暴发性1型糖尿病：一种不可忽视的重症糖尿病

暴发性1型糖尿病以起病急骤、代谢紊乱严重、胰酶升高并缺乏糖尿病相关抗体为特征。本文回顾分析我院收治的3例暴发性l型糖尿病的临床资料并结合文献与经典1型糖尿病进行对比复习,以提高对该病的认识。3例患者平均病程5．3天,入院平均血糖27．8mmol／L,平均糖化血红蛋白（HbAlC）6．8％,平均空腹C肽0．043ng／ml,平均餐后2hC肽0．04ng／ml,平均胰岛素使用剂量0．50U／（kg·d）。随访6个月HbAlC平均值为7．5％,胰岛8细胞功能无改善。暴发性1型糖尿病较经典1型糖尿病有更严重的胰岛素缺乏、代谢紊乱,更强烈的免疫反应,预后较差。     

The Chronotype-Academic Performance Model (CAM): Daytime sleepiness and learning motivation link chronotype and school performance in adolescents

Many adolescents experience a discrepancy between their biological time, which is shifted toward eveningness, and early school starting times. Due to this social jetlag, eveningness is negatively correlated with school performance. On the basis of the here presented data, we derived a model for the association of chronotype and school performance, the Chronotype-Academic Performance Model (CAM), including daytime sleepiness and achievement motivation as mediating factors. The sample comprised N = 273 adolescents aged 14–16 years. Circadian preference, daytime sleepiness, learning and achievement motivation, and information about participants’ last school certificate were assessed online. Chronotype was not directly related to academic performance, but was mediated by daytime sleepiness and learning motivation. Morning-orientation was negatively associated with daytime sleepiness and positively with learning motivation, which, in turn, affected performance. In evening-types, we found the strongest association between sleepiness and refusal to work. The CAM suggests that chronotype may not directly influence academic performance, but be mediated by daytime sleepiness and learning motivation. Evening types seem to be at high risk to suffer from daytime sleepiness and to display dysfunctional attitudes toward work. Measures of reducing sleepiness and modifying attitudes toward academic achievement might attenuate the disadvantages of evening-types due to social jetlag.     

Examining posttraumatic growth among Japanese university students

Abstract

To determine the underlying factor structure of the Japanese version of the Posttraumatic Growth Inventory (PTGI-J), a principal components analysis was performed on data from 312 Japanese undergraduate students who reported growth due to their most traumatic event within the last 5 years. Results showed the PTGI-J has high internal consistency and, of the original five factors reported by Tedeschi and Calhoun (1996), three were replicated: Relating to Others, New Possibilities, Personal Strength, and a fourth factor integrating Spiritual Change and Appreciation of Life emerged. There were neither gender differences nor relationships with time since trauma. PTGI-J scores were positively associated with posttraumatic symptoms and correlated with type of traumatic event experienced. These results and future directions are discussed from a cross-cultural viewpoint.     

Emotional Reactions During and After Trauma: A Comparison of Trauma Types

Peri- and posttraumatic emotional responses have been understudied, and furthermore, have rarely been compared among trauma types. The current study compared college students' retrospective self-reports of peri- and posttraumatic responses of fear, shame, guilt, anger, and sadness among four types of traumatic events: sexual assault, physical assault, transportation accident, and illness/injury. Overall emotional responding was generally high for all trauma types, and for those in the sexual assault group, emotion increased sharply from the peri- to posttraumatic time point. Generally, fear was higher during the trauma compared to after the trauma, whereas the other emotions tended to remain stable or increase posttrauma. The sexual assault group tended to report higher levels of posttrauma emotion than the other trauma type groups.     

Analyzing the role of culture in shaping American childhood: A twentieth-century case

Widespread beliefs about the nature and functions of children change over time, and affect actual treatment of children within and without the family. Significant changes in beliefs about children developed in the United States from the 1920s onward, with emphasis both on emotional value and on weakness or vulnerability. Increased consumption of expert advice played a key role in this shift, along with cultural translation of new issues concerning child labor and schooling. Key changes occurred in all industrial societies, but American culture generated some distinctive features that continue to show up in the anxieties many parents harbor about children and their effort to intervene on their children's behalf.     

