Common and specific cognitive deficits in schizophrenia: relationships to function

The goals of the present study were to assess the interrelationships among tasks from the MATRICS and CNTRACS batteries, to determine the degree to which tasks from each battery capture unique variance in cognitive dysfunction in schizophrenia, and to determine the ability of tasks from each battery to predict functional outcome. Subjects were 104 schizophrenia patients and 132 healthy control subjects recruited as part of the CNTRACS initiative. All subjects completed four CNTRACS tasks and two tasks from the MATRICS battery: Brief Assessment of Cognition in Schizophrenia Symbol Coding and the Hopkins Verbal Learning Test. Functional outcome was also assessed in the schizophrenia subjects. In both the patient and control groups, we found significant intercorrelations between all higher order cognitive tasks (episodic memory, goal maintenance, processing speed, verbal learning) but minimal relationships with the visual task. For almost all tasks, scores were significantly related to measures of functional outcome, with higher associations between CNTRACS tasks and performance-based measures of function and between one of the MATRICS tasks and self-reported functioning, relative to the other functioning measures. After regressing out variance shared by other tasks, we continued to observe group differences in performance among task residuals, particularly for measures of episodic memory from both batteries, although these residuals did not correlate as robustly with functional outcome as raw test scores. These findings suggest that there exists both shared and specific variance across cognitive tasks related to cognitive and functional impairments in schizophrenia and that measures derived from cognitive neuroscience can predict functional capacity and status in schizophrenia.     

Personal Growth of Mothers of Preterms: Objective Severity of the Event,Subjective Stress,Personal Resources,and Maternal Emotional Support

This prospective study investigated the personal growth of Israeli mothers of premature babies at two medically defined risk levels (infants at low risk, n = 42; infants at moderate-high risk, n = 52), examining the contribution to the five dimensions of personal growth of objective event characteristics (baby’s risk level), perceived levels of mother’s stress (linear and curvilinear associations), and mother’s personal resources (self-esteem, attachment styles, perceived emotional support from her own mother). In addition, the role of the event severity as a moderator of the association between perceived maternal emotional support and personal growth was explored. Findings indicate that mothers in the two risk groups did not differ in level of perceived stress. Mothers of infants at moderate-high risk, however, experienced more spiritual change. In addition, consistent curvilinear associations emerged between perceived levels of stress and personal growth for three dimensions of growth: new possibilities, personal strength, and relations with others (with a similar trend for appreciation of life). Thus, mothers reporting moderate stress levels experienced the highest personal growth. Finally, risk group played a moderating role in the association between perceived maternal emotional support and personal growth on the dimensions of new possibilities, personal strength, and relations with others. On these dimensions, only among mothers of low-risk babies were higher levels of maternal emotional support associated with greater personal growth. The results highlight the importance of the subjective experience and the value of maternal emotional support for the personal growth of mothers of preterms. These findings may help in designing measures to identify populations at risk and developing appropriate interventions, as well as impact on the working procedures and support currently offered in most neonatal intensive care units.     

论病历所有权归属与所有权行使

在现行法律框架下,通过文献检索、走访调研以及比较法研究方法探讨我国病历的所有权归属与所有权行使问题.本文认为病历具有物的属性,这是本文展开探讨的前提.基于对患者与医疗机构之间的空白病历买卖合同关系、医疗服务合同关系、医疗机构与医务人员之间的雇佣关系等多重法律关系的分析以及出于对患者隐私权等权利保护的考虑,认为病历所有权应归属于患者.同时,在病历私有说的基础上,分析了病历所有权行使、病历所有权的限制以及病历所有权受侵害时的救济等问题.     

女性盆腔脏器脱垂的传统手术治疗

对于女性盆腔脏器脱垂的手术治疗,传统的手术方式包括阴道封闭术、曼氏手术和阴式全子宫切除术.阴道封闭术操作相对简单,适用于无性生活要求的、合并症较多的年老体弱者,但术后可能存在新发压力性尿失禁,并且导致性功能障碍,术中是否切除子宫尚有争议.曼氏手术保留子宫、操作简单,但术后脱垂复发及妊娠后宫颈机能不全问题仍有待研究.阴式全子宫切除术对于POP-Q评分II期及以内的脱垂患者,治疗效果最佳,期别高的患者术后复发仍可使用保守或再次手术治疗补救,本手术方式术后较少出现性交痛.总而言之,选择适当的适应证并积极与患者沟通后,女性盆腔脏器脱垂的传统手术治疗仍为不错的治疗方式.     

