苯丙胺类兴奋剂(ATS)娱乐性使用的不良后果调查

目的 :了解娱乐性ATS使用者的躯体、心理状况及其相关问题。方法 :采用病例发现法和易接近对象晤谈法 ,对受试者进行定式检查并记录。结果 :使用者在使用ATS时 :5 0 %以上的使用者曾出现过恶心、不适和 /或焦虑紧张的体验 ,约 2 5 %的使用者曾出现过工作学习出错 ,16 9%的使用者曾出现过伤害事故。使用者在使用ATS后 :60 %以上的人体验到一系列成瘾者的特征 ,3 2 3 %的使用者出现家庭和社会问题 ,10 2 %的使用者由于使用ATS而导致法律问题 ,约 5 0 %的使用者表现有心理问题。结论 :娱乐性ATS使用者是一个亚健康的特殊群体 ,需采取有效的干预措施     

住院精神分裂症患者的自杀行为

目的 :了解精神分裂症患者自杀意念和自杀未遂的发生率及特征。方法 :通过自编自杀行为调查表对 177例连续入院的精神分裂症患者的自杀行为进行研究。结果 :自杀意念发生率为 47 46% (84例 ) ,已往出现过且目前也存在自杀意念者为 3 0 95 % ,仅目前存在或仅既往出现者分别为 2 6 19%和42 86% ;自杀意念短暂出现者为 9 2 9% ,持续一周者为 5 0 0 0 % ,持续两周以上者为 10 71% ;自杀意念严重者为 3 1 67% ;11 91%有自杀意念的患者对自杀意念能控制 ,9 5 2 %的患者不能控制 ,78 5 7%的患者表示不确定。自杀未遂的发生率为 15 82 % (2 8例 ) ,其中 1次者占 64 2 8% ,2次者占 17 86% ,3次及 3次以上者占 17 86%。 77 78%自杀未遂发生在发病期 ;自杀方式多为服用精神科药物 (4 4 44 % ) ;发生地点多在家中 (86 67% ) ;实施自杀未遂行为前 ,71 11%患者明确表达或暗示过其自杀意图 ;60 %患者未作过准备 ,准备不充分者为 3 7 78% ,仅 2 2 2 %的患者有充分准备 ;15 5 6%患者留有遗言。结论 :自杀意念是导致精神分裂症患者死亡的主要因素之一 ,临床工作中应提高警惕 ,及时干预     

海南地区β-地中海贫血基因突变类型的研究

目的　了解海南省 β -地中海贫血基因突变类型特点。方法　用反向点杂交法分析 30例临床诊断为 β -地中海贫血患儿及 3对曾生育过重型地贫患儿的夫妇的基因突变类型。结果　 30例患儿中 7例为纯合子 ;1 5例为双重杂合子 ;8例为杂合子。 58条 β -地贫阳性染色体中确定 8种突变类型 ,其中CD41 - 4 2 (-TTCT) (占 51 7%) ;- 2 8(AG) (占1 3 8%) ;CD71 - 72 ( A) (占 1 0 3 %) ;IVS-II- 654(CT) (占 1 0 3 %) ;- 2 9(AG) (占 1 72 %) ;CD1 7(AT) (占 1 72 %)CD2 6(GA) (占 1 72 %) ;起始codon(ATGACG) (占 1 72 %)还有不明 (占 6 9%)。结论　海南省 β -地中海贫血的基因突变类型与国内广东、广西、湖北相似 ,以CD41 - 4 2 ,- 2 8,CD71 - 72 ,IVS -II 654 ,4种类型为常见。明显不同于海南黎族     

广东佛山地区β地中海贫血基因突变类型分析

目的　了解广东佛山地区 β地中海贫血基因突变类型及其频率。方法　应用反向点杂交法检测 16种 β地贫点突变基因。结果　 4 30例中检出 10种 β地贫基因突变类型 ,按其发生率高低排列为 :CD4 1/ 4 2 188例 ,占 4 3 7% ;IVS -nt6 5 410 7例 ,占 2 4 4 % ;TATAnt- 2 84 3例 ,占 10 0 % ;CD174 2例 ,占 9 8% ;CD71/ 72 18例 ,占 4 2 % ;CD4 311例 ,占 2 5 % ;TATA - 2 95例 ,占 1 2 % ;CD1- 15例 ,占 1 2 % ;βE 4例 ,占 0 9% ;CD2 7/ 2 83例 ,占 0 6 % ,4例为未知类型。结论　佛山地区 β地贫突变频率与广东省已有的研究资料数据较接近 ,但也有一定差异。     

