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Depression and anxiety across Parent-child behavior 亲子行为中的抑郁和焦虑
Pub Date : 2018-12-05 DOI: 10.31579/2637-8892/034
Tabor Chedid
Using the Fragile Families and Child Wellbeing Study, we examine the association between parental major depressive and generalized anxiety disorders and child behavior problems across family types: married, cohabiting, involved nonresident father, and noninvolved nonresident father. Among 3‐year‐olds in all families, maternal anxiety/depression is associated with increased odds of anxious/depressed, attention deficit, and oppositional defiant disorders (N = 2,120). Paternal anxiety/depression has no significant association with these problem behaviors; father’s illness, however, exacerbates anxious/depressed behaviors in young children if both parents are ill and he is co resident. The findings underscore the importance of maternal mental health for child well‐being and suggest that a negative interaction between parent illnesses is most likely when parents and children share the same disorder.
利用脆弱家庭和儿童健康研究,我们研究了父母重度抑郁和广泛性焦虑障碍与儿童行为问题之间的关系,包括不同的家庭类型:已婚、同居、参与的非居民父亲和不参与的非居民父亲。在所有家庭的3岁儿童中,母亲焦虑/抑郁与焦虑/抑郁、注意力缺陷和对立违抗障碍的几率增加有关(N = 2120)。父亲焦虑/抑郁与这些问题行为无显著关联;然而,如果父母双方都生病并且父亲是共同住院医师,父亲的疾病会加剧幼儿的焦虑/抑郁行为。研究结果强调了母亲心理健康对儿童健康的重要性,并表明当父母和孩子患有相同的疾病时,父母疾病之间的负面互动最有可能发生。
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引用次数: 0
Theoretical and Therapeutic Applications of Mental Pain in Childhood cancer Survivors of the Findings of the paper 心理疼痛在儿童癌症幸存者中的理论与治疗应用的研究结果
Pub Date : 2018-12-05 DOI: 10.31579/2637-8892/007/
Haya Raz
The paper deals with a review of “Mental Pain in Israeli Adult Childhood Cancer Survivors and Its Effects on their Quality of Life” by H. Raz, N. Tabak, Y. Alkalay, & S. Kreitler (1). The review focuses on theoretical and therapeutic implications of the findings. The major theoretical elaboration of the findings focuses on the construct of mental pain. This seems advisable both because there are several apparently similar concepts which presumably render mental pain superfluous and because mental pain was found to characterize pediatric cancer survivors who otherwise were found to be well adjusted as adults. The new redefinition of mental pain focuses on the components of low self-image and low meaningfulness of life. The constructs of mental pain in the past and of tolerance of mental pain were found to be less useful in this context. The new redefinition points to two new venues of interventions for reducing mental pain: enhancing self-image and increasing meaningfulness of life. The two kinds of interventions, which are based on elaborating meanings, are briefly described.
本文回顾了H. Raz, N. Tabak, Y. alkay和S. Kreitler对“以色列成年儿童癌症幸存者的精神疼痛及其对生活质量的影响”的研究(1)。该综述侧重于研究结果的理论和治疗意义。这些发现的主要理论阐述集中在精神疼痛的构建上。这似乎是明智的,因为有几个明显相似的概念可能使精神痛苦变得多余,因为精神痛苦被发现是儿童癌症幸存者的特征,否则他们会被发现作为成年人适应得很好。精神痛苦的新定义集中在低自我形象和低生活意义的组成部分。在这种情况下,过去的精神痛苦和对精神痛苦的容忍的构念被发现用处不大。新的重新定义指出了减少精神痛苦的两个新的干预途径:增强自我形象和增加生活的意义。本文对这两种基于阐述意义的干预进行了简要描述。
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引用次数: 0
Estimate the scope of behavioral health need among women beginning pregnancy care by an EMR-based assessment 通过基于电子病历的评估估计开始妊娠护理的妇女行为健康需求的范围
Pub Date : 2018-12-05 DOI: 10.31579/2637-8892/035
Shu Ling, Yu Wenli
Background: It is well-recognized that behavioral health problems are under detected and undertreated in primary care. Medical settings have been identified as likely settings to detect and address these problems, but any such efforts would require a strategic approach based on needs in the treated population. Obstetric settings are being encouraged to detect and address behavioral health needs. Methods: An EMR-based approach for developing an initial estimate of the portion in need, and the range of conditions present, was developed for the obstetric setting. A list was developed of behavioral health diagnoses and prescriptions that could be queried using the electronic medical record (EMR). For diagnoses, the ICD-9 set of "mental disorder" diagnoses (codes 290-319) was used. For prescriptions, a list of behavioral health medications published by NIMH was used, augmented with the behavioral health medications noted in a recent "Top 200" prescription list published by Verispan, a commercial firm. Results: Of this cohort of 3,290 women beginning pregnancy care in a one-year time span, this EMR query indicated that 394 (12.0%) had a behavioral health need; 5.2% were prescribed a medication alone, 3.1% had a diagnosis alone, and 3.6% had both. This is likely an underestimate, but the efficient EMR method serves as a helpful starting place for determining behavioral health needs to be addressed. Conclusions: These data indicate that screening for these conditions will likely yield modest, but steady, numbers of patients with behavioral health needs that could be integrated with obstetric care. Readily available data regarding most common diagnoses and most frequently prescribed drugs can be used to develop an initial estimate of the burden of behavioral health need in obstetrics. Other primary care settings could readily replicate this approach as an initial step for addressing behavioral health burden in primary care.
