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81.
Outcomes for cognitive-behaviour therapy (CBT) in randomised controlled trials (RCTs) have rarely been compared to those in routine clinical practice. Taking the case of CBT for chronic fatigue syndrome (CFS), we evaluated the results of a successful RCT against those of the same treatment given in the same setting as part of routine practice. Fatigue and social adjustment scores were compared for patients who received CBT for CFS as part of a RCT (N=30) and patients who received CBT as part of everyday clinical practice (N=384). The results in the RCT were superior to those in routine clinical practice. Between pre-treatment and 6-month follow-up, the RCT showed a larger reduction in fatigue and greater improvement in social adjustment than those in routine treatment. The changes in fatigue scores were similar for both groups during treatment but were greater in the RCT between post-treatment and follow-up. Potential reasons for the superior results of the RCT include patient selection, therapist factors and the use of a manualised treatment protocol. Practitioners need to pay particular attention to relapse prevention and ensuring adequate follow-up in addition to encouraging patients to continue with cognitive-behavioural strategies once treatment has ended. 相似文献
82.
Fragile X syndrome is primarily due to a CGG repeat expansion found in the FMR1 X-linked gene. In a previous study, we conducted
focus groups with women to assess their attitudes towards fragile X carrier screening. In this follow-up study, we conducted
in-depth interviews of general population reproductive-age women who were identified as carriers. We explored their attitudes
toward testing for carrier status of the fragile X mutation. These women underwent screening primarily to participate in a
research project rather than in search of a diagnosis for specific symptoms. As such, these women were wholly unprepared for
positive carrier results. Their responses about their results and carrier screening, in many cases, were being worked out
over the course of the interview itself. The most salient finding of this work is the apparent lack of relevance of carrier
status to these women. Many expressed that although the information could be relevant in the future, it is not relevant at
this stage of their lives in terms of family planning (either with respect to having unaffected offspring or to premature
ovarian failure) and personal relationships. Although issues of abortion seemed prominent in the focus groups, we found that
carrier status did not have an apparent effect on women’s attitudes about termination. We hypothesize this may be related
to the fact that women had not processed their new carrier status and had not related it to previously-formed personal opinions.
The findings of this work have significant implications for genetic counseling and population screening. Genetic counselors
should be mindful that general population women may not recognize the immediate importance of their carrier status even when
literature is provided and discussed prior to providing a sample. As part of comprehensive genetic counseling, counselors
should identify the reproductive life stage of the woman receiving the new information and help her identify when this information
would be more meaningful in her life. Counselors can assist in setting up a personalized road map with specific types of services
that will be more applicable to the woman as her carrier status becomes more relevant. 相似文献
83.
Ann Streissguth 《Journal of clinical psychology in medical settings》2007,14(2):81-101
Before alcohol was generally known to cause birth defects, NIAAA in 1974 began funding a population-based Seattle study on
alcohol use and pregnancy outcome. Women receiving prenatal care by mid-pregnancy were recruited (N = 1,529) and interviewed at home. Approximately 500 offspring exposed to a range of alcohol levels were examined on 11 occasions
between day 1 and 25 years. Neuropsychological and neurobehavioral performance measures are correlated with prenatal alcohol
dose, without substantial confounding by socio-demographic or rearing conditions, smoking, nutrition, or other drugs. Deficits
in attention, arithmetic skill, spatial-visual memory, and IQ, as well as increased alcohol problems and psychiatric disorders
are among offspring outcomes correlated at several ages with maternal drinking during and before pregnancy recognition. Findings
are not confined to women who believed they had alcohol problems. Not all exposed offspring appear affected. 相似文献
84.
唐氏综合征是智力低下最常见的原因,目前无法治愈。在传统功利主义生命价值观影响下,患者被主流社会忽视和歧视,其生存环境不容乐观。本文从价值多元论的角度探讨了对唐氏综合征患者进行人文关怀方面的依据,并就如何对唐氏综合征患者进行人文关怀提出建议。 相似文献
85.
