Barriers to patient recruitment in a poststroke neurorehabilitation multicenter trial in Brazil

There is a high demand for stroke rehabilitation in the Brazilian public health system, but most studies that have addressed rehabilitation for unilateral spatial neglect (USN) after stroke have been performed in high-income countries. Therefore, the aim of this study was to analyze USN patient recruitment in a multicenter noninvasive brain stimulation clinical trial performed in Brazil and to provide study design recommendations for future studies. We evaluated the reasons for exclusion of patients from a multicenter, randomized, double-blinded clinical trial of rehabilitation of USN patients after stroke. Clinical and demographic variables were compared between the included and excluded patients. A descriptive statistical analysis was performed. Only 173 of the 1953 potential neglect patients (8.8%) passed the initial screening. After screening evaluation, 87/173 patients (50.3%) were excluded for clinical reasons. Cognitive impairment led to the exclusion of 21/87 patients (24.1%). Low socioeconomic status led to the exclusion of 37/173 patients (21.4%). Difficulty obtaining transportation to access treatment was the most common reason for their exclusion (16/37 patients, 43.3%). The analyzed Brazilian institutions have potential for conducting studies of USN. The recruitment of stroke survivors with USN was restricted by the study design and limited financial support. A history of cognitive impairment, intracranial stenting or craniectomy, and lack of transportation were the most common barriers to participating in a multicenter noninvasive brain stimulation trial among patients with USN after stroke.

Treatment strategy for pediatric supracondylar humeral fractures with callus formation and displacement neglected for over 1 week / 中华创伤骨科杂志

Objective:To investigate the treatment strategy for pediatric humeral supracondylar fractures with callus formation and displacement neglected for over 1 week.Methods:A retrospective analysis was made of the clinical data of 36 children who had been treated at Department of Pediatric Orthopaedics, Medical Center, The Second Affiliated Hospital, Inner Mongolia Medical University from January 2011 to January 2021 for humeral supracondylar fractures with callus formation and displacement neglected for over 1 week. There were 22 boys and 14 girls, with an age of (6.7±2.7) years (from 2.3 to 12.8 years). All fractures were Gartland type Ⅲ. The patients were divided into 2 groups according to their treatment methods: a closed reduction and percutaneous pinning (CRPP) group of 15 patients subjected to the CRPP treatment only, and a leverage group of 21 patients subjected to CRPP assisted by the "lever technique" with posterior elbow Kirschner wire prying and pulling. The 2 groups were compared in terms of operation time, fluoroscopy frequency, quality of reduction, and recovery time for elbow range of motion; the elbow range of motion, visual analogue scale (VAS), Mayo elbow performance score (MEPS) and complications were assessed at the last follow-up.Results:The 2 groups were comparable because there was no significant difference between them in the general information before operation ( P>0.05). All patients were followed up for (26.2±16.3) months (from 6 to 96 months). All the fractures obtained acceptable reduction and clinical union 4 to 6 weeks after operation. The operation time [(28.2±6.8) min] and fluoroscopy frequency [(27.0±6.0) times] in the leverage group were significantly less than those in the CRPP group [(40.8±10.8) min and (43.3±11.4) times] ( P<0.05). The CRPP group was significantly better than the leverage group in the intraoperative Baumann angle (78.1°±1.6° versus 73.7°±4.1°), lateral capitellohumeral angle (58.3°±2.6° versus 49.6°±5.2°) and horizontal rotation rate (109.5%±3.0% versus 103.2%±4.9%) ( P<0.05). The intraoperative reduction in the CRPP group was significantly closer to the normal mean value than that in the leverage group ( P<0.05). There was no significant difference in the recovery time for elbow range of motion between the CRPP and the leverage groups ( P>0.05). At the last follow-up, the Baumann angle (75.4°±2.8°) and the lateral capitellohumeral angle (53.2°±3.6°) in the leverage group were still significantly better than those in the CRPP group (78.3°±1.5° and 57.5°±2.3°) ( P<0.05). However, there was no significant difference in the elbow range of motion, VAS, MEPS or incidence of complications between the 2 groups ( P>0.05). Conclusion:To treat humeral supracondylar fractures with callus formation and displacement neglected for over 1 week in children, CRPP assisted by the "lever technique" with posterior elbow Kirschner wire prying and pulling is an efficient and accurate method, because it can lead to more satisfactory reduction than CRPP only.

Effect of hand controlled rhythm music therapy on unilateral spatial neglect after stroke / 中国康复理论与实践

ObjectiveTo observe the clinical effect of hand controlled rhythm music therapy on unilateral spatial neglect for stroke patients. MethodsFrom September, 2020 to September, 2022, 52 patients with unilateral spatial neglect after stroke in Wuxi Central Rehabilitation Hospital were randomly divided into control group (n = 26) and observation group (n = 26). Both groups accepted routine rehabilitation, and the observation group accepted hand controlled rhythm music therapy in addition, for eight weeks. Before and after treatment, the patients were assessed with Chinese Behavioral Inattention Test-Hong Kong version (CBIT-HK) routine tests (line crossing, letter cancellation, star cancellation, line bisection, figure and shape copying, and representational drawing) and modified Barthel Index (MBI). ResultsAfter treatment, six scores of CBIT-HK routine tests and the scores of MBI increased in both groups (|t| > 3.077, P < 0.05), and they were higher in the observation group than in the control group (|t| > 2.639, P < 0.05). ConclusionHand controlled rhythm music therapy could effectively alleviate the symptoms of unilateral spatial neglect after stroke, and improve the activities of daily living.

Notifications of physical, sexual and emotional violence and neglect against children in Brazil, 2011-2019: an ecological time-series study / Notificaciones de violencia física, sexual, psicológica y negligencia practicada contra niños en Brasil, 2011-2019: estudio ecológico de serie temporal / Notificações de violência física, violência sexual, violência psicológica e negligência praticadas contra crianças no Brasil, 2011-2019: estudo ecológico de série temporal

ABSTRACT Objective To describe the temporal trend of notifications of physical, sexual and emotional violence and neglect against children in Brazil between 2011 and 2019. Methods This was an ecological time-series study based on notifications of violence against children aged 0-9 years held on the Brazilian Notifiable Health Conditions Information System. Age-adjusted notification rates were calculated for Brazil as a whole, by national macro-region and by sex. Trends were assessed using Joinpoint Regression. Results We analyzed 88,820 notifications of physical violence, 87,141 notifications of sexual violence, 52,359 notifications of emotional violence and 166,664 notifications of neglect. A rising trend was identified for notifications of physical, sexual and emotional violence and neglect for Brazil as a whole and for both sexes. Neglect accounted for the highest rate (95.24 notifications per 100,000 children in 2019). The Northeast and Southeast macro-regions had rising trends for all forms of violence. Conclusion Notifications of physical, sexual and emotional violence and neglect showed rising trends in Brazil in the period studied.

