Seminar联合SPOC教学模式在助产士临床实践教学中的应用

探讨Seminar联合小型私人网络课程(Small prirate online course,SPOC)SPOC模式教学法在助产实践教学中的应用效果。选择2019年1月—2019年6月在中国医科大学附属盛京医院实习的66名助产士作为实验组,采用Seminar联合SPOC模式教学法。选择2019年7月—2019年12月在中国医科大学附属盛京医院实习的64名助产士作为对照组,采用传统的带教模式,实习前后对2组助产士的理论水平和技能操作进行考核,并对得分情况进行比较。针对助产士必备技能进行考核,比较2组成绩。调查2组助产士对教学方法的满意度,进行比较。实验组助产士理论成绩和技能操作成绩均明显高于对照组(P<0.05),其各项技能均高于对照组,同时,实验组对教学方法的满意程度也高于对照组(P<0.05)。采用Seminar联合SPOC教学模式对助产士实践教学的应用效果良好,在临床上值得推广。     

基于医教研一体化改革模式探讨中医儿科研究生的培养策略

医教研一体化教育模式是中医学教育发展至今的必经之路,福建中医药大学附属人民医院儿科是全国中医院校中首批授予硕士点单位之一,历经40余年的耕耘发展,逐步形成了学术领先的中医临床、科研、教学发展的龙头单位。笔者现从创新理念、课程设置特点、教学模式、科研能力、临床实践能力以及人文素质教育等方面对中医儿科研究生的培养策略进行探讨,以达到全方位提高中医儿科研究生综合素质的目的。     

不同带教模式对本科实习护生职业获益感的影响

目的探讨不同带教模式对临床本科实习护生职业获益感的影响。方法选取某医学院校本科实习护生78名,按班级的不同分为观察组(42名)和对照组(36名),观察组采用一对一导师制带教模式培养,对照组以传统功能制带教模式培养,比较2组在职业获益感及出科成绩方面的差异。结果观察组的职业获益感总分、正向职业感知维度、团队归属感维度、自身的成长维度及出科成绩均高于对照组,差异有统计学意义(P<0.05)。结论一对一导师制带教模式较传统功能制带教优势明显,有利于提高实习护生职业获益感,培养更为优秀的护理人才。     

2型糖尿病健康教育的研究进展

从2型糖尿病健康教育团队的组成、教育模式、教育内容（2型糖尿病的危害、预防、饮食、运动、心理、药物及血糖监测的护理）及效果评价概括2型糖尿病健康教育的研究进展，归纳总结出2型糖尿病健康教育中存在的不足，并提出相关对策，以提高2型糖尿病健康教育的质量。     

农村社区护理中心模式构想

分析了农村开展社区护理的必要性与必然性 ,认为当前我国农村社区护理中心的模式应以乡村医生为主体 ,以镇村组织一体化为基础 ,以初级卫生保健为主要内容 ,以地方经济为后盾 ,并对这一模式的发展前景进行了展望。     

Significance of longitudinal changes in the default‐mode network for cognitive recovery after stroke

Although a considerable number of patients suffer from cognitive impairments after stroke, the neural mechanism of cognitive recovery has not yet been clarified. Repeated resting‐state functional magnetic resonance imaging (fMRI) was used in this study to examine longitudinal changes in the default‐mode network (DMN) during the 6 months after stroke, and to investigate the relationship between DMN changes and cognitive recovery. Out of 24 initially recruited right‐hemispheric stroke patients, 11 (eight males, mean age 55.7 years) successfully completed the repeated fMRI protocol. Patients underwent three fMRI sessions at 1, 3 and 6 months after stroke. Their DMNs were analysed and compared with those of 11 age‐matched healthy subjects (nine males, mean age 56.2 years). Correlations between DMN connectivity and improvement of the cognitive performance scores were also assessed. The stroke patients were found to demonstrate markedly decreased DMN connectivity of the posterior cingulate cortex, precuneus, medial frontal gyrus and inferior parietal lobes at 1 month after stroke. At 3 months after stroke, the DMN connectivity of these brain areas was almost restored, suggesting that the period is critical for neural reorganization. The DMN connectivity of the dorsolateral prefrontal cortex in the contralesional hemisphere showed a significant correlation with cognitive function recovery in stroke patients, and should be considered a compensatory process for overcoming cognitive impairment due to brain lesion. This is the first longitudinal study to demonstrate the changes in DMN during recovery after stroke and the key regions influencing cognitive recovery.     

