车祸致颅脑损伤患者家属心理健康状况与社会支持相关性研究

目的 了解车祸致颅脑损伤患者家属的心理健康状况和社会支持状况,探讨其相关性。方法 采用自编一般资料调查表、症状自评量表（SCL - 90）和社会支持量表（SSRS）,对225名到精神专科医院就诊的车祸致颅脑损伤患者家属进行问卷调查。结果 车祸致颅脑损伤患家属的SCL - 90总分为（178.45±82.56）分, SCL - 90总分、阳性项目数和9个因子分均显著高于肿瘤患者家属和全国常模(P＜0.05)。社会支持总分为（38.52±8.23）分,社会支持水平与家属的心理健康状况呈显著的负相关（r = - 0.416, P＜0.05）。多元线性回归分析显示,社会支持总分可以负向预测家属的心理健康状况（β = - 0.399,P＜0.05）。结论 车祸致颅脑损伤患者家属的心理问题发生率较高,应从个人、家庭和社会层面为家属提供社会支持资源。     

注意缺陷多动障碍伴孤独症特征患儿行为和家庭环境研究

目的 探讨注意缺陷多动障碍（ADHD）伴孤独症特征（ATs）患儿社交行为和家庭环境特点。方法 收集2019年3月至2021年12月安徽省儿童医院儿童保健科就诊的106例ADHD患儿临床资料,根据社交反应量表（SRS）评分分为ADHD-ATs组（SRS评分≥60分）和对照组（SRS评分<60分）,各53例。比较两组SRS、中文版ADHD评定量表-父母版（SNAP-IV）、家庭环境量表中文版（FES-CV）评估结果。结果 ADHD-ATs组SRS总分、社交知觉、认知、沟通、动机和孤独症行为方式评分高于对照组（P<0.05）。ADHD-ATs组SNAP-IV总分、注意缺陷、对立违抗评分高于对照组（P<0.05）。ADHD-ATs组FES-CV亲密度和独立性评分低于对照组（P<0.05）。结论 ADHD-ATs患儿较一般ADHD患儿存在显著的社交困难,并且注意缺陷和对立违抗症状更突出,家庭环境中的亲密度和独立性较低。     

影响精神分裂症患者阴、阳性症状疗效的因素分析

目的 :探讨抗精神病药物及临床常见因素对精神分裂症患者阴、阳性症状疗效的影响。方法 :采用前瞻性设计的方法 ,对连续入院的 12 9例精神分裂症病人 ,分别在 6周的单一抗精神病药物治疗前后使用BPRS ,SANS ,SAPS及自编问卷进行调查和评估。并应用t检验和多逐步回归进行统计学分析。结果 :各量表总分治疗前后差异有显著意义 (P <0 .0 0 1) ,但SANS与SAPS各自治疗前后差值之间无显著差异 (P >0 .0 5 )。阴、阳性症状的疗效与性别和家族史的关系特别密切 (P <0 .0 5 )。结论 :性别和家族史对于精神分裂症阴、阳性症状的疗效有显著影响而抗精神病药物似乎不存在明显的优劣之分。有关发现值得进一步探讨研究。     

家庭心理教育在精神分裂症患者康复中的作用

探讨家庭心理教育对精神分裂症康复的影响,方法采用对照研究的方法,对病人家属进行家庭心理教育,应用ＢＲＰＳ和Ｍ－ＳＤＳＳ量表对病人进行评定。结果在两年间的历次评定中,研究组病人ＢＰＲＳ和Ｍ－ＳＤＳＳ量表评分明显低于对照组。结论家庭心理教育对促进精神分裂症病人康复具有积极意义。     

发展家庭医学之必然趋势

发展全科医学的必要性已逐渐为社会所共识,从家庭的特性和时代的要求两个方面阐述了发展家庭医学的必然趋势。     

COVID-19 vaccine and pregnancy: A safety weapon against pandemic

The ongoing COVID-19 pandemic is raising great concern all over the world. The recent introduction of vaccines has offered reason for optimism, however, new issues have arisen, such as vaccine reluctance. The safety of vaccines for pregnant women is one of the most serious of these concerns. The purpose of this review article is to provide updated international vaccine recommendations, results of ongoing studies and clinical trials, and the role of gynecologists in counseling the women to understand the risks versus benefits as well as form an informed decision towards vaccine acceptance for COVID-19.Although COVID-19 infection increases the risk of severe morbidity and mortality in pregnant women, pregnant women were not included in the initial vaccine trials. As a result, safety information is scarce. Nations have differing recommendations, though many have recently approved the COVID-19 immunization in pregnancy following a risk-benefit analysis. The Joint Committee on Vaccination and Immunization (JCVI) of the United Kingdom recently approved an mRNA vaccination for pregnant women. Vaccination is recommended by the CDC, ACOG, ARFM, and WHO. India recently took a stand, with the ICMR and the Ministry of Health and Family Welfare recommending vaccination during pregnancy and lactation.     

