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Preliminary study of associative stigma among trainee psychiatrists in Flanders, Belgium

World Journal of Psychiatry 2014年第3期4卷 62-68页

作者： Kirsten Catthoor Joost Hutsebaut Didier Schrijvers Marc De Hert Jozef Peuskens Bernard Sabbe Department of Psychiatry Psychiatrisch Zie- kenhuis Stuivenberg ZNA Antwerpen B2060 Antwerp Belgium Col-laborative Antwerp Psychiatric Research institute Campus Drie Eiken 2610 Wilrijk Belgium De Viersprong (Landelijk Centrum voor Per- soonlijkheidsproblematiek) 4661 EP Halsteren The Netherlands Department Neurosciences KU Leuven UPC KULeuven Campus Kortenberg 3070 Kortenberg Belgium

AIM: To study the degree of stigmatization among trainee psychiatrists, individual characteristics potentially leading to higher associative stigma, and coping ***: Two hundred and seven trainee psychiatrists in Flanders(Belgium), all member of the Flemish Association of Trainee Psychiatrists, were approached to participate in the survey. A non-demanding questionnaire that was specifically designed for the purpose of the study was sent by mail. The questionnaire consisted of three parts, each emphasizing a different aspect of associative stigma: devaluing and humiliating interactions, the focus on stigma during medical train-ing, and identification with negative stereotypes in the media. Answers were scored on a Likert scale ranging from 0 to 3. The results were analyzed using SPSS Version 18.0. RESULTS: The response rate of the study was 75.1%. The internal consistency of the questionnaire was good, with a Cronbach's α of 0.71. Seventy-five percent of all trainee psychiatrists confirmed hearing denigrating or humiliating remarks about the psychiatric profession more than once. Additionally, more than half of them had had remarks about the incompetence of psychiatrists directed at them. Only 1.3% remembered having stigma as a topic during their psychiatric training. Trainees who had been in training for a longer period of time had experienced a significantly higher level of stigmatization than trainees with fewer years of experience(mean total stigma scores of 16.93 ± SD 7.8 vs 14.45 ± SD 6.1, t =-2.179 and P child or youth psychiatry(mean item score 0.38 ± SD 0.77 vs 0.15 ± SD 0.53, t =-2.153, P < 0.05). Biologically oriented trainees were mo

关键词： Associative stigma Trainee psychiatrist Psychiatry training Mental health gap Coping mechanisms

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Liver failure after an uncovered TIPS procedure associated with hepatic infarction

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World Journal of Hepatology 2010年第4期2卷 167-170页

作者： Eric López-Méndez Daniel Zamora-Valdés Mariana Díaz-Zamudio Oscar F Fernández-Díaz Lourdes ávila Department of Gastroenterology National Institute of Medical Sciences and Nutrition Salvador Zubirán (INCMNSZ) Vasco de Quiroga 15 Zip Code 14000 Mexico City Mexico Department of Surgery INCMNSZ Vasco de Quiroga 15 Zip Code 14000 Mexico City Mexico Department of Radiology and Imaging INCMNSZ Vasco de Quiroga 15 Zip Code 14000 Mexico City Mexico

Transjugular intrahepatic portosystemic shunt (TIPS) is a safe and effective procedure for the treatment of complications of liver cirrhosis, such as refractory ascites, hepatic hydrothorax and refractory variceal bleeding. The aim of this paper is to describe a rare case of liver failure after a TIPS procedure. A 38-year-old diabetic male with child-Pugh C liver cirrhosis due to chronic hepatitis C infection who had developed refractory ascites was scheduled for a TIPS procedure. Within 24 h following TIPS placement, the patient developed distributive shock, jaundice, persistentgrade 3 hepatic encephalopathy, severe coagulopathy andacute renal failure. He was treated with lactulose enemas, broad-spectrum antibiotics and blood-derived products. Laboratory data revealed a 100-fold increase in aminotransferases and a non-enhanced computed tomography showed an irregular hypodense area in the right posterior segment of the liver. Despite being initially being in a stable condition, the patient developed progressive liver failure and died 2 mo later. Hepatic infarction is an uncommon phenomenon after a TIPS procedure; however, it can greatly complicate the course of a disease in a patient with an already compromised liver function.