RESUMEN Objetivo Describir la tendencia temporal de notificaciones de violencia física, sexual, psicológica y negligencia practicada contra niños en Brasil entre 2011 y 2019. Métodos Estudio ecológico de series temporales de notificaciones registradas en el Sistema de Información de Agravamientos de Notificación contra niños (0-9 años). Se calcularon las tasas de notificación ajustadas por edad para Brasil por macrorregión y sexo. Se analizó la tendencia mediante regresión joinpoint. Resultados Se incluyeron 88.820 notificaciones de violencia física, 87.141 de violencia sexual, 52.359 de violencia psicológica y 166.664 de negligencia. Se identificó una tendencia ascendente de las notificaciones de violencia física, sexual y psicológica y de negligencia para Brasil y para ambos sexos. La negligencia tuvo la tasa más alta (95,24 notificaciones por 100.000 en 2019).Noreste y Sureste presentaron tendencia creciente en todos los tipos de violencia. Conclusión Las notificaciones de violencia contra los niños mostraron tendencia creciente entre 2011 y 2019 en Brasil.

RESUMO Objetivo Descrever a tendência temporal das notificações de violência física, violência sexual, violência psicológica e negligência praticadas contra crianças no Brasil, entre 2011 e 2019. Métodos Estudo ecológico de série temporal, sobre notificações de violência contra crianças de 0 a 9 anos no Sistema de Informação de Agravos de Notificação. Taxas de notificação ajustadas por idade foram calculadas para Brasil, macrorregiões nacionais e sexo. Analisou-se a tendência das taxas por regressão joinpoint. Resultados Foram analisadas 88.820 notificações de violência física, 87.141 de violência sexual, 52.359 de violência psicológica e 166.664 notificações de negligência. Identificouse tendência crescente de notificações de violência física, sexual, psicológica e negligência, para o Brasil e ambos os sexos. Negligência apresentou a maior taxa [95,24 notificações/100 mil crianças (2019)]. Nordeste e Sudeste apresentaram tendência crescente para todas as violências. Conclusão Notificações de violência física, sexual, psicológica e negligência contra crianças apresentaram tendência crescente no Brasil, no período.

Representações sociais de pessoas vivendo com hiv: do abandono do tratamento à motivação para a retomada / Representaciones sociales de las personas que viven con vih: del abandono del tratamiento a la motivación para reanudar / Social representations of people living with hiv: from treatment abandonment to motivation for resuming

Introdução: O uso contínuo da terapia antirretroviral é eficiente para interromper a replicação viral causada pelo Vírus da Imunodeficiência Humana impedindo o comprometimento do sistema imunológico e o aparecimento das infecções oportunistas. Estima-se que em 2021, 10,2 milhões de pessoas infectadas pelo HIV não se beneficiaram com o uso dos antirretrovirais em todo o mundo. No mesmo ano esse indicador atingiu 333 mil pessoas, e na esfera municipal de Londrina, 288 pessoas vivendo com HIV encontravam-se em abandono do tratamento. Objetivo: Apreender as representações sociais de pessoas vivendo com HIV acerca do abandono do tratamento e a motivação para a retomada. Percurso metodológico: Trata-se de um estudo qualitativo pautado na Teoria das Representações Sociais de Serge Moscovici. O cenário foi um Serviço de Atendimento Especializado em HIV/aids localizado na região Sul do Brasil. A população foi composta por 288 pessoas diagnosticadas com HIV em abandono do tratamento por período superior a 100 dias. Destas, 250 foram excluídas em função de critérios relacionados a informações cadastrais incompletas ou equivocadas, e aspectos impeditivos do comparecimento ao serviço e de contato. Outras 18 pessoas foram consideradas perdas por desistência. A amostra foi composta por 20 pessoas que se enquadraram aos critérios de elegibilidade e aceitaram participar do estudo. A coleta das informações ocorreu entre junho de 2021 e junho de 2022 em entrevistas semiestruturadas audiogravadas e transcritas na íntegra. Para análise das falas foi utilizado o discurso do sujeito coletivo. Resultados: Participaram do estudo 20 pessoas vivendo com HIV, sendo 12 homens e oito mulheres, com idade entre 27 e 55 anos. O tempo de abandono variou entre 210 e 1580 dias. A análise das entrevistas permitiu a emersão de 18 ideias centrais e duas ancoragens, as quais foram agrupadas em quatro grandes temas: 1) Abandono do tratamento por questões intrínsecas à pessoa vivendo com HIV; 2) Abandono do tratamento por questões ligadas à terapia medicamentosa; 3) Abandono do tratamento por dogmas sociais; 4) Forças propulsoras para a retomada do tratamento. Considerações finais: A análise qualitativa das representações sociais das pessoas vivendo com HIV indicou que o abandono da terapia antirretroviral é multifatorial, e envolve questões socioculturais, geográficas, familiares e biológicas. É essencial considerar todas as questões que permeiam e impactam as vidas das pessoas vivendo com HIV em abandono do tratamento para além das questões biológicas, viabilizando a implementação de ações que contribuam para a efetividade das políticas públicas de saúde no intuito de estimular a adesão e encorajar a retomada ao tratamento. Almeja-se que esta investigação possa despertar para as questões subjetivas ao universo da pessoa que vive com HIV e estas respeitadas na prática humanizada, voltadas ao incentivo do tratamento contínuo para controle da infecção e promoção da qualidade de vida.

