我国轻度认知障碍研究热点分析及展望

背景　随着人口老龄化进程的加快，包括痴呆在内的老年人健康问题日益突出。轻度认知障碍作为阿尔茨海默病的临床前阶段，早已成为研究者关注的热点。但是目前尚缺乏对我国轻度认知障碍研究热点的整理与分析。目的　分析2008-2018年我国轻度认知障碍研究的热点，了解该领域的现状和发展趋势。方法　2019年6月，以“轻度认知障碍”为关键词，采用主题检索的方式，在中国期刊网全文数据库（CNKI）中进行检索，检索时间为2008-2018年，文献来源类别限定为SCI来源文献、EI来源期刊、核心期刊、中文社会科学引文索引（CSSCI）以及中国科学引文数据库（CSCD）。采用中医药数据关联分析平台（XMiner软件）、SPSS 22.0统计学软件、Excel软件对关键词进行词频分析和共词聚类分析。结果　最终纳入符合标准的文献413篇，获得高频关键词41个（g=41）。通过共词聚类分析总结出2008-2018年我国轻度认知障碍的7个研究热点，分别为轻度认知障碍的病因学研究、神经心理评估及筛查研究、诊断及分类研究、干预研究、流行病学研究、精神行为症状研究、生物标志物及中医证候研究。结论　2008-2018年我国轻度认知障碍的研究热点分别为轻度认知障碍的病因学研究、神经心理评估及筛查研究、诊断及分类研究、干预研究、流行病学研究、精神行为症状研究、生物标志物及中医证候研究，该分析结果有助于广大卫生服务人员了解该领域的现状和发展趋势，且对其今后的研究方向有一定的指导作用。     

“I’ve changed so much within a year”: care leavers' perspectives on the aftercare planning process

ABSTRACT

Increasing the participation of children and young people in matters related to their care and aftercare is regarded as international best practice. While research demonstrates that children and young people benefit from involvement in care-related processes, participation continues to pose challenges for social work practitioners. Studies to date have tended to focus on in-care engagement and, consequently, relatively little is known about the experiences of young people as they age out of care, particularly in terms of their perceived involvement and engagement in the planning-to-leave care process. This paper examines young people’s experiences of the aftercare planning process in Ireland drawing on data from the first phase of a qualitative longitudinal study of young people leaving care. Sixteen participants were recruited at baseline and interviewed in-depth. The approach to interviewing was flexible and encouraged participants to talk about their experiences of care and the aftercare planning process. The findings indicate considerable diversity in how young people experience and attach meaning to the transition out of care. They also reveal complexities surrounding youth participation in the leaving care planning process and uncover a number of distinct facilitators and barriers to participation. Conclusions are drawn and the implications for practice are discussed.     

A critical ethnographic evaluation of pediatric haematology/oncology physicians and burn-out

Abstract

This qualitative study aims to ascertain what it is that affects pediatric hematology/oncology physicians professional and personal attitudes within their work environment. This research is based in one pediatric oncology unit in western Canada using a critical ethnographic research approach. Critical ethnography was the methodology used to conduct this study. Critical Ethnography (CE) is an interpretative research methodology that allows the researcher to evaluate the cultural aspects of a group, or an organization 'within their setting'; to understand and expose the meaning of the relationships in that environment; without meaning being imposed on them externally. 11 physicians (N?=?11) participated in this study, this represents approximately 80% of the physician population in this unit. Semi-structured interviews were conducted which lasted an average of 36?minutes per interview. Physicians described their relationships with colleagues, patients and families as both rewarding but also producing symptoms of burn-out. The majority agreed that they enjoy their job because of the constantly evolving research and scientific updates in oncology research. There is a paradox of conflicting satisfiers and dissatisfiers mainly pertaining to patient, parent, physician relationships. Consideration to offering sabbatical leave should be assessed.     

Investigation of strategies to improve concussion reporting in American football

ABSTRACT

While research on sport-related concussion has increased dramatically over the past decade, research investigating concussion reporting is in its early stages. The purpose of this project was to assess concussion reporting and work with stakeholders to develop and assess strategies to improve reporting. We used a multi-site, repeated measures design with three NCAA Division I football programs, including 223 athlete participants. A modified community-based participatory research (CBPR) approach was used to develop intervention strategies (Fall 2017 season) with stakeholders designed to increase concussion reporting intentions. Preseason and postseason surveys were administered to determine effectiveness. Main outcome measures included concussion knowledge, intervention effectiveness, and reporting intention measures. For all three programs, concussion knowledge was unrelated to reporting intentions. Two of the three programs implemented the intervention strategies and for these programs there was evidence that the interventions were effective. Specifically, athletes from these two programs perceived more support from coaches about reporting (P< 0.05; t= 2.83), received education more frequently (P< 0.05; t= 2.67), and reported being more likely to report concussion symptoms (P< 0.05; t= 2.14). Our study demonstrates that working with stakeholders to develop site-specific strategies to improve concussion reporting is an effective approach to help improve reporting behaviours.     

