People and objects affect the quality of vocalizations in infants with down syndrome

The vocalizations of eight infants with Down syndrome were recorded longitudinally in relation to different social and non-social contexts. The infants were observed biweekly from 8 to 24 weeks and monthly up to 40 weeks. At each visit the infants were presented with their mother, a female stranger, and a rattle puppet, each alternately active and passive. Each condition lasted 60 sec. The results showed that by 4 months of age, the infants produced different types of vocal sounds in relation to environmental contexts. They produced significantly more melodic (speechlike) sounds, vocalic (non-speechlike) sounds, and emotional (crying, laughing and fussing) sounds when facing people than objects. By 6 months of age, these utterances began to be distinguished between mother and female stranger and active and passive adults. However, within the communicative context the overall amount of vocalic (non-speechlike) sounds produced was larger than the amount of melodic (speechlike) sounds. It is suggested that this low output of melodic sounds in the overall vocal production of these infants may adversely affect the development of more appropriate vocal behaviour.     

Symptom patterns in late luteal-phase dysphoric disorder

The symptom patterns of 180 women with prospectively confirmed late luteal-phase dysphoric disorder (LLPDD) were examined using a careful application of factor and cluster analytic techniques. Factor analysis of premenstrual change scores on 33 common premenstrual syndrome symptoms yielded four orthogonal factors that were consistent across two sets of menstrual cycle data. These were a negative affect dimension with concomitant behavioral changes, physical symptoms, agitation, and positive arousal. Cluster analysis of factor scores grouped patients into one of five symptom patterns, the most common of which is a general distress cluster, characterized by symptoms across all dimensions. The LLPDD symptom groups identified are remarkably consistent with those of earlier studies using both normative and clinic samples, and consideration of symptom pattern differences in future research may greatly increase our understanding of this disorder.     

The psychology behind the masks: Psychological responses to the severe acute respiratory syndrome outbreak in different regions

Severe acute respiratory syndrome (SARS) was first reported in China, and spread to 29 regions, affecting over 8000 people worldwide. For the general public, the psychological impact of SARS may have been greater than the physical health danger of the disease. The present paper proposes the influence of psychological factors on people's cognitive, affective, and behavioral responses during the SARS outbreak. The various papers in this special issue of the Journal reveal how people have reacted during the SARS outbreak: People's general coping styles may be related to their health behavior during the outbreak. Cultural differences were evident in the perception of SARS, and individuals' perceptual styles may have influenced their ability to cope with the outbreak. The way in which individuals coped with SARS-related stressful events was different from their usual practices of managing daily stress. Individual differences in the adoption of preventive measures were related to the distinct susceptibility to several social-cognitive biases.     

Optimism across cultures: In response to the severe acute respiratory syndrome outbreak

Based on our early research, we predicted that the Chinese may be more optimistic and less pessimistic than North Americans in response to negative life events. A survey was conducted to investigate optimism cross culturally in the context of the severe acute respiratory syndrome (SARS) outbreaks in Canada and China. Chinese students in Beijing and European Canadians in Toronto answered questions about their perceptions of SARS. No significant cultural difference was found on dispositional optimism, as measured by the Revised Life Orientation Test (LOT-R). Unrealistic optimism was measured in the context of SARS. Both groups demonstrated unrealistic optimism (i.e. reporting that the self was less likely than an average person to get infected with SARS). Such optimistic bias was stronger among Chinese than among Canadians. Compared to the actual infection rates in Beijing and Toronto, both Chinese and Canadian participants overestimated their own chances of getting infected, indicating that they were being pessimistic. Indeed, Chinese were less pessimistic than Canadians. In addition, even though the Chinese reported more inconvenience brought by SARS than did Canadians, they also reported more positive changes brought by SARS, reflecting the Chinese dialectical views of events. Implications for research on optimism in context are discussed.     

Cognitive behavioural treatment for chronic fatigue syndrome in a rehabilitation setting: effectiveness and predictors of outcome

Cognitive behavioural therapy (CBT) was combined with graded exercise therapy (GET) for patients with chronic fatigue syndrome (CFS) in an uncontrolled implementation study of an inpatient multidisciplinary group therapy. During the intake procedure, 160 CFS patients completed a questionnaire on fatigue related measurements, physical impairment, depression, somatic and psychological attributions, somatic focus, and sense of control over symptoms. Pre-treatment physical activity level was measured with an actometer. At baseline, post-treatment and 6-month follow-up individual strength, subjective fatigue and physical impairment, were reassessed. Large effect sizes were found on subjective fatigue (1.2 post-treatment; 1.2 follow-up) and physical impairment (−.9 post-treatment; −.9 follow-up), Clinically significant improvement was found in 33.8% of the participants at post-treatment and 30.6% at follow-up. Individual strength at post-treatment was predicted by level of physical activity before treatment, and by sense of control over symptoms and physical activity at follow-up. Clinically significant improvement in subjective fatigue was predicted by not receiving a disablement insurance benefit, shorter duration of fatigue, higher sense of control over symptoms and, at follow-up by more pre-treatment physical activity. In conclusion, the intervention was effective for CFS patients. Cognitive behavioural factors that perpetuate fatigue symptoms are also predictors of treatment outcome.     

难治性肾病综合征典型病例的临床决策

难治性肾病综合征在肾内科临床实践中并不少见,其主要治疗是联合应用激素和细胞毒药物（如环磷酰胺、环孢素等）。少数患者,经以上联合治疗后仍不能达到临床缓解。而对于这些患者,长期使用激素及细胞毒药物不仅不能取得满意的效果,而且可能出现严重感染等并发症,甚至危及患者的生命,故在临床中应权衡利弊进行治疗决策。     

肠道菌群与代谢综合征

人类肠道内定植着大量的微生物,肠道菌群通过多种机制参与机体的能量代谢,影响着宿主食物向能量的转化,对宿主的健康有着重要作用,因此,可以将肠道菌群看作是具有多种调节功能的“体外器官”。近年来研究的结果提示人类胃肠道菌群的改变参与了肥胖及胰岛素抵抗的发生。本综述旨在探讨肠道正常菌群与代谢综合征的关系。     

直立位机械通气可行性的探讨

机械通气是治疗急性肺损伤／急性呼吸窘迫综合征（ALI／ARDS）的重要措施之一,本文从理论上探讨直立位机械通气的可行性,推测其可能的机制,与肺保护通气策略的关系,尚需要解决的问题,以期证明优于传统机械通气方式。     

The Monkey as a Psychological Subject

Many species in long-term captivity have tried to kill time by playing friendly games with their warders. In the end, only rhesus monkeys (Macaca mulatta) could tolerate the tedious hide-and-seek games that their human jailers prefer to play. In this article, written many years before the Stockholm syndrome was first described, the author relates how it was eventually discovered which species is most willing to contribute to the development of a genuinely scientific human psychology. Harry F. Harlow died in 1981 and Dr. Frank C.P. van der Horst (fhorst@fsw.leidenuniv.nl) of Leiden University stands as the person to addess correspondence to.

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What I Wish I Knew Then...Reflections from Personal Experiences in Counseling about Down Syndrome

Sharing the news about a newborn baby’s diagnosis of Down syndrome with families is a scenario genetic counselors frequently face. Yet often we may feel uncomfortable or unsure how to best support families in this setting in a way that will foster competence and resilience. This commentary is a reflection of one genetic counselor’s experiences in counseling about Down syndrome over the course of her career and how her thinking has transitioned from a medical based model of disability to a more individual and family-focused model. Ideas and suggestions are offered that genetic counselors can incorporate into their practice.