Pain Trajectories and Predictors: A 7-Year Longitudinal Study of Women With Vulvodynia

IntroductionA significant proportion of women report a reduction of symptoms over time—even without treatment—yet the natural progression of vulvodynia and which factors may explain decrease vs persistence of pain remain unclear.AimTo identify subgroups of pain trajectories in women with vulvodynia and to predict these different trajectories by treatments undertaken, pain characteristics, and psychosocial factors.MethodsData on pain intensity, treatments undertaken, pain characteristics, and psychosocial factors were collected 3 times over a 7-year period from 173 women who screened positive for vulvodynia. Latent class growth analysis was conducted to identify homogeneous subgroups with distinct pain trajectories. A multivariate binomial logistic regression was used to examine whether treatments, pain characteristics, and psychosocial factors predicted these trajectories.Main Outcome MeasureThe main outcome was pain intensity (0–10), measured at 3 time points with the numerical rating scale.Results2 pain trajectories were identified: 1 where pain persisted (28.9%), and 1 where pain decreased over time (71.1%). Whether a treatment had been undertaken was not predictive of the course of pain over time. Women who were older at first pain onset, had pain at another location than the entrance of the vagina, and reported more anxiety were more likely to have a persistent pain trajectory relative to the decreased pain trajectory.Clinical ImplicationsFindings suggest that the evolution of pain differs among women with vulvodynia depending on pain characteristics and anxiety.Strengths & LimitationsStrengths of the study include the 7-year longitudinal design to examine the natural history of provoked vestibulodynia and the inclusion of biopsychosocial factors as predictors of pain trajectories. However, women with major medical and psychiatric illnesses or deep dyspareunia were not included, and, thus, these factors could not be examined as predictors.ConclusionAssessing baseline characteristics associated with different pain trajectories during medical visits could have positive implications for the management of vulvodynia.Pâquet M, Vaillancourt-Morel M-P, Jodouin J-F, et al. Pain Trajectories and Predictors: A 7-Year Longitudinal Study of Women With Vulvodynia. J Sex Med 2019;16:1606–1614.     

181例离退休干部抑郁状况及影响因素的研究

目的 了解离退休干部抑郁状况及有关影响因素。方法对181例离退休干部进行GDS量表评定，并进行相关分析和逐步回归分析。结果离退休干部抑郁症状患病率为25．4％，对其影响的最主要因素为身体状况、生活感觉、性别、家庭关系，标准化回归系数分别为-0．294、0．260、-0．163、-0．169。结论必须从多方面采取综合干预措施，才能改善离退休干部的抑郁状况，从而达到心理健康水平。     

High-Risk Drinking across the Transition from High School to College

Alcohol use and related problems were studied from the senior year in high school to the first autumn in college for 366 heavy drinking students. Four risk factors-subject sex, family history of drinking problems, prior conduct problems, and type of college residence-were evaluated as predictors of: (1) differential changes in drinking rates, (2) differential changes in alcohol-related problems, and (3) alcohol dependence symptoms during the first college term. Results suggest that both dispositional and environmental factors are associated with changes in drinking rates and the existence of dependence symptoms. Increases in the frequency of drinking were specifically and strongly associated with residence in a fraternity (men) or sorority (women). Three risk factors were associated with increased quantity of drinking: male gender, residence in a fraternity or sorority, and a history of conduct problems. Prior conduct problems were also consistently associated with dependence symptoms during the first term in college. A family history of alcohol problems was not consistently related to changes in use rates or problems, although some analyses suggest interactive effects. Early interventions on college campuses should target individuals using additive risk profiles.     

