Efficacy of the cognitive orientation to daily occupational performance with Brazilian children with developmental coordination disorder

Background: Children with Developmental Coordination Disorder (DCD) have difficulties performing daily activities which reflects negatively on participation, impacting their lives.

Objectives: To examine the effects of the cognitive orientation to daily occupational performance Approach (CO-OP Approach) protocol on occupational performance and satisfaction of Brazilian children who have DCD; to examine whether children could transfer strategies and skills learned during CO-OP to untrained goals.

Methods: A pre-post group comparison design with eight boys aged 6–10 years old. Children participated in 12 CO-OP sessions with their parents twice a week, with an extra session added to the protocol for parents´ orientation. The Canadian Occupational Performance Measure and the Performance Quality Rating Scale were used as outcome measures. The study was registered by the United States Institutes of Health at ClinicalTrials.gov (NCT03112746).

Results: Intervention resulted in higher, clinically and statistically significant, occupational performance measures according to parents, children’s, and external evaluators’ perspectives. All children improved occupational performance on their selected goals and five children could transfer the ability to use cognitive strategies to tasks not addressed in therapy.

Conclusions: This study provides initial directions for future research to investigate the applicability and to implement CO-OP approach on pediatric settings in Brazil.     

六西格玛在评价内分泌项目分析性能上的应用

目的探讨六西格玛(6σ)在评价内分泌项目分析性能上的应用价值。 方法收集本实验室2018年10月至2019年3月室内质控(IQC)数据以及2018年第二次和2019年第一次室间质量评价(EQA)数据，应用四个不同来源的性能规范作为质量目标、室内质控长期累计的变异系数作为精密度和室间质评项目的百分差值作为偏倚分别评估内分泌项目的σ水平，分析不同质量目标对内分泌项目的σ值所产生的差异，并制定个性化的室内质控方案。评估σ值<6项目的质量目标指数(QGI)，为实验室的质量改进提供实施方案。 结果不同的质量目标，各项目的σ分布存在显著差异，依据国家EQA评价标准、生物学变异导出"适当的"质量规范和美国临床实验室标准化协会(CLSI)推荐的质量规范，σ值≥6项目的比例分布于20.0%~35.4%之间；依据西班牙EQA评价标准，则未见σ值≥6的项目。依据各项目的分析性能，制定个性化的室内质控方案：总三碘甲状腺原氨酸(TT3)、促甲状腺素(TSH)、黄体生成素(LH)和睾酮(T)选择单规则1_3s进行质量控制；催乳素(PRL)选择多规则1_3s/2_2s/R_4s进行质量控制；游离甲状腺素(FT4)选择多规则1_3s/2_2s/R_4s/4_1s进行质量控制；游离三碘甲状腺原氨酸(FT3)、总甲状腺素(TT4)、雌二醇(E2)、卵泡刺激素(FSH)和孕酮(P)选择多规则1_3s/2_2s/R_4s/4_1S/8_X进行质量控制。依据我国EQA评价标准，FT3、FT4、TT4、E2、FSH、P、PRL项目均需优先改进精密度。 结论6σ能够客观评价内分泌项目的分析性能，并促进实验室检测质量的持续改进。     

吉林辽宁两省18年来的目标设置对突发公共卫生事件应急工作落实情况的关联研究

目的本研究立足于项目组前期研究的成果上，积极探索吉林辽宁两省目标设置水平的差异，并进一步探究受目标设置影响下的工作落实结果情况，探讨产生差异的原因。 方法以系统穷尽的方式收集吉林辽宁两省2000至2017年有关目标与工作落实情况的指标，利用Spearman相关和线性回归分析吉林辽宁两省目标设置对于突发应急工作落实情况的影响。 结果吉林辽宁两省突发应急领域的目标设置水平与工作落实情况总体均呈现上升趋势，截至2017年，吉林目标设置水平与工作落实情况分别为46%与60%，辽宁为60%与53.3%，且目标设置水平与工作落实呈正相关。 结论有公众需要为依据且定量可考的目标设置对于工作落实、推进、完善具有积极的正反馈作用，建立科学量化的突发应急目标设置评价体系是适宜可行的。     

课程思政融入《口腔生物学》课堂教学的探索

立德树人作为我国高等学校的育人的方向,是高校的立身之本。育人先育德,教师理应把立德树人作为一种教育理念贯穿于课堂教学中,做到育人育才有机结合,在专业课授课过程中注重对思想政治教育元素的提炼和融入,加强对学生的思想政治教育,注重对学生世界观、人生观和价值观的正确引导和塑造,为我国社会主义建设培养合格的建设者和接班人。文章以《口腔生物学》课堂教学为例,探讨了课程思政教育背景下新型课堂教学的设计思路与理念,课堂教学中思政元素的提炼和融入的措施和方法。通过将思政教育元素有机融入课堂教学各环节,既提升了课堂教学的效果,又圆满实现了育人目标。     

基于King达标理论的实习护生行为目标达成度评价

目的:以King达标理论为基础理论框架,探讨和分析中、高职护生实习期间的本专业行为目标达成度及其影响因素,以便更好地指导临床护理教学。方法:采用便利抽样方式抽取实习中、高职护生204名,采用具有较好信效度的中文版护士行为目标达成度评价量表(NPGA)进行测评。结果:58.67%的护生认为自身护理行为水平较低,未达成预期目标,34.69%的护生认为自身护理行为需要改善;高职护生行为目标达成度水平总体高于中职护生(P0.05)。结论:目前临床实习的中、高职护生均对自身护理行为不甚满意,专业行为目标达成度不够,需要医院及学校在临床实践教学方面给予更多的关注与支持。     

