Experience-dependent neuropsychological recovery and the treatment of chronic alcoholism

This paper reviews the relationship between cognitive status and treatment outcome in chronic alcoholics, the natural history of recovery, and the role of cognitively oriented remediation programs in facilitating recovery. Seven studies of experience-dependent recovery are described in which behavioral improvement was noted. Various recommendations for treatment over the course of recovery are made, guided by anticipated changes in capacity to process complex information over time.     

不同性．别的非吸烟COPD患者肺功能和疾病严重程度的比较

比较不同性别的非吸烟的COPD患者的肺功能和疾病严重程度。选择承德医学院附属医院门诊就诊的非吸烟的稳定期COPD患者93例,其中男性34例,女性59例。对两组患者的肺通气功能和弥散功能,过去一年的急性加重次数、改良的呼吸困难评分及疾病严重程度进行比较。非吸烟的COPD患者男性组和女性组在FEVl％pred,FVC％pred,PEF％pred,FEF25—75％pred,FEF25％pred,FEF75％pred,DOSE评分方面比较,差异有统计学意义（P〈0．05）;在DL—CO％pred和Raw％pred方面比较,差异无统计学意义（P〉0．05）。非吸烟的女性COPD患者较男性COPD患者肺通气功能和小气道功能差,疾病严重程度重,可能与女性患者对生物燃料、空气污染等危险因素易感有关。     

EGFR基因突变NSCLC全程管理

表皮生长因子受体（EGFR）基因突变的非小细胞肺癌（non-small cell lungcancer,NSCLC）是一类具有独特病理和临床特征的恶性肿瘤。目前由于针对EGFR基因突变阳性NSCLC治疗中TKIs的应用,患者的生存期已超过三年,所以此类患者从诊断到治疗应进行全程管理。首先要进行分子检测,发现EGFR基因突变NSCLC,以避免失去EGFR—TKIs的治疗机会。研究证明,EGFR基因突变NSCLC任何线接受第一代抑制剂治疗,患者疗效及生存获益且耐受性良好。一代EGFR—TKIs耐药后根据失败模式选择后续局部或全身治疗,或根据耐药失败分子机制给予新的分子靶向治疗。对EGFR基因突变NSCLC应实施科学、有序的全程管理。     

动作疗法在灾后心理康复中的运用

在四川经历了汶川大地震后两年,青海又发生了玉树地震。地震灾害不仅对灾区幸存者造成了身体上的伤害,让人们失去家园和亲人,在心理上也给他们造成了严重的创伤。因此,对于这类人群的灾后心理康复治疗尤为重要。然而,幸存者心理的康复,单纯依靠心理辅导和治疗是不够的,而肢体上的运动能够起到缓解心理症状的良好效果。动作疗法就是一种行之有效的疗法。本文将介绍动作疗法在灾后心理康复的治疗中的运用,并提出具有针对性的动作疗法的措施。     

‘Sticking to a healthy diet is easier for me when I exercise regularly’: Cognitive transfer between physical exercise and healthy nutrition

Objective: Long-term rehabilitation success depends on regular exercise and healthy nutrition. The present study introduces a new framework to explain this association on a psychosocial level. The exercise–nutrition relationship was investigated by exploring the sequential mediation of habit strength and transfer cognitions.

Design: Analyses were performed at two measurement points in time (at 12 and 18?months after rehabilitation), involving 470 medical rehabilitation patients who participated in an exercise intervention.

Main outcome measures: Patients filled in paper-pencil questionnaires assessing exercise (t1) and habit strength, transfer cognitions and healthy nutrition at follow-up (t2).

Results: Habit strength and transfer cognitions mediated the relationship between exercise and nutrition.

Conclusion: Findings suggest that habit strength and transfer cognitions are important factors underlying the relationship between exercise and nutrition.     

