住院空巢老人焦虑抑郁和主观幸福感现状及影响因素研究

目的调查住院空巢老人的焦虑抑郁状况及主观幸福感水平,并分析其影响因素。方法采用一般资料调查表、焦虑自评量表、老年抑郁量表和纽芬兰纪念大学幸福度量表对2014年3月至10月105名住院空巢老人进行问卷调查。结果住院空巢老人中27.62%(29名)存在焦虑状况,37.14%(39名)存在轻度抑郁,16.19%(17名)存在中重度抑郁,主观幸福感水平不高。老人的主观幸福感与焦虑和抑郁情绪呈显著负相关(P0.01)。经逐步多元回归分析显示,睡眠情况和娱乐活动是住院空巢老人焦虑情绪的影响因素;娱乐活动、文化程度、慢性病种类及体育锻炼是抑郁的影响因素;影响住院空巢老人主观幸福感的因素有抑郁、睡眠情况、娱乐活动。结论住院空巢老人焦虑抑郁的发生率较高,主观幸福感水平不高,焦虑抑郁情绪严重影响着他们的主观幸福感及生活质量;护理工作者在常规日常护理的同时,应注意影响住院空巢老人心理状况的因素,采取有效的措施加以疏导,促进老人的身体和心理健康。     

空巢老人原发性高血压患者心理健康状况与生活质量的相关性研究

目的了解和掌握重庆市九龙坡区社区空巢老人原发性高血压(EH)患者的心理健康水平及其与生活质量的相关性,为制定预防干预措施和实施健康教育提供科学依据。方法以生活质量量表(SF-36)和症状自评量表(SCL-90)为研究工具,分别对重庆市建设医院就诊的256例空巢老人EH患者的心理健康及生活质量水平进行调查。结果空巢老人EH患者生活质量的总体健康得分为(54.32±11.30)分,明显低于国内高血压老人的常模得分;而且,SCL-90量表总得分为(142.15±18.94)分,也明显高于高血压老人常模分值;等级相关分析(Spearman)结果显示,SCL-90量表中躯体化、人际关系敏感、抑郁、焦虑4个维度与生活质量之间呈正相关,差异有统计学意义(P0.05);量表总得分与生活质量得分亦呈正相关,差异有统计学意义(P0.05)。结论空巢老人EH患者心理健康和生存质量水平均较低且两者呈正相关,改善患者心理健康水平将有助于提高其生活质量。     

昆明市空巢老人抑郁状况调查及其影响因素

目的:调查空巢老人抑郁现状,分析其影响因素.方法:随机抽取昆明市四城区300名老人,采用老年抑郁量表、领悟社会支持量表、幸福感指数量表和人口统计学调查表测查.结果:(1)空巢独居老人抑郁得分以及检出率显著高于空巢同居与非空巢老人,社会支持得分显著低于非空巢老人(P<0.05);(2)从抑郁状况看,丧偶空巢老人显著高于有配偶者、中专文化程度者显著高于其他文化程度者、低于当地经济水平者显著高于其他经济水平者(P<0.05或P<0.001);(3)抑郁与社会支持、幸福感指数呈显著负相关(P<0.01),而幸福感指数与社会支持呈显著正相关(P<0.01).结论:抑郁严重影响空巢老人特别是空巢独居老人的心身健康,社会支持、经济等因素影响空巢老人的抑郁和生存质量.     

社区空巢老人抑郁状况的影响因素分析

目的了解上海市社区空巢老人的抑郁状况及其影响因素,为政府有关部门完善相关政策提供依据。方法便利抽样选择上海市嘉定区真新街道4个街区的空巢老人212名,应用老年抑郁量表、社会支持量表等测量工具对其进行调查,并对结果进行统计分析。结果社区空巢老人抑郁发生率为31.13%。经单因素分析,年龄大、无配偶、文化程度低、独居、参加体育活动频率低、1年内住过院、自我健康评价低者,其抑郁评分及其发生率高,差异有统计学意义(均P0.05)。经逐步多元线性回归分析,社区空巢老人抑郁评分的主要影响因素包括年龄、有无配偶、居住状况、参加体育活动频率、自我健康状况评价、1年内是否住过院(P0.05)。相关性分析发现,社区空巢老人的抑郁分值与其客观支持、主观支持、对社会支持利用度、社会支持总分均呈负相关(P0.01)。结论社区空巢老人抑郁状况的影响因素众多,社区及家庭应多给予关注,尤其是高龄、无配偶、独居的空巢老人,以期为空巢老人营造幸福安康的生活环境,提高其生命质量。     

