Religion and anxiety treatments in primary care patients

Earlier data suggested that religious physicians are less likely to refer to a psychiatrist or psychologist. This follow-up study measures how religious beliefs affect anxiety treatments in primary care. We surveyed US primary care physicians and psychiatrists using a vignette of a patient with anxiety symptoms. Physicians were asked how likely they were to recommend antianxiety medication, see the patient for counseling, refer to a psychiatrist, refer to a psychologist or licensed counselor, encourage meaningful relationships and activities, and encourage involvement in religious community. We experimentally varied symptom severity, whether the patient was Christian or Jewish, and whether she attended religious services. Physician attendance at religious services was assessed in the survey. The response rate was 896 out of 1427 primary care physicians and 312 out of 487 psychiatrists. Religious physicians were more likely to promote religious resources. There was no statistically significant difference between physicians' recommendations for religious and nonreligious patients. There was no statistically significant difference in religious and nonreligious physicians' referrals to a psychologist, licensed counselor, or psychiatrist. Ultimately, we did not find a difference in religious and nonreligious physicians' support for mental health referrals, however, religious physicians were more likely to encourage using religious resources.     

价值观的神经机制:另一种研究视角

神经机制分析是价值观研究的一种新视角.内稳态机制和情绪反应的固有模式可能体现出价值观的神经生物原型.社会认知神经科学试图从子价值观、价值取向、价值观结构等方面寻找价值观的神经实体证据,也对价值评价、价值决策等相关过程进行了神经活动分析.初步发现了个体价值观与部分脑区活动的相关关系,涉及前额叶-顶叶-颞叶神经网络带的众多大脑结构.未来研究可沿循静态的价值观结构和动态的价值观加工过程两条线路,整合和完善现有分散的神经生理研究,将有助于更系统地理解价值观的神经机制.     

Referrers' Perceived Utility and Outcomes of Clinical Neuropsychological Assessment in an Adolescent and Young Adult Public Mental Health Service

Despite frequent informal or anecdotal acknowledgement of the usefulness of neuropsychological services within various settings, including mental health settings, few studies have formally investigated the satisfaction, perceived utility, or outcomes associated with such a service. This survey‐based study evaluated referring clinicians’ (n = 35) perceptions of the usefulness and outcomes associated with the provision of clinical neuropsychological assessment and feedback within an adolescent and young adult public mental health service in Melbourne, Australia. The results suggest that referrers perceive the neuropsychological service, including formal neuropsychological assessment report and verbal and written feedbacks, as a highly useful adjunct to their clinical practice. In addition, referrers frequently reported clinically meaningful outcomes in association with the neuropsychological service, including diagnostic changes or additions (11% of clients referred), changes to approaches in treatment (52% of clients referred), and increased or appropriate access to services, education, or work (33% of clients referred). Referrers also reported that almost 60% of neuropsychological assessment reports were forwarded to other services or clinicians involved in the client's care. The findings suggest that mental health settings are likely to benefit from routine inclusion of specialist neuropsychology services. However, future research should also examine client and family perceptions regarding the satisfaction and usefulness of neuropsychological services.     

记忆再巩固的时间动态性及其生物学机制

记忆巩固需经觉醒状态下的信息编码和睡眠状态下的巩固阶段两个过程。记忆再巩固理论认为记忆巩固是一个需要多次反复巩固的过程,即使已巩固的记忆也会在提取激活后变得不稳定, 需经再巩固才能重返稳定状态, 此过程需要新的蛋白质的合成。记忆再巩固具有较强的时间特征, 发生在记忆巩固之后, 依赖于蛋白质降解的去稳定化阶段和依赖于蛋白质合成的记忆再稳定阶段, 所持续的时间窗为6 h。不同类型的记忆是否引发记忆再巩固或消退行为, 取决于提取试次暴露所持续时间的长短。     

