“快乐骨科”的起源、发展和临床实践

矫形外科治疗的病人都是肢体畸形残疾的弱势群体,多经历了艰难的求医过程,承载着肢体残障与尊严浩劫的心灵创伤。为了给肢体残疾者创造一个好的医疗环境,提出并建立了“快乐矫形骨科病区”,包括围手术期无痛病房、医患交流科普文化墙、定期举办医患联欢等。在不断实践中,提升了医生对生命的敬畏,对现代医术的驾驭和为病人解决问题的能力。在手术治疗复杂肢体畸形残疾近4 000例中,未发生1例大的医疗冲突事件,使矫形外科病房成为肢体残疾者恢复运动功能与心灵抚慰的康复乐园。     

TRAINED,GENERALIZED, AND COLLATERAL BEHAVIOR CHANGES OF PRESCHOOL CHILDREN RECEIVING GROSS-MOTOR SKILLS TRAINING

Three preschool children participated in a behavioral training program to improve their gross-motor skills. Ten target behaviors were measured in the training setting to assess direct effects of the program. Generalization probes for two gross-motor behaviors, one fine-motor skill, and two social behaviors were conducted in other settings. Results indicated that the training program improved the gross-motor skills trained and that improvements sometimes generalized to other settings. Contrary to suggestions in educational literature, the gross-motor training program did not produce changes in fine-motor skills or social behaviors. Implications for educators and for the development of the technology of generalization are outlined.     

The effects of classwide peer tutoring on correct cardiopulmonary resuscitation performance by physical education majors

Previous research conducted on the effectiveness of basic life support skills courses has reported that participants typically do not achieve correct performance of life support skills. We used a multiple baseline design across subjects to assess the effects of a classwide peer tutoring intervention on the correct cardiopulmonary resuscitation skills of ten physical education majors. The classwide peer tutoring intervention consisted of (a) a checklist, (b) a prompting procedure, and (c) immediate feedback on performance. Procedural fidelity measures were taken on the correct implementation of the basic life supports skill course and on the implementation of the classwide peer tutoring intervention. Results indicated that students achieved and maintained 100% correct performance during the classwide per tuition condition. These results challenge the current polices of the American Red Cross and the American Heart Association who have reduced course performance criteria because participants were not achieving an adequate standard of performance.     

The impact of daycare environments on children's mood and behavior

This study examined the influence of different environmental features at nine daycare centers on 74 children's (42 boys and 32 girls) emotions in relation to their individual traits. The environments were predominantly assessed by semantic scales, and the children's emotions using a structured observational technique. Hierarchical regression analysis revealed that the activation level as well as the control of the behavior were related to the individual traits of the children, whereas the directedness and the hedonic tone of the behavior were related to the environment and the situation (meal or free play). Of special interest is the result that extrovert children displayed higher levels of control than the more introvert children. The most important quality of the physical daycare environment was unity, whereas intensity and familiarity were to most salient qualities of the social environment     

Physical complaints,anxiety, and its body outcomes: A psychophysiological field study

The relationship between the subjective experience of physical complaints and anxiety and physiological measurements was investigated in a psychophysiological field study. Dependent physiological variables were heart rate and electromyogram (EMG). Of 178 adolescents two extreme groups, each equal in age and sex, were assigned: one group (N=9) characterized by high scores in anxiety and physical complaints, and the other group (N=9) by low scores in these factors. The assertion was that particularly strong psychophysiological reactions would be found to be dependent on individual psychological dispositions. All adolescents were measured with a portable psychophysiological recording device during a normal school day of 7 hr. In the physiological measurements, the two groups differed from each other in that the adolescents reporting many physical complaints and having a high score in anxiety showed an overall higher EMG and an overall lower heart rate (not significant) during the course of the day. This pattern could be reproduced after 2 months. The physiological data appear to be rather stable. The high-scoring group's reactions were more inflexible in relation to the physiological measurements, and they showed a tendency to respond in the same way to different situations, while the other group reacted more flexibly to situational demands.     

