福建省高校贫困大学生心理健康水平与人格特征

目的:了解贫困生的心理健康现状和人格特征。方法:于2005-09/11随机抽取福州大学、福建师范大学、福建农林大学、福建中医学院、闽江学院2002-2004级学生2400名。男1478名,女922名,平均(20±1)岁。根据2004-11-04福建省福州市政府办公厅正式下发的《福州市人民政府关于提高城区城镇及农村居民最低生活保障标准的通知》中的规定,即城镇多人户每人每个月210元、单人户230元;农村多人户每人每月155元、单人户175元,本文把家庭人均月收入较少,有一定数额债务,只能缴纳部分学杂费,基本生活费接近于当地居民最低生活保障线(如上规定,本文以230元为基准)的学生定为“贫困生”。采用精神症状自评量表和16种人格因素问卷对高校贫困生的心理健康和人格特征进行调查。结果:发放问卷2400份,收回有效问卷2111份。其中贫困生539份。①贫困生精神症状自评量表的躯体化、强迫、人际敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性、其他、总症状指数得分均高于非贫困生(贫困生:1.61±0.56,2.02±0.64,1.92±0.63,1.71±0.56,1.65±0.58,1.73±0.68,1.57±0.62,1.81±0.65,1.67±0.54,1.76±0.63,1.74±0.49;非贫困生:1.48±0.45,1.89±0.56,1.79±0.57,1.61±0.51,1.54±0.50,1.61±0.56,1.44±0.49,1.66±0.54,1.54±0.46,1.61±0.53,1.62±0.41,P<0.01)。男女贫困生之间各因子分差异均不显著(P>0.05)。②福建省高校贫困大学生的心理问题检出率为24.5%,其中轻度心理问题(2≤因子分<3)为22.6%;中度心理问题(3≤因子分<4)为1.7%;重度心理问题(4≤因子分<5)为0.2%。心理问题以强迫、人际敏感、偏执、忧郁、敌对、焦虑等心理问题最为突出。③16种人格因素问卷中,贫困生乐群性、聪慧性、兴奋性、敏感性、怀疑性上得分低于非贫困生,有恒性、忧虑性、独立性得分高于非贫困生(贫困生:5.20±1.77,4.70±1.93,5.49±1.87,6.46±1.79,4.29±1.71,4.60±1.63,6.64±1.82,5.07±1.82;非贫困生:5.39±1.74,4.95±1.99,5.82±1.91,6.66±1.75,4.55±1.77,4.36±1.69,6.43±1.94,4.89±1.77,P<0.05～0.01)。④影响贫困生心理健康水平的主要人格因素按其影响作用从大到小有怀疑性、忧虑性、稳定性、兴奋性、自律性。结论:福建省高校贫困大学生的心理健康状况令人担忧,其人格特征对心理健康水平有重要影响。     

Effect of Blood Product Transfusion-Induced Tolerance on Incidence of Cardiac Allograft Rejection

Background

Blood product transfusion has been successfully used in solid-organ transplantation to induce tolerance. Whether a similar protective effect of blood product transfusion exists in heart transplantation is controversial.

Objective

To investigate the effect of cellular blood product transfusion within 2 weeks posttransplantation on the incidence of cellular and antibody-mediated rejection.

Patients and Methods

Patients were grouped on the basis of number of blood transfusions; group 1 received no transfusions, and groups 2, 3, and 4 each received an incremental number of transfusion units. All endomyocardial biopsy samples were routinely studied using immunofluorescence in the first 12 weeks posttransplantation.

Results

Baseline characteristics including age, sex, body mass index, history of diabetes, donor characteristics, and pretransplantation laboratory values were similar except that group 4 had a higher rate of previous sternotomy and longer ischemic time during transplantation. Approximately 9200 endomyocardial biopsy samples composed the data. Short- and long-term freedom from the International Society for Heart & Lung Transplantation grade 3A or higher cellular rejection and from antibody-mediated rejection were comparable between groups.

Conclusions

Blood transfusions within the first 2 weeks post-transplantation do not seem to confer any protective effect against posttransplantation cellular rejection or antibody- mediated rejection. Whether other unmeasured confounding factors mask their effect requires further prospective studies.     

