Letting go of your dreams—Adjustment of child-related goal appraisals and depressive symptoms during infertility treatment

To examine the adjustment of child-related goal appraisals during infertility treatment and whether such adjustment contributes to depressive symptoms 178 (86 men, 92 women; age for women M = 33.92, SD = 0.34, for men M = 35.68, SD = 0.45) patients at an Infertility Clinic filled in child-related goal appraisal questionnaires six times: (1) before starting the hormone injections, (2) before the oocytes were retrieved, (3) after embryo transfer, (4) the day when the pregnancy test was done, and (5) two and (6) six months after the infertility treatment. At the first and last measurement times they filled in questionnaire on depressive symptoms. Appraisals concerning child-related goal changed in tandem with the treatment result, and goal adjustment had an effect on depressive symptoms.     

失眠症治疗的最新进展

失眠是睡眠障碍之一,主要表现为睡眠时间减少、入睡困难、入睡后易惊醒、醒后不易再入睡等。本文主要探讨了失眠的非药物治疗,包括睡眠约束,光疗法,认知治疗,松弛疗法和行为治疗。     

Anxiety sensitivity: a unique predictor of dropout among inner-city heroin and crack/cocaine users in residential substance use treatment

The present study examined the extent to which anxiety sensitivity (AS) at treatment entry was related to prospective treatment dropout among 182 crack/cocaine and/or heroin-dependent patients in a substance use residential treatment facility in Northeast Washington, DC. Results indicated that AS incrementally and prospectively predicted treatment dropout after controlling for the variance accounted for by demographics and other drug use variables, legal obligation to treatment (i.e., court-ordered vs. self-referred), alcohol use frequency, and depressive symptoms. Findings are discussed in relation to the role of AS in treatment dropout and substance use problems more generally.     

HIV/Aids: an encounter with death or a journey into life?

This is an account of a panel discussion. It focuses on an encounter with the HIV/Aids virus. Such an encounter may result in a descent into despair, hopelessness and ultimately death, or it may offer the opportunity of possible transformation of consciousness to embrace a life lived productively and meaningfully with a chronic but manageable disease. A picture is provided of the dire situation that exists regarding the HIV/Aids pandemic in South Africa. The HI-virus is compared to a malevolent trickster type energy that uses ingenious means to gain access to the host. It is an impersonal agent seeking only its own survival but if left untreated will ultimately result in the death of the host. Reference is made to characters in the musical, The Lion King, to illustrate that it is the willingness to suffer the painful emotions evoked following a diagnosis of being HIV-positive more consciously that allows for a transformation from despair and hopelessness to a life lived productively and meaningfully. Two of the panelists who are HIV-positive share their experiences of this process. One recounts how, living with Aids, his connections with others and human relatedness helped to restore his dignity and self-worth. The other relates how his willingness to state his status publicly allowed him to overcome the stigma and shame that are evoked when diagnosed as HIV-positive. This has allowed him to seek appropriate treatment with ARV's. He now lives with a chronic but manageable infection and leads a creative and significant life. The difficulties encountered regarding the prevention of HIV/Aids when attempting to change potentially destructive sexual behaviours in teenagers are discussed. An inspiring account of work in treating those that live with HIV/Aids under difficult circumstances is also discussed.     

Interdependent Group Contingency Management for Cocaine-Dependent Methadone Maintenance Patients

Contingency management (CM) for drug abstinence has been applied to individuals independently even when delivered in groups. We developed a group CM intervention in which the behavior of a single, randomly selected, anonymous individual determined reinforcement delivery for the entire group. We also compared contingencies placed only on cocaine abstinence (CA) versus one of four behaviors (CA, treatment attendance, group CM attendance, and methadone compliance) selected randomly at each drawing. Two groups were formed with 22 cocaine-dependent community-based methadone patients and exposed to both CA and multiple behavior (MB) conditions in a reversal design counterbalanced across groups for exposure order. The group CM intervention proved feasible and safe. The MB condition improved group CM meeting attendance relative to the CA condition.     

Splitting as a Focus of Couples Treatment

Current developments in neurophysiology and trauma have re-awakened interest in the reciprocal influences of the interpersonal and intrapsychic domains. Although object relations theory continues to guide clinical practice, its integration into models of best practice has been limited by a lack of empirical study. This paper examines the defense mechanism of splitting in couples from the theoretical, empirical and clinical perspectives in ways that allow for integration with research findings. It is proposed that splitting operates on a continuum from a specific response that is stimulated by anxiety, to a fundamental style of relating that is marked by emotional reactivity, impaired problem solving and relationship instability. Specific treatment interventions that integrate object relations and cognitive perspectives are summarized.     

糖尿病足诊疗与预防进展

糖尿病足是糖尿病的严重并发症,血管狭窄闭塞、神经病变和感染是主要的临床表现,本文主要从糖尿病足的定义、病因、病理生理、临床表现、检测方法、分级及治疗和预防进展方面进行总结。糖尿病足的诊治是个系统工程,单一的方法难以治愈,且治疗效果欠佳,故我们在临床上以预防为主,早期诊断,早期治疗。     

由角膜新生血管的治疗引发的思考

探讨角膜新生血管的有效治疗措施。运用现代医学知识,以创造性思维突破常规, 多因素多环节不同水平干扰发病过程。创造性思维可寻找有效的辅助治疗措施。在角膜新生血管的治疗中正确运用哲学观点,充分发挥创造性思维能力,可降低本病的致盲率和后遗症的发生率,促进人类健康生存,提高生活质量。     

抛开一线治疗的争论 采取个体化的降压治疗——解读最新欧洲高血压治疗指南

欧洲心脏病学会／欧洲高血压学会（ESC／ESH）于2007年公布了新的《高血压治疗指南》,新的指南主要围绕着近年来循证医学的证据,对高血压的控制目标以及治疗等方面提出了一些新的观点,并根据英国高血压治疗指南关于G阻滞剂的新观点,强调了个体化降压治疗的重要性,并指出G阻滞剂仍可作为高血压患者治疗的一线药物。