A questionnaire examining learning in general practice

Vocational training is a key element of professional development in general practice. Learner-centred approaches to teaching bring a need for greater understanding of the individual learning styles and preferences of trainees. This paper reports the findings of a pilot study undertaken to determine factors that may influence learning among general practice trainees. A questionnaire survey of 261 trainees in six regions in the UK was carried out to explore attitudes to a series of themes identified in semi-structured interviews with trainees at the end of their training. Six distinct subscales were identified using principal components analysis. These are named 'Learning from Patients', 'Openness to Criticism', 'Negative Attitudes', 'Desire for Clear Guidelines', 'Peer Support', and 'Academic Approach'. Males scored significantly higher on 'Academic Approach' (   P < 0.05  ). Each of the subscales reflects themes that permeate the atmosphere of general pratice training. Further work is required to establish relationships between the subscales and the outcomes of learning and to explore the implications for continuing professional development. The questionnaire is an instrument that may prove useful in the future investigation of learning in general practice.     

The Development and Teaching of the Ethical Principles and Guidelines for Family Scientists*

This article describes the development of the Ethical Principles and Guidelines for Family Scientists that the National Council on Family Relations Board of Directors unanimously approved. Furthermore, it discusses the importance of ethics education for family professionals and provides suggestions for educators. Finally, the ethical principles and guidelines are delineated. We argue that the development of a scholarship on ethics education is important for current and future family scientists.     

7个非综合征型耳聋家系患者的mtDNA A1555G突变分析

目的探讨非综合征型耳聋家系患者mtDNA A1555G突变及其临床特征。方法应用聚合酶链反应、限制性核酸内切酶酶切和DNA测序技术对7个非综合征型耳聋家系112个成员的mtDNA A1555G突变进行检测，并分析听力临床资料。结果7个家系中所有受检的母系成员mtDNA A1555G突变均为阳性，突变性质含同质性和异质性二种；非母系成员及配偶该突变为阴性。突变的性质与临床表型的有关。结论mtDNA A1555G突变可导致非综合征型耳聋和氨基糖苷类抗生素致聋，其突变性质含均质性和异质性两种，且与临床表型相关。     

低收入大学生一般自我效能感、主观幸福感研究

近年来 ,低收入大学生作为高校中的一个特殊群体逐渐受到研究者和教育者的关注。目前对低收入大学生的一般自我效能感 (generalself -efficacy)和主观幸福感的研究还不多见。一般自我效能感是指个体对各种挑战或新情境的应对能力的总体信心[1] 。一般自我效能感描述的是个体有效地应对各种紧张情境的广义而稳定的个人能力感 ,它与身心健康存在一定的关系[1- 2 ] 。主观幸福感 (subjectivewell-being)是指人们对于自己是否幸福的主观感受 ,是反应心理健康水平的重要指标之一。研究低收入大学生的一般自我效能感和幸福感的特点及其关系对于揭…     

精神分裂症恢复期患者及家属家庭干预的对照研究

目的：以康复期出院精神分裂症患者和家属为对象，定期复诊进行家庭干预并对照研究。方法：干预组68例，对照组52例，采用BPRS评定；干预组家属74人，对照组家属65人，采用SCL－90评定。结果：6个月后干预组患者BPRS和入组时对照比较均有显著性差异（P＜0．01），说明干预组患者的精神症状，不良情绪及社会功能明显好转，入组时两组家属SCL－90评定与常模对照比较，均有明显差异（P＜0．05或0．01），经干预后干预组与全国常规比较无显著性差异（P＞0．05），说明患者家属普遍存在心理障碍，经干预后家属心理状况明显改善。结论：对康复期病人及家属进行门诊家庭干预，是有效的康复方法，值得推广应用。     

The categorical and dimensional models of endogenous depression

We calculated a Research Diagnostic Criteria (RDC) endogenous score for 257 depressed inpatients based on the number of endogenous criteria present. The distribution of RDC endogenous scores was unimodal. There was no association between endogenous scores and results of the Dexamethasone Suppression Test, or morbid risk for depression in the patients' first-degree relatives. The morbid risk for a family history of alcoholism tended to decrease with increasing endogenous scores, although a consistent steady decline was not observed. The results suggest that the RDC criteria do not fit either the categorical or dimensional model of endogenous classification. Potential sources of difficulty with the RDC endogenous criteria are discussed.     

