A Longitudinal Factor Analytic Study of Children’s Neurocognitive Abilities

The neurocognitive abilities of 503 Portuguese children aged 8–11.9 years at onset of the study were assessed annually for 8 years in 3 functional domains: memory, motor and visual motor functions, and attention. A series of exploratory principal axis factor analyses, with varimax rotation, revealed seven factors: Divided Attention, Selective Attention, Verbal Learning and Recall, Visual Learning and Recall, Motor Speed, Visual-Motor Speed, and Working Memory. The same factors emerged across the 8-year period, suggesting that children's neurocognitive structures are articulated and stable throughout this period of development. From these exploratory analyses a small set of cost-effective neuropsychological tests were found to characterize children's functioning consistently throughout the 8-year period.     

丙泊酚脂肪乳注射液生物等效性研究实施和管理的专家共识

丙泊酚脂肪乳注射液是临床上广泛使用的静脉用麻醉药。近年来国内丙泊酚临床需求不断增加,丙泊酚生物等效性研究数量持续攀升,然而其设计、实施、管理尚缺乏共识和指南。本专家组共同研讨,达成此共识,旨在为国内开展丙泊酚生物等效性研究提供参考和指导。     

‘Struggling to be an insider’: a phenomenological design of new nurses’ transition

Aims and objectives. To obtain a comprehensive understanding of the transition process of new nurses in Taiwan. Background. The transition period for new nurses can be a daunting and traumatic experience. The large number of newly graduated Taiwanese nurses who resign from their jobs within three months indicates that this process can be complicated. However, the problems associated with the experiences of new nurses have not yet been recognised. Design. We adopted a phenomenological design using focus group interviews. Methods. Sixteen new nurses (less than one year working experience) participated in eight weekly group interviews lasting two hours each to grasp their experience of ‘being new’. Interview data were analysed according to Sloan’s (2002) three moments, and the whole process of analysis followed the suggestions of Agar (1986) , which was performed in a close collaboration between researchers until the consensus about the findings could be reached. Results. The overarching pattern of the transition process of new nurses becoming experienced members of the clinical nursing team was revealed as a journey of ‘struggling to be an insider’. This phenomenon was characterised by four themes, including (1) ‘being new as being weak’, (2) ‘masking myself’, (3) ‘internalising the unreasonable’ and (4) ‘transforming myself to get a position’. Conclusions. While Western culture view abusive indoctrination of new nurses as toxic behaviour, under the Chinese traditions of yield, tolerance and self‐oppression, following the power hierarchy and seeking harmony, the transition of new nurses is interpreted differently. Relevance to clinical practice. Recognition of the journey of ‘struggling to be an insider’ helps nurse administrators to (1) gain a better understanding of what new nurses encounter in their transition process, (2) help new nurses without harm, (3) improve in‐service training programmes and (4) retain future nurses.     

4种宫内节育器使用36个月效果观察

目的:比较4种宫内节育器(IUD)的使用效果.方法:对分别放置4种IUD的3 000例育龄妇女随访36个月,对比观察其的使用效果、副反应等.结果:放置吉妮致美IUD 1 200例、爱母功能性IUD 1 000例、母体乐铜375IUD 400例、活性γ型IUD 400例,4种IUD 3年带器妊娠率分别为1.54/百妇女年、4.49/百妇女年、1.92/百妇女年、3.53/百妇女年,差异有统计学意义(P＜0.05)；脱落率分别为4.07/百妇女年、5.36/百妇女年、4.80/百妇女年、5.62/百妇女年,差异有统计学意义(P＜0.05)；在疼痛和出血副反应发生率方面,以母体乐铜375 IUD较高.结论:吉妮致美IUD避孕效果较好,副作用少,值得临床应用.     

Adequate sample size for developing prediction models is not simply related to events per variable

ObjectivesThe choice of an adequate sample size for a Cox regression analysis is generally based on the rule of thumb derived from simulation studies of a minimum of 10 events per variable (EPV). One simulation study suggested scenarios in which the 10 EPV rule can be relaxed. The effect of a range of binary predictors with varying prevalence, reflecting clinical practice, has not yet been fully investigated.Study Design and SettingWe conducted an extended resampling study using a large general-practice data set, comprising over 2 million anonymized patient records, to examine the EPV requirements for prediction models with low-prevalence binary predictors developed using Cox regression. The performance of the models was then evaluated using an independent external validation data set. We investigated both fully specified models and models derived using variable selection.ResultsOur results indicated that an EPV rule of thumb should be data driven and that EPV ≥ 20 ​ generally eliminates bias in regression coefficients when many low-prevalence predictors are included in a Cox model.ConclusionHigher EPV is needed when low-prevalence predictors are present in a model to eliminate bias in regression coefficients and improve predictive accuracy.     

The influence of age and gender on motor and non-motor features of early Parkinson's disease: Initial findings from the Oxford Parkinson Disease Center (OPDC) discovery cohort

BackgroundIdentifying factors influencing phenotypic heterogeneity in Parkinson's Disease is crucial for understanding variability in disease severity and progression. Age and gender are two most basic epidemiological characteristics, yet their effect on expression of PD symptoms is not fully defined. We aimed to delineate effects of age and gender on the phenotype in an incident cohort of PD patients and healthy controls from the Oxford Parkinson Disease Centre (OPDC).MethodsClinical features, including demographic and medical characteristics and non-motor and motor symptoms, were analyzed in a group of PD patients within 3 years of diagnosis and a group of healthy controls from the OPDC cohort. Disease features were stratified according to age and compared between genders, controlling for effects of common covariates.Results490 PD patients and 176 healthy controls were analyzed. Stratification by age showed increased disease severity with age on motor scales. Some non-motor features showed similar trend, including cognition and autonomic features. Comparison across genders highlighted a pattern of increased severity and greater symptom symmetricality in the face, neck and arms in men with women having more postural problems. Amongst the non-motor symptoms, men had more cognitive impairment, greater rate of REM behavior disorder (RBD), more orthostatic hypotension and sexual dysfunction.ConclusionsAge in PD is a strong factor contributing to disease severity even after controlling for the effect of disease duration. Gender-related motor phenotype can be defined by a vertical split into more symmetrical upper-body disease in men and disease dominated by postural symptoms in women.