Introduction: The continuous use of antiretroviral therapy is efficient to interrupt viral replication caused by the Human Immunodeficiency Virus, preventing the compromise of the immune system and the appearance of opportunistic infections. It is estimated that in 2021, 10.2 million people infected with HIV did not benefit from the use of antiretrovirals worldwide. In the same year, this indicator reached 333,000 people, and at the municipal level of Londrina, 288 people living with HIV were abandoning treatment. Objective: To apprehend the social representations of people living with HIV about abandoning treatment and the motivation for resuming it. Methodological path: This is a qualitative study based on Serge Moscovici's Theory of Social Representations. The setting was a Specialized Care Service for HIV/AIDS located in the south of Brazil. The population consisted of 288 people diagnosed with HIV who had abandoned treatment for more than 100 days. Of these, 250 were excluded due to criteria related to incomplete or wrong registration information, and aspects that impeded attendance at the service and contact. Another 18 people were considered dropout losses. The sample consisted of 20 people who met the eligibility criteria and agreed to participate in the study. Data collection took place between June 2021 and June 2022 in semi-structured interviews that were audio-recorded and transcribed in full. For the analysis of the speeches, the collective subject discourse was used. Results: 20 people living with HIV participated in the study, 12 men and eight women, aged between 27 and 55 years. The abandonment time varied between 210 and 1580 days. The analysis of the interviews allowed the emergence of 18 central ideas and two anchors, which were grouped into four major themes: 1) Abandonment of treatment due to issues intrinsic to the person living with HIV; 2) Abandonment of treatment due to issues related to drug therapy; 3) Abandonment of treatment by social dogmas; 4) Driving forces for the resumption of treatment. Final considerations: The qualitative analysis of the social representations of people living with HIV indicated that the abandonment of antiretroviral therapy is multifactorial, and involves sociocultural, geographic, family and biological issues. It is essential to consider all the issues that permeate and impact the lives of people living with HIV who abandon treatment in addition to biological issues, enabling the implementation of actions that contribute to the effectiveness of public health policies in order to stimulate adherence and encourage resumption of treatment. It is hoped that this investigation may awaken to the subjective issues of the universe of the person living with HIV and these respected in humanized practice, aimed at encouraging continuous treatment to control the infection and promote quality of life.

Introducción: El uso continuo de la terapia antirretroviral es eficaz para interrumpir la replicación viral provocada por el Virus de la Inmunodeficiencia Humana, previniendo el compromiso del sistema inmunológico y la aparición de infecciones oportunistas. Se estima que en 2021, 10,2 millones de personas infectadas por el VIH no se beneficiaron del uso de antirretrovirales en todo el mundo. En el mismo año, este indicador alcanzó a 333.000 personas, ya nivel municipal de Londrina, 288 personas viviendo con VIH estaban abandonando el tratamiento. Objetivo: Aprehender las representaciones sociales de personas viviendo con VIH sobre el abandono del tratamiento y la motivación para retomarlo. Camino metodológico: Se trata de un estudio cualitativo basado en la Teoría de las Representaciones Sociales de Serge Moscovici. El escenario fue un Servicio de Atención Especializada en VIH/SIDA ubicado en el sur de Brasil. La población estuvo conformada por 288 personas diagnosticadas con VIH que habían abandonado el tratamiento por más de 100 días. De estos, 250 fueron excluidos por criterios relacionados con información de registro incompleta o incorrecta, y aspectos que impidieron la asistencia al servicio y contacto. Otras 18 personas fueron consideradas pérdidas por deserción. La muestra estuvo conformada por 20 personas que cumplieron con los criterios de elegibilidad y aceptaron participar en el estudio. La recolección de datos ocurrió entre junio de 2021 y junio de 2022 en entrevistas semiestructuradas que fueron grabadas en audio y transcritas en su totalidad. Para el análisis de los discursos se utilizó el discurso del sujeto colectivo. Resultados: Participaron del estudio 20 personas viviendo con VIH, 12 hombres y ocho mujeres, con edades entre 27 y 55 años. El tiempo de abandono varió entre 210 y 1580 días. El análisis de las entrevistas permitió el surgimiento de 18 ideas centrales y dos anclas, que fueron agrupadas en cuatro grandes temas: 1) Abandono del tratamiento por cuestiones intrínsecas a la persona que vive con VIH; 2) Abandono del tratamiento por cuestiones relacionadas con la farmacoterapia; 3) Abandono de tratamiento por dogmas sociales; 4) Fuerzas impulsoras de la reanudación del tratamiento. Consideraciones finales: El análisis cualitativo de las representaciones sociales de las personas viviendo con VIH indicó que el abandono de la terapia antirretroviral es multifactorial, e involucra cuestiones socioculturales, geográficas, familiares y biológicas. Es fundamental considerar todas las cuestiones que permean e impactan la vida de las personas que viven con el VIH que abandonan el tratamiento además de las cuestiones biológicas, posibilitando la implementación de acciones que contribuyan a la efectividad de las políticas públicas de salud para estimular la adherencia y alentar la reanudación. De tratamiento se espera que esta investigación pueda despertar a las cuestiones subjetivas del universo de la persona que vive con VIH y estas respetadas en la práctica humanizada, con el objetivo de incentivar el tratamiento continuo para el control de la infección y promover la calidad de vida.

Trastorno límite de la personalidad (TLP), experiencias adversas tempranas y sesgos cognitivos: una revisión sistemática

Introducción: La investigación actual y los artículos rastreados sobre adversidad temprana y sesgos cognitivos en pacientes con trastorno límite de la personalidad (TLP) evidencian la relación entre estas variables y la gravedad de los síntomas clínicos de este trastorno. Objetivo: Revisar sistemáticamente la evidencia de la relación entre adversidad temprana, sesgos cognitivos y agudización de los síntomas del TLP. El vacío investigativo tiene que ver con el tipo específico de adversidad temprana y su relación con el tipo específico de sesgos cognitivos y el curso del TLP de pacientes con este diagnóstico. Metodología: Se realizó una revisión sistemática de la literatura y para reportar la evidencia se utilizó la versión 2020 de la declaración Prisma. Las bases de datos consultadas fueron Scopus, Pubmed, Web of Science y PsycInfo. En la búsqueda también se incluyeron bases de datos de literatura gris como Google Académico, Open Gray y WorldCat. Resultados: En total se incluyeron en el estudio 13 artículos que satisficieron criterios de originalidad, temática estudiada (adversidad temprana, funcionamiento cognitivo y sintomatología límite) y población indicada (pacientes con diagnóstico de TLP). Conclusiones: Si bien existe evidencia de que la adversidad temprana en general es un factor de riesgo para el TLP, se necesita más investigación para comprender los tipos específicos de adversidad que pueden estar más fuertemente relacionados con el desarrollo del TLP. Si bien algunos estudios han identificado sesgos cognitivos en individuos con TLP, poco se conoce sobre el modo en que estos sesgos se desarrollan y cambian con el tiempo, o según la etapa de exposición del paciente a la adversidad temprana.

