Alcohol Use among Subcritically Injured Emergency Department Patients

Objectives: To determine the incidence of alcohol use in subcritically injured patients presenting to the ED, by using a saliva alcohol test (SAT) at ED triage during the ED initial assessment; to compare the incidence of alcohol use revealed by the SAT with documentation of alcohol use by ED nurses and emergency physicians (EPs) blinded to the SAT results; and to describe the demographics of the SAT-positive, subcritically injured population.
Methods: A blinded, prospective, observational evaluation of ED patients presenting with subcritical injuries was performed. The patients were tested for alcohol use with an SAT, and a subsequent record review was conducted for extraction of demographic data and evidence of documentation of alcohol use by ED nurses and EPs blinded to the SAT results.
Results: During the study. 791 subcritically injured patients had SATs performed. Twenty-one percent of these patients were found to be alcohol-positive by SAT. Either the ED nurse or the EP documented a clinical impression of alcohol use for 52% of the SAT-positive patients. There were higher SAT-positive rates among men (24%), victims of assault (47%), and patients arriving at night (41%).
Conclusions: While the SAT identified 21% of the subcritically injured patient population as alcohol-positive, ED nurse and EP documentation did not identify half of these alcohol-positive patients. Many of these patients may be at risk for additional injuries related to their drinking behavior.     

Titration of duration discrimination in behavioral pharmacology and toxicology

This study investigated a discrete-trial, titration duration discrimination procedure in behavioral pharmacology. Pentobarbital and d-amphetamine, measured with this procedure, selectively affected discrimination more than response tendencies. Pentobarbital also tended to affect selectively discrimination of longer durations, whereas d-amphetamine did not. Further experiments showed that (1) other algorithms for modulating stimulus duration are useful in behavioral pharmacology and toxicology, (2) threshold estimates are similar with the method of constant stimuli and the method of titration, and (3) this titration procedure permits the separate examination of drug effects upon discrimination and upon response tendencies; the fixed-interval procedure does not. Baseline variability was an important correlate of drug effects in that the endpoints with more variable baselines were also more sensitive to drugs.     

Social-Emotional Predictors of Preschoolers'' Responses to Adult Negative Emotion

The study examined predictors of children's prosocial responses to adult negative emotions. An adult displayed anger, sadness and pain during play sessions with 39 preschoolers (mean age = 43 months). Older children responded more prosocially to all three emotions, whereas children with greater emotion knowledge responded more prosocially to the adult's sadness. Children who behaved prosocially in response to peers' negative emotions also were prosocial after the adult's negative emotions, even with effects of age and emotion knowledge held constant. Assertive children responded more prosocially to the adult's anger, even with effects of other variables held constant. Both theoretical and practical implications are discussed.     

Antisocial personality disorder, HIV risk behavior and retention in methadone maintenance therapy

In a sample of 55 consecutive methadone maintenance admissions to our clinic, 42% were diagnosed with antisocial personality disorder (ASPD) using the National Institute of Mental Health Diagnostic Interview Schedule NIMH DIS. Individuals with ASPD exhibited greater risk for HIV infection as defined by more sexual contacts, needle use and equipment sharing. Data at 1 year follow-up were obtained on this group of patients. The objective was to compare the ASPD and non-ASPD groups with regards to demographics, drug abuse history, outcome and retention in treatment. There were no significant differences between the groups on any demographic or treatment outcome variables. Survival analysis indicated that there were no group differences in treatment retention. In conclusion, although there were no differences in treatment outcome between ASPD and non-ASPD groups it is possible that ASPD patients who drop out of treatment will be at higher risk for contracting and spreading HIV within the IV drug using population. These data also suggest that in this population the diagnosis of ASPD using primarily behavioral traits as measured in the NIMH-DIS-III, has little utility in predicting treatment outcome.     

Pathological laughter and crying in patients with multiple system atrophy-cerebellar type.

In the cerebellar type of multiple system atrophy (MSA-C), the burden of pathological changes involves the cerebellum and its associated brainstem structures in the basis pontis and the inferior olivary nucleus, and as a result, the clinical phenotype is dominated early on by the cerebellar dysfunction. We report our clinical and post mortem findings in a patient with MSA-C who exhibited pathological laughter in the absence of any congruent changes of mood. A review of the clinical notes of 27 other patients with MSA-C revealed a problem with pathological laughter, or crying, or both in 9 more patients. Our finding of about 36% occurrence suggests that the problem of dysregulation of emotional expression is more prevalent in MSA-C than the paucity of reports in the literature suggests. Our findings are consistent with the view that the cerebellum and its interconnected structures may be involved in the regulation of emotional expression.     

