血清Cys C的检测对肾移植术后患者肾功能评价的临床意义

探讨分析血清胱抑素C（Cys C）水平在肾移植术后患者肾功能监测中的应用价值.对25例肾移植成功患者在术前、术后第1、3、5、7、10天的血清Cys C、Scr、β2-MG、BUN水平进行动态监测,同时随机抽取健康体检者中的20例作为对照组.发现移植组的Cys C、Scr、β2-MG、BUN水平在术前均明显高于健康对照组（P＜0.01）.这四项指标在手术后第一天都有所下降,且术后第1、3、5、7、10天的水平都比术前低（P＜0.01）.四项指标与GFR的关系均为显著性负相关（P＜0.01）,其中血清Cys C与GFR的相关性最好.Cys C、Scr、β2-MG、BUN检测后的ROC曲线下面积分别是：0.937、0.838、0.798、0.772,其差异都具有统计学意义（P＜0.05）.血清Cys C优于Scr、β2-MG、BUN,在肾移植患者术后的动态监测中具有重要的临床应用价值.     

Anxiety,depression, and health-related quality of life in aging people living with HIV compared to diabetes patients and patients with minor health conditions: a longitudinal study

HIV infection has evolved from a fatal to a treatable condition, leading to an increase in the rate of elderly People Living with HIV (PLWH). However, little is known about the psychosocial burden of elderly PLWH. Thus, the aim of this longitudinal multi-center cohort study was to investigate whether elderly PLWH experience more anxiety and depression and reduced health related quality of life (HRQOL) compared to elderly patients with other chronic conditions. PLWH were compared to diabetes patients (DM) and patients with minor health conditions (MHC), e.g. patients with hypertension or allergic conditions. All patients were over 50 years old. Anxiety and depression (HADS) as well as HRQOL (SF-36) were assessed at baseline and after 12 months. 218 PLWH, 249 DM and 254 MHC were included. At baseline, the study groups did not differ in anxiety, depression, and physical HRQOL. However, PLWH indicated lower mental HRQOL than DM and MHC patients (p = 0.001). We did not obtain any moderating effects showing a differential effect of patient characteristics on anxiety, depression, and HRQOL in the three patient groups. At follow-up, the level of anxiety, depression, and HRQOL did not change significantly. The prevalence of anxiety ranged between 27 and 35%, and that of depression between 17 and 28%. Thus, the results of our investigation tentatively suggest that the psychosocial adaptation to HIV among elderly PLWH resembles those of other chronic diseases. There may be some subtle impairments, though, as PLWH experienced lower mental HRQOL.     

Body-image,quality of life and psychological distress: a comparison between kidney transplant patients and a matching healthy sample

The purpose of the current study was to assess the uniqueness of the condition of kidney transplant recipients in comparison to a sample of matching healthy peers in relation to body-image dissatisfaction and identification, quality of life and psychological distress. Participants were 45 kidney transplant recipients who were under follow-up care at a Transplant Unit of a major Medical Center, and a sample of 45 matching healthy peers. Measures were taken using self-report questionnaires [Body-Image Ideals Questionnaire (BIIQ), Body Identification Questionnaire (BIQ), Brief Symptoms Inventory (BSI), and the SF-12]. The major findings were the following: (i) kidney transplant recipients reported lower levels of quality of life and higher levels of PsD when compared to their healthy peers; (ii) no difference in body-image dissatisfaction was found between the two studied groups; (iii) significant correlations between body-image dissatisfaction quality of life and PsD were found only in the kidney transplant recipients. The kidney transplantation condition has a moderating effect in the association between body-image dissatisfaction PsD but not in the association between body-image dissatisfaction and quality of life; (iv) kidney transplant recipients experienced higher levels of body identification than did their healthy peers. Taken together, these findings highlight the unique condition of kidney transplant recipients, as well as the function that body-image plays within the self.     

Religion and Disability: Variation in Religious Service Attendance Rates for Children with Chronic Health Conditions

Prior research consistently demonstrates greater religious involvement is associated with improved health outcomes for those with chronic health conditions. Fewer studies focus on how chronic health conditions influence religious service attendance rates and most focus on older Americans. Using three waves of a nationally representative sample of children in the United States, I test whether children with a chronic health condition never attend religious worship services at rates significantly higher than children without a condition. I also investigate variation in attendance rates across a broad range of conditions, something previously overlooked. Children with chronic health conditions are more likely to never attend religious worship services. Specifically, children with chronic health conditions that impede communication and social interaction are most likely to never attend. Despite shifts in prevalence these findings are stable over time. Implications for researchers, religious communities, families with children with chronic health conditions, and health‐care providers are discussed.     