关键词： Hepatic ischemia Ischemic hepatitis Liver infarc tion Transjugular intrahepatic portosystemic shunt Complications

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Endoscopic retrograde cholangiopancreatography in cirrhosis-a systematic review and meta-analysis focused on adverse events

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World Journal of Gastrointestinal Endoscopy 2018年第11期10卷 354-366页

作者： Shailender Singh Mashiana Amaninder Singh Dhaliwal Harlan Sayles Banreet Dhindsa Ji Won Yoo Qing Wu shailender singh Ali A Siddiqui Gordon Ohning Mohit Girotra Douglas G Adler Department of Internal Medicine University of Nevada Las Vegas School of MedicineLas VegasNV 89102United States Division of Gastroenterology and Hepatology University of Nebraska Medical Center982000 Nebraska Medical CenterOmahaNE 68198-2000United States Department of Biostatistics University of Nebraska Medical Center982000 Nebraska Medical CenterOmahaNE 68198-2000United States Nevada institute of Personalized Medicine Department of Environmental and Occupational HealthSchool of Community Health SciencesUniversity of NevadaLas VegasNV 89154-4009United States Division of Gastroenterology Jefferson Medical CollegePhiladelphiaPA 19107United States Division of Gastroenterology University of Nevada Las Vegas School of MedicineLas VegasNV 89102United States Division of Gastroenterology University of Miami Miller School of MedicineMiamiFL 33136United States Division of Gastroenterology and Hepatology University of Utah School of MedicineHuntsman Cancer CenterSalt Lake CityUT 84132United States

AIM To investigate indications and outcomes of endoscopic retrograde cholangiopancreatography(ERCP) in cirrhotics, especially adverse events. Patients with cirrhosis undergoing ERCP are believed to have increased risk. However, there is a paucity of literature describing the indications and outcomes of ERCP procedures in patients with cirrhosis, especially focusing on adverse *** We performed a systematic appraisal of major literature databases, including PubMed and EMBASE, with a manual search of literature from their inception until April *** A total of 6,505 patients from 15 studies were analyzed(male ratio 59%, mean age 59 years), 11% with alcoholic and 89% with non-alcoholic cirrhosis, with 56.2% child-Pugh class A, and 43.8% class B or C. Indications for ERCP included choledocholithiasis 60.9%, biliary strictures 26.2%, gallstone pancreatitis 21.1% and cholangitis 15.5%. Types of interventions included endoscopic sphincterotomy 52.7%, biliary stenting 16.7% and biliary dilation 4.6%. Individual adverse events included hemorrhage in 4.58%(95%CI: 2.77-6.75%, I^2 = 85.9%), post-ERCP pancreatitis(PEP) in 3.68%(95%CI: 1.83-6.00%, I^2 = 89.5%), cholangitis in 1.93%(95%CI: 0.63-3.71%, I^2 = 87.1%) and perforation in 0.00%(95%CI: 0.00-0.23%, I^2 = 37.8%). Six studies were used for comparison of ERCPrelated complications in cirrhosis vs non-cirrhosis, which showed higher overall rates of complications in cirrhosis patients with pooled OR of 1.63(95%CI: 1.27-2.09, I2 = 65%): higher rates of hemorrhage with OR of 2.05(95%CI: 1.62-2.58, I^2 = 2.1%) and PEP with OR of 1.33(95%CI: 1.04-1.70, I2=65%), but similar cholangitis rates with OR of 1.23(95%CI: 0.67-2.26, I^2 = 44.3%).CONCLUSION There is an overall higher rate of adverse events related to ERCP in patients with cirrhosis, especially hemorrhage and PEP. A thorough risk/benefit assessment should be performed prior to undertaking ERCP in patients with cirrhosis.

关键词： Meta-analysis endoscopic retrograde cholangiopancreatography Systematic review Adverse events Cirrhosis

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Venous thromboembolism in children with acute lymphoblastic leukemia in China:a report from the Chinese children’s Cancer Group-ALL-2015

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Frontiers of Medicine 2023年第3期17卷 518-526页