Introduction: Current research and articles on early adversity and cognitive biases in patients with borderline personality disorder (BPD) demonstrate the relationship between these variables and the severity of the clinical symptoms of this disorder. Objective: The aim was to systematically review the evidence of the relationship between early adversity, cognitive biases, and exacerbation of symptoms of borderline personality disorder. The research gap concerns the particular type of early adversity and its relationship with the specific type of cognitive biases and the course of BPD in patients with this diagnosis. Methodology: We conducted a systematic literature review, and the Prisma statement version 2020 was used to report the evidence. The databases consulted were Scopus, Pubmed, Web of Science, and PsycInfo. Gray literature databases, such as Google Scholar, Open Gray, and WorldCat, were also included in the search. Results: We included 13 articles in the study that met the criteria for originality, studied theme (early adversity, cognitive functioning, and borderline symptomatology), and target population (patients diagnosed with a personality disorder). Conclusions: We found that while there is evidence that early adversity, in general, is a risk factor for BPD, further research is needed to understand the specific types of adversity that may be more strongly related to the development of BPD. In addition, although some studies have identified cognitive biases in individuals with BPD, little is known about how these biases develop and change over time or according to the stage of the patient's exposure to early adversity.

Factores de riesgo relacionados con el abandono de la lactancia materna exclusiva / Risk factors related to the abandonment of exclusive breastfeeding / Fatores de risco relacionados ao abandono do aleitamento materno exclusivo

RESUMEN Introducción: la lactancia materna es la forma ideal y superior de nutrición para los recién nacidos a término y hasta los 6 meses de edad de forma exclusiva. Objetivo: caracterizar los factores que se relacionan con el abandono precoz de la lactancia materna exclusiva. Métodos: se realizó un estudio observacional, descriptivo, transversal en 27 madres que abandonaron la lactancia materna exclusiva antes de los 6 meses de edad del bebé. Se diseñó un cuestionario para la recolección de la información que analizó las siguientes variables: edad materna, escolaridad, ocupación, estado civil, paridad, antecedentes de destete precoz, tipo de parto y causas por la que abandonó la lactancia materna, se utilizaron técnicas de estadísticas descriptivas: frecuencia absoluta y relativa (número y porciento) como medidas de resumen. Resultados: el grupo de edad de 15 a 19 años de las madres estudiadas fue el más representativo con el 40,7 % y el nivel de escolaridad medio superior con el 48,1%, el 55,6 % de las madres eran solteras y el mismo porciento estudiantes, el 66,6 % de las madres eran nulíparas y prevalecieron las multíparas con antecedentes de destete precoz, la incorporación al estudio, la sensación de falta de producción de leche y mastalgia fueron algunas de las causas referidas por las encuestadas. Conclusiones: la edad materna, historia de destete precoz anterior, incorporación a la vida estudiantil, sensación de falta de producción de leche, mastalgia y grietas en los pezones fueron los principales factores relacionados con el abandono de la lactancia materna.

ABSTRACT Introduction: breastfeeding is the ideal and superior form of nutrition for full-term newborns and exclusively up to 6 months of age. Objective: to characterize the factors that are related to the early abandonment of exclusive breastfeeding. Methods: an observational, descriptive, cross-sectional study was carried out in 27 mothers who abandoned exclusive breastfeeding before the baby was 6 months old. A questionnaire was designed to collect the information that analyzed the following variables: maternal age, schooling, occupation, marital status, parity, history of early weaning, type of delivery and reasons why breastfeeding was abandoned, techniques of descriptive statistics: absolute and relative frequency (number and percentage) as summary measures. Results: the age group of 15 to 19 years of the mothers studied was the most representative with 40.7% and the level of higher education with 48.1%, 55.6% of the mothers were single and the same percentage of students, 66.6% of the mothers were nulliparous and multiparous with a history of early weaning prevailed, joining the study, the feeling of lack of milk production and mastalgia were some of the causes referred by the respondents. Conclusions: maternal age, history of previous early weaning, incorporation into student life, feeling of lack of milk production, mastalgia and cracks in the nipples were the main factors related to the abandonment of breastfeeding.

RESUMO Introdução: o aleitamento materno é a forma ideal e superior de nutrição para recém-nascidos a termo com idade exclusiva de 6 meses. Objetivo: caracterizar os fatores que estão relacionados ao abandono precoce do aleitamento materno exclusivo. Métodos: um estudo observacional, descritivo e transversal foi realizado em 27 mães que abandonaram a amamentação exclusiva antes dos 6 meses de idade do bebê. Foi elaborado um questionário para a coleta de informações que analisaram as seguintes variáveis: idade materna, escolaridade, ocupação, estado civil, paridade, histórico de desmasmaamento precoce, tipo de parto e causas para as quais abandonou o aleitamento materno, foram utilizadas técnicas estatísticas descritivas: frequência absoluta e relativa (número e percentual) como medidas sumárias. Resultados: a faixaetária de 15 a 19 anos das mães estudadas foi a mais representativa com 40,7 % e o ensino médio superior com 48,1 %, 55,6 % das mães eram solteiras e o mesmo percentual de alunos, 66,6 % das mães eram nuparas e mulheres multiparas com histórico de desmamaamento precoce prevaleceram, a incorporação no estudo, o sentimento de falta de produção de leite e mastalgia foram algumas das causas relatadas pelos entrevistados. Conclusões: idade materna, história do desmaamento precoce anterior, incorporação na vida estudantil, sensação de falta de produção de leite, mastalgia e rachaduras nos mamilos foram os principais fatores relacionados ao abandono do aleitamento materno.

Social Factors Contributing to Substance Abuse: A Narrative Analysis

Background: India has seen a rise in the use of substance abuse. A national survey in 2019 showed that around 2.1% of the country’s population uses opioids and 2.8% of Indians between the ages 10-75 use cannabis. In order to prevent substance related disorders it is necessary to get in-depth understanding of the various social factors leading to the use of substance use. Methodology: The researcher used Narrative Analysis to gather data from 4 individuals through the use of semi-structured interview. The participants were undergoing treatment at a rehabilitation center in Mumbai. Results: Through narrative analysis 3 common themes namely, friends (peer pressure), curiosity and parental neglect were identified. There were 3 unique themes identified- stamina/booster, bad neighbourhood and resentment towards family. Conclusions: This research identifies some common themes that can help those working in the field of mental health to focus on those areas while working with young children and their families. This research shows the importance of teaching assertiveness training to young children to prevent them from trying substances. The parents need to be trained and informed about various parenting styles and how to develop secure attachment styles with children. This research also paves the way for further research by identifying which other parental styles leads substance abuse