Inhibition of Opioid Transmission at the ��-Opioid Receptor Prevents Both Food Seeking and Binge-Like Eating

Endogenous opioids, and in particular μ-opioid receptors, have been linked to hedonic and rewarding mechanisms engaged during palatable food intake. The aim of this study was to investigate the effects of GSK1521498, a novel μ-opioid receptor antagonist, on food-seeking behavior and on binge-like eating of a highly preferred chocolate diet. Food seeking was measured in rats trained to respond for chocolate under a second-order schedule of reinforcement, in which prolonged periods of food-seeking behavior were maintained by contingent presentation of a reward-associated conditioned reinforcer. After reaching a stable baseline in both procedures, animals were treated with GSK1521498 (0.1, 1, and 3 mg/kg; IP) or naltrexone (NTX, 0.1, 1, and 3 mg/kg; SC). The binge eating model was characterized by four temporally contiguous phases: 1-h chow access, 2-h food deprivation, 10-min chow access, and 10-min access to either chocolate-flavoured food or standard chow. During training the rats developed binge-like hyperphagia of palatable food and anticipatory chow hypophagia (anticipatory negative contrast). Both compounds reduced binge-like palatable food hyperphagia. However, GSK1521498 reduced the impact of high hedonic value on ingestion more specifically than NTX, abolishing anticipatory chow hypophagia. GSK1521498 also dose-dependently reduced food seeking both before and after food ingestion, whereas NTX reduced food seeking only after food ingestion. Thus, while both drugs affected the hedonic value of the preferred food, GSK1521498 also directly decreased incentive motivation for chocolate. Selective μ-opioid receptor antagonism by GSK1521498 may have utility as a treatment for reducing maladaptive, palatability-driven eating behavior by reducing the motivational properties of stimuli that elicit the binge eating commonly associated with obesity.     

Use of the Internet by Patients Undergoing Elective Hernia Repair or Cholecystectomy

INTRODUCTION

Patient-directed information available on the internet is not always regulated; it may be confusing and sometimes just overwhelming. We aimed to establish the proportion of patients undergoing two common surgical procedures, who searched the internet for information about their operations and to assess the usefulness of the information they received.

PATIENTS AND METHODS

A total of 105 consecutive patients undergoing elective abdominal wall hernia repair (n = 54) or laparoscopic cholecystectomy (n = 51) in a single surgical firm were included in the study. Patients were counselled about their operation in pre-operative assessment clinics and standard trust information leaflets were provided without any mention of this study. Patients were then asked to complete a questionnaire on the morning of their operation.

RESULTS

All patients completed the questionnaire. Of the patients, 59% stated that they had access to the internet and 77% of these accessed the internet over 2 h a week. Of the patients with internet access, 31% used it to acquire additional information about their operations and 58% used internet search engines. Of the patients who searched the internet regarding their operations, 26% were confused and/or worried by the information they received.

CONCLUSIONS

A significant proportion of patients undergoing common surgical procedures used the internet and about one-third of them specifically sought information about their operation on the internet. Such information can cause worry and confusion in patients. Our study highlights the need for regulated, comprehensible, patient information on hospital websites to which patients should be directed.     

Parallel and interactive learning processes within the basal ganglia: relevance for the understanding of addiction

In this review we discuss the evidence that drug addiction, defined as a maladaptive compulsive habit, results from the progressive subversion by addictive drugs of striatum-dependent operant and Pavlovian learning mechanisms that are usually involved in the control over behaviour by stimuli associated with natural reinforcement. Although mainly organized through segregated parallel cortico-striato-pallido-thalamo-cortical loops involved in motor or emotional functions, the basal ganglia, and especially the striatum, are key mediators of the modulation of behavioural responses, under the control of both action-outcome and stimulus-response mechanisms, by incentive motivational processes and Pavlovian associations. Here we suggest that protracted exposure to addictive drugs recruits serial and dopamine-dependent, striato-nigro-striatal ascending spirals from the nucleus accumbens to more dorsal regions of the striatum that underlie a shift from action-outcome to stimulus-response mechanisms in the control over drug seeking. When this progressive ventral to dorsal striatum shift is combined with drug-associated Pavlovian influences from limbic structures such as the amygdala and the orbitofrontal cortex, drug seeking behaviour becomes established as an incentive habit. This instantiation of implicit sub-cortical processing of drug-associated stimuli and instrumental responding might be a key mechanism underlying the development of compulsive drug seeking and the high vulnerability to relapse which are hallmarks of drug addiction.     

Benefits of implementing a link nurse group across both an acute and a primary care trust

This paper describes how two tissue viability nurses, one from an acute trust and one from a primary care trust, joined forces to set up a link nurse group. This helped raise the profile of wound care and improve standards of care.