论英语写作教学中批判性阅读模式的培养

无论采取哪种英语写作教学法,前提是使学生具备英语语言意识,而语言意识的获得依赖于大量阅读,批判性阅读作为一种高效的阅读模式能大大促进写作活动。本文分析了批判性阅读模式的三个发展阶段和英语写作活动的密切关系。     

Is Mode of Delivery Associated With Sexual Response? A Pilot Study of Genital and Subjective Sexual Arousal in Primiparous Women With Vaginal or Cesarean Section Births

IntroductionAlthough postpartum sexual concerns are common, limited data exist on postpartum sexual response. Furthermore, the physiological process of vaginal birth may negatively impact genital response compared with unlabored cesarean section (C-section), but this hypothesis has yet to be tested.AimTo (i) compare genital and subjective sexual response and sexual concordance by mode of delivery with inclusion of a control group, (ii) compare groups on self-reported sexual function over the past month, (iii) examine the relationship between laboratory measurement of sexual response and self-reported sexual function, and (iv) investigate association between obstetrical factors and breastfeeding and between sexual response and self-reported sexual function.Methods3 groups of cisgender women were recruited from the community: primiparous women who delivered via vaginal birth within the past 2 years (VB group; n = 16), primiparous women who delivered via unlabored C-section within the past 2 years (CS group, n = 15), and age-matched nulliparous women (NP group, n = 18). Laser Doppler imaging was used to assess genital response while participants watched a neutral and erotic film.Main Outcome MeasuresThe main outcome measures were change in flux units from neural to erotic video as a measure of genital response, subjective sexual arousal rated continuously throughout films, perceived genital response rated after films, and Female Sexual Function Index (FSFI).ResultsWomen in the VB group had significantly lower change in flux units than women in the CS (P = .005, d = 1.39) and NP (P < .001, d = 1.80) groups. Groups did not differ on their subjective indices of sexual response or in sexual concordance. Women in both postpartum groups reported lower FSFI scores than women in the NP group. No relationship was determined between FSFI scores and sexual response in the laboratory. Results suggested that genital trauma and breastfeeding may negatively impact FSFI scores, but they were not related to genital response or subjective sexual arousal as measured in the laboratory.Clinical ImplicationsResults underscore the importance of balancing objective and subjective indices of sexual response and function, especially considering the biopsychosocial nature of postpartum sexuality.Strengths & LimitationsThe present study is the first to apply modern sexual psychophysiological methodology to the study of postpartum sexuality. Cross-sectional methodology limits the ability to make causal inferences, and the strict inclusion criteria limits generalizability.ConclusionPhysiological changes as a result of labor and delivery may have a detrimental impact on genital response; however, these physiological differences may not impact women's subjective experience of postpartum sexuality.Cappell J, Bouchard KN, Chamberlain SM, et al. Is Mode of Delivery Associated With Sexual Response? A Pilot Study of Genital and Subjective Sexual Arousal in Primiparous Women With Vaginal or Cesarean Section Births. J Sex Med 2020; 17:257–272.     

中医学本质论

文章在东、西方哲学、逻辑、科学技术史、医学等领域进行了广泛的比较研究,从构筑一门科学知识体系(范式)的本体论和方法论两个层面,对中、西医学理论体系进行了深入的比较研究,发现西方医学是观察和分类在其中起主要作用,形成的把握了人体结构-功能层面生命规律的经验科学。中医学是观察和模式推理在其中起主要作用,形成的把握了人体现象-状态层面生命规律的理论科学。     

孕期体重管理对初产妇体重控制、分娩方式及新生儿体重的影响

目的:探讨通过孕期体重管理软件控制初产妇体重对分娩方式及新生儿体重的影响.方法:在门诊随机选择孕妇100例,采用随机方法分为对照组和观察组各50例.对照组采用常规围产期保健检查及孕期指导,观察组则在常规产检基础上发放孕期体重管理软件进行孕期饮食指导,记录两组初产妇体重增加情况、分娩方式及新生儿体重情况.结果:与对照组比较,观察组初产妇体重增加小于对照组,剖官产率和新生儿平均体重低于对照组,均P＜0.05.结论:孕期体重管理软件能够控制初产妇体重,降低剖官产率,控制新生儿的体重在正常范围,从而降低巨大儿的发生率.     

