课堂多媒体教学中教师角色定位的探讨

课堂多媒体教学已经成为各级各类学校重要的教学组织形式。在多媒体教学中如何定位教师的角色是一个值得探讨的问题,文章分析了教师在多媒体课堂教学中主要扮演的五种角色的职责和要求。     

The quality of communication between parents and adolescent children in the case of parental cancer.

BACKGROUND: This study was designed to investigate: (i) parent-adolescent communication in families of cancer patients; (ii) relationships between parent-adolescent communication and posttraumatic stress symptoms (PTSS) in adolescent children; and (iii) associations between parents' illness characteristics and parent-adolescent communication. PATIENTS AND METHODS: A total of 212 adolescents completed the Impact of Event Scale and Parent-Adolescent Communication Scale. RESULTS: Adolescents communicated less openly with mothers with cancer than controls with mothers; this was the only significant difference with the reference group. Daughters communicated more openly with ill parents than with healthy parents. More open communication with healthy parents was related to fewer PTSS in daughters. More problem communication with both parents was related to more PTSS in both sons and daughters. Sons reported more problems in communication with ill parents in case of more intensive treatment or recurrent disease. Daughters experienced less open communication with both parents when ill parents received more intensive treatment. Time since diagnosis was not related to parent-adolescent communication. Multivariate analyses showed that communication patterns specifically affected PTSS of daughters. Problem communication with the healthy parent was the strongest predictor of intrusion while problem communication with the ill parents was the strongest predictor of avoidance. CONCLUSIONS: Parent-adolescent communication in families of cancer patients differs little from that in families not confronted with parental cancer. Problem communication outweighed lack of openness with respect to development of PTSS. Recurrent disease and intensive treatment regimens affected parent-adolescent communication negatively.     

Executive function and general intellectual functioning in dyskinetic cerebral palsy: Comparison with spastic cerebral palsy and typically developing controls

AimTo comprehensively describe intellectual and executive functioning (EF) in people with dyskinetic cerebral palsy (DCP), by comparing their performance with that of: 1) age- and sex-matched typically developing controls (TDC); and 2) participants with spastic cerebral palsy (SCP) matched for age, sex, term/preterm and gross motor function classification system (GMFCS).MethodThis cross-sectional study was conducted by the University of Barcelona in collaboration with five institutions. Participants were people with DCP (n = 52; 24 females, median age 20.5 y: 5mo, interquartile range [IQR] = 13.75 y: 7mo; GMFCS I–V). As comparison groups, participants with SCP (n = 20; 10 females, median age = 20.5 y: 5.5mo, IQR = 13.75 y 9mo; GMFCS I–V) and TDC (n = 52; 24 females, median age = 20 y: 4mo, IQR = 12 y 7mo) were included. Intelligence and EF were assessed using common tests in all participants.ResultsBoth CP groups had lower intelligence than TDC and performed poorer in almost all EF tasks. Intelligence was higher in DCP than SCP (z = ?2.51, p = 0.01). Participants with DCP also performed significantly better in goal-setting tasks (z = 2.27, p = 0.03) and information processing (z = ?2.54, p = 0.01) than those with SCP.ConclusionPeople with DCP present lower general intellectual functioning and poorer EF across multiple domains than typically developing controls. People with DCP have higher general intellectual functioning and better EF than people with SCP when levels of motor severity are similar.     

