人文关怀：ICU不容忽视的问题

ICU挽救了大量重症患者的生命,但也让很多患者留下了痛苦的回忆,ICU内人文关怀的缺失是发生这种现象的重要原因。疾病及医疗护理行为、ICU的环境、失眠、生命尊严与求生欲望之间的矛盾都使患者产生痛苦,由此提出要从制度层面完善学科设置,明确学科定位,加强专科人才培养,合理配置人力资源,完善管理政策,技术层面要对患者进行有效的镇静、镇痛治疗,重视患者诉求,减少有创操作,开展ICU床旁早期活动和康复治疗,从心理层面建立友好的ICU环境,注重医护患沟通,从多角度实施临终关怀,帮助患者减少痛苦。     

PREGNANT WOMEN'S RECOLLECTIONS OF EARLY MATERNAL BONDING: ASSOCIATIONS WITH MATERNAL–FETAL ATTACHMENT AND BIRTH CHOICES

Recollections of own maternal care measured by parental bonding were found to be important in the pregnant woman's construction of herself as a mother. Although these recollections were studied with regard to various variables, there is a dearth of studies associated with pregnancy and childbirth. In this cross‐sectional study, 341 pregnant women were recruited. Measures included a Sociodemographics–Obstetric History Questionnaire; the Childbirth Choices Questionnaire (H. Preis, M. Gozlan, U. Dan, & Y. Benyamini, 2018); the Parental Bonding Instrument (G. Parker, H. Tupling, & L.B. Brown, 1979); a question regarding the planned presence of the woman's mother at delivery; and the Maternal‐Fetal Attachment Scale (M.S. Cranley, 1981). Parental recollections of Care were associated with fewer natural birth choices (hence, a more “medicalized” delivery), lower maternal–fetal attachment, and a wish for the mother's mother to be present at the birth. Parental recollections of Encouragement of Behavioral Freedom in childhood were associated with more natural choices regarding childbirth. In addition, women with higher scores on the parental bonding Denial of Autonomy factor reported stronger maternal–fetal attachment. Thus, early recollections of experiences with caregivers as manifested in parental bonding may be a possible influence on the transition to motherhood, and working through possible difficulties associated with these recollections may improve adjustment to motherhood.     

Profile of cognitive deficits and associations with depressive symptoms and intelligence in chronic early‐onset schizophrenia patients

Cognitive deficits in several domains have been demonstrated in early‐onset schizophrenia patients but their profile and relation to depressive symptoms and intelligence need further characterization. The purpose was to characterize the profile of cognitive deficits in chronic, early‐onset schizophrenia patients, assess the potential associations with depressive symptom severity, and examine whether cognitive deficits within several domains reflect intelligence impairments. This study compared attention, visual‐construction, aspects of visual and verbal memory, and executive functions in chronic, early‐onset schizophrenia patients (mean age = 20.7 years) (N = 18) and healthy controls (N = 38). Schizophrenia diagnoses were established at the time of the patients' first clinical presentation during childhood or adolescence and were confirmed five years later. In the chronic phase of early‐onset schizophrenia, significant deficits were observed in all specific cognitive functions. The profile of cognitive deficits was jagged, and visual‐construction, attention, and one aspect of verbal memory (verbal stories recall) were differentially impaired. Deficits of visual recall, visual recognition, and executive functions were accounted for by deficits in intelligence, while this was not the case for deficits of verbal recall of stories or attention. No significant associations were observed between the severity of cognitive deficits and that of depressive symptoms. Chronic, early‐onset schizophrenia is characterized by a broad and jagged profile of cognitive deficits. Deficits of attention and verbal recall of stories appear not to be accounted for by deficits in intelligence, and the severity of cognitive deficits seems independent from that of depressive symptoms     

The Bonds that Remind Us: Maternal Reminiscing for Bonding Purposes in Relation to Children's Perceived Competence and Social Acceptance

The present study investigated the relation between characteristics of mother–child reminiscing and children's perceived competence and social acceptance. We focused specifically on conversations for bonding purposes (i.e., conversations that serve the function of maintaining or strengthening the relationship between the child and the mother) as bonding may be a particularly salient context for the development of self‐views. Fifty‐two mothers and their 4‐year‐old children engaged in a past‐talk conversation where mothers were instructed to try to bond with their children. Children's perceived cognitive and physical competence and maternal and peer acceptance, along with language, were measured. Our results indicated that characteristics of maternal talk, particularly maternal support of child's autonomy and child‐centred content, were strongly related to children's perceived social acceptance. Although weaker, there were also associations between maternal talk and children's perceived competence. Results are discussed in light of theories arguing in favour of parent–child discourse as a mechanism for self‐development. Copyright © 2014 John Wiley & Sons, Ltd.     