背景:人们普遍认为,在初级保健中,行为健康问题检测不足,治疗不足。医疗环境已被确定为可能检测和解决这些问题的环境,但任何此类努力都需要根据接受治疗人群的需求采取战略方法。鼓励产科机构检测和解决行为健康需求。方法:为产科环境开发了一种基于EMR的方法,用于对需要的部分和目前的状况范围进行初步估计。制定了一份行为健康诊断和处方清单,可以使用电子病历(EMR)进行查询。对于诊断,使用ICD-9“精神障碍”诊断集(代码290-319)。对于处方,使用了NIMH发布的行为健康药物列表,并添加了商业公司Verispan最近发布的“200强”处方列表中提到的行为健康药。结果:在一年内开始妊娠护理的3290名女性队列中,该EMR查询显示394名(12.0%)有行为健康需求;5.2%的患者单独服用药物,3.1%的患者单独诊断,3.6%的患者同时服用药物。这可能被低估了,但有效的EMR方法是确定行为健康需要解决的一个有用的起点。结论:这些数据表明,对这些疾病的筛查可能会产生适度但稳定的行为健康需求患者数量,这些患者可以与产科护理相结合。关于最常见的诊断和最常见的处方药的现成数据可用于对产科行为健康需求的负担进行初步估计。其他初级保健机构可以很容易地复制这种方法,作为解决初级保健中行为健康负担的第一步。
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引用次数: 0
“A Greedy Man in a Hungry World”: does hunger lead to depression and anxiety?” 《饥饿世界里的贪婪之人》:饥饿会导致抑郁和焦虑吗
Pub Date : 2018-08-20 DOI: 10.31579/2637-8892/026
V. V. Ginneken
We live in a divided world with reasoning for depression and anxiety (Figure 1). I say something rude -because it touches me emotionallywhile on the other side of the world in the US children are doing suicide because they are obese (BMI> 30) [1], at the same time, a huge number of children are dying mainly in East Africa in the subSaharan region as a result of hunger in combination with war. These scientific facts support my perception that we live in a divided, torn "Hunger-Obesity" world, and although the phenomenon of hunger has been less common since the 1990s, it seems as if people in developed countries have become emotionally insensitive to this phenomenon because this phenomenon is far away from the Industrialized Western World or Developed countries. In 1991, only a select number of developing countries had undernourishment levels <5%. In 2015, many countries achieved this, particularly across Latin America, the Middle East and North Africa [2]. United Nations warned as many as 1.4 million children could die of starvation in the coming months [4]. While at this time for the victims of this famine food supply is a top priority, I raise in this editorial the scientific question: “whether hunger distress is accompanied with depression and anxiety and whether at all biomarkers for human starvation/hunger stress exist”. These issues are important to answer in order to help traumatized victims during the famine, not solely with food, but with mental support or afterwards during their nutritional recovery period. If we see figure 2 which is a global map for “national happiness rankings” (a rough indicator for the parameters depression & anxiety) how this “emotion” is distributed on our planet, it seems that relatively most unhappy people live at the African continent which is stroke by famine and war. Brutal conflicts in South Sudan, Yemen and Nigeria have driven millions of people from their homes and left millions more in need of emergency food. [3].