143例异常核型与临床表现关系分析

我室 1991年 1月至 2 0 0 2年 2月对 2 0 5 4例遗传咨询者进行细胞遗传学检查 ,检出异常核型 14 3例 ,异常率 6 .96 %。异常核型者均有某些特异的临床表现。跟踪随访 12 1例 ,随访率84 .6 2 %。现报告如下。1　对象与方法14 3例异常核型者中 ,男 72例 ,女 71例 ;年龄最大 5 1岁 ,最小出生后 4小时。就诊原因 :智低、表型异常 71例 ,占 4 9.6 5 % ;自发流产、死胎、死产、生育智低或畸形儿 2 2例 ,占 15 .38% ;闭经、性发育异常、不育症 4 8例 ,占 33.5 7% ;恶性肿瘤 2例 ,占1.4 %。对 14 1例外周血淋巴细胞、1例骨髓细胞、1例羊水细胞进行培…     

48例蚕豆病临床分析

蚕豆病 (Ｆａｖｉｓｍ)是一种先天性 (遗传性 )红细胞葡萄糖- 6 -磷酸脱氢酶 (Ｇ6ＰＤ)缺陷的疾病 ,该病主要是因进食干、鲜蚕豆或蚕豆制品 ,或吸入蚕豆花粉 ,服用具有氧化作用的药物而引起的急性血管内溶血。我科在 1998年～ 2 0 0 1年期间共收治蚕豆病 4 8例 ,现报告如下。临床资料一、一般资料1 诊断标准 :　本组 4 8例蚕豆病 ,均符合《实用儿科学》Ｇ6ＰＤ缺陷症的诊断标准[1]2 性别年龄 :　本组 4 8例 ,4 7例为男性 ,占 97.9% ,女性 1例 ,占 2 .1%。发病年龄最小 2月 ,最大 9岁 ,其中～ 1岁 3例 ,占 4 .3% ,～ 3岁 2 4例 ,占 5 0 % ,…     

300例住院病人抗菌药物使用情况调查

目的及方法 :为了解当前住院病人中抗菌药物的使用情况 ,我们从某院病案室 2 0 0 2年 1 2月至 2 0 0 3年1月出院的病例中 ,随机抽取 9个科室共 3 0 0份病案 ,查看并统计抗菌药物使用的有关情况。　　结果 :3 0 0例住院病人中使用抗菌药物的 2 69例 ,占 89.3 %。在使用抗菌药物的病例中 ,诊断有“感染”(包括上呼吸道感染 )的仅 1 2 3例 ,占 45 .7% ,无明确感染 ,属预防用药的 1 46例 ,占 5 4.3 %。如“痛风”患者静滴培氟沙星 ,正常分娩妇女预防性服用头孢氨苄者达 80 %。所有使用抗菌药物的病人 ,无一例有病原学检查结果 ,“经验”用药现象…     

后筛窦的影像解剖学研究

目的 :为了提供对内窥镜鼻窦外科及颅底外科手术更具指导意义的后筛窦影像解剖学资料。方法 :取 5 0具成人头颅标本 ,行冠状位、矢状位及水平位薄层CT扫描 ,从不同层面及不同方位观测后筛窦的气化发育情况。结果 :发现属管前型的占 2 3 % ( 2 3侧 ) ;半管型的占 2 8% ( 2 8侧 ) ;全管型的占 3 3 %( 3 3侧 ) ;蝶鞍型的占 16 % ( 16侧 )。其中两侧气化分型完全相同者占 3 3例 ( 6 6侧 ) ;两侧气化不相同者占 17例 ( 3 4侧 )。发现属Ⅰ°后筛窦的占 43 % ( 43侧 ) ;属Ⅱ°后筛窦的占 3 5 % ( 3 5侧 ) ,其中属Ⅱa°后筛窦的占 19%( 19侧 ) ,属Ⅱb°后筛窦的占 16 % ( 16侧 ) ;属Ⅲ°后筛窦的占 2 2 % ( 2 2侧 )。其中两侧分度完全相同者占 2 9例( 5 8侧 ) ;两侧分度不相同者占 2 1例 ( 42侧 )。结论 :后筛窦影像解剖分型分度对内窥镜鼻窦外科及颅底外科手术具有实际的指导意义。     

