脑卒中后抑郁的影响因素分析

探讨脑卒中后抑郁的影响因素,找出预防脑卒中后抑郁的有效措施。采用汉密尔顿抑郁量表（HAMD）及神经功能缺损量表（SSS）对患者分别进行抑郁状态及疾病严重程度的评分,同时针对可能的影响N素制定问卷并进行问卷调查。卒中后抑郁的发生与神经功能的缺损程度、病程、负性生活事件及脑损害是否为部位优势半球有关。卒中后抑郁的发生可能是...     

中西医结合脑卒中治疗新模式的探讨

卒中是危害人类健康最严重的疾病之一,其发病率高、死亡率高、致残率高,已成为世界范围内的健康问题。卒中单元已被证实是目前治疗卒中最有效的方法,组织化卒中医疗作为卒中单元的进一步发展,成为脑卒中治疗模式新的趋势;中医强调整体观念和辨证论治,将中西医结合起来,建立和实施中西医结合脑卒中治疗新模式,有助于降低脑卒中患者的死亡率,减少并发症,提高生活质量。通过探讨一种中西医结合脑卒中治疗模式的特点和运作方式,为脑卒中治疗模式的发展提供新的思路。     

感染对缺血性脑卒中发病的影响

缺血性脑卒中的发生除传统高危因素外还和动脉的炎性反应有关,如血管壁内炎性细胞的聚集,早期参与触发动脉粥样硬化的形成,晚期促进动脉粥样硬化斑块的破裂和血栓的形成。微生物的慢性感染已被发现有增加卒中发生的危险,而机体产生免疫反应的强弱程度也起到重要作用。微生物的感染通过多个机制影响卒中的发生。概述了感染、炎症与缺血性脑卒中发病方面的研究现状以及由此带来的对缺血性脑卒中预防与治疗决策的可能影响。     

A free and simple computerized screening test for visual field defects

About 30–40% of stroke patients suffer from visual field defects following injury. These can interfere with the standard neuropsychological assessment and complicate the interpretation of tests that use visual materials. However, information about the integrity of a patient's central visual field is often unavailable. We, therefore, designed a screening tool, the computerized visual field test (c‐VFT), specifically targeted at providing easily available, but rough, information about patients' central visual field. c‐VFT was tested in two samples of stroke patients. Eleven patients were tested on c‐VFT and on the Esterman test. Five patients were tested on c‐VFT and the Humphrey Visual Field Analyzer (HFA), central 10‐2. Criterion validity of the c‐VFT was investigated by calculating quadrantwise intraclass correlation for both comparisons. For the HFA comparison, we also calculated point‐to‐point intraclass correlation, sensitivity, and specificity. Analyses revealed moderately good correspondence between c‐VFT and the Esterman test, and between c‐VFT and HFA 10‐2, respectively. When looking specifically at test points within one degree of visual angle apart in the two tests, intraclass correlation increased. For these points, the sensitivity of c‐VFT was 0.89 and specificity was 0.97. While the c‐VFT is not designed to be diagnostic nor to replace the detailed visual field analysis, this study shows that it provides a reasonable screening of the central visual field. The test can easily be used and will be made freely available to neuropsychological clinicians and researchers.     

Intimate partner cohesion and military unit cohesion: Different types of interpersonal relationships each uniquely predict soldier well-being

Although research on military populations has found that measures of personal well-being are correlated with both intimate partner cohesion and military unit cohesion, it is not clear how these correlations should be interpreted. Based on Relationship Regulation Theory, it was expected that each type of interpersonal relationship would have independent effects, that each would uniquely predict outcomes, and that effects would remain significant after controlling for person-level traits and experiences, such as trait resilience and exposure to combat. A sample of 273 active-duty military personnel completed self-report measures of cohesion in two types of interpersonal relationships (intimate relationships and military unit relationships), two control variables (trait resilience and combat exposure), and three outcome variables (well-being, negative emotionality, and trauma-related stress). Results indicated that cohesion in the two types of relationships were minimally related to each other, but both correlated with outcome variables. Effects for each type of interpersonal relationship remained significant after controlling for the other type and controlling for trait resilience and combat exposure. The results suggest that the effects of interpersonal cohesion are best understood as reflecting experiences in specific types of relationships rather than general characteristics of people in those relationships.     

