Constructing robust selves after brain injury: positive identity work among members of a female self-help group

Despite common experiences of identity damage, decline, and deterioration, many brain injury survivors succeed in reconstructing robust identities in the wake of injury. Yet, while this accomplishment greatly benefits survivors’ quality of life, little is known about how positive identity work might be facilitated or enhanced in therapeutic institutions. Drawing on data from a women’s self-help group, we argue that an egalitarian, reflective, strength-focused, and gender-segregated environment can provide female ABI (acquired brain injury) survivors with a fertile scene for identity enhancement and offer unique opportunities for collective identity development. Sociolinguistic interactional analysis revealed four types of positive identity work undertaken within the group: constructing competent selves; tempering the threat of loss and impairment; resisting infantilisation and delegitimisation; and asserting a collective gender identity. This identity work was facilitated by specific programme attributes and activities and contributed to the global project of decentring disability and destigmatising impairments and losses. We call for increased attention to identity issues in brain injury rehabilitation and argue that gender-segregated programming can provide a unique space for female survivors to construct empowering individual and collective identities after injury.     

Self-reported outcomes of a randomized trial comparing three community health worker interventions for diabetes prevention among Cambodian Americans with depression

ObjectiveCambodian Americans have complex, interrelated and persistent medical and mental health problems stemming from genocide and the social determinants of health. We examined changes in multiple domains of self-reported health outcomes from a diabetes prevention trial. Methods: Cambodian Americans with depression and high risk for diabetes (n = 188) were randomized to one of three community health worker interventions: lifestyle vs lifestyle plus medication therapy management vs social services. Assessments were at baseline, 12- and 15-months. Results: The typical participant was 55 years old, female, earned below $20,000 annually, and had 7 years of education. About one-third were taking antidepressant medication and over half had elevated depressive symptoms. Relative to social services, lifestyle and lifestyle plus medication therapy management were both similarly effective at increasing diabetes knowledge, nutrition habits, sleep quality and decreasing pain; 2) lifestyle alone was superior to social services for self-reported health; and, 3) all three groups showed improved anxiety and insomnia. There were no effects on physical activity or physical functioning. Conclusion: Community health worker interventions have multiple benefits beyond delaying diabetes. Practice Implications: Health promotion programs that are designed and delivered appropriately can impact even hard to reach and hard to treat groups.     

自律:在医患关系中的定位

医疗行为的特殊性，决定了医患双方在医学信息方面的不对称性和医者拥有一定的自由裁量权，因此，医者作为医疗服务的主体，如何增强自律意识，直接关系到诚信的树立及和谐的互动式医患关系的建立和发展。     

高中生自我和谐与应对方式及其相互关系

目的了解高中生自我和谐、应对方式的特征及其相互关系,为开展心理健康教育提供依据。方法采用自我和谐量表及简易应对方式问卷,对755名高中生进行问卷调查。结果高中生总分和各因子分在性别、是否独生子女、城乡、文理科等方面差异均无统计学意义,自我和谐总分存在年级差异;积极应对和消极应对维度在性别、是否独生子女、城乡、文理科等方面差异均无统计学意义,消极应对维度存在年级差异。应对方式与自我和谐总分及分量表得分存在不同程度的相关。结论采用积极应对方式有助于促进高中生的自我和谐,而消极应对方式对自我和谐存在不利影响。     

大学生自我和谐与社交焦虑的相关研究

目的探讨大学生的自我和谐与交往焦虑的特点和关系。方法采用自我和谐量表和交往焦虑量表对310名大学生进行调查。结果男生在自我灵活性和自我和谐上得分低于女生（P〈0．01），研究生在自我灵活性上得分低于本科生（P〈0．01），理科生在社交焦虑上得分低于文科生（P〈0．05）；高自我和谐组在社交焦虑上得分低于低自我和谐组（P〈0．05）；从总体上看，社交焦虑与自我与经验的不和谐、自我刻板性、总体的自我和谐均呈正相关（P〈0．01）。结论大学生的自我和谐和社交焦虑之间均存在相关，自我和谐对社交焦虑具有良好的预测作用。     

医院消毒灭菌效果自我监测的情况及分析

目的 :探讨医院消毒灭菌效果自我监测能力的可靠性。方法 :回顾性总结了对医院消毒灭菌效果定期及不定期进行监测的情况 ,及上级防疫部门对医院消毒灭菌效果抽查的情况。结果 :医院自查物品合格率略高于防疫站抽查物品合格率。但两组资料比较P >0 0 5 ,差异不显著。结论 :医院自我监测能力是可靠的 ,必须在加强医院自我监测能力的基础上 ,被动监测变为主动监测 ,回顾性调查变为前瞻性监控 ,才能保证消毒灭菌质量 ,才能提高医疗质量 ,提高社会效益和经济效益。     

Localization of self antigen: implications for antigen presentation and induction of tolerance

