A mechanism for gratitude development in a child

Most scholars consider gratitude as a moral emotion, with only few seeing it as a character trait. As a result, no systematic mechanism has ever been attempted to develop gratitude in children. Given the social issue of widespread lack of gratitude in the one-child generations of China, this article attempts to outline a mechanism of parental moral education for gratitude development. The mechanism is underpinned by love, induction and discipline; and theoretically justified in accordance with key psychological and sociological theories, such as Piaget's theory of moral development, Kohlberg's moral stages theory, attachment theory, Hoffman's internalisation theory, Rest's social justice theory and Baumrind's parenting styles theory. The benefits and potential risks of each strategy of the mechanism are addressed.     

An Environmental Scan of the National and Provincial Diagnostic Reference Levels in Canada for Common Adult Computed Tomography Scans

Several regulatory bodies have agreed that low-dose radiation used in medical imaging is a weak carcinogen that follows a linear, non-threshold model of cancer risk. While avoiding radiation is the best course of action to mitigate risk, computed tomography (CT) scans are often critical for diagnosis. In addition to the as low as reasonably achievable principle, a more concrete method of dose reduction for common CT imaging exams is the use of a diagnostic reference level (DRL). This paper examines Canada's national DRL values from the recent CT survey and compares it to published provincial DRLs as well as the DRLs in the United Kingdom and the United States of America for the 3 most common CT exams: head, chest, and abdomen/pelvis. Canada compares well on the international scale, but it should consider using more electronic dose monitoring solutions to create a culture of dose optimization.     

《金匮要略》痈脓辨治探讨

回顾《内经》相关理论，指出痈脓病机关键在于气血凝滞、经络阻塞、脏腑失和，可分期论治。总结《金匮要略》治疗痈脓的方法，认为痈脓应尽早治疗，防邪深入；并根据证情辨证使用清热解毒，活血消散；排除脓毒，泄浊于外等治法。对现代临床仍具实用价值。      

Understanding the Influence of Nanocarrier-Mediated Brain Delivery on Therapeutic Performance Through Pharmacokinetic-Pharmacodynamic Modeling

This study aimed at evaluating how encapsulation in a regular nanocarrier (NC) (providing extended circulation time) or in a brain-targeting NC (providing prolonged circulation time and increased brain uptake) may influence the therapeutic index compared with the unformulated drug and to explore the key parameters affecting therapeutic performance using a model-based approach. Pharmacokinetic (PK) models were built with chosen PK parameters. For a scenario where central effect depends on area under the unbound brain concentration curve and peripheral toxicity relates to peak unbound plasma concentration, dose-effect and drug-side effect curves were constructed, and the therapeutic index was evaluated. Regular NC improved the therapeutic index compared with the unformulated drug due to reduced peripheral toxicity, while brain-targeting NC enhanced the therapeutic index by lowering peripheral toxicity and increasing central effect. Decreasing drug release rate or systemic clearance of NC with drug still encapsulated could increase the therapeutic index. Also, a drug with shorter half-life would therapeutically benefit more from a NC encapsulation. This work provides insights into how a NC for brain delivery should be optimized to maximize the therapeutic performance and is helpful to predict if and to what extent a drug with certain PK properties would obtain therapeutic benefit from nanoencapsulation.     

实时校验本年盈余与预算结余差异调整法探讨

正确编制“本年盈余与预算结余差异调节表”是公立医院执行《政府会计制度》的一大难点,现有的几种差异调节方法存在诸多不足,核算正确与否依赖会计人员的基本素质,而且工作量巨大。以财务会计与预算会计差异产生的基本原理为基础,利用计算机软件实时校验并自动登记差异,是简便、高效、准确编制“本年盈余与预算结余差异调节表”的方法,本文对此进行了举例说明。     

A cross-sectional examination of sociodemographic factors associated with meeting physical activity recommendations in overweight and obese US adults

ObjectiveObesity has reached epidemic proportions in the US. Physical activity is an important component of obesity reduction, but little is known about contemporary exercise levels among overweight/obese American adults. In this study, we compared current physical activity levels in overweight and obese US adults to those of normal weight individuals as well as ascertained which sociodemographic factors influence the meeting of physical activity recommendations in these three groups.MethodsWe used national data from 2015 and 2017 Behavioral Risk Factor Surveillance System surveys (n = 726,075). Bivariate analyses were conducted to determine unadjusted physical activity levels in normal weight, overweight, and obese adults. We fit multinomial logistic models to identify associations between sociodemographic factors and meeting physical activity recommendations in our study population.ResultsAround 45% of overweight and 57% of obese adults failed to meet physical activity guidelines compared to 41% of normal weight adults. Age, sex, and race were significantly associated with physical activity levels for both overweight and obese adults. In overweight and obese individuals, associations between sociodemographic factors and physical activity were more similar between the two comparisons of insufficiently active (IA) versus active (A)/highly active (HA) and A versus HA but quite different to those in the inactive (IN) versus IA/A/HA comparison.ConclusionsFuture physical activity interventions should be aimed at increasing the number of overweight and obese US adults who meet physical activity guidelines as well as targeted towards specific sociodemographic groups within the overweight/obese population with low exercise levels.