Trends in U.S. Ambulatory Cardiovascular Care 2013 to 2017: JACC Review Topic of the Week

The National Cardiovascular Data Registry PINNACLE (Practice Innovation and Clinical Excellence) Registry is the largest outpatient cardiovascular practice registry in the world. It tracks real-world management and quality of 4 common cardiovascular conditions: heart failure, coronary artery disease, atrial fibrillation, and hypertension. In 2013, the PINNACLE Registry contained information on 2,898,505 patients, cared for by 4,859 providers in 431 practices. By 2017, the registry contained information on 6,040,996 patients, cared for by 8,853 providers in 724 practices. During this time period, care processes for PINNACLE patients generally improved. Among patients with heart failure, combined beta-blocker and renin-angiotensin antagonist medication rates increased from 60.7% to 72.8%. Among patients with coronary artery disease, statin medication rates increased from 66% to 80.1%. Among patients with atrial fibrillation, oral anticoagulation rates increased from 52.7% to 65.2%. In contrast, blood pressure control rates among patients with hypertension were largely stable. PINNACLE data also fueled a variety of quality measurement programs and 51 peer-reviewed publications.     

Thematic analysis of qualitative data: AMEE Guide No. 131

Abstract

Thematic analysis is a widely used, yet often misunderstood, method of qualitative data analysis. It is a useful and accessible tool for qualitative researchers, but confusion regarding the method’s philosophical underpinnings and imprecision in how it has been described have complicated its use and acceptance among researchers. In this Guide, we outline what thematic analysis is, positioning it in relation to other methods of qualitative analysis, and describe when it is appropriate to use the method under a variety of epistemological frameworks. We also provide a detailed definition of a theme, as this term is often misapplied. Next, we describe the most commonly used six-step framework for conducting thematic analysis, illustrating each step using examples from our own research. Finally, we discuss advantages and disadvantages of this method and alert researchers to pitfalls to avoid when using thematic analysis. We aim to highlight thematic analysis as a powerful and flexible method of qualitative analysis and to empower researchers at all levels of experience to conduct thematic analysis in rigorous and thoughtful way.     

CircRNA在妇科肿瘤中的研究进展

CircRNA是非编码RNA中最为稳定的RNA分子,其稳定存在于各种生物体中并参与生物体的代谢功能调节。近年来,大量研究从基因组学及信号通路方向深入研究,发现CircRNA可与miRNA通过复杂调控参与机体各种疾病的发生及发展,其中CircRNA在肿瘤细胞的增殖、凋亡及转移中的作用备受瞩目。妇科肿瘤是妇科疾病中危害最大的疾病。本文主要从CircRNA的特征功能认知、在肿瘤发生及发展中途径、以及其在妇科肿瘤中的致病机理和未来诊断方向上,综合国内外相关研究进展进行整理,总结CircRNA在妇科肿瘤中的临床应用。     

Enhancement imaginaries: exploring public understandings of pharmaceutical cognitive enhancing drugs

Abstract

The growing use of psychoactive substances in everyday life, the increasing experimentation among users and the potential of poly drug use for non-medical, lifestyle or enhancement purposes presents an evolving policy challenge. The paper aims to build on previous research to gain a more in-depth qualitative understanding of the imaginaries around pharmaceutical cognitive enhancement (PCE). It focuses in particular on how the so-called pharmaceutical cognitive enhancing drugs (PCEDs) might be used and the social acceptability of these uses across multiple social contexts and groups. Data come from 23 focus groups (99 participants), representing a wide range of social groups, recruited in the UK. We discuss four distinct ‘enhancement practices’ where PCE use was conceptualised as a way to (1) become the best version of oneself; (2) gain a competitive edge over others; (3) for personal achievement or well-being; and (4) promote personal/public safety. The findings problematise the term ‘enhancement’ by showing the different ways in which the use of pharmaceutical ‘enhancement’ drugs can be imagined and understood. We argue for the value of policy responses that acknowledge and respond to a wider range of enhancement practices including those of prospective user groups.