Lifetime Abuse and Mental Health Among Older Persons: A European Study

This study aimed to investigate the association of lifetime abuse and mental health among older persons, considering associated factors (e.g., demographics) through a cross-sectional design. We recruited 4,467 women and men ages 60–84 years from 7 European cities. Mental health was measured with the Hospital Anxiety and Depression Scale, and abuse (psychological, physical, sexual, financial, and physical injuries) based on the Revised Conflict Tactics Scale and the UK survey of abuse/neglect of older people. Multiple logistic regression analyses showed that country of residence, low educational level, and experienced financial strain increased the odds of probable cases of anxiety and depression. Female sex, white-collar profession, and financial support by social/other benefits/or partner income were associated with higher odds of anxiety, while older age and experience of lifetime injury were associated with increased odds of depressive symptoms. The findings of this study indicate that socioeconomic factors, as well as experienced lifetime severe physical abuse leading to injuries, are significant in perceived mental health of adults in later life.     

Inconsistencies in the Reporting of Perceived Trauma Severity Among Acute Physical Injury Survivors

This study aimed to identify and predict inconsistency in perceived trauma severity reports over time among trauma survivors. Hospitalized adult survivors of a traumatic injury completed trauma exposure assessments within 40 days post-injury and 6 weeks later (n = 77). The following trauma severity characteristics were examined: (1) threat of loss of life, (2) threat of loss of a body part, (3) threat of serious injury, and (4) peritraumatic emotionality. Potential predictors of inconsistency were also examined. About half of the reports regarding perceived trauma severity characteristics were inconsistent between the baseline to 6-week assessment. The inconsistent reports were mostly small and equally likely to be either more or less severe over time. Increases in posttraumatic stress disorder (PTSD; especially avoidance) predicted increases in severity of life threat and threat of loss of a body part. Thus, acute reports of perceived trauma severity vary and are influenced by PTSD symptoms.     

理清思路,预防喉返神经损伤

喉返神经损伤是甲状腺手术常见而严重的并发症.阐述了喉返神经的局部解剖及一些重要的解剖变异,分析了导致喉返神经损伤的一些常见原因,并运用唯物辩证法的观点提出了预防喉返神经损伤的一系列措施.     

Two Kinds of Brain Injury in Sport

Abstract

After years of skepticism and denials regarding the significance of concussions in sport, the issue is now front and center. This is fitting, given that the impact of concussions in sport is profound. Thus, it is with trepidation that one ventures to direct some attention onto brain injuries other than concussions incurred through sport. Given a closer look, however, it may be that considering various kinds of brain injuries, with different causes, will help us better understand the range and seriousness of brain injuries in sport. My focus is on emotional trauma in sport. I argue that severe emotional pathology is evidence of underlying brain injury. Any attempt to minimize the significance of emotional disturbance that results from emotional trauma as ‘merely’ psychological in nature is thus misguided.     

Role of cerebellum in fine speech control in childhood: persistent dysarthria after surgical treatment for posterior fossa tumour

Dysarthria following surgical resection of childhood posterior fossa tumour (PFT) is most commonly documented in a select group of participants with mutism in the acute recovery phase, thus limiting knowledge of post-operative prognosis for this population of children as a whole. Here we report on the speech characteristics of 13 cases seen long-term after surgical treatment for childhood PFT, unselected for the presence of post-operative mutism (mean time post-surgery = 6y10 m, range 1;4-12;6 years, two had post-operative mutism), and examine factors affecting outcome. Twenty-six age- and sex- matched healthy controls were recruited for comparison. Participants in both groups had speech assessments using detailed perceptual and acoustic methods. Over two-thirds of the group (69%) with removal of PFT had a profile of typically mild dysarthria. Prominent speech deficits included consonant imprecision, reduced rate, monopitch and monoloudness. We conclude that speech deficits may persist even up to 10 years post-surgery in participants who have not shown mutism in the acute phase. Of cases with unilateral lesions, poorer outcomes were associated with right cerebellar tumours compared to left, consistent with the notion based on adult data that speech is controlled by reciprocal right cerebellar/left frontal interactions. These results confirm the important role of the cerebellum in the control of fine speech movements in children.     

