The Use of Videotape Self-Monitoring to Facilitate Interactive Intervention in Speech-Language Therapy with Preschool Children with Autism

ABSTRACT

This article describes the outcomes of a videotape self-monitoring project involving two graduate student clinicians enrolled in a clinical practicum in a speech-language pathology program. The goal of the project was to increase the clinicians' use of child-centered, interaction-promoting, and language-promoting strategies while interacting with preschool children with autism. The graduate student clinicians viewed videotapes of their weekly therapy sessions to identify and self-monitor their use of the interactive strategies with the children. The supervisees' and supervisor's ratings of the videotaped sessions were compared to each other and to the videotaped observational data. The outcomes are discussed from a developmental perspective for both supervisor and supervisees.     

糖尿病患者自我血糖监测现状调查

目的了解糖尿病患者自我血糖监测的相关知识认知情况及血糖自我监测现状,为进一步开展糖尿病教育、加强糖尿病患者自我管理提供依据。方法采用问卷调查法对500例糖尿病患者就自我血糖监测相关知识的掌握情况和血糖监测状况进行调查,发放问卷500份,收回有效问卷485份。结果79．8％的患者对血糖监测重要性认识不足,73．6％不了解血糖控制的目标;44.3％患者没有进行自我血糖监测,原因包括因经济问题不愿使用血糖仪、不会使用血糖仪等;55．7％患者进行自我血糖监测,其中半数以上患者对血糖监测方法未正确掌握,62．2％对血糖监测的时间和频率缺乏认识。结论糖尿病患者自我监测血糖现状不乐观,且监测血糖相关知识缺乏。应加强对糖尿病患者自我血糖监测知识宣教,提高糖尿病患者对血糖监测重要性的认识,加强对糖尿病患者自我血糖监测技术上指导,提高糖尿病患者的自我管理意识和能力。     

国家标准化代谢性疾病管理中心应用于糖尿病患者管理的效果研究

背景　我国糖尿病的发病率迅猛发展且呈年轻化趋势,糖尿病及其并发症降低了患者生活质量,给家庭和社会带来了巨大的经济负担,科学的管理方式是预防和控制并发症发生、发展的关键环节。近年来提出的国家标准化代谢性疾病管理中心（MMC）是全新的管理模式,使糖尿病患者得到了有效管理。目的　探讨MMC在糖尿病患者管理中的应用效果。方法　本研究采用方便取样的方法,选择2017年7月-2019年1月在大连医科大学附属第一医院内分泌科住院的140糖尿病患者为研究对象。随机分为对照组（n=70）和试验组（n=70）。对照组接受常规入院全面评估和常规出院个性化指导。试验组在对照组的基础上出院后即进入MMC进行随访管理。在干预前和干预1年后采用糖尿病自我管理行为（SDSCA）量表对患者自我管理能力进行评价;在干预前和干预后6个月、1年分别检测空腹血糖（FPG）和餐后2 h血糖（2 hPG）、糖化血红蛋白（HbA1c）和血脂指标〔三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）〕。结果　本研究纳入的140例糖尿病患者中途失访9例,最终纳入试验组66例、对照组65例。干预1年后,对照组饮食、运动、血糖监测、足部护理、药物依从性及SCSCA量表总分低于试验组（P<0.05）。时间因素、干预方式因素在FPG、2 hPG、HbA1c上主效应显著（P<0.05）,时间因素、干预方式因素在FPG、2 hPG、HbA1c上存在交互作用（P<0.05）。干预1年后,试验组TG、LDL-C低于对照组（P<0.05）;干预1年后,两组TC和HDL-C比较,差异无统计学意义（P>0.05）。结论　MMC管理模式提高了糖尿病患者的自我管理能力,能够降低患者的FPG、2 hPG和HbA1c,改善患者TG、LDL-C水平。     

Estimating average glucose levels from glycated albumin in patients with end-stage renal disease

Purpose

In patients with diabetic end stage renal disease (ESRD), glycated albumin (GA) reflects recent glycemic control more accurately than glycated hemoglobin (HbA_1c). We evaluated the relationship between GA and average blood glucose (AG) level and developed an estimating equation for translating GA values into easier-to-understand AG levels.

Materials and Methods

A total of 185 ESRD patients, including 154 diabetic and 31 non-diabetic participants, were enrolled (108 hemodialysis, 77 peritoneal dialysis). Patients were asked to perform four-point daily self-monitoring of capillary blood glucose (SMBG) at least three consecutive days each week for four weeks. Serum levels of GA, HbA_1c and other biochemical parameters were checked at baseline, as well as at 4 and 8 weeks.

Results

Approximately 74.3±7.0 SMBG readings were obtained from each participant and mean AG was 169.1±48.2 mg/dL. The correlation coefficient between serum GA and AG levels (r=0.70, p<0.001) was higher than that of HbA_1c and AG (r=0.54, p<0.001). Linear regression analysis yielded the following equation: estimated AG (eAG) (mg/dL)=4.71×GA%+73.35, and with this formula, serum GA levels could be easily translated to eAG levels. Multivariate analysis revealed significant contributions of postprandial hyperglycemia (β=0.25, p=0.03) and serum albumin (β=0.17, p=0.04) in determining serum GA level, independent to other clinical parameters.

