Convergent Reliability and Validity of the Questions About Behavioral Function and the Motivation Assessment Scale: A Replication Study

This study compared key psychometric properties of the Motivation Assessment Scale (MAS) and the Questions About Behavioral Function (QABF) and explored their convergent validity. Twenty adults with mental retardation and problem behaviors (aggression, self-injury, or property destruction) and 31 respondents participated. Test–retest reliability of the subscales in both scales was good to excellent (Cicchetti, D. V., 1994, Psychol. Assess. 6: 284–290), and—except for 1 QABF subscale—internal consistency was good considering the small number of items and the purpose of the scale. Consistent with some earlier studies, interrater reliability was less satisfactory with both scales falling only into the fair to good range.Correlations between functionally equivalent subscales were statistically significant and were generally higher than correlations between nonequivalent subscales. The QABF and the MAS were found to be comparable in terms of the assessed reliabilities, and both instruments appear to be measuring very similar constructs.     

Differential role for the striatum and cerebellum in response to novel movements using a motor learning paradigm.

The aim of this pilot study was to examine the role of the striatum and cerebellum in the adaptation to a novel movement within a sequence of practiced movements using a motor learning paradigm. The performance of patients in the early or advanced stages of Parkinson's disease (PD) and of patients with damage to the cerebellum (CE) was compared, respectively to a group of aged and young matched controls on an adapted version of the Mirror-Tracing Test. In this task, subjects were required to trace a series of complex figures in two conditions: (1) a Practiced condition, in which the figures were composed of the juxtaposition of three simple designs that were extensively practiced before; and (2) a Mixed condition in which triads were created by replacing the last simple figure of the triads in the Practiced condition by a new simple figure that had never been traced individually before. Results showed that all clinical groups were slower than controls at tracing the Practiced triads. Most interestingly, however, only patients in the advanced stages of PD showed increased completion time to trace the triads in the Mixed condition. This suggests that a bilateral striatal dysfunction affects the ability to adapt to a novel motion within a sequence of practiced movements. Although exploratory, these results support a functional dissociation between the striatum and cerebellum in acquiring visuomotor skilled behaviors.     

Muscular activation patterns of healthy persons and low back pain patients performing a functional capacity evaluation test

The results of most reported studies show differences between the muscular activity of low back pain patients and healthy subjects, but the focus has usually been on trunk muscles only, and they have not involved work-related tests or exercises. The reintegration of chronic low back pain patients to job market is a common problem. Therefore assessment systems like the functional capacity evaluation (FCE) according to Isernhagen [S.J. Isernhagen, Work Injury: Management and Prevention, Aspen Publishers Inc., Gaithersburg, MD, 1988] are often used tools to determine the physical abilities and deficits of long-time incapacitated persons. The aim of the present study was to compare the healthy persons and chronic low back pain patients in performing a FCE-test and to analyse their muscular activation and motion patterns. The results indicate differences in the activation patterns of the groups in the test task “floor to waist lift” common in many occupations.     

Factors associated with mortality and functional disability after hip fracture: an inception cohort study

Hip fracture results in excess mortality and functional disability. This study sought to identify predictors of mortality and limited functional ability 1 year after hip fracture. We conducted a 1-year follow-up of a prospective population-based inception cohort of 218 hip fracture patients who had been consecutively admitted and discharged from hospital during the previous year. Mortality was observed to be independently associated with poor mental status (relative risk [RR]=6.96; 95% confidence interval [95% CI], 1.73–28.00), prefracture limited functional ability (RR=4.35; 95% CI, 1.32–14.36), institutionalized disposition at discharge (RR=2.92; 95% CI, 1.02–8.38), and male gender (RR=2.44; 95% CI, 1.01–5.93). Independent predictors of limited functional ability were prefracture functional disability (RR=34.14; 95% CI, 3.13–372.33), poor mental status (RR=9.71; 95% CI, 1.57–59.82), age >80 years (RR=4.03; 95% CI, 1.48–11.00), and female gender (RR=3.57; 95% CI, 0.08–0.98). On discharge, special attention and care should thus be given to all patients displaying any of the above predictive factors.     

国产促动力药物治疗功能性消化不良的成本-效果分析

目的　评价不同药物治疗功能性消化不良的经济效果。方法　运用经济学中的成本 -效果分析方法 ,对莫沙必利、伊托必利和吗丁啉治疗功能性消化不良方案进行分析。结果　莫沙必利与吗丁啉成本效果比相当 ,但所需增长的成本效果比高 ;伊托必利的成本效果比和增长的成本效果比均高于吗丁啉。结论　吗丁啉是治疗功能性消化不良的最佳用药方案     

抗抑郁治疗对功能性消化不良的辅助治疗作用

功能性消化不良是指具有上腹痛、上腹胀，早饱、暖气、食欲不振、恶心、呕吐等上腹不适症状，经检查排除引起这些症状的器质性疾病的一组临床综合征。在经济、科技、工业化高度发展的社会，已经成为危害人们健康状况和生活质量的最常见的消化系统疾病，因而受到广泛重视。欧美的流行病学调查表明，普通人群中有消化不良症状者占19％-41％，在我国人群中总的患病率为20％。普通门诊中占20％-40％，在消化专科中占60％-70％。FD的发病机制复杂，部分患者存在精神心理的异常，本文通过对FD患者进行抑郁自评量表（zuag评分）评定和抗抑郁药物治疗，旨在探讨二者关系及抗抑郁治疗FD的疗效。     

The composite N1 component to gaps in noise.

