纤维乳管镜临床应用中的问题与争议

纤维乳管镜主要应用于乳头溢液的诊断,提高了诊断的准确率,减小了手术切除范围,并修改了部分乳腺疾病的手术指征.但由于乳腺导管系统解剖的复杂性以及乳管镜本身的限制,乳管镜在乳腺导管内病变的切除、导管炎症治疗、乳腺癌筛查、保乳手术中辅助判定切缘等临床应用方面,尚存在诸多的问题与争议.     

影响晚期胃癌患者生活质量的因素分析

分析晚期胃癌患者的生活质量情况及其影响因素,为晚期胃癌患者的临床护理干预提供科研数据.选择2010年5月至2011年5月在辽宁医学院附属第一医院胃肠外科及肿瘤科的晚期胃癌患者173名进行生活质量的乱查,并通过EORTC QLQ —C30,SSRS,MCMQ,SAS等量表和一般人口学资料及临床病例资料进行评估.晚期胃癌患者总体生活质量评分低,仅29.54±12.21;社会支持、医学应对方式、焦虑及患者临床资料(除放疗外)对晚期胃癌患者总体生活质量影响较明显(P＜0.05).晚期胃癌患者的生活质量较差,其影响因素是多方面的,临床上医务人员应采取必要的措施提高晚期胃癌患者的生活质量.     

纤维乳管镜的漏诊问题及其应对策略

虽然纤维乳管镜在病理性乳头溢液诊断中的临床应用已超过20年,但对于其临床价值仍存在争议,焦点之一为漏诊问题.通过文献复习,发现漏诊问题与乳管系统解剖的复杂性、乳管镜自身性能的限制、导管内癌的起源特点以及检查者的经验与操作技巧等多方面原因有关,目前尚难以完全避免. 针对上述原因采取相应措施,则可能有助于降低漏诊率,推动乳管镜技术的进一步应用.     

目标性意图与执行性意图调节情绪反应的效果比较

目标性意图和执行性意图作为目标的不同形式,对情绪调节的影响有待探讨。本研究试图考察目标性意图和执行性意图与表达抑制相结合之后,在调节情绪反应方面的作用。实验采用主观报告和生物反馈的方法对58名大学生进行测试。结果发现：（1）执行性意图组被试在观看负性和中性图片时对自身情绪唤醒度的评价均显著低于目标性意图组,在观看负性图片时其情绪唤醒度也显著低于控制组。（2）执行性意图组被试在各项生理反应指标上均显著低于目标性意图组和控制组,主要表现为形成执行性意图的个体在皮肤电导增加量、皮温降低量和指脉增加量上均显著低于形成目标性意图或不形成任何意图的个体。上述结果表明,相较于仅仅给出情绪体验下调目标的目标性意图,与表达抑制结合在一起的执行性意图能有效下调个体的负性情绪反应。     

语音象征的产生机制：基于敏感期的先天后天作用模型

Bouba-Kiki效应(简称BK效应)指语音和形状特征之间的映射关系。针对BK效应的产生机制,先天论和后天论之间争论激烈。先天论的观点认为人们对语音象征的敏感性是出生时便存在的一种语言机制。而后天论的观点则强调语音象征是语言经验的产物。上述理论均获得大量研究证据的支持,且均无法完全否定对方。这表明,上述理论可能均未完整揭示语音象征的产生机制。鉴于此,针对BK效应的产生机制,梳理先天论与后天论的支持证据,并率先提出语言相关的BK效应敏感期假设。同时,梳理了支持BK效应敏感期的初步研究证据及可能的影响因素。进而,以语言相关的BK效应敏感期假设为基础,提出语音象征产生的先天后天相互作用模型,以整合以往研究中的矛盾。最后,展望了语音象征的未来研究进展和方向。     

Suicide Intervention Skills and Related Factors in Community and Health Professionals

Health and community professionals have considerable exposure to suicidal people and need to be well skilled to deal with them. We assessed suicide intervention skills with a Dutch version of the SIRI in 980 health and community professionals and psychology students. Suicide intervention skills clearly differed among professional groups and were strongly related to experience, especially suicide‐specific experience. Some community professionals scored below acceptable levels on their ability to respond appropriately to suicidal people they encounter, and tended to overestimate their skills level. Training is therefore indicated for these groups, and may be useful to more highly experienced groups too.     

