患者健康教育需求评估工具研究进展

<正>健康教育是通过信息传播和行为干预帮助个人或集体掌握卫生健康知识,树立健康观念,自愿采取有利于健康的行为和生活方式的健康活动过程,其目的就是消除或减轻影响健康的危险因素,预防疾病,促进健康和提高生活质量[1-2]。随着以"健康为中心"的医学模式的转变和优质护理的推进,健康教育也已成为责任制医院整体护理的一个重要组成部分。护士作为健康教育的主要执行者,其教育内容直接影响健康     

不同阅读方式对中班幼儿叙事能力的影响

目的 分析自主阅读和分享阅读对幼儿叙事能力的影响,为有效促进幼儿叙事能力的发展提供科学依据。方法 2017年3-5月抽取1所幼儿园,将其中班幼儿分为实验组(分享阅读组)和对照组(自主阅读组)进行为期4周的实验研究。结果 方差分析表明,前后测试,阅读方式和故事要素主效应显著(F=40.44,28.60,39.67,P<0.001)。简单效应分析表明,在后测试中分享阅读组的成绩显著高于自主阅读组,且故事背景、尝试行动及故事结果的成绩显著高于故事起因和内在反应(P<0.05),但在故事起因维度中,分享阅读组的成绩与自主阅读组的成绩差异无统计学意义(P>0.05)。结论 不同阅读方式对促进幼儿的叙事能力各维度的发展均有正向作用,但效果不一。分享阅读对幼儿叙事能力发展的效果优于自主阅读,但在故事起因方面,两种阅读方式均无显著促进作用。     

The quality of mother–child shared reading: its relations to child’s storytelling and home literacy environment

In the present study, we analysed the relations among the quality of mother–child shared reading, child’s storytelling and family literacy environment. The sample included 20 mother–child dyads, with 5-year-old children, who were recorded during shared reading. The quality of shared reading was assessed with the Scale for Observing Shared Reading while children’s storytelling was assessed with the textless book Frog Goes to Dinner. We found that the quality of mother–child shared reading was related to the coherence of children’s stories and to the factors of home literacy environment. Child’s age when parents started reading to him, the number of all books and children’s books in child’s home together explained 43.1% of the variance in the quality of shared reading. The findings give an insight into the process of the quality of the interactive reading between a child and an adult and emphasize the importance of shared reading for child’s storytelling.     

Transposable elements shape the human proteome landscape via formation of cis‐acting upstream open reading frames

Transposons are major drivers of mammalian genome evolution. To obtain new insights into the contribution of transposons to the regulation of protein translation, we here examined how transposons affected the genesis and function of upstream open reading frames (uORFs), which serve as cis‐acting elements to regulate translation from annotated ORFs (anORFs) located downstream of the uORFs in eukaryotic mRNAs. Among 39,786 human uORFs, 3,992 had ATG trinucleotides of a transposon origin, termed “transposon‐derived upstream ATGs” or TuATGs. Luciferase reporter assays suggested that many TuATGs modulate translation from anORFs. Comparisons with transposon consensus sequences revealed that most TuATGs were generated by nucleotide substitutions in non‐ATG trinucleotides of integrated transposons. Among these non‐ATG trinucleotides, GTG and ACG were converted into TuATGs more frequently, indicating a CpG methylation‐mediated process of TuATG formation. Interestingly, it is likely that this process accelerated human‐specific upstream ATG formation within transposon sequences in 5′ untranslated regions after divergence between human and nonhuman primates. Methylation‐mediated TuATG formation seems to be ongoing in the modern human population and could alter the expression of disease‐related proteins. This study shows that transposons have potentially been shaping the human proteome landscape via cis‐acting uORF creation.     