Emotions Know Best: The Advantage of Emotional versus Cognitive Responses to Failure

Making mistakes or failing at tasks is a common occurrence in human life. People can respond to and cope with failure in many ways. In this research, we examine potential advantages of relatively emotional (versus cognitive) responses to failure. In particular, we study how effort and time spent in subsequent tasks depend on whether people predominantly focus on their emotions or their cognitions as they respond to a failure. We demonstrate that, left to their own means, people's cognitions upon a failure are mainly justificatory in nature and thus do not automatically have the commonly believed reflective, self‐improving qualities. We further argue and demonstrate that a relative focus on cognitions following a failure can prevent improvement in subsequent episodes, but a focus on emotions can allow for learning and, therefore, increased effort. Copyright © 2017 John Wiley & Sons, Ltd.     

“Behave like a responsible adult” – Relation between social identity and psychosocial skills at stake in self-management of a chronic disease

We show that the development of psychosocial skills promoting self-management of a chronic disease is associated with the acquisition of a social identity valued in the ideological context of reference. To do this, we focus on a skill that is important for people suffering from a chronic disease to acquire: Assuming responsibility for self-managing one’s own pathology. Because acting responsibly is also a skill socially attributed to the identity of adults in Western liberal societies, we studied the chronically ill’s sense of belonging to the adult social group. In Study 1 (N = 102 diabetics), we suggested that behaving like a “responsible adult” in the self-management of a chronic disease is socially valued. In Study 2 (N = 261 diabetics), we suggested that identification with this group is associated with a feeling of responsibility promoting improved self-management behaviors. The results obtained from the two studies are consistent with our hypotheses. They allow us to conceptualize psychosocial skills through the identity, ideological and normative issues that underpin their development.     

Cumulative Adversity as a Correlate of Posttraumatic Growth: The Effects of Multiple Traumas,Discrimination, and Sexual Harassment

While trauma is, by definition, a necessary precursor of posttraumatic growth, other aspects of individuals’ life experiences affect their ability to cope with trauma, foster resilience, and grow following adversity. Most research on posttraumatic growth overlooks the accumulation of trauma and sub-trauma stressors as possible predictors of growth. In addition, most research on cumulative adversity omits all but the most extreme examples of discrimination and sexual harassment stressors. This exploratory study of 46 university students with trauma histories used measures of posttraumatic growth, trauma, major (sub-trauma) life events, chronic stressors, sexual harassment, and discrimination to examine the relationship between cumulative adversity and the development of posttraumatic growth. We found that cumulative adversity is positively correlated with posttraumatic growth, and that there are important relationships between gender, race, and cumulative adversity. A hypothesized curvilinear relationship between cumulative adversity and posttraumatic growth was not supported. These findings suggest that successfully coping with some amount of sub-trauma adversity may facilitate the development of posttraumatic growth. Additionally, sexual harassment and discrimination were closely linked to the number of chronic stressors; thus, they need to be included in measures of cumulative adversity to more fully represent the experiences of marginalized groups.     

Trauma-Focused CBT in the Context of Parental Chronic Medical Conditions: A Case Report

Parental chronic medical conditions (CMCs) are relatively common and have been shown to impact children’s psychosocial functioning. Previous research suggests that, for some youth, parental CMCs may be conceptualized as a form of traumatic stress. Trauma-focused cognitive behavioral therapy (TF-CBT) is a multicomponent, evidence-based intervention that is designed to reduce symptoms of posttraumatic stress, depression, and anxiety, as well as behavioral problems, among children and adolescents. Despite its robust empirical support, however, no known studies have utilized this treatment approach to address the mental health needs of youth affected by parental CMCs. The purpose of this article is to describe the application of TF-CBT to treat an adolescent male whose mother was diagnosed with a CMC, which had resulted in continuous family stressors since his birth. Results suggest that TF-CBT offers a promising approach for treating symptoms of posttraumatic stress, anxiety, and depression among children of parents with CMCs, and clinical trials to investigate its effectiveness among this population may be warranted.     

失败恐惧对大学生失败学习的影响：一个有调节的中介模型

基于保护动机理论,将经历失败事件的596名大学生作为研究对象,探讨失败恐惧对大学生失败学习的影响机制,分析保护性努力的中介效应与应对导向的调节效应。研究发现：（1）失败恐惧显著正向预测大学生失败学习;（2）保护性努力在失败恐惧与大学生失败学习间起部分中介效应;（3）应对导向在失败恐惧与保护性努力的关系中起调节效应,应对导向越高的大学生,其失败恐惧对保护性努力的正向影响越大。     

系统论视野下的心力衰竭与限钠利尿

综述心力衰竭时的神经、内分泌激活与血钠浓度的关系,血钠浓度在心力衰竭时的神经、内分泌的影响,并且运用系统论的观点重新认识心力衰竭与限钠利尿的关系,以便更好地处理这个治疗矛盾,打断心力衰竭发生发展的恶性循环,促使疾病向好的方向发展.同时,也为心力衰竭研究提出一种新思路和新的方法.