The association between sleep spindles and IQ in healthy school-age children

Recent studies have suggested that sleep is associated with IQ measures in children, but the underlying mechanism remains unknown. An association between sleep spindles and IQ has been found in adults, but only two previous studies have explored this topic in children. The goal of this study was to examine whether sleep spindle frequency, amplitude, duration and/or density were associated with performance on the perceptual reasoning, verbal comprehension, working memory, and processing speed subscales of the Wechsler Intelligence Scale for Children-IV (WISC-IV). We recruited 29 typically developing children 7–11 years of age. We used portable polysomnography to document sleep architecture in the natural home environment and evaluated IQ. We found that lower sleep spindle frequency was associated with better performance on the perceptual reasoning and working memory WISC-IV scales, but that sleep spindle amplitude, duration and density were not associated with performance on the IQ test.     

Intensive supervised rehabilitation versus less supervised rehabilitation following anterior cruciate ligament reconstruction? A systematic review and meta-analysis

ObjectivesTo investigate whether intensive supervised rehabilitation following ACL reconstruction leads to superior self-reported function and sports participation compared to less supervised rehabilitation.DesignSystematic review and meta-analysis.MethodsWe included randomised controlled trials (RCTs) comparing supervised rehabilitation to rehabilitation with a similar protocol that used less supervised sessions for athletes following ACL reconstruction. Two reviewers independently screened studies and extracted data. The Physiotherapy Evidence Database (PEDro) scale was used to evaluate methodological quality and GRADE to evaluate overall quality of evidence. Self-reported function and sports participation were the primary outcomes. Data were pooled using random effects meta-analyses.ResultsOur search retrieved 4075 articles. Seven articles reporting on six RCTs were included (n = 353). Very-low to low-certainty evidence suggests intensive supervised rehabilitation is not superior to less supervised rehabilitation following ACL reconstruction for improving self-reported function, sports participation, knee flexor and extensor strength, range of motion, sagittal plane knee laxity, single leg hop performance, or quality of life.ConclusionBased on uncertain evidence, intensive supervised rehabilitation is not superior to less supervised rehabilitation for athletes following ACL reconstruction. Although high-quality RCTs are needed to provide more certain evidence, clinicians should engage athletes in shared decision making to ensure athletes’ rehabilitation decisions align with current evidence on supervised rehabilitation as well as their preferences and values.     

近10年国内外老年居家护理研究热点的对比分析

目的探讨国内和国外老年居家护理研究热点的差异,为我国老年居家护理研究提供参考。方法基于CNKI、Web of Science核心合集,检索2010年1月1日—2020年7月8日收录的国内外老年居家护理相关文献,采用SPSS、COOC等软件对检索结果进行可视化分析。结果近10年国内和国外老年居家护理共同研究热点为健康教育、家庭照顾者、生活质量、老年痴呆、社区护理、长期护理。国内和国外学者对老年痴呆、长期护理研究的侧重点不同。近10年国内外老年居家护理研究热点差异体现在护理模式、家庭功能、老年人身心健康管理等方面,国内学者多关注老年人躯体疾患管理,国外学者在居家老年人疾病管理上更注重老年人健康管理、尊严等高维度需求的满足。结论近10年国内外老年居家护理研究热点差异主要集中在护理层面,国内注重疾病护理,国外更注重高维度的心理需求与健康水平管理;提示我国学者可以开展老年人高维度需求方面的现状调研,以及满足策略的相关研究。     

国际居家护理模式现况与研究进展

随着全球老龄化的加剧,居家护理成为健康养老的新理念。如何为老年人提供连续实用、经济便利的居家照护服务,已成为各个国家长期照护体系改革的目标。目前国际上具有代表性的居家护理体系包括私人及社会保险支付费用、私有机构提供服务的模式(美国模式);政府支付费用、私有机构提供服务为主的模式(加拿大模式);政府与个人共同支付费用、多元化服务提供主体的模式(澳大利亚模式);保险支付费用、多元化服务提供主体的模式(日本模式)。本文总结以美国、加拿大、澳大利亚、日本为代表的居家护理模式,阐述居家护理的核心要素,分析其特征及优缺点,提出我国应借鉴其他国家居家护理的长处,结合我国社会制度和经济水平的特点,创建符合国情的居家护理模式。     

Influence of anti‐inflammatory irrigant on substance P expression for single‐visit root canal treatment of teeth with irreversible pulpitis

