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Quantitative tractography is the term used to indicate informing the estimation of the major axonal pathways of the brain from diffusion MRI with microstructural information (such as volume, myelin, axonal densities, etc.) to deliver veridical and biologically meaningful connectomes. The literature is replete with studies showing promising results obtained with such methods; however, did you know that these methods also have some subtle pitfalls that aren't immediately apparent but, if neglected, could result in incorrect or biased conclusions? This brief paper provides an overview of such pitfalls and solutions to mitigate them.
When Old People Suffer Because of the Sex of the Young: A Commentary on Korte, A. & Tschuschke, V. (2023). The Media's Stranglehold on Sturm und Drang - The Sorrows of Generation Z Regarding Sex and Gender Abstract: In their article "Sturm und Drang im Würgegriff der Medien - Die Leiden der jungen Generation am eigenen Geschlecht" in the Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie (volume 51, issue 5), our colleagues Korte and Tschuschke address the question of the extent to which the increase in gender identity deviations among adolescents "also results from upheavals the cultural landscape and, above all, in media technology." The authors look critically at the planned German "Self-Determination Law," the social transition of children and adolescents, the so-called puberty blockade, and hormone therapy in adolescents and justify their preference for a gender-critical over a transaffirmative therapy approach. Although the article introduces some interesting hypotheses from the perspective of cultural studies and philosophy (among others), it may contribute to uncertainty among colleagues in treating trans*people because of its trans-critical tone. This stems from linguistic devices, misleading and erroneous quotations, and incomplete or incorrect descriptions of facts. This contribution therefore takes a critical look at the article by Korte and Tschuschke, using critical linguistic analysis and examining the facts, data, and sources cited by the authors. It encourages our colleagues to engage in a joint, participatory, trans*respectful treatment process with gender-dysphoric children and adolescents while exploring the sizeable intermediate area between "gender-critical" and "transaffirmative" attitudes, which the authors Korte and Tschuschke barely touch on in their article. Zusammenfassung: Im Artikel „Sturm und Drang im Würgegriff der Medien – Die Leiden der jungen Generation am eigenen Geschlecht“ in der Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie (Jahrgang 51, Heft 5) setzen sich die Kollegen Korte und Tschuschke mit der Frage auseinander, inwiefern der Anstieg von Abweichungen im Geschlechtsidentitätserleben bei Jugendlichen „auch ein Resultat kultureller und vor allem medientechnologischer Umbrüche ist“. Die Autoren beziehen kritisch Stellung zum geplanten deutschen „Selbstbestimmungsgesetz“, zu sozialer Transition bei Kindern und Jugendlichen, zur sogenannter Pubertätsblockade sowie zur Hormontherapie bei Jugendlichen, und rechtfertigen den Vorzug eines genderkritischen gegenüber dem eines transaffirmativen Therapieansatzes. Obgleich der Artikel einige interessante Hypothesen aus dem Blickwinkel u. a. der Kulturwissenschaft und Philosophie einbringt, kann er doch auf Grund des transkritischen Grundtenors zur Verunsicherung von Kolleg_innen in der Behandlung von trans*Personen beitragen. Dies ist auf sprachliche Mittel, irreführende und fehlerhafte Zitate und unvollständige bzw. inkorrekte Schilderung von Fakten zurückzuführen. Die vorliegende Arbeit möchte sich daher kritisch mit dem zur Diskussion gestellten Artikel der Autoren Korte und Tschuschke befassen und bedient sich dabei einer sprachkritischen Untersuchung sowie einer Überprüfung der von den Autoren angeführten Fakten, Daten und Quellen. Sie möchte versuchen, Kolleg_innen dazu zu ermuntern, sich mit geschlechtsdysphorischen Kindern und Jugendlichen in einen gemeinsamen, partizipativen, trans*respektvollen Behandlungsprozess zu begeben und den von den Autoren Korte und Tschuschke im Artikel wenig beachteten, großen Zwischenbereich zwischen „genderkritischer“ und „transaffirmativer“ Haltung auszuloten.