为了探讨重症急性胰腺炎(SAP)并发急性呼吸窘迫综合征(ARDs)的危险因素,回顾性分析了我院76例SAP患者入ICU时的年龄、血糖、APACHEⅡ评分等17项指标,根据是否合并ARDS对各项指标进行单因素及多因素Logistic回归分析。单因素分析显示两组在年龄、呼吸频率、血糖、感染、APACHEⅡ评分、Ranson评分、CT评分、ICU住院日方面差异有显著性(P〈0.05),多因素Logistic回归分析显示年龄、血糖、感染、APACHEⅡ、Ranson、CT评分与SAP并发ARDS有关。故得出结论,年龄、血糖、感染、APACHEⅡ、Ranson与CT评分是SAP并发ARDS的独立危险因素。 相似文献
86.
机体对营养物质和病原体在长期的进化过程中形成相同的感应系统。病原体的入侵和营养物质的过剩均可造成免疫系统活化,从而发生代谢性炎症,继而出现代谢综合征,使得以糖尿病为代表的代谢性疾病发病日益增多。代谢性炎症是代谢和免疫相互作用的交叉点,因此阻断代谢性炎症对于预防和控制代谢性疾病具有重要意义。 相似文献
87.
Executive dysfunction is a characteristic impairment of individuals with Autism Spectrum Disorders (ASD). However whether such deficits are related to autism per se, or to associated intellectual disability is unclear. This paper examines executive functions in a group of children with ASD (N = 54, all IQ?70) in relation to a typically developing control group individually matched on the basis of age, gender, IQ and vocabulary. Significant impairments in the inhibition of prepotent responses (Stroop, Junior Hayling Test) and planning (Tower of London) were reported for children with ASD, with preserved performance for mental flexibility (Wisconsin Card Sorting Task) and generativity (Verbal Fluency). Atypical age-related patterns of performance were reported on tasks tapping response inhibition and self-monitoring for children with ASD compared to controls. The disparity between these and previous research findings are discussed. A multidimensional notion of executive functions is proposed, with difficulties in planning, the inhibition of prepotent responses and self-monitoring reflecting characteristic features of ASD that are independent of IQ and verbal ability, and relatively stable across the childhood years. 相似文献
88.
Previous studies indicated impaired magnocellular (M) and relatively spared parvocellular (P) visual pathway functioning in patients with fragile X syndrome. In this study, we assessed M and P pathways in 22 female fragile X premutation carriers with normal intelligence and in 20 healthy non-carrier controls. Testing procedure included visual contrast sensitivity and vernier threshold measurements. Results revealed that carriers were selectively impaired on tests of M pathways (low spatial/high temporal frequency contrast sensitivity and frequency-doubling vernier), whereas they showed intact performance on P pathway tests. These results suggest that the deficit of the M pathway is an endophenotype of fragile X syndrome. 相似文献
89.
Limb apraxia is a neurological disorder of higher cognitive function characterized by an inability to perform purposeful skilled
movements and not attributable to an elementary sensorimotor dysfunction or comprehension difficulty. Corticobasal Syndrome
(CBS) is an akinetic rigid syndrome with asymmetric onset and progression with at least one basal ganglia feature (rigidity,
limb dystonia or myoclonus) and one cortical feature (limb apraxia, alien hand syndrome or cortical sensory loss). Even though
limb apraxia is highly prevalent in CBS (70–80%), very few studies have examined the performance of CBS patients on praxis
measures in detail. This review aims to (1) briefly summarize the clinical, neuroanatomical and pathological findings in CBS,
(2) briefly outline what limb apraxia is and how it is assessed, (3) to comprehensively review the literature on limb apraxia
in CBS to date and (4) to briefly summarize the literature on other forms of apraxia, such as limb-kinetic apraxia and buccofacial
apraxia. Overall, the goal of the review is to bring a model-based perspective to the findings available in the literature
to date on limb apraxia in CBS. 相似文献
90.
Stl Bjrkly 《Aggression and violent behavior》2009,14(5):306-312
The main purpose of this article is to delineate findings from a review of the literature on the empirical basis for the existence of a relationship between Asperger's syndrome (AS) and violence risk. A second aim is to examine whether certain characteristics of the disorder may have a higher violence-triggering potential. Results of this review show that there are very few empirical studies that confirm a stable link between AS and violence. Only 11 studies involving 22 patients and 29 violent incidents met the criteria for inclusion in the review after the search of the literature. However, a qualitative analysis of the studies yielded some indications of possible patterns of dynamics of violence that may prove to be typical of persons with AS. A tentative comparison of AS and psychopathy indicated that there may be qualitative differences in the characteristics of violent behavior between the disorders. Suggestions for further research are presented. 相似文献