青年缺血性卒中心理状态

目的 评估青年缺血性卒中后心理状态.方法 入选2008年3月~2011年3月期间两院90例青年缺血性卒中患者,男58例,女32例,年龄21~45岁.使用中国版SCL-90评估心理状态,测量值与常模比较.结果 和常模比较,青年缺血性卒中测量值在抑郁,焦虑,躯体化症状,恐惧,厌恶和精神症状方面差别有统计学意义(P<0.01),而在强迫、敌意和妄想方面的差异无统计学意义(P>0.05).抑郁/焦虑的发生率是43.33%,其中女性占75%,男性占25% (P<0.01).受教育程度差异无统计学意义(P> 0.05).医保患者抑郁/焦虑发生率是29.2%,低于自费患者的发生率(66.7%,P< 0.05).脑损伤部位与抑郁/焦虑发生率有关,双重大脑半球缺血者的发生率是75% (P< 0.05).结论 青年缺血性卒中伴有抑郁、焦虑、躯体化症状、人际关系敏感、恐惧和精神症状,但是强迫、敌意和妄想与常模没有明显的差异.性别、医疗费用和缺血部位影响抑郁/焦虑的发生率.     

Does a dedicated program for young breast cancer patients affect the likelihood of fertility preservation discussion and referral?

PurposeTo assess whether a dedicated program for young breast cancer patients, including a nurse navigator, improves the frequency of: a) fertility discussion documentation and b) fertility preservation (FP) referrals.MethodsA retrospective chart review and prospective survey were undertaken of breast cancer patients diagnosed at age 40 or younger between 2011 and 2013 who received adjuvant or neo-adjuvant chemotherapy at two academic cancer centers in Toronto, Canada. The Odette Cancer Centre (OCC) has a dedicated program for young breast cancer patients while Princess Margaret Cancer Centre (PM) does not. Patient demographics, tumor pathology, treatment and fertility discussion documentation prior to systemic chemotherapy administration were extracted from patient records. Prospective surveys were administered to the same cohort to corroborate data collected.ResultsEighty-one patient charts were reviewed at both OCC and PM. Forty-seven and 49 at OCC and PM returned surveys for a response rate of 58% and 60% respectively. Chart reviews demonstrated no difference in the frequency of fertility discussion documentation (78% versus 75% for OCC and PM, p = 0.71); however, surveys demonstrated higher rates of recall of fertility discussion at OCC (96% versus 80%, p = 0.02). A greater proportion of women were offered FP referrals at OCC, as observed in chart reviews (56% versus 41%, p = 0.09), and surveys (73% versus 51%, p = 0.04). Time to initiation of chemotherapy did not differ between women who underwent FP and those who did not.ConclusionA dedicated program for young breast cancer patients is associated with a higher frequency of FP referrals without delaying systemic therapy.     

Knowledge and Attitudes About Pre-Exposure Prophylaxis Among Young Adults Experiencing Homelessness in Seven U.S. Cities

Purpose

Evidence suggests that young adults experiencing homelessness (YEH) are at elevated risk of HIV compared to housed youth. Given the limited research on pre-exposure prophylaxis (PrEP) awareness among YEH, this study examined their PrEP knowledge and attitudes.

青年人非小细胞肺癌的临床病理特征及预后研究进展

 青年人非小细胞肺癌（NSCLC）发病率呈逐年升高趋势。目前多以发病年龄≤40岁作为青年人NSCLC的年龄界定标准。其发病原因可能与青年人吸烟人数增加、遗传易感性、内外环境改变等有关。青年人NSCLC临床表现缺乏特异性，易被误诊及漏诊，确诊时间长。年轻女性发病率高于老年女性；以腺癌为多见；以分化差的进展期病例为主，手术切除率低。青年NSCLC患者表皮生长因子受体（EGFR）突变阳性率可能低于老年NSCLC患者，而棘皮动物微管相关蛋白样4-间变性淋巴瘤激酶（EML4-ALK）融合基因阳性率可能相对高于其他人群；其一线治疗肿瘤进展时间短，肿瘤进展迅速。提高对青年人NSCLC的认识，争取早期诊治，对其进行精确分子分型可能有助于改善其预后。     