The neural correlates of worry in association with individual differences in neuroticism

The tendency to worry is a facet of neuroticism that has been shown to mediate the relationship between neuroticism and symptoms of depression and anxiety. The aim of the current study was to investigate the neural correlates of state worry in association with neuroticism. One‐hundred twenty participants were selected from an initially recruited sample of 240 women based on their neuroticism score. First, participants completed a questionnaire to assess the excessiveness and uncontrollability of pathological worry. Second, we measured brain activation with functional magnetic resonance imaging (fMRI) while participants were randomly presented with 12 worry‐inducing sentences and 12 neutral sentences in a mood induction paradigm. Individuals scoring higher on neuroticism reported to worry more in daily life and to have generated more worry‐related thoughts after the presentation of a worry‐inducing sentence. Furthermore, imaging results showed the involvement of default mode and emotional brain areas during worry, previously associated with self‐related processing and emotion regulation. Specifically, cortical midline structures and the anterior insula showed more activation during worry, when individuals indicated to have generated more worry‐related thoughts. Activation in the retrosplenial and visual cortex was decreased in individuals scoring higher on neuroticism during worry, possibly suggesting reduced autobiographical specificity and visual mental imagery. In the literature, both these processes have been related to the cognitive avoidance of emotional distress. Excessive worry features in a number of emotional disorders and results from studies that elucidate its neural basis may help explain how and why neuroticism contributes to vulnerability for psychopathology. Hum Brain Mapp 35:4303–4315, 2014. © 2014 Wiley Periodicals, Inc .     

Brain networks disconnection in early multiple sclerosis cognitive deficits: An anatomofunctional study

Severe cognitive impairment involving multiple cognitive domains can occur early during the course of multiple sclerosis (MS). We investigated resting state functional connectivity changes in large‐scale brain networks and related structural damage underlying cognitive dysfunction in patients with early MS. Patients with relapsing MS (3–5 years disease duration) were prospectively assigned to two groups based on a standardized neuropsychological evaluation: (1) cognitively impaired group (CI group, n = 15), with abnormal performances in at least 3 tests; (2) cognitively preserved group (CP group, n = 20) with normal performances in all tests. Patients and age‐matched healthy controls underwent a multimodal 3T magnetic resonance imaging (MRI) including anatomical T1 and T2 images, diffusion imaging and resting state functional MRI. Structural MRI analysis revealed that CI patients had a higher white matter lesion load compared to CP and a more severe atrophy in gray matter regions highly connected to networks involved in cognition. Functional connectivity measured by integration was increased in CP patients versus controls in attentional networks (ATT), while integration was decreased in CI patients compared to CP both in the default mode network (DMN) and ATT. An anatomofunctional study within the DMN revealed that functional connectivity was mostly altered between the medial prefrontal cortex (MPFC) and the posterior cingulate cortex (PCC) in CI patients compared to CP and controls. In a multilinear regression model, functional correlation between MPFC and PCC was best predicted by PCC atrophy. Disconnection in the DMN and ATT networks may deprive the brain of compensatory mechanisms required to face widespread structural damage. Hum Brain Mapp 35:4706–4717, 2014. © 2014 Wiley Periodicals, Inc .     

Neuropsychiatric symptoms in Alzheimer's disease are related to functional connectivity alterations in the salience network

Neuropsychiatric syndromes are highly prevalent in Alzheimer's disease (AD), but their neurobiology is not completely understood. New methods in functional magnetic resonance imaging, such as intrinsic functional connectivity or “resting‐state” analysis, may help to clarify this issue. Using such approaches, alterations in the default‐mode and salience networks (SNs) have been described in Alzheimer's, although their relationship with specific symptoms remains unclear. We therefore carried out resting‐state functional connectivity analysis with 20 patients with mild to moderate AD, and correlated their scores on neuropsychiatric inventory syndromes (apathy, hyperactivity, affective syndrome, and psychosis) with maps of connectivity in the default mode network and SN. In addition, we compared network connectivity in these patients with that in 17 healthy elderly control subjects. All analyses were controlled for gray matter density and other potential confounds. Alzheimer's patients showed increased functional connectivity within the SN compared with controls (right anterior cingulate cortex and left medial frontal gyrus), along with reduced functional connectivity in the default‐mode network (bilateral precuneus). A correlation between increased connectivity in anterior cingulate cortex and right insula areas of the SN and hyperactivity syndrome (agitation, irritability, aberrant motor behavior, euphoria, and disinhibition) was found. These findings demonstrate an association between specific network changes in AD and particular neuropsychiatric symptom types. This underlines the potential clinical significance of resting state alterations in future diagnosis and therapy. Hum Brain Mapp 35:1237–1246, 2014. © 2013 Wiley Periodicals, Inc.