医学对急性呼吸窘迫综合征（ARDS）的认识

ARDS是一个临床综合征,其特征是炎症性肺水肿,严重的低氧血症,僵硬肺和弥漫性内皮和上皮损伤。既往50年中,特别是SARS在全球暴发以来,对ARDS病因、生理学、组织学和管理上有了重大的进展。然而,尽管围绕ARDS的研究显著增加,依然有许多重要问题亟待解决。     

Theory of Planned Behaviour, Skin Care and Pressure Sores Following Spinal Cord Injury

Objectives: To use the Theory of Planned Behaviour to explore factors associated with performing skin care behaviors and the occurrence of pressure sores in people with spinal cord injury. Design: A within-group cross-sectional design was used to assess 59 people with spinal cord injury living in the community. Of these, 17 participants returned a repeat assessment allowing a longitudinal examination of the relationship between intention and actual behaviour. Methods: A measure was developed in accordance with the Theory of Planned Behaviour guidelines through interviews with people with spinal cord injury. Measures of mood and knowledge of skin care behaviour were also included. Results: The Theory of Planned Behaviour components, mood and knowledge of skin behaviours predicted intention, skin care behaviour and occurrence of pressure sores. Knowledge of skin care was negatively correlated with occurrence of pressure sores (r=−.38, p < .01). Indirect perceived control was a particularly important predictor of pressure relief, accounting for 24% of the variance. Conclusions: Psychosocial factors, including the Theory of Planned Behaviour components, predicted skin care behaviours and the occurrence of pressure sores. These findings provide empirical support for the Theory of Planned Behaviour. The study also carries clinical implications for skin care education for people with SCI and their families.     

Social cure and social curse: Social identity resources and adjustment to acquired brain injury

There is increasing evidence that identification with social groups can protect and enhance health, establishing a kind of ‘social cure’. However, for those affected by chronic or disabling conditions such as acquired brain injury (ABI), their identity may also represent a burden, a form of ‘social curse’. The present study explored the identity benefits and burdens available to 15 participants living with ABI using semi-structured interviews. The qualitative data was then analysed systematically using thematic analysis. The findings highlight social identity changes as central to the experience of brain injury. Participants reported changes in their social networks and social group memberships after injury. Identity loss and reduced social support were described as disabling. Engagement in meaningful group activity with others affected by ABI and access to affected peers enabled new group-based resources such as social support. In this way, group activity can be seen as a form of identity enactment that can drive social cure effects. Similarly, adaptation to life after injury was demonstrably linked to social identity processes pointing to the importance of a social cure approach to rehabilitation.     

Family factors associated with self‐harm in adults: a systematic review

The aim of this study was to systematically review the literature pertaining to family dynamics in the adult self‐harming population. PsycINFO, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Applied Social Sciences Index and Abstracts (ASSIA) were searched for studies containing two keywords, one relating to self‐harm and the second relating to a family relationship. The final search was run on 4 August 2017. The electronic search yielded a total of 2,623 studies; 119 texts were selected for full review and twenty‐seven articles were included in the analysis. Thematic analysis was used to synthesize the results. Results indicated that insecure parental attachments, neglectful, overprotective, disempowering and abusive parenting were associated with self‐harm. Similarly, insecure attachments and abusive relationships with romantic partners were linked to self‐harm. Finally, self‐harm was found to be related to poor family functioning.     

“Staring into the abyss”: veterans’ accounts of moral injuries and spiritual challenges

The concept moral injury is receiving increased attention, especially as it pertains to military trauma. In war, service members may both observe and directly experience horrific events that one can scarcely prepare for. For some, this can result in a shattering of their assumptive world and loss of meaning. For those who are spiritually oriented, a spiritual or existential crisis may ensue. This qualitative study examines military related spiritual and moral wounds experienced by 23 veterans receiving services at a United States Veteran Administration Medical Center. In these first-person accounts, veterans provide insight into a variety of trauma-related struggles including guilt and shame, loss of trust and betrayal, the search for meaning and for the forgiveness of self and others, loneliness and withdrawal, anger, and negative changes in spiritual beliefs and practices. The findings support a call for additional trauma treatment options that address the spiritual and moral components.