替格瑞洛与氯吡格雷对急性STEMI患者急诊PCI术后炎症因子的影响

为比较替格瑞洛与氯吡格雷对急性ST段抬高型心肌梗死（STEMI）患者急诊经皮冠状动脉介入术（PCI）术后炎症因子的影响,将176例急性STEMI且行急诊PCI术的患者分为替格瑞洛组（A组）58例、氯吡格雷常规组（B组）58例、氯吡格雷强化组（C组）60例,分别测定术前、术后12小时、术后7天、术后1个月、术后3个月、6个月时炎症因子e反应蛋白（CRP）、白细胞介素-6（IL6）、髓过氧物酶（MPO）、可溶性CD40受体（sCD40L）的含量,比较3组患者各炎症因子在不同时间点有无统计学差异。结果显示c组和A组较B组明显降低（P〈0．05）,有统计学意义,而A组较c组稍降低（P〉0．05）,但两者无统计学意义。由此可见,替格瑞洛的抗炎作用较常规剂量氯吡格雷作用明显增强,和强化剂量氯吡格雷作用相仿。     

Personal and communal resilience in communities exposed to missile attacks: Does intensity of exposure matter?

Based on the salutogenic model, this study aimed to examine the role of personal and communal resiliency in reducing individuals’ psychological distress when facing intensive missile attacks. We examined the relationships between these resources and psychological distress in communities which were exposed to different intensities of attacks. Data was gathered via anonymous self-report questionnaires from 843 adults during the period from one week to one month after intensive attacks in southern Israel. Questionnaires included demographic data as well as sense of coherence (SOC), community resiliency and psychological distress. Differences in levels of resiliency and distress were found among the groups with different ‘exposure levels’. Moreover, only personal resilience SOC explained psychological distress in the entire population, while community resiliency had no effect. Results are discussed on the basis of the salutogenic model with implications for developments of interventions with populations who are exposed to differing intensities of missile attacks.     

Prevalence and correlates of metabolic syndrome in Hong Kong Chinese adults—a random community sample study

The study investigates the prevalence and correlates of metabolic syndrome (MS) among Hong Kong Chinese adults. Random cluster sampling design and International Diabetes Federation (IDF) MS criteria were adopted. Totally 737 adults participated in questionnaire survey and received waist circumference (WC) measurement. Among them 335 showed central obesity (WC > 80 and 85 cm for women and men respectively). Subsequently 229 accepted blood test. Totally 71 participants met MS criteria, suggesting an overall prevalence of 14.1%. Both central obesity and MS increase sharply with age. Chi-square/ANOVA analyses revealed significant positive associations between central obesity with: being male, marital status being married/cohabit, lower education level, occupation as managers or housewives, and alcohol consumption. For MS, the significant positive correlates were: lower education level, occupation as service workers or housewives, lower income level, and alcohol consumption. After controlling for age, binary logistic regression analyses suggested the significant risk factors for central obesity were being male (OR = 1.4), married/cohabit (OR = 1.8), longer working hours (OR = 1.5), eating less vegetables (OR = 1.5), and alcohol consumption (OR = 1.8). For MS, only alcohol consumption appeared to be a significant risk factor (OR = 2.3). Multivariate binary logistic regressions also supported that age group and alcohol consumption were significant predictors of MS. To conclude, adopting randomized cluster sampling and IDF criteria, the study revealed a prevalence rate of MS at 14.1%. Alcohol consumption appears to be the strongest risk factor of MS, which however needs further investigation.     

People with severe and profound intellectual disability: Nurse carer experiences in a South African setting

We explored nurse carer experiences with people with severe and profound intellectual disability in a care and rehabilitation centre in South Africa. Informants were a convenience sample of 10 nurses (females = 7; males = 3; mean years of service = 7.8, SD = 4.8 years). They completed an unstructured interview on their care provision experiences. The data were thematically analysed using Tesch’s method of open coding. Findings resulted in the following three themes to characterise the nurse carer experiences: compassion, person-centred care, and importance of parent involvement. Compassionate and person-centred care is fundamental to the establishment of a therapeutic relationship between nurse carers and people with severe and profound intellectual disability.     

Self-reported stress and psychophysiological reactivity in paramedics

Background: As an important group of health care professionals, paramedics accomplish sophisticated and frequently stressful tasks.

Design: The study investigated self-reported stress burden, self-reported health status, coping strategies, personality traits and psychophysiological reactivity in paramedics.

Methods: 30 paramedics were compared with 30 professionals from other disciplines, in terms of self-reported stress, physical complaints, coping strategies, personality traits and psychophysiological reactivity during aversive visual and acoustic stimuli, and cognitive challenge. Regression analyses were performed for the prediction of stress burden and physical complaints in paramedics according to coping and personality factors.