152例绒毛孕早期产前诊断

1　材料与方法1 1　 材料　收集 15 2例绒毛组织材料。夫妇一方有明显致畸因素接触史 6 5人 ,占 42 8% ;有不良妊娠史者 2 9例 ,占19 0 8% ;高龄孕妇 (>30岁 )者 30例 ,占 19 7% ;生过染色体病患儿者 15例 ,占 9 9% ;父母一方染色体异常携带者 5例 ,占 3 3% ;其他 8例 ,占 5 2 %。1 2　方法　所有病例均采用宫颈盲吸绒毛 ,短期培养法 ,Ｈａｎｋｓ液漂洗绒毛 ,放入 16 40培养基加秋水仙在 37℃培养1～ 2ｈ ,固定 2次 ,加 6 0 %冰醋酸 0 5ｍｌ内滴片 3ｍｉｎ ,Ｇｉｅｍｓａ染色用直接法以 0 85 %盐水漂洗绒毛 ,低渗 ,37℃水浴 15～ 2 0ｍ…     

家庭因素对医学新生适应能力的影响

目的 :探讨家庭因素对医学新生适应能力的影响。方法 :使用“一般情况问卷”、“大学生适应情况调查表”、“父母养育方式问卷”、“家庭环境量表中文版”对三所医学院校新生 5 5 6人进行调查。通过单因素分析和多元回归分析等方法 ,筛选影响新生适应能力的主要家庭因素。结果 :入学新生四个月后仍有9 7%不能适应大学学习 ,3 6 %不适应大学生活 ,11 9%不适应大学的人际关系。女生差于男生。父母情感温暖、亲密度、成功性、娱乐性与适应得分呈低度正相关 (r =0 16～ 0 2 4) ,而父母严厉惩罚、拒绝否认、过度保护、矛盾性、控制性呈低度负相关 (r =-0 15～ 0 2 4)。多元逐步回归显示 :矛盾性、娱乐性、组织性、控制性、父亲过度保护是影响医学新生适应能力的主要因素 (r =3 8～ 2 1)。结论 :家庭背景对新生的适应能力有显著影响     

Injecting equipment sharing among injecting drug users in Togliatti City, Russian Federation: maximizing the protective effects of syringe distribution

OBJECTIVE: To compare risk factors for injecting equipment sharing among injecting drug users (IDUs) in Togliatti City, Russia. DESIGN: Unlinked, anonymous, cross-sectional community-recruited survey with oral fluid sample collection. METHODS: Between September and October 2001, 426 IDUs completed an interviewer-administered questionnaire and oral fluid samples were tested for HIV. Univariate and multivariate analyses compared potential risk factors for injecting equipment sharing. RESULTS: More than half (56% [234/418]) of the sample were positive for antibodies to HIV. A third (36%) had injected with used needles and syringes in the last 4 weeks. IDUs who reported syringe exchanges or outreach workers as their main sources of new needles and syringes in the last 4 weeks had 0.3 times the odds of sharing compared with those obtaining them from a pharmacy or shop, whereas those whose main source was buying them from the streets or obtaining them from friends, sexual partners, or other drug users had 12 times the odds of receptive needle and syringe sharing. IDUs who reported being last arrested or detained by the police for a drug-related offense had higher odds of sharing. CONCLUSIONS: Findings highlight the delicate balance in HIV prevention between potentially competing strategies of law enforcement and syringe distribution.     

Social network and demographic predictors of length of participation in a parent education program

The study sought to determine whether there were social network and demographic differences between short-term (nonusers) and long-term (users) participants in an educational support program for parents of very young children. The sample included 55 working-class and low-income mothers. Nonusers were found to have less involvement in community affairs, a fewer number of nearby friends and relatives, and received less instrumental help from parents than program users. Nonusers gave more overall in helping relationships but received more help at the time of the child's birth than users. Nonusers also had a fewer number of children than users. There were no significant income differences between nonusers and users. The data suggested that social network attributes may play a role in determining an individual's need and style regarding participation in a formal peer-oriented program. Implications for program development and future research were suggested.     

