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  • 文章类型: Journal Article
    轻微的身体异常(MPA)是解剖变异,是异常早期神经发育的标志。精神分裂症与MPA频率增加有关,然而,在精神分裂症中,MPA的频率和分布表现出明显的异质性,并且并非该疾病所独有。不同位置的MPA可能代表不同的发育起源,并且可能与潜在的遗传易感性或发展全面精神病的脆弱性有关。因此,我们对精神分裂症(Sch)和一级亲属(SchRel)中的轻微身体异常(MPA)进行了全面回顾.分析了1980年1月至2023年10月发表的52项研究,荟萃分析比较了3780名精神分裂症患者和3871名对照患者的MPA得分。以及1415SchRel和1569控制。与对照组相比,精神分裂症的MPA总分显着增加(g=0.78[0.63-0.93],p<0.001)。在区域MPA荟萃分析中,效应大小范围从0.56到0.78。SchRel与对照组之间的差异中等(g=0.44[0.28-0.61],p<0.001)。当单个MPA项目分别分析时,精细的电动头发,畸形的耳朵,不对称的耳朵,弯曲的第五指是精神分裂症和SchRel共有的异常。此外,对精神分裂症及其亲属中MPA的频率进行了直接比较。此外,精神分裂症的早期发病年龄与口腔异常相关(Z=-2.13,p=0.03),和耳朵异常与精神分裂症组中较高比例的男性相关(Z=2.64,p=0.008)。这些发现支持以下观点:不同的MPA可能与遗传易感性以及对发展为全面精神病的脆弱性有关。调查精神分裂症中MPA的临床和神经生物学相关性的研究可能有助于表征与不同发育过程相关的精神病亚型。
    Minor physical anomalies (MPAs) are anatomical variations that are markers of aberrant early neurodevelopment. Schizophrenia is associated with increased MPA frequency, however, the frequency and distribution of MPAs exhibit substantial heterogeneity in schizophrenia and are not exclusive to this disorder. MPAs at different localizations might represent different developmental origins and might be related to latent genetic predisposition or vulnerability to develop full-blown psychosis. Therefore, we conducted a thorough review of minor physical anomalies (MPAs) in schizophrenia (Sch) and first-degree relatives (SchRel). Analyzing 52 studies published from January 1980 to October 2023, the meta-analysis compared MPA scores between 3780 schizophrenia patients and 3871 controls, as well as 1415 SchRel and 1569 controls. The total MPA score was significantly increased in schizophrenia compared to controls (g = 0.78 [0.63-0.93], p<0.001). In regional MPA meta-analyses, effect sizes ranged from 0.56 to 0.78. The difference between SchRel and controls was moderate (g = 0.44 [0.28-0.61], p<0.001). When individual MPA items were analyzed separately, fine electric hair, malformed ear, asymmetrical ear, curved 5th finger were anomalies that were shared between both schizophrenia and SchRel. Also, direct comparisons of the frequency of MPAs in schizophrenia and their relatives were conducted. Additionally, the early age of onset of schizophrenia was associated with mouth anomalies (Z=-2.13, p = 0.03), and ear anomalies were associated with a higher percentage of males in the schizophrenia group (Z = 2.64, p = 0.008). These findings support the notion that different MPAs might be associated with genetic susceptibility as well as vulnerability to developing full-blown psychosis. Studies investigating clinical and neurobiological correlates of MPAs in schizophrenia might be helpful in characterizing subtypes of psychoses that are associated with different developmental processes.
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  • 文章类型: Journal Article
    家庭成员在住院患者进入精神病医院期间在照顾他们方面发挥着重要作用。他们从多学科小组获得的支持有限,因为他们没有关系可以促进家庭表达他们的想法,更确切地说,多学科团队和家庭成员共享的互动是关于入院的州患者.
    本文探讨并描述了有亲戚在精神病医院住院的州患者的家庭成员的经历。根据调查结果,我们提供了具体的建议,以促进未来州患者家属的心理健康。
    这项研究是在参与者的家中进行的;当家庭成员来见多学科团队时,只有一次采访是在精神病医院进行的。
    这项研究采用了定性的,探索性和情境性研究设计。家庭成员的生活经历进行了深入的现象学访谈,后来进行了分析。
    调查结果表明,家庭成员经历了负面情绪,支持他们的亲戚的真诚愿望,以及分享有关精神疾病的信息和知识的巨大需求。
    该研究表明,州患者“家庭成员”的心理健康应得到关注,以提高他们对精神疾病的认识。
    这项研究的结果呼吁家庭成员之间的合作,警察和医院的多学科小组,家庭的心理健康意识和咨询。
    UNASSIGNED: Family members play an important role in caring for state patients during their admission to a psychiatric hospital. They receive limited support from the multidisciplinary team because they do not have a relationship that will promote the families to verbalise their thoughts, rather the interaction that the multidisciplinary team and family members share is about the admitted state patient.