Bidding for delayed rewards: Accumulation as delay discounting,delay discounting as regulation,demand functions as corollary

In the accumulation paradigm animals press one manipulandum to accumulate pellets or seconds of access to food, and then press another manipulandum, or run some distance, to collect it. The accumulation may be interpreted as delay discounting, with the animals adjusting the distal amount to compensate for its distance or delay. The amount accumulated before being collected is a linear function of the distance or time that the experimental paradigm stipulates for collecting it. That linear function follows from the Unit‐Price/Unit‐Amount axiom. The inverse of the linear compensation functions gives a delay‐discount hyperbola. The advantages of the accumulation paradigm and analytic framework for delay discounting studies are noted. Compensation functions are then derived from a behavioral regulation model, which generalizes them to contexts where the individual's budget for response cost becomes over‐taxed. In turn, such compensation/regulation models lead directly to representative demand functions. In sum, regulation models provide a theoretical grounding for demand functions, compensation functions, and delay discounting hyperbolas. The parameter that links them is the unit amount k, the slope of the compensation function and of the discount function, the setpoint for consumption in a regulation model, and the ideal quantity consumed at minimal price in a demand analysis.     

Examples of real world engineering ethics problems

Nine examples are presented illustrating the kinds of problems encountered in actual practice by conscientious engineers. These cases are drawn fom the records of the IEEE Ethics Committee, and from the experience of the ethics help-line initiated recently by the Online Ethics Center for Engineering and Science. They range from situations in which companies try to cheat one another to those in which human health and safety are jeopardized. In one case, an engineer learned that even a quiet resignation can prove very costly in a personal sense. Some ways in which professional societies might make ethical practice of engineering somewhat easier are mentioned. An carlier, shorter version of this paper was presented at the International Conference on Ethics in Engineering and Computer Science, Case Western Reserve University, Cleveland, March 21–24, 1999, and can be accessed on line at http://onlineethics.org/cases/unger.html. In all cases described in this paper, the names of individuals and organizations have been suppressed or fictionalized. Professor Unger was Chairman of the IEEE (Institute of Electrical and Electronics Engineers) Ethics Committee (1997–1998).     

Secondary attention-deficit/hyperactivity disorder following perinatal and childhood stroke: impact on cognitive and academic outcomes

This cross-sectional retrospective clinical research study examines a large group of children followed within a pediatric stroke program and a developmental attention-deficit/hyperactivity disorder (ADHD) clinic at the Hospital for Sick Children, between May 2004 and June 2016. All children with a history of stroke who participated in a neuropsychological assessment between the ages of 4 and 18 years were considered for inclusion. From a sample of 275 participants with a history of stroke, 36 children (13.1%) received a diagnosis of secondary ADHD. Children with secondary ADHD were younger at the time of stroke and more likely to be identified as having a presumed perinatal stroke and persistent seizures than children without secondary ADHD diagnoses. There were no differences in pattern of lesion, size, or laterality between children who developed secondary ADHD and those who did not. Children with secondary ADHD had the lowest scores across all cognitive and academic measures compared to children with stroke-only and developmental ADHD. Findings highlight the added risk of receiving a diagnosis of secondary ADHD following pediatric stroke. Implications for future research and directed intervention are discussed.     

Post-stroke depression as a predictor of caregivers burden of acute ischemic stroke patients in China

Our aim was to explore the independent attribution of Post-stroke depression (PSD) to caregiver burden of acute ischemic stroke patients. A cross-sectional survey was performed with 271 acute ischemic stroke patients in the Huai-He Hospital and First People’s Hospital of Kaifeng City in China. PSD was assessed by Self-rating Depressive Scale, and caregiver burden was assessed by Zarit Caregiver Burden Interview. Clustered logistic regression was applied to identify the impact of PSD on caregiver burden. As results, female patients, normal muscle strength and PSD were associated with caregiver burden. PSD correlated with an independent influence of 17.2% on the risk of caregiver burden, The independent influence of PSD on caregiver burden was smaller than that of social-demographics of caregivers and clinical factors of stroke patients This study suggests that PSD may have a modest influence on caregiver burden.     

Can Video Self-Modeling Improve Affected Limb Reach and Grasp Ability in Stroke Patients?

The authors examined whether feedforward video self-modeling (FF VSM) would improve control over the affected limb, movement self-confidence, movement self-consciousness, and well-being in 18 stroke survivors. Participants completed a cup transport task and 2 questionnaires related to psychological processes pre- and postintervention. Pretest video footage of the unaffected limb performing the task was edited to create a best-of or mirror-reversed training DVD, creating the illusion that patients were performing proficiently with the affected limb. The training yielded significant improvements for the forward movement of the affected limb compared to the unaffected limb. Significant improvements were also seen in movement self-confidence, movement self-consciousness, and well-being. FF VSM appears to be a viable way to improve motor ability in populations with movement disorders.