支持与家庭亲密度的不满程度没有显著相关，但与家庭适应性的不满程度呈显著负相关；不同录取批次高校大学生的家庭适应性以及对家庭亲密度和适应性的不满程度存在显著性差异，在领悟家庭内支持得分上没有显著性差异；女生在家庭亲密度上的得分显著高于男生，在家庭适应性方面则没有显著性差异；在领悟家庭内支持和领悟家庭外支持方面，女生的得分均显著高于男生；在家庭现实亲密度与领悟家庭内支持方面，父亲受教育程度的主效应显著，母亲受教育程度的主效应不显著；城乡大学生在家庭亲密度和适应性以及领悟社会支持方面均没有显著差异。     

重度烧伤患者家庭亲密度和适应性与社交回避和苦恼的相关性

目的调查重度烧伤患者家庭亲密度和适应性、社交回避和苦恼的现状,探讨二者的相关性,为制定干预措施提供依据。方法 2013年1月至2015年6月,对出院后来门诊复查的289例重度烧伤患者进行现场问卷调查,包括自行设计的一般情况调查表、中文版家庭亲密度和适应性量表(FACESⅡ)、社交回避及苦恼量表(SADS),进行Pearson相关分析。结果重度烧伤患者家庭实际亲密度、实际适应性均明显低于国内常模(t3.830,P0.01),理想亲密度、亲密度不满意程度、理想适应性、适应性不满意程度均明显高于国内常模(t3.857,P0.01);SADS得分明显高于常模。重度烧伤患者家庭实际亲密度、实际适应性、FACESⅡ总分与SADS各项评分均呈负相关(P0.05),家庭亲密度不满意程度、适应性不满意程度与SADS评分均呈正相关(P0.05)。结论重度烧伤患者存在较为严重的社交回避和苦恼,可能受家庭亲密度和适应性下降影响。应采取有针对性的护理措施。     

重度烧伤患者家庭亲密度和适应性与社交回避和苦恼的相关性北大核心CSCD

目的调查重度烧伤患者家庭亲密度和适应性、社交回避和苦恼的现状,探讨二者的相关性,为制定干预措施提供依据。方法 2013年1月至2015年6月,对出院后来门诊复查的289例重度烧伤患者进行现场问卷调查,包括自行设计的一般情况调查表、中文版家庭亲密度和适应性量表(FACESⅡ)、社交回避及苦恼量表(SADS),进行Pearson相关分析。结果重度烧伤患者家庭实际亲密度、实际适应性均明显低于国内常模(t>3.830,P<0.01),理想亲密度、亲密度不满意程度、理想适应性、适应性不满意程度均明显高于国内常模(t>3.857,P<0.01);SADS得分明显高于常模。重度烧伤患者家庭实际亲密度、实际适应性、FACESⅡ总分与SADS各项评分均呈负相关(P<0.05),家庭亲密度不满意程度、适应性不满意程度与SADS评分均呈正相关(P<0.05)。结论重度烧伤患者存在较为严重的社交回避和苦恼,可能受家庭亲密度和适应性下降影响。应采取有针对性的护理措施。     

应对方式、家庭亲密度适应性与乳腺癌患者自尊的关系

目的 探讨乳腺癌术后化疗患者应对方式、家庭亲密度适应性与自尊的关系.方法 采用Rosenberg自尊量表、医学应对问卷、家庭亲密度适应性量表,对300例乳腺癌术后化疗患者进行横断面调查.结果 乳腺癌患者的自尊与面对应对方式呈正相关(r=0.16,P＜0.05),与屈服应对方式呈负相关(r＝-0.16,P＜0.05).乳腺癌患者家庭实际亲密度、实际适应性与自尊均呈正相关(P＜0.05);亲密度不满意程度、适应性不满意程度与自尊均呈负相关(P＜0.05).结论 护理人员可引导乳腺癌患者采取积极的应对方式并发挥其家庭功能,以提高患者的自尊水平.     