抑郁障碍患者与家属家庭亲密度适应性和情绪状况的研究

目的探讨抑郁障碍患者与家属的家庭亲密度适应性和情绪状况,为抑郁障碍患者的健康教育及家庭干预提供科学有效的理论依据。方法选择2006年6～9月在北京大学第六医院就诊的抑郁障碍患者95例及共同陪伴的直系家属95例为调查对象。采用家庭亲密度和适应性量表中文版(FACES-CV)、Zung氏焦虑自评量表和Zung氏抑郁自评量表。结果1患者的家庭亲密度得分与国内常模一致(P>0.05),但适应性得分低于国内常模(P<0.01);焦虑、抑郁得分高于国内常模(P<0.01)。家属的家庭亲密度得分高于国内常模(P<0.01),适应性得分低于国内常模(P<0.01)。家属的焦虑得分与国内常模一致(P>0.05),但抑郁得分高于国内常模(P<0.05)。2家庭模式分型构成比:中间型47.9%,平衡性26.3%,极端型25.8%。患者的家庭"拱极模式"以"僵硬—松散型"居多,家属则以"自由—缠结型"居多。3家庭亲密度与患者的家属的文程化度有关,相关系数范围(r=0.21～0.26,P<0.05)、与家庭人数呈负相关(r=-0.21,P<0.01);与患者及家属的焦虑、抑郁情绪呈显著负相关,相关系数范围(r=-0.30～0.37,P<0.01);家庭适应性与患者的年龄(r=0.28,P<0.01)、文化程度(r=0.34,P<0.01)有关。与家属的年龄(r=0.26,P<0.05)文化程度(r=0.22,P<0.05)有关。与患者和家属的焦虑、抑郁情绪呈显著负相关,相关系数范围(r=-0.30～-0.42,P<0.01)。结论家庭亲密度适应性与患者和家属的文化程度、焦虑、抑郁情绪有关,家庭亲密度与患者的家庭人数有关,家庭适应性与患者和家属的年龄有关。     

Family History of Hypertension and Cardiovascular Responses to Orthostatic Stress

Cardiovascular effects of orthostatic stress (sitting to standing) were assessed in 60 healthy young male subjects according lo family history of hypertension (half with a positive and half with a negative family history' of hypertension). Systolic (SBP) and diastolic blood pressure (DBF) were recorded on each successive heart heal using a non-invasive blood pressure tracking system. Heart rate (HR) and respiration rate (RR) were also recorded. During the postural change, characteristic phasic changes were shown with an initial fall and subsequent recover of SBP and DBF and a mirror image response in MR and RR. Phasic analysis of the pre-standing sit, peak/trough, and recovery stand values indicated group differences in the initial as well as the later phases of orthostatic response. In the initial phase, subjects with a positive family history of hypertension showed an earlier trough in systolic and pulse pressure and an earlier peak in heart rate response immediately on standing up. The level of the pulse pressure trough was also higher in these subjects. In the later standing phase, these subjects showed higher levels of pulse pressure. The results were interpreted in terms of increased sympathetic nervous system activity during the initial phase and structural and neurocirculatory abnormalities in the later phase of orthostatic regulation in individuals with a positive family history of hypertension.     

中学生对立违抗性障碍的父母养育方式和家庭环境特征的初步研究

目的：了解单纯对立违抗性障碍（ODD）儿童的父母养育方式及家庭功能。方法：应用向制儿童行为调查表、家庭环境量表中文版（FES～CV）、父母养育方式量表（EMBU），对115例单纯ODD儿童（研究组）和115名非ODD正常儿童（对照组）进行评定和病例对照分析，结果：ODD组儿童家庭矛盾性得分较对照组高（P〈0．01），ODD组父母双亲的“情感温暖．理解”得分均明显比对照组得分低（父亲P〈0．01，母亲P〈0.05）．而其“惩罚，严厉”和“拒绝，否认”二因子得分则明显比对照组高（P〈0．01）；ODD组母亲的“过分干涉，过度保护”，因子得分也明显高于对照组（P〈0．01）。结论：ODD中学生的家庭存在高度的矛盾性．他们的父母养育方式不良，应引起重视。     

SAGE遗传分析系统的功能及应用

SAGE是集多功能于一体的医学遗传学群体与家系资料计算机分析系统。本文概述SAGE系统的主要功能及应用环境。重点介绍了FCOR2和TDTEX两个功能模块的数学原理和使用方法。应用TDTEX模块 ,我们发现微卫星标记 85ca与小儿失神症存在连锁不平衡 ,提示在该位点附近存在小儿失神症的易感基因