家庭干预在精神分裂症患者社会功能障碍康复中的效果分析

目的分析精神分裂症患者社会功能障碍的现状并探讨家庭干预对其康复效果的影响。方法分析我院门诊收治的128例精神分裂症患者入院治疗前的社会功能状况;患者出院后,将患者随机分为家庭干预组和对照组各64例;对照组给予常规精神病药物维持治疗,干预组在此基础上给予家庭干预治疗1年,并采用社会功能缺陷量表（SDSS）及康复状态量表（MRSS）评估患者的治疗效果;并观察患者的服药依从性及病情复发情况。结果 120（93.7%）例的患者存在明显的社会功能障碍,集中表现在职业及工作、计划性及责任心、对外界的关心及兴趣方面;家庭干预前两组间SDSS、MRSS评分并无显著差异（P〉0.05）,干预后干预组此两项得分均低于对照组（P〈0.05）;同时干预组的服药依从性、复发率情况均优于对照组（P〈0.05）。结论精神分裂症患者大都存在较为严重的社会功能障碍,家庭干预可以显著提高患者生活质量,改善社会功能,降低复发率。     

Psychological Distress for African-American Adolescent Males: Exposure to Community Violence and Social Support as Factors

This study examined exposure to community violence and depressive and post-traumatic stress disorder (PTSD) symptoms within a non-random sample of low-income, African-American male adolescents. The moderating effect of social support on these relationships was also examined. Seventy-seven African-American adolescent males were recruited from an inner-city, Midwestern high school and surveyed on exposure to violence, depression, post-traumatic stress, and social support. Regression analyses revealed that exposure to violence was significantly associated with both depressive and PTSD symptoms. However, social support was not found to moderate the relationship between exposure to community violence and psychological distress. Implications for intervention are discussed.     

Reorganization of brain activity for multiple internal models after short but intensive training

Internal models are neural mechanisms that can mimic the input-output properties of controlled objects. Our studies have shown that: 1) an internal model for a novel tool is acquired in the cerebellum (Imamizu et al., 2000); 2) internal models are modularly organized in the cerebellum (Imamizu et al., 2003); 3) their outputs are sent to the premotor regions after learning (Tamada et al., 1999); and 4) the prefrontal and parietal regions contribute to the blending of the outputs (Imamizu et al., 2004). Here, we investigated changes in global neural networks resulting from the acquisition of a new internal model. Human subjects manipulated three types of rotating joystick whose cursor appeared at a position rotated 60 degrees, 110 degrees, or 160 degrees around the screen's center. In a pre-test after long-term training (5 days) for the 60 degrees and 160 degrees joysticks, brain activation was scanned during manipulation of the three joysticks. The subjects were then trained for the 110 degrees for only 25 min. In a post-test, activation was scanned using the same method as the pre-test. Comparisons of the post-test to the pre-test revealed that the volume of activation decreased in most of the regions where activation for the three rotations was observed. However, there was an increase in volume at a marginally significant level (p < .08) only in the inferior-lateral cerebellum and only for the 110 degrees joystick. In the cerebral cortex, activation related to 110 degrees decreased in the prefrontal and parietal regions but increased in the premotor and supplementary motor area (SMA) regions. These results can be explained by a model in which outputs of the 60 degrees and 160 degrees internal models are blended by prefrontal and parietal regions to cope with the novel 110 degrees joystick before the 25-minute training; after the acquisition within the cerebellum of an internal model for the 110 degrees, output is directly sent to the premotor and SMA regions, and activation in these regions increases.     

药物再开发社会影响债券模式及其启示

目的：介绍国外药物再开发社会影响债券为我国提供借鉴和启示。方法：分析国外药物再开发社会影响债券基本内涵和适用条件,并深入探究药物再开发社会影响债券项目运行机制和相关成功案例。结果与结论：药物再开发社会影响债券可以为患者加速获得新疗法,节约医疗卫生费用。结合我国医药产业实际情况,建议借鉴国外药物再开发社会影响债券成功经验,引入社会资本,注重社会效益评价,制定和完善我国药物再开发相关政策。     

A comparison of different severities of nausea and vomiting during pregnancy relative to stress, social support, and maternal adaptation

A cross-sectional and comparative research design with convenience sampling was used to recruit pregnant women from prenatal clinics in southern Taiwan between 2002 and 2003 to examine the differences in perceived stress, social support, and maternal psychosocial adaptation among women with different severities (mild or less than mild, moderate, and severe) of nausea and vomiting during pregnancy. A total of 150 pregnant women participated in this study. One-way analysis of variance indicated that perceived stress was significantly different among the 3 groups. The least significant difference post-hoc test revealed that pregnant women with mild nausea and vomiting had significantly lower stress than did pregnant women with severe nausea and vomiting. The severity of nausea and vomiting was significantly associated with the Prenatal Self Evaluation Questionnaire subscales for "acceptance of pregnancy" and "fear of helplessness and loss of control in labor." Social support and maternal psychosocial adaptation were not significantly different among these three groups. The degree of perceived stress and maternal psychosocial adaptation may be related to the severity of nausea and vomiting during pregnancy.     

A Nepalese bipolar case amidst risk and protective factors during COVID‐19 pandemic

Bipolar disorder is a chronic and recurring psychiatric illness. Emphasis on enhancing key protective factors like social support systems and promoting this to minimize risk factors like non‐compliance is one of the key strategies tied to enhance overall psychological, intellectual, and emotional health for symptoms remission and relapse prevention even during adverse situations like the COVID‐19 crisis. We intend here to point out implication of the dynamics of the protective and risk factors for bipolar mood through a 23‐year patient from eastern Nepal, which is largely harmonious in its multi‐ethnic, multilingual and multicultural social composition. This attribute of social cohesiveness and compassion is evident in this case report. When disturbed and ill, neighbors from native semi‐urban Nepalese society did support even in the times of crisis of COVID‐19 pandemic. The support of other people including neighbors is a key factor for the short‐term and long‐term management of bipolar mood.     

计算机模拟病例考试方法在全科医师培训中的研究与运用

全科医师计算机模拟病例考试系统 (考核系统 )采用多选题答题形式 ,病例题库设计围绕教学考核大纲基本要求 ,从临床和社区医疗的实际出发 ,选择各种常见健康问题作为考核病例。考核过程模拟实践工作场景 ,通过提示病情资料 ,围绕病例和测试目标逐步引申出一系列问题 ,提问由浅入深 ,层层紧扣 ,具有动态的、连贯性的特点 ,考核系统知识点涵盖面全、考试结果客观公正 ,可用于测试学员在全科医疗实践中综合运用所学知识的能力。我院已运用考核系统对浙江省 10 9名全科医学岗位培训学员 ,31名规范化培训学员进行了测试。考试结果显示 :规范化培训与岗位培训测试成绩有显著性差异 (t =5 816 ,P <0 0 1) ,各场岗位培训考试成绩无显著性差异 (p =0 35 8～ 0 911)。     

新型冠状病毒肺炎疫情期间一线护士心理健康状况调查

目的探讨突发新型冠状病毒肺炎疫情期间护士心理健康状况,为采取针对性措施促进护士心理健康提供参考。方法在突发新型冠状病毒肺炎疫情期间,采用心理健康状况量表、社会支持及应对方式量表对175名一线护士进行调查。结果护士躯体化、焦虑得分显著高于常模(均P0.01)。护士心理健康与社会支持、应对方式具有显著相关性(均P0.01)。结论突发新型冠状病毒肺炎疫情期间临床护士躯体化与焦虑评分较高,发挥社会支持、应对方式的正向作用有利于改善护士的心理健康状态。