In the Context of Risk: Supportive Adults and the School Engagement of Middle School Students*

Abstract: Many students in the United States, particularly those from lower income or racially/ethnically diverse families, are exposed to clusters of risk factors that have a negative impact on school success. This study examined the association between the number of supportive and caring adults in the home, school, and neighborhood and the school engagement of students in early adolescence. Results revealed that students who reported such supportive adults in their lives also reported higher levels of psychological and behavioral engagement with their schooling. Additionally, including measures of environmental risk factors in analytical models of the school engagement of middle school students reduced otherwise statistically significant race/ethnicity differences to nonsignificance. Implications for practice and policy are discussed.     

Correction of webbed-neck deformity in Turner's syndrome

Summary A case of Turner's syndrome with the typical marked webbing of the neck is presented. A posterior approach is preferred for correction of this webbed neck deformity. A butterfly shaped portion of excess skin is excised and the margins of the defect mobilised as four flaps. The flaps are sutured with a very short midline vertical component, resulting in an almost X-shaped scar. The first procedure resulted in only a partial correction of the deformity and an excess of hypertrophic scar tissue. This was treated with a repeat of the procedure but the midline wounds was repaired with mulitple small Z-plasties. The final appearance of the neck was satisfactory in the lateral profile, but there was still some excess tissue posteriorly.     

“津血同源”“肾为唾”的研究

以23例肾功能不全与20例肾功正常患者的唾液尿素氮、钠、钾、舌面pH值和血液的相应生化检查作对照。结果唾液尿素氮、钾与血尿素氮、钾成正相关性。证实了中医“津血同源”“肾为唾”的理论。     

Health status,work limitations,and return-to-work trajectories in injured workers with musculoskeletal disorders

BACKGROUND: The purpose of this study was to describe the health status and work limitations in injured workers with musculoskeletal disorders at 1 month post-injury, stratified by return-to-work status, and to document their return-to-work trajectories 6 months post-injury. METHODS: A sample of 632 workers with a back or upper extremity musculoskeletal disorder, who filed a Workplace Safety and Insurance Board lost-time claim injury, participated in this prospective study. Participants were assessed at baseline (1 month post-injury) and at 6 months follow-up. RESULTS: One month post-injury, poor physical health, high levels of depressive symptoms and high work limitations are prevalent in workers, including in those with a sustained first return to work. Workers with a sustained first return to work report a better health status and fewer work limitations than those who experienced a recurrence of work absence or who never returned to work. Six months post-injury, the rate of recurrence of work absence in the trajectories of injured workers who have made at least one return to work attempt is high (38%), including the rate for workers with an initial sustained first return to work (27%). CONCLUSIONS: There are return-to-work status specific health outcomes in injured workers. A sustained first return to work is not equivalent to a complete recovery from musculoskeletal disorders.     

用自组织理论浅析医学诊疗思维的差异

自组织理论不仅证实了物质自我运动、自我发展的科学原理,而且为我们认识研究各种事物的演化、发展提供了具有普遍意义的新思路和新方法。熟谙生命系统的自组织性,恰当运用医学思维模式,对于开拓诊疗思维、提高诊疗效果会提供有益尝试和多元选择。     

健康教育与大众媒体互动合作机制的定性研究

目的了解大众媒体报道艾滋病的现状，探索大众媒体与健康教育机构之间的互动合作模式。方法以艾滋病的宣传报道为切入点，对15名从事艾滋病宣传报道的负责人或记者进行个人深入访谈。结果影响大众媒体与健康教育机构之间合作的因素主要是资金、观念与机制。大众媒体与健康教育机构之间合作的最佳方式是相互理解、优势互补，建立健全双方长期、定时的信息交流机制和良好的互动合作机制，前者提供宣传平台，后者提供健康信息。结论大众媒体与健康教育机构之阃的合作既有基础，又有必要。加强两者的合作，将是一项双赢的策略。     

中性粒细胞在高浓度氧诱发急性肺损伤中的作用

目的:测定鼠支气管肺泡清洗液中细胞成分,阐明高浓度氧诱发急性肺损伤的发生机制。方法:20只雄性6周龄[(226±53.6)g]Wistar鼠被分为3组:(1)对照组(空气中饲养,n=6)。(2)实验组1(暴露在90%～95%氧气中24～48h,n=7)。(3)实验组2(暴露在90%～95%氧气中72h,n=7)。实验中动物可自由进食和水。结果:与对照组相比,实验组2的支气管肺泡清洗液中总细胞数减少[(3.81±0.35)×105/ml,(2.53±0.77)×105/ml];巨噬细胞数减少[(3.80±0.36)×105/ml,(2.09±0.59)×105/ml];而中性粒细胞计数明显增多[0,(43.56±42.63)×103/ml]。实验组2的动物都出现双侧胸水。结论:中性粒细胞动员并进入肺组织是高浓度氧诱发急性肺损伤的明显特征,损伤的发生与暴露时间有关。提示早期抑制中性粒细胞进入肺组织是治疗高浓度氧诱发急性肺损伤的重要途径。     

Cerebrovascular deaths before and after the appearance of oral contraceptives

The mortality of cerebrovascular diseases in Denmark was analysed for men and women 15-44 years of age, in a 14-year period before and after the appearance of oral contraceptives (OC) in 1966. 1,670 deaths were registered over 28 years, during which the female incidence of cerebrovascular deaths increased by 19% (P less than 0.025), while the male mortality was unchanged. Women showed a percentage increase in deaths from cerebral thromboembolic attacks (CTA) of 33%, men a fall of 14%. The increase of female CTA deaths was most pronounced in the young fertile group, the age group with a high OC use. A relative risk of CTA of 3.3-4.5 for OC users compared with non-users could explain the CTA trend difference between women and men. No other single risk factor responsible for the observed trends could be identified. Both women and men had a significant increase in the mortality of subarachnoidal hemorrhages, and a significant fall in the mortality of intracerebral hemorrhages.