Factors Associated with Delay in Treatment of Cancer

Introduction: This is a cross sectional study conducted on cancer patients who presented at the periph-eral cancer center, Mandya Institute of Medical Sciences, Mandya with an objective to find out the possi-ble factors influencing the delay in treatment of cancer. Method: Each day the patients coming for radiotherapy treatment were selected, based on the inclusion criteria for the study and an informed consent was taken before collecting the data. Data was collected by questionnaire method and was entered in an excel sheet and analyzed. Result: The result revealed that 65% of the patients belonged to the age group 50-69 and that the delay in treatment significantly increased with increase in age, 80% of the patients were not aware and their median delay was about 60 days, 59% of the patients neglected the symptoms and their median delay was about 60 days, and 5 percent of them took self-treatment and their median delay was 60 days. Conclusion: This study, revealed that 4 important factors, all of which belonged to the patient, were re-sponsible for the significant delay in the treatment. The 4 factors were age of the patient, awareness about the symptom, neglecting the symptom and history of self-treatment.

Maltrato en la infancia y consumo de drogas en adolescentes de preparatoria / Child abuse and drug use in high school adolescents

Resumen Objetivo: Conocer la relación entre el maltrato en la infancia y el consumo de drogas en adolescentes. Materiales y métodos: Estudio cuantitativo, descriptivo, correlacional, transversal; mediante el muestreo aleatorio estratificado, se seleccionaron a los adolescentes de preparatoria. Se aplicó una cédula de datos personales, el Cuestionario de Maltrato en la Infancia, Test de Identificación de los Trastornos Debidos al Consumo de Alcohol, validados y utilizados en población mexicana, en investigaciones previas. Este estudio se apegó al Reglamento de la Ley General de Salud en materia de investigación para la salud. Resultados: Participaron 239 adolescentes de una preparatoria pública, las edades oscilaron entre los 15 a 19 años (M = 16.41; DE= 1.04), las mujeres predominaron con 54.5%. En la variable de maltrato en la infancia y subescalas por sexo se encontró diferencia significativa en la subescala de abuso físico mostrando que los hombres (Mdn=7.00/ M=8.11, DE=3.08) presentaron mayor puntaje de abuso físico en comparación con las mujeres (Mdn=7.00/ M=7.28, DE=2.64) con una U=5760.0, p<0.032. Al correlacionar las variables de maltrato en la infancia y consumo de drogas, se encontró una correlación positiva y estadísticamente significativa del número de drogas con el total AUDIT, el consumo sensato y dañino con el puntaje total de maltrato y las subescalas de abuso sexual, negligencia emocional y negligencia física. Conclusiones: Los hombres presentaron mayor abuso físico. En la relación entre las variables de estudio se encontró que el maltrato en la infancia, se relacionó con el consumo de alcohol dañino y con el número de drogas consumidas.

Abstract Objective: To know the relationship between abuse in childhood and drug use in adolescents. Materials and methods: Quantitative, descriptive, correlational, cross-sectional study; Using stratified random sampling, high school adolescents were selected. A personal data card, the Child Abuse Questionnaire, and the Alcohol Use Disorders Identification Test were applied, validated and used in the Mexican population, in previous investigations. This study adhered to the Regulations of the General Health Law regarding health research20. Results: 239 adolescents from a public high school participated, the ages ranged from 15 to 19 years (M = 16.41; SD = 1.04), women predominated with 54.5%. In the variable of abuse in childhood and subscales by sex, a significant difference was found in the physical abuse subscale, showing that men (Mdn = 7.00/M = 8.11, SD = 3.08) had a higher physical abuse score compared to women. (Mdn = 7.00/M = 7.28, SD = 2.64) with a U = 5760.0, p <0.032. When correlating the variables of abuse in childhood and drug use, a positive and statistically significant correlation of the number of drugs with the total AUDIT, the sensible and harmful consumption with the total score of abuse and subscales of sexual abuse, emotional neglect and neglect physical. Conclusions: Men presented more physical abuse. In the relationship between the study variables, it was found that abuse in childhood was related to the consumption of harmful alcohol and the number of drugs consumed.

Analysis of reported animal abuse in Campo Magro, Paraná, Brazil / Análise de denúncias de maus-tratos aos animais no município de Campo Magro, Paraná

Animal abuse is a criminal offense in Brazil and can be dealt with by several government agencies, including municipal ones. Cases of animal abuse reported to the Department of Health Surveillance, of the Municipal Health Secretariat of Campo Magro, Paraná, Brazil, between March of 2019 and December of 2020 were analyzed to assess the most common forms of abuse and animals involved. A total of 140 complaints were received in this period; 132 were investigated, of which 81 were considered authentic. The most common form of abuse was neglect 64.2% (52/81). Cases of neglect were further classified into four types (although cases may be classified with more than one type), resulting in 106 classifications of neglect. Behavioral neglect was the most common form of neglect 33.9% (36/106). As more than one animal could be involved in each report, the 81 authentic cases involved a total of 471 animals. Dogs were the species most commonly affected 78.5% (370/471). The vast majority of animal abuse was perpetrated against adult animals. Statistically significant correlations were found between the sex and age of dogs and abuse and between species and the different forms of abuse for dogs and cats.(AU)

Os maus-tratos aos animais são considerados crime no Brasil e o atendimento desse tipo de ocorrência pode ser realizado por diferentes órgãos governamentais, incluindo os municipais. O presente trabalho analisa denúncias atendidas pelo Departamento de Vigilância em Saúde, da Secretaria Municipal de Saúde de Campo Magro, Paraná, Brasil, entre março de 2019 e dezembro de 2020 e avalia os tipos mais comuns de maus-tratos a animais e os animais envolvidos. Um total de 140 denúncias foram recebidas e 132 foram fiscalizadas, destas, 81 foram consideradas procedentes. A forma mais prevalente de maus-tratos foi a negligência com 64,2% (52/81). Os casos de negligência foram classificados em quatro diferentes tipos (cada caso pode ser classificado em mais de um tipo de negligência). O tipo mais frequente foi a negligência comportamental com 33,9% (36/106). Como mais de um animal podia estar envolvido em cada caso de maus-tratos, os 81 casos procedentes contabilizaram 471 animais envolvidos. A espécie canina foi a mais afetada, sendo 78,5% (370/471). A maior parte dos casos de maus-tratos foram cometidos contra animais adultos. Correlações estatísticas significativas foram encontradas entre o sexo e faixa etária dos cães em relação à ocorrência de maus-tratos e, também, entre a espécie e os diferentes tipos de maus-tratos para cães e gatos.(AU)

