食管裂孔疝的外科治疗进展

食管裂孔疝即腹腔内脏器经食管裂孔疝入胸腔,并引发烧心、反酸等消化道及其他非消化道症状。按其解剖及临床表现可分为四型。通过病史采集、体格检查及一系列客观检查可以明确食管裂孔疝的诊断、分型及疾病进展程度。食管裂孔滑动疝并发反流、食管裂孔旁疝合并明显症状、混合型及多器官型食管裂孔疝或内科治疗效果不佳的通常应优先考虑手术治疗,以消除疝形成的因素,控制胃食管反流。食管裂孔疝手术目前通常采取腹腔镜下疝修补、补片加强及胃底折叠术,同时也存在食管延长、胃固定等其他替代术式。围手术期通过积极地控制风险因素,有助于降低各类术中、术后并发症风险及复发率。对复发、儿童及肥胖等特殊患者,也应视患者条件积极实施手术治疗。随着研究的进一步深入,食管裂孔疝手术在手术入路、补片材料、复发及并发症控制、日间手术模式应用等方面将取得更大的进展。     

Problematic,absent and stigmatizing diagnoses in current mental disorders classifications: Results from the WHO-WPA and WHO-IUPsyS Global Surveys

This study examined English- and Spanish-speaking psychologists’ and psychiatrists’ opinions regarding problematic, absent and stigmatizing diagnoses in current mental disorders classifications (ICD-10 and DSM-IV), and their perceived need for a national classification of mental disorders. Answers to open-ended questions included in WHO-WPA and WHO-IUPsyS surveys were examined using an inductive content-analysis method. A total of 3,222 participants from 35 countries were included. The most problematic diagnostic group was personality disorders, especially among psychiatrists, because of poor validity and lack of specificity. Complex posttraumatic stress disorder was the most frequent diagnosis suggested for inclusion, mainly by psychologists, to better account for the distinct processes and consequences of complex trauma. Schizophrenia was the diagnosis most frequently identified as stigmatizing, particularly by psychiatrists, due to lack of public understanding or knowledge about the diagnosis. Of the 14.4% of participants who perceived a need for a national classification system, two-thirds were from Africa or Latin America. The rationales provided were that mental disorders classifications should consider cultural and socio-historical diversity in the expression of psychopathology, differences in the perception of what is and is not pathological in different nations, and the existence of culture-bound syndromes. Implications for ICD-11 development and dissemination are discussed.     

The “impact factor style of thinking”: A new theoretical framework

Over the last few years, university policy in developed countries has placed too much emphasis on assessing publications on the basis of the impact factor. Any scientific material that has not been published in a journal indexed in the Journal Citation Reports is academically irrelevant. Hence, researchers strive hard to publish in such journals. Failure to achieve this means not having a successful career or receiving any academic recognition. A thorough analysis of the effects of this phenomenon on the researcher community leads to the conclusion that the overestimation of the impact factor is likely to cause disappointment among many researchers. Researchers only have two options: adopting a politically correct behavior, that is, following the “impact factor style of thinking”, or accepting the futility of their research regardless of its relevance. This is an example of the involvement of university policy habitus obsessed impact index. O policy impact index is accepted, or is doomed to academic ostracism, and exclusion from participation in all university policy.     

管理者核心自我评价对下属组织公民行为的影响：道德式领导和集体主义导向的作用

采用配对问卷调查法, 以150位管理者和464位下属为研究对象, 考察了管理者核心自我评价对下属组织指向和人际指向公民行为的影响以及道德式领导和下属集体主义导向在其中的作用。跨层次分析结果表明：管理者核心自我评价对下属公民行为有显著正向影响; 道德式领导在管理者核心自我评价与下属公民行为关系中有中介作用; 下属集体主义导向在道德式领导与公民行为关系中具有调节作用, 表现为道德式领导对公民行为的正向影响对高集体主义导向的员工来说更明显。文章揭示了管理者核心自我评价对下属公民行为的影响效果、内在机制和作用条件, 也在一定程度上支持了领导有效性研究的特质-行为整合视角模型。     

