ALI/ARDS患者糖皮质激素的治疗效果和时机

急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)是临床各科经常遇到的急症,其发病机制主要是中性粒细胞向炎症部位的移动,释放出大量的炎性介质和细胞因子,引起肺泡毛细血管膜通透性增高,弥漫性肺损伤和蛋白性肺泡水肿液聚集等病理生理改变。临床表现为呼吸困难、呼吸窘迫、顽固的低氧血症,虽然使用机械通气和呼气末正压通气(PEEP)后,其病死率有所下降,但仍然维持在50%左右。就糖皮质激素的作用机制,对不同原因引起的ALI/ARDS治疗效果,使用时机作一综述,期望对ALI/ARDS治疗过程中糖皮质激素的使用予以规范。     

急性肺损伤与急性呼吸窘迫综合征的诊断与治疗策略

急性肺损伤（ALI）和急性呼吸窘迫综合征（ARDS）是多个危险因素直接或间接引起肺部损伤的连续病理过程,以表现低氧血症为特征,ARDS是ALI严重末期的表现。低流量、呼气末正压（PEEP）保护性通气的措施可明显改善氧和,减轻机械通气肺损伤,降低病死率,明显优于传统通气方式。     

Intrinsic and extrinsic factors associated with night waking in 9-month-old infants

This study examined relations between infant night waking and both daytime behaviors reflective of poor behavioral and emotional regulation (intrinsic factors) and parent behaviors that may contribute to infant night waking (extrinsic factors) in 41 infants. Mothers completed questionnaires and an infant sleep and crying diary. More time awake at night was related to separation distress, frequent daytime crying, dysregulation, co-sleeping with parents, breast feeding, and being put to bed asleep. More frequent waking was related to separation distress, frequent daytime crying, co-sleeping, and breast feeding. The combination of intrinsic and extrinsic factors predicted night waking better than behaviors from one category alone. Implications for parenting are discussed.     

亲社会行为与利他主义

本文概要地介绍了利他主义与亲社会行为的定义、理论解释和一些影响因素.     

Emotional Reactions to Health Status Changes and Emotional Well-Being Among HIV-Positive Persons with Limited Reading Literacy

People living with HIV-AIDS experience emotional distress in response to negative changes in their health status. The current study hypothesized that individuals with poorer health literacy skills would evidence greater emotional distress in response to negative changes in health status compared to persons with higher health literacy skills. HIV positive persons (N = 294) completed anonymous surveys that included measures of depression and social support and a subset of 98 participants completed two experimental vignettes depicting a person receiving test results showing an increase in HIV viral load (negative health changes) followed by a vignette suggesting decreased viral load (improved health changes). Responses to affective reactions and coping strategies indicated that persons with lower health literacy skills more strongly endorsed negative affective states and maladaptive coping strategies compared to persons with higher health literacy skills. In addition, lower health literacy was associated with greater symptoms of affective depression and poorer social support, whereas higher literacy was associated with greater negativistic thinking. Findings suggest the need for patient education and counseling regarding changes in health status among people living with HIV-AIDS, particularly persons with limited health literacy skills.     

