角膜屈光手术治疗的综合启示

角膜屈光手术是近年发展起来的治疗屈光不正的重要技术。已应用于临床,并取得了令人鼓舞的结果。尤其是准分子激光的实时扫描跟踪技术,并辅之眼前段成像系统与波前相差技术的一体化,极大提高了手术疗效。纵观其发展过程,认识到角膜屈光手术的发展是多学科联合发展的结果。     

科学技术发展与角膜屈光手术的研究进展

角膜屈光手术是自20世纪50年代开始出现,由最初的冷冻角膜磨镶术到PRK、LASIK、个体化切削,伴随着科学技术的发展和进步,新技术的不断涌现并应用于临床,角膜屈光手术也日新月异,手术安全性、预测性有了极大提高.今天,角膜屈光手术已经极大地改变我们的生活,显示出科学技术的强大力量.本文就科学技术的发展对角膜屈光手术的促进和影响作一概述.     

波前相差引导的个体化切削治疗近视

角膜的个体化切削是在PRK、LASIK、LASEK的基础上发展起来的一种新的屈光手术技术.其最大的优点是根据不同眼的特点对角膜进行切削,使其达到最佳的视觉效果.现回顾角膜屈光手术的发展,并运用哲学原理对个体化切削的依据、技术创新及其具体应用加以综述.     

波前相差引导的个体化切削治疗近视

角膜的个体化切削是在PRK、LASIK、LASEK的基础上发展起来的一种新的屈光手术技术。其最大的优点是根据不同眼的特点对角膜进行切削,使其达到最佳的视觉效果。现回顾角膜屈光手术的发展,并运用哲学原理对个体化切削的依据、技术创新及其具体应用加以综述。     

现代科学技术与角膜屈光性手术的发展

通过回顾角膜屈光性手术的发展历史,从中可以看出角膜屈光性手术的发展过程是一个实践－认识－再实践－再认识的过程,相关学科的进步以及新科技的引进,是认识的不深化以及实践的理论和物质基础,激光,电子计算机,材料学及制作工艺等现代科学技术的进步在角膜炎屈光性手术发生中起了决定性的作用。     

个体化角膜屈光手术的探讨

对个体化角膜屈光手术这一屈光矫正领域的新理念和新方法进行探讨,提出医务工作者要勇于思想创新;以辩证思维看问题;关注社会需求,正确处理以人为本与追求经济利益的关系;加强多学科交叉合作和复合型人才的培养,才能推动个体化角膜屈光手术不断向更高层次迈进.     

个体化角膜屈光手术的探讨

对个体化角膜屈光手术这一屈光矫正领域的新理念和新方法进行探讨,提出医务工作者要勇于思想创新;以辩证思维看问题;关注社会需求,正确处理以人为本与追求经济利益的关系;加强多学科交叉合作和复合型人才的培养,才能推动个体化角膜屈光手术不断向更高层次迈进。     

白内障手术治疗的发展与思考

白内障是常见的致盲眼病之一,目前治疗白内障唯一有效的方法是通过手术摘除混浊的晶状体并植入人工晶状体.随着白内障摘除手术技术的提高和仪器设备的不断更新,手术理念已由原来的白内障复明手术逐渐向白内障屈光手术转变,手术目的已不单纯局限在复明,而是旨在恢复更合乎生理状况的视觉功能.随着科学技术的发展,白内障手术技术的日趋成熟,人们关注的重点也逐渐从手术效果、术后视力的恢复,过渡到手术过程中患者的舒适程度、满意程度上来.使得白内障的手术治疗过程更具有人性化的特点,体现了当代医疗对患者的人文关怀.     