Effects of a post-hospitalization group health education programme for patients with coronary heart disease

Abstract

Effects of a post-hospitolization group health education programme for patients with coronary heart disease. A health education programme was offered to groups of coronary heart patients and their partners after discharge from hospital. A randomized pre-test post-test control group design was used to evaluate the effects of this experimental intervention. The health education programme was offered to 109 coronary heart patients in groups of between five and eight patients together with their partners in addition to standard medical care and physical training. A control group of 108 patients received only standard medical care and physical training.

The intervention consisted of eight weekly two-hour group health education sessions and one follow-up session. All sessions focused on the promotion of healthy habits and the reduction of adverse psychosocial consequences of the incident.

In the short term (about four months after the incident) the health education programme showed statistically significant intervention effects on knowledge about coronary heart diseases, smoking cessation, healthy eating habits and the number of consultations with the family physician, but no effects on emotional distress. In the long term (one year after the incident) there was only a significant intervention effect on smoking cessation.

These results suggest that the effects of the programme are modest, especially in terms of maintenance of behavioural change. As a consequence, it is suggested that the programme should not be offered to all coronary patients during cardiac rehabilitation, but only to those who can be expected to profit most from it.     

Adoption of community-based cardiac rehabilitation programs and physical activity following phase III cardiac rehabilitation in Scotland: A prospective and predictive study

Little is known about levels of physical activity and attendance at phase IV community-based Cardiac Rehabilitation (CR) programs following completion of exercise-focussed, hospital-based phase III CR. This study aims to test, compare and combine the predictive utility of the Common-Sense Self-Regulation Model (CS-SRM) and the extended Theory of Planned Behaviour (TPB) with action planning for two rehabilitation behaviours: physical activity and phase IV CR attendance. Individuals diagnosed with coronary heart disease (n = 103) completed baseline measures of illness perceptions, intentions, perceived behavioural control (PBC), action planning and past physical activity in the last week of a phase III CR program, and 95 participants completed follow-up measures of physical activity and attended phase IV CR (objectively confirmed) 2 months later. Only one predictor (PBC/cyclical timeline) significantly predicted levels and change of physical activity. While illness perceptions were not predictive of phase IV CR attendance, the extended TPB model showed good predictive power with action planning and intention as the most powerful predictors. Amongst participants who planned when and where to attend phase IV CR at the end of phase III rehabilitation, 65.9% subsequently attended a phase IV CR program compared to only 18.5% of those who had not made a plan. This study adds to our understanding of cardiac rehabilitation behaviour after completion of health service delivered programs. Comparing theoretical models and rehabilitation behaviours contributes to the development of behaviour theory.     

Neurocognitive Sequelae of Pediatric Sickle Cell Disease: A Review of the Literature

This literature review summarizes all studies relating neuropsychological performance to neuroimaging findings in pediatric sickle cell disease (N=28; published 1991–2005). Although inconsistencies exist within and across domains, deficits in intelligence (IQ), attention and executive functions, memory, language, visuomotor abilities, and academic achievement have been identified. Overall neurocognitive compromise was revealed to be related to the level of neurological injury and the location of silent infarct. Attentional and executive dysfunction is prevalent and related to frontal lobe abnormalities.     

The Role of Filipino Occupational Therapists in Substance Addiction and Rehabilitation: A Q-Methodology

More than the shortage of manpower, occupational therapists (OTs) in substance addiction and rehabilitation (SAR) practice have remained underused and misunderstood in the Philippines. This study aimed to identify the role of Filipino OTs in people with SUD based on the perspectives of OTs, mental health professionals, and former service users and carers in the community. Using Q-Methodology (QM), this research revealed a tripartite role for Filipino OTs in SAR: (a) “Promoter of occupational participation,” (b) “Collaborator to enhance participation and well-being,” and (c) “Facilitator of environmental supports for occupational participation.”     

从医学整合的角度谈现代肺癌的防治

肺癌是严重影响群众健康的常见恶性肿瘤,当前肺癌防治工作中面临一系列由于分科过细、欠缺协作等导致的问题。加强肺癌防治领域中学科、技术、资源的整合,才能够有效应对越来越严峻的肺癌防治形势。建立以疾病为中心的肺癌整体防治模式,对于其他单一重大疾病的防治也有重要参考意义。