    UNASSIGNED: This article explored and described the experiences of family members who have a relative admitted as a state patient in a psychiatric hospital. Based on the findings, specific recommendations were provided to facilitate the mental health of state patients\' family members in the future.
    UNASSIGNED: The study was conducted in participants\' homes; only one interview took place in the psychiatric hospital when the family member came to meet the multidisciplinary team.
    UNASSIGNED: The study employed a qualitative, exploratory and contextual research design. Family members\' lived experiences were explored using in-depth phenomenological interviews and later analysed.
    UNASSIGNED: The findings indicated family members experienced negative feelings, a sincere desire to support their relatives and a great need to share information and knowledge about mental illness.
    UNASSIGNED: The study indicated that state patients\' family members\' mental health should be focused on to improve their understanding of mental illness.
    UNASSIGNED: The findings of this study call for collaboration between the family members, the police and multidisciplinary teams from the hospitals, the mental health awareness and counselling for families.
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  • 文章类型: Journal Article
    青少年怀孕仍然是一个全球性问题,因为它对青少年的影响,她的孩子,她的家人,和社会。在海地,这种怀孕给家庭经济带来负担。此外,青少年生育率仍然很高,尽管努力减少它。本文旨在分析海地怀孕青少年亲属的感知和体验。基于杜威的社会调查进行了定性研究设计。数据来自17名亲属(伴侣,父母,监护人,和其他人)海地北部和东北部的怀孕青少年。使用主题分析对这些数据进行了分析。根据结果,在海地,少女怀孕被视为灾难或社会问题。给亲属带来许多心理和经济困难,他们是怀孕青少年经济和社会支持的唯一来源。考虑到亲戚的脆弱,政策,旨在减少少女怀孕的负面后果的干预措施应考虑到这一群体。
    Teenage pregnancy remains a global problem because of its consequences for the teenager, her child, her family, and society. In Haiti, this type of pregnancy burdens the family economy. In addition, the adolescent fertility rate is still high, despite efforts to reduce it. This article aims to analyze the perception and experiential experience of relatives of pregnant adolescents in Haiti. A qualitative study design based on Dewey\'s social survey was conducted. Data were collected from 17 relatives (partners, parents, guardians, and others) of pregnant adolescents in Haiti\'s North and Northeast departments. These data were analyzed using thematic analysis. According to the results, teenage pregnancy is seen as a disaster or a social problem in Haiti. It leads to many psychosocial and economic difficulties for the relatives, who are the only source of economic and social support for pregnant adolescents. Considering the vulnerability of relatives, policies, and interventions aimed at reducing the negative consequences of teenage pregnancy should consider this group of individuals.
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  • 文章类型: Meta-Analysis
    背景:Antisaccade,被描述为看着目标的相反位置,是用于评估精神分裂症认知功能的眼球运动范例。反扫视中扫视的启动和维持由额叶和顶叶皮层区域管理。前视异常是精神分裂症中公认的发现。然而,在精神病性障碍的早期阶段和精神病的临床/家族风险的研究报告了不一致的结果。当前的系统评价旨在回顾研究首次发作精神病(FEP)的反扫视错误率的研究结果,精神病高危人群(UHRP),与健康对照组相比,家族性精神病高风险(FHRP)。
    方法:对17项研究进行了荟萃分析,以定量评估FEP的反扫视错误,UHR-P和FHRP。在总共860个FEP之间比较了错误率(Hedges\'g),UHRP,FHRP,和817个健康对照。效果大小的对冲\'g,I2用于估计变异性的百分比,通过R软件评估发表偏倚。
    结果:这项荟萃分析的结果表明,FEP与抗扫视错误率的稳健缺陷相关(g=1.16,CI=0.95-1.38)。此外,临床和家族性高危组的AS错误均出现小幅但显著的增加(分别为g=0.26,CI=0.02~0.52和g=0.34,CI=0.13~0.55).