One element, potassium, can be identified as the connecting link in the research of Czech neurophysiologist Prof. František Vyskočil. It accompanied him from the first student experiments on the frog muscle (Solandt effect) via sodium-potassium pump and quantum and non-quantum release of neurotransmitters (e.g. acetylcholine) to the most appreciated work on the reversible leakage of K+ from brain neurons during the Leao´s spreading cortical depression, often preceding migraine. He used a wide range of methods at the systemic, cellular and genetic levels. The electrophysiology and biochemistry of nerve-muscle contacts and synapses in the muscles and brain led to a range of interesting findings and discoveries on normal, denervated and hibernating laboratory mammals and in tissue cultures. Among others, he co-discovered the facilitating effects of catecholamines (adrenaline in particular) by end-plate synchronization of individual evoked quanta. This helps to understand the general effectiveness of nerve-muscle performance during actual stress. After the transition of the Czech Republic to capitalism, together with Dr. Josef Zicha from our Institute, he was an avid promoter of scientometry as an objective system of estimating a scientist´s success in basic research (journal Vesmír, 69: 644-645, 1990 in Czech).
Media's Stranglehold on Storm and Stress - The Sorrows of Generation Z about Sex and Gender Abstract: The feeling of not belonging to one's birth sex is not new; one can trace this phenomenon back even to ancient mythology. Although it has always been rare, there has recently been a sharp increase in gender identity deviations among adolescents. This text addresses this problem by asking to what extent this development also results from upheavals in the cultural landscape and, above all, in media technology. Do they cause young people to believe they are in the "wrong gender" and, in extreme cases, to strive for transition? We present the most salient cornerstones of the planned German self-determination law (Self-ID), most of which, however, are unlikely to do justice to the underlying problem. The text concludes by describing several unanswered questions concerning this matter and by attempting to propose first answers. The advantages of a gender-exploratory over the trans affirmative therapy approach are summarized. Zusammenfassung: Das Gefühl der Nichtzugehörigkeit zum Geburtsgeschlecht ist nicht neu, als Phänomen kann es bis in die antike Mythologie zurückverfolgt werden. Aber es war stets selten, wohingegen aktuell ein sprunghafter Anstieg von Abweichungen im Geschlechtsidentitätserleben bei Jugendlichen zu verzeichnen ist. Der Text geht dieser Problematik anhand der Frage nach, inwieweit diese Entwicklung auch ein Resultat kultureller und vor allem aber medientechnologischer Umbrüche ist, die bedingen, dass Jugendliche sich im „falschen Geschlecht“ wähnen und im Extremfall eine Transition anstreben. Die wichtigsten Eckpunkte des geplanten deutschen „Selbstbestimmungsgesetzes“ werden vorgestellt, das allerdings der zugrundeliegenden Problematik kaum gerecht werden dürfte. Der Text schließt damit, dass er diesbezüglich eine Reihe offener Fragen benennt, erste Antworten versucht und die Vorteile eines explorativen, genderkritischen gegenüber einem transaffirmativen Therapieansatz zusammenfasst.
The global coronavirus disease 2019 (COVID-19) crisis has exerted significant psychological impacts on university students who have faced drastic changes in the learning mode and suspension of classes. Despite these challenges, many students maintained subjective well-being. In this study, we examined the role of "hope" as a potential protector to maintain their subjective well-being when facing adversity during this global crisis. Specifically, we explored the mediating role of two hope components (agency thinking and pathways thinking) on the association of positive emotions and life satisfaction among Chinese university students. We conducted an online survey at a local university and recruited a total of 315 undergraduates from the humanities, creative arts, and social sciences programs through convenience sampling. Participants confirmed their informed consent and completed a set of self-administered questionnaires measuring positive emotions, hope, life satisfaction, and demographic variables. The results of mediation testing indicated that, during a global crisis such as COVID-19, positive emotions indirectly influenced life satisfaction through agency thinking rather than pathways thinking. The findings highlight the importance of agency thinking among Chinese university students in adverse situations and provide valuable insights for psychological interventions during a crisis. The article concludes by discussing possible explanations and implications of the findings in a post-pandemic world.
