大豆异黄酮对MMTV-erbB-2 转基因小鼠乳腺肿瘤中MMP-2 和TIMP-2 表达影响的研究

目的:利用MMTV-erbB-2转基因小鼠,探讨食物中大豆异黄酮对MMTV-erbB-2转基因小鼠乳腺肿瘤发生发展的影响。方法:选择健康雌性MMTV-erbB-2转基因小鼠60只,随机分为实验组(自鼠龄四周起喂养含有大豆异黄酮的豆饲料和对照组(喂养不含大豆异黄酮的普通饲料)。观察两组小鼠生长情况,观察各组小鼠乳腺肿瘤的发病率和潜伏期、记录肿瘤生长情况,并通过HE染色观察其病理类型,免疫组织化学染色SP法检测各组小鼠乳腺癌组织及正常乳腺组织中MMP-2和TIMP-2的表达并分析其关系。结果:豆饲料干预组,普通饲料干预组小鼠乳腺肿瘤的发瘤率分别为36.7%,66.7%,豆饲料干预组小鼠乳腺肿瘤发瘤率与对照饲料干预组相比明显降低,差异有统计学意义(P<0.05)。小鼠肿瘤多生长在第2-3对乳腺上,两组小鼠乳腺肿瘤最大平均直径及潜伏期相比较差异无统计学意义。两实验组小鼠乳腺肿瘤组织经HE染色后全部确定为乳腺癌组织。两实验组小鼠乳腺肿瘤组织中MMP-2和TIMP-2表达均高于正常乳腺组织,差异有统计学意义(P<0.05),MMP-2和TIMP-2在乳腺肿瘤组织中表达呈负相关,在正常乳腺组织中表达无相关性。MMP-2在豆饲料干预组,普通饲料干预组小鼠乳腺肿瘤组织中的阳性率分别为83.3%,73.9%,各实验组阳性率相比较差异无统计学意义(P=0.888);TIMP-2在豆饲料干预组,普通饲料干预组小鼠乳腺肿瘤组织中的阳性率分别为33.3%,43.5%,各实验组阳性率相比较差异无统计学意义。结论:大豆异黄酮能抑制MMTV-erbB-2转基因小鼠乳腺肿瘤的发生,但其对小鼠乳腺肿瘤的作用与MMP-2及TIMP-2的表达无明显相关,具体机制尚待进一步研究。     

Development and Two-Year Follow-Up Evaluation of a Training Workshop for the Large Preventive Positive Psychology Happy Family Kitchen Project in Hong Kong

Evidence-based practice and capacity-building approaches are essential for large-scale health promotion interventions. However, there are few models in the literature to guide and evaluate training of social service workers in community settings. This paper presents the development and evaluation of the “train-the-trainer” workshop (TTT) for the first large scale, community-based, family intervention projects, entitled “Happy Family Kitchen Project” (HFK) under the FAMILY project, a Hong Kong Jockey Club Initiative for a Harmonious Society. The workshop aimed to enhance social workers’ competence and performance in applying positive psychology constructs in their family interventions under HFK to improve family well-being of the community they served. The two-day TTT was developed and implemented by a multidisciplinary team in partnership with community agencies to 50 social workers (64% women). It focused on the enhancement of knowledge, attitude, and practice of five specific positive psychology themes, which were the basis for the subsequent development of the 23 family interventions for 1419 participants. Acceptability and applicability were enhanced by completing a needs assessment prior to the training. The TTT was evaluated by trainees’ reactions to the training content and design, changes in learners (trainees) and benefits to the service organizations. Focus group interviews to evaluate the workshop at three months after the training, and questionnaire survey at pre-training, immediately after, six months, one year and two years after training were conducted. There were statistically significant increases with large to moderate effect size in perceived knowledge, self-efficacy and practice after training, which sustained to 2-year follow-up. Furthermore, there were statistically significant improvements in family communication and well-being of the participants in the HFK interventions they implemented after training. This paper offers a practical example of development, implementation and model-based evaluation of training programs, which may be helpful to others seeking to develop such programs in diverse communities.     

