Reducing Psychological Distress in Patients with Inflammatory Bowel Disease by Cognitive-Behavioural Treatment: Exploratory Study of Effectiveness

Background: This prospective study aimed to determine whether cognitive-behavioural group treatment accompanying medical standard care is effective in reducing psychological distress in patients with inflammatory bowel disease. Methods: Twenty-eight outpatients with Crohn disease or ulcerative colitis completed the treatment programme. Psychological treatment consisting of 12 weekly sessions was conducted in a group setting. Medical and psychometric assessments were taken at the beginning of the 3-month pretreatment waiting period, at pretreatment, at post-treatment and at the 3, 6 and 9-month follow-ups. Results: During baseline, no change was observed in psychological distress. Disease-related worries and concerns decreased significantly from pretreatment to the follow-ups. The disease groups differed in the decline of concerns between pre- and post-treatment, with a significant reduction of concerns in patients with ulcerative colitis but not Crohn disease. This difference did not occur at the follow-ups, indicating long-term improvement for both disease groups. Depressive coping decreased significantly in women and remained stable at the follow-ups, whereas depressive coping did not change in men. The same gender difference was found for depressive symptoms. Conclusions: The exploratory findings suggest that psychological group treatment for outpatients is a feasible and effective approach for the short- and long-term reduction of psychological distress for patients with inflammatory bowel disease. However, the revealed gender differences on coping and depression might indicate the necessity to consider gender-specific aspects of inflammatory bowel disease when designing and evaluating psychological interventions.     

How a Child's Blood Pressure is Related to Psychological Influences Some Results with R. Zazzo's Bestiary Test

The purpose of the study was to investigate the relationships between some psychological characteristics and blood pressure. We used the Bestiary Test which gives an impression of the child's psychological characteristics and his way of coping with personal conflicts. The test was applied to 766 children between the ages of 4-10 years. By discriminant analysis we established relations between systolic blood pressure, and the responses to the test. By correspondence analysis we found that hypertensive children have a tendency to perceive human relationships, especially those between males and females, as aggressive.     

Psychological defence and nuclear war

Society is influenced by the unconcious aspects of the minds of the member individuals. This paper describes a psychoanalytic approach to some aspects of the social processes that give rise to the attitudes in Western society towards nuclear war and the nuclear threat. It is concluded that there are profound hidden factors that work against changing the current views on war and nuclear war, and that some peace groups are inadvertently recruited into maintaining the status quo.     

Compulsory mourning

The bold decision was taken in Afghanistan in 2002 to provide donor-funded public health services by means of contracting-out of predefined health care packages. This study seeks to identify the extent to which progress has been made in public health services provision in the context of broader state-building agendas. The article argues that the provision of public health services was also intended to generate a peace dividend and to legitimize the newly established government. The widely portrayed success of the contracting model is backed up by very high official figures for health service coverage. This contrasts with evidence at household level, which suggests limited utilization of public health services, and perceptions that these offer inferior quality, and a preference for private providers. The dissonance between these findings is striking and confirms that public health care cannot remain immune from powerful market forces, nor from contextual determinants outside the health field.     

The effects of physical exercise training and cardiac education on levels of anxiety and depression in the rehabilitation of coronary artery bypass graft patients

Objective: to evaluate whether an exercise and education-based rehabilitation programme is sufficient treatment for individuals with clinically significant levels of anxiety or depression following coronary artery bypass graft (CABG) surgery. Design: follow-up and repeated assessment after surgery. Setting: outpatient cardiac rehabilitation programme. Patients: all 88 attenders after CABG surgery. Assessments: structured interview and Hospital Anxiety and Depression (HAD) scale (using 8 as the cut-off) administered by rehabilitation nurses at start of course and HAD repeated at 12 weeks and 6 and 12 months (by post after discharge). Results: return rates of 76 and 80% at 6- and 12-month assessments, respectively; statistically significant reductions in levels of anxiety and depression found between first and all subsequent assessments; subdividing into groups revealed significant reduction in anxiety and depression in the anxious and depressed groups at 12 weeks and 6 months, respectively, but at 12 months there was no significant reduction. Conclusions: there is a need to address the problems of anxiety and depression directly by screening and treatment, and to provide more psychologically-orientated cardiac rehabilitation programmes.     