1型葡萄糖转运体缺陷综合征一例报告及文献复习

目的总结1型葡萄糖转运体缺陷综合征的临床特点、实验室检查、分子遗传学诊断及生酮饮食治疗疗效。方法报告1例以痫样发作为首发的1型葡萄糖转运体缺陷综合征病例。检索国内外相关文献,共检索出明确诊断的1型葡萄糖转运体缺陷综合征32例,进行文献复习。结果包括作者报告1例患者,共33例,男19例,女14例。临床特点:27/33例有痫样发作,发作年龄2个月至35岁之间。大多发作年龄在6个月以内。25/33例有共济失调,大多数轻中度共济失调,少部分患者共济失调影响行走及日常生活。24/33例肌张力障碍。14/33例有小头畸形。实验室检查:30/33例患者进行了脑脊液糖检查,23-56mg/dl之间,平均34.2±4.7mg/dl。脑脊液糖/血糖0.24-0.57之间,平均0.38±0.07。21/33例患者进行了红细胞摄取3-O-甲基-D-葡萄糖的能力检查,结果显示红细胞摄取3-O-甲基-D-葡萄糖的能力较正常对照下降约50%左右。29/33例进行了脑电图检查,发现痫样放电25例,表现为多灶性棘波、棘慢波。32/33例患者进行了GLUT1-DS基因SLC2A1筛查,发现12例错义突变,2例无义突变,2例插入突变,16例缺失或剪切位点突变。治疗:所有癫痫患者均进行了抗癫痫药物治疗,痫样发作均难以控制。28/33例患者(25例癫痫患者和3例发作性运动障碍)进行了生酮饮食治疗。24例癫痫患者的痫样发作完全控制,1例痫样发作明显缓解。3例发作性运动障碍明显改善。结论 1型葡萄糖转运体缺陷综合征临床以难治性痫样发作、语言智能发育落后、脑脊液糖/血糖明显降低为特点,常规抗癫痫药物难以控制痫样发作,生酮饮食能够控制痫样发作,并对语言、认知、运动障碍均有改善作用。     

The effect of extensive reading and paired-associate learning on long-term vocabulary retention: An event-related potential study

We investigated the relative efficacy of extensive reading (ER) and paired-associate learning (PAL) in the ability of second language (L2) learners to retain new vocabulary words. To that end, we combined behavioral measures (i.e., vocabulary tests) and an event-related potential (ERP) investigation with a focus on the N400 ERP component to track short- and long-term vocabulary retention as a consequence of the two different approaches. Behavioral results indicated that both ER and PAL led to substantial short-term retention of the target words. In contrast, on a long-term basis, ER was more effective than PAL to a considerable degree as indicated by a large-size effect (d = 1.35). Evidence from the N400 effects (d = 1.70) observed in the parietal electrode group (P3, Pz, P4) provided further support for the superior effects of ER over PAL on long-term vocabulary retention. The converging evidence challenges the assumptions of some L2 researchers and makes a significant contribution to the literature of vocabulary acquisition, because it provides the first ERP evidence that ER is more conducive to long-term vocabulary retention than PAL.     

自我效能理论在护理教育中的应用及研究进展

Band ura[1]认为,人们对其能力的判断在其自我调节系统中起主要作用,并由此提出自我效能感这一概念.自我效能指人们对自己实现特定领域的行为目标所需能力的信心或信念,是人对自己是否能够成功地进行某一行为的主观判断[1].它涉及的不是技能本身,而是自己能否运用所拥有的技能去完成工作行为的自信程度[2].     

抗糖尿病药致不良反应的文献分析

目的：探讨抗糖尿病药致不良反应发生的情况,为临床合理用药服务。方法：通过中国期刊全文数据库（CNKI）收集1998-2011年发表的抗糖尿病药致不良反应发生的相关文献,对不良反应发生的患者性别与年龄构成、发生时间分布、累及器官或系统、药品种类等进行汇总、分析。同时对糖尿病并发症相关药物的不良反应亦做了归纳与分析。结果：抗糖尿病药引发不良反应的年龄主要集中于51岁以上;发生时间主要集中于1d～2个月;累及器官或系统涉及全身各大系统,其中最常见的为胃肠道反应;严重不良反应主要发生于心血管系统、免疫系统、内分泌系统中,包括室性早搏、低血糖性昏迷、过敏性休克、全身剥脱性皮炎甚至死亡等。结论：糖尿病及其并发症治疗药物产生的不良反应是广泛的,有些甚至是严重的;广大临床医师及药师应对其进行密切的监测,积极推进抗糖尿病药临床合理使用。     

The Herniated Thoracic Disc: A Review of Literature

Abstract

This literature review discusses the epidemiology and etiology of thoracic disc lesions and describes signs and symptoms, diagnostic procedures, differential diagnosis, and treatment. Data presented in case series reports published between 1985-2001 is summarized: Thoracic disc herniations are more common than previously thought. They may cause mild, moderate, severe or confusing symptoms or be asymptomatic; 49% of cases were in men and 51% in women. Trauma was a precipitating factor in 31%; multiple herniations were reported in 9%. In symptomatic cases, 57% of patients presented with radicular pain, 48% with back pain, 63% with weakness, 60% with sensory complaints, 25% with bowel or bladder symptoms, and 59% with hyperreflexia. Typical presentations of upper, middle, and lower thoracic disc are summarized. Diagnosis is made by correlating clinical signs and symptoms with the results of diagnostic imaging. Surgery is recommended for patients with progressive neurological dysfunction. Research on the efficacy of conservative treatment is lacking in the literature.