Mediating effect of life satisfaction between child neglect and problematic mobile phone use of middle school students / 中华行为医学与脑科学杂志

Objective:To explore whether life satisfaction has a mediating effect between child neglect and middle school student’ problematic mobile phone use.Methods:Totally 1 692 middle school students from four middle schools of Xiamen in June 2020 were selected by cluster stratified sampling.The self-rating questionnaire for adolescent problematic mobile phone use (SQAPMPU), child neglect scale (CNS) and quality of life scale for children and adolescents (QLSCA) were used for the survey. SPSS 23.0 software was used for descriptive statistics, correlation analysis, regression analysis and the mediating effect analysis.Results:The scores of CNS, QLSCA and SQAPMPU were (24.45±14.28), (134.44±19.34), (23.20±8.94)respectively.And the detection rate of problematic mobile phone use was 23.6%. There were significant differences in the scores of SQAPMPU scale in different grades, father's education degrees, mother's education degrees and monthly pocket money(all P<0.05). In SQAPMPU, high school students scored significantly higher than junior school students( t=-2.403, P=0.016), adolescents with undergrate education of their father and mother scored the lowest( F=3.411, P=0.017; F=2.729, P=0.043), adolescents with monthly pocket money of "500-1 000" and "1 000-2 000" scored significantly higher than those with monthly pocket money of "under 500". The total scores and sub scores of child neglect were significantly positively correlated with the total scores and sub scores of problematic mobile phone use ( r=0.177-0.360, all P<0.05). The total scores and sub scores of life satisfaction were significantly negative correlated with the total scores and sub scores of problematic mobile phone use ( r==-0.508--0.250, all P<0.05). Child neglect had a positive predictive effect on problematic mobile phone use ( t=15.598, R2=0.130, P<0.05), but had a negative predictive effect on life satisfaction ( t=-27.798, R2=0.321, P<0.05). There were the part intermediary role of life satisfaction between child neglect and problematic mobile phone use( t=-13.937, R2=0.222, P<0.05), and the mediating effect accounted for 58.29% of the total effect. Conclusion:The neglected experience in childhood of adolescents not only can directly affect problematic mobile phone use, but also can affect the problematic mobile phone use by affecting life satisfaction.

Domain specific roles of child neglect on the latent profiles of security in children / 中华行为医学与脑科学杂志

Objective:To explore the latent categories of child security and analyze domain-specific roles of child neglect on security among children aged 10-13 years.Methods:From October to December 2019, the security questionnaire (SQ), child neglect scale (CNS) and Buss-Perry aggression questionnaire (BPAQ) were used to investigate 577 children aged 10-13 years. Mplus 7.0 software was used for latent profile analysis (LPA) to explore the latent categories of child security. SPSS 22.0 software was used for multinomial Logistic regression to examine the effects of different domains of child neglect on the child security categories.Results:(1) Child security was divided into three categories named "medium-slightly low-security subgroup (48.9%)" , "high-security subgroup (31.8%)" , and "inability control subgroup (19.3%)" (entropy = 0.90, Lo-Mendell-Rubin likelihood, and Bootstrapped likelihood ratio test, all P<0.01). (2) Child security(35.06±6.08, 51.49±4.99, 69.67±6.13, F=1 378.09, P<0.01), neglect(71.09±20.58, 59.96±12.90, 50.76±9.27, F=74.50, P<0.01), and aggression(54.31±15.23, 46.44±12.46, 34.19±12.61, F=90.95, P<0.01) were significantly different among the "medium-slightly low-security subgroup" , "high-security subgroup" , and "inability control subgroup" . (3)Compared with "high-security subgroup" , the proportion of children with poor parental relationship and low paternal education level were higher in the other two subgroups(all P<0.05), while the proportion of children in the fifth grade were lower(all P<0.05). (4)In " inability control subgroup" , safe neglect had no impact on security( B=0.01, OR=1.02, 95% CI=0.91-1.13, P>0.05), while physical neglect ( B=0.13, OR=1.14, 95% CI=1.01-1.28), affection neglect( B=0.14, OR=1.15, 95% CI=1.07-1.23), and communication neglect( B=0.15, OR=1.16, 95% CI=1.03-1.30) predicted the "inability control subgroup" (all P<0.05). Only communication neglect predicted the "medium-slightly low-security subgroup" ( B=0.16, OR=1.17, 95% CI=1.07-1.28, P<0.01). Conclusion:Security is heterogenous with three latent categories among Children aged 10-13 years. Child neglect plays domain-specific roles in different child security categories.

Investigation of P300 evoked by Stroop Color Word Task in children with emotional neglect / 四川精神卫生

ObjectiveTo investigate the P300 evoked by Stroop Color Word Task in children with emotional neglect, and to explore their implication for inhibition control. MethodsA cluster sampling was conducted for the first grade students of a middle school in Sanmenxia City, Henan Province. The students from 3 classes were assessed by standard Raven reasoning test and Child Neglect Scale (CNS), and a total of 147 eligible students were screened out. Children were divided into the emotional neglect group (n=40) and the control group (n=40) according to the 27% before and after the score of CNS emotional neglect factor. Both groups completed the Stroop Color word task, and EEG data were collected to compare the response time, accuracy, amplitude and latency of P300 between the two groups. ResultsThe CNS total score and the scores of safety neglect, communication neglect, physical neglect and emotional neglect factors in the emotional neglect group were significantly higher than those in control group (t=15.003, 4.301, 11.495, 4.803, 23.957, P<0.01). The average reaction time in the incongruent task of emotional neglect group was significantly longer than that in the control group [(879.02±101.52) ms vs. (756.93±113.91) ms, t=5.061, P<0.01]. Under incongruent task, the average amplitude of P300 in emotional neglect group was lower than that of the control group [(3.97±1.12) μV vs. (8.71±1.24) μV, t=-17.976, P<0.01]. The average latency of P300 of emotional neglect group was longer than that of the control group [(361.81±39.69) ms vs. (301.35±33.67) ms, t=7.346, P<0.01]. ConclusionUnder incongruent task, children with emotional neglect had longer response time, longer latency and lower amplitude of P300， which suggested that children with affective neglect may have inhibition and control disorder.

