A Narrative Inquiry into a Female Athlete’s Experiences with Protracted Concussion Symptoms

This article explores a female university volleyball student-athlete’s experience with protracted concussion symptoms. Through the methodology of narrative inquiry, four salient themes became apparent related to Daphnée’s experiences: (a) “I felt so alone,” (b) “I had to make one of the hardest decisions of my life,” (c) “I feel like I’m in prison,” and (d) “There’s no light at the end of the tunnel.” Overall, this study offers a rare look into the impact of concussion on an individual’s athletic and academic identities, career progression, and in turn, her imagined stories of who she was and who she was becoming.     

Motor imagery in spinal cord injured people is modulated by somatotopic coding,perspective taking,and post‐lesional chronic pain

Motor imagery (MI) allows one to mentally represent an action without necessarily performing it. Importantly, however, MI is profoundly influenced by the ability to actually execute actions, as demonstrated by the impairment of this ability as a consequence of lesions in motor cortices, limb amputations, movement limiting chronic pain, and spinal cord injury. Understanding MI and its deficits in patients with motor limitations is fundamentally important as development of some brain–computer interfaces and daily life strategies for coping with motor disorders are based on this ability. We explored MI in a large sample of patients with spinal cord injury (SCI) using a comprehensive battery of questionnaires to assess the ability to imagine actions from a first‐person or a third‐person perspective and also imagine the proprioceptive components of actions. Moreover, we correlated MI skills with personality measures and clinical variables such as the level and completeness of the lesion and the presence of chronic pain. We found that the MI deficits (1) concerned the body parts affected by deafferentation and deefferentation, (2) were present in first‐ but not in third‐person perspectives, and (3) were more altered in the presence of chronic pain. MI is thus closely related to bodily perceptions and representations. Every attempt to devise tools and trainings aimed at improving autonomy needs to consider the cognitive changes due to the body–brain disconnection.     

防范儿童意外伤害的人文策略

意外伤害是危害儿童健康的主要因素,虽然其发生具有一定的随机性和不可预料性,但仍然是可防、可控的;在掌握了儿童意外伤害的流行特征之后,我们可以采取一系列具有人文策略的干预措施,来增加儿童及家长的依从性,从而降低致残率和致死率;有关儿童意外伤害的研究工作还存在一些问题。     

ALI/ARDS患者糖皮质激素的治疗效果和时机

急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)是临床各科经常遇到的急症,其发病机制主要是中性粒细胞向炎症部位的移动,释放出大量的炎性介质和细胞因子,引起肺泡毛细血管膜通透性增高,弥漫性肺损伤和蛋白性肺泡水肿液聚集等病理生理改变。临床表现为呼吸困难、呼吸窘迫、顽固的低氧血症,虽然使用机械通气和呼气末正压通气(PEEP)后,其病死率有所下降,但仍然维持在50%左右。就糖皮质激素的作用机制,对不同原因引起的ALI/ARDS治疗效果,使用时机作一综述,期望对ALI/ARDS治疗过程中糖皮质激素的使用予以规范。     

急性肺损伤与急性呼吸窘迫综合征的诊断与治疗策略

急性肺损伤（ALI）和急性呼吸窘迫综合征（ARDS）是多个危险因素直接或间接引起肺部损伤的连续病理过程,以表现低氧血症为特征,ARDS是ALI严重末期的表现。低流量、呼气末正压（PEEP）保护性通气的措施可明显改善氧和,减轻机械通气肺损伤,降低病死率,明显优于传统通气方式。     

Spatial-temporal analysis of pedestrian injury severity with geographically and temporally weighted regression model in Hong Kong