Conclusion

Compared to HbA_1c, serum GA levels were better correlated with AG levels. Using the estimating equation, an average blood glucose level of 155-160 mg/dL could be matched to a GA value of 18-19% in patients with ESRD.     

Effects of demand for performance,self-monitoring of arousal,and increased sympathetic nervous system activity on male erectile response

Clinical programs for the treatment of impotence generally have been successful but without experimental verification of their individual components or factors associated with the development of impotence. Twenty-four normal males participated in an investigation comparing factors believed to inhibit or facilitate penile tumescence. The effects of demand for performance, self-monitoring of erection, and increased SNS activity, were evaluated. Subjects were exposed to sexual stimuli under these conditions and measurements of penile responses were taken. Results indicated that there were no differential effects on penile responses between demand and no-demand or between self-monitoring and no self-monitoring. Increased SNS activity appeared to facilitate loss of erection, but only after, and not during, the sexual stimulus. The clinical and theoretical implications of these findings are discussed, and suggestions are made for future research.     

Investigating the language,cognition and self-monitoring abilities of speakers with jargon output

Background: Jargon aphasia is a complex acquired language disorder which is characterised by fluent verbal output and usually accompanied by poor error monitoring. Written or graphemic jargon may or may not co-occur with spoken jargon. Intervention to address jargon behaviour is difficult to design due to the presence of poor self-monitoring of errors.

Aims: This study investigated the potential underpinning language and cognitive systems in the production of jargon behaviour and the ability to monitor spoken errors. We propose that jargon behaviour – poor language monitoring and jargon output – arise from an intersection of impaired language and cognitive systems.

Methods & Procedures: Six individuals with jargon aphasia participated in the study. A range of background language and cognition tests were selected. Experimental tests were designed to measure participants’ abilities to monitor their spoken and written output.

Outcomes & Results: Only three of the six participants were able to complete the full assessment battery, with each participant demonstrating a different profile of results across the experimental language monitoring tests. Participants who were better at monitoring their speech (AJ, AE, and LS) scored on the higher end of tests on access to auditory discrimination and repetition. Results from the background cognitive tests identified a range of cognitive impairments including difficulties with attention, problem solving, and sequencing.

Conclusions: Participants with relatively well-preserved skills in auditory discrimination and repetition were better at monitoring their spoken output. This suggests that language competence has a contribution to self-monitoring. All participants were found to have previously unidentified significant cognitive deficits. The significance of this is discussed in relation to language monitoring skills and potential treatment approaches.     

Measuring the Year Consumption of Alcohol: The Development of a Questionnaire

Most general alcohol consumption population surveys are meant to represent the year consumption, although they actually ask only for habitual drinking and/or frequencies and quantities of binge drinking in the past months. These surveys typically cover about half of the alcohol sales figures. In order to enhance sales coverage and to reduce seasonal bias, we developed a year consumption questionnaire on the basis of daily and weekly drinking adding 13 categories of less-than-weekly drinking occasions over the year. As a first test we offered the new questionnaire together with a traditional typical week questionnaire, in different modes to various groups adding up to a purposive high diversity sample of 101 drinking persons (56 women, 44 men, 16–69 years old, mean age 34 years). After correction for overlaps between weekly habits and less-than-weekly occasions, the new questionnaire produces considerably higher reports of annual consumption, compared with the typical-week-based estimates of year consumption. Limitations of the study are discussed.     

An Analysis of Data Management Tools for Diabetes Self-Management: Can Smart Phone Technology Keep Up?

In this issue of Journal of Diabetes Science and Technology, Rao and colleagues present a comparison of three iPhone diabetes data management applications: the Diamedic Diabetes Logbook, Blood Sugar Diabetes Control, and WaveSense Diabetes Manager. These applications provide patients the ability to enter blood glucose readings manually, view graphs and simple statistics, and email data to health care providers. While these applications show promise, they are limited in their current forms. All require manual data entry and none convert insulin-to-carbohydrate ratios to insulin dose. Future development of these types of technology should consider integration with blood glucose meters and expanded calculation capabilities, as well as monitoring of other risk factors, e.g., blood pressure and lipids, and tracking of preventive examinations, e.g., eye, foot, and renal.     

妊娠期糖尿病患者持续血糖监测系统的应用研究进展

2021年6月发布的《中共中央国务院关于优化生育政策促进人口长期均衡发展的决定》做出落实三孩政策的重大决策，高龄孕产妇人数将明显增加。妊娠期糖尿病作为妊娠期常见的并发症之一，严重影响孕妇和胎儿的身体健康。持续血糖监测被称为"有效自我管理的路线图"，在妊娠期糖尿病患者的血糖管理中至关重要。本文就持续血糖监测的发展及其在妊娠期糖尿病患者中的应用和影响进行综述，旨在为促进持续血糖监测的临床应用、鼓励妊娠期糖尿病患者参与糖尿病应对和改善血糖精准管理。