作者： Mengmeng Yin Hongsheng Wang Xianmin Guan Ju Gao Minghua Yang Ningling Wang Tianfeng Liu Jingyan Tang Alex WK Leung Fen Zhou Xuedong Wu Jie Huang Hong Li Shaoyan Hu Xin Tian Hua Jiang Jiaoyang Cai Xiaowen Zhai Shuhong Shen Qun Hu Department of Pediatrics Tongji Hospital of Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Hematology/Oncology Children’s Hospital of Fudan UniversityShanghai 201100China Department of Hematology/Oncology Shanghai Children’s Medical CenterSchool of MedicineShanghai Jiao Tong UniversityKey Laboratory of Pediatric Hematology&Oncology of China Ministry of HealthShanghai 200120China Department of Hematology/Oncology Chongqing Medical University Affiliated Children’s HospitalChongqing 400015China Department of Pediatrics Key Laboratory of Birth Defects and Related Disease of Women and ChildrenMinistry of EducationWest China Second University HospitalSichuan UniversityChengdu 610041China Department of Pediatrics Xiangya Hospital Central South UniversityChangsha 410008China Department of Pediatrics Anhui Medical University Second Affiliated HospitalHefei 230601China State Key Laboratory of Experimental Hematology and Division of Pediatric Blood Diseases Center Institute of Hematology and Blood Diseases HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesTianjin 300020China Department of Pediatrics Hong Kong Children’s HospitalThe Chinese University of Hong KongHong Kong SAR 999077China Department of Pediatrics Union Hospital of Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Department of Pediatrics Nanfang HospitalSouthern Medical UniversityGuangzhou 516006China Department of Hematology/Oncology Children’s Hospital of Nanjing Medical UniversityNanjing 210008China Department of Hematology/Oncology Shanghai Children’s HospitalShanghai Jiao Tong UniversityShanghai 200062China Department of Hematology/Oncology Children’s Hospital of Soochow UniversitySuzhou 215002China Department of Hematology/Oncology Kunming Children’s HospitalKunming 650103China Department of Hematology/Oncology Guangzhou Women and Children’s Medical CenterGuangzhou 510620China

Venous thromboembolism(VTE)is a complication in children with acute lymphoblastic leukemia(ALL).The Chinese children’s Cancer Group-ALL-2015 protocol was carried out in China,and epidemiology,clinical characteristics,and risk factors associated with VTE were *** collected data on VTE in a multiinstitutional clinical study of 7640 patients with ALL diagnosed in 20 hospitals from January 2015 to December ***,VTE occurred in 159(2.08%)patients,including 90(56.6%)during induction therapy and 108(67.92%)in the upper extremities.T-ALL had a 1.74-fold increased risk of VTE(95%CI 1.08–2.8,P=0.022).Septicemia,as an adverse event of ALL treatment,can significantly promote the occurrence of VTE(P<0.001).Catheter-related thrombosis(CRT)accounted for 75.47%(n=120);and,symptomatic VTE,58.49%(n=93),which was more common in patients aged 12–18 years(P=0.023),non-CRT patients(P<0.001),or patients with cerebral thrombosis(P<0.001).Of the patients with VTE treated with anticoagulation therapy(n=147),4.08%(n=6)had *** VTE recurrence rate was 5.03%(n=8).Patients with VTE treated by non-ultrasoundguided venous cannulation(P=0.02),with residual thrombus(P=0.006),or with short anticoagulation period(P=0.026)had high recurrence ***,preventing repeated venous puncture and appropriately prolonged anticoagulation time can reduce the risk of VTE recurrence.

关键词： acute lymphoblastic leukemia child venous thromboembolism epidemiology clinical characteristic risk factor

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智利儿童参与校外项目——主观幸福感、空闲时间利用满意度与校外项目满意度调查

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中国校外教育 2022年第3期 101-128页

作者：洛雷托·迪策尔费伦·卡萨斯哈维尔·托雷斯-瓦莱霍斯费尔南多·雷耶斯杰米·阿尔法罗周宇雯张乐云费知行韩戈玲庄甘林(译) Faculty of Psychology Universidad del DesarrolloChile Doctoral Program in sychology Health and Quality of Life University of GironaSpain Research institute on Quality of Life University of GironaSpain Doctoral Program on Education and Society Faculty of Education and Social SciencesUniversidad Andres BelloChile Faculty of Education of Social Sciences Universidad Andres BelloChile 华东理工大学外国语学院伯明翰大学上海理工大学上海外国语大学贤达经济人文学院

对1033名9~14岁智利儿童(其中49.1%为女孩)的主观幸福感和其空闲时间利用的满意度进行调查,其中568人参加了公共校外项目,465人没有参加。所有参与调查的儿童就读于市立学校,且生活在高度脆弱的社会环境中。研究采用此前智利研究人员验... 详细信息