Multiple sclerosis (MS) is an autoimmune demyelinating neurodegenerative disease of the central nervous system (CNS) due to injury of the myelin sheath by immune cells. The clotting factor fibrinogen is involved in the pathogenesis of MS by triggering microglia and the progress of neuroinflammation. Fibrinogen level is correlated with MS severity; consequently, inhibition of the fibrinogen cascade may reduce MS neuropathology. Thus, this review aimed to clarify the potential role of fibrinogen in the pathogenesis of MS and how targeting of fibrinogen affects MS neuropathology. Accumulation of fibrinogen in the CNS may occur independently or due to disruption of blood-brain barrier (BBB) integrity in MS. Fibrinogen acts as transduction and increases microglia activation which induces the progression of inflammation, oxidative stress, and neuronal injury. Besides, brain fibrinogen impairs the remyelination process by inhibiting the differentiation of oligodendrocyte precursor cells. These findings proposed that fibrinogen is associated with MS neuropathology through interruption of BBB integrity, induction of neuroinflammation, and demyelination with inhibition of the remyelination process by suppressing oligodendrocytes. Therefore, targeting of fibrinogen and/or CD11b/CD18 receptors by metformin and statins might decrease MS neuropathology. In conclusion, inhibiting the expression of CD11b/CD18 receptors by metformin and statins may decrease the pro-inflammatory effect of fibrinogen on microglia which is involved in the progression of MS.
Objectives: The aim of this scoping review was to map out the existing evidence of the impact of the COVID-19 lockdown on parents of children and adolescents. We sought to: 1) identify parenting domains that were particularly affected by lockdown measures, 2) describe the challenges and opportunities of lockdown measures in these domains, and 3) define protective and exacerbating factors modulating the effect of lockdown measures on parents. Methods: We identified five main domains investigated in the context of parenting during the early COVID-19 lockdown derived from 84 studies: health and wellbeing, parental role, couple functioning, family and social relationships, and paid and unpaid work. For each domain, we listed challenges and opportunities, as well as discriminant factors. Results: The lockdown impacted all five different but interconnected domains, introduced new roles in parents' lives, and particularly affected women and vulnerable populations. Conclusion: This scoping review highlights the importance of approaching public health policymaking from a social justice perspective. Such an approach argues for social and public health policies to promote health accounting for its social, economic, political, and commercial determinants.
Through a 2 × 2 experimental vignette design, we tested if partner perceived attractiveness in interaction with appearance-related comments from one's partner might affect women and men's body dissatisfaction, body shame, acceptance of cosmetic surgery, and perceived relationship quality. Participants were 154 women and 157 men living in Italy (mean age = 30.97; all of them were in a couple relationship), who read a vignette describing the purchase of a swimsuit, through which partner attractiveness (poor versus high) and partner commentary (negative versus positive) were manipulated. Some ANCOVAs were performed on women and men separately. For men, partner commentary affected body dissatisfaction with low body fat. Moreover, the main effect of partner attractiveness was found in their consideration of undergoing cosmetic procedures. Among women, a significant partner attractiveness X partner commentary interaction effect emerged on acceptance of cosmetic surgery for social reasons. As regards relationship quality, for women, there was a main effect of partner attractiveness on relational communication, while a marginally significant interaction effect between partner attractiveness and partner commentary emerged for men's self-disclosure. Our findings suggest that partner attractiveness is generally beneficial, but when combined with negative feedback concerning the appearance, it might lose its advantages. These findings should be considered for planning interventions aimed at both preventing body dissatisfaction and acceptance of cosmetic surgical procedures for not medical reasons and promoting relationship satisfaction among women and men.
The Sorrows of Young Werther (1774). By Johann Wolfgang von Goethe, translated by Elizabeth Mayer and Louise Bogan. 167 pp. In The Sorrows of Young Werther, and Novella. New York: Random House, 1971.
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This study explores the experiences and adjustment process among older Bhutanese refugees resettled in the United States and identifies their unmet health and social service needs. This phenomenological study design included the conduction of nine in-depth semistructured interviews in the respondents' native language. The researchers adhered to the steps outlined by Moustakas for data analysis. The five identified themes included the following: a better life but with little sorrows, cultural tensions related to adaptation, language as a barrier to success in the United States, isolation and loneliness, and worries about citizenship and its impact on the future. Discussion/Implications for Practice: Psychological adjustment to life in the United States can have profound impact on the health of Bhutanese older adults. Nurses and health care providers should integrate culturally congruent health care, raise awareness of the unique needs, and advocate for policy changes that will benefit this group of older adult refugees whose lives have frequently been upended.