Dreaming under fire: the psyche in times of continuous stress

Continuous stress and trauma are manifested in dreams, the study of which can expand our knowledge concerning unconscious reactions to trauma and efforts of coping with continuous traumatic situations. In our research we asked people living under continuous threat of rocket attacks to record their dreams and their associations to them during four consecutive weeks. We collected 609 dreams from 44 women and 18 men (age range 14-62). The dreams submitted were analysed according to the Jungian approach in the light of the information and associations presented by the subjects. Full dream series of dreamers from each group were analysed in an attempt to capture the depth-psychological experience of living and dreaming under fire. The most frequent themes found were: ‘concrete vs. symbolic', ‘togetherness', ‘active ego', ‘fear and anxiety', ‘shadow' and ‘personal issue'. The subjects were divided into three age groups. Differences between the occurrences of themes were examined. On the unconscious level our results showed that the adolescents group seemed to be the most vulnerable to the stress situation (preponderance of concrete dreams), the mature adults group was the least influenced by it (preponderance of symbolic dreams and of the ‘personal issue' theme) and the young adults group made the greatest psychological efforts for coping (preponderance of ‘active ego' theme). We noted few anima figures appearing in the men's dreams, while animus figures appeared in the women's dreams. In another study undertaken immediately after one of the recent wars in Gaza we collected dreams of Israelis living in the south of Israel who were under heavy daily rocket attacks, and dreams of Palestinians living in the West Bank. The most significant difference we found between the groups was a preponderance of symbolic dreams among the Palestinians, as opposed to a preponderance of concrete trauma dreams among the Israeli group living on the Gaza border. In both groups we found archetypal symbols of evil. In conclusion, dreams can help us detect emotional distress, even when subjects seem ‘ok'. Early detection and working with dreams can help prevent the severity of delayed PTSD.     

Impact of assertive and accusatory communication of distress and anger: A verbal component analysis

Forty undergraduate women were asked to imagine discussing an important problem in their relationship with a personally close partner and to rate likely emotional and behavioral reactions to four kinds of statements: 1) assertive communication of distress, 2) assertive communication of anger, 3) accusatory communication of distress, and 4) accusatory communication of anger. Accusatory “you” statements were rated as more aversive and evoked more negative emotional and behavioral response inclinations than did assertive “I” messages. Statements including “anger” words evoked more negative emotional and behavioral response inclinations than statements including “distress” words. Findings were related to research on cue-controlled aggression and the work of Staats, which predicts ways that verbal labels (language) exert control over emotions and behavior.     

Mindfulness May Buffer Psychological Distress in Adolescents during the COVID-19 Pandemic: The Differential Role of Mindfulness Facets

The COVID-19 pandemic strongly impacts adolescents’ mental health, a population particularly vulnerable to mental disorders, highlighting the need to identify protective factors against COVID-19 related psychological distress to inform policies and intervention strategies. Previous research suggests that mindfulness may be a promising factor that can lower the risk of detrimental psychological consequences related to the COVID-19 pandemic. However, it is currently unknown which aspects of mindfulness contribute most to its protective effects. Moreover, previous studies mainly focused on adult samples. The present study aimed to address this gap by investigating the impact of specific mindfulness facets on adolescents’ COVID-19 related psychological functioning. 246 Dutch-speaking adolescents were recruited via social media to complete a cross-sectional online survey between June 29 and October 11, 2020. Participants were 16–18 years of age, most of them women (71%), and the majority followed the highest level of Belgian secondary education. Logistic regression analyses were performed to test the differential effects of each mindfulness facet on psychological functioning. Our results identified decentering as the facet of mindfulness that was uniquely associated with decreased worry and stress, improved mental health and quality of life, as well as with an increase in social connectedness with others following the outbreak of the COVID-19 pandemic. Unexpectedly, decentering was negatively associated with adolescents’ helping behaviour during compared to before the pandemic. Implications for research on and application of mindfulness are discussed. Taken together, these findings suggest that the facet of decentering, among all facets of mindfulness, may represent the main protective factor against psychological distress during the COVID-19 pandemic.     

Victims' emotional distress and preventive measures usage: Influence of crime severity,risk perception,and fear

The central thesis of this study is that crime victims' emotional distress, influenced by the severity of the offence experienced, impacts their propensity to utilize preventive measures via its influence on perceived risk of victimization and fear of crime. Path analysis was conducted to test a model of these relationships, utilizing data from a crime victimization survey conducted on the Caribbean Island, Trinidad, in 2015. Results suggest a direct predictive relationship between crime severity and emotional distress and indirect effects of emotional distress on preventive measures through risk perception and fear of crime. Findings were discussed in the context of prior research, comparability, and variances, and practical implications were noted.