严重创伤后血清胆碱酯酶活性的动态变化

研究目的：创新要点：研究方法：重要结论：探讨严重创伤患者早期血清胆碱酯酶（ChE）活性的动态变化规律与临床意义。阐明了在严重创伤后早期血清ChE动态的变化规律,为评估创伤的严重程度和预后判断提供新的参考辅助指标。前瞻性观察研究：分析81例严重创伤患者伤后第1、3、7天血清ChE活性的动态变化,通过亚组（不同预后、不同伤情严重程度）间变化比较及与损伤严重度评分（ISS）、急性生理和慢性健康评分Ⅲ（APACHEⅢ）和创伤严重程度评分（TRISS）进行比较,评估其反映病情严重程度和预后的价值;同时分析伤后血清ChE活性与急性期蛋白（APP）,如白蛋白（ALB）、前白蛋白（PAB）、转铁蛋白（TRF）和C反应蛋白（CRP）浓度变化的关系。血清ChE活性在严重创伤后显著降低,持续下降的幅度越大,则提示损伤越重,预后可能越差,而且血清ChE或可视为负急性期蛋白的一种,血清ChE作为严重创伤伤情和预后评估的简单辅助指标具有一定的可靠性。     

《聚会》中的创伤书写简

2007年曼布克奖得主安妮·恩莱特在其最富盛名的小说《聚会》中植入家庭关系、爱尔兰的沉重历史等主题,将爱尔兰历史的再现、对在海格迪家族中生活点滴记忆的修复以及主人公本人现实生活中难以忘却的伤疤和婚姻破碎等各种创伤因素融入作品之中,并在小说主题和人物构造中融入创伤的气息,赋予原本平淡的主题以新意的同时,增加了作品的深度.以安妮·恩莱特的文本《聚会》分析为基础,以文化创伤理论为指导,试图从进一步揭示《聚会》中的各创伤因素出发,深层剖析隐藏于《聚会》文字背后坚强有力却又让人不安的情感来由.     

悲伤与坚定并存--解读《聚会》中的创伤与救赎

安·恩莱特在《聚会》中将最伤痛的故事用最美的语言书写了出来,彰显出这个家族悲伤与坚定并存的一面。从揭露海格迪家族三代人的过去与现在入手,分析小说中个人创伤和集体创伤的书写,以及三代人为治愈创伤所进行的救赎,以此显示这个命运多舛的家族在侵蚀中最终实现了悲伤与坚定并存的平衡。     

Parents’ behavior in response to infant crying: Abusive head trauma education

Abusive head trauma (AHT) is still too common, and probably underestimated. It is the leading cause of death from child abuse. Crying is thought to contribute to the act of shaking. Objectives of this study were to (a) assess parents’ knowledge about infant crying, their ability to manage crying, and their knowledge about AHT; and (b) assess the feasibility and the impact of a simple educational intervention about crying and AHT with parents shortly after their child's birth. A short questionnaire was completed orally by the parents of 190 consecutive newborns in a maternity hospital at day 2 of life. Then, during the routine examination of the child, the pediatrician gave parents a short talk about infant crying and AHT, and a pamphlet. Finally, parents were contacted by phone at 6 weeks for the post-intervention questionnaire assessing their knowledge about crying and AHT. Among 202 consecutive births, parents of 190 children were included (266 parents; 70% mothers) over a 1-month period and answered the pre-intervention questionnaire. The intervention was feasible and easy to provide. Twenty-seven percent of mothers and 36% of fathers had never heard of AHT. At 6 weeks, 183 parents (68% of the sample; 80% mothers) answered the post-intervention questionnaire. Parents’ knowledge improved significantly post-intervention. Parents found the intervention acceptable and useful. Health care professionals such as pediatricians or nurses could easily provide this brief talk to all parents during systematic newborn examination.     