We aimed to provide health practitioners greater insight into the public perception of traditional and complementary medicine (T&CM) use. Our objectives were to identify news media reports of children abandoning conventional treatment for traditional and complementary medicine, analyze the thematic content of these news articles and estimate the tonality portrayed. LexisNexis and Factiva were searched for terms related to cancer, children and T&CM. Inclusion criteria were children less than 18 years, in curative phase of treatment who attempted to abandon conventional therapy for any traditional and complementary medicine use. A secondary search was performed in LexisNexis, Factiva and Google News Archive with the names of children in identified cases. Qualitative analysis of news media reports was completed using a grounded theory approach. Quantitative analysis of article sentiment was performed using a linear support vector machine. Seventeen cases occurring between 2002 and 2016 were included. Five main themes were identified: treatment as torture, power imbalances, rights of parents, evidence versus beliefs and the rights of Indigenous Peoples. Sentiment analysis revealed an overall negative tone, as demonstrated by 73% of the articles. A better understanding of factors that lead to abandonment of conventional therapy for traditional and complementary medicine as portrayed in the news media may help healthcare providers prevent the occurrence of these cases.
The mental burdens among pregnant and postpartum women were exacerbated by cultural expectations and policy shifts, which can be mitigated by social support. To identify the networks of comorbid somatic and mental health, diverse sources of support (interpersonal and policy), and symptom-support interactions in pregnant and postpartum women. Participants were recruited from seven Chinese tertiary hospitals. Health conditions, supports, and combined system networks were estimated. Core symptoms and support sources were identified via centrality indices. Two thousand nine hundred and eighty-nine participants were included, network analysis identified 'feeling tired/having low energy' and 'suicidal thoughts' in depression symptoms as the most central symptoms. Strongest edges were identified between 'uncontrollable worry-trouble relaxing' (anxiety), 'slowed movement-suicidal thoughts' (depression), and 'feeling your heart pound or race-shortness of breath' (somatic symptoms). Somatic health exhibited strong connections with depression symptoms, especially between 'trouble sleeping' and 'sleep problems'. In the support network, 'my friends offer practical help' and 'fiscal assistance programs' exhibited highest strength centrality, 'friends share joys and sorrows with me' and 'family willingly helps me make decisions' were key mediators with high betweenness. All supports were negatively associated with mental/somatic symptoms. Family and friend support had stronger negative connections with hopelessness. 'Health management', 'reliable friends', and 'family emotional support' presented the strongest negative relationships with mental health. Fatigue and suicidal ideation were identified as interconnected symptoms, informal interpersonal support, and fiscal assistance as key elements. Preventions and interventions should prioritize core symptoms while leveraging the power of support networks, to safeguard maternal health and well-being. Main findings: Fatigue and suicidal ideation were identified as interconnected symptoms in mental health symptoms of pregnant and postpartum women, informal interpersonal support, and fiscal assistance as key elements in the support system.Added knowledge: This study provided a novel blueprint for the network of mental health among pregnant and postpartum women, pinpointing fatigue and suicidality as core treatment targets and clarifying how distinct support sources function as key mediators.Global health impact for policy and action: These findings mapped clear imperatives that preventions and interventions should prioritize core symptoms while leverage the power of support networks, to safeguard maternal mental health and well-being.
The following article incorporates findings from a humanbecoming inquiry on feeling unsure, storytelling, and poetry to discuss the experience of going Nowhere.
This narrative explores my experience as a family doctor deeply embedded in a rural community comprising 9 villages. The regional cemetery, a symbol of mortality, serves as a focal point for meditations on what it means to bear witness as a family doctor, depicting some of the joys and sorrows I have witnessed over the last quarter of a century serving this community. Grounded in the philosophy of "to cure-sometimes, to relieve-often, and to comfort-always," I underscore the importance of presence and compassion in family medicine, ultimately embracing mortality as a shared human journey that shapes both patients and their caregivers.
In this narrative medicine essay, a pregnant pediatric critical care fellow in her third trimester cannot help but worry about her impending delivery contrasted with the grave illnesses of her patients and the sorrows of their parents.