An exploratory assessment of theory of mind and psychological impairment in patients with bulimia nervosa

This study aimed to investigate psychosocial functioning and different dimensions of theory of mind (ToM) in people with bulimia nervosa (BN) and Eating Disorder Not Otherwise Specified‐BN type (EDNOS‐BN). Psychosocial functioning and ToM were assessed in a sample of young adult females, 16 BN and 16 EDNOS‐BN outpatients and 16 healthy controls (HCs). They were assessed using the Eating Disorder Inventory‐Symptom Checklist‐2 (EDI‐2 SC) for evaluating psychological traits associated with eating disorders; the Symptom Checklist‐90‐Revised (SCL‐90‐R) for evaluating psychopathological status; and the Theory of Mind Assessment Scale (Th.o.m.a.s.), a semi‐structured interview aimed at assessing a person's different dimensions of ToM. The BN and EDNOS‐BN groups exhibited worse performance than the control group on all dimensions of the SCL‐90‐R, and on all dimensions of the EDI‐2 SC. The only difference for perfectionism was that BN obtained higher scores than EDNOS‐BN group. Our results also revealed an impairment of third‐person and second‐order ToM in patients with bulimia (BN and EDNOS‐BN) with respect to control subjects. These preliminary data have important implications for future empirical work, in that they provide valuable information regarding the importance of investigating the various facets of ToM ability separately, in order to provide a more detailed profile of ToM functioning in the clinical samples.     

The effectiveness of a proactive coping intervention targeting self-management in diabetes patients

Objective: The study’s aim was to investigate psychological, behavioral and medical long-term outcomes of an existing self-management intervention targeting the development of proactive coping skills (e.g. goal setting and identifying barriers) in type 2 diabetes patients. The study aimed to replicate prior research showing the intervention’s effectiveness, and to extend it by (a) adding booster sessions and (b) prolonging the period of follow-up measurement to capture long-term effects.

Design/outcome measures: A total of 141 type 2 diabetes patients were included in the intervention. The intervention employed a 5-step approach to target proactive coping skills. Psychological (e.g. proactive coping and self-efficacy) and behavioural variables (e.g. self-care, diet and physical activity) were assessed at baseline (T1), after the initial phase of the intervention (T2), after the booster phase (T3) and at follow-up (T4), comprising a total period of 15 months. Medical variables were assessed at T1 and T4.

Results: Employing piecewise Latent Growth Curve Modelling, results showed that participants improved on all psychological and behavioural variables during the initial phase and maintained these improvements over 12 months. The booster phase yielded no further improvements. Mixed findings were obtained on medical outcomes.

Conclusion: The original intervention is effective, but the added value of the booster sessions is uncertain.     

The impact of a laryngectomy on the spouse: Who is better off?

Background: Diabetes self-care is a key element in the overall management of diabetes. However, the importance of psychosocial factors for successful disease management is under investigated. This study aimed at exploring the role of coping styles and social support in the relationship between self-care activities and glycated haemoglobin in patients with type 2 diabetes.

Methods: One hundred adults (60% female, aged 40–70 years) with type 2 diabetes completed questionnaires assessing self-care activities, coping styles and social support. In addition, a blood test was performed to obtain glycated haemoglobin levels.

Results: Result showed significant relationships of glycated haemoglobin with self-care activities, coping styles and social support. Regression analysis indicated that social support had a moderating role on the relationship between self-care activities and glycated haemoglobin, such that, at very high levels of social support the association, between Self-Care and HbA1c disappears.

Conclusions: Findings indicate that health care providers, within the context of the Iranian social and cultural situation, should pay more attention to psychosocial factors when addressing self-care activities. Delineation of the role of coping styles and social support might be useful for identifying patients in need of particular counselling and support for improving self-care activities and HbA1c levels.     

多阶段增长模型的方法比较

多阶段增长模型（Piecewise Growth Modeling,PGM）可以解决发展趋势中具有转折点的情形,并且相对其他复杂的曲线增长模型,解释更简单.已有的统计方法主要通过多层线性模型和潜变量增长模型对多阶段模型进行估计.通过模拟研究,用HLM6.0和Mplus6.0对上述两种模型分别进行估计,结果发现在参数估计的精度上,两种估计方法没有差异,只是在犯一类错误的概率上后者略小.进一步通过对错误模型的探讨发现,在样本量小（n=50）,斜率变化小（△b=0.2）时,用线性模型拟合数据而非PGM所犯错误概率较小,整体拟合更佳.但随着样本的增加和斜率变化的增加,错误模型的犯错概率明显增大.故在实际应用中,为了能更好拟合数据,研究者应根据数据本身的情况选择恰当的模型.     

Aging and Visual Short-term Memory: Effects of Object Type and Information Load

ABSTRACT

Previous research has observed that the size of age differences in short-term memory (STM) depends on the type of material to be remembered, but has not identified the mechanism underlying this pattern. The current study focused on visual STM and examined the contribution of information load, as estimated by the rate of visual search, to STM for two types of stimuli – meaningful and abstract objects. Results demonstrated higher information load and lower STM for abstract objects. Age differences were greater for abstract than meaningful objects in visual search, but not in STM. Nevertheless, older adults demonstrated a decreased capacity in visual STM for meaningful objects. Furthermore, in support of Salthouse's processing speed theory, controlling for search rates eliminated all differences in STM related to object type and age. The overall pattern of findings suggests that STM for visual objects is dependent upon processing rate, regardless of age or object type.