Optimism,well-being,depressive symptoms,and perceived physical health: a study among Stroke survivors

The investigation of the relation of positive personality characteristics to mental and physical health among Stroke survivors has been a neglected area of research. The purpose of this study was to examine the relationship between optimism, well-being, depressive symptoms, and perceived physical health among Stroke survivors. It was hypothesized that Stroke survivors’ optimism would explain variance in their physical health above and beyond the variance explained by demographic variables, diagnostic variables, and mental health. One hundred seventy-six Stroke survivors (97 females, 79 males) completed the Revised Life Orientation Test, the Center for Epidemiological Studies Depression Scale, two items on perceived physical health from the 36-item Short Form of the Medical Outcomes study, and the Identity scale of the Illness Perception Questionnaire. Pearson correlations, hierarchical regression analyses, and the PROCESS approach to determining mediators were used to assess hypothesized relations between variables. Stroke survivors’ level of optimism explained additional variance in overall health in regression models controlling for demographic and diagnostic variables, and mental health. Analyses revealed that optimism played a partial mediator role between mental health (well-being, depressive symptoms and total score on CES-D) variables and overall health.     

Predictors of adherence to aerobic exercise in rectal cancer patients during and after neoadjuvant chemoradiotherapy

This pilot study explored predictors of adherence to exercise during and after neoadjuvant chemoradiotherapy (NACRT) in rectal cancer patients. Eighteen rectal cancer patients were prescribed three supervised aerobic exercise sessions/week during NACRT followed by ≥150 min/week of unsupervised aerobic exercise after NACRT. Although not statistically significant, adherence to supervised exercise during NACRT was meaningfully better for patients who were women (d = .82; P = .12), younger (d = ?.62; P = .30), married (d = .62; P = .42), with better mental health (r = .32; P = .21), fewer diarrhea symptoms (r = .48; P = .052), and higher anticipated enjoyment (r = .31; P = .23), support (r = .32; P = .22), and motivation (r = .31; P = .23). After NACRT, adherence was significantly better for patients who reported worse mental health (r = ?.56; P = .046) and meaningfully better for patients who were women (d = .54; P = .38), better educated (d = .77; P = .22), had no comorbidities (d = ?.63; P = .17), and exercised at baseline (d = 1.05; P = .12). Demographics, tumor side effects, and motivational variables may predict adherence to exercise during and after NACRT.     

Complainer Profile Identification (CPI): properties of a new questionnaire on subjective cognitive complaints

Subjective cognitive complaints (SCC) and their role as a possible indicator for subsequent dementia became of growing interest in recent research. In contrast to studies that focused primarily on memory complaints, we aimed to (a) evaluate a questionnaire to register SCC in multiple cognitive domains (Complainer Profile Identification, CPI), (b) assess the association between SCC and psychosocial variables, and (c) assess whether complainer types can be differentiated. Confirmatory factor analysis to evaluate construct validity was computed based on a sample of 734 healthy participants (mean [M] = 43.15 years). On a subsample of 644 participants, the relationship between the total level of SCC with age, depression, social integration, and aging stereotypes was assessed utilizing multiple regression analysis. Differences in complainer types were assessed by multivariate analysis of variance. The results indicate sound psychometric properties of the CPI. The overall level of SCC is largely influenced by depressiveness, whereas executive complainers show the highest level of depressive affect, being overall younger and less socially integrated.     

发挥中药在肿瘤症状处理中的作用——兼谈结直肠癌的中医“病证结合辨治”

改善症状是中医治疗晚期恶性肿瘤的优势,但简单的对症治疗显然体现不了中医的特色;辨证论治虽然是中医治疗的核心,但在对癌病本质的把握上缺乏理论和实践的支撑;单一的辨病论治强调以毒攻毒,却不能改善症状及预后。本文作者以对结直肠癌的治疗为例,认为抓主症,将病证与辨治相结合,有望较好地解决“症”“证”“病”三者的关系,在改善症状...     

Child Outcomes of Nonabusive and Customary Physical Punishment by Parents: An Updated Literature Review

This article updates the only previous systematic literature review of child outcomes of nonabusive and customary physical punishment by parents. The outcomes differ by methodologic, child, and subcultural factors as well as by how the physical punishment was used. All six studies that used clinical samples (including four randomized clinical studies) and all three sequential-analysis studies found beneficial outcomes, such as reduced noncompliance and fighting, primarily when nonabusive spanking was used to back up milder disciplinary tactics in 2- to 6-year olds. Five of eight longitudinal studies that controlled for initial child misbehavior found predominantly detrimental outcomes of spanking. However, those detrimental outcomes were primarily due to overly frequent use of physical punishment. Furthermore, apparently detrimental outcomes have been found for every alternative disciplinary tactic when investigated with similar analyses. Such detrimental associations of frequent use of any disciplinary tactic may be due to residual confounding from initial child misbehavior. Specific findings suggest discriminations between effective and counterproductive physical punishment with young children. More research is needed to clarify the role of spanking and alternative disciplinary tactics in control system aspects of parental discipline.