降低医疗的二次伤害是医学人性化发展方向

医学是一种人性化的表达,然而,医学手段的伤害性特征也是现代医学本身无法回避的一个缺陷,忽视对医学技术本身的伤害性因素的认识,是当下医学人文衰退的一个重要原因,也是构建人性化医疗的一道障碍,面对越来越多的对医学伤害性的质疑,医学应该进行自我剖析,撕开医学手段的非人性化面纱,务必直面问题和解决问题,用医学的人性化关怀弥补医学手段的伤害性缺陷,并以医学技术本身的发展,促进医学向无伤害的人性化方向发展,这是现代医学发展的终极目标。     

片段弓矫治技术在前牙外伤中的应用

本文探讨片段弓矫治技术在前牙外伤中的应用效果。利用方丝弓矫治器对上前牙外伤68例患者（共89颗外伤牙,其中29颗松动Ⅱ度,51颗松动Ⅲ度,9颗完全脱位）进行复位、固定,并在治疗结束后半年、一年进行随诊观察。一年后固定成功率达到90％以上,患牙及颌骨复位精确,咬合关系恢复良好,并发症少。应用片段弓矫治技术治疗前牙外伤可获得良好的疗效,该技术安全可靠。     

An Examination of Disclosure of Nonsuicidal Self‐injury among University Students

Despite the widespread prevalence of nonsuicidal self‐injury (NSSI) among community‐based samples, little is known about which self‐injurers disclose their NSSI or the factors that promote disclosure among self‐injurers. To address this gap in the literature, we examined whether disclosers could be differentiated from nondisclosers on the basis of NSSI characteristics (e.g. frequency of NSSI and severity of NSSI), NSSI motivations (e.g. interpersonal and intrapersonal motivations) and psychosocial factors (e.g. suicidal ideation and self‐esteem). Participants consisted of a large sample of 268 self‐injuring undergraduate students (M_age = 19.07 years, 70.3% women) at a Canadian university. Results indicated that 57% of self‐injurers had never disclosed their NSSI to anyone. Self‐injurers were most likely to disclose to peers and romantic partners. Logistic regression analyses revealed that pain during NSSI, severity of NSSI, interpersonal motivations for engaging in NSSI, higher suicidal ideation and higher friendship quality were all associated with a greater likelihood of NSSI disclosure. Our findings suggest that individuals with severe NSSI and suicidal ideation may be more likely to disclose. Moreover, our findings underscore the importance of equipping friends and romantic partners with effective responses to NSSI disclosures to promote more formal help‐seeking behaviours among self‐injurers. Copyright © 2014 John Wiley & Sons, Ltd.     

Quantifying Supervisory Decision Making: Eye‐Tracking Technology Applications for the Promotion of Child Safety

Previous research has investigated various risk factors correlated with childhood injury, but few studies have successfully investigated these variables beyond participant self‐report. The present study utilized infrared eye‐tracking and computer‐based latency measures to evaluate caregiver supervision decisions in injury risk situations for typically developing children and children with autism spectrum disorder. The sample included 99 young women, ages 18–24 years, who are frequent non‐parental caregivers for children. Results indicated that participants altered their speed of response, child monitoring, and intervention decisions on the basis of idiosyncratic assessment of injury risk. Minimal significant differences emerged with regard to supervision behavior and chosen strategies when comparing children with autism spectrum disorder to typically developing children. Overall, results suggest that non‐parental caregivers integrate child characteristics and environmental risk factors when assessing risk and choosing interventions. Implications are discussed with regard to injury prevention programs emphasizing protective aspects of supervision for children across various settings. Copyright © 2015 John Wiley & Sons, Ltd.     