女性性受害者心理健康状况及其影响因素分析

目的 探讨女性性受害者心理健康状况及其影响因素.方法 对102名女性性受害者采用症状自评量表、领悟社会支持量表、特质应对方式问卷、自我接纳问卷和一般自我效能感量表进行测评分析.结果 女性性受害者症状自评量表各因子分均显著高于国内常模(P＜0.01);女性性受害者领悟社会支持量表总分和家庭外支持维度评分均与症状自评量表总分及因子分呈显著正相关,家庭内支持维度评分与症状自评量表总分及躯体化、人际关系、抑郁、焦虑、恐怖、精神病性因子分呈显著正相关(P＜0.05或0.01);特质应对方式问卷消极应对维度评分与症状自评量表人际关系、抑郁、敌对因子分呈显著负相关,积极应对维度评分与症状自评量表总分及躯体化、强迫、人际关系、抑郁、焦虑、恐怖、偏执、精神病性因子分呈显著正相关(P＜0.05或0.01);自我接纳问卷的自我接纳维度评分与症状自评量表人际关系、抑郁因子分呈显著负相关,自我评价维度评分与症状自评量表总分及人际关系、抑郁、偏执、精神病性因子分呈显著正相关(P＜0.05或0.01);一般自我效能感量表评分与症状自评量表人际关系、抑郁、精神病性因子分呈显著正相关(P＜0.05或0.01).结论 女性性受害者心理健康水平低于普通人群,其社会支持、积极应对、自我评价、自我效能感对心理健康有负面影响,自我接纳、消极应对能改善人际关系及抑郁情绪.     

兰州市空巢老人生活质量现况调查

[目的]了解兰州市空巢老人生活质量现况,为兰州市开展提高空巢老人生活质量干预提供理论依据。[方法]采用多阶段随机抽样的方法,于2014年6月—12月采用一般情况问卷、简明健康状况量表(SF-36)、社会支持评定量表对兰州市608名空巢和非空巢老人进行问卷调查。[结果]兰州市空巢老人慢性病患病率为72.6%,非空巢老人慢性病患病率为66.4%,二者比较差异无统计学意义。兰州市空巢老人生活质量在躯体角色、总体健康、活力、社会功能、情感角色、心理健康6个维度得分和生活质量总分低于非空巢老人(P0.05),空巢老人社会支持总分及各维度得分低于非空巢老人(P0.05)。[结论]兰州市空巢老人慢性病患病率较高,生活质量低于非空巢老人。因此社会、家庭应多关爱空巢老人,并制定切实可行的措施来提高空巢老人的生活质量。     

心理干预对独生子女家庭空巢老人心理状况的影响

目的 探讨心理干预对独生子女家庭空巢老人心理状况的影响,以提高其生活质量.方法 选择北京市垡头社区独生子女家庭空巢老人60名,按随机数字表法,随机分为对照组30名和实验组30名.对照组不给予心理干预,实验组进行心理干预,干预前后采用自制独生子女家庭空巢老人心理状况问卷、UCLA孤独量表(UCLA)、焦虑自评量表(SAS)、抑郁自评量表(SDS)进行调查,分析干预效果,并与对照组比较.结果 实验组干预后UCLA、SAS、SDS得分分别为(35.1±2.6),(40.5±3.4),(38.6±2.1)分,均优于干预前[(45.4±5.3),(55.4±4.3),(58.8±4.7)分],差异有统计学意义(t值分别为9.5564,14.887 6,21.4926;P ＜0.01);对照组UCLA、SDS、SAS得分分别为(44.9±4.8),(56.2±4.1),(59.1±4.5)分,与实验组干预后比较差异有统计学意义(t值分别为9.832 8,16.144 7,22.610 9;P＜0.01).结论 独生子女家庭空巢老人普遍存在心理问题,对独生子女家庭空巢老人进行心理干预可明显改善其心理状态,对提高其生活质量有积极意义.     

城市空巢老年高血压患者心理健康状况与生活质量的相关性分析

目的 探讨城市空巢老年高血压患者心理健康状况与生活质量的相关性.方法 将100例城市空巢老年高血压患者设为研究组,98例非空巢老年高血压患者设为对照组.比较两组症状自评量表及健康调查简表评分,分析城市空巢老年高血压患者心理健康状况与生活质量的相关性.结果 研究组症状自评量表各维度评分均显著高于对照组(P<0.01),健康调查简表各维度评分均显著低于对照组(P<0.01).城市空巢老年高血压患者症状自评量表抑郁、躯体化、强迫、焦虑评分与健康调查简表精神健康、生理功能评分呈显著负相关(P<0.05).结论 城市空巢老年高血压患者心理健康状况与生活质量较差,心理健康状况与生活质量存在一定程度的相关性,应关注空巢老年高血压患者的心理健康状况,提高其生活质量.     

