儿童常见发育异常性疾病的情绪行为与社交功能问题

孤独症谱系障碍(ASD)、注意缺陷多动障碍(ADHD)和语言障碍(LD)等神经发育障碍性疾病是儿童常见的发育异常性疾病,常伴心理行为与社交功能问题,早期识别、诊断和早期针对性的干预措施,对改善其预后具有重要意义。本文就儿童常见发育异常性疾病的心理行为与社交功能进行介绍,供相关专业人员参考。     

儿童心理问题的家庭治疗原则与策略

儿童心理问题的常规治疗包括心理治疗和药物治疗,但是两者具有一定的局限性和社会不适性。家庭对儿童的成长具有重大影响,也是儿童出现心理问题的重要源头,所以家庭的介入对于心理问题儿童的治疗非常关键。家庭治疗的主要原则包括培养儿童的独立性、解决儿童与外界之间的冲突以及重视家庭成员间的和谐关系。家庭治疗所采取的策略主要是转变家庭内部态度、重视家庭的整体性、心理治疗和家庭治疗的互相配合以及对医学诊断的重视。在专业医学诊断指导下,通过家庭介入传统的心理治疗,从而更好地改善儿童所面临的心理问题。本文回顾了现有的儿童心理问题的研究成果,强调了家庭对儿童心理问题的影响,总结了儿童心理问题的家庭治疗原则和策略。     

Optimal control problems with Atangana‐Baleanu fractional derivative

In this paper, we study fractional‐order optimal control problems (FOCPs) involving the Atangana‐Baleanu fractional derivative. A computational method based on B‐spline polynomials and their operational matrix of Atangana‐Baleanu fractional integration is proposed for the numerical solution of this class of problems. With this numerical technique, the FOCPs are reduced to a system of equations which are solved for the unknown parameters with the help of Mathematica® software. Our results show the applicability and usefulness of the numerical technique.     

The effect of lengthening the gastrocnemius muscle in chronic therapy resistant plantar fasciitis

BackgroundThe aetiology of chronic therapy resistant plantar fasciitis (CTRPF) is multifactorial with more focus in recent times on the gastroc-soleus complex. This study evaluates the effect of lengthening the gastrocnemius muscle in CTRPF.MethodsAll patients with CRTPF complaints for at least one year underwent the same standard conservative treatment prior to surgery. 32 patients failed this treatment and underwent gastrocnemius recession. Silfverskiöld test, questionnaires and plantar pressure measurements were obtained at 5 visits.ResultsOne year follow up showed a significantly increase in dorsiflexion of the ankle (16 degrees), a decrease in VAS; 78 (SD: 19) to 20 (SD: 24) and significant improved functional scores. Plantar pressure measurements showed an increase of pressure under the medial proximal part of the midfoot and the 1 st metatarsal and a decrease under the hallux.ConclusionsA gastrocnemius recession results in a significant gain in dorsiflexion, altered loading of the foot and good clinical outcome in patients with CTRPF.Level of EvidenceLevel 2     

Sobre la pornografía y la educación sexual: ¿puede «el sexo» legitimar la humillación y la violencia?

The aim of this article is to argue for the need and urgency to open an interdisciplinary debate on the goals of critical sexual education. From a philosophical and gender approach, the consequences of generalized online access to pornography, a profitable business, are analyzed as a school of sexuality for youth. The article deals with the violence and misogyny of many of the most visited contents and poses two hypothesis to debate. Firstly, pornography is subject to a process of erotizing violence, which may become a new space of legitimization of inequality between female and male teenagers. Secondly, a mismatch exists between the expectations of female and male teenagers regarding what a good sexual life is. Movements such as Me too and Cuéntalo as well as social polarization over trials like that of “the herd” would confirm such a mismatch. The conclusions reflect on the contradictions in societies, committed to equality, which increasingly tolerate less sexual abuse and aggression and at the same time are becoming more tolerant towards pornographic contents freely accessed by young people as a school of misogyny and violence. Some of the most serious consequences of those contradictions are dealt with by way of three current examples.     

Dreaming the impossible dream? An exploratory study on the expectations of Dutch clients with multiple problems concerning the co-production of public services

Currently, many policymakers try to encourage client involvement during the public service delivery process and make it a co-production. Clients are encouraged to act as active agents and embrace an integrated approach to address their problems to empower them. However, different studies have raised questions regarding to what extent these ambitions are appropriate for clients with vulnerabilities, such as clients with multiple problems. Aiming to further explore this issue, we studied the expectations of clients with multiple problems concerning the co-production of public services. We interviewed 46 clients with multiple problems at the start of their support trajectory. All 46 participants lived in five districts in Rotterdam, the Netherlands, and were recruited via community-based primary care teams. Our study indicates that co-production ambitions might not resonate with clients with multiple problems. The study shows that these clients’ expectations are driven by their feelings of being overwhelmed and stressed out by their situation, feelings of being a victim of circumstances, bad experiences with public services in the past, their evaluation of what counts as a problem and the envisioned solutions. These clients expect public service providers to take over, fix their main problem(s) and not interfere with other aspects of their lives (not an integrated approach). Although participants seek a ‘normal’ life with, e.g., a house, work, partner, children, holidays, a pet, and no stress (a white picket fence life) as ideal, they do not feel that this is attainable for them. More insight into the rationale behind these expectations could help to bridge the gap between policymakers’ ambitions and clients’ expectations.     

Response to the Distilled spirits Industry Council of Australia Inc. position paper 'Alcohol Availability'

A critique is offered of the Distilled Spirits Industry Council position paper 'Alcohol Availability'. It is argued that this position paper presents a simple-minded analysis of the complex relationship between the availability of alcohol and its consumption which pays no attention to the importance of price in determining consumption. As a consequence, it misconstrues the lessons to be drawn from the Victorian experiment in liberalization and fails to consider its implications for the incidence of alcohol related problems.     

Aesthetics of feminizing the male face by craniofacial contouring of the facial bones

The forceful and macho look of a prototypical man may not be unduly appealing to others whom he meets. This forceful look might not even appeal to the individual himself. In order to soften this appearance, a series of operative procedures has been devised for use on the craniofacial skeleton. These surgical steps can be done in a single operation or as a series of multiple operative procedures. Moreover, the needs of some patients may require that only special segments of these procedures be performed. This article presents these operative procedures and describes the feasibility with which they can be performed. Complications and unfavorable outcomes, when they occur, are usually related to unrealistic expectations on the part of the patient. The surgical steps routinely performed are those that contour the forehead, orbits, malar eminence, cheeks, chin, angle of the mandible, and larynx. Three categories of patients are described: the female with a male face; the male with a forceful look; and the patient requesting a gender identity change. The psychosocial, psychological, and behavioral problems leading to the decision for surgery will be the basis of final patient selection.Presented at the 9th Congress of the International Society of Aesthetic Plastic Surgery, New York City, October 1987     

病毒性肝炎的基因治疗及其伦理问题

病毒性肝炎迄今仍无特异有效的治疗药物和方法.而近年发展起来的基因治疗可能将是一种有效的治疗方法,并在体外和实验动物中取得了相当的成功,但若应用于人体还需解决很多问题尤其是伦理学问题.