The social dynamics involved in recovery and return to sport following a sport-related concussion: A study of three athlete-teammate-coach triads

An athlete's connection to their team and team members is an important part of their sport experience. However, researchers currently know little about the nature of these social dynamics with respect to concussed athletes. Our study explored athletes' recovery and reintegration into the team environment following a sport-related concussion. We conducted semi-structured interviews with each member of three athlete-teammate-coach triads (N = 9). We analysed the data using thematic narrative analysis and present the results as three stories that focused on each athlete's experience. For Cassie, we found two major plot points in her story: the transition in her role (and shift in identity) from athlete to student assistant coach/team manager and, once recovered, back to an athlete on the team. For Jess, we found that the main plot in her story was “pressure”. Specifically, the interplay between internal (placed on herself) and external (perceived from teammates and coaches) pressures to return to sport. In the third and final story, the main plot point was the tensions that arose from Jaden's preferences for social support and the type of support that his teammates and coaches believed he needed during his recovery. Our results highlight the interplay between athlete's personal and social identities, feelings of pressure to return and readiness, and the challenges of providing the right amount and type of social support. This research contributes to our limited understanding of the social dynamics involved in athletes' return to sport following a concussion.     

A systematic review of the effectiveness of machine learning for predicting psychosocial outcomes in acquired brain injury: Which algorithms are used and why?

Clinicians working in the field of acquired brain injury (ABI, an injury to the brain sustained after birth) are challenged to develop suitable care pathways for an individual client’s needs. Being able to predict psychosocial outcomes after ABI would enable clinicians and service providers to make advance decisions and better tailor care plans. Machine learning (ML, a predictive method from the field of artificial intelligence) is increasingly used for predicting ABI outcomes. This review aimed to examine the efficacy of using ML to make psychosocial predictions in ABI, evaluate the methodological quality of studies, and understand researchers’ rationale for their choice of ML algorithms. Nine studies were reviewed from five databases, predicting a range of psychosocial outcomes from stroke, traumatic brain injury, and concussion. Eleven types of ML were employed with a total of 75 ML models. Every model was evaluated as having high risk of bias, unable to provide adequate evidence for predictive performance due to poor methodological quality. Overall, there was limited rationale for the choice of ML algorithms and poor evaluation of the methodological limitations by study authors. Considerations for overcoming methodological shortcomings are discussed, along with suggestions for assessing the suitability of data and suitability of ML algorithms for different ABI research questions.     

广西扶绥肝癌防治引发的环境与健康关系的哲学思考

从分析文献资料入手,对环境与健康的关系进行哲学思考。广西扶绥以玉米为主食的人群,因摄入过量黄曲霉素及饮用污染塘水,导致肝癌高发和高死亡率;而减少黄曲霉素摄入量、改饮清洁水,肝癌发生率和死亡率随之降低。因此,环境与健康相互影响,高温高湿环境诱发玉米产生黄曲霉素,污染塘水存在大量腐殖酸,食之饮之严重危害人的健康;健康意识觉醒,主粮由玉米改为水稻,饮用深井水,健康状况得以改善。在尊重环境与健康相互影响客观性基础上,追求客观性与主观性、人文性的统一。     

心理学视角下的极端膜拜伤害问题

对极端膜拜团体造成身心伤害现象的科学研究, 集中在对极端膜拜伤害的界定、测量和机制三个方面。本文的目的, 是梳理这三个主题上的研究脉络, 明晰其中的争议之处和取得的成绩。文本分析表明, 对极端膜拜伤害的界定从“洗脑”转向了“心理虐待”, 对这类伤害的经验观察由个体症状转向了群体行为和经历的描述, 测量方法由传统心理测试工具变成了新型团体心理虐待量表, 膜拜伤害的心理机制研究在综合环境和个人精神特质两种因素的基础上建立了二者交互的病理模型, 表观遗传学和人际神经生物学用于极端膜拜伤害的生理机制研究已见端倪。但是, 迄今对于极端膜拜伤害的学术研究尚未形成范式。     

彰显道德韧性：应对疫情中的道德创伤

道德韧性是成功应对道德逆境的高尚道德操守。面对新型冠状病毒感染的肺炎疫情,中华民族的道德韧性得以彰显,有效地遏制了道德创伤的发生;但社会个体道德韧性的缺失,也使得部分道德创伤不容忽视,如果任其恣意蔓延必将消解和冲击人们抗击疫情的道德情感和道德意志。抵御疫情中的道德创伤,必须在坚定文化自信中传承道德韧性,在应对道德逆境中塑造道德韧性,在探寻生命意义中升华道德韧性,在领导和权威人士履职尽责中激发道德韧性。     

Executive function outcomes of children with traumatic brain injury sustained before three years

Traumatic brain injury (TBI) is a common cause of disability in childhood. While the outcomes of TBI sustained in school years has been heavily researched, very little is known about the impact of TBI in infants and young children. The aim of this study was to investigate the impact of TBI on executive function (EF) in children who sustained a TBI before 3 years of age. A group of 55 children, 19 with a mild TBI, 16 children with a moderate-severe TBI, and 20 uninjured comparison children participated. The EF of children aged 3 to 6 years were compared using child-based measures of attentional control and information processing. Parents completed questionnaires rating their child's EF. Severity groups differed on the child-based EF measure of attentional control with children with TBI performing below the control group. There were no significant group differences for information processing or parent-rated EF. It appears that children who sustain a TBI before the age of 3 years display impairments in some areas of attentional control 3–4 years postinjury. The findings fit with the existing EF literature for older children.     

Functional analysis and treatment of inappropriate sexual behavior

The results of a functional analysis showed that inappropriate sexual behaviors exhibited by a 9-year-old boy who had been diagnosed with traumatic brain injury were maintained by positive reinforcement in the form of social attention. An intervention consisting of functional communication training and extinction resulted in reduced levels of inappropriate sexual behaviors.     

肝移植的伦理学问题

肝脏移植和其它器官移植一起实现了人类长期以来渴望生命再生的梦想,并成为终末期肝病的有效治疗方法。器官移植也面对许多伦理道德方面的难题。供体,特别是活体器官的摘取,受体的选择等,都受到社会道德观的制约。从伦理道德角度来分析如何制定相关的法律法规,成为当前社会关注的热点。从受体的利益、人体科研的道德规范以及相关制度的伦理学要求等方面,较为详细的阐述肝移植伦理学的基本原则。     

急性肾损伤肾脏替代治疗模式的临床决策

急性肾损伤是指病程3个月内的,包括血、尿、组织学及影像学检查所见的肾脏结构与功能异常。目前,急性肾损伤肾脏替代治疗的模式尚无明确定论。常用的模式有间断性血液透析、持续性肾脏替代治疗、杂合式肾脏替代治疗、腹膜透析。临床上应根据患者的年龄、病因、病情危重程度、所在医院的条件和经济状况等选择合适的治疗模式。     

药物性肝损伤的诊断思维

药物性肝损伤（DILI）是指由于药物或其代谢产物引起的肝脏损害。DILI的诊断尚无金标准,目前国际上比较常用的诊断标准分别从数个不同方面各自进行量化评分,根据得分情况做出诊断。本文归纳DILI的产生机制、诊断标准、临床分型及病理类型,总结推论其临床诊断思维与决策,以供临床医生参考,提高诊断水平。