OBJECTIVE: To indicate whether the double peaked N(1) to gaps in continuous white noise is a composite of onset and offset responses to transients or whether it reflects higher processing such as change or mismatch detection and to assess the role of attention in this process. METHODS: Evoked potentials were recorded to two binaural stimulus types: (1) gaps of different durations randomly distributed in continuous white noise; and (2) click pairs at intervals identical to those between gap onsets and offsets in the continuous noise stimulus. Potentials to these stimuli were recorded while subjects read a text and while detecting gaps in noise or click pairs. RESULTS: Potentials were detected to all click pairs and to gaps of 5 ms or longer, corresponding to the subjects' psychoacoustic gap detection threshold. With long gap durations of 200-800 ms, distinct potentials to gap onset and gap offset were observed. The waveforms to all click pairs and to offsets of long gaps were similar and single-peaked, while potentials to gaps of 10 ms and longer, and potentials to onsets of long gaps were double-peaked, consisting of two N(1) negativities, 60 ms apart, irrespective of gap duration. The first (N(1a)), was more frontal in its distribution and similar to that of clicks. The second (N(1b)) peak's distribution was more central/temporal and its source locations and time course of activity were distinct. No effects of attention on any of the varieties and constituents of N(1) were observed. CONCLUSIONS: Comparing potentials to gap onsets, to click pairs and to gap offsets, suggests that potentials to gap onsets involve not only sound onset/offset responses (N(1), N(1a)) but also the subsequent pre-attentive perception of the cessation of an ongoing sound (N(1b)). We propose that N(1b) is distinct from change or mismatch detection and is associated with termination of an ongoing continuous stimulus. We propose to call it the N(egation)-process. SIGNIFICANCE: A constituent of the N(1) complex is shown to be associated with the pre-attentive perception of termination of an ongoing stimulus and to have distinct scalp distribution and intracranial sources.     

The Effects of Depressed Affect on Functional Disability Among Rural Older Adults

This study investigates functional disability among some of the nation's most vulnerable older adults: rural Medicaid recipients. Data were provided by 221 older adults (mean age = 75.9 years; 82% women) who were receiving community-based long-term care services through Medicaid. Participants self-reported functional ability involving the completion of six basic activities of daily living (BADLs), three cognitive instrumental activities of daily living (IADLS), and four physical IADLs. Self-reports of depressed affect and the number of physical health conditions were also obtained. Path analysis was used to examine all of the associations among age, gender, number of chronic health conditions, depressed affect and functional disability. The tested model was significant [chi2 (DF = 3, n = 221) = 5.052, p = 0.168; TLI = 0.945; CFI = 0.992; RMSEA = 0.056] and explained 45.1% of the variance in BADL disability. Depressed affect significantly predicted disability in cognitive IADLs and physical IADLs, which predicted disability in BADLs. Age and gender had indirect effects on BADL, through their association with cognitive IADLs and physical IADLs. The number of chronic health conditions exerted both indirect and direct effects on BADL disability. Results are discussed within the context of the growing literature that suggests the importance of psychological variables as predictors of functional disability. Moreover, we discuss whether community-based long-term care is appropriate for older adults with high levels of functional disability.     

COPD肺心病多器官功能损害

目的 :研究COPD肺心病急性加重期多个器官的受损情况。方法 :采用日本OLYMPUS公司AU10 0 0全自动生化分析仪测量 10 9例肺心病急性加重期患者的 17项血生化指标。并与 110例健康体检者进行对照研究。结果 :两组之间血肌酐 (Cr)差异不显著 (P >0 .0 5 ) ,总胆红素 (TBIL)及空腹血糖 (GLU)差异显著 (P <0 .0 5 ) ,其余 14项生化指标P值均 <0 .0 1,两组间差异非常显著。结论 :COPD肺心病急性加重期除了心力衰竭 ,呼吸衰竭之外 ,还常常伴有肝损害、肾损害、高血糖、低脂低胆固醇血症、低蛋白血症及营养不良。保肝护肾 ,注意血糖血脂及营养支持治疗不容忽视     

地塞米松对扩张皮瓣血运障碍的救治

目的寻求扩张皮肤Ⅱ期手术形成皮瓣时出现血运障碍及防止坏死的有效治疗方法。方法皮瓣出现血运障碍时，立即静脉给予地塞米松0．4mg／kg，然后逐渐减量，术后6d停药。10d时观察判断皮瓣成活情况。结果35例出现血运障碍的皮瓣，经救治完全成活33例，大部分成活2例。成活后皮瓣色泽、弹性均好。结论及时用地塞米松是防止扩张皮瓣出现血运障碍及坏死的良好方法。