环境中的风险认知特征

采用多维度的心理测量范式,研究公众在“影响程度”、“可控性”、“了解程度”、“影响的持续性”、“发生的可能性”、“结果的严重性”六个维度上对39个环境条目的风险认知特征。研究结果验证了“风险程度指标”,并将环境风险划分为“生态环境”“疾病与灾害”“生活环境”三个大类并探讨其风险认知特征。结果显示,由“客观认识”和“主动作用”两维度形成的认知地图可有效地指导风险沟通。     

If We Build It … Will They Come? – Establishing a Cancer Genetics Services Clinic for an Underserved Predominantly Latina Cohort

Background: Cancer genetic counseling and testing is a standard of care option for appropriate families and can identify individuals at increased risk prior to diagnosis, when prevention or detection strategies are most effective. Despite documented efficacy of cancer risk reduction in high-risk individuals, underserved and minority individuals have a disproportionate cancer burden and limited access to genetic counseling. Methods: A needs assessment survey documented gaps in knowledge and interest in prevention. Satellite clinics were established at two indigent healthcare systems. Cancer genetics CME lectures were conducted and referral guidelines disseminated to clinicians who referred patients for counseling. Results: An increase in clinician knowledge was demonstrated post-CME and reflected by quality referrals. Eighty-eight percent of patients kept their appointments. In the predominantly Latina⁶ (n=77) clinic population, 71.4% were affected with cancer, and 17 mutation positive families were identified. Preliminary data shows a positive impact on patients' motivation and behavior. The majority has expressed satisfaction and reduction in anxiety. Conclusions: This study demonstrates feasibility and acceptability of cancer genetics services in this population, suggesting the potential to reduce cancer morbidity in underserved, high-risk families.“Latino” is the most common census term for individuals of Spanish, Mexican, Central and South American, Cuban, or Puerto Rican descent, referring to ethnicity, and is generally considered a more ethnically/culturally based term for individuals of the aforementioned groups. As this cohort is female the feminine noun “Latina” is used     

The Effect of Genetic Counseling on Knowledge and Perceptions Regarding Risks for Breast Cancer

In 1994, a clinic for cancer risk counseling was opened at Hadassah University Hospital in Jerusalem. Most of the counselees have been women who had breast cancer and/or a relative with breast cancer. In order to evaluate the effect of this counseling on women's knowledge and perceptions regarding the risks for breast cancer, a questionnaire was given before and after the counseling session to 60 healthy women who came to the clinic because they have relatives with breast cancer. According to the genetic counselors' estimations, most of these women had a significantly increased risk (compared to the general population) of developing cancer. Before counseling, the women overestimated the population risk for breast cancer, the contribution of heredity to morbidity of cancer, and their own risks to get cancer. After counseling session, they gave reduced estimates, closer to the real ones. The subjective perceptions regarding these risks were reduced after counseling, except for the perceptions regarding their relativerisks which have not changed after the counseling. About 90% of the women who came to the clinic wanted to be tested for genetic predisposition to cancer. For most of these women, the expectations that the test can rule out a genetic predisposition to cancer became more realistic after the counseling. The option to first test an affected relative was offered to all families, and a test was actually conducted in 75% of the families.     

建立风险管理机制防范医疗纠纷的探讨

"医疗风险无处不在".针对医疗纠纷的起因及医疗风险管理的办法阐述了国内外医疗风险管理的现状,提出医疗风险管理的建议,使医疗风险管理规范化、制度化、社会化.     

Are fear-avoidance beliefs related to the inception of an episode of back pain? A prospective study

Abstract

Fear-avoidance beliefs and catastrophizing have been implicated in chronic pain and theoretical models have been developed that feature these factor in the transition from acute to chronic pain. However, little has been done to determine whether these factors occur in the general population or whether they arc associated with the inception of an episode of neck or back pain. The aim of this study was to evaluate prospectively the effects of fear-avoidance beliefs and catastrophizing on the development of an episode of self-reported pain and associated physical functioning. To achieve this, we selected a sample of 415 people from the general population who reported no spinal pain during the past year. At the pretest a battery of questionnaires was administered to assess beliefs about pain and activity and it featured the Pain Catastrophizing Scale and a modified version of the Fear-Avoidance Beliefs Questionnaire. One year later outcome was evaluated by self-reports of the occurrence of a pain episode as well as a self-administered physical function test. The results showed that scores on both fear-avoidme and cabstrophizing were quite low. During the one year follow-up, 19% of the sample suffered an episode of back pain. Those with scores above the median on fear-avoidance beliefs at the pretest had twice the risk of suffering an episode of back pain and a 1.7 times higher risk of lowered physical function at the follow-up. Catastrophizing was somewhat less salient, increasing the risk of pain or lowered function by 1.5. but with confidence intervals falling below unity. These data indicate that fear-avoidance beliefs may be involved at a very early pint in the development of pain and associated activity problems in people with back pain. Theoretically. our results support the idea that fear-avoidance beliefs may develop in an interaction with the experience of pain. Clinically, the results suggest that catastrophizing and particularly fear-avoidance beliefs are important in the development of a pain problem and might be of use in screening procedures.     