Severe fatigue following COVID-19 is a debilitating symptom in adolescents for which no treatment exists currently. The aim of this study was to determine the effectiveness and feasibility of cognitive behavioural therapy (CBT) for severe fatigue following COVID-19 in adolescents. A serial single-case observational design was used. Eligible patients were ≥12 and <18 years old, severely fatigued and ≥6 months post-COVID-19. Five patients, consecutively referred by a paediatrician, were included. The primary outcome was a change in fatigue severity, assessed with the fatigue severity subscale of the Checklist Individual Strength, 12 weeks after the start of CBT, tested with a permutation distancing two-phase A-B test. Secondary outcomes were the presence of severe fatigue, difficulty concentrating and impaired physical functioning directly post-CBT as determined with questionnaires using validated cut-off scores. Also, the frequency of post-exertional malaise (PEM) and absence from school directly post-CBT determined with self-report items were evaluated. All five included patients completed CBT. Twelve weeks after starting CBT for severe post-COVID-19 fatigue, three out of five patients showed a significant reduction in fatigue severity. After CBT, all five patients were no longer severely fatigued. Also, four out of five patients were no longer physically impaired and improved regarding PEM following CBT. All five patients reported no school absence post-CBT and no difficulties concentrating. This study provides a first indication for the effectiveness and feasibility of CBT among adolescents with post-COVID-19 fatigue.
Anecdotal evidence suggests a spike in suicides occurred after the publication of Goethe's The Sorrows of Young Werther in 1774. Imitation suicides elicited by media portrayals of suicide have since been termed the "Werther effect." However, evidence for a suicide "epidemic" after the publication of Goethe's Werther is limited to unsystematically documented cases. This study provides an overview of all previously noted copycat suicides, as well as a systematic search for anecdotal evidence of suicides imitating Goethe's Werther in the press. Newspaper databases of the DACH countries were searched for reports of suicides that the press had connected to Goethe's Werther since 1774. In addition to confirming most suicides that have previously been reported in the literature, eight additional suicides attributed to Goethe's Werther not yet addressed in previous literature were identified in the newspapers. Goethe's Werther was presumably connected to several copycat suicides. However, newspapers reported on the Werther-epidemic itself and the moral implications of glamorizing suicide much more than on specific imitative suicides. Whether the reports identified by this study substantiate a "Werther epidemic" remains up to interpretation. The lack of research on possible further Werther effects elicited by fiction books is discussed.
The captivating tribal communities living across the length and breadth of the state of Central India and mostly in Odisha have enriched the cultural heritage of the region by their cultural diversities. Gadaba's religious life reflected through their rich folk traditions of songs, dance, music, rituals and festivals celebrated round the year adds colourful dimensions to their very existence. The amazing conglomeration of traditions, beliefs, sorrows and philosophies that together constitute and vitalize the religion of tribes has descended from antiquity and has been preserved unimpaired to the present day. Every dimension of their life covering round the year activities is intimately connected with religion and the world view associated with it. It is these aspects of their culture that give meaning and depth to their lives and solidarity to their social structure. However, in recent days many changes have been taken place in traditional religious life of Gadaba tribe. Against this backdrop, this paper has tried to explore some of that core structure of Gadaba's religious life as well as the changing dimensions of their religious manifestation.
Palliative care strives to improve quality of life for patients with incurable diseases. This approach includes adequate support of the patients' loved ones. Consequently, loved ones have personal experiences of providing end-of-life care for their next. This is a resource for information and may help to investigate the loved ones' perspectives on need for improvements. To identify further quality aspects considered important by loved ones to improve the quality of care at the end of life as an addition to quantitative results from the Care of the Dying Evaluation for the German-speaking area (CODE-GER) questionnaire. Within the validation study of the questionnaire 'Care of the Dying Evaluation' (CODETM) GER, loved ones were asked to comment (free text) in parallel on each item of the CODE-GER. These free-text notes were analysed with the qualitative content analysis method by Philipp Mayring. Loved ones of patients (n=237), who had died an expected death in two university hospitals (palliative and non-palliative care units) during the period from April 2016 to March 2017. 993 relevant paragraphs were extracted out of 1261 free-text notes. For loved ones, important aspects of quality of care are information/communication, respect of the patient's and/or loved one's will, involvement in decision-making at the end of life (patient's volition) and having the possibility to say goodbye. It is important for loved ones to be taken seriously in their sorrows, to be informed, that the caregivers respect the patients' will and to be emotionally supported. This study was registered at the German Clinical Trials Register (DRKS00013916).