256例性病门诊患者安全性行为调查分析

目的:了解性病患者对安全性行为知识的知晓情况。方法:采用问卷方式对256例性病门诊患者进行安全套问题调查,并对所得数据进行统计分析。结果:从不使用安全套患者由初诊117例(45.7%)降到复诊时86例(33.6%);得知自己患性病后不用安全套与他人性交初诊118例(46.1%)下降到复诊时97例(37%);不用安全套与无性病症状的人性交会否感染性病回答不知道的由初诊58例(22.7%)下降到复诊时14例(5.5%)。结论:加大提倡使用安全套的宣传力度,提高人们对安全性行为的认识水平,提高安全套的使用率,是控制和预防性病及爱滋病经性接触传播流行的关键。     

行为干预对慢性乙型肝炎患者健康相关行为影响的研究

目的 观察行为干预对慢性乙型肝炎患者健康行为的影响。方法 将300例慢性乙型肝炎患者作为目标人群进行健康教育，建立目标人群管理档案，进行目标人群健康行为干预，比较教育前后相关行为的改变。结果 慢性乙型肝炎患者8项健康行为和8项危险健康行为有明显改观，差异具有统计学意义（P〈0．01）。结论 通过行为干预，有效地使慢性乙型肝炎患者完全遵从医嘱合理用药，完全依从健康行为，从而减少危险行为的发生。     

Endogenous opioid-immunoreactive neurons of the ventromedial hypothalamic nucleus concentrate estrogen in male and female rats

Estrogen stimulates expression of proenkephalin mRNA in neurons of the hypothalamic ventromedial nucleus, and evidence is accumulating that synaptic release of one of the peptide end products, met-enkephalin, influences events that regulate reproductive behavior. To address the question of whether estrogen acts directly on neurons that synthesize met-enkephalin or indirectly through a separate neuronal population, we combined estrogen autoradiography with endogenous opioid peptide (EOP) immunohistochemistry. In agreement with previous studies, the ventrolateral subdivision of the hypothalamic ventromedial nucleus was densely packed with EOP-immunoreactive cells. In males, 48% of the estrogen-concentrating cells of the ventrolateral subdivision of the hypothalamic ventromedial nucleus contained EOP, and, in females, 27% of the estrogen-concentrating cells contained EOP. These findings indicate that estrogen acts directly on neurons that express EOP and suggest a mechanism that underlies sexually differentiated reproductive behavior.     

农村居民艾滋病防治知识及高危行为调查研究

目的　通过对农村居民艾滋病 (AIDS)防治知识及高危行为的研究 ,为制定AIDS预防控制措施提供依据。方法　运用横断面调查研究方法 ,通过两阶段人群抽样对其AIDS防治知识及相关行为进行研究。结果　调查对象听说过AIDS的为 6 1.78% ;答对 0～ 3题为 5 6 .91% ,4～ 9题为 38.4 8% ,10～ 13题为 4 .5 5 % ;认为不可能感染艾滋病病毒的为 5 6 .94 % ,不清楚的为 38.38% ,有可能的为 4 .6 8%。 12人有卖血史 ,15人有性病史 ,在有性行为的 886人中 ,7.6 7%有过 1个以上多性伴。结论　农村居民AIDS知识匮乏 ,存在着相关危险行为。所以 ,我省预防AIDS的策略主要是开展健康教育积极推进健康促进 ,改善危险行为 ,提倡安全性行为和推广安全套的使用     

社区居民健康相关行为讨论与分析

目的了解当前社区居民中健康认知和主要健康相关行为，为深入开展健康教育提供科学依据。方法对黄浦区8个街道117个居委2546名居民分别召开座谈会，讨论并分析健康认知与健康相关行为。结果在2546名居民中对健康有正确认识的948人，占37．2％．自我评价身体状态为健康的531人，占20．9％，个人不健康行为位于前三位的是吸烟、不合理膳食和缺乏运动。团体不健康行为位于前三位的是出售不健康食品、食品污染和公共场所脏乱。结论健康相关行为受多因素及其多水平的影响，必须运用健康教育行为改变理念，采纳健康相关行为的生态学的观点，结合相关学科的方法，开展健康教育，促进人们的健康行为。