青少年抑郁情绪的发展轨迹:界定亚群组及其影响因素

本研究意在分性别考察中国青少年抑郁情绪的发展轨迹及其影响因素。785名男生和859名女生参加了3轮追踪研究,初始测量阶段的年龄跨度为10~16岁,平均年龄分别为12.99±1.84和12.96±1.87岁。采用流调中心抑郁量表(CES-D)简版测量青少年的抑郁情绪。模型拟合的结果显示男女生的抑郁情绪在10~19岁时段皆呈线性增长趋势,其中男生分为两个亚群组,人际关系解释了部分变异;女生分为4个亚群组,学业压力和人际关系均解释了部分变异。     

Stopping speech suppresses the task-irrelevant hand

Some situations require one to quickly stop an initiated response. Recent evidence suggests that rapid stopping engages a mechanism that has diffuse effects on the motor system. For example, stopping the hand dampens the excitability of the task-irrelevant leg. However, it is unclear whether this ‘global suppression’ could apply across wider motor modalities. Here we tested whether stopping speech leads to suppression of the task-irrelevant hand. We used Transcranial Magnetic Stimulation over the primary motor cortex with concurrent electromyography from the hand. We found that when speech was successfully stopped the motor evoked potential from the task-irrelevant hand was significantly reduced compared to when the participant failed to stop speaking, or responded on non stop signal trials, or compared to baseline. This shows that when speech is quickly stopped, there is a broad suppression across the motor system. This has implications for the neural basis of speech control and stuttering.     

Why Young Men Drive Dangerously: Implications for Injury Prevention

Why is risk consistently underestimated, and why do young men in particular take exceptionally high risks and think of themselves as invulnerable? Two explanatory paths are proposed. The first is that risk taking in young males has been shaped by evolutionary forces to provide a fitness value. The second pathway is through myth and the other narrative forms that affirm the ego's immortality and invulnerability. Because of its evolutionary base, risk taking is emotionally driven: Emotions are preverbal and irrational, which means that persuasive prevention cannot be more than weakly successful. Three prevention challenges emerge from this analysis: to determine what it is that young drivers fear, to attach affectively experienced fears to defined driving behaviors, and to devise injury-prevention programs that acknowledge that young males' risk taking is not "stupid," but driven by adaptive needs that are as significant to today's young adults as they were to our distant ancestors.     

Resilience in the Face of Maternal Psychopathology and Adverse Life Events

Maternal psychopathology has long been recognized as a risk factor for psychopathology in offspring; however, some resilient youth achieve a favorable outcome in the presence of maternal psychopathology. We identified factors that predicted resilience among youth who were exposed to adverse life events, and also examined whether the same factors protected youth against maternal psychopathology and adverse life events. Main and interaction effects of child and family factors were examined employing cross-sectional data from a household probability sample of 1285 youth aged 9 through 17 collected at four sites. On average, children exhibited a greater degree of resilience when they had higher IQ, closer parental monitoring, better family functioning, higher educational aspiration, and were female. Interaction between maternal psychopathology and IQ was significant, and there was a trend between maternal psychopathology and gender. A higher IQ is a protective factor against both maternal psychopathology and adverse life events; whereas being a girl seems to be a protective factor against maternal psychopathology, but not adverse life events.     

Visualizing the temporal dynamics of spatial information processing responsible for the Simon effect and its amplification by inhibition of return

Research has shown that the Simon effect is larger for targets suffering from inhibition of return (IOR). We used speed–accuracy trade-off (SAT) methodology to explore the temporal dynamics underlying this interaction. In Experiment 1, a new method for sorting the data was used to reveal a monotonic decay in the impact of task-irrelevant location information that is responsible for the Simon effect. In Experiment 2, we show that IOR delays both task-relevant identity and task-irrelevant location codes; a relatively longer delay for location than identity codes accounts for the effect of IOR on the Simon effect. When location information was made task-relevant in Experiment 3, IOR delayed the accumulation of this information by about the same amount as when location was irrelevant. The results suggest that IOR, therefore, has a greater effect on location than identity information.