医学生动机及学习策略量表的构建

目的:编制医学生动机及学习策略量表,并对其进行信度、效度检验,为评价医学生的动机水平及学习策略提供参考。方法:确定本量表的4个维度,初步拟定80个条目,并用初始量表对655名医学生进行测量,以检验量表的信度和效度。根据结果不断筛选,最终得出有效条目构成本量表。结果:本量表保留50个条目,其中内在动机13项,任务分析12项,外在动机14项,自我认知11项。本量表总体Cranach'sα系数为0.805,各维度Cranach'sα系数为0.716~0.831,说明此量表具有较好的内在一致性;总体分半信度为0.800,各维度分半信度为0.760~0.835,均在0.700以上;采用复本法得出总体的内容效度为0.892,表明量表充分代表了所要测试的内容范围;结构效度采用主成分因子分析法,显示有内在动机、外在动机、任务分析、自我认知4个主要成分。结论:该量表具有较好的信度和效度,适于评价医学生的学习动机水平和学习策略,能够为学生更好地自主学习起一定的启示作用。     

医学生自主学习能力测评量表的信效度检验

目的对自制的医学生自主学习能力测评量表,进行信度、效度检验,检验其在医学生中的适用性。方法采用横断面调查的方法,用医学生自主学习能力测评量表对全国3423名医学生进行测评。结果总量表重测信度为0.992(P0.001),各分量表重测信度为0.983(P0.001),0.975(P0.001),均在0.700以上,说明此量表具有较好的重复性;总量表Cronbach'α系数为0.929(P0.001),各分量表的Cronbach'α系数为0.809(P0.001),0.914(P0.001),均在0.700以上,说明此量表具有较好的内在一致性;总量表分半信度为0.892(P0.001),各分量表分半信度为0.795(P0.001),0.883(P0.001),均在0.700以上,符合量表评价标准;专家对量表总体评定的内容效度指数为0.970(P0.001),表明量表各条目有效反映了其所属维度的内容;结构效度采用因子分析提取出6个因子,累计贡献率为53.194%,数据分析的理论结构与假设基本一致,量表结构效度较好;标准关联效度为0.510(P0.001)说明量表的关联效度高。结论本研究编制的量表具有较好的信度、效度,对于了解医学生自主学习能力,提高其自身素质,具有一定应用价值,同时对医学教育也有一定启示作用。     

大学生自杀榜样效应认同度量表的编制及信效度检验

目的:编制自杀榜样效应认同度量表(Suicide Modeling Effect Acceptance Scale,SMEAS),并检验其信效度。方法:在267名大学生中初测,确定37个条目的正式量表。之后采用分层整群抽样法,随机抽取601名广东省在校大学生进行正式施测。结果:量表共6个因子,分别为:认同、倾向、关注、回忆、交往和理解,共解释方差51.475%。验证性因子分析得出模型拟合指数:χ2=1305,df=614,NNFI=0.92,CFI=0.92,RMSEA=0.066。总量表和各因子的α系数在0.50-0.90之间;量表总分和各因子的重测信度系数在0.77-0.93之间。量表总分与自杀意念问卷(Suicide Ideation Questionnaire,SIQ)总分呈显著正相关(r=0.553,P<0.01),且能有效区分自杀意念的高低分组。结论:自杀榜样效应认同度量表在大学生群体中具有良好的信效度指标。     

Beck自杀意念量表中文版评价抑郁症患者的信、效度

目的探讨Beck自杀意念量表中文版(Beck Scale for Suicide Ideation-Chinese Version,BSI-CV)在抑郁症患者自杀意念评价中的信、效度。方法采用BSI-CV和自杀意念自评量表(SIOSS)对334名抑郁患者进行问卷调查。用SPSS软件和LISREL8.7进行信度、效度分析。结果①BSI-CV用于评价抑郁症患者"近1周"和"最消沉忧郁"时自杀意念的内部一致性信度分别为0.944/0.957,分半信度分别为0.926/0.896;②模型拟合分析显示,各条目因子载荷均在0.5以上,模型拟合优度指标提示模型拟合较好;③BSI-CV评分与SIOSS评分呈相关关系(P<0.01)。结论 Beck自杀意念量表中文版在抑郁症患者人群中具有良好的信、效度。     

生存理由量表在中国大学生群体中的应用

目的:评价生存理由量表(RFL-C)在大学生群体中的信、效度。方法:采用分层随机抽样法,在6所高校中选取48个班级共2166名大学生完成RFL-C、贝克自杀意念等量表。随机抽取140名学生,间隔4周重测RFL-C。结果:①条目与总分的相关在0.231～0.626之间;量表的cronbachα系数在0.74～0.94之间;重测信度在0.65～0.87之间。②探索性因子分析显示,RFL-C由六因子构成,结构模型分析显示六因子模型拟合指数RMSEA=0.04,GFI=0.92,NNFI=0.94,IFI=0.94,CFI=0.94。③RFL-C总分及6个因子分与贝克自杀意念量表总分呈负相关(r=-0.34～-0.10,P<0.05)。除自杀恐惧因子、道德反对因子外,无自杀意念组的生存理由量表总分及其他因子分均高于曾经有自杀意念组、曾经有自杀行为组与现有自杀意念组得分。结论:RFL-C在大学生群体中有良好的信度、效度。     