我们生活在一个分裂的世界里,有关于抑郁和焦虑的推理(图1)。我说了一些粗鲁的话,因为这触动了我的情感。而在世界的另一端,美国的儿童因为肥胖(BMI>30)而自杀[1],与此同时,大量儿童主要在东非撒哈拉以南地区死于饥饿和战争。这些科学事实支持了我的看法,即我们生活在一个分裂、撕裂的“饥饿-肥胖”世界中,尽管自20世纪90年代以来,饥饿现象已经不那么常见了,但发达国家的人们似乎对这种现象在情感上变得不敏感,因为这种现象远离工业化的西方世界或发达国家。1991年,只有少数发展中国家的营养不良率<5%。2015年,许多国家实现了这一目标,尤其是拉丁美洲、中东和北非[2]。联合国警告说,未来几个月可能有多达140万儿童死于饥饿[4]。虽然在这个时候,粮食供应是饥荒受害者的首要任务,但我在这篇社论中提出了一个科学问题:“饥饿是否伴随着抑郁和焦虑,以及是否存在人类饥饿/饥饿压力的所有生物标志物”。为了在饥荒期间帮助受创伤的受害者,这些问题的答案很重要,不仅要提供食物,还要提供精神支持或在他们营养恢复期之后。如果我们看到图2,这是一张“国民幸福感排行榜”(抑郁和焦虑参数的粗略指标)的全球地图,这种“情绪”是如何在我们的星球上分布的,那么相对而言,大多数不快乐的人似乎生活在遭受饥荒和战争的非洲大陆。南苏丹、也门和尼日利亚的残酷冲突迫使数百万人背井离乡,数百万人需要紧急粮食。[3] 。
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引用次数: 0
Clinical practice of Headache: The Patient’s Education 头痛的临床实践:病人的教育
Pub Date : 2018-08-20 DOI: 10.31579/2637-8892/025
Helena Presado
Headache is the commonest reason for neurology referrals, and the commonest neurological reason for patients attending Emergency Departments (EDs). An ethical approach to health care requires that patients be provided with informed choice about management. However researchers have not addressed patients’ concerns and choices in managing headache. This study aims to describe the views of patients, their fears, use of EDs, their perceived need for a scan and its outcome for them.
头痛是神经内科转诊最常见的原因,也是急诊科(EDs)患者最常见的神经内科原因。一种合乎道德的保健方法要求向患者提供关于管理的知情选择。然而,研究人员还没有解决患者在治疗头痛方面的担忧和选择。本研究旨在描述患者的观点,他们的恐惧,急诊科的使用,他们对扫描的感知需求及其结果。
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引用次数: 0
Patients with dementia and depression-complexity 痴呆症和抑郁症患者
Pub Date : 2018-07-06 DOI: 10.31579/2637-8892/030
Samuel Langhorne
For a long time researchers and clinicians have been trying to clarify the possible existing relationships between Alzheimer’s disease and the depression in the elderly. This article tries to take stock of these complex links. It seems that often depression is clinically confused with apathy.
长期以来,研究人员和临床医生一直试图弄清阿尔茨海默病与老年人抑郁症之间可能存在的关系。本文试图分析这些复杂的联系。在临床上,抑郁症似乎常常与冷漠相混淆。
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引用次数: 0
Immune deficiency derive a favorable response to IVIg in PANDAS 免疫缺陷在PANDAS中对IVIg有良好的反应
Pub Date : 2018-07-06 DOI: 10.31579/2637-8892/032
Eric Arthur Blair
For two decades, pediatric autoimmune neuropsychiatric disorder associated with group a beta hemolytic streptococcal infection (PANDAS) has been treated with high-dose intravenous immune globulin (IVIg) therapy based upon the understanding that the disorder is partly due to post-infectious dysimmunity.
二十年来,与a组β-溶血性链球菌感染(PANDAS)相关的儿童自身免疫性神经精神障碍一直在接受高剂量静脉注射免疫球蛋白(IVIg)治疗,这是基于对该疾病部分是由于感染后免疫障碍的理解。
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引用次数: 0
“Extension of the “Fetal Origin Hypothesis of Barker” towards the “Fetal Origin Hypothesis of Mental Diseases” “巴克的胎儿起源假说”对“精神疾病的胎儿起源假设”的延伸
Pub Date : 2018-07-06 DOI: 10.31579/2637-8892/033
V. V. van Ginneken, C. Löwik
In this editorial we will first describe most common information about the intriguing “traditional” fetal origin hypothesis of Barker for physiological, endocrine and cardiovascular diseases (CVDs). The ‘developmental origins of adult disease’ hypothesis, often called the ‘Barker hypothesis’, states that adverse influences early in development, and particularly during intrauterine life, can result in permanent changes in physiology and metabolism, which result in increased disease risk in adulthood.