对1033名9~14岁智利儿童(其中49.1%为女孩)的主观幸福感和其空闲时间利用的满意度进行调查,其中568人参加了公共校外项目,465人没有参加。所有参与调查的儿童就读于市立学校,且生活在高度脆弱的社会环境中。研究采用此前智利研究人员验证有效的幸福感量表和国际通用的空闲时间利用项目量表,采用验证性因素分析和多群组结构方程模型分析评估量表的拟合度和组间评分的等效性。总体结果显示,两组儿童的主观幸福感都很高。尽管大多数参加校外项目的儿童得分较高,但该结果所体现的差异并不具备统计学意义。进一步分析结果表明,参加校外项目的儿童在主观幸福感的某些方面得分明显更高,且与未参加校外项目的儿童相比,他们更快乐,对空闲时间的利用也更满意。调查结果还表明,学生对校外项目的高满意度与参与度和校外活动的多样性显著相关。此外,采用多元回归分析了年龄和性别等社会人口学变量的影响。目前,关于公共校外项目对儿童幸福感影响的研究不足,鉴于此,对这一问题展开另外两点论述。具体来说,研究不仅可以丰富人们对儿童主观幸福感的认知,还讨论了对支持儿童的公共政策进行评价时使用主观幸福感指标的问题。

关键词：主观幸福感童年校外项目空闲时间利用公共政策

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Pandemic 2009 influenza A(H1N1)-associated deaths among children in China:A retrospective analysis

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Pediatric Investigation 2018年第3期2卷 166-171页

作者： Zhiwei Lu Yuejie Zheng Yanxia He Huizhong Chen Heping Wang Ling Cao Deyu Zhao Wei Ji Yunxiao Shang Changchong Li Zhimin Chen Shunying Zhao Guangmin Nong Qiang Chen Enmei Liu Chaomin Wan Ying Wang Tong Yang Zhenhua Wang Li Deng Quan Lu Department of Respiratory Medicine Shenzhen Children's HospitalShenzhenGuangdongChina Department of Pulmonology Children's Hospital Affiliated to Capital Institute of PediatricsBeijingChina Department of Respiration Children's Hospital of Nanjing Medical UniversityNanjingJiangsuChina Department of Respiration Children's Hospital of Soochow UniversitySuzhouJiangsuChina Department of Pediatric Respiratory Medicine Shengjing Hospital of China Medical UniversityShenyangLiaoningChina Department of Respiration Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouZhejiangChina Department of Pulmonology The Children's HospitalZhejiang University School of MedicineHangzhouZhejiangChina Department of Respiratory Medicine Beijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina Department of Pediatrics The First Affiliated Hospital of Guangxi Medical UniversityNanningGuangxiChina Department of Respiration Jiangxi Provincial Children's HospitalNanchangJiangxiChina Department of Respiration Children's Hospital Affiliated to Chongqing Medical UniversityChongqingChina Department of Infectious Disease West China Second HospitalSichuan UniversityChengduSichuanChina Department of Pediatrics Guilin People's HospitalGuilinGuangxiChina Department of Pediatrics Liuzhou General HospitalLiuzhouGuangxiChina Department of Respiration Changchun Children's HospitalChangchunJilinChina Department of Respiration Guangzhou Women and Children's Medical CenterGuangzhouGuangdongChina Department of Respiration Children's Hospital of Shanghai Jiaotong UniversityShanghaiChina

Importance:A cluster of influenza-associated deaths occurred among children during pandemic 2009 influenza A(H 1N1)in China,but the risk factors and causes for death have not been ***:We describe the clinical findings regarding 2009 influenza A(H1N1)-associated pediatric deaths in China,including the risk factors for ***:The definition of 2009 influenza A(H1N1)-associated pediatric death is death in a child who is younger than 14 years and has laboratory-confirmed *** collected data of total 810 hospitalized patients with 2009 influenza A(H 1N 1)infection from September 2009 to February 2010 in 17 hospitals across *** clinical characteristics,laboratory abnormalities,and treatment course were retrospectively ***:Of the 810 patients hospitalized with 2009 influenza A(H1N1)infection,19(2.3%)*** patients died from severe pneumonia and acute respiratory distress syndrome;eight died from encephalopathy/encephalitis;one died from secondary fungal *** who died were more likely than patients who survived to have neutrophilia,lymphopenia,elevated C-reactive protein,and elevations of lactate dehydrogenase,creatine kinase,creatine kinase-MB,aspartate aminotransferase and alanine *** were no significant differences in the median age,median time from onset of illness to admission,underlying chronic disease,and initiation of antiviral therapy within 48 hours of illness onset,between patients who died and those who ***:The risk factors for pediatric death associated with 2009 influenza A(H 1N 1)infection are different from those of seasonal *** most common causes of death are viral pneumonia,acute respiratory distress syndrome,and encephalopathy/encephalitis.

关键词： 2009 influenza A(H 1N1) Mortality rates children

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