高等中医药院校贫困生心理健康、防御方式和社会支持的相关分析

目的探讨不同心理健康状况的贫困大学生的防御方式和社会支持特点及其关系。方法采用防御方式问卷(DSQ)、社会支持评定量表、症状自评量表(SCL-90)对302名中医院校贫困大学生进行测评。结果贫困生的心理健康水平低于国内青年常模,但在人口学统计变量上的差异不显著;不同心理健康水平的学生的防御方式和社会支持均具有显著性差异,心理健康状况差的学生较心理健康好的学生更多地使用不成熟的防御策略,且在客观支持、主观支持、对支持的利用度和总分上均显著地低于心理健康状况好的学生;不成熟的防御策略对心理健康具有显著影响。结论贫困生的心理健康与防御方式和社会支持之间具有显著的关联性,应从转导不成熟的防御策略和营造良好社会支持系统两方面对贫困生的心理健康进行维护。     

Geriatric care on a ward without nurses

The Multiphasic Environmental Assessment Procedure (MEAP; Moos and Lemke, 1984) was used to assess three long-stay settings within a geriatric hospital, one of which is a non-nursing unit committed to the philosophy of residents viewing the setting as their own home. Findings suggest positive outcomes for residents on the nonnursing unit, and support the view that types of care fostering independence and personal responsibility of elderly residents in their setting may be associated with increased mental functioning and activity. The lack of trained nursing staff had no detrimental effect on any measure of resident life, and some specific caring practices on the unit may be interpreted as having a positive outcome for residents.     

精神发育迟滞儿童特殊教育三年随访

采用Ｈ－ＮＴＬＡ量表及婴儿～初中学生社会生活能力量表对太原市一个培智学校４４例精神发育迟滞患儿从１９８９～１９９２年连续４次测查智力，２次测查适应行为。结果显示３年间ＩＱ值变化无显著统计学意义，但视觉联想、概念关系、注意力及视觉识知能力有明显提高。患儿适应行为明显提高。经多元逐步回归分析显示，精神发育迟滞儿童智商的提高和母亲文化程度较高、患儿智力低下程度较轻、母亲职业为科技或行政管理人员、患儿初始教育年龄早呈正相关。     

Personality variables as moderators between hassles and subjective indications of distress

The research was designed to investigate the moderating effect of some personality traits on subjective distress caused by daily hassles. The traits were internal locus of control, repression, ego strength, and barrier (as studied and defined by S. Fisher). The last two variables were negatively correlated both with the somatic and emotional distress indications and with the frequency of hassles reportED; internal locus of control showed an inverse relationship only with frequency of hassles. The hypothesis is formulated that ego strength and barrier are personality factors influencing not only the outcomes of coping (ie the stress response), but also event appraisal.     

Graves病的发病与社会心理因素

对１０７例甲状腺机能亢进症患者和９１名正常人采用艾森克个性问卷及自编社会环境的调查显示：４６．９４％的患者起病前有负性生活事件发生，个性特征甲亢组神经不稳定型及掩饰性评分显著高于正常组，有显著性差异，此结果提示甲亢患者存在明显个性缺陷和负性生活事件，这些因素可作为甲亢发病的一种诱因。     

The influence of clinical problems, age and social support on outcomes for elderly persons referred to regional aged care assessment teams

Abstract Background: Aged Care Assessment Teams (ACATs) have been established throughout Australia during the past seven years. Early studies of their effect have concentrated on their impact on the rate of institutionalisation of disabled elderly, the clinical characteristics of referred cases and the relationship between disability and recommended care plan. Aims: The aim of this study was to explore the relationship between age, clinical features and social characteristics of AC AT subjects with outcomes at 12 months after assessment. Methods: The examination of an arbitrary sample of persons referred to ACATs over a year by one generalist geriatrician with follow-up of all cases by the three ACATs associated with the study was carried out. All analyses were performed on raw data presented as categorical variables in the form of contingency tables. Results: The sample included 324 subjects who suffered from 2030 clinical problems with a mean of 6.5 per person aged 75 or over and 5.5 for those under 75. Cardiovascular and neurological disease were the commonest source of problems. Study of accommodation outcome at 12 months, for those subjects who survived this period revealed that, in the older group, over 60% of subjects with neurological disease were resident in nursing homes while the majority of all other groups remained in the community, as did two-thirds of those aged under 75. Admission to a nursing home was independent of social support for older subjects with neurological disease, but it played a significant role in those with cardiopulmonary or musculoskeletal disease. Conclusions: The study demonstrates that for one-year survivors there is an increased likelihood of admission to a nursing home of people aged 75 or over with neurological disease, while those under 75 were more likely to remain at home. The association was independent of whether spouse, family or friends were living with the subject. (Aust NZ J Med 1994; 24: 378–385.)     