This study intended to (1) investigate the pedestrian injury severity involved in traffic crashes; and (2) address the spatial and temporal heterogeneity simultaneously. To achieve the objectives, geographically and temporally weighted regression (GTWR) model was proposed to deal with both spatial and temporal heterogeneity simultaneously. The pedestrian crash data of Hong Kong metropolitan area from 2008 to 2012 were collected, involving 1652 pedestrian-related injury samples. By comparing GTWR model and standard geographically weighted regression (GWR) model and temporally weighted regression (TWR) model, the proposed GTWR model showed potential benefits in modeling both spatial and temporal non-stationarity simultaneously in terms of goodness-of-fit and F statistics. Results revealed that number of vehicles, number of pedestrian-related casualties, speed limit, vehicle movement and injury location have significant influence on pedestrian injury severity in different areas. The conclusions are reached that GRWR model can address the relationship between pedestrian injury severities and influencing factors, as well as accommodating spatial and temporal heterogeneity simultaneously. The findings provide useful insights for practitioners and policy makers to improve pedestrian safety.     

Reciprocal relations between autonomous motivation from self-determination theory and social cognition constructs from the theory of planned behavior: A cross-lagged panel design in sport injury prevention

ObjectivesThe present study examined reciprocal relations between autonomous motivation from self-determination theory (SDT) and constructs from the theory of planned behavior (TPB) in a sport injury context.MethodsThe study adopted a three-wave longitudinal cross-lagged panel design. Physical education students in China (N = 4414; M_age = 14.42, SD = 1.75) completed self-report measures of autonomous motivation, attitude, subjective norm, and perceived behavioral control with respect to sport injury prevention at baseline (T1) and at two follow-up occasions one (T2) and three (T3) months later. Proposed reciprocal relations between autonomous motivation and the TPB constructs controlling for construct stability over time were tested using structural equation modeling.ResultsThree cross-lagged SEMs for effects of constructs measured at T1 on constructs measured at T2 and T3, and effects of constructs measured at T2 on constructs measured at T3 met goodness-of-fit criteria (CFI > 0.95, TLI > 0.94, RMSEA = 0.03, SRMR = 0.05) with consistent patterns of effects. Across the three models, autonomous motivation predicted the prospectively-measured TPB constructs with small-to-medium effect sizes (β range = 0.17 to 0.32, ps < .001), but associations between the TPB variables and prospectively-measured autonomous motivation were markedly smaller in size (β range = 0.01 to 0.18, ps range = .001 to .892).ConclusionsFindings provide initial support for the temporal ordering of the constructs in the integrated model of SDT and TPB in a sport injury context. Autonomous motivation from SDT is likely to be an antecedent of the constructs from the TPB.     

Injury characteristics across functional classes of self-injurious behavior

Self-injurious behavior (SIB) is inherently problematic because it can lead to injuries, including those that are quite severe and may result in loss of function or permanent disfigurement. The current study replicated and extended Rooker et al. (2018) by classifying the physical characteristics of injuries across groups of individuals with automatically maintained SIB (ASIB Subtypes 2 and 3) and socially maintained SIB. Individuals with Subtype 2 ASIB had the most frequent and severe injuries. Further, an inverse relation was found between the level of differentiation in the functional analysis and the number of injuries across groups. Studying the response products of SIB (the injuries) documents the risks associated with SIB, justifies the need for research and the intensive intervention, and advances knowledge of SIB. Additional research is needed to replicate these findings, and determine the variables that produce different characteristics of injury secondary to SIB.     

心理学视角下的道德损伤

道德损伤是指个体实施、未能阻止、目睹或听闻违背自身深层的道德信念和期望的行为,对心理、生理、精神、行为和社会的持久影响。道德损伤作为一个跨学科概念,自2009年Litz从心理学角度对其重新做出界定以来,在心理学、伦理学、精神病学、社会学等领域引起了广泛关注。目前研究者已经编制出多个多维度量表来对道德损伤的事件或症状进行测量,运用认知行为疗法、认知加工疗法和针对道德损伤研发的适当暴露疗法等措施来进行干预。未来的研究可以继续深入探究道德损伤的发生发展机制,确立道德损伤的诊断标准,推广道德损伤的适用范围,丰富道德损伤的内涵,从而拓展道德损伤研究的广度和深度。