Posttraumatic stress mediates the relationship between childhood victimization and current mental health burden in newly incarcerated adults

The purpose of this study was to evaluate the interrelationship among childhood abuse and traumatic loss, posttraumatic stress symptoms (PTSS), and Axis I psychiatric disorders other than PTSD among newly incarcerated adults, and to test a proposed model in which the severity of PTSS mediates the relationship between childhood abuse/loss and adult psychiatric disorders. Four hundred sixty-five male and female inmates participated in a structured clinical research interview. Four types of interpersonal potentially traumatic experiences (physical abuse, sexual abuse, emotional abuse, and traumatic loss) were assessed for occurrence prior to the age of 18 years old. Current psychiatric disorders and PTSS were also assessed by structured interview. Negative binomial regression was used to evaluate the association between the cumulative number of types of childhood abuse/loss experienced and number of current Axis I disorders, and to test the mediation model. Approximately half of the sample (51%) experienced 1 or more types of childhood abuse/loss, and 30% of the sample had at least one psychiatric disorder other than PTSD. For both men and women, childhood physical abuse and childhood sexual abuse were independently associated with psychiatric morbidity, and an increasing number of types of childhood trauma experienced was associated with an increase in the number of current Axis I diagnoses. However, these associations were no longer statistically significant when severity of PTSS was added to the model, providing support for the proposed mediation model. Implications for secondary prevention services for at-risk inmates are discussed.     

天真的堕落——凯瑟琳·安·波特《马戏》与《坟》的创伤视角解读

凯瑟琳·安·波特作为美国著名的女作家,创作了不少丰满的女性人物,“米兰达”系列小说便是其中最为重要的作品之一.《马戏》与《坟》这两篇短篇小说作为主人公米兰达童年故事的收尾之作,在整个“米兰达”系列中具有十分重要的意义.在波特看来,人性之恶源于童年时所受到的各种创伤,而这些创伤导致了儿童天真的丧失.《马戏》和《坟》标志着米兰达“天真的堕落”,为成年后米兰达的创伤埋下了伏笔.本文以创伤为视角解读这两篇小说中的儿童心理创伤,从而更深入地理解波特对于人性的思考.     

MANAGING VULNERABILITY

The notion that journalists can develop emotional problems after being exposed to violent or traumatic events has only recently become part of the dialogue about sound newsroom management. This study, based on a national survey of 400 US news people, examines issues related to journalists' coverage of tragic events. It also explores their views about management attitudes toward news workers who are experiencing profound emotional reactions after covering violent or traumatic events. It finds that when journalists see managers as empathetic on these matters, job satisfaction and perceived morale are higher, and journalists also are more likely to remain committed to their careers.     

奥古斯特·威尔逊《钢琴课》的创伤解读

1990年,威尔逊因《钢琴课》第二次荣获普利策奖。随着创伤理论的兴起,对《钢琴课》的重新解读令人深刻地体会到这更是一部关于非裔移民的创伤戏剧。这部戏剧围绕姐弟俩对于处置祖先留下来的钢琴截然不同的态度展开,追述了家族的历史,刻画了姐姐伯妮斯和弟弟威利在家族遭受变故后受到创伤迷失自我,走出创伤重获新生的艰难历程。     

Exploring perspectives of whole-school attachment and trauma aware approaches in a specialist provision

A recent focus on attachment and trauma awareness (ATA) in schools has led to whole-school training programmes and evaluations. The outcomes have been positive; however, the dominant focus of research is on the implementation of whole-school ATA in mainstream settings. This project adopted a case study to explore how the training and approaches had been implemented in a school community, including a special school and pupil referral units. Data were collected from three semi-structured interviews with staff in varying roles, and the views of 11 pupils were obtained via a classroom activity as supplementary data. Thematic analysis highlighted five key themes which directly answered the three research questions, namely: strategies and approaches used; pupil outcomes; facilitators to implementation; barriers to implementation; and training and improvements. It is hoped that this study will help further professional understanding and implementation of ATA in non-mainstream settings. The implications and limitations of the study are discussed.