The transgenerational transmission of holocaust trauma

Abstract

This paper outlines an attachment-theory based model of transgenerational trauma inspired by the successful psychoanalytic treatment of a severely disturbed adolescent with obsessive-compulsive disorder who was the first child of the first daughter of a holocaust survivor. It is proposed that the transmission of specific traumatic ideas across generations may be mediated by a vulnerability to dissociative states established in the infant by frightened or frightening caregiving, which, in its turn, is trauma-related. Disorganized attachment behaviour in infancy may indicate an absence of self-organization, or a dissociative core self. This leaves the child susceptible to the internalization of sets of trauma-related ideation from the attachment figure, which remain unintegrated in the self-structure and cannot be reflected on or thought about. The disturbing effect of these ideas may be relatively easily addressed by a psychotherapeutic treatment approach that emphasizes the importance of mentalization and the role of playful engagement with feelings and beliefs rather than a classical insight-oriented, interpretive approach.     

病人参与病人安全研究发展现状分析与思考

从概念、研究意义、国内发展现状及展望综述病人参与病人安全研究发展现状。指出未来应在借鉴国外成功经验的基础上结合我国实际情况,探索构建一个系统、全面、科学的评价指标体系,以期为我国病人参与病人安全的相关研究开展提供参考和借鉴,指导临床实践,从而促进我国医疗卫生事业的不断发展,更好地保障病人安全。     

Measuring Knowledge of Fertility Preservation in Women With Cystic Fibrosis: Instrument Development and Psychometric Analysis

ObjectiveTo describe the development, evaluation, and psychometric properties of a new instrument that measures fertility preservation (FP) knowledge in women with cystic fibrosis (CF) titled the Knowledge of FP in Women With CF Instrument (KFP-WCFI).DesignThe 10-item KFP-WCFI was developed and evaluated through a cross-sectional survey.SettingParticipants were recruited nationally from CF Foundation–accredited CF clinics and via snowball sampling.ParticipantsFifty women with CF ages 18 through 35 years completed the instrument.MeasurementsConstruct validity was assessed using confirmatory factor analysis (CFA). In the CFA, the model fit was evaluated using standardized root mean square residual, root mean square error of approximation, and comparative fit index. Cronbach’s alpha was used to examine internal consistency reliability. The criterion validity was assessed using inferential statistics.ResultsThe CFA with two subscales, General Fertility Knowledge and Transplant-Related Fertility Knowledge, demonstrated good fit, with a standardized root mean square residual of 0.07, root mean square error of approximation of 0.06, and comparative fit index of 0.97, indicating good construct validity of the instrument. This instrument demonstrated internal consistency reliability with a Cronbach’s alpha of .91 for the General Fertility Knowledge subscale and .64 for the Transplant-Related Fertility Knowledge subscale. Women who reported a pregnancy scored higher than women who did not report a pregnancy (p = .02), suggesting criterion validity.ConclusionThe newly developed KFP-WCFI appears to be a valid and reliable instrument that can be used to measure self-assessed FP knowledge in women with CF.     

子宫颈支原体感染与胚胎停止发育的关系

目的:探讨子宫颈支原体感染与胚胎停止发育的关系。方法:病例选取起止时间为2018年7月至2019年12月,入组200例病例均为本院收治的流产患者。对其临床资料进行回顾性分析,将发生子宫颈支原体感染患者纳入研究组(100例),将未发生感染患者纳入对比组(100例)。对比分析两组患者发生胚胎停止发育的情况。结果:组间对比,研究组患者发生胚胎停止发育的例数为32例,占比32.00%,对比组发生胚胎停止发育患者例数为12例,占比12.00%,研究组胚胎停止发育比例更高(P<0.05)。两组患者胚胎停育1次、2次以及3次以上比例无统计学差异(P>0.05),支原体感染与胚胎停育次数无正相关性。结论:子宫颈支原体感染是引发胚胎发育异常的重要原因,会引发不良妊娠结局。     

Age-related changes in oral motor-control strategies during unpredictable load demands in humans

To investigate age-related changes in oral motor strategies in response to unpredictable load demands. Sixty-five healthy children (aged 3–17 yr) were divided into five age-groups based on their dental eruption stages and compared with a group of healthy adults (aged 18–35 yr). Each participant was asked to perform a standardized motor control task involving ‘pulling’ and ‘holding’ a force transducer with the anterior teeth. Different loads were attached to the force transducer in an unpredictable manner. The temporal force profile was divided into two time-segments (an initial segment and a later segment). The peak force and peak force rate during the initial time-segment, and the holding force and intra-trial variability (coefficient of variation) during the later time-segment, were measured. The results showed no differences in the peak force, peak force rate, holding force, and force variability in children compared with adults. However, the trends in the data evaluated using a segmented regression analysis showed that a breakpoint (abrupt change) consistently occurred in the late-mixed dentition group (age 9–11 yr) for most of the outcome variables. The results indicate that while the motor control strategies in children appear to be similar to those in adults, there is a shift in the oral motor developmental trend during the late-mixed dentition stage.     

Melnick-Needles syndrome associated molecule,Filamin-A regulates dental epithelial cell migration and root formation

BackgroundFilamin-A (FLNA) is one of the adaptor proteins binding to both integrin beta chain and actin filament. Several kind of mutation in human FLNA gene were observed in Melnick-Needles syndrome (MNS). However, the role of FLNA in tooth formation is still unknown.Matrials and methodsWe analyzed the tissue expression of FLNA during tooth development using immunostaining. The role of FLNA in cell migration was analyzed using a scratch assay. In addition, we analyzed the phenotype of teeth in patients with Mernick-Needles syndrome caused by FLNA gene abnormalities.ResultsFLNA expressed in inner and outer enamel epithelium in mouse tooth germ and also expressed in cervical region of dental epithelium. In postnatal stage, FLNA expressed in ameloblast and odontoblast layers. In rat dental epithelium cell line SF2, FLNA is localized at the boundary between cells and co-localized with the terminal region of F-actin filament. shRNA-FLNA transfected cells showed delayed cell migration and scratch closure compared with control cells. Analysis of actin fiber movement by time-lapse confocal microscopy showed slower fiber movement in shRNA-FLNA over expressing SF2 cells. Novel mutation in FLNA gene was observed in MNS with tooth anormaly. This patient showed tooth agenesis and short root in both primary and permanent dentition with thin enamel.ConclusionTaken together, these results suggest that filamin-A is play a key role for dental epithelium migration and root formation.