表象预期调控生物运动性别信息的识别

生物运动系在运动的生物体身的关键节点安置12～15个光点的运动痕迹形成的动画。研究表明光点生物运动包含了丰富的社会性信息,其社会性信息的识别涉及多个心理活动过程,其中大脑自上而下的知觉调控过程发挥重要作用。本研究通过两个实验探讨了表象预期在大脑自上而下调控光点生物运动性别信息识别的作用。结果发现：（1）表象预期能够加快男性生物运动的性别识别速度;想象中性形象被试倾向于将性别中立的生物运动识别为中性,而较少为男性或者女性。（2）表象预期条件和无表象预期条件下性别中立的光点生物运动性别类型识别都表现出“男性偏差”现象。（3）反应类型能够影响生物运动的性别识别。本研究有利于揭示大脑自上而下调控光点生物运动性别信息识别的心理机制。     

若干实验室指标对糖尿病神经病变的预测意义

近年来,人们发现了一些实验室指标对糖尿病神经病变有一定预测意义,包括糖化血红蛋白、维生素B12、甲基丙二酸、全反钴胺素、同型半胱氨酸、氧化型低密度脂蛋白、甘油三酯、超敏C反应蛋白、肿瘤坏死因子α(TNF-α)、可溶性肿瘤坏死因子受体1、可溶性肿瘤坏死因子受体2等。这些指标对糖尿病神经病变的早期防治提供了帮助。     

致病性微生物耐药性严重化问题的思辨

致病性微生物耐药性严重化是一道世界性医学难题。微生物使出种种耐药的"招术",不只是其对药物作用的反应,更应看到是耐药内外因相互作用的结果,是其生物本性之使然。微生物的基本特性使其具备这种"能耐"。这些耐药性应存在一定的"原动机制",可以认定微生物的耐药性必然永远存在。人类社会必须构建长效的、与时俱进的防、抗致病微生物耐药性的卫生工作机制。     

综合医院精神医学问题的认识

综合医院精神医学问题涉及面较广,主要是指除精神病外的各种心理障碍与心理应激相关疾病。患者就诊主诉多样化,就诊医院或专科繁多。提高对综合医院精神医学问题的识别能力对临床各科医务人员非常重要。本文对综合医院常见器质性和功能性精神疾病的临床特点、识别处理作一概述。     

人体实验失范原因分析及对策

人体实验是一种特殊的交易活动.信息不完备与不对称、交易制度监督漏洞都使卫生研究机构在交易博弈中处于优势地位.集体机会主义行为是导致违规人体实验的重要因素.对违规人体实验的宽容在一定程度上怂恿了这种行为.从健全制度、完善法治、加强教育等方面提出了对策.     

The neural correlates of orienting to walking direction in 6‐month‐old infants: An ERP study

The ability to detect social signals represents a first step to enter our social world. Behavioral evidence has demonstrated that 6‐month‐old infants are able to orient their attention toward the position indicated by walking direction, showing faster orienting responses toward stimuli cued by the direction of motion than toward uncued stimuli. The present study investigated the neural mechanisms underpinning this attentional priming effect by using a spatial cueing paradigm and recording EEG (Geodesic System 128 channels) from 6‐month‐old infants. Infants were presented with a central point‐light walker followed by a single peripheral target. The target appeared randomly at a position either congruent or incongruent with the walking direction of the cue. We examined infants' target‐locked event‐related potential (ERP) responses and we used cortical source analysis to explore which brain regions gave rise to the ERP responses. The P1 component and saccade latencies toward the peripheral target were modulated by the congruency between the walking direction of the cue and the position of the target. Infants' saccade latencies were faster in response to targets appearing at congruent spatial locations. The P1 component was larger in response to congruent than to incongruent targets and a similar congruency effect was found with cortical source analysis in the parahippocampal gyrus and the anterior fusiform gyrus. Overall, these findings suggest that a type of biological motion like the one of a vertebrate walking on the legs can trigger covert orienting of attention in 6‐month‐old infants, enabling enhancement of neural activity related to visual processing of potentially relevant information as well as a facilitation of oculomotor responses to stimuli appearing at the attended location.