    结论:FEP估计的大效应大小与先前报道的慢性精神分裂症患者的结果一致。此外,亲属有小到中等效应大小和显著差异的异常.目前的发现表明,反扫视错误可能是精神病的潜在内表型。
    BACKGROUND: Antisaccade, which is described as looking at the opposite location of the target, is an eye movements paradigm used for assessing cognitive functions in schizophrenia. Initiation and sustainment of saccades in antisaccade are managed by frontal and parietal cortical areas. Antisaccade abnormalities are well-established findings in schizophrenia. However, studies in the early phases of psychotic disorders and clinical/familial risk for psychosis reported inconsistent findings. The current systematic review aimed to review the results of studies investigating antisaccade error rates in first-episode psychosis (FEP), individuals with ultra-high-risk for psychosis (UHRP), and familial-high-risk for psychosis (FHRP) compared to healthy controls.
    METHODS: A meta-analysis of 17 studies was conducted to quantitatively review antisaccade errors in FEP, UHR-P and FHRP. The error rate (Hedges\'g) was compared between the total of 860 FEP, UHRP, FHRP, and 817 healthy controls. Hedges\' g for effect size, I2 for estimating the percentage of variability, and publication bias were evaluated through the R software.
    RESULTS: The outcomes of this meta-analysis suggested that FEP is associated with a robust deficit in the antisaccade error rate (g = 1.16, CI = 0.95-1.38). Additionally, both the clinical and familial high-risk groups showed small but significant increases in AS errors (g = 0.26, CI = 0.02-0.52 and g = 0.34, CI = 0.13-0.55, respectively).
    CONCLUSIONS: The large effect size estimated for FEP was compatible with previously reported results in chronic schizophrenia patients. Additionally, relatives had abnormalities with small to medium effect sizes and significant differences. The current findings suggest that antisaccade errors might be a potential endophenotype for psychotic disorders.
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  • 文章类型: Journal Article
    合成代谢雄激素类固醇(AAS)因其美学和性能增强作用而使用,并与身体和心理副作用有关。情绪波动时的行为变化/副作用,侵略性,抑郁症,效力问题,焦虑,使用AAS的人的近亲报告了情绪冷淡。
    这项现象学研究是基于反思生命世界研究方法。采访了十二位近亲,了解他们与使用AAS的人生活在一起的经历。
    使用AAS的人的近亲特别脆弱,因为他们几乎没有机会影响自己的处境。他们的给定和安全的背景丢失了,他们的生活受到不安全感的限制,恐惧,无能为力,和悲伤。当别人没有注意到他们的问题并且缺乏家庭和社会的支持时,孤独感就会发展。
    我们的研究增加了使用AAS如何影响近亲的重要知识。需要理解,以灵活和同情的方式接近近亲的生活世界,以解决他们的困难和脆弱性。医疗保健专业人员和其他相关职业需要意识到近亲存在的需求,以便能够满足和支持他们的生活情况。
    UNASSIGNED: Anabolic androgenic steroids (AAS) are used for their aesthetic and performance-enhancing effects and are associated with physical and psychological side effects. Behavioural changes/side effects as mood swings, aggressiveness, depression, potency problems, anxiety, and emotional coldness have been reported by next of kin to people using AAS.
    UNASSIGNED: This phenomenological study is based on the reflective lifeworld research approach. Interviews were conducted with twelve next of kin about their experiences of living close to persons using AAS.
    UNASSIGNED: Next of kin to persons using AAS are particularly vulnerable because they experience little opportunity to influence their situation. Their given and safe context is lost, and their lives are circumscribed by feelings of insecurity, fear, powerlessness, and grief. Feelings of loneliness develop when their problems are not noticed by others and support is lacking from family and society.
    UNASSIGNED: Our research adds important knowledge on how the use of AAS affects next of kin. Understanding is required to approach the lifeworld of next of kin with flexibility and empathy in their difficulties and vulnerability. Healthcare professionals and other concerned professions need to be aware of next of kin existential needs to be able to meet and support them in their life situation.
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  • 文章类型: Journal Article
    BACKGROUND: The shoulder rotator cuff (RC) is crucial to shoulder function and involvement in shoulder pathology. RC tears have been extensively studied, and several classifications have been devised to quantify their magnitude. Various RC measurement techniques were introduced previously, utilizing cadaveric specimens, X-rays, CT scans, and MRI with different results published regarding humeral heads\' different plane diameters and the correlation to age, gender, and height. There are very few studies measuring RC length in the general population.