脑瘫精细运动功能测试量表在偏瘫型患儿中需要重新建立评估标准与程序

目的 分析脑瘫精细运动功能测试量表(FMFM)在偏瘫和非偏瘫型脑瘫间的项目功能差异(DIF)。方法 收集2001至2018年复旦大学附属儿科医院康复中心及其医联体儿童康复协作网诊断为脑瘫并行FMFM评估的患儿,从FMFM评估数据中提取偏瘫患儿对侧数据,随机选择30%样本作为DIF的焦点组样本;根据整体样本中非偏瘫型与偏瘫型的比例确定采用随机分层匹配对照组样本。采用Conquest软件把两组合并数据样本分别与FMFM中B~E区的全部56个项目以及经项目内容分析后划分出的30个单手项目和26个双手项目进行Rasch分析,以内聚拟合度(Infit)的均方来确定FMFM的单维性,标准为MnSq在0.6～1.4,并对全部56项、单双手项目组进行项目功能差异分析。结果 1 556例脑瘫患儿的3 442次FMFM评估作为整体样本和数据,焦点组198个和对照组792个FMFM评估数据进入本文分析,单独样本配对检验显示两组FMFM分值[112(96,146) vs 113(95,145)]差异无统计学意义。经过3轮项目内容分析,30个归入单手项目,26个归为双手项目。全部56个项目的难度尺度对数值之差的绝对值>0.5分别有41个(73.2%),30个单手和26个双手项目的难度尺度对数值之差的绝对值>0.5分别有23个(76.7%)和9个(34.6%)。结论 FMFM全部56个操作项目在偏瘫和非偏瘫型脑瘫间存在DIF,在单手项目中尤其显著,为了更为精准地评价偏瘫儿童的精细运动功能,需要重新建立评估标准与程序。     

精神分裂症患者认知功能与精神症状相关性研究

目的：探讨精神分裂症患者认知功能与精神症状的相关性。方法：对40例精神分裂症患者于治疗前、治疗12周末分别进行韦氏成人智力量表（WAIS-R）、韦氏记忆量表（WMS）、H—R神经心理成套测验（HRB）中的连线测验A、威斯康星卡片分类测验（WCST）及言语流利性测验及简明精神病评定量表（BPRS）评定。结果：治疗前焦虑抑郁因子分与总记忆商数（MQ）分显著相关,迟滞因子分与WCST完成类别数、智力显著相关;治疗12周末焦虑抑郁因子分与总智商（IQ）显著相关,迟滞因子分与WCST持续反应数、言语IQ、操作IQ显著相关,猜疑因子分与WCST持续反应数显著相关。结论：精神分裂症患者部分认知功能与精神症状显著相关。     

Sexual Functioning in Female Patients Undergoing Surgical Treatment for Colorectal Cancer—A Single-Center,Prospective Triple Timepoint Yearly Follow-Up

The study was aimed at assessing the quality of sexual functioning in female patients having undergone surgical treatment for cancer depending on the type of surgery. The prospective cohort consisted of 48 female patients (23 patients with stoma [A2] and 25 patients with maintained continuity of the GI tract [A1]). Study methods included a diagnostic survey and the analysis of medical records of patients. Research tools consisted of a standardized FSFI questionnaire and a proprietary form for evaluation of sociodemographic data. Measurements were performed at threetimepoints: On the day before the surgery (Measurement I) as well as six and 12 months after the surgery (Measurements II and III, respectively). Statistically significant differences in results were observed in Measurements II and III in the subscales of arousal (II:p = 0.0068, III:p = 0.0018), lubrication (II:p = 0.0221, III:p = 0.0134), orgasm (II:p = 0.0044, III:p = 0.0021), satisfaction (II:p = 0.0021, III:p = 0.0433), and pain/discomfort (II:p = 0.0343, III:p = 0.0473). In all cases, lower scores corresponding to lower quality of sexual functioning were observed in patients in whom stoma had been performed. Statistically significant differences in sexual functioning were observed at Measurements II and III in each group, with the results being significantly (p > 0.05) worse in patients having undergone Hartmann’s procedure or abdominoperineal resection). Variables significantly affecting self-assessed sexual satisfaction included marital status, age, and modality of neoadjuvant treatment. Restoration of the continuity of the gastrointestinal tract is a chance for better self-assessment of the patient’s quality of life as regards sexual functioning.     