个体动态化体重管理对体外受精-胚胎移植超重肥胖患者体重控制及妊娠结局的影响

目的:针对接受体外受精-胚胎移植(IVF-ET)的超重肥胖患者实施个体动态化体重管理,探讨该干预方法对体重控制及妊娠结局的影响。方法:选择2017年5月至2018年12月就诊于我院拟行IVF-ET的超重肥胖患者共99例纳入本研究,随机分为实验组50例与对照组49例,分别采取个体动态化体重管理及常规干预的方法对两组进行体重管理,记录并统计干预前后相关指标的组间差异。结果:两组干预前后BMI的差值差异有统计学意义(P0.05);内膜厚度、获卵数、可用胚胎数、移植胚胎数的组间比较差异无统计学意义(P0.05)。两组临床妊娠率与活产率差异有统计学意义(P0.05);出生婴儿体重组间差异无统计学意义(P0.05);干预满意度评分差异有统计学意义(P0.05)。结论:个体动态化体重管理的干预方法可有效减轻接受IVF-ET的超重肥胖患者的体重,降低体重指数,提高IVF-ET的移植成功率、活产率,值得临床推广应用。     

心理干预对老年脑卒中患者神经功能缺损和幸福感的影响

目的：探讨心理干预对老年脑卒中患者神经功能缺损及幸福指数的影响。方法：选择2014 年2 月~2015 年2 月我院收治的 100例老年脑卒中患者,随机分为干预组和对照组,每组各50 例。对照组患者给予常规治疗,干预组在对照组基础上进行心理干 预。采用Barthel指数评估量表、脑卒中患者临床神经功能缺损程度评分标准（MESSS）及总体幸福感量表（GWB）对两组患者干预 效果进行评分。结果：两组患者干预前各项评分无统计学差异（P>0.05）;干预后,两组患者Barthel 指数和GWB 评分均较干预前 提高,且干预组高于对照组,差异具有统计学意义（P<0.05）;干预后,两组患者MESSS 评分较干预前降低,且干预组低于对照组, 差异具有统计学意义（P<0.05）。结论：心理干预能够缓解老年脑卒中患者的神经功能缺损症状,提高患者幸福指数,具有一定的临 床应用价值。     

A clinical trial of chronic care diabetic clinics in general practice in the United Arab Emirates: a preliminary analysis

Control of diabetes mellitus is a high priority for primary health care systems. One innovative method of diabetes care delivery is the use of structured diabetes care in primary care. This includes the use of chronic care diabetes clinics or mini-clinics operated by general practitioners in primary care. There is limited experience with this model in non-Western settings. This study sought to evaluate a multi-component structured approach to diabetes care in primary care including chronic care diabetes clinics in a newly developed country in the Arabian Gulf. The study design used was a controlled before-after methodology. Three primary health centers were chosen for the intervention with six of the remaining clinics in a Health District being used as controls. A multifaceted intervention was initiated in the intervention clinics composed of chronic care diabetes clinics, a diabetic flow chart, and educational programs for clinic nurses and doctors and patients. The study intervention took place over a period of 18 months with three diabetic outcomes (fasting blood glucose, blood pressure and cholesterol) and adherence to seven diabetes guidelines being compared for the year prior to the intervention and during the last 12 months of the intervention period. Knowledge and satisfaction questionnaires were also administered to intervention and control subjects at the end of the study. In this study, 219 subjects were enrolled (130 males and 89 females). They had a mean age of 51.6 years and a mean of 3.1 years of formal education. Of these 109 were enrolled in one of three clinics that had a chronic care diabetes clinic and 110 were enrolled in one of the six control clinics. Subjects had diabetes for a mean of 7.8 +/- 4.8 years and the majority was treated with pharmacological therapy. Baseline characteristics in the intervention and the control clinics were similar with the exception of younger age (p = 0.01) and a trend for more males (p = 0.06) in the intervention clinics. There was a statistically insignificant change noted with the intervention in the three clinical outcomes studied (fasting blood glucose, blood pressure and cholesterol) both in comparison to the control group before and after and within the intervention group. However most changes noted were in the expected direction of improvement; six of the seven guidelines were statistically improved in the intervention group when compared with the control group. Within the intervention group, adherence with five of seven guidelines was also statistically significantly increased with the remaining guidelines showing a trend in favor of improvement (fasting blood glucose measurements (p = 0.07) and urine determinations for protein (p = 0.07)). Knowledge questionnaire scores were similar between the intervention and control groups on completion of the study but 2 of 4 items on a satisfaction scale were statistically significantly higher in the intervention group. The intervention described in this setting was successful in improving adherence to diabetes guidelines and increased some aspects of satisfaction with diabetes care. The intervention did not result in a statistically significant improvement in clinical outcomes but changes noted were in the expected direction of improvement. The significant improvement in adherence to diabetes guidelines suggests that this intervention is a promising model for diabetes care for newly developed countries.     