Generalizability of WISC-IV index and subtest score profiles in children with traumatic brain injury

The Wechsler Intelligence Scale for Children, 4th edition (WISC-IV) is often used to assess children with traumatic brain injury (TBI); although limited information is available regarding its psychometric properties in these children. Two recent reports suggest that the Perceptual Reasoning Index is not uniquely sensitive to TBI, which differs from the Perceptual Organization Index of the WISC-III. The current study examined WISC-IV profiles in two independently gathered samples of children with TBI. Examination of profiles indicated similarities between the current findings and those reported in other studies, in that the greatest deficits were present on the Processing Speed Index and its component subtests of Coding and Symbol Search, while the Perceptual Reasoning index score was comparable to the Verbal Comprehension Index. Also, no significant index or subtest score differences were present when the current sample was compared to the children with TBI reported by Allen, Thaler, Donohue and Mayfield (2010 Allen, D. N., Thaler, N. S., Donohue, B. and Mayfield, J. 2010. WISC-IV profiles in children with traumatic brain injury: Similarities to and differences from the WISC-III. Psychological Assessment, 22(1): 57–64. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). The present findings are consistent with two prior studies of the WISC-IV in children with TBI, providing additional evidence for profile differences between the WISC-III and WISC-IV. The results also suggest that WISC-IV profiles reported in prior studies are generalizable across TBI samples and study sites.     

Supportive psychotherapy of a psychodynamic orientation as an adjunctive treatment for drug-induced depression: A case study

Abstract

Treatment for drug-induced depression usually consists of cessation or reduction of the causative agent and psychopharmacologic management. In addition, psychotherapy can be useful as an adjunctive treatment. The author presents case material related to a young woman with an inborn physical illness, who became depressed during the course of interferon treatment for a medical complication, hepatitis virus infection. In addition to the cessation of interferon and pharmacologic management, supportive psychotherapy of a psychodynamic orientation was started in order to address the patient’s low self-esteem and anxiety about her future. During the course of psychotherapy, it was understood that the premature cessation of interferon was, to her, a narcissistic injury. It was also important to explore the meanings of her inborn illness and her guilty feelings. After reviewing various formulations of depression, the author discusses the case material from an integrative perspective, which describes vicious cycles of depression.     

Dimensionality of the Beck Anxiety Inventory in a Polytrauma Sample of OEF/OIF/OND Veterans: Findings From Exploratory and Confirmatory Factor Analysis

The Beck Anxiety Inventory (BAI) is commonly used as a screening instrument for symptoms of anxiety in clinical settings. The factor structure has been researched in a variety of different clinical settings with results ranging from a 2- to 5-factor structure. The purpose of this study was to explore the factor structure of this instrument in a polytrauma veteran sample. A sample of 304 veterans was used for this study. All subjects were administered the BAI screening measure as part of an evaluation in an outpatient polytrauma clinic. Exploratory factor analysis was conducted for half of the sample, followed by confirmatory factor analysis for the remaining sample to determine the best model. Factor analyses revealed that a 5-factor model provided a best fit. It is interesting to note that previously identified models of the BAI with other types of samples did not provide the best fit for this polytrauma sample. The BAI may provide additional information for clinicians when examining the 5-factor model with veterans in polytrauma settings. The factor structure of the BAI includes 1 factor (i.e., personal safety) that may be unique for veterans who have served in combat zones.     

Construct and Criterion Validity of the Comprehensive Trail Making Test in Children and Adolescents with Traumatic Brain Injury

The current study examined the construct and criterion validity of the Comprehensive Trail Making Test (CTMT) when used to evaluate children and adolescents with traumatic brain injury (TBI). Participants included 100 children and adolescents, 50 who had sustained TBI and 50 normal comparisons (NC). Analyses indicated that the CTMT factor scores were significantly correlated with tests of perceptual organizational ability, processing speed, and motor function and provided support for its construct validity. Additionally, correlations between the various CTMT scores suggested that a different pattern of associations was present in the TBI group compared to the NC group. Finally, the TBI group performed significantly worse (p < .001) on all of the CTMT scores, including each of the five CTMT trails as well as the factor and composite index scores. Results support the construct and criterion validity of the CTMT when used to assess children and adolescents with TBI.     

Recovery in Memory Function,and its Relationship to Academic Success,at 24 Months Following Pediatric TBI*

While a number of research papers have reported findings on memory deficits following traumatic brain injury (TBI), only limited studies have monitored the recovery of these skills over time. The present study examined memory ability and its effect on academic success in a group of children who had sustained a mild, moderate, or severe traumatic brain injury (TBI). Results showed that the severe TBI group exhibited greater deficits on memory tasks, irrespective of modality, in the acute, 6-, 12-, and 24-month postinjury stages, in comparison to mild and moderate TBI groups. Performance on academic measures was dependent on both injury severity and task demands. Preinjury academic ability and verbal memory indices best predicted academic success.