Complementary health approaches for health and wellness in midlife and older US adults

ObjectivesTo characterize the use of complementary health approaches (CHA) and examine the perceived benefits of using CHA by reason for use among midlife and older adults.Study designAnalysis of 2012 National Health Interview Survey data, a nationally representative US sample using cross-tabulations with design-based F-tests and multiple logistic regression. The analytic sample included adults aged over 50 years (N = 14,849).Main outcome measuresThe proposed benefits of using CHA included: (1) better control over health, (2) reduced stress/relaxation, (3) better sleep, (4) feeling better emotionally, (5) coping with health problems, (6) improved health/feeling better, and (7) improved relationships.ResultsOverall, 31% of this sample of midlife and older US adults had used CHA in the past year. Among users, 15% had used CHA for treatment only, 40% for wellness only, and 45% for combined wellness and treatment. Herbs (60%), chiropractic (28%), massage (22%), and yoga (19%) were the most common CHA. Wellness-only and combined users had significantly higher odds of reporting that CHA conferred benefit compared with treatment-only users.ConclusionsCHA are used by nearly a third of midlife and older adults and are perceived to provide substantial benefit. Integrating CHA as part of a healthy lifestyle has the potential to contribute to healthy aging among midlife and older adults.     

Do we talk to different people in different ways?: types and sources of social support and support-gaining strategies

The present paper examined whether people employ different support-gaining strategies toward various sources of support. In Study 1, 231 Taiwanese undergraduates were asked the frequency of each strategy they used for three support types: tangible, psychological, and informational, from four support sources: parents, professors, same-sex close friends, and same-sex acquaintances. In Study 2, 363 undergraduates were asked to think of an opposite-sex friend: an acquaintance, a close friend, or romantic partner, and write the frequency of each strategy they used. Results of ANOVA indicated that main effects of source and strategy and a three-way interaction of source by strategy by gender were significant. In Study 1, the students used various strategies most frequently toward parents and same-sex close friends, and least frequently to professors, and in Study 2, more frequently to close friends and romantic partners than to acquaintances. The strategy most often used was reasoning, followed by entreaty, roundabout request, exploitation, promise of reward, exhortation, and threat, in the descending order. No effect was found for the support type factor.     

Program Directors' Perceptions of Undergraduate Athletic Training Student Retention

Context:The average retention rate for students enrolled in undergraduate athletic training programs (ATPs) nationwide has been reported to be 81%, and slightly more than half of program directors (PDs) have indicated that retention of athletic training students (ATSs) is a problem. However, why PDs do or do not believe ATS retention is problematic is unknown.Objective:To determine why PDs do or do not believe ATS retention is problematic.Design:Qualitative study.Setting:Undergraduate ATPs.Results:Program directors believed that retaining ATSs was a problem because students lack information regarding athletic training and the rigor of the ATP. Program directors were consistent in their perception that ATPs do not have a retention challenge because of the use of a secondary admissions process. This finding was likely based on personal use of a secondary admissions process in the ATPs these PDs lead.Conclusions:Program directors who lead ATPs that struggle to retain ATSs should consider using a secondary admissions process. During the preprofessional phase of the ATP, faculty and staff should work to socialize students to the demands of the ATP and the professional lives of athletic trainers.Key Words: athletic training education, persistence, departure, attrition

Key Points

• Early socialization and orientation of athletic training students into the roles and expectations of athletic trainers and the program may help to improve retention.
• Secondary admissions processes may aid athletic training programs in retaining students.