Patient-Reported Outcomes Measurement in Radiation Oncology: Interpretation of Individual Scores and Change over Time in Clinical Practice

Tools for measuring patients’ perceived health and quality of life, such as patient-reported outcome measures (PROMs), inform clinical decisions for patients requiring radiation therapy. However, there may be inconsistencies in how patients interpret and respond to PROMs due to cultural, environmental, personal, or experiential factors. Differential item functioning (DIF) and response shift (RS) refer to differences in the meaning of PROMs between patients or over time (respectively). DIF and RS can threaten the accurate interpretation and use of PROMs, potentially resulting in erroneous conclusions about effectiveness, and flawed individual-level clinical decision-making. Given the empirical evidence of DIF and RS, we aim to review clinical implications and solutions for addressing DIF and RS by providing vignettes from collaborative examinations with workshop participants, as well as the literature. By making these methodological concepts accessible and relevant, for practice, clinicians may feel more confident to ask clarifying questions of patients when PROM scores and the contextual patient information do not align. PROM scores need to be interpreted via dialogue with the patient to avoid misinterpretation due to DIF and RS, which could diminish patient–clinician communication and impede shared decision-making. This work is part of an interdisciplinary knowledge translation initiative focused on the interpretation of PROM scores by clinically-oriented audiences.     

真菌诱导子对怀地黄组培苗生长及次生代谢产物合成的影响

目的:研究分离自地黄不同部位的内生真菌诱导子对怀地黄组培苗生长及其次生代谢产物含量的影响,初步探究其促生作用。方法:以2株Alternaria属内生真菌A.alternata,Penicillium属内生真菌P.axalicum制备不同类型的诱导子,发酵液滤液和菌丝降解液,分别考察其对地黄组培苗株高、鲜重、叶绿素含量、梓醇及毛蕊花糖苷含量的影响,并用SPSS 17.0进行数据分析。高效液相色谱法测定梓醇及毛蕊花糖苷含量。结果:不同菌株制备的真菌诱导子促生作用差异明显,以Penicillium属内生真菌P.axalicum制备的真菌诱导子对怀地黄组培苗促生效果较佳,且以其发酵液滤液促生效果最好。在该培养条件下,怀地黄组培苗株高、鲜重、根长、总叶绿素、梓醇及毛蕊花糖苷含量增加率分别为27.80%,29.49%,22.08%,15.05%,35.98%和68.18%。结论:内生真菌诱导子可促进怀地黄组培苗生长,并提高其次生代谢产物含量,在今后地黄内生真菌应用中可做进一步探究。     

Psychometric properties of visual functioning index using Rasch analysis

Acta Ophthalmol. 2010: 88: 797–803

Abstract.

Purpose: The visual functioning index (VFI) was one of the first questionnaires developed using classical test theory to assess outcomes of cataract surgery. However, it was not Rasch‐validated. The objective of this study was to examine the psychometric properties of the VFI using Rasch analysis in patients with cataract. Methods: The 11‐item VFI was self‐administered to 243 patients (mean age 73.9 years) drawn from a cataract surgery waiting list. We examined the response category thresholds, item fit statistics, differential item functioning and unidimensionality for the VFI and its three subscales. Results: Category thresholds were ordered. The person separation and reliability were low, indicating the poor discriminatory ability of the VFI. No items misfit but there was suboptimal targeting of item difficulty to patient ability. On the whole the items in the VFI were too easy for the sample. Only one item showed moderate differential item functioning. Conclusion: The VFI does not meet the stringent requirements of the Rasch model. However adding more items to suit the more able patients with cataract as well as those awaiting second‐eye cataract surgery could optimize the VFI.     

如何加快实习护士的临床角色适应

本文探讨了实习护士在进行临床角色转换时遇到的各种困难和相关的促进实习护士适应其临床角色的方法。实习护士在临床角色的适应过程中会受多方面因素的影响,带教老师要帮助实习护士尽快地适应其临床角色,以顺利地完成实习和实现教学目标。