基于潜意识理论的青少年网络成瘾研究

本文综述了青少年网络成瘾的预防和戒除方法,坚持了"习惯说",保留了对"疾病说"的看法。基于潜意识理论,将网络成瘾视为心理亚健康状态,分析了青少年网络成瘾的发生机理、提出了其预防和戒除原则。青少年网络成瘾的成因是心理上的缺失感,与青少年自我防护意识差、自我控制能力小、心理弹性弱,以及潜意识具有反复影响才可改变的特点有关。戒除网络成瘾的原则是淡化评判试测的标准、分散注意力、培养成就感、增强自信心、坚持以心治心等。     

An integrated mRNA-lncRNA signature for relapse prediction in laryngeal cancer

Patients with laryngeal cancer with early relapse usually have a poor prognosis. In this study, we aimed to identify a multi-gene signature to improve the relapse prediction in laryngeal cancer. One microarray data set GSE27020 (training set, N = 109) and one RNA-sequencing data set (validation set, N = 85) were included into the analysis. In the training set, the microarray expression profile was re-annotated into an mRNA-long noncoding RNA (lncRNA) biphasic profile. Then, LASSO Cox regression model identified nine relapse-related RNA (eight mRNA and one lncRNA), and a risk score was calculated for each sample according to the model coefficients. Patients with high-risk showed poorer relapse-free survival than patients with low risk (hazard ratios (HR): 6.189, 95% confidence interval (CI): 3.075-12.460, P < 0.0001). The risk score demonstrated good accuracy in predicting the relapse (area under time-dependent receiver-operating characteristic (AUC): 0.859 at 1 year, 0.822 at 3 years, and 0.815 at 5 years). The results were validated in the validation set (HR: 3.762, 95% CI: 1.594-8.877, P = 0.011; AUC: 0.770 at 1 year, 0.769 at 3 years, and 0.728 at 5 years). The multivariate analysis reached consistent results after adjustment by multiple confounders. When compared with a 27-gene signature, a 2-lncRNA signature, and Tumor-Node-Metastasis stage, the risk score also showed better performance (P < 0.05). In conclusion, we successfully developed a robust mRNA-lncRNA signature that can accurately predict the relapse in laryngeal cancer.     

Beneficial Coercion in Psychiatric Care: Insights from African Ethico‐Cultural System

There is a ‘catch 22’ situation about applying coercion in psychiatric care. Autonomous choices undeniably are rights of patients. However, emphasizing rights for a mentally‐ill patient could jeopardize the chances of the patient receiving care or endanger the public. Conversely, the beneficial effects of coercion are difficult to predict. Thus, applying coercion in psychiatric care requires delicate balancing of individual‐rights, individual well‐being and public safety, which has not been achieved by current frameworks. Two current frameworks may be distinguished: the civil liberty approach and the Stone model. Both frameworks are restrictive, and not respectful of human dignity. In a civil liberty approach, individuals who are severely mentally‐ill but not dangerous would be denied care because they do not meet the dangerousness threshold or because the use of coercion will not lead to rebirthing of autonomy. This is unsatisfactory. Albeit involuntary interventions such as talk therapies, peer‐support etc., may not always lead to rebirthing of autonomy or free patients from mental illness; they can however help to maintain the dignity of each mentally ill patient. In place of these frameworks, this study proposes a new ethical framework for applying coercion in psychiatric care that is respectful of human dignity. Specifically, it draws on insights from the African ethico‐cultural system by using the Yoruba concept Omo‐olu‐iwabi to develop this new framework. This way, the study shows that only a more respectful approach for applying coercion in psychiatric care can lead to the careful balancing of the competing interests of individual's rights, individual's well‐being and public safety.     

RGG/RG Motif Regions in RNA Binding and Phase Separation

RGG/RG motifs are RNA binding segments found in many proteins that can partition into membraneless organelles. They occur in the context of low-complexity disordered regions and often in multiple copies. Although short RGG/RG-containing regions can sometimes form high-affinity interactions with RNA structures, multiple RGG/RG repeats are generally required for high-affinity binding, suggestive of the dynamic, multivalent interactions that are thought to underlie phase separation in formation of cellular membraneless organelles. Arginine can interact with nucleotide bases via hydrogen bonding and π-stacking; thus, nucleotide conformers that provide access to the bases provide enhanced opportunities for RGG interactions. Methylation of RGG/RG regions, which is accomplished by protein arginine methyltransferase enzymes, occurs to different degrees in different cell types and may regulate the behavior of proteins containing these regions.     