医学人文学科创新成果的展示——评《医学与语言》

《医学与语言》是邱鸿钟教授集20余年心血完成的一部对“医学的历史、主体文本和临床的语言观”进行系统研究的学术专著,是一部具有一定理论深度和强烈实践精神的原创性论著.《医学与语言》开辟了医学人文研究的新领域;拓展了医学人文研究的新视野;提升了理论服务社会的新境界.     

The Development of Children's Concepts of Hardness

This study was conducted for three purposes. First, we assessed the development of children's concepts of hardness as an intensive physical quantity. We hypothesized a U-shaped behavioral growth curve for children's judgments on tasks measuring intensive physical quantity, but the hypothesis was not confirmed. The justifications accompanying correct and incorrect judgments for hardness were similar to those where U-shaped behavioral growth was found for other intensive physical quantities (temperature and sweetness). The second purpose was to determine how children solve seriation and transitivity tasks where hardness was the content. More older than younger children solved these tasks, and the transitivity task was correctly solved after the seriation task was correctly solved. One pattern of solutions for transitivity and intensive physical quantity allowed for differentiation between younger and older children who solved the intensivity tasks correctly. The third purpose was to determine whether children think that objects' hardnesses are labile (i.e., hard objects can become soft and vice versa) by simply adding more of that substance. More younger than older children thought that this was true     

The Baby Boomers Meet Menopause: Fertility, Attractiveness, and Affective Response to the Menopausal Transition

The purpose of this study was to identify social factors that affect women’s concerns about menopause. Data from a sample of 1,037 baby-boomer women who took part in two waves of the Midlife in the United States survey (MIDUS) were utilized. Two waves of survey data were collected in 1996 and 2005 from a nationally representative sample of women born between 1946 and 1964 residing in the United States. Women’s concerns about the effects of menopause on attractiveness, fertility, and the cessation of menstruation were examined. Analyses were replicated in Wave I and II of the study. Women who occupied multiple roles had fewer concerns about the loss of fertility. Women who had more symptoms were significantly more concerned about the effects of menopause on attractiveness. Concerns about the effects of menopause were also related significantly to women’s age, education, and financial security.     

A randomised controlled trial of a brief online mindfulness-based intervention

ObjectivesThere is growing evidence that mindfulness has positive consequences for both psychological and physical health in both clinical and non-clinical populations. The potential benefits of mindfulness underpin a range of therapeutic intervention approaches designed to increase mindfulness in both clinical and community contexts. Self-guided mindfulness-based interventions may be a way to increase access to the benefits of mindfulness. This study explored whether a brief, online, mindfulness-based intervention can increase mindfulness and reduce perceived stress and anxiety/depression symptoms within a student population.MethodOne hundred and four students were randomly allocated to either immediately start a two-week, self-guided, online, mindfulness-based intervention or a wait-list control. Measures of mindfulness, perceived stress and anxiety/depression were administered before and after the intervention period.ResultsIntention to treat analysis identified significant group by time interactions for mindfulness skills, perceived stress and anxiety/depression symptoms. Participation in the intervention was associated with significant improvements in all measured domains, where no significant changes on these measures were found for the control group.ConclusionsThis provides evidence in support of the feasibility and effectiveness of shorter self-guided mindfulness-based interventions. The limitations and implications of this study for clinical practice are discussed.     

Mortality-Related Differences and Changes in Episodic Memory Among the Oldest Old: Evidence From a Population-Based Sample of Nonagenarians

We examined cross-sectional differences and longitudinal changes in episodic memory performance related to impending death among a group of very old people, aged 90–101 years. Participants were assessed at 3 measurement points across a 6-year interval. Three groups were identified: those who survived the entire follow-up period (n =40), those who died before the first follow-up (n =44), and those who died after the first follow-up (n =14). Participants completed a battery of episodic memory tasks consisting of face recognition, word recognition, word recall, and object recall with selective reminding. Those who survived performed better than those who were going to die in object recall at baseline. A Cox regression analysis, controlling age, revealed that object recall performance was significantly related to subsequent mortality status. Longitudinal analyses demonstrated significant 3-year decline for both face recognition and object recall, but no evidence of differential decline as a function of mortality group. Thus, longitudinal changes in memory preceding death were not as pronounced as the corresponding cross-sectional differences in this very old sample. In general, the results suggest that mortality-related memory deficits are present in extreme old age, although these deficits are relatively small and task-specific.