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.     

阿卡波糖、二甲双胍联合胰岛素类似物治疗肥胖糖尿病短期疗效

观察阿卡波糖、二甲双胍联合胰岛素类似物治疗肥胖2型糖尿病的短期疗效。将60例符合标准患者随机分为观察组和对照组各30例,均给予重组甘精胰岛素联合赖脯胰岛素强化治疗控制血糖,观察组同时给予阿卡波糖及二甲双胍口服,出院时进行疗效评价。观察组血糖达标时间、胰岛素用量少于对照组,餐时胰岛素停用比例大于对照组,差异有统计学意义（P＜0．05）;两组患者出院时体重较入院时均有所下降,观察组较对照组体重变化更明显（P＜0．01）。阿卡波糖、二甲双胍联合胰岛素类似物治疗方案,可作为初诊肥胖2型糖尿病治疗的理想方法之一。     

食管裂孔疝的外科治疗进展

食管裂孔疝即腹腔内脏器经食管裂孔疝入胸腔,并引发烧心、反酸等消化道及其他非消化道症状。按其解剖及临床表现可分为四型。通过病史采集、体格检查及一系列客观检查可以明确食管裂孔疝的诊断、分型及疾病进展程度。食管裂孔滑动疝并发反流、食管裂孔旁疝合并明显症状、混合型及多器官型食管裂孔疝或内科治疗效果不佳的通常应优先考虑手术治疗,以消除疝形成的因素,控制胃食管反流。食管裂孔疝手术目前通常采取腹腔镜下疝修补、补片加强及胃底折叠术,同时也存在食管延长、胃固定等其他替代术式。围手术期通过积极地控制风险因素,有助于降低各类术中、术后并发症风险及复发率。对复发、儿童及肥胖等特殊患者,也应视患者条件积极实施手术治疗。随着研究的进一步深入,食管裂孔疝手术在手术入路、补片材料、复发及并发症控制、日间手术模式应用等方面将取得更大的进展。     

A Probabilistic and Individualized Approach for Predicting Treatment Gains: An Extension and Application to Anxiety Disordered Youth

The objective of this study was to extend the probability of treatment benefit method by adding treatment condition as a stratifying variable, and illustrate this extension of the methodology using the Child and Adolescent Anxiety Multimodal Study data. The probability of treatment benefit method produces a simple and practical way to predict individualized treatment benefit based on pretreatment patient characteristics. Two pretreatment patient characteristics were selected in the production of the probability of treatment benefit charts: baseline anxiety severity, measured by the Pediatric Anxiety Rating Scale, and treatment condition (cognitive-behavioral therapy, sertraline, their combination, and placebo). We produced two charts as exemplars which provide individualized and probabilistic information for treatment response and outcome to treatments for child anxiety. We discuss the implications of the use of the probability of treatment benefit method, particularly with regard to patient-centered outcomes and individualized decision-making in psychology and psychiatry.     

Mechanisms of Change in Brief Couple Therapy for Depression

The goal of the present study was to investigate potential mechanisms of previously documented treatment effects for a brief, 5-session, problem-focused couple therapy for depression in a sample of 35 depressed women and their nondepressed husbands. The primary treatment effects were reducing women’s depressive symptoms and their husbands’ psychological distress and depression-specific burden. Secondarily, treatment resulted in increased relationship satisfaction for both partners. Given these significant treatment changes observed in 5 sessions, we sought to examine the mechanisms of change by testing the following three factors as potential mediators: (a) negative behaviors and attitudes toward depression, (b) support provision, and (c) empathic communication towards the depressed female partners. Women’s depression and husbands’ depression-specific burden were alleviated by positive changes in their illness-related attitudes and behaviors. Improvements in women’s marital satisfaction were also mediated by positive change in their illness-related attitudes and behaviors, along with perceptions of increased positivity and support from their husbands. Findings highlight the importance of targeting specific treatment agents in a brief couple therapy for depression such as psychoeducation about depression and support-building to increase partners’ understanding and acceptance of the illness, and teaching communication skills to reduce negative behaviors and criticism that are replaced by more empathic communication towards the depressed individual.     

Soins pénalement ordonnés et positionnements professionnels : des pratiques au carrefour de la Santé et de la Justice

At the crossroad of Health and Justice, penally ordered care underlies professional practices, the articulation of which can turn out to be delicate. Here we tackle the relevance and practical application of these measures. For that purpose, semi-directive interviews and field observations have been conducted with probation agents, judges (who follow up the way sentences are executed) and psychologists. The professionals’ comments and experiences show the complexity of these measures, which intend to make “care” into a recidivism prevention tool. Misconceptions appear about theory, practices and interprofessional relationships. The idea of “care” as a sole medical term appears to be ineffective and calls for the creation of new practices.     

超声引导介入治疗在老年原发性肝癌中的应用

超声引导介入治疗是一种微创靶向治疗,具有操作简单、安全性高等优点,已成为临床肝癌非手术领域不可缺少的新技术。治疗手段主要包括微波消融、局部注射无水酒精、抗肿瘤生物反应调节剂等。在老年人这个特殊人群中的应用得到较多重视。本文就超声引导介入治疗在老年原发性肝癌中的应用做一讨论。     

血管内皮生长因子与结直肠癌的研究

血管内皮生长因子(vascular endothelial growth factor,VEGF)是一高度特异作用于内皮细胞的糖蛋白,是目前发现的最重要的肿瘤血管生长因子之一.结直肠癌的生长、侵袭和转移与血管内皮生长因子有密切的关系,VEGF在结直肠癌治疗中的作用日益突出.本文就VEGF的功能、在结直肠癌中的表达和治疗的作用作一综述.     

循环肿瘤细胞的研究进展

循环肿瘤细胞（circulating tumor cells,CTCs）指自发或因诊疗操作由实体瘤或转移灶释放进入外周血循环的肿瘤细胞。CTCs能被看作液体活检,具有实时监测功能,是一种非侵入性的新型诊断工具,有助于早期发现肿瘤的微转移,可评估预后,在治疗的监测及个体化治疗上具有重要的临床意义。     

The Good Behavior Game: a best practice candidate as a universal behavioral vaccine

A behavioral vaccine provides an inoculation against morbidity or mortality, impacting physical, mental, or behavior disorders. An historical example of a behavioral vaccine is antiseptic hand washing to reduce childbed fever. In current society, issues with high levels of morbidity, such as substance abuse, delinquency, youth violence, and other behavioral disorders (multiproblems), cry out for a low-cost, widespread strategy as simple as antiseptic hand washing. Congruent research findings from longitudinal studies, twin studies, and other investigations suggest that a possibility might exist for a behavioral vaccine for multiproblem behavior. A simple behavioral strategy called the Good Behavior Game (GBG), which reinforces inhibition in a group context of elementary school, has substantial previous research to consider its use as a behavioral vaccine. The GBG is not a curriculum but rather a simple behavioral procedure from applied behavior analysis. Approximately 20 independent replications of the GBG across different grade levels, different types of students, different settings, and some with long-term follow-up show strong, consistent impact on impulsive, disruptive behaviors of children and teens as well as reductions in substance use or serious antisocial behaviors. The GBG, named as a best practice for the prevention of substance abuse or violent behavior by a number of federal agencies, is unique because it is the only practice implemented by individual teachers that is documented to have long-term effects. Presently, the GBG is only used in a small number of settings. However, near universal use of the GBG, in major political jurisdictions during the elementary years, could substantially reduce the incidence of substance use, antisocial behavior, and other adverse developmental or social consequences at a very modest cost, with very positive cost-effectiveness ratios.