以实践为基础、科研为导向的中医医院护理带教老师培养

目的 探讨以实践为基础、以科研为导向的护理带教老师培养模式.方法 在带教老师培养中注重以实践为基础,以科研为导向,运用科学思维指导临床实践的过程.结果 该模式使带教老师的批判性思维能力、科研能力、带教质量均较前有很大提高(均P<0.05).结论 以实践为基础、以科研为导向的带教老师培养模式可以提高带教老师的临床思维能力、科研能力和带教质量.     

失效模式与效应分析在儿科门诊输液风险管理中的应用

目的：探讨失效模式与效应分析（FMEA）在儿科门诊输液风险管理中的应用效果。方法：应用FMEA方法对儿科门诊输液过程中可能出现的失效模式进行分析、评估,找出影响静脉输液安全的原因,通过计算RPN值,找出问题,并按照PDCA循环制订方案,落实改进措施,评估实施后的效果。结果：FMEA改进措施实施后,静脉输液流程风险顺位前10位的RPN值明显下降,下降幅度为87．19～509．81;患者满意度由实施前的63．2％上升至实施后的90．4％（P〈0．05）;护士满意度由实施前的69．6％上升至实施后的100％（P〈0．05）。结论：将FMEA应用于儿科门诊输液风险管理,能在风险事件发生前对其进行有效预测、评估,使隐性风险得到量化,并针对不同等级的风险,采取有效的应对措施,可降低儿科门诊静脉输液意外事件的发生率。     

大鼠海人酸颞叶癫痫模型及病理和致痫机制研究

目的 建立海人酸颗叶癫痫模型，观察症状、脑电图(EEG)和病理改变，探讨病理和致痫机制。方法 立体定向注射海人酸(KA)于大鼠单侧海马腹后部致痫。视频监测；深部EEG；Nissl染色、。Timm’s染色。结果 大鼠症状及EEG呈急性期、静止期和慢性期3个阶段性变化。海马结构神经元死亡主要在急性期，以实验侧CA3区最明显。齿状回(DG)出现苔藓状纤维(MF)发芽并进行性增加。结论 KA模型是模拟人类颗叶癫痫理想的动物模型。     

宏观视角下健康管理新模式构建

阐述了宏观视角下的健康管理新内涵,解析了健康管理当前存在的问题：发展远景明晰但缺乏统筹规划;居民意识觉醒但依从性低;信息来源广泛但缺乏规范;体检企业趋多但同质竞争;有准入但无可测量性评价。并针对这些问题提出宏观视角下健康管理新模式构建,包括内外结合,实现政府、医疗机构、健康产业联动;教育引领,提升全社会健康管理理念;以人为本,构建全程个性化的健康管理新体系;继承创新,传统医学健康管理有机结合;数据共享,推行移动健康;循证干预,探索可测量的健康管理评价工具。     

大学生网络伦理危机现状与教育模式分析

目的 了解目前大学生的网络伦理现状,为高校建立大学生网络伦理教育模式提供依据.方法 采用自行设计的问卷,对1200名大学生进行有关网络伦理的问卷调查.结果 性别变量相比其他变量在大学生网络伦理危机方面差异显著.结论 高校应重视网络伦理教育,丰富网络伦理教育内容,拓展网络伦理教育途径,提升大学生的网络伦理素质水平.     

惠州市妇产科医务人员对分娩方式选择的调查分析

目的通过进行惠州市妇产科医务人员对分娩方式选择的问卷式调查，了解惠州市剖宫产率与医务人员年龄、职称、学历之间的相关性。方法采用分层抽样的方法，对惠州市各区12所二级、三级医院的妇产科医务人员进行问卷式调查。结果年龄小、职称低、学历低者选择剖宫产的比例增加（P值均〈0．05）；三级医院较二级医院医务人员同意孕妇要求进行无医学指征剖宫产的比例明显增高（P=0．001）；年龄越小的医师越认为孕妇有权利选择分娩方式（P=0．027）；助产士较医师选择剖宫产的比例较高（P=0．002）；年龄越大、职称越高、二级医院的医师主张前次剖宫产再次阴道试产的比例明显增加（P值均〈0．05），且年龄越大、职称越高的医师在分娩方式的选择上较少受到社会因素的干扰（P值均〈0．01）。结论医师具有良好的心理素质、丰富的临床经验及助产士业务水平的提高，是降低剖宫产率的重要因素。