高职院校专科生心理健康状况与应对方式和社会支持相关性研究

目的 探讨高职院校专科生心理健康状况与应对方式、社会支持的相关性,为开展有针对性的心理健康教育提供依据.方法 对1 196名高职院校专科生采用症状自评量表、应对方式问卷、社会支持评定量表进行测评分析.结果 高职院校专科生症状自评量表各因子分均显著高于中国常模(P＜0.01),心理问题检出率为24.16%.男生症状自评量表强迫、人际关系、抑郁、焦虑、恐怖因子分均显著低于女生(P＜0.01),敌对及精神病性因子分均显著高于女生(P＜0.05);文科生各因子分均显著高于理科生(P＜0.01);来源于城市的学生各因子分均显著低于农村的学生(P＜0.01).不同性别专科生应对方式问卷各因子分差异均有显著性(P＜0.01),不同科别专科生解决问题、自责、求助、合理化因子分差异有显著性(P＜0.01).专科生症状自评量表均分及各因子分与应对方式问卷解决问题、求助因子分呈显著负相关(P＜0.05或0.01),与自责、幻想、退避、合理化因子分呈显著正相关(P＜0.01);症状自评量表均分及各因子分与社会支持评定量表对支持的利用度维度分呈显著负相关(P＜0.05或0.01),焦虑、恐怖因子分与客观支持维度分呈显著正相关(P＜0.05),除躯体化、恐怖因子外的其他因子分及均分与主观支持维度分呈显著负相关(P＜0.05或0.01).应对方式问卷的解决问题、求助、自责、幻想因子和社会支持评定量表的3个维度对预测心理健康有一定作用.结论 高职院校专科生心理问题检出率较高,其心理健康状况与应对方式、社会支持密切相关,学校开展有针对性的心理健康教育,对提高学生的心理健康水平具有重要意义.     

驻岛官兵人格特征主观幸福感与心理健康状况的相关性调查

目的探讨驻岛官兵人格特征、主观幸福感与心理健康状况的相关性,为部队开展心理卫生工作提供依据。方法对328名驻岛官兵采用症状自评量表、艾森克个性问卷和总体幸福感量表进行测评分析。结果驻岛官兵艾森克个性问卷的内外向维度评分与症状自评量表人际关系、抑郁因子分呈显著正相关〈P〈0．05）,精神质维度评分与人际关系、焦虑、敌对、偏执及其他因子分呈显著正相关〈P〈0．05或0．01）,神经质维度评分与躯体化、人际关系及精神病性因子分呈显著正相关〈P〈0．05）;艾森克个性问卷的内外向维度评分与总体幸福感量表总分及对健康的担心、忧郁或愉快的心境、对情感和行为的控制因子分呈显著正相关〈P〈0．05或0．01）,精神质维度评分与总体幸福感量表总分及对生活的满足和兴趣、松弛或紧张因子分呈显著负相关〈P〈0．05或0．01）,神经质维度评分与总体幸福感量表总分及除精力因子分外的其他因子分呈显著负相关〈P〈0．05或0．01）;总体幸福感量表总分对症状自评量表总均分有显著预测作用〈P〈0．01）。结论驻岛官兵的人格特征与主观幸福感、心理健康状况密切相关,主观幸福感越强,心理健康水平越高。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Structure and function of "metalloantibiotics"

Although most antibiotics do not need metal ions for their biological activities, there are a number of antibiotics that require metal ions to function properly, such as bleomycin (BLM), streptonigrin (SN), and bacitracin. The coordinated metal ions in these antibiotics play an important role in maintaining proper structure and/or function of these antibiotics. Removal of the metal ions from these antibiotics can cause changes in structure and/or function of these antibiotics. Similar to the case of "metalloproteins," these antibiotics are dubbed "metalloantibiotics" which are the title subjects of this review. Metalloantibiotics can interact with several different kinds of biomolecules, including DNA, RNA, proteins, receptors, and lipids, rendering their unique and specific bioactivities. In addition to the microbial-originated metalloantibiotics, many metalloantibiotic derivatives and metal complexes of synthetic ligands also show antibacterial, antiviral, and anti-neoplastic activities which are also briefly discussed to provide a broad sense of the term "metalloantibiotics."