异地务工青年心理健康与幸福感的相关研究

目的探讨肇庆市异地务工青年心理健康现状与幸福感程度,并了解二者之间的相互关系。方法采用症状自评量表(SCL-90)和认知幸福与情绪幸福量表对296名肇庆市异地务工青年进行调查分析。结果 1肇庆市异地务工青年心理健康水平低于全国常模(t=4.885,P0.001),且在性别上存在显著差异(t=2.218,P0.05),技术人员比普通工人和管理人员的心理健康水平低(F=4.962,P0.01),单身和已婚者比有恋人者幸福感水平更高(F=3.025,P0.05);2肇庆市异地务工青年的SCL-90总分与幸福感呈现负相关,(r=-0.417,P0.01)。结论肇庆市异地务工青年的心理健康水平低于全国平均水平;男青年的心理健康水平和幸福感水平均比女青年低;心理健康水平越高,幸福感水平也越高。     

Effect of integrated caregiver support on caregiver burden for people taking care of people with cancer at the end of life: A cohort and quasi-experimental clinical trial

BackgroundPrevious studies have shown small-to-medium effects of support on reducing the caregiver burden for advanced cancer patients. A dearth of studies utilized longitudinal design to examine and evaluate the effect of support for the caregiving burden till the patient's death.ObjectivesTo test the ability of an integrative intervention program for caregivers of advanced cancer patients to lower caregiving burden as death approaches.DesignA two-group comparative design with repeated measures.SettingTwo cancer wards of a single university hospital.ParticipantsAdvanced cancer patients (N = 81) and their caregivers were allocated into two groups: an experimental group (N = 40) receiving coping strategies, assistance, recourses, and education intervention and a control group (N = 41) receiving standard care.MethodsCaregivers received training in the caregiver support intervention at least 3 times every 2 weeks to help them reduce their caregiving burden. Subjective (Caregiver Reaction Assessment) and objective (Heart Rate Variability) measures of caregiver burden were evaluated for caregivers of patients approaching death. Only data within 3 months before the patients’ death were analyzed.ResultsCaregiver self-efficacy significantly increased and the subjective caregiving burden significantly decreased in the experimental group as patients’ death approached. Heart Rate Variability also indicated a calming effect of the intervention, helping caregivers face patients’ death.ConclusionsThe caregiver support intervention can increase caregiver self-efficacy and reduce the subjective caregiving burden. Heart Rate Variability parameters have the potential to be useful for monitoring caregiver burden in facing patients’ death.     

城乡地区青年人主观幸福感相关因素研究

目的了解城乡地区影响青年人主观幸福感的相关因素。方法采用生活满意度指数A(LS IA)量表,选取河北城乡地区184名20~27岁的青年人做问卷调查。结果①青年人的主观幸福感在性别,城乡,独生与否上没有显著性差异(t=1.2,-1.7,3.1;P>0.05);②青年人的主观幸福感在学历上存在显著差异(t=3.1,P<0.05);③青年人的主观幸福感在婚姻状况,抱负水平上不存在显著差异,但在家庭和睦上存在显著差异(F=3.36,P<0.01)。结论社会青年群体的主观幸福感低于大学生;青年人与其家人关系越和睦,其生活满意度指数越高。     

Supporting people with young onset dementia and their families: An evaluation of a training course for care workers

This article reports the findings of an evaluation of a training course for care workers who care for people with dementia in the community. Twenty-four care workers participated in the training which took place in London and Surrey, United Kingdom. The training had a significant positive impact on participants’ confidence in understanding the experiences and social care needs of people with young onset dementia (YOD) and their families. Participants also perceived that the training would help them improve their working practice by furthering their understanding of practical approaches to supporting and caring for people with dementia in general. Additionally, participants reported many ways in which they perceived being able to specifically support and empower people with YOD. It was concluded that the short training course improved knowledge and confidence for care workers on dementia care, and specifically in understanding how to support people with YOD and their families. Dementia specific training should be considered by service managers as a way of potentially increasing care worker job satisfaction.