Interaction of Combat Exposure and Unit Cohesion in Predicting Suicide‐Related Ideation Among Post‐Deployment Soldiers

Suicide is one of the leading causes of death among U.S. Army soldiers. Suicide‐related ideation, which is associated with suicide attempts and suicide, can cause considerable distress. In a sample of 1,663 recently redeployed soldiers, we used factor analysis and structural equation modeling to test the associations between combat exposure, unit cohesion, and their interaction in predicting suicide‐related ideation. We found that combat exposure was a significant risk factor for suicide‐related ideation, while unit cohesion was a significant protective factor. The significant interaction between the two factors indicated that soldiers who experienced greater combat exposure but also had higher levels of unit cohesion had relatively lower levels of suicide‐related ideation. In addition, those who had higher levels of combat exposure and lower unit cohesion were most at risk for suicide‐related ideation. Our findings indicate the importance of unit cohesion in protecting soldiers from suicide‐related ideation and suggest a higher risk group of soldiers who should be targeted for interventions.     

Trajectories of Suicide Ideation,Nonsuicidal Self‐Injury,and Suicide Attempts in a Nonclinical Sample of Military Personnel and Veterans

Nonsuicidal self‐injury (NSSI) is a risk factor for suicide attempts, but little is known about NSSI among military personnel and veterans, or about the temporal sequencing of NSSI relative to suicide ideation and attempts. This study evaluates trajectories of suicide ideation, NSSI, and suicide attempts in a sample of 422 military personnel and veterans. Of those with a history of NSSI, 77% also experienced suicide ideation. Suicide ideation emerged before NSSI (67%) more often than the reverse (17%). Of those with a history of suicide attempt, 41% also engaged in NSSI. NSSI emerged prior to the first suicide attempt (91%) more often than the reverse (9%). The length of time from suicide ideation to suicide attempt was longer for those who first engaged in NSSI (median = 3.5 years) compared with those who did not engage in NSSI (median = 0.0 years), Wald χ²(1) = 11.985, p = .002. Age of onset was earlier for participants reporting NSSI only compared with those reporting both NSSI and suicide attempts (16.71 vs. 22.08 years), F(1, 45) = 4.149, p = .048. NSSI may serve as a “stepping stone” from suicide ideation to attempts for 41% of those who attempt suicide.     

Comparisons of the Interpersonal–Psychological Theory of Suicide Constructs Among Individuals Without Suicidality,Ideators, Planners,and Attempters

The Interpersonal–Psychological Theory of Suicide (IPTS) proposes that combinations of thwarted belongingness, perceived burdensomeness, and acquired capability lead to suicide ideation, planning, and attempting. We compared individuals with and without suicidality on thwarted belongingness and perceived burdensomeness, and compared a combined group of planners and attempters to ideators on fearlessness about death (one component of acquired capability). Individuals with suicidality had higher thwarted belongingness and perceived burdensomeness than individuals without suicidality. Planners and attempters did not have higher fearlessness about death than ideators. These findings partially support IPTS hypotheses. Assessing thwarted belongingness and perceived burdensomeness may improve suicide risk determination.     

Suicidal Ideation and Behavior in Adolescents Aged 12–16 Years: A 17‐Year Follow‐Up

The prevalence of suicidal ideation/behavior in 1983 or 1987 and its association with future mental health in 2001 were evaluated in a provincially representative sample of Canadian adolescents (n = 1,248) aged 12 to 16 years. Approximately 13.3% (95% CI = 11.5–15.3) of adolescents self‐reported suicidal ideation/behavior. Adolescent agreement with parent (κ = .07) and teacher (κ = .05) reports at baseline was low because adults identified so few subjects. In adulthood, the associations between adolescent self‐reports of suicidal behavior/ideation and major depression and other mental health indicators were explained by respondent sex and adolescent emotional problems reported in 1983/1987. Adolescents with suicidal behavior/ideation often are not recognized by their parents and teachers and may be at risk for persistent psychiatric problems attributable to coexisting mental health problems early‐on.