Considering how athletic identity assists adjustment to spinal cord injury: a qualitative study

Objectives

To establish how sport, and access to an athletic identity, has been used when adjusting to a spinal cord injury.

Design

Qualitative study using semi-structured interviews.

Setting

Private athletic club.

Participants

Eight (six males and two females) athletes from a wheelchair badminton club participated in the study. The individuals had finished rehabilitation, and were aged between 20 and 50 years.

Main outcome measures

A single semi-structured interview was undertaken with each participant.

Results

Following the thematic analysis, two final themes were presented: (1) adjustment and paradox of chronic illness; and (2) the role and value of an athletic identity.

Conclusions

Badminton provided participants with an opportunity to continue and develop a positive athletic identity. Identity may be used as a factor that can promote recovery, and is considered as a way to encourage and maintain positive long-term adjustment to disability.     

Attendance at a psychological support group for people with multiple sclerosis and low mood

Purpose: A cognitive behavioural group promoting psychological adjustment for people with multiple sclerosis (MS) was found to reduce psychological distress. Not all those offered treatment attended the group sessions. The aims were to examine the rates of attendance and to evaluate feedback from participants. Method: Participants with MS and low mood were recruited to a randomized trial comparing attendance at a psychological support group with a usual care control group. The attendance at each session was determined and those who attended were compared with those who failed to attend using a Mann–Whitney U-test or chi-squared. A sample of participants completed a telephone feedback questionnaire to determine their views of the group. Results: The 44 participants who attended four or more sessions were not significantly different from the 28 who attended fewer than four sessions on demographic variables, disability, self-efficacy or quality of life, but significantly fewer men attended than women (p?=?0.03). Participants’ feedback from the group was mainly positive, and no factors were identified associated with non-attendance. Conclusions: Men were less likely to attend group treatment sessions than women, but no other variables were associated with non-attendance. Attendance rates influence the effectiveness of interventions and reasons for non-attendance need to be determined.

Implications for Rehabilitation

• Not all people with multiple sclerosis (MS) and low mood offered psychological support will attend group sessions.

• Women are more likely to attend psychological support groups for people with MS than men.

• In clinical practice it may be possible to adjust the membership of groups to increase attendance more than in randomized trials.

     

班级环境对初中生学校适应的影响

目的:探讨初中生班级环境对其学校适应的影响,为改善学生班级环境,提高学生的学校适应提供参考。方法:采用问卷,对596名初中生知觉的班级环境和学校适应的现状进行了调查。结果:班级环境的各个维度与学校适应的各个维度均存在显著的相关;班级环境可以分为良好型、一般型、问题型三种类型。班级环境类型越好,学生学校适应越好;班级环境对学校适应有显著的预测作用。结论:班级环境对初中生学校适应存在显著的影响。     

War and the family

Although war can impose powerful stresses on family relationships and functions, and its horros have been described since Euripides wrote The Trojan Women, the subject has received little scientific study. The American Civil War had significant effects on the family and increasing industrialization further disrupted family ties and transformed women's roles. Twentieth-century wars have had both immediate and delayed effects on the family, ranging from anxiety and grief about losses and separations to increased antisocial behavior and juvenile delinquency. Subsequent problems stem from readjustments to civilian life, high divorce rates and women assuming more powerful roles in the family and society. Analysis of a random sample of child guidance clinic records 1923-1983 revealed an increase in children's academic problems and aggressive behaviors during and after World War II. Increases in anxiety and obsessive and aggressive behaviors were evident following the Vietnam conflict along with the adverse effects of post traumatic stress disorder on family life. Although US participation in the Gulf War was limited, disruptive effects were seen in the children of affected military families, and for Iraqi children the consequences were devastating. War generally accelerates dormant changes in family life not yet fully apparent or appreciated.     

Strategies for studying schizophrenic behavior

Definitions, interdisciplinary constructs, and simple schizophrenicnormal comparisons are described as major problems retarding progress in schizophrenia research in the past. A stimulus redundancy formulation is presented in order to resolve some of the apparently conflicting research evidence. This formulation, and the research related to it, argues that schizophrenia can best be understood in terms of at least two different types of progressions.Paper presented at the meetings of the American College of Neuropsychopharmacology, December 10–11, 1970, San Juan, Puerto Rico, as part of a symposium, Behavioral Mechanisms of Drug Action in Schizophrenia, Solomon C. Goldberg, Chairman.     

