Refractoriness of on Extended Movement to Directional Change

An extended movement was used to compare the memory-drum and single-channel definitions of psychological refractoriness. The basic movement In response to the first signal (S₁) was a forward lunge and a concurrent arm swing through a target string. The response to the second signal (S₂) was a reversal of the original movement The interstimulus Interval (ISI) ranged from .10 – .70 sec. in .10-sec. steps. The hypothesis that refractoriness of the reversal movement would decrease as ISI shortened was confirmed by the fact that error frequencies decreased significantly and substantially with decreasing IS I. The availability of some residual capacity to deal with S₂ during the refractory period was also indicated by an examination of the relationship between RT₂ and the interval between S₂ and RT₁. This departure from the classical single-channel model shows some agreement with the neuromotor-programming theory.     

两种术式治疗腰椎管狭窄症的疗效分析

探讨后路椎弓根螺钉系统固定、Cage加自体骨椎间融合(PLIF)与传统术式(开窗减压、半椎板切除、全椎板截骨回植)治疗腰椎管狭窄症的疗效差异。2006年6月～2008年8月,对85例腰椎管狭窄症患者行传统术式减压(A组38例)、PLIF治疗(B组47例)。术后随访16个月～43个月,平均23个月。采用JOA评分评估疗效并行统计学分析。结果A组有效率78.94%,B组有效率95.74%。A组与B组比较,B组疗效优于A组,差异有统计学意义。因此,后路椎弓根螺钉系统固定、Cage加自体骨椎间融合治疗腰椎管狭窄症的疗效优于传统术式。     

Corporeal illusions in chronic spinal cord injuries

While several studies have investigated corporeal illusions in patients who have suffered from a stroke or undergone an amputation, only anecdotal or single case reports have explored this phenomenon after spinal cord injury. Here we examine various different types of bodily misperceptions in a comparatively large group of 49 people with spinal cord injury in the post-acute and chronic phases after the traumatic lesion onset. An extensive battery of questionnaires concerning a variety of body related feelings was administered and the results were correlated to the main clinical variables. Six different typologies of Corporeal Illusion emerged: Sensations of Body Loss; Body-Part Misperceptions; Somatoparaphrenia-like sensations; Disownership-like sensations; Illusory motion and Misoplegia. All of these (with the exception of Misoplegia) are modulated by clinical variables such as pain (visceral, neuropathic and musculoskeletal), completeness of the lesion, level of the lesion and the length of time since lesion onset. In contrast, no significant correlations between bodily illusions and personality variables were found. These results support data indicating that at least some cognitive functions (in particular the body, action and space representations) are embodied and that somatosensory input and motor output may be necessary to build and maintain a typical self-body representation.     

人工腰椎间盘置换预示了腰椎融合的终结？

腰椎间盘退变性疾患的治疗方法主要是病变椎间盘的单纯切除和腰椎融合。而人工腰椎间盘置换的出现预示了脊柱外科一个新的时代的到来。简要介绍SB charité人工腰椎间盘置换技术,并分析了其早期的临床效果及可能出现的一些并发症,总结了目前人工腰椎间盘的应用所遇到的一些问题。客观的评价人工腰椎间置换技术,为临床实践和进一步研究提供依据。     

Ethics,Brain Injuries,and Sports: Prohibition,Reform, and Prudence

Abstract

In this paper, we explore the issue of the elimination of sports, or elements of sports, that present a high risk of brain injury. In particular, we critically examine two elements of Angelo Corlett’s and Pam Sailors’ arguments for the prohibition of football and Nicholas Dixon’s claim for the reformation of boxing to eliminate blows to the head based on (a) the empirical assumption of an essential or causal connection between brain injuries incurred in football and the development of a degenerative brain disease known as chronic traumatic encephalopathy (CTE); and (b) John Stuart Mill’s rejection of consensual domination (ie voluntary enslavement). We present four arguments to contest the validity of Corlett, Dixon’s and Sailor’s positions. Specifically, we argue that (i) certain autonomy-based arguments undermine paternalist arguments for reform; (ii) the nature of the goods people pursue in their lives might justify their foregoing (degrees of) future autonomy; (iii) Mill’s argument against consensual domination draws on ambiguous and arbitrary distinctions; (iv) the lack of consensus and empirical evidence regarding CTE arising from brain injuries in sport underdetermines calls for reform. We conclude that these proposals for reforming or eliminating sports with high risks of brain injuries are not well founded.     