Identifying patients at risk for,and treatment of major psychiatric complications of cancer

A critically important aspect of supportive care in cancer is the prompt recognition and effective treatment of psychiatric complications. Psychiatric disorders such as depression, anxiety and delirium occur in a signifcant percentage of cancer patients, particularly as disease advances and as cancer treatments become more aggressive. This paper reviews factors that can be utilized to identify patients who are at increased risk for developing psychiatric complications, such as those with advanced disease, certain cancer treatments, uncontrolled physical symptoms, functional limitations, lack of social support, and past history of psychiatric disorder. Methods of diagnostic assessment and strategies for managing depression, anxiety, delirium and suicidal ideation are also reviewed.Presented as an invited lecture at the 6th International Symposium: Supportive Care in Cancer, New Orleans, La., USA, 2–5 March 1994     

深圳南山0～2岁儿童营养状况及其影响因素的调查研究

目的 了解深圳南山0～2岁儿童营养状况及影响因素。方法 Z评分法、NCHS标准评价儿童营养,检测血红蛋白和血Cu、Fe、Zn、Ca、Mg、P,问卷调查有关社会环境因素。结果 深圳南山0～2岁儿童营养不良率为8.08％。常住儿童与暂住儿童营养不良率间差别有显著性意义(P<0.01)。营养不良的影响因素:儿童户籍是否常、暂住,膳食结构中谷类食物量,婴儿期是否母乳喂养。儿童年龄与贫血患病率间存在一定线性依从关系(P<0.01),暂住与常住儿童贫血患病率间差别有显著性意义(尸<0.05)。235名儿童的血Cu、Mg值均正常,而儿童缺Ca、Zn、P、Fe的发生率分别为71.06％、54.89％、22.12％和6.8％。结论 我区0～2岁儿童营养状况不容乐观,尤其暂住儿童更是高危人群。我们在重点营养干预同时,要注意改善整体儿童营养状况。     

哈尔滨市社区卫生服务需求、利用及影响因素分析

目的：为了了解哈尔滨市居民对社区卫生服务的需求、利用情况以及影响因素。方法：采用分层整群抽样，对哈尔滨市2000名居民进行了入户调查。结果：被调查居民的两周患病率为34．3％，两周就诊率为27．7％，其未就诊率为30．0％。影响人们对卫生服务利用的因素有收入、患病次数、健康状况等因素。结论：社区卫生服务应不断加强和完善，从而真正成为实现卫生目标的有效途径。     

甘南州合作地区藏汉学生个性特征及其影响因素的初步探讨

对生长在合作地区的955名藏、汉族学生进行了个性特征及其影响因素的调查探讨。结果表明:本民族间男、女生E分比较,男生低于女生,显示女生性格较男生性格外向倾向性大。稳定性方面女生N分高于男生,即女生情绪一般不及男生稳定。此外与该地区藏汉族学生个性特征关系较为密切的因素是:兄弟姐妹数、父母亲文化程度、职业以及学前教育和智商。     

妇癌患者的社会心理因素调查

本文以自编病前负性情绪调查表、ＬＳＥ─Ｒ及ＥＰＱ对５６例妇癌住院病人进行了调查，并以５６例内科病住院病人作对照。结果显示，６９．６％的妇癌病人在病前有负性情绪，而内科病病人只有１６．１％；８５．７％的妇癌病人病前经历了负性生活事件，而内科病组则为５８．９％；ＥＰＱ评定结果神经质分亦为前者高于后者，均提示社会心理因素与妇癌的发生密切相关。     

Development of a Novel Scale to Assess Life Fulfilment as Part of the Further Refinement of a Quality-of-Life Model for Epilepsy

Summary: We have been involved in developing a health-related quality-of-life model for use as an outcome measure in epilepsy. As part of the further development of this model, we have developed a measure of life fulfilment. This scale is based on methods previously described by Krupinski in 1980. The value of Krupinski's approach is the opportunity for patients to weight the numerous aspects of their quality of life and assess the discrepancy between their actual and desired circumstances. The life fulfilment scale has been shown to be reliable (α= 0.7) and valid. The scale is currently being applied to several clinical studies in epilepsy. We believe that the scale provides a valuable contribution to our health-related quality-of-life model.