一种与N-Back诱发脑力疲劳相关的特异性脑电网络结构

探究脑力疲劳引起的静息态脑电网络结构的改变,以及体力疲劳的引入对脑力疲劳相关脑电网络的影响。分别以2-back实验和功率自行车诱发脑力、体力疲劳,采集10名被试脑力疲劳前后以及体脑疲劳前后4种状态下20个导联的静息脑电信号(EEG),进行偏定向相干因果性分析。对被试的脑电网络连接逐个进行威尔科克森符号秩检验,选择PDC值显著性大于阈值的连接赋为1,构建出二值化脑电网络。通过对疲劳前后脑电网络的比较与拆分计算,提取出一个N-back实验下与脑力疲劳相关的特异性脑电网络结构,该网络以额区的FP2导联为中枢节点,呈现出由全脑所有导联指向FP2的规律。在脑力疲劳和体脑疲劳两种疲劳状态下,该网络的连接形式基本保持一致,连接系数分别是4.060 3和4.142 1,没有发生显著改变,所以是一种相对独立、稳定并与脑力疲劳密切相关的功能网络。该方法和结果有望为研究脑力疲劳和探索体脑疲劳交互影响机制提供一个新的视角。     

造血干细胞移植病人的心理护理干预

目的：探讨造血干细胞移植病人的心理护理干预,为日后的临床护理提供参考。方法随机选择2013年1月-2014年12月收治的80例造血干细胞移植病人为研究对象,随机分为两组,即观察组与对照组,每组患者40例。观察组患者实施优质心理护理干预,对照组患者实施常规心理护理干预,对比两组患者的心理护理干预情况。结果经过临床心理护理,观察组患者的心理护理效果明显优于对照组。观察组患者的SAS评分为（32.7±4.7）分,SDS评分为（34.9±6.3）分;对照组患者的SAS评分为（56.8±7.8）分,SDS评分为（57.9±6.7）分,两组患者比较差异有统计学意义（P<0.05）。观察组患者心理状况明显优于对照组,证明优质心理护理干预比较有效。结论对造血干细胞移植病人实施优质心理护理干预,可减少患者的负面情绪,促进患者心理上的稳定,帮助患者理性的对待疾病,树立康复的信心。     

Free-breathing 3D steady-state free precession coronary magnetic resonance angiography: comparison of diaphragm and cardiac fat navigators

PURPOSE: To compare the performance of the conventional diaphragm navigator (DNAV) and the recently developed cardiac fat navigator (FatNAV) in suppressing respiration-induced cardiac motion in free-breathing 3D balanced steady-state free precession coronary MRA (SSFP CMRA). MATERIALS AND METHODS: In 16 healthy volunteers the right coronary artery (RCA) was imaged at 1.5T using a navigator-gated 3D SSFP CMRA sequence. DNAV and FatNAV gating were performed in random order. Image quality difference was scored by three experienced readers blinded to the gating technique. Blood signal-to-noise ratio (SNR), blood-to-myocardium contrast-to-noise ratio (CNR), and navigator efficiency were calculated. RESULTS: Diagnostically interpretable CMRA was obtained successfully in all 16 subjects with FatNAV gating (0% failure rate) and only 14 subjects with DNAV gating (12% failure rate). Compared to DNAV gating, FatNAV gating provided similar SNR and CNR, better image quality (P < 0.01), and 28% improvement in navigator efficiency (P = 0.002). CONCLUSION: FatNAV gating provides more effective motion suppression and better image quality than DNAV gating for free-breathing 3D SSFP CMRA of the RCA in healthy subjects.     

术中护理对髋关节置换手术患者下肢深静脉血栓形成的影响

目的：探讨术中护理对髋关节置换手术患者下肢深静脉血栓形成的影响。方法选择2013年6月~2014年12月湖北省鄂州市中心医院收治的157例髋关节置换手术患者,按住院号单双分为观察组83例,对照组74例。对照组采用常规术中护理,观察组采用改进术中护理。比较两组手术前后血液流变学和凝血功能变化及下肢深静脉血栓形成情况。结果观察组出血量、术中输血量明显少于对照组(P<0.05)。观察组术后1 d全血高切黏度、全血低切黏度、血浆黏度、红细胞聚集指数均明显低于术前1 d和对照组(P<0.05),凝血酶原时间、纤维蛋白原略低于术前1 d和对照组,但差异无统计学意义(P跃0.05);对照组术后1 d全血高切黏度、全血低切黏度、血浆黏度、红细胞聚集指数、凝血酶原时间、纤维蛋白原与术前1 d比较差异无统计学意义(P跃0.05)。观察组术后2例(2.41%)发生下肢深静血栓,对照组8例(10.81%)发生下肢静脉血栓,两组比较,差异有统计学意义(P<0.05)。结论改进术中护理提高手术室护理质量可有效改善髋关节置换患者血液高凝状态,降低术后下肢深静脉血栓形成发生率。