For a multitude of reasons, athletic training student (ATS) retention has become a strong focus in the literature.^1–4 One possibility for the increased attention to ATS retention may stem from the move to accredited professional education programs. Before 2004, prospective athletic trainers could enter the profession through either an accredited program or an internship route. With athletic training education reform, the internship route was abandoned and candidates were required to graduate from an accredited athletic training program before sitting for the Board of Certification examination. Elimination of the internship path has caused the number of undergraduate athletic training programs (ATPs) in the United States to more than double to 343 as of the spring 2011 semester. ⁵ A previous author found that younger ATPs had lower ATS retention rates (Valerie Herzog, written communication, 2006). Because reform has caused a dramatic increase in the number of young programs, perhaps retention is more of a problem now. Another potential reason for the increase in interest in ATS retention may have to do with upholding the ATPs'' reputation⁶ as maintaining high ATS retention rates can help to improve public opinion of ATPs. Finally, reasons for ATS dropout have been identified, particularly the demanding coursework and time-consuming clinical education experiences.⁷ However, whether dropout is considered problematic or a necessity to remove those who cannot complete the ATP or enter professional practice is currently unknown.Most of the existing literature has examined retention and attrition from the student point of view.^1–3 Athletic training students persist when they are integrated academically, socially, and clinically through proper socialization and when they experience positive relationships with other ATP stakeholders.^1,2 Although the findings are insightful and can aid in retention initiatives offered by ATPs, more research is warranted; additional studies must be undertaken before the current state of ATS retention can be fully understood. Understanding the unique vantage point of program directors (PDs) is important as they are responsible for the overall day-to-day operations of ATPs.⁸ One previous study⁹ sought retention and attrition data from PDs of ATPs before the 2004 athletic training educational reform. Programs at institutions with higher enrollments had a larger number of ATSs. Similarly, programs at state institutions and institutions with lower tuition costs had larger athletic training class sizes. The participants, 25 PDs, stated that most ATSs left the ATP in the first 2 semesters after formal acceptance. In addition, the majority of participants confirmed that administrators had not identified the ATS retention rate at their institution as a problem. The authors concluded that larger programs were not as concerned with ATS attrition as smaller programs because they had larger numbers of available ATSs.⁹We should further understand the present condition of ATS attrition before investigating ATS retention factors. The overall national retention rate for ATSs in undergraduate ATPs from formal admittance to graduation has been reported as 81.0%.⁴ Although this rate appears satisfactory compared with other health care professional programs, mainly nursing, which previously set a benchmark of 80%,¹⁰ approximately half of PDs believed that retaining ATSs was a problem facing athletic training education.⁴ Why some PDs believe retention is a problem while others do not, despite the relatively high overall retention rate, is unclear. Therefore, the purpose of our study was to determine why PDs do or do not believe ATS retention is problematic. We gathered data from PDs because we felt they have a broad understanding of retention based on their experience with cohorts of students, typically over multiple years in their current positions. We also believe PDs have conversations with colleagues about such issues, making their insights meaningful. Although the perspectives of ATSs can also be helpful, students have a much more centralized focus, making it difficult for them to know if attrition is a problem in athletic training education. Further, ATSs'' perspectives on reasons for persistence and departure have been explored previously.^1–3 A broader lens allows PDs to draw on experiences with a multitude of ATSs who may have departed or persisted for very different reasons. Understanding why PDs feel that ATS retention is or is not a problem may help other PDs or faculty make curricular changes to improve the retention rates of the ATSs in the ATPs they lead.     

Genotype-phenotype correlations of KCNJ2 mutations in Japanese patients with Andersen-Tawil syndrome

Andersen-Tawil syndrome (ATS) is a rare inherited disorder characterized by periodic paralysis, mild dysmorphic features, and QT or QU prolongation with ventricular arrhythmias in electrocardiograms (ECGs). Mutations of KCNJ2, encoding the human inward rectifying potassium channel Kir 2.1, have been identified in patients with ATS. We aimed to clarify the genotype-phenotype correlations in ATS patients. We screened 23 clinically diagnosed ATS patients from 13 unrelated Japanese families. Ten different forms of KCNJ2 mutations were identified in the 23 ATS patients included in this study. Their ECGs showed normal QTc intervals and abnormal U waves with QUc prolongation and a variety of ventricular arrhythmias. Especially, bidirectional ventricular tachycardia (VT) was observed in 13 of 23 patients (57%). Periodic paralysis was seen in 13 of 23 carriers (57%), dysmorphic features in 17 (74%), and seizures during infancy in 4 (17%). Functional assays for the two novel KCNJ2 mutations (c. 200G>A (p. R67Q) and c. 436G>A (p. G146S)) displayed no functional inward rectifying currents in a heterologous expression system and showed strong dominant negative effects when co-expressed with wild-type KCNJ2 channels (91% and 84% reduction at -50 mV respectively compared to wild-type alone). Immunocytochemistry and confocal imaging revealed normal trafficking for mutant channels. In our study, all of the clinically diagnosed ATS patients had KCNJ2 mutations and showed a high penetrance with regard to the typical cardiac phenotypes: predominant U wave and ventricular arrhythmias, typically bidirectional VT.     