The fifth component of complement (C5) is a self antigen expressed in serum of normal mice at a concentration of about 50 μg/ml. We have previously shown that C5 is constitutively processed and presented by antigen-presenting cells (APC) in normal mice to induce and maintain complete tolerance in major histocompatibility complex (MHC) class II-restricted T cells. This report addresses the question of whether C5 presentation involves exogenous antigen which has been internalized for processing or whether intracellular, biosynthesized C5 is being presented with MHC class II. Macrophages were found to synthesize, but not secrete C5 in bone marrow chimeras made from irradiated C5-deficient [C5(?)] hosts reconstituted with C5-sufficient [C5(+)] bone marrow [C5(+) ← C5(?)]. In these mice, macrophages are the only source of C5. [C5(+) ← C5(?)] chimeras are not tolerant of C5 and generate C5-specific T and B cell responses upon immunization indistinguishable from those of C5(-) mice. Macrophages from [C5(+) ← C5(-)] chimeras are unable to activate C5-specific T cell hybrids in vitro unlike macrophages from a C5(?) strain that has matured in a C5-expressing environment [C5(?) ← C5(+) chimeras]. This shows that under physiological conditions in vivo intracellular C5 does not get access to the class II presentation pathway and thus, does not induce tolerance in class II-restricted T cells.     

Lateralized rewarding brain stimulation affects forepaw preference in rats

Rats trained to reach for food pellets into a narrow tubular feeder consistently prefer to perform this stereotype instrumental movement with either the left or right forepaw. In 16 rats with established handedness electrodes were implanted into both lateral hypothalami. The animals were rewarded by intracranial self stimulation (ICSS, 300 msec, 50 Hz, 20-60 microA) for reaching into a modified feeder for a plastic ball operandum, the movement of which between the bottom and entrance of the feeder was monitored by mechanical contacts. The rats readily continued to reach when ICSS was delivered immediately after the photoelectrically detected reach or after the displacement of the operandum. Most rats learned in a single session to modify the movement when ICSS delivery was made contingent upon holding the operandum between the bottom and entrance of the feeder for 256 or 512 msec. The efficiency of reaching (ratio of successful reaches to all reaches) decreased with increasing holding time; only a few animals were able to master a 1024 msec delay. Reaching was supported by ICSS of either lateral hypothalamus. Whereas in 8 rats the strongly expressed forepaw preference was not changed by lateralized ICSS, in 8 latently ambidextrous animals stimulation of the lateral hypothalamus ipsilateral to the preferred forepaw increased reaching with the normally non-preferred forepaw from 15% to 60%. Stimulation of the lateral hypothalamus contralateral to the preferred forepaw did not change the preference. The preference shift was equally well expressed in simple and difficult versions of the task. It is concluded that lateralization of motivational influences can be reflected in the asymmetry of the neural mechanisms processing the lateralized sensory signals and/or elaborating the lateralized motor output.     

Factors related to postmenopausal muscle performance: a cross-sectional population-based study

The aim of the present study was to investigate cross-sectionally the association of postmenopausal muscle strength with simple performance tests. A random sample of 1,166 naturally postmenopausal women (born 1932–1941) was selected from the Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) study cohort. Grip and quadriceps strength were measured with strain gauge dynamometers and reported in both absolute values (KPa and kg) and per kilogram of body mass (N cm^–2 kg^–1 and N kg^–1). In addition, two performance tests, ability to stand on one foot and ability to squat down to touch the floor were carried out. A five-category self-assessment of overall health (very good, good, moderate, bad, and very bad) was obtained by postal questionnaire. The women that were able to stand on one foot and able to squat down to touch the floor had greater grip and quadriceps strength than their counterparts (P<0.001 and P<0.03 in ANOVA, respectively). In addition, self-assessed health had a strong positive association with muscle strength in the grip and leg extensor muscles in ANOVA (P<0.001 between very good and moderate or poorer state of health) and regression model (P<0.001). Adjustment for age, duration of menopause, body mass, height, physical activity level, use of HRT, and number of diseases and medications did not change any of the main effects. Also, there were no differences in results between absolute measurement values and values reported per kilogram of body mass. According to the present study, a simple performance test may be useful in the prediction of postmenopausal muscle strength. Furthermore, self-assessed state of health is strongly associated with muscle strength in postmenopausal women.     

初三学生成就动机与学业成绩的关系研究

编制中学生成就动机量表 ,考察 2 86名初三学生的成就动机状况。运用逐步回归分析探讨成就目标、归因方式、自我效能与学业成绩的关系 ,并对成就目标进行自我效能和归因方式的回归分析。结果表明 :影响初三学生学业成绩的主要成就动机因素是自我效能、表现目标、能力归因和掌握目标 ,努力归因、运气归因和自我效能是影响初三学生成就目标的主要因素 ,客观因素归因也会影响表现目标。对研究结果进行本土化思考 ,建构中学生成就动机的理想模型