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。     

Expressive Electronic Journal Writing: Freedom of Communication for Survivors of Acquired Brain Injury

In addition to the impaired ability to effectively communicate, adults with acquired brain injury (ABI) also experience high incidences of depression, social isolation, and decreased quality of life. Expressive writing programs have been shown to be effective in alleviating these concomitant impairments in other populations including incarcerated inmates (Lane, Writing as a road to self-discovery, F & W, Cincinnati 1993). In addition, computer applications such as email have been suggested as an effective means of improving communication and social isolation in adults with brain injury (Sohlberg et al. [2003]. Brain Injury, 17(7), 609–629). This investigation examines the effects of on-line expressive journal writing on the communication, emotional status, social integration and quality of life of individuals with brain injury.     

SUPPORT FOR A NEUROPSYCHOLOGICAL MODEL OF SPIRITUALITY IN PERSONS WITH TRAUMATIC BRAIN INJURY

Recent research suggests that spiritual experiences are related to increased physiological activity of the frontal and temporal lobes and decreased activity of the right parietal lobe. The current study determined if similar relationships exist between self‐reported spirituality and neuropsychological abilities associated with those cerebral structures for persons with traumatic brain injury (TBI). Participants included 26 adults with TBI referred for neuropsychological assessment. Measures included the Core Index of Spirituality (INSPIRIT); neuropsychological indices of cerebral structures: temporal lobes (Wechsler Memory Scale‐III), right parietal lobe (Judgment of Line Orientation), and frontal lobes (Trail Making Test, Controlled Oral Word Association Test). As hypothesized, spirituality was significantly negatively correlated with a measure of right parietal lobe functioning and positively correlated (nonsignificantly) with measures of left temporal lobe functioning. Contrary to hypotheses, correlations between spirituality and measures of frontal lobe functioning were zero or negative (and nonsignificant). The data support a neuropsychological model that proposes that spiritual experiences are related to decreased activity of the right parietal lobe, which may be associated with decreased awareness of the self (transcendence) and increased activity of the left temporal lobe, which may be associated with the experience of specific religious archetypes (religious figures and symbols).     

You still feel different: the experience and meaning of women's self‐injury in the context of a lesbian or bisexual identity

This article reports an intensive qualitative study of the subjective experience and meaning of self‐injury for 16 women who identified as lesbian or bisexual and who had deliberately self‐injured on repeated occasions. In individual interviews, the women talked about their experiences of self‐injury and the role it played in their lives as lesbian or bisexual women. Interpretative Phenomenological Analysis (IPA) was used to elicit themes arising within their accounts. These highlighted a number of ways in which social and contextual factors contributed to the development of self‐injury. Although many of these factors seemed applicable to any woman who self‐injures, there were some aspects that were specific to the experience of lesbian and bisexual women. In addition, the women's accounts raised a number of important issues about the way in which mental health services respond to lesbian and bisexual women who self‐injure. It is argued that self‐injury can be understood as a coping response that arises within a social context characterized by abuse, invalidation, and the experience of being regarded as different or in some way unacceptable. These factors are especially salient in the lives of women, and they emerge particularly strongly as part of the experience of women who are developing a lesbian or bisexual identity. Copyright © 2004 John Wiley & Sons, Ltd.     

Assessment and treatment of automatically reinforced self‐induced emesis

Frequent emesis can cause substantial deleterious effects to a child's health and environment. We conducted a functional analysis of a 3‐year‐old girl's self‐induced emesis and confirmed that emesis was maintained by automatic reinforcement. In a reversal design, we evaluated the efficacy of implementing response blocking at 100% and 50% treatment integrity levels on both attempts and successful production of emesis. One hundred percent blocking, but not 50% blocking, was successful in reducing attempts and emesis below baseline levels.     

A prospective comparison of lower extremity kinematics and kinetics between injured and non-injured collegiate cross country runners

Collegiate cross country runners are at risk for running related injuries (RRI) due to high training volume and the potential for aberrant lower extremity biomechanics. However, there is a need for prospective research to determine biomechanical risk factors for RRI. The purpose of this study was to prospectively compare ankle, knee, and hip kinematics and kinetics and ground reaction force characteristics between injured and non-injured cross country runners over a 14-week season. Biomechanical running analyses were conducted on 31 collegiate-cross country runners using a 3-dimensional motion capture system and force plate prior to the start of the season. Twelve runners were injured and 19 remained healthy during the course of the season. Peak external knee adduction moment (KAM), a surrogate for frontal plane knee loading, and peak ankle eversion velocity were greater in runners who sustained an injury compared to those who did not, and no differences were noted in ground reaction force characteristics, or hip kinematics and kinetics. Reducing the KAM and ankle eversion velocity may be an important aspect of preventing RRI.     

Lifetime Abuse and Mental Health Among Older Persons: A European Study

This study aimed to investigate the association of lifetime abuse and mental health among older persons, considering associated factors (e.g., demographics) through a cross-sectional design. We recruited 4,467 women and men ages 60–84 years from 7 European cities. Mental health was measured with the Hospital Anxiety and Depression Scale, and abuse (psychological, physical, sexual, financial, and physical injuries) based on the Revised Conflict Tactics Scale and the UK survey of abuse/neglect of older people. Multiple logistic regression analyses showed that country of residence, low educational level, and experienced financial strain increased the odds of probable cases of anxiety and depression. Female sex, white-collar profession, and financial support by social/other benefits/or partner income were associated with higher odds of anxiety, while older age and experience of lifetime injury were associated with increased odds of depressive symptoms. The findings of this study indicate that socioeconomic factors, as well as experienced lifetime severe physical abuse leading to injuries, are significant in perceived mental health of adults in later life.     

Inconsistencies in the Reporting of Perceived Trauma Severity Among Acute Physical Injury Survivors

This study aimed to identify and predict inconsistency in perceived trauma severity reports over time among trauma survivors. Hospitalized adult survivors of a traumatic injury completed trauma exposure assessments within 40 days post-injury and 6 weeks later (n = 77). The following trauma severity characteristics were examined: (1) threat of loss of life, (2) threat of loss of a body part, (3) threat of serious injury, and (4) peritraumatic emotionality. Potential predictors of inconsistency were also examined. About half of the reports regarding perceived trauma severity characteristics were inconsistent between the baseline to 6-week assessment. The inconsistent reports were mostly small and equally likely to be either more or less severe over time. Increases in posttraumatic stress disorder (PTSD; especially avoidance) predicted increases in severity of life threat and threat of loss of a body part. Thus, acute reports of perceived trauma severity vary and are influenced by PTSD symptoms.     

理清思路,预防喉返神经损伤

喉返神经损伤是甲状腺手术常见而严重的并发症.阐述了喉返神经的局部解剖及一些重要的解剖变异,分析了导致喉返神经损伤的一些常见原因,并运用唯物辩证法的观点提出了预防喉返神经损伤的一系列措施.