Single-handed practices – their contribution to an undergraduate teaching network in the first year of the new curriculum

OBJECTIVES: The new curriculum at King's College School of Medicine and Dentistry, which commenced in September 1996, requires all medical undergraduates to have a general practice placement throughout the 5 years of their medical education. DESIGN: This paper discusses recruitment, training and support of teaching practices for the new curriculum, reviews the distribution of single-handed general practices in the network and, via a selection of monitoring and evaluation procedures, discusses the implications of a policy which is inclusive of single-handed practices. The findings relate to the experience of the first semester of the first year of the new curriculum. It also examines the contributions that single-handed practices have made to the teaching network and the kind of support needed, if single-handed practices are to continue to contribute to the King's teaching network. SETTING: King's College School of Medicine and Dentistry. SUBJECTS: Medical undergraduates. RESULTS: The findings of this paper revealed that over a third of general practice provision is via single-handed practices in South-east London. Within the undergraduate teaching network, 10% of practices are single-handed. Students are welcomed and receive a learning experience comparable to those students in larger practices. Attendance at training events has proved difficult for some of these tutors, but the extra input from the department, in order to address this deficit, has not been onerous. Indeed, single-handed practices have not been unique with regard to difficulties in attendance at training events. CONCLUSIONS: The study concludes that single-handed practices can make satisfactory provision for undergraduates in the new curriculum and there is no evidence from this study to suggest otherwise.     

Family history as an independent risk factor for ischaemic heart disease in a low incidence area (Galicia, Spain)

It has been suggested that a family history positive for coronaryheart disease (CHD) increases the risk of CHD. We studied thisassociation to determine the degree of risk, the independenceof this association and the presence of interaction of a familyhistory of CHD with the major known risk factors in a law incidencearea. One hundred and six hospital cases (85 males and 21 females)of CHD and 106 hospital controls individually matched with eachcase for sex, age and place of residence (rural–urban)were studied. From every participant, information was collectedon their personal and family history of cardiovascular diseaseand risk factors; height, weight, lipid profile and blood pressurewere measured, and an electrocardiogram was recorded. Conditionallogistic regression was used in the analysis. The observed odds ratio of patients suffering from CHD amongthose with, compared to those without, a positive family historyof CHD was 4.95 (95. confidence interval = 1.27–19.28)after adjusting for the major known risk factors in each individualand their families (no interaction term remained in the model). The results support the hypothesis that a family history ofCHD, acting through mechanisms other than known risk factorsor their familial aggregation, is an independent risk factorfor CHD even in a low incidence area. No interaction effectwas observed between family history and the presence of thethree major risk factors of CHD. This should help to identifyindividuals at greater risk of CHD.     

Headache and family history

In two headache questionnaire surveys we inquired about the occurrence of headache in the mothers, fathers, siblings and children of the respondents. In total, 633 people completed valid questionnaires, 260 in the first survey and 373 in the second. The hypothesis was that familial headache occurrence would be positively associated with headache frequency. In each survey, the regression of headache frequency on the number of parents having headache was highly significant. Neither sex nor the sibling and children variables were significant predictors. In the cross-tabulations of the parental occurrence of headache with headache frequency we saw a clear "break-point" between the "no headache" and the headache frequency categories studied. For the final analyses the dichotomy "headache/no headache" was related in fourfold tables to headache occurrence in the father and the mother separately, and to the number of headache parents. The positive associations were not simply due to the large number of migraine cases since they remained after removing the migraineurs.     

A factor analytic study of teaching in off-campus general practice clerkships

The Preceptor-evaluation questionnaire (PEQ) was developed at the University of Mississippi Medical Center to evaluate the clinical teaching behaviour of general practice doctors in private practice who have one or more third-year medical students per year in their offices for a required general practice clerkship. The PEQ was designed to provide feedback to these doctors and the sponsoring department in an effort to improve teaching in this setting. Developed from the input of family practice doctors who have supervised students in their offices and from a review of related literature, the instrument was given to students to determine the level of importance they attributed to each teaching characteristic. A principle components factor analysis and subsequent varimax rotation produced six significant teaching factors in this setting. These six factors were:

• 1 demonstrates a humanistic orientation toward patients and staff;
• 2 demonstrates a humanistic orientation toward student;
• 3 provides opportunity for practice;
• 4 motivates and stimulates student's thinking;
• 5 communicates effectively with student; and
• 6 demonstrates comfort and confidence in the roles of doctor and teacher.

The factor relating to the humanistic orientation toward student has not appeared as a separate factor in other studies of clinical teaching. This may be due to the unique aspects of the relationship between student and doctor in this setting which may not occur in other settings. The PEQ and similar reliable and valid instruments can provide valuable information for the doctors in these off-campus teaching situations as well as provide useful programme planning information for the sponsoring academic departments. This information may also be valuable for off-campus residency training.