青少年脊柱侧弯的临床诊治进展

青少年特发性脊柱侧弯（AIS）既对患儿及家庭所造成的痛苦,也对患者家庭和国家财政都造成沉重的经济负担,引发各国及各级政府的高度关注。但是,随着对AIS了解的深入,质疑和犹豫也逐渐产生。本文回顾当前关于AIS的临床和基础研究结果,发现其中许多研究结论都充满了临床悖论。本文还通过总结作者单位的临床经验,提出的AIS诊治新原则。该原则利用脊柱对于AIS的充分代偿能力,改变聚焦于纠正脊柱畸形的传统理念,尽量维护脊柱的代偿平衡,同时避免对AIS患儿的歧视性宣传,避免诱导其发生心理自卑感。通过借鉴“代偿稳定、阴阳自和”等中医哲学理念可以在AIS等脊柱损伤退变性疾病的临床诊治过程中为患者争取最为实效的临床利益。     

Theory of Planned Behaviour, Skin Care and Pressure Sores Following Spinal Cord Injury

Objectives: To use the Theory of Planned Behaviour to explore factors associated with performing skin care behaviors and the occurrence of pressure sores in people with spinal cord injury. Design: A within-group cross-sectional design was used to assess 59 people with spinal cord injury living in the community. Of these, 17 participants returned a repeat assessment allowing a longitudinal examination of the relationship between intention and actual behaviour. Methods: A measure was developed in accordance with the Theory of Planned Behaviour guidelines through interviews with people with spinal cord injury. Measures of mood and knowledge of skin care behaviour were also included. Results: The Theory of Planned Behaviour components, mood and knowledge of skin behaviours predicted intention, skin care behaviour and occurrence of pressure sores. Knowledge of skin care was negatively correlated with occurrence of pressure sores (r=−.38, p < .01). Indirect perceived control was a particularly important predictor of pressure relief, accounting for 24% of the variance. Conclusions: Psychosocial factors, including the Theory of Planned Behaviour components, predicted skin care behaviours and the occurrence of pressure sores. These findings provide empirical support for the Theory of Planned Behaviour. The study also carries clinical implications for skin care education for people with SCI and their families.     

Quality of Social Support Predicts Hopelessness and Depression Post Spinal Cord Injury

Research has documented elevated levels of depression and suicide in the spinal cord injured (SCI) population, with the majority of suicide attempts occurring within 12 months of injury onset. Social support has been linked with depression and suicidal intent, and this study aimed to determine the impact of the quality and quantity of social support on levels of depression and hopelessness, an indirect indicator of suicide risk in the SCI population. Fifty-three individuals with traumatic SCI at Week 6 of their rehabilitation, and 42 at Week 18, with an approximate male to female ratio of 4:1, completed the Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), and Social Support Questionnaire. Stepwise multiple regression analyses revealed that high quality of social support was associated with low hopelessness and depression scores, being more pronounced at Week 18 postinjury. The impact of social support on psychological well-being demonstrates the importance of fostering and integrating social support in rehabilitation following spinal cord injury.     

Intervention Models for Mothers and Children at Risk for Injuries

We review risk factors commonly associated with childhood unintentional injuries and highlight adolescent mothers and their young children as a high risk group. Several intervention models of injury, including the epidemiological model, Peterson and Brown's working model, and the socioecological model have been proposed to explain the events that lead to injuries. Discussion of these models is provided and a synthesis of the adolescent parenting model and the socioecological model of injury is suggested as way to address the complex variables that lead to an injury causing event for adolescent mothers and their young children. Finally, we suggest areas of future investigation and their implications for prevention and treatment.     

Natural sequence of recovery from child post-traumatic amnesia: A retrospective cohort study

The aim of this study was to determine the sequence of skills recovery during post-traumatic amnesia (PTA) in children with moderate to severe traumatic brain injuries (TBIs). Setting: Fifty children aged 8 to 15 years consecutively admitted to a children’s hospital with TBI and PTA>24 were tested in a retrospective cohort study where the main measure was the Westmead PTA Scale (WPTAS). The group analyses show that orientation to time took longer to recover than orientation to person and place, but not memory, while the individual analyses revealed that when orientation to time was grouped with memory, 94% of children recovered orientation to person and place before orientation to time and memory (examiner and pictures). Correlation coefficients between age and the number of days taken to recover skills were not found to be significant. It was established that, in terms of the natural sequence of skills recovery in children aged 8 to 15 years following moderate to severe TBI, recovery of orientation to time is more closely aligned to memory than to orientation to person and place. It was also established that WPTAS items are developmentally appropriate for children aged 8 to 15 years who have sustained TBI. These findings are clinically important because monitoring recovery from PTA both impacts the rehabilitation offered to individuals during acute care and aids discharge planning.