    OBJECTIVE: We aimed to assess the geometrical relation between rotator cuff tendon length and humeral head sagittal and axial diameters.
    METHODS: A total of 100 shoulder MRI scans of labral tear-suspected patients were reviewed, and the geometrical parameters of the rotator cuff length and proximal humerus sagittal and axial diameters were measured.
    RESULTS: The healthy population has wide variability in humeral diameter and rotator cuff length. We found a high correlation between humeral head sagittal and axial plane diameters and the rotator cuff tendon dimension. The orthogonal plane diameters disagree with the humeral head being round but rather spheric. The rotator cuff length changes according to the patient\'s gender and height.
    CONCLUSIONS: This is a novel method for rotator cuff measurement, description, and classification according to the percentage of tear instead of length (cm). This method is more clinically oriented and relevant than most other previous methods.
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  • 文章类型: Journal Article
    背景:在过去十年中,荷兰持续深度镇静(CDS)的发生率增加了一倍以上,虽然这种增长的原因还没有完全理解。患者和亲属在决定CDS中起着至关重要的作用。我们假设CDS实践的增加与患者和亲属在决定CDS中的角色变化有关。
    目的:描述患者和亲属对CDS的看法和经验。这种洞察力可以帮助专业人士和政策制定者更好地理解和应对不断发展的CDS实践。
    方法:对患者和亲属进行了定性访谈,这些患者和亲属有CDS的亲身经历或自己考虑了CDS。
    结果:绝大多数受访者认为CDS是一种姑息治疗选择,没有一个受访者报告(道德)反对CDS。大多数受访者优先考虑避免生命终结时的痛苦。患者和家庭通常认为CDS是他们可以选择的姑息治疗选择。同样,根据我们的受访者,启动CDS的决定是由他们做出的,而不是医生。CDS护理的负面经历主要与失去代理意识有关,由于医疗保健专业人员的沟通或信息提供不足。缺乏护理的连续性也是痛苦的根源。我们观察到受访者对CDS和其他临终关怀决策之间区别的理解多种多样,包括安乐死.一些人认为CDS加速了死亡。
    结论:传统观点认为CDS是医生在生命结束时减轻患者痛苦的最后手段,在患者和亲属中并不明确。相反,我们的研究结果表明,他们认为CDS是一种常规的姑息治疗选择.随着CDS的规范化,患者和亲属声称在决策中有很大的发言权,主要是出于避免痛苦和在生命结束时行使控制的愿望。这些关于患者CDS的不同观点,他们的亲属和医疗保健提供者应在CDS指南和协议中进行协调.
    我们团队的作者之一(G.H.)具有CDS作为亲戚的经验,并确保患者/亲戚的观点在我们研究的设计和实施中得到充分反映。在我们研究的初步阶段,G.H.调整了主题列表,以便更好地适应当前的CDS实践。在数据分析过程中,G.H.阅读了几次采访,并作为作者团队的重要成员参加了关于中心主题和核心概念的公开和批判性讨论,从而保证患者/相对观点在我们最终研究结果中的中心位置。
    BACKGROUND: The incidence of continuous deep sedation (CDS) has more than doubled over the last decade in The Netherlands, while reasons for this increase are not fully understood. Patients and relatives have an essential role in deciding on CDS. We hypothesize that the increase in CDS practice is related to the changing role of patients and relatives in deciding on CDS.
    OBJECTIVE: To describe perceptions and experiences of patients and relatives with regard to CDS. This insight may help professionals and policymakers to better understand and respond to the evolving practice of CDS.
    METHODS: Qualitative interviews were held with patients and relatives who had either personal experience with CDS as a relative or had contemplated CDS for themselves.
    RESULTS: The vast majority of respondents appreciated CDS as a palliative care option, and none of the respondents reported (moral) objections to CDS. The majority of respondents prioritized avoiding suffering at the end of life. The patients and families generally considered CDS a palliative care option for which they can choose. Likewise, according to our respondents, the decision to start CDS was made by them, instead of the physician. Negative experiences with CDS care were mostly related to loss of sense of agency, due to insufficient communication or information provision by healthcare professionals. Lack of continuity of care was also a source of distress. We observed a variety in the respondents\' understanding of the distinction between CDS and other end-of-life care decisions, including euthanasia. Some perceived CDS as hastening death.