大学生学习适应量表的编制

对当代大学生学习适应问题进行了深入分析,在有关研究的基础上,探讨了当代大学生学习适应的主要因素,并编制一套适合当代大学生学习适应的测验。对四类院校918名大学生进行了施测,对调查数据进行了探索性因素分析和验证性因素分析。探索性因素分析结果表明,大学生学习适应的主要因素包括学习动机、教学模式、学习能力、学习态度、环境因素等5个方面;验证性因素分析结果表明,所提取的5个因素与构想模型拟合较好,测验具有较好的信、效度     

中青年脑卒中患者创伤后成长质性研究

为深入了解中青年脑卒中患者创伤后成长的真实体验,运用现象学研究方法,选取10例受访者进行深度面对面半结构化访谈,访谈资料采用Colaizzi现象学分析法进行整理分析。提炼主题可归纳为中青年经历脑卒中后的心理痛苦、中青年患者创伤后成长促进因素及中青年患者创伤后成长体验三个部分。中青年脑卒中患者存在创伤后成长这一积极心理体验,为临床心理护理干预提供新的切入点。临床医护人员应关注患者早期创伤反应及压力源,从促进因素入手,激发中青年患者的潜能和力量,充分利用其心理资源以达到身心适宜的状态。     

Exercise as a coping strategy and its impact on the psychological well-being of Japanese community-dwelling older adults during the COVID-19 pandemic: A longitudinal study

This study aimed to examine the prevalence of exercise as a coping strategy among Japanese community-dwelling older adults and its impact on their psychological well-being during the COVID-19 pandemic. In October 2019 (baseline [BL]), 720 community-dwelling older adults living in an urban area in Japan participated in a comprehensive health survey. Of these, 618 responded to a mail survey (follow-up [FL]) in June 2020, after the first state of emergency was lifted. Their psychological well-being was assessed using the WHO-5 Well-Being Index (WHO-5). Exercise as a coping strategy during the stay-at-home period was determined at FL by asking respondents whether they had engaged in 1) walking and 2) at-home exercise and strength training to maintain their physical and mental health. Each type of exercise’s impact and the effective exercise combinations were examined. Time and group interaction effects on the WHO-5 scores were investigated using a two-way analysis of covariance. Of the final sample, 65.1% engaged in walking. The WHO-5 mean scores at BL and FL were 16.7 and 15.4 for the walking group and 16.7 and 14.5 for the non-walking group, respectively; interaction for time and group was significant. Additionally, 56.4% of the participants engaged home training. The WHO-5 mean score at BL and FL were 17.5 and 15.5 for the home training group and 15.7 and 14.5 for the no home training group, respectively; there was no significant interaction. Older adults who engaged in both walking and home training received higher score on the WHO-5 than those who engaged in only one activity at FL. The decline in psychological well-being was most attenuated in the walking only group compared to the at-home exercise and strength training groups. Exercise as a coping strategy during the stay-at-home period was associated with psychological well-being, with different impacts observed depending on the type of activity.     

母亲元情绪理念与学前儿童社会适应的相互作用关系

采用追踪设计对438名学前儿童母亲进行问卷调查研究,主要探讨了母亲元情绪理念与学前儿童社会适应的相互作用关系。交叉滞后分析结果表明：（1）相邻两次测量的母亲各元情绪理念之间,社会适应各指标之间均具有中等程度的稳定性;（2）同一时间点的母亲各元情绪理念与儿童社会适应各指标之间均显著相关;（3）母亲元情绪理念与儿童社会适应之间部分存在着相互作用关系：控制了变量自身的连续性后,前测的母亲情绪教导显著正向预测后测的儿童敏感合作;前测的母亲情绪不干涉显著正向预测后测的儿童愤怒攻击、焦虑退缩行为;反过来,前测的儿童敏感合作能正向预测后测的母亲情绪教导,显著负向预测情绪不干涉、情绪摒除和情绪紊乱;前测的焦虑退缩能显著正向预测后测的母亲情绪摒除和情绪紊乱。