Return to work and adjustment latitude among employees on long-term sickness absence

Introduction: The aim was to study whether return to work (RTW) after long-term sickness absence is affected by adjustment latitude i.e. opportunities to adjust one's work to one's state of health by e.g. choosing among work tasks and deciding about work pace and working hours. We also studied whether the effect of adjustment latitude differed between those returning full-time and those returning part-time. Methods: Differences between men and women were also studied. A questionnaire was sent to 5,590 salaried employees who had been on sick leave for at least 90 days in 2000. The year after, 2001, they received a questionnaire which included questions about work status, working conditions, adjustment latitude and health. Results: The questionnaire was returned from 3056 persons. Among women 32% were fully back to work, 34% were partly back and 34% were still on sick leave. Comparable figures for men were 33%, 32% and 36%. Conclusion: For both men and women the likelihood to RTW increased with increasing number of opportunities to adjust. Adjustment latitude increased returning to part-time as well as full-time work. The study indicates that work organisation is important for RTW.     

美国《孤儿药法案》建立与修订过程研究及对我国的启示

目的：为我国应对孤儿药问题的政策制订提供建议。方法：应用文献研究法分析美国《孤儿药法案》的主要内容、建立和修订背景和动因,并提出对我国的启示。结果：《孤儿药法案》界定了罕见病及孤儿药,对罕见病的界定融入经济与社会因素,其颁布与修订涉及众多利益相关方,包括联邦政府、企业、患者,民众和媒体发挥重大推动作用;法案既丰富了孤儿药市场,又造成部分药品的高价问题。结论：我国可以采用美国关于罕见病的界定策略,但须积极控制孤儿药高价问题。     

Adjusting for publication biases across similar interventions performed well when compared with gold standard data

Objective

To extend, apply, and evaluate a regression-based approach to adjusting meta-analysis for publication and related biases. The approach uses related meta-analyses to improve estimation by borrowing strength on the degree of bias.

Study Design and Setting

The proposed adjustment approach is described. Adjustments are applied both independently and by borrowing strength across journal-extracted data on the effectiveness of 12 antidepressant drugs from placebo-controlled trials. The methods are also applied to Food and Drug Administration (FDA) data obtained on the same 12 drugs. Results are compared, viewing the FDA observed data as gold standard.

Results

Estimates adjusted for publication biases made independently for each drug were very uncertain using both the journal and FDA data. Adjusted estimates were much more precise when borrowing strength across meta-analyses. Reassuringly, adjustments in this way made to the journal data agreed closely with the observed estimates from the FDA data, while the adjusted FDA results changed only minimally from those observed from the FDA data.

Conclusion

The method worked well in the case study considered and therefore further evaluation is encouraged. It is suggested that this approach may be especially useful when adjusting several meta-analyses on similar interventions and outcomes, particularly when there are small numbers of studies.     

高中生的适应性障碍以及相关对策研究

高中生正处于心理与生理发展与完善的关键时期,在这个过程中最易出现学习、生活以及人际交往方面的不适应,直接导致不同程度的心理问题,甚至发展成适应性障碍。高中学生适应障碍主要表现:学习适应性障碍、生活适应性障碍、人际交往障碍。这些适应性障碍将直接影响高中生的学习、生活甚至身心健康的发展,通过分析高中生适应性障碍成因,提出相关决策变得至关重要。     

取消药品加成对医疗费用的影响分析

目的为了解取消药品加成对医疗费用的影响,特选取药品零加成后（2018年第一季度）及药品零加成前（2017年第一季度）医院住院病例中的8个病种,对之进行费用分析。方法采用文献分析法分析费用构成变化情况;使用SAS 8.0统计软件和Excel表格进行数据分析;利用复利系数计算法,减少时间因素对费用的影响。结果药品零加成后,8个病种的平均住院费用均有不同程度降低,其中药费因素贡献程度最大。费用结构中,药费比重大幅度下降,治疗费、检查费、化验费、手术病种手术费用均有一定程度上升,平均住院日有不同程度缩短;平均住院床日费用有不同程度下降。药品零加成在一定程度上缓解了“看病贵”问题。结论取消药品加成对降低患者药品费用起到了明显促进作用。医院应进一步加强医院管理和成本核算,提高运行效率。