自内障手术治疗的发展与思考

白内障是常见的致盲眼病之一,目前治疗白内障唯一有效的方法是通过手术摘除混浊的晶状体并植入人工晶状体。随着白内障摘除手术技术的提高和仪器设备的不断更新,手术理念已由原来的白内障复明手术逐渐向白内障屈光手术转变,手术目的已不单纯局限在复明,而是旨在恢复更合乎生理状况的视觉功能。随着科学技术的发展,白内障手术技术的日趋成熟,人们关注的重点也逐渐从手术效果、术后视力的恢复,过渡到手术过程中患者的舒适程度、满意程度上来。使得白内障的手术治疗过程更具有人性化的特点,体现了当代医疗对患者的人文关怀。     

白内障手术治疗的发展与思考

白内障是常见的致盲眼病之一,目前治疗白内障唯一有效的方法是通过手术摘除混浊的晶状体并植入人工晶状体。随着白内障摘除手术技术的提高和仪器设备的不断更新,手术理念已由原来的白内障复明手术逐渐向白内障屈光手术转变,手术目的已不单纯局限在复明,而是旨在恢复更合乎生理状况的视觉功能。随着科学技术的发展,白内障手术技术的日趋成熟,人们关注的重点也逐渐从手术效果、术后视力的恢复,过渡到手术过程中患者的舒适程度、满意程度上来。使得白内障的手术治疗过程更具有人性化的特点,体现了当代医疗对患者的人文关怀。     

Psychopathy and behavioral correlates of victim injury in serious juvenile offenders

The study examines delinquent behavior and psychopathy and assesses their relationship to victim injury in a population of 168 incarcerated juvenile delinquent males with lengthy histories of criminal and violent behavior. A series of multiple regressions found that 17% of the variance associated with level of victim injury was accounted for by a model that included the three-factor model of the Psychopathy Checklist: Youth Version [Forth, Kosson, and Hare, 2003], criminal versatility, and age of onset of criminal offending. Notably, anger and DSM-IV symptoms of conduct disorder were not related to level of victim injury. The results of this study support an escalation hypothesis where individuals with earlier onset to criminal behavior and greater criminal versatility escalate to more severe violence. The current results demonstrate the importance of integrating established theories of juvenile delinquency when explaining severe violence in youth.     

Juvenile onset Huntington's disease--clinical and research perspectives

Huntington's disease (HD) is an inherited neurodegenerative disorder. The mutation which causes the disease is an expansion in the number of repetitions of three nucleotides, C, A, and G in exon 1 of the huntingtin gene. The gene normally has 15 to 30 repeats and an expansion to 40 or more is associated with HD. HD usually has a mid-life onset, but a juvenile form, defined by onset of symptoms before the age of 21 years, is present in about 7% of HD cases. Juvenile HD is characterized by (1) transmission from an HD affected father, (2) an unusually large repeat size, usually of 60 or more units, and (3) unique clinical features, including rigidity and seizure disorder. Although juvenile onset is associated with a more severe neuropathological involvement, the neuropathological characteristics of juvenile HD are similar to those seen in the adult form in that the striatum bears the brunt of the illness. Clumps of protein, termed inclusion bodies, which stain positive for huntingtin and ubiquitin, are found primarily in the nucleus but also in the cytoplasm and axons in HD neurons. Research suggests that these inclusion bodies sequester a deleterious protein fragment and prolong cell life during the degenerative process of the disease.     

Female juvenile delinquency, motherhood, and the intergenerational transmission of aggression and antisocial behavior

The current study explored the intergenerational transmission of aggression and antisocial behavior by examining mothers' juvenile delinquency, their pregnancies, and its impact on their children's aggressive behavior. The sample consisted of the first 181 biological mothers recruited as part of the Vancouver Longitudinal Study on the Psychosocial Development of Children (British Columbia, Canada). Results indicated that mothers who were juvenile delinquents were more likely to experience social adversity, to use substances during pregnancy and to offend in adulthood. Furthermore, mothers who reported juvenile delinquency had children who were more physically aggressive and had an earlier onset of physical aggression. This pattern of association held when controlling for sociodemographics, social adversities, prenatal substance exposure, and criminal involvement in adulthood. The study findings highlighted the importance of understanding the role and impact of female delinquency and motherhood on the intergenerational transmission of antisocial behavior.     