Beck绝望量表中文版在青少年中使用的信度和效度

目的:研究Beck绝望量表中文版在青少年中使用的信度和效度。方法:采用Beck绝望量表和自杀意向量表,在大连医科大学和辽宁省大连市庄河县分别选取了192名大学生和292名高中生。间隔一周后对其中的86个大学生样本进行重测。主要采用相关分析和因子分析评价量表的信度和效度。结果:20个项目与总分之间的相关系数在0.19-0.70之间,平均相关系数为0.52。量表的Cronbachα系数为0.85,重测信度为0.62(P<0.001)。绝望量表总分与自杀意念量表总分成正相关(r=0.35,P<0.001),无自杀意念被试绝望量表的平均得分低于有轻度自杀意念和有自杀意图被试绝望量表的平均得分(P=0.007和P<0.001)。探索性因子分析提取了动力丧失、对未来的感觉和对未来的期望3个因子(累计解释的方差为43.44%)。除了项目3、4,其他条目的负荷范围在0.47-0.77之间。项目3、6、7、14、18的归属与Beck的假设不一致。结论:Beck绝望量表中文版在青少年中使用有较好的信度和构想效度,但是仍然需要扩大样本在将来的研究中更深入地验证并改进其结构效度。     

心理弹性量表中文版在医学生中的信效度检验

目的:对心理弹性量表中文版(CD-RISC)在医学生样本中进行信效度检验。方法:采用整群抽样的方法对463名大三到大五的中南大学医学生进行问卷调查,利用同质性信度、分半信度、重测信度、校标关联效度、结构效度等统计指标对量表进行信效度分析。同时比较2个条目和10个条目的心理弹性量表与25个条目的心理弹性量表进行信效度系数。结果:对量表进行探索性因素分析得出3个因子,项目分析结果显示心理弹性量表中文版(CD-RISC)各条目分与量表总分相关系数在0.348~0.809之间,各分量表分与总分之间的相关系数在0.512~0.952之间,均达到显著水平(P0.01),27%标准分出的高分组和低分组的平均数的差异检验中中文版CDRISC总分的CR值为35.146,各条目的 CR值在0.568~1.696之间,均达到显著差异(P0.001);总量表的Cronbach’sα系数为0.951,分半信度为0.928,一周后重测信度为0.590;中文版CD-RISC总分与DASS-21总分的相关系数为-0.470,与其分量表分的相关系数在-0.309~-0.506之间,均达到显著水平(P0.01)。验证性因素分析结果显示χ2/df=2.685,CFI=0.935,TLI=0.928,RMSEA=0.060,RMR=0.037。结论:心理弹性量表中文版(CDRISC)在医学生样本中具有良好的信效度,可以用于医学生心理弹性水平测验。     

青少年家庭满意度的理论构建及量表的初步编制

目的:编制青少年家庭满意度量表(AFSS)并检验其信效度。方法:通过开放式问卷调查初步获得量表的结构和条目,在1253名大、中学学生中测试该量表,检验其信效度。结果:AFSS由家庭环境、家庭养育方式、家庭成员间的沟通和了解3个因素构成,共计42个条目。AFSS各因素的同质信度在0.882~0.972之间,重测信度在0.671~0.823之间。探索性因素分析各因子条目的载荷范围在0.458~0.753之间,累积方差贡献率为51.532%。结论:青少年家庭满意度量表具有较好的信效度,可作为评估青少年家庭满意度的测评工具。     

自杀状态问卷中文版在大学生样本中的信效度检验

目的：检验自杀状态问卷（Suicide Status Form,SSF）中文版在大学生样本中的信度与效度。方法：对248名有自杀倾向的大学生进行中文版SSF施测,以心理痛苦量表、知觉压力量表、激越量表、绝望量表、自我厌恶量表、自杀行为筛查问卷为聚合效度检验工具,以国际简明神经精神访谈为实证效度检验工具。另对114名大学生进行SSF团体施测,间隔一周后完成重测。结果：SSF二因子模型拟合良好（χ2/df=1.25, SRMR=0.02, RMSEA=0.03, NFI=0.99,RFI=0.97, TLI=0.99, AGFI=0.97）,各条目与相似测量之间聚合效度良好（r=0.39～0.72）,自杀风险现患者在各条目与因子上得分均显著高于非自杀风险现患者(P<0.05)。两个因子Cronbach’s α系数分别为0.73、0.58,各条目和因子的重测信度在0.41～0.83之间。结论：自杀状态问卷中文版信效度良好,可用于后续自杀评估与干预研究。     

Beck绝望量表在农村自杀死亡研究中的信效度

目的:检验Beck绝望量表中文版在农村自杀死亡研究中的信度和效度。方法:利用山东省疾病监测点上获得198例农村自杀死亡者和201例正常对照者,用Beck绝望量表(BHS)进行测量,用特质焦虑量表(TAI)为效标。结果:自杀死亡组和正常对照组BHS的Cronbachα系数分别为0.92和0.86。BHS和TAI总分呈正相关(r=0.73,P<0.001)。按照自杀死亡组和正常对照组进行探索性因子分析,分别提取4个和5个公因子,提取的公因子个数与原量表设计者的假设不一致。结论:Beck绝望量表在农村自杀研究中具有较好的信度和效标效度,但结构效度有待完善。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.