Military Veterans and Service Dogs: A Qualitative Inquiry Using Interpretive Phenomenological Analysis

There are over 18.8 million veterans of the United States of America's Armed Forces. After military service veterans may find it difficult transitioning back to civilian life. Veterans reintegrating may experience physical and psychological challenges related to their military service. For many, a successful role change takes considerable time and determination. In order to ease their transition, veterans are using the assistance of service dogs to aid in symptom management and assist with positive reintegration into civilian life. Service dogs are highly trained animals that help individuals perform life tasks to assist with physical and psychological challenges. The purpose of this qualitative study was to give voice to the experiential viewpoints of veterans who utilize service dogs. Guided by the theoretically informed method of interpretation— interpretive phenomenological analysis (IPA)—the researchers uncovered the veterans’ perspectives, which provided meaningful insight into their lives with a service dog. Semi-structured interviews were conducted with veterans (n = 21) who utilized a service dog. The interviews lasted approximately one hour and were video or audio recorded. The most salient themes that emerged from the interviews were grouped into four superordinate themes: Procurement, psychosocial functioning, value, and detriments. Results suggest that service dogs improved veterans’ physical and psychological health, provided a coping resource and a form of social support, and supported sustaining their independence. Veterans’ right to privacy and the public's lack of knowledge and understanding of legal accommodation requirements via the Americans with Disabilities Act (ADA) were perceptible. Implications for policy, practice, and research, are discussed.     

Global dynamics of an epidemiological model with age of infection and disease relapse

In this paper, an epidemiological model with age of infection and disease relapse is investigated. The basic reproduction number for the model is identified, and it is shown to be a sharp threshold to completely determine the global dynamics of the model. By analysing the corresponding characteristic equations, the local stability of a disease-free steady state and an endemic steady state of the model is established. By means of suitable Lyapunov functionals and LaSalle's invariance principle, it is verified that if the basic reproduction number is less than unity, the disease-free steady state is globally asymptotically stable, and hence the disease dies out; if the basic reproduction number is greater than unity, the endemic steady state is globally asymptotically stable and the disease becomes endemic.     

Diabetes mellitus in people with schizophrenia,bipolar disorder and major depressive disorder: a systematic review and large scale meta‐analysis

Type 2 diabetes mellitus (T2DM) is highly predictive of cardiovascular diseases and can have particularly deleterious health impacts in people with severe mental illness (SMI), i.e. schizophrenia, bipolar disorder or major depressive disorder. This meta‐analysis aimed: a) to describe pooled frequencies of T2DM in people with SMI; b) to analyze the influence of demographic, illness and treatment variables as well as T2DM assessment methods; and c) to describe T2DM prevalence in studies directly comparing persons with each specific SMI diagnosis to general population samples. The trim and fill adjusted pooled T2DM prevalence among 438,245 people with SMI was 11.3% (95% CI: 10.0%‐12.6%). In antipsychotic‐naïve participants, the prevalence of T2DM was 2.9% (95% CI: 1.7%‐4.8%). There were no significant diagnostic subgroup differences. A comparative meta‐analysis established that multi‐episode persons with SMI (N=133,470) were significantly more likely to have T2DM than matched controls (N=5,622,664): relative risk, RR=1.85, 95% CI: 1.45‐2.37, p<0.001. The T2DM prevalence was consistently elevated in each of the three major diagnostic subgroups compared to matched controls. Higher T2DM prevalences were observed in women with SMI compared to men (RR=1.43, 95% CI: 1.20‐1.69, p<0.001). Multi‐episode (versus first‐episode) status was the only significant predictor for T2DM in a multivariable meta‐regression analysis (r²=0.52, p<0.001). The T2DM prevalence was higher in patients prescribed antipsychotics, except for aripriprazole and amisulpride. Routine screening and multidisciplinary management of T2DM is needed. T2DM risks of individual antipsychotic medications should be considered when making treatment choices.     

Steps,challenges and lessons in developing community mental health care

This paper summarises our own accumulated experience from developing community-orientated mental health services in England and Italy over the last 20-30 years. From this we have provisionally concluded that the following issues are central to the development of balanced mental health services: a) services need to reflect the priorities of service users and carers; b) evidence supports the need for both hospital and community services; c) services need to be provided close to home; d) some services need to be mobile rather than static; e) interventions need to address both symptoms and disabilities; and f) treatment has to be specific to individual needs. In this paper we consider ten key challenges that often face those trying to develop community-based mental health services: a) dealing with anxiety and uncertainty; b) compensating for a possible lack of structure in community services; c) learning how to initiate new developments; d) managing opposition to change within the mental health system; e) responding to opposition from neighbours; f) negotiating financial obstacles; g) avoiding system rigidities; h) bridging boundaries and barriers; i) maintaining staff morale; and j) creating locally relevant ser- vices rather than seeking “the right answer” from elsewhere.