Predictors of early vocabulary growth in children born preterm and full term: A study of processing speed and medical complications

Delays in expressive vocabulary may be harbingers of long-term language difficulties. In toddlers born full term (FT), individual differences in language processing speed are associated with variation in expressive vocabulary growth. Children born preterm (PT) are at increased risk for persistent language deficits. Here, we evaluate predictors of early vocabulary growth in PT toddlers in relation to two sources of variability: language processing speed and medical complications of prematurity. Vocabulary growth from 16 to 30 months (adjusted for degree of prematurity) was modeled longitudinally using parent reports in English-speaking FT (n = 63; ≥37 weeks, ≥2495 g) and PT (n = 69; ≤32 weeks, <1800 g) children, matched on sex and socioeconomic status. Children were tested in the “looking-while-listening task” at 18 months to derive a measure of language processing speed. Each PT child was assessed for number of medical complications (13 maximum), based on medical chart reviews. PT and FT children displayed similar vocabulary trajectories; however, birth group disparities began to emerge by 30 months. PT children were slower in language processing speed than FT children. Critically, language processing speed predicted expressive vocabulary size at 30 months; interactions with birth group were not significant (all p > .20). In PT children, faster language processing speed predicted stronger outcomes regardless of number of medical complications; slower processing speed and more medical complications predicted poorer outcomes. Faster processing speed reflected favorable neuropsychological processes associated with faster expressive vocabulary growth that overrode the impact of medical complications on language outcomes in PT children.     

Le consentement en droit médical

Medical law, which derogates from ordinary law, interests and questions by its particularities. However, the Mercier decision of 1936 seems to have denied this by forcing an ordinary “medical contract” between the doctor and his patient. But the medical relationship, far beyond a contractual logic, seems to be unable to blend into the civil law elements of contract law. As such, consent, keystone of this medical matter, does not meet the standards of contract law yet imposed by the Court of Cassation. This article aims to unravel and clarify the scope and regime of this consent not quite like the others.     

Gender congruence and body satisfaction in nonbinary transgender people: A case control study

Abstract

Background: Binary transgender people access gender affirming medical interventions to alleviate gender incongruence and increase body satisfaction. Despite the increase in nonbinary transgender people, this population are less likely to access transgender health services compared to binary transgender people. No research has yet understood why by exploring levels of gender congruence and body satisfaction in nonbinary transgender people.

Objective: The aim of this study was to compare levels of gender congruence and body satisfaction in nonbinary transgender people to controls [binary transgender people and cisgender (nontrans) people].

Method: In total, 526 people from a community sample in the UK took part in the study (97 nonbinary, 91 binary, and 338 cisgender identifying people). Participants were asked to complete an online survey about gender congruence and body satisfaction.

Results: There were differences in gender congruence and body satisfaction between nonbinary and binary transgender people. On sex-specific parts of the body (i.e., chest, genitalia, and secondary sex characteristics), nonbinary transgender people reported significantly higher levels of gender and body satisfaction compared to binary transgender people. However, there was no difference in congruence and satisfaction with social gender role between the two transgender groups (nonbinary and binary). Cisgender people reported significantly higher levels of gender congruence and body satisfaction compared to transgender people (nonbinary and binary).

Conclusions: There are differences in gender congruence and body satisfaction between nonbinary and binary transgender people. Nonbinary individuals may be less likely to access transgender health services due to experiencing less gender incongruence and more body satisfaction compared to binary transgender people. Transgender health services need to be more inclusive of nonbinary transgender people and their support and treatment needs, which may differ from those who identify within the binary gender system.     

原发性乳腺癌新辅助化疗与过度医疗、无效治疗

新辅助化疗已经使众多原发性乳腺癌患者受益.依据不同的判断标准,它又可以被视为无效治疗或过度医疗.新辅助化疗应用于临床,引起了哲学意义上的争议.医者原因是重要原因之一.要重视矛盾问题"底线"的研究,提供相对宽松的技术、学术、文化氛围;医者持续的、有计划的学习与培训是增强其主体性的保证和前提.     

介入性超声与临床医学的辩证统一

介入性超声是近年来超声领域开拓的一项崭新技术,它的出现从根本上改变了超声诊断作为单纯辅助科室的陈旧观念,使诊断和治疗真正成为一个整体过程.变革了超声医生的知识结构及思维方式,促进了临床各学科之间的综合与发展.要在日益深入局部微观研究使临床各学科越来越分化的同时,更广泛地注意整体的辩证统一,充分体现了辩证唯物主义的自然观.     

建立我国医事仲裁机制的再思考

仲裁是解决医疗纠纷的有效机制.然而,我国至今仍未建立医事仲裁机制.在考察我国仲裁解决医疗纠纷的现状和成因的基础上,提出构建医事仲裁机制建议.     

医患关系现状的多维视角思考的研究

依据社会学和心理学理论,从社会政治、经济、文化、心理、法律多维层面对医患关系的现状进行思考.认为其形成原因是多元的;改善途径应是全方位的;努力应是社会的;历程是漫长的;人性化的医疗服务是必要的.     

国内外知名大学医学教育办学管理模式的比较分析

为了探讨适合我国国情的医学教育办学管理模式,对国内外医学教育的历史沿革、组织管理、资金渠道等进行比较、分析,对国内外知名医学院校基本状况进行汇总.结果显示,国内外知名医学院校在行政隶属、管理体制、职责权限、与附属医院关系、资金渠道方面均有较大差别.研究也表明,紧密合作型办学管理模式是适应我国国情的有益尝试.     

人文关怀与青光眼的诊治

青光眼是一类不可逆性致盲性眼病,早期诊断、早期治疗具有十分重要的意义.眼科医师在青光眼早期诊断中应遵循最优化原则,避免过度医疗,给予患者更多的人文关怀.     

关于晚期恶性肿瘤放弃治疗的思考

晚期恶性肿瘤的放弃治疗,关键是明确四个方面问题:对于某些晚期恶性肿瘤病人为什么要放弃治疗,应该放弃哪些治疗,什么时候开始放弃治疗,如何进行放弃治疗.意义就在于尊重生命,合理分配和利用医疗资源,体现社会公平的原则.