家庭亲密度和适应性与脑梗死后抑郁的相关性分析

目的探讨家庭亲密度和适应性与脑梗死后抑郁的关系。方法采用汉密尔顿抑郁量表、家庭亲密度和适应性量表对108例首次发病脑梗死患者进行调查,根据是否存在抑郁,分为抑郁组（63例）和非抑郁组（45例）。比较两组患者家庭亲密度和适应性的差别,并进行家庭亲密度和适应性评分与抑郁的相关性分析。结果抑郁组实际亲密度和实际适应性评分均低于非抑郁组患者（P〈0．01）,亲密度不满意程度和适应性不满意程度评分均高于非抑郁组患者（P〈0．01）。抑郁与实际亲密度和实际适应性均呈负相关（P〈0．05）,与亲密度不满意程度和适应性不满意程度均呈正相关（P〈0．05）。结论家庭亲密度和适应性差是脑梗死后抑郁的重要原因。     

家庭亲密度和适应性与大学生的应付方式

目的:分析大学生家庭类型与应付方式之间的关系。方法:于2005-04使用聚类随机抽样的方法,从不同类型大学(师范类、工专类、农林类)选取大学生342人为受试者。①采用自制一般情况调查表调查大学生的一般情况,包括调查对象的性别、家庭来源、父母职业类型及父母受教育程度。②采用家庭亲密度与适应性量表中文版调查大学生的家庭功能评价,家庭亲密度与适应性量表包含两个分量表30个项目。亲密度量表(即大学生家庭成员之间的情感关系状况)和适应性量表(即家庭体系随家庭处境和家庭不同发展阶段出现的问题而相应改变的能力)。对量表的每个项目受试者要回答两次,一次是对自己家庭现状的实际感受,另一次是自己希望的理想家庭的状况。③采用肖计划编制的应付方式量表调查大学生面对应激环境所采用的应付方式,该问卷包含6个因子62个条目:退避、幻想、自责、求助、合理化、解决问题。在调查过程中,统一指导语,团体测试,问卷现场收回。结果:发放问卷342份,回收342份,兼顾调查对象家庭来源与性别的因素,按比例分层抽样的方法得到255份有效试卷,有效率74.6%。①女性自责因子低于男性,存在性别差异(P=0.006);家庭来源的不同,导致了幻想(P=0.0004)、解决问题(P=0.01)、求助(P=0.0003)、退避(P=0.009)4个因子的差异有显著性意义,并且农村学生普遍低于城市。②实际家庭的亲密度与理想家庭的适应性存在有较高的相关关系(r=0.512,P=0.001)。③在实际家庭中,女性适应性分值高于男性,存在有性别差异(P=0.001)。在理想家庭中,女性亲密度分值高于男性,存在有性别差异(P=0.035)。④无论是实际家庭还是理想家庭,受试者来源间无差异。⑤解决问题、幻想与实际家庭亲密度呈正相关;自责与实际家庭的的亲密度和适应性呈显著性负相关;求助与理想家庭的亲密度呈正相关;退避与实际家庭和理想家庭的的亲密度和适应性都有显著的负相关关系;合理化与实际家庭的亲密度及理想家庭的亲密度和适应性有负相关关系。结论:影响应付方式的因素中,家庭来源的不同更重于性别的不同;性别与家庭类型的关系强度更胜于家庭来源的不同,性别是影响家庭类型的主要因素。应付方式与家庭亲密度和适应性之间存在密切的关系。     

护理专业本科生人际关系状况及影响因素研究

目的：探讨护理专业本科生人际关系状况及其影响因素。方法对1094名护理专业本科生采用人际关系综合诊断量表、症状自评量表、交往焦虑量表、社交回避及苦恼量表、家庭功能评定量表及家庭亲密度和适应性量表进行测评分析。结果本组22．1％的学生存在不同程度的人际交往困扰;护理专业本科生人际关系综合诊断量表总分与症状自评量表、交往焦虑量表、社交回避及苦恼量表、家庭功能评定量表及家庭亲密度和适应性量表评分均呈显著相关（P＜0．01）;逐步回归分析发现人际关系综合诊断量表总分与躯体化、问题解决及实际亲密因子呈显著负相关（ P＜0．05或0．01）,与强迫、人际关系敏感、精神病性、沟通、角色、情感反应、社交回避及苦恼量表、交往焦虑量表得分呈显著正相关（ P＜0．05或0．01）。结论护理专业部分本科生存在不同程度的人际交往困扰,其影响因素众多,高校管理部门应予以有针对性地干预,以提高学生的人际交往能力及心理健康水平。     

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.     

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.     

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.