One of the main objectives of root canal treatment is to alleviate the pain associated with irreversibly inflamed pulps. However, some patients may have moderate to severe pain following treatment. The aim of this study was to compare and assess the effect of ketorolac tromethamine on substance P expression in the pulp and periapical tissues when used as a root canal irrigant for single‐visit root canal treatment in teeth with irreversible pulpitis. Thirty‐six patients were randomly allotted to three irrigant groups – saline (n = 14), 3% sodium hypochlorite (n = 11) and ketorolac tromethamine (n = 11). Pulp blood samples (S1) were collected on gaining access to the pulp, and periapical blood samples (S2) were collected after root canal preparation. Quantification of substance P was done by ELISA test. The ketorolac tromethamine group had greater reduction in substance P expression (S2). Post‐operative pain levels were not significantly influenced by the different root canal irrigants.     

Intensive Home Hemodialysis: An Eye at the Past Looking for the Hemodialysis of the Future

Multiple observational studies along with a limited number of randomized clinical trials suggest that intensive hemodialysis (IHD) not only improves outcomes for uremic patients undergoing chronic dialysis but does so with a more favorable cost/benefit ratio compared with conventional hemodialysis. As a result of this, there has been a rapid increase in the interest in home hemodialysis (HHD) as HHD represents the easiest means of implementing IHD. While HHD has generated increased interest given its association with better outcomes/reduced hospitalizations, there are very few randomized controlled trials comparing HHD with other hemodialysis methods. Reported HHD‐associated increased survival benefits compared with in‐center hemodialysis are from uncontrolled studies, which raise patient selection bias as underlying the differences found. Thus, while HHD draws increasing attention, studies that pay careful attention to the psychosocial, demographic, and clinical factors associated with patients selected to undergo HHD will be needed to ultimately demonstrate its benefits, clarify the clinical applications, and determine the limits of IHD use in dialysis patients.     

中文修订版护理院治疗性环境筛查量表的信效度检验

目的检验中文修订版护理院治疗性环境筛查(Therapeutic Environment Screening Survey for Nursing Home,TESS-NH)量表信度和效度。方法通过系统的翻译、回译、德尔菲专家咨询对英文版TESS-NH量表汉化、修订,确立中文修订版TESS-NH量表的内容和条目,并进行信度和效度检验。结果中文修订版TESS-NH量表内容效度指数(CVI)平均值为0.980,折半信度为0.712,总量表Cronbach′sα系数为0.808,5个维度Cronbach′sα系数为0.716~0.770,重测信度为0.859,不同评定者间信度为0.872;各条目在所提取的相应公因子上的载荷值均大于0.5,因子分析提取的6个公因子共解释总变异的69.706%。结论中文修订版TESS-NH量表具有较好的信度和效度,可用于中国养老机构老年痴呆治疗性环境质量水平的评价和研究。     

Comparison of three different approaches in the treatment of chronic low back pain

Our aim is to investigate the effects of three therapeutic approaches in the chronic low back pain on pain, spinal mobility, disability, psychological state, and aerobic capacity. Sixty patients with chronic low back pain were randomized to three groups: group 1, aerobic exercise + home exercise; group 2, physical therapy (hot pack, ultrasound, TENS) + home exercise; group 3, home exercise only. Spinal mobility, pain severity, disability, and psychological disturbance of the patients were assessed before and after the treatment and at 1-month follow-up. Aerobic capacities of the patients were measured before and after treatment. All of the groups showed similar decrease in pain after the treatment and at 1-month follow-up, and there was no significant difference between the groups. In group 2, a significant decrease in Beck Depression Inventory scores was observed with treatment. At 1-month follow-up, group 1 and 2 showed significant decreases in General Health Assessment Questionnaire scores. In group 2, there was also a significant improvement in Roland Morris Disability scores. There were similar improvements in exercise test duration and the MET levels in all the three groups. All of the three therapeutic approaches were found to be effective in diminishing pain and thus increasing aerobic capacity in patients with chronic low back pain. On the other hand, physical therapy + home exercise was found to be more effective regarding disability and psychological disturbance.     

Hemoglobin A1c,frequency of glucose testing and social disadvantage: Metrics of racial health disparity in youth with type 1 diabetes

Introduction

Black youth with type 1 diabetes (T1D) have higher HbA1c than whites. To understand HbA1c differences, we examined the relationship of psycho-social factors and glucose testing with HbA1c.