胃癌术后患者早期肠内营养达标状况及其影响因素研究

目的了解胃癌术后患者早期肠内营养达标状况,分析影响营养达标的因素,为进一步制定有效护理措施改善胃癌术后患者营养支持状况提供参考。方法根据肠内营养制剂第3天供给热量能否达到患者需求[104.6kJ/(kg.d)]的60%,将82例患者分为达标组和未达标组,分析比较两组患者的一般资料及临床特征,通过Logistic回归进行多因素分析,探讨影响早期肠内营养达标的主要因素。结果82例患者中17例(20.73%)达标。达标组患者体质量水平、术中出血量、肠内营养不耐受例数显著低于/少于未达标组(P<0.05,P<0.01)。Logistic回归分析显示,患者体质量、术中失血量、肠内营养不耐受对早期营养达标有影响。结论胃癌术后早期肠内营养实施状况有待进一步提高,体质量越重、术中失血量越多、肠内营养不耐受发生率越高的患者早期肠内营养不达标的危险大。     

Rostrocaudal functional gradient among the pre‐dorsal premotor cortex,dorsal premotor cortex and primary motor cortex in goal‐directed motor behaviour

The dorsal premotor cortex residing in the dorsolateral aspect of area 6 is a rostrocaudally elongated area that is rostral to the primary motor cortex (M1) and caudal to the prefrontal cortex. This region, which is subdivided into rostral [pre‐dorsal premotor cortex (pre‐PMd)] and caudal [dorsal premotor cortex proper (PMd)] components, probably plays a central role in planning and executing actions to achieve a behavioural goal. In the present study, we investigated the functional specializations of the pre‐PMd, PMd, and M1, because the synthesis of the specific functions performed by each area is considered to be essential. Neurons were recorded while monkeys performed a conditional visuo‐goal task designed to include separate processes for determining a behavioural goal (reaching towards a right or left potential target) on the basis of visual object instructions, specifying actions (direction of reaching) to be performed on the basis of the goal, and preparing and executing the action. Neurons in the pre‐PMd and PMd retrieved and maintained behavioural goals without encoding the visual features of the visual object instructions, and subsequently specified the actions by multiplexing the goals with the locations of the targets. Furthermore, PMd and M1 neurons played a major role in representing the action during movement preparation and execution, whereas the contribution of the pre‐PMd progressively decreased as the time of the actual execution of the movement approached. These findings revealed that the multiple processing stages necessary for the realization of an action to accomplish a goal were implemented in an area‐specific manner across a functional gradient from the pre‐PMd to M1 that included the PMd as an intermediary.     

Occupational performance: a case for self‐determination

The term, ‘self‐determination’, implies that individuals have choice and control over aspects of their lives. Individual/family preferences and choices are now core aspects of Australia's National Disability Insurance Scheme, underpinning the importance attributed to these concepts in relation to the fostering of wellbeing. As occupational therapists, in collaboration with our clients, we facilitate and enable occupational performance goals which are personally meaningful and self‐endorsed. As such, our professional practice provides us with a powerful motivational tool by which we can harness individuals’ energies in the pursuit of their goals – occupation. Self‐Determination Theory (SDT) is an influential theory of human motivation and is presented as a way of understanding the elements of our occupational therapy transactions, and the way in which we enact them so as to enhance client outcomes. In SDT, it is proposed that individuals engage in, pursue and persist with certain behaviours when three psychological needs are being met. These needs are for autonomy (engaging in behaviour that is self‐endorsed), relatedness (feeling cared for and connected to others) and competence (feeling effective in one's environment). A focus on supporting satisfaction of these basic psychological needs, it will be argued, engenders therapeutic alliance and internalisation of goal pursuits, thus optimising therapy engagement and outcomes. Examples of practice approaches that attend to the psychological needs for autonomy, relatedness and competence will be presented. A case will be made for embedding SDT into our models of practice as a sound way of articulating how we practise.     

Bi‐directional modulation of food habit expression by the endocannabinoid system

The compulsive, habitual behaviors that have been observed in individuals diagnosed with substance use disorders may be due to disruptions in the neural circuits that mediate goal‐directed actions. The endocannabinoid system has been shown to play a critical role in habit learning, but the role of this neuromodulatory system in habit expression is unclear. Here, we investigated the role of the endocannabinoid system in established habitual actions using contingency degradation in male C57BL/6 mice. We found that administration of the endocannabinoid transport inhibitor AM404 reduced habitual responding for food and that antagonism of cannabinoid receptor type 1 (CB1), but not transient receptor potential cation subfamily V (TRPV1), receptors produced a similar reduction in habitual responding. Moreover, pharmacological stimulation of CB1 receptors increased habitual responding for food. Co‐administration of an enzyme inhibitor that selectively increases the endocannabinoid 2‐arachidonoyl glycerol (2‐AG) with AM404 partially restored habitual responding for food. Together, these findings demonstrate an important role for the endocannabinoid system in the expression of habits and provide novel insights into potential pharmacological strategies for reducing habitual behaviors in mental disorders.