Far space neglect in left spatial neglect patients: features and assessment / 中国康复理论与实践

ObjectiveTo explore the features and assessment for far space neglect in left spatial neglect patients after right brain stroke. MethodsFrom January to October, 2021, 30 left unilateral spatial neglect (USN) patients after right stroke (patients, n = 30) from Beijing Bo'ai Hospital and healthy volunteers matching with gender, age and level of education (controls, n = 30) were evaluated with line cancelation (LC), star cancelation (SC) and line bisection (LB) tests, nearly and far away. The 25 controls were evaluated with LB on the second day. ResultsNo line or star was omissed in the controls. Both the deviation and percentage were more in the patients than in the controls (|t| > 4.319, P < 0.001). Both the deviation and percentage were less different for all the test (|Z| < 1.638, t = -1.282, P > 0.05) between nearly and far away, except the deviation of LB (t = -4.994, P < 0.001). The ICC of test-retest was above 0.462 (P < 0.01). ConclusionRight brain stroke patients with USN may present far spatial neglect, which can be assessed with LB.

Prevalência e coocorrência de Experiências Adversas na Infância: um inquérito de base escolar no município do Rio de Janeiro / Prevalence and co-occurrence of Adverse Childhood Experiences: a school-based survey in Rio de Janeiro

Resumo Este estudo tem como objetivos estimar a prevalência de Experiências Adversas na Infância (EAI), investigar o seu perfil de coocorrência e sua distribuição de acordo com características individuais, familiares, socioeconômicas e escolares de adolescentes de escolas públicas e privadas de uma Região Administrativa do Rio de Janeiro. Trata-se de um estudo seccional com 681 indivíduos, selecionados através de amostragem aleatória complexa. As EAI foram identificadas através do questionário QUESI e perguntas diretas. Estimou-se as prevalências e a correlação entre pares das EAI e o perfil de coocorrência das EAI. Os resultados revelaram que abuso e negligência emocionais e dissolução da família biparental foram as adversidades mais comuns. Setenta por cento da amostra sofreu pelo menos uma EAI e 9%, quatro ou mais. Cerca de 20% vivenciou abuso e negligência e 9% a coocorrência de abuso, negligência e ausência de pelo menos um genitor durante a infância. Os subgrupos mais vulneráveis foram: meninas, filhos de mães adolescentes, os que não moravam com ambos os pais, os de escola pública e os de baixa renda. As altas prevalências e o perfil de coocorrência das adversidades sugerem que as políticas voltadas à prevenção e ao acolhimento de vítimas sejam abrangentes e multissetoriais.

Abstract This study aimed to estimate the prevalence of categories of adverse childhood experiences (ACE) among high school students in Rio de Janeiro, investigate the ACE co-occurrence profile, and examine the distribution of exposure to ACE according to individual, family, socioeconomic, and school characteristics. A cross-sectional study was conducted with 681 individuals selected using a complex random sampling design. Exposure to ACE categories was identified using a cross-culturally adapted version of the Childhood Trauma Questionnaire (CTQ) and direct questions. We calculated prevalence and correlation between ACE pairs and determined the co-occurrence profile of childhood adversities. The findings reveal that the most common adversities were emotional abuse and neglect and biparental family dissolution. Seventy percent of the sample reported having been exposed to at least one ACE and 9% had been exposed to four or more. Around 20% of respondents reported exposure to abuse and neglect and 9% to the co-occurrence of abuse, neglect, and absence of at least one parent during childhood. The most vulnerable subgroups were girls and respondents who were born to teenage mothers, not living with both parents, studying at public schools, and from low-income families. The high prevalence and co-occurrence profile of ACE reveals the need for wide-ranging intersectoral policies designed to prevent adverse childhood experiences and provide victim support.

Abordaje integral del adulto mayor ante diferentes formas de abuso: un acercamiento desde la medicina familiar en Colombia / Comprehensive Approach to the Elderly in the Face of Different Forms of Abuse: Boarding from Family Medicine in Colombia

RESUMEN El envejecimiento poblacional es un tema de gran importancia por su crecimiento rápido y progresivo en los últimos años. Así mismo, con el aumento de la edad crece el grado de dependencia funcional, por consiguiente, mayor probabilidad de maltrato en el adulto mayor; convirtiéndose en un problema social y de salud pública a nivel mundial. El objetivo de este artículo es dar a conocer la importancia del abuso en el adulto mayor, sospecha y reconocimiento oportuno del mismo para realizar un abordaje integral desde la atención primaria. Se realizó una revisión narrativa que incluyó revisiones sistemáticas, revisiones de la literatura, reportes de caso y otros elementos, como noticias locales en Colombia, entre 2015 a 2019. No existe consenso alguno de la definición exacta, sin embargo, la más aceptada es la propuesta por la Organización Mundial de la Salud y la Organización de los Estados Americanos. Se han identificado factores de riesgo individuales, relacionales, socioculturales y comunitarios asociados a la perpetuación de este. Su clasificación está basada en dos grandes grupos: maltrato directo e indirecto. Existen diferentes herramientas de tamización de maltrato en el adulto mayor, dentro de estas la más utilizada es el Elder Abuse Suspicion Index (EASI), y estrategias que ayudan al médico de atención primaria al reconocimiento temprano y abordaje holístico del paciente. Tanto en Colombia como a nivel mundial, el Médico Familiar está en la capacidad de establecer un contacto más cercano con el anciano y su entorno generando un clima de confianza y empatía que permiten al profesional desde la atención primaria la detección temprana y prevención de cualquier tipo de abuso en esta población.

ABSTRACT Population ageing is an important issue due to its rapid and progressive growth in the last years. In addition, with increasing age, the degree of functional dependence increases, and with it, the likelihood of abuse in older adults, becoming a global social and public health problem. The aim of this article is to show the importance of abuse in older adults, and of early suspition and discovery, in order to carry out a comprehensive approach. This narrative review included systematic reviews, literature reviews, case reports, and other elements such as local news in Colombia, from 2015 to 2019. There is no consensus on the exact definition, however, the most accepted is the proposal of the World Health Organization and the Organization of American States. Several risk factors associated with its perpetuation have been identified, including relational, individual, sociocultural, and community factors. The abuse of older adults is classified into five groups: physical, emotional or psychological, economic or financial, sexual abuse, and neglect, the latter also includes abandonment. There are different screening tools for older adult abuse, among which the most used is the Elder Abuse Suspicion Index (EASI), and strategies that help the primary care physician to early recognition and carry out a holistic approach. Both in Colombia and worldwide, the Family Physician can establish closer contact with the older adults and their environment, generating a climate of trust and empathy that helps the primary care professional to early detection and prevention of any kind of abuse in this population.