Psychological correlates of violent and non-violent Hong Kong juvenile probationers

There is little known about Hong Kong juvenile offenders on probation. The purpose of this study was to compare Hong Kong juvenile violent with non-violent probationers on static demographic and psychological variables. The study comprised 109 male juvenile probationers aged 14-20 years (M = 16.97, SD = 1.44) in community transitional housing; 34 were adjudicated for violent offenses, while 75 were non-violent. The Rosenberg Self-Esteem Scale (RSES), Satisfaction with Life Scale (SWLS), Social Bonding Scale-Theft (SBS-T), Social Bonding Scale-Violent Crime (SBS-VC), Positive and Negative Affect Scales (PANAS), Impulsiveness Scale-Short Form (IS-SF) and CRIME-PICS II were administered to measure self-esteem, life satisfaction, social bond, positive and negative affect, impulsivity, pro-offending attitudes, and self-perceived life problems. Data on onset age of delinquent behavior, age of first adjudication, number of prior adjudications, and frequency of self-reported delinquency in the past year were also collected. t-tests were consistent with significant differences for violent offenders including higher self-esteem (p < 0.05). Non-violent offenders self-reported significantly more theft (p < 0.05) with a tendency to deny victim hurt more often (p < 0.01); 76.5% of violent offenders self-reported both violent and non-violent crime, while 58.7% of non-violent offenders reported only non-violent crime. For violent and non-violent offenders, the onset of delinquency was inversely related to the frequency of self-reported delinquency. Using ordinary least-squares (OLS) regression analyses, self-anticipated violent reoffending risk was predicted by age of onset, frequency of self-reported delinquency, social bond (inversely), and impulsivity, while non-violent reoffending risk was predicted by the number of prior convictions and self-reported delinquency. Only two psychological correlates, social bond and impulsivity, were related to violent delinquency; interventions are suggested.     

To whom the play signal is directed: a study of headshaking in black-handed spider monkeys (Ateles geoffroyi)

Spider monkeys shake their heads so as to facilitate amicable social contact. This occurs frequently during vigorous play fighting, and so is common during the juvenile period. Occasionally, juvenile spider monkeys use headshakes during nonsocial locomotor play. In this study, head shaking in early infancy and in adulthood was studied in a captive troop of spider monkeys, with a total of 8 infants studied from shortly after birth to just before weaning. Three hypotheses to account for these nonsocial headshakes were tested. The play as the experience of the unexpected hypothesis was found wanting because nonsocial headshakes were most common in early infancy, before the onset of the juvenile peak in play. The immature misdirection of signals hypothesis was also found wanting because the headshakes were correctly directed at other monkeys, but not at inanimate objects that were grabbed and mouthed. Both also failed to predict the occurrence of the observed nonsocial headshakes in adults. The hypothesis best supported by the data is that, under some situations, headshakes are self-directed to promote action when confronting contexts of uncertainty.     

Criminal Recidivism Among Hong Kong Male Juvenile Probationers

Hong Kong juvenile probationers are scarcely studied. The purpose of this study was to explore the 6-month short-term recidivism rate of 92 male juvenile probationers (aged 14–20?years), with and without controlling for their index crime. Generally, 30% of the juveniles reoffended within the 6-month follow-up period (82 and 18% were adjudicated of a nonviolent and violent offense respectively). Eight personality and psychosocial properties (self-esteem, life satisfaction, social bond, positive and negative affect, impulsivity, pro-offending attitudes, and self-perceived life problems) were assessed in both Wave 1 and Wave 2 periods. Only three properties (negative affect, self-perceived life problems, and self-esteem) yielded significant changes within the 6-month period. Beyond the exploratory analyses, another aim of this study was to identify significant predictors of recidivism in these rarely sampled juvenile probationers. Results indicated that type of crime, onset age of delinquent behavior, frequency of delinquency involvement in the past year, social bond, negative affect, impulsivity, and pro-offending attitudes were significant risk factors for recidivism. These findings highlight the need for social workers and other youth justice personnel to prioritize the intervention resources for juvenile probationers in light of the high estimated lifetime cost of crime for young offenders. Cognitive-behavioral treatment modalities with emphases on family functioning and problem-solving strategies were found to be an effective intervention approach for juvenile offenders. Limitations and future research directions are discussed.     