在这篇社论中,我们将首先描述巴克关于生理、内分泌和心血管疾病(CVD)的有趣的“传统”胎儿起源假说的最常见信息。“成人疾病的发育起源”假说,通常被称为“巴克假说”,指出发育早期的不良影响,特别是在宫内生活期间,会导致生理和代谢的永久性变化,从而增加成年后的疾病风险。
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引用次数: 1
LINAC treating more patients having brain arteriovenous malformations with stereotactic radiosurgery technique LINAC立体定向放射外科技术治疗更多脑动静脉畸形
Pub Date : 2018-07-01 DOI: 10.31579/2637-8892/031
Ricardo Reyes
All thirteen patients underwent stereotactic radiosurgery by linear accelerator based treatment delivery system (BrainLab) over three years. These included 7 males and 6 females, with median age of 22 years. Intracranial hemorrhage was a presenting feature in 7 (54 %) of patients. Prior embolization was done in 10 (77%) patients with 7 patients having more than once undergone this procedure. The location of AVM was superficial in 9 (70%) and deep in brain in 4 (30%) patients. The mean AVM score was 0.97 with 3 patients having AVM score ≥ 1 with mean Spetzler-Martin grade of 2.7 and 8 (62%) patients having grade 3 or more. Median follow up was 30 months. Mean dose delivered was 21.7 Gy in single fraction. Complete obliteration of AVM nidus was achieved in 9 (70%) patients while 4 patients (30%) had partial obliteration. Six patients (67 %) achieved complete obliteration among 9 who had AVM score of less than 1. Post radiosurgery neurological deficit occurred in only one patient in form of right temporal field loss.
所有13例患者均在三年内接受了基于线性加速器的治疗传递系统(BrainLab)的立体定向放射手术。其中男性7名,女性6名,中位年龄22岁。颅内出血是7例(54%)患者的主要表现。在10例(77%)患者中,有7例患者接受过一次以上的栓塞治疗。AVM的位置为浅表9例(70%),脑深部4例(30%)。AVM平均评分为0.97,其中3例AVM评分≥1,平均Spetzler-Martin分级为2.7,8例(62%)AVM评分为3级及以上。中位随访时间为30个月。单次平均剂量为21.7 Gy。AVM病灶完全闭塞9例(70%),部分闭塞4例(30%)。在AVM评分小于1分的9例患者中,有6例(67%)实现了完全消除。放疗后仅1例患者出现右侧颞野丧失的神经功能缺损。
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引用次数: 0
Current Studies of Immunotherapy for glioblastoma triggers a measurable immune response 胶质母细胞瘤免疫治疗的现状研究引发可测量的免疫反应
Pub Date : 2018-07-01 DOI: 10.31579/2637-8892/029
Sandford Thabit
Glioblastoma is a form of brain tumor with a very high morbidity and mortality. Despite decades of research, the best treatments currently in clinical practice only extend survival by a number of months. A promising alternative to conventional treatment for glioblastomas is immunotherapy. Although proposed over a century ago, the field of cancer immunotherapy has historically struggled to translate it into effective clinical treatments. Better understanding is needed of the various regulatory and co-stimulatory factors in the glioblastoma patient for more efficient immunotherapy treatments. The tumor microenvironment is anatomically shielded from normal immune-surveillance by the blood-brain barrier, irregular lymphatic drainage system, and it’s in a potently immunosuppressive environment. Immunotherapy can potentially manipulate these forces effectively to enhance anti-tumor immune response and clinical benefit. New treatments utilizing the immune system show promise in terms of targeting and efficacy. This review article attempts to discuss current practices in glioblastoma treatment, the theory behind immunotherapy, and current research into various clinical trials.
胶质母细胞瘤是一种发病率和死亡率都很高的脑肿瘤。尽管经过了几十年的研究,目前临床实践中最好的治疗方法只能延长几个月的生存期。免疫疗法是胶质母细胞瘤的一种有希望的替代传统治疗方法。虽然在一个多世纪前提出,但癌症免疫治疗领域一直在努力将其转化为有效的临床治疗。为了更有效的免疫治疗,需要更好地了解胶质母细胞瘤患者的各种调节和共刺激因子。肿瘤微环境在解剖学上被血脑屏障、不规则淋巴排水系统屏蔽,不受正常免疫监测的影响,它处于一个强有力的免疫抑制环境中。免疫治疗可以有效地控制这些作用力,从而提高抗肿瘤免疫应答和临床疗效。利用免疫系统的新疗法在靶向性和有效性方面显示出希望。这篇综述文章试图讨论目前胶质母细胞瘤治疗的实践,免疫治疗背后的理论,以及目前各种临床试验的研究。
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引用次数: 0
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Psychology and mental health care : open access
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