Effect of a Video-Based Case Presentation Educational Intervention Anchored on the Theory of Planned Behavior on Adoption of Oral Health Behaviors Among Dental Patients: A Quasi-Experimental Study / Efecto de una intervención educativa de presentación de casos en video basada en la teoría del comportamiento planificado sobre la adopción de comportamientos de salud oral entre los pacientes dentales: un estudio cuasi-experimental

ABSTRACT: Objective: The integration of video technology in case-based presentations are useful approaches in teaching real-world problems that ultimately improves an individual's ability to reflect, analyze, and decide regarding any circumstance leading to change in behavior. Anchored on the Theory of Planned Behavior, this study aims to determine the effectiveness of an online case-based video patient education tool on the adoption of oral health behaviors by patients in the dental setting. Materials and Methods: The study was carried on 74 dental patients who were selected using simple sampling (37 patients each in Groups I and II). The two groups differed in presence (Group I-Control) or absence (Group II-Experimental) of prior exposure to professional oral care before Patient Educational Intervention through video-based case presentation was performed in the control and experimental groups. Data were collected using a questionnaire and analyzed by the Statistical Package for the Social Sciences version 18 software at 0.05 significance level. Results: A total of 37 participants per group in Groups I and II (N=74) responded to the pre-test phase and post-test phase. The pre-test mean scores of Groups I and II were 11.43 and 15.05, respectively. The post-test mean score of Groups I and II were 10.81 and 12.76, respectively. There is no statistical significance seen in the pre-test mean score and the post-test mean score of the patients who experienced professional oral health care (Group I) (p=0.113). However, there is a statistical significance in the mean pre-test score and the mean post-test score among patients who never experienced professional oral health care (Group II) (p=0.032). Conclusion: The study revealed that the video-based case presentations is an effective patient education strategy for dental patients who have never experienced professional oral health care manifested as a decline in the degree of dental neglect.

RESUMEN: Objetivo: La integración de la tecnología de video en presentaciones basadas en casos son enfoques útiles para enseñar problemas del mundo real que, en última instancia, mejoran la capacidad de un individuo para reflexionar, analizar y decidir sobre cualquier circunstancia que conduzca a un cambio de comportamiento. Anclado en la Teoría del Comportamiento Planificado, este estudio tiene como objetivo determinar la efectividad de una herramienta de educación del paciente en video basada en casos en línea sobre la adopción de comportamientos de salud bucal por parte de los pacientes en el entorno dental. Materiales y métodos: El estudio se llevó a cabo en 74 pacientes dentales que fueron seleccionados mediante muestreo simple (37 pacientes cada uno en los Grupos I y II). Los dos grupos difirieron en presencia (Grupo I-Control) o ausencia (Grupo II-Experimental) de exposición previa a cuidados bucales profesionales antes de que se realizara la Intervención Educativa del Paciente a través de la presentación de casos en video en los grupos control y experimental. Los datos se recopilaron mediante un cuestionario y se analizaron con el software Statistical Package for the Social Sciences versión 18 a un nivel de significancia de 0.05. Resultados: Un total de 37 participantes por grupo en los Grupos I y II (N=74) respondieron a la fase previa a la prueba y a la fase posterior a la prueba. Las puntuaciones medias previas a la prueba de los Grupos I y II fueron 11,43 y 15,05, respectivamente. La puntuación media posterior a la prueba de los Grupos I y II fue 10,81 y 12,76, respectivamente. No se observa significancia estadística en la puntuación media previa a la prueba ni en la puntuación media posterior a la prueba de los pacientes que recibieron atención profesional de la salud bucal (Grupo I) (p=0,113). Sin embargo, existe una significancia estadística en la puntuación media previa a la prueba y la puntuación media posterior a la prueba entre los pacientes que nunca recibieron atención médica bucal profesional (Grupo II) (p=0,032). Conclusión: El estudio reveló que las presentaciones de casos en video son una estrategia eficaz de educación del paciente para los pacientes dentales que nunca han experimentado la atención de la salud bucal profesional que se manifiesta como una disminución en el grado de negligencia dental.

Mediating effect of resilience and depression between social support and self-neglect in empty-nest community-dwelling elderly / 中华行为医学与脑科学杂志

Objective:To explore the mediating effects of resilience and depression on the relationship between social support and self-neglect.Methods:From July to October 2020, a cross-sectional survey was conducted among 549 empty-nest community-dwelling elderly in the community using the social support rating scale, Connor and Davidson resilience scale, geriatric depression scale and elderly self-neglect scale. SPSS 22.0 and AMOS 24.0 were used for data analysis, including descriptive analysis, correlation analysis and structural equation modeling.Results:The scores of social support, resilience and self-neglect of the empty-nest elderly were (38.63±7.47), (64.30±14.57) and (3.72±2.67) respectively, and 31.70% (174/549) of the subjects had depressive symptoms. The score of self-neglect was negatively correlated with the score of social support ( r=-0.597, P<0.01) and resilience ( r=-0.557, P<0.01), and positively correlated with depression score ( r=0.675, P<0.01). The score of social support was positively correlated with resilience score ( r=0.531, P<0.01) and negatively correlated with depression ( r=-0.597, P<0.01). Social support could affect self-neglect directly ( β=-0.485, P<0.05), and it could also influence self-neglect indirectly through the partial mediating effect of resilience ( β=-0.451, P<0.05). The mediating effect of resilience and depression accounted for 12.18% and 36.00% of the total effects respectively. Conclusion:Social support could influence self-neglect directly or indirectly through resilience and depression. The empty-nesters should be encouraged to participate more in social activities so as to improve their resilience, reduce the occurrence of self-neglect.

Features and Rehabilitation of Pusher Syndrome after Parietal Lobe Hemorrhage: A Case Report / 中国康复理论与实践

Objective:To explore the features and rehabilitation of Pusher syndrome (PS). Methods:A female patient was reported and the literatures were reviewed. Results:The patient presented moderate ipsilateral, deep sensory disturbance, left spatial neglect and disuse. White matter degeneration was found. After four-week rehabilitation, the score of Scale for Contraversive Pushing decreased from 2.5 to 0.75, and her hand function recovered to assistant hand. Conclusion:The degeneration of white matter develops rapidly in PS patient, while the recovery of motor function is relatively slow, and need longer and comprehensive rehabilitation, especially the exercise therapy and somatosensory stimulation.