Early drinking onset: A study of prevalence and determinants among 13‐year‐old adolescents in Norway

Early drinking onset is associated with different psychosocial adjustment problems among adolescents. The aim of this study was to assess determinants associated with early drinking and to identify factors predicting early drinking onset among adolescents. The study included 1,550 eighth‐graders with a mean age of 13.5 years from 41 schools. A total of 24% (boys 29%, girls 19%) had ever drunk alcohol, while 14% had drunk some alcohol in the last 30 days. Further, early drinking was associated with gender, religion, school performance, smoking and bullying in the bivariate tests. Predictors of early drinking onset were identified by generalized linear mixed models with two multivariable models created. The first model included social and environmental variables. Entering intentions, expectancies, attitudes and norms into the multivariable analysis resulted in a significant improvement of the model fit constituting 86% in the second model. The percentage correctly classified those (56%) who had been drinking in the second model which was two times higher compared to the first model. Gender, religion and smoking emerged as significant predictors of drinking in both models.     

特殊类型的无骨折脱位型颈髓损伤治疗分析

为了探讨多节段后纵韧带骨化伴颈椎间盘突出的无骨折脱位型颈髓损伤的治疗,回顾了本院收治的4例多节段后纵韧带骨化伴颈椎间盘突出的无骨折脱位型颈髓损伤患者的临床资料,并结合相关文献报道进行分析。结果显示,4例患者均早期行前后路联合手术椎管减压,3例患者行预防性气管切开,4例患者术后随访时间6个月～48个月,平均随访24个月。固定节段均获骨性融合,内固定物无松动、断裂;后路手术无再关门现象。术后神经功能评价按Frankel分级,均有1个～2个级别恢复,术前A级2例,B级2例;术后B级2例,C级1例,D级1例。提示对于多节段后纵韧带骨化伴颈椎间盘突出的无骨折脱位型颈髓损伤早期行前后路联合手术减压;预防性气管切开可获得良好的治疗结果。     

Enrichment in Pre-Kindergarten Life Predicts Initiation of Cigarette Smoking in Asian American and Hispanic/Latino Adolescents

The risk of tobacco use during adolescence may be traced back to early childhood, the time when a child is most vulnerable to environmental influence. We examined daily-life enrichment during pre-kindergarten period as a predictor of initiation of cigarette smoking among Asian American and Hispanic/Latino children during adolescence. Survey data were collected from students in grades seven to nine in California. Among the 2,719 participants who completed the survey, 37% were Asian American and 44% were Hispanic/Latino. Five aspects of childhood life before kindergarten were assessed, including having lots of toys for the child, parents' read to the child often, having a plenty of good food for the child, bringing the child to travel, and parents spending adequate time with the child. Findings from our research indicate that children with more enriched early childhood are less likely to start smoking during adolescence. Consequently, enhancing daily life during early childhood may represent a new strategy for adolescent smoking prevention.     

小学低年级儿童的计算流畅性与数学焦虑:基于变量为中心与个体为中心的分析

为考察计算流畅性对小学低年级儿童数学焦虑的影响及作用机制,对592名小学二年级儿童的计算流畅性、数学学习兴趣、教师支持和数学焦虑进行测查。结果发现:(1)计算流畅性不仅通过数学学习兴趣间接影响数学焦虑,也可通过数学学习兴趣进而通过教师支持间接影响数学焦虑;(2)对计算流畅性和数学学习兴趣得分进行潜剖面分析,可将儿童区分为三种类型:低能力-低兴趣型、高能力-高兴趣型和低能力-高兴趣型;(3)低能力-低兴趣型儿童的数学焦虑得分显著高于其他两类,而低能力-高兴趣型和高能力-高兴趣型儿童的数学焦虑得分则无显著差异。上述结果表明计算流畅性、数学学习兴趣和教师支持在预防和干预小学低年级儿童的数学焦虑中具有重要作用。     

Childhood Domestic Violence Exposure among a Community Sample of Adult Perpetrators: What Mediates the Connection?

The association between childhood exposure to domestic violence and later intimate partner violence (IPV) perpetration in adulthood has been well established in the literature. However, the literature examining the factors of exposure that contribute to perpetration in adulthood is fraught with mixed findings, with some studies finding a direct link between childhood domestic violence exposure and later IPV perpetration and others ruling out a link after controlling for other contextual barriers such as community violence and socioeconomic status. This study examined 124 non-treatment-seeking and unadjudicated adult male IPV perpetrators and found exposure to domestic violence in childhood contributes to the normalization of violence, which could predict future adult IPV perpetration. Practice implications are discussed, namely primary and secondary prevention of intimate partner violence.