    CONCLUSIONS: The traditional view of CDS as a last resort option for a physician to relieve a patient\'s suffering at the end of life is not explicit among patients and relatives. Instead, our results show that they perceive CDS as a regular palliative care option. Along with this normalization of CDS, patients and relatives claim a substantial say in the decision-making and are mainly motivated by a wish to avoid suffering and exercise control at the end of life. These distinct views on CDS of patients, their relatives and healthcare providers should be reconciled in guidelines and protocols for CDS.
    UNASSIGNED: One of the authors in our team (G. H.) has experience with CDS as a relative and ensured that the patient/relative viewpoint was adequately reflected in the design and conduct of our study. In the preliminary phase of our study, G. H. adjusted the topic list so it was better adapted to the current practice of CDS. During the data analysis, G. H. read several interviews and took part in the open and critical discussion on central themes and core concepts as an important member of the author team, thereby guaranteeing the central position of the patient/relative perspective in our final research outcome.
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  • 文章类型: English Abstract
    在法国,自20世纪70年代和所谓的加瓦法以来,是否将死者的尸体视为可能的公共卫生对象,和他或她的机关作为公共财产?它首先是亲密的社会关系和奇异的痛苦的核心。
    In France, since the 1970s and the so-called Cavaillet law, has the body of a deceased person been treated as a possible object of public health, and his or her organs as public property? It is first and foremost at the heart of intimate social relations and singular suffering.
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  • 文章类型: English Abstract
    作为一般意志的表达,法律将器官切除和移植定为合法活动。立法者以个人至上为条件,身体的不可侵犯性和同意的必要性。
    As an expression of the general will, the law makes organ removal and transplantation a lawful activity. The legislator makes them conditional on the primacy of the person, the inviolability of the body and the need for consent.
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  • 文章类型: Journal Article
    痴呆症通常与老年有关,但也可能发生在中年时期。后者通常被称为青年型痴呆(YOD)。诊断不仅对患有YOD的人有影响,而且对他们的家庭成员也有影响。对于家庭成员来说,诊断改变了他们的生活,随着责任和角色的改变,当亲戚的照顾和福祉日益成为焦点时。这项研究的目的是探索家庭成员与被诊断为YOD的亲戚分享生活的经验-从症状发作到该人搬迁到疗养院。
    该研究采用了定性方法,并进行了深入访谈。总的来说,这项研究包括15名年龄≥18岁的家庭成员,所有的亲属都在65岁之前被诊断患有痴呆症。在面试的时候,都有一个亲戚住在养老院。访谈采用主题分析法进行分析。
    确定了两个关键主题:负责任和处理局势。家庭成员发现自己对亲属生活的许多部分负有越来越多的责任,并被迫代表他们做出决定。这被认为是孤独的,因为家庭成员希望分担他们的责任。尽管他们努力控制和处理他们的情况,家庭成员报告缺乏影响某些因素的权力,例如获得适当的医疗保健服务,造成痛苦的感觉。
    这些研究结果强调需要为患有YOD的家庭成员提供改进和量身定制的支持和指导。Further,研究结果强调了在社会工作者和其他医疗保健专业人员中提高对YOD患者家庭成员的支持的知识和意识的重要性。
    UNASSIGNED: Dementia is often associated with old age but can also occur in midlife. The latter is commonly referred to as young-onset dementia (YOD). The diagnosis not only has an impact on the persons with YOD but also on their family members. For family members, the diagnosis changes their lives, as responsibilities and roles alter when the care and wellbeing of the relative increasingly come into focus. The aim of this study was to explore family members\' experiences of sharing lives with a relative diagnosed with YOD - from onset of symptoms until the person relocated to a nursing home.
    UNASSIGNED: The study has a qualitative approach with in-depth interviews. In total, the study included 15 family members aged ≥18 years participated, all with a relative diagnosed with dementia before the age of 65. At the time of the interview, all had a relative living in a nursing home. The interviews were analyzed using thematic analysis.
    UNASSIGNED: Two key themes were identified: Becoming responsible and Dealing with the situation. Family members found themselves increasingly responsible for many parts of their relatives\' lives and forced to make decisions on their behalf. This was experienced as being lonely, as family members wished to share their responsibility. Despite of their efforts to control and deal with their situation, family members reported a lack of power to influence certain factors, such as access to appropriate healthcare services, causing feelings of distress.
    UNASSIGNED: These findings emphasize the need of improved and tailored support and guidance for family members of persons with YOD. Further, the findings highlight the importance of increased knowledge and awareness among social workers and other healthcare professionals regarding support to family members of persons with YOD.
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