The volatility of the amygdala response to masked fearful eyes

Recently, it has been suggested that backwardly masked, and thus subliminally presented, fearful eyes are processed by the amygdala. Here, we investigated in four functional magnetic resonance imaging experiments whether the amygdala responds to subliminally presented fearful eyes per se or whether an interaction of masked eyes with the masks or with parts of the masks used for backward masking might be responsible for the amygdala activation. In these experiments, we varied the mask as well as the position of the target eyes. The results show that the amygdala does not respond to masked fearful eyes per se but to an interaction between masked fearful eyes and the eyes of neutral faces used for masking. This finding questions the hypothesis that the amygdala processes context‐free parts of the human face without awareness. Hum Brain Mapp, 2010. © 2010 Wiley‐Liss, Inc.     

A public health approach to fall prevention among older persons in Canada

In 2008 to 2009, there were 53,545 fall-related hospitalizations among Canadian seniors, accounting for 85% of all injury-related hospitalizations and 7% of all hospitalizations for those aged 65 years and older. The estimated cost of fall-related injuries to the Canadian health care system in 2004 was more than $2 billion among a population of 4.1 million seniors. This article describes highlights of how policy makers, researchers, and practitioners are applying a public health approach to the issue of seniors' falls in Canada, including the successes, challenges, and recommendations for the future.     

Comprehensive approach to fall prevention on a national level: New Zealand

Individual assessment and treatment are important for older people at high risk of falls and injury. But falls are common. The problem cannot be addressed solely on an individual patient, individual clinician basis. Fall prevention programs that have broad coverage, good uptake and adherence, and can be seen to maintain independent living benefit individuals and help control health service costs. Two such programs have been successfully introduced in New Zealand: the home-based Otago Exercise Programme and tai chi classes. The difficulty now is in maintaining the nationwide commitment to these preventive measures.     

住院患者跌倒事件影响因素的回顾性分析

目的 对21例跌倒事件进行回顾性分析,探讨影响跌倒的相关因素.方法 采用自行设计的调查表,调查发生跌倒的相关因素,并对调查的结果进行分析.结果 ①年龄、科室跌倒事件的发生率差异无统计学意义（P＞0.05）,性别、教育程度差异有统计学意义（P＜0.05）;③跌倒前活动能力以完全独立（占52.4%）和部分依赖（占42.9%）为主,跌倒多发生在室内（占73%）,跌倒状态以正在走路（占33.3%）和上厕所（占33.3%）多见,跌倒的损伤以骨折（38%）和软组织损伤（占56%）为主.④跌倒多发生在午晚餐（以晚餐时间段17～19pm为甚）和凌晨3～5时;⑤在跌倒原因中排前五位是健康教育不到位（85.7%）、培训不到位（57.1%）、腿脚无力（54.7%）、头晕（47.6%）、环境设施（占47.6%）.结论 性别、教育程度与跌倒事件发生有关,护理健康教育及培训的缺乏、患者躯体症状、环境设施不良是影响跌倒事件发生的主要原因.     

跌倒/坠床风险评估对感染科患者安全的干预效果评价

目的:探讨在感染科应用跌倒/坠床风险评估对患者进行安全管理的效果。方法:选择2009～2011年感染科收治的3000例住院患者,采用前后对照的方法,2009年1月～2010年5月未实施跌倒/坠床风险评估的患者1460例为对照组,2010年6月～2011年12月实施跌倒/坠床风险评估的患者1540例为干预组。对照组采取常规防跌倒/坠床护理,干预组应用Morse跌倒评估量表进行风险评估,落实干预措施,对患者实施防跌倒/坠床护理安全管理,观察两组患者跌倒的发生率并进行比较。结果:干预组患者跌倒发生率低于对照组,差异具有统计学意义(P<0.01)。结论:跌倒/坠床风险评估有效减少住院患者跌倒发生率,在感染科护理安全管理中具有良好的应用效果。     

A comparison of two mechanisms of severe paediatric injury in Northern Israel

Background

An increased incidence of severe injury due to falls from buildings (FFB) is reported in the rural area of northern Israel. This makes FFB, and motor vehicle collision (MVC) the two leading causes of severe paediatric trauma.

Methods

A single-centre, age-sex matched comparison analysis of the two mechanisms of injury was conducted. Children involved in MVC (study subjects) or FFB (controls), who were brought by the Emergency Medical System Mobile-Intensive-Care-Unit from the field to the trauma bay of the Emergency Department (ED) were enrolled on the basis of a convenience sample. Immediately following ED admission, heart rate (HR), systolic blood pressure (SBP), and base deficit (BD) were recorded. Types of injuries, Glasgow Coma Score (GCS) on scene, and Injury Severity Score (ISS) were also obtained.

Results

Eleven study subjects and 22 controls were enrolled during a 1-year period. The mean ISS for the study subjects group and for the controls was 23.4 and 19.5, respectively. No difference was found in comparing the ISS, BD, SBP and HR of the two groups (p = 0.261, p = 0.421, p = 0.314, and p = 0.824, respectively). Controls had a lower GCS (p < 0.031) and were more likely to have a skull fracture (p < 0.0082). Study subjects were more likely to have limb injuries (p < 0.0001) and thoracoabdominal injuries (p < 0.0059).

Conclusions

This study suggests that the Injury Severity Score of the two mechanisms of paediatric injury is high. The haemodynamic characteristics on ED admission were comparable between the two groups of patients but the likelihood of specific type of injury was different.     

Neurocognitive functioning in the early stages of bipolar disorder: visual backward masking performance in high risk subjects

Introduction  Cognitive deficits, including deficits in early information processing, are associated with remitted bipolar disorder. The temporal relationship between these deficits and the clinical course is not known. The current study investigated whether or not deficits in early information processing were present before the onset and/or during the early stages of bipolar disorder. Methods  Unaffected and remitted high risk offspring of well-characterized bipolar parents completed a visual backward masking task. For comparison we included a cohort of unaffected offspring of well parents and a clinically referred group of remitted bipolar patients. Results  There was no evidence of a deficit in early information processing in well high risk subjects. As expected, the referred patient group had the highest error rates. After excluding the patients, interaction effect showed that the affected remitted high risk subjects performed differently in terms of error rates than unaffected high risk and control subjects. There were no significant differences in response times across study groups. Exploratory analyses revealed an association between a lifetime history of psychosis and increased errors on the task. Conclusions  There was no evidence of a vulnerability in early information processing in offspring at risk for bipolar disorder. However, there were emergent changes in performance in the affected remitted high risk group. Psychosis appears to be an important clinical correlate associated with cognitive deficits. Mapping of the early course of bipolar disorder and associated changes in cognition has important implications for establishing critical periods for intervention.     

2007年青岛市黄岛区农村老年人跌落伤害情况调查

[目的]了解青岛市黄岛区农村60岁以上老年人跌落伤害发生情况及相应影响因素,为制定干预策略和政策奠定基础。[方法]2007年9月,在黄岛区农村抽取2 052名60岁以上老年人进行入户调查。[结果]调查2 052人,过去1年发生过跌落的185人,跌落发生率为9.02%。跌落发生率,男性为8.34%,女性为9.64%（P〉0.05）;60-69岁为5.65%,70-79岁为8.38%,80岁以上为14.67%（P〈0.01）。跌落的185人合计跌落201人次（例）,引起皮肤擦伤的占30.35%,软组织挫伤的占16.42%,骨折占12.44%,脱臼占8.46%,脑震荡占5.97%,昏迷占4.48%。[结论]黄岛区农村老年人跌落发生率较低,但由此引起的伤害较严重。