Psychological well‐being and psychosocial work environment characteristics among emergency medical and nursing staff

The aim of this study was to determine if the effect of psychosocial work environment on psychological well‐being was different for doctors and nurses who work in emergency departments in Spain. A cross‐sectional survey was carried out among 945 emergency doctors and nurses staff from Spain. The outcome variable was the psychological well‐being measured by two dimensions of SF‐36 Health Survey (SF‐36) (mental health, vitality) and one dimension of Maslach's Burnout Inventory (emotional exhaustion). The explanatory variable was the psychosocial work environment evaluated according to Karasek and Johnson's demand‐control model that includes the dimensions of psychological demands, job control, supervisor social support and co‐workers' social support. The adjusted odds ratios and their 95 per cent confidence intervals were calculated by logistic regression. The prevalence of low vitality, bad mental health and high emotional exhaustion was higher among doctors than nurses. Exposure to high psychological demands increased the probability of low vitality, bad mental health and high emotional exhaustion among doctors and nurses. Low job control and low co‐workers' social support at work were associated with poor psychological well‐being only among doctors. Low job supervisors' social support increased the risk of bad mental health among doctors and of high emotional exhaustion among nurses. There is a different effect of psychosocial work environment on psychological well‐being between doctors and nurses. Copyright © 2007 John Wiley & Sons, Ltd.     

肝硬化合并肠功能紊乱的临床治疗观察

目的探讨肝硬化合并肠功能紊乱的有效治疗方法。方法将50例肝硬化合并肠功能紊乱患者,随机分成治疗组(26例)与对照组(24例),治疗组在对照组治疗方案的基础上给予口服贝飞达、双迪28d,同时给予心理干预治疗。观察两组治疗前后临床症状及主要的肝功能指标。结果对照组肠道功能改善总有效率70%,治疗组总有效率92%,治疗组疗效优于对照组(P<0.05)。两组患者治疗后主要肝功能指标均明显改善,治疗组治疗后ALT、T-BiL值低于对照组(P<0.05)。结论肝硬化合并肠功能紊乱的患者给予微生态制剂、肠动力药及心理干预治疗可有效改善患者临床症状,并降低肝功能指标。     

Vessel-encoded arterial spin-labeling using pseudocontinuous tagging.

A new signal-to-noise ratio (SNR) efficient method is introduced for the mapping of vascular territories based on pseudocontinuous arterial spin labeling (ASL). A pseudocontinuous tagging pulse train is modified using additional transverse gradient pulses and phase cycling to place some arteries in a tag condition, while others passing through the same tagging plane are in a control condition. This is combined with a Hadamard or similar encoding scheme such that all vessels of interest are fully inverted or relaxed for nearly all of the encoding cycles, providing optimal SNR. The relative tagging efficiency for each vessel is measured directly from the ASL data and is used in the decoding process to improve the separation of vascular territories. High SNR maps of left carotid, right carotid, and basilar territories are generated in 6 min of scan time.     

多系统萎缩的临床特征与疾病进展的特点

目的探讨多系统萎缩(MSA)的临床特征与疾病进展的特点。方法回顾性分析28例拟诊MSA患者的临床资料;用代表日常生活活动能力(ADL)的3个重要事件(辅助行走、依靠轮椅、卧床状态)对疾病进展进行评估;通过Kaplan-Meier曲线分析各亚组间的差异。结果3个以上系统受累26例(92.9%),普遍存在自主神经功能障碍。从起病进展为临床MSA平均2年;进展为辅助行走、依靠轮椅和卧床状态分别为3年、5年、7年。运动和自主神经系统同时受累的患者起病3年内疾病进展的危险性明显增加(P<0.01)。结论MSA是一种多系统受累的慢性进展性疾病,从起始症状到同时出现运动和自主神经功能障碍的间隔时间能够预测MSA功能衰退的进展。