The short-term consequences of early onset cannabis use

The associations between early onset (prior to 15 years of age) cannabis use and rates of mental health or adjustment problems during the period from 15 to 16 years of age were studied in a New Zealand birth cohort. Early onset cannabis users were at increased risks of later substance use behaviors, conduct/oppositional disorders, juvenile offending, severe truancy, school dropout, anxiety, depression, and suicidal ideation. Early cannabis users had odds of these outcomes ranging from 2.7 to 30.8 times higher than the odds for those who did not use cannabis prior to age 15. Most of the elevated risks of early onset users were explained by the fact that they were a high-risk group of adolescents characterized by family disadvantages, early adjustment problems, and high affiliations with substance-using or delinquent peers. Nonetheless, even after adjustment for a wide range of confounding factors, early onset users had increased risks of later cannabis use. It is concluded that while most of the elevated risks of early onset users were explained by social, family, and individual characteristics of this group, early onset users were at increased risks of later cannabis use.This research was funded by grants from the Health Research Council of New Zealand, the National Child Health Research Foundation and the Canterbury Medical Research Foundation.     

Can the distress-signal and arousal-reduction views of crying be reconciled? Evidence from the cardiovascular system

Theorists have staked out two ostensibly opposing views of human crying as either an arousing behavior that signals distress or a soothing behavior that reduces arousal after distress. The present study examined whether these views of crying might be reconciled by attending to physiological changes that unfold over crying episodes. Sixty female students watched neutral and cry-eliciting films while autonomic physiology, including respiratory sinus arrhythmia and pre-ejection period, was assessed. Crying participants exhibited heart rate increases that rapidly subsided after crying onset. Crying onset was also associated with increases in respiratory sinus arrhythmia and slowed breathing. All crying effects subsided by 4 minutes after onset. It is possible that crying is both an arousing distress signal and a means to restore psychological and physiological balance, depending on how and when this complex behavior is interrogated.     

Association between polymorphisms in the dopamine transporter gene and depression: evidence for a gene-environment interaction in a sample of juvenile detainees

Previous research has generated examples of how genetic and environmental factors can interact to create risk for psychopathology. Using a gene-by-environment (G x E) interaction design, we tested whether three polymorphisms in the dopamine transporter gene (DAT1, also referred to as SLC6A3, located at 5p15.33) interacted with maternal parenting style to predict first-onset episodes of depression. Participants were male adolescents (N= 176) recruited from a juvenile detention center in northern Russia. As hypothesized, one of the polymorphisms (rs40184) moderated the effect of perceived maternal rejection on the onset of major depressive disorder, as well as on suicidal ideation. Further, this G x E interaction was specific to depression; it did not predict clinically significant anxiety. These results highlight the need for further research investigating the moderating effects of dopaminergic genes on depression.     

Adolescents in Residential Treatment: Caregiver and Peer Predictors of Risk Behavior and Academic Performance

The purpose of this research was to better understand the substance use and sexual risk taking behavior among high-risk adolescent populations placed in residential treatment facilities, including those in the foster care and juvenile justice systems. The primary predictors considered in this study included caregiver support, caregiver closeness, other adult support, adolescent self-disclosure/communication with caregiver, caregiver expectations about sexual behavior, and peer influence regards to drugs/alcohol and sexual behavior. Participants included 120 adolescent females in grades 7 to 12 (median grade?=?10; mean age 15.7 years), primarily African American (57.2 %) and White (29 %), in a residential treatment setting in a large urban area in the Midwest. Caregiver support and self-disclosure/communication with caregivers predicted condom use at most recent intercourse, but variables related to substance use were most consistently predictive of sexuality variables including onset and frequency of behavior. None of these support variables significantly predicted onset and frequency of substance use. Caregiver support was the contributing variable in predicting academic achievement.