Predictors of Waterpipe Smoking Among Secondary School Adolescents in Al Hassa, Saudi Arabia

Background

There has been a global upsurge of waterpipe (WP) smoking over the past several years. This can be attributed at least partly to various factors like lack of knowledge regarding its health effects, social acceptability, and intensive preventive programs focusing selectively on cigarettes smoking.

Purpose

This study aimed to determine the prevalence and psychosocial determinants of WP smoking among secondary school adolescents in Al Hassa, Saudi Arabia, and also to assess their attitudes toward WPs smoking and knowledge regarding the related health effects.

Methods

Cross-sectional study included 1,652 students of both genders selected by multistage proportionate sampling method. Data collection was carried out using a self-administered anonymous Arabic version of the Global Youth Tobacco Survey, modified with items dedicated to WP smoking. Items to assess participants' knowledge about the health-related hazards and attitude towards WP were added. Patient Health Questionnaire was used to screen for the presence of anxiety and depressive disorders.

Results

Of the included adolescents, 358 (21.7%) were current smokers; cigarettes (46.1%), both cigarettes and WP (16.5%), and only WP (37.4%). Current WP users accounted for 193; 96.4% were males and 62.7% were ??18?years of age. Outing, boredom, meeting friends, and family gatherings were the most frequently stated motives. WP users demonstrated a higher incidence of depressive and generalized anxiety disorders. Common assumptions regarding WP smoking included: WP smoking is less harmful than cigarettes and with no addictive property as stated by 47.8% and 65.9% of adolescents, respectively, harmful substances are purified through water filtration as believed by 59.2%, and it is more socially acceptable than cigarettes as agreed by 54.1%. Hierarchical regression analysis showed that male gender and increasing age of adolescents, WP smoking among close family and friends, and socializing motives were significant predictors for the current WP smoking state.

Conclusion

Social acceptability, poor knowledge of WP health-related hazards, and socio-demographics are favoring the current increasing trend of WP use among adolescents in Al Hassa, Saudi Arabia.     

Cannabis: What Makes University Students More or Less Likely to Use It?

University students' motivations for using or not using cannabis were investigated. Students ( n = 189) aged 17 to 29 years completed a survey to assess their intention to use cannabis and their beliefs about (a) advantages and disadvantages of using cannabis; (b) their perceptions of what significant others think they should do in relation to cannabis use; and (c) factors that might encourage them to use or not use cannabis. Two weeks later, they completed a follow-up survey asking about their actual behavior over the previous 2 weeks. Compared to non-users, users believed more strongly that cannabis would help them fit in with their friends, feel relaxed, forget their worries, and enjoy themselves. They also believed that their close friends, partner/spouse, siblings, and workmates would approve of their using cannabis. Users believed that certain factors (e.g., force of habit, wanting to relax, feeling stressed, being around other people using cannabis) would encourage them to use, while non-users rated work and study as strong reasons for not using cannabis. Beliefs that are relevant to users and non-users in education campaigns can be targeted to reduce the negative consequences of use in tertiary settings.     

A survey of professional help sought by patients for psychosocial problems.

A sample of patients aged 25-75 years was drawn from one general practice. The patients were sent a postal questionnaire to ascertain whether they had had a personal or emotional problem in the last 10 years and whom they had confided in. Of the 396 respondents 281 (71%) admitted to having had such a problem. It was found that significantly more women then men had had a problem. Of these 281 individuals, 94% had confided in someone, mainly friends and relatives, 47% had consulted one or more professionals or agencies and 37% had confided in their general practitioner. Although the majority had found the contact with the agency or professional helpful, those with depression/anxiety or problems following a bereavement were less likely to feel that they had been helped. The provision of practical advice, sympathy and support were most often mentioned as being helpful. This study demonstrates the important role of the general practitioner in the management and treatment of psychosocial problems.