Results: Paramedics reported lower stress and less somatic complaints, and exhibited reduced electrodermal activity and heart rate responses to experimental stimuli, as well as higher respiratory sinus arrhythmia. They indicated less negative coping strategies, reduced empathy, and higher conscientiousness and sensation seeking. Higher self-reported stress burden and more physical symptoms were associated inter alia with more negative coping strategies, less conscientiousness and lower empathy.

Conclusion: The findings support the notion of reduced self-reported stress burden, and improved general health and stress resistance in paramedics. In addition to health benefits, stress tolerance may contribute to the prevention of performance decline during situations in which health and life are at stake.     

Associations between childhood biomedical factors,maternal smoking,personality traits,Body and Mass Index and the prevalence of asthma in adulthood

Objective: The study set out to investigate socio-economic, biomedical, health and behavioural and psychological factors in childhood and adulthood associated with the prevalence of asthma in adulthood, drawing data from The National Child Development Studies (NCDS), a birth cohort in the UK.

Design: The National Child Development Study, a nationally representative sample of 17,415 babies born in Great Britain in 1958 and followed up at 7, 11, 33 and 50 years was used.

Main Outcome Measure: The prevalence of asthma at age 50 was the outcome measure. The analytic sample consists of 5118 participants with complete data on a set of measures at birth, at ages 7, 11, 33 and 50 years.

Results: Using logistic regression analyses, results showed that childhood asthma (OR = 6.77: 4.38–10.48, p < .001) and respiratory symptoms (OR = 1.83: 1.18–2.86, p < .01), maternal smoking during pregnancy (OR = 1.26: 1.00–1.59, p < .05), Body and Mass Index (BMI) (OR = 1.03: 1.02–1.05, p < .001), traits Neuroticism (OR = 1.13: 1.01–1.21, p < .05) and Conscientiousness (OR = 0.76: 0.76–0.96, p < .01), as well as sex (OR = 1.49: 1.15–1.94, p < .001) were all significantly associated with the prevalence of asthma in adulthood.

Conclusion: The study shows that both childhood and adulthood psychological and sociological factors are significantly associated with the prevalence of asthma in adulthood, though more work need to be done in this area.     

Attention network test: Assessment of cognitive function in chronic fatigue syndrome

Information processing difficulties are common in patients with chronic fatigue syndrome (CFS). It has been shown that the time it takes to process a complex cognitive task, rather than error rate, may be the critical variable underlying CFS patients' cognitive complaints. The Attention Network Task (ANT) developed by Fan and colleagues may be of clinical utility to assess cognitive function in CFS, because it allows for simultaneous assessment of mental response speed, also called information processing speed, and error rate under three conditions challenging the attention system. Comparison of data from two groups of CFS patients (those with and without comorbid major depressive disorder; n = 19 and 22, respectively) to controls (n = 29) consistently showed that error rates did not differ among groups across conditions, but speed of information processing did. Processing time was prolonged in both CFS groups and most significantly affected in response to the most complex task conditions. For simpler tasks, processing time was only prolonged in CFS participants with depression. The data suggest that the ANT may be a task that could be used clinically to assess information processing deficits in individuals with CFS.     

Gray’s revised Reinforcement Sensitivity Theory in relation to Attention-Deficit/Hyperactivity and Tourette-like behaviors in the general population

Attention-Deficit/Hyperactivity Disorder (ADHD) and Tourette syndrome (TS) present as distinct conditions clinically; however, they show comorbidity and inhibitory control deficits have been proposed to underlie both. The role of reinforcement sensitivity in ADHD has been studied previously, but no study has addressed this in relation to TS-like behaviors in the general population. The present study examined these associations within the remit of the revised Reinforcement Sensitivity Theory (rRST). One hundred and thirty-eight participants completed psychometric measures of the rRST, and self-report checklists for ADHD- and TS-like behaviors. The results show that whilst ADHD-inattention was only linked to increased anxiety (BIS), ADHD-hyperactivity/impulsivity was linked to increased impulsivity (BAS-fun seeking), anxiety (BIS) and punishment sensitivity (FFFS), and to reduced reward sensitivity (BAS-reward responsiveness), independently of ‘comorbid’ TS-like behaviors. TS-related phonic tics were associated with increased BIS and FFFS, and TS-related obsessive–compulsive behaviors (OCBs) with increased goal-orientation (BAS-drive) and reduced impulsivity (BAS-fun seeking). However, these associations were driven by ADHD-like behaviors or OCB co-occurrence, respectively, suggesting little role of the rRST in pure TS-like behaviors. The results are discussed in light of mixed findings in the literature and the importance of distinguishing between multiple processing models of the rRST in distinct disorder phenotypes.