The Impact of Leadership Programme on Self-Esteem and Self-Efficacy in School: A Randomized Controlled Trial

Background

Leadership training programs by experiential learning among adolescents are very popular worldwide and in particular developed countries, but there exists few studies which formally assessed their impact on the psychological well-being of program participants. This study evaluated the effectiveness of leadership training programs on self-esteem and self-efficacy among adolescents.

Methodology/Principal Findings

a total of 180 students of the same grade of one secondary school were randomized into an intervention (n = 50) and a control group (n = 130). The students in the intervention group participated in a 6-month program of leadership training and service learning, while the control group did not participate in any training. Their self-esteem and self-efficacy were assessed by Rosenberg Self-Esteem questionnaire and Chinese Adaptation of the General Self-Efficacy Scale, respectively, before and after the program. Both scales have been recognized internationally as valid and reliable survey instruments to measure these psychological attributes. The scores were compared by Student’s tests according to gender. A total of 180 students were enrolled during the study period October, 2009 to May, 2010. Their mean age was 15.18 years (0.62) and 56.7% were male. Students allocated to the intervention and control group had statistically similar demographic characteristics except gender (male 36.0% vs. 64.6%, p = 0.001). Overall, the self-esteem scores increased by 1.28 and decreased by 0.30 (p = 0.161) while the self-efficacy scores increased by 0.26 and decreased by 0.76 (p = 0.429) in the intervention and control group, respectively. Among female students, the intervention group showed significant improvements in both self-esteem (2.38 vs. −0.24, p<0.001) and self-efficacy (1.32 vs. –0.04, p = 0.043).

Conclusions/Significance

Leadership training program were not found to be effective to enhance self-esteem and self-efficacy in adolescents, except girls who showed modest increase in these outcomes. Future research should assess the reasons why these programs are effective among female.     

产后抑郁情绪高危影响因素的早期筛选与护理干预效果分析

目的:探讨产妇产后抑郁情绪的影响因素,研究其意义及有效护理策略,提高其生存质量。方法:选取2013年6至2014年7月间我院产科收治的门诊、住院产妇350例进行问卷调查。在350产妇中,37例出现抑郁情绪,将37例产后抑郁情绪高危产妇的随机均分为两组,其中干预组行针对性护理干预,对照组产妇采用常规心理护理。综合分析两组产妇的临床治疗资料,并进行早期护理干预。结果:25岁的产妇6例(16.22%),25~34岁的产妇27例(72.97%),≥34岁的产妇4例(10.81%),25~34岁产妇出现抑郁情绪的概率明显高于其他年龄段的产妇,差异具有统计学意义(P0.05)。干预组产妇的孕期并发症、不良妊娠结局、夫妻关系、婴儿性别、经济收入、婴儿状况等与对照组存在显著差异,差异具有统计学意义(P0.05)。同时,进行针对性护理后,干预组产妇的抑郁情绪好转情况明显优于对照组,差异具有统计学意义(P0.05)。结论:导致产妇出现产后抑郁情绪的高危影响因素很多,护理人员应进行深入分析,并制定个性化的早期护理干预方案,提高其生存质量。     

Seasonal variation in the diet of stoats in a breeding colony of Hutton's shearwaters

Abstract

Two advantages could be gained by developing multi-species control by aerial baiting. It should assist pest managers to achieve sustainable resource management by improving the efficiency of operations; and it should reduce the likelihood of unwanted ecological side-effects (such as prey-switching) that sometimes follow when pest species are controlled individually. The technology to achieve efficient multi-species control is already well advanced, aided particularly by the refinement of aerial control of possums and by the development of baits for individual species. More effort will, however, be required to develop predictive models for planning the integration of multi-species control with conventional single-species control, and for predicting the ecological effects of such intervention.     

社区综合干预对老年阿尔茨海默症患者的康复效果

目的:探讨社区综合干预对老年阿尔茨海默症患者的康复效果。方法:选择本社区管理的50例阿尔茨海默症患者,随机分为对照组和研究组,每组25例。对照组患者采用常规模式进行康复训练,研究组患者在此基础上加以综合干预。观察并比较两组患者干预前后的精神症状评分(PANSS)、生活质量评分(QQL-100)、康复效果评分(MRSS)、智力评分(MMSE)以及记忆力评分(IMCT)等。结果 :两组患者接受干预前的各项指标无显著性差异(P>0.05)。与干预前比较,两组患者干预后的PANSS、QQL-100、MRSS、MMSE及IMCT均获得不同程度改善,且研究组患者显著优于对照组,差异具有统计学意义(P<0.05)。结论 :社区综合干预可改善老年阿尔茨海默症患者的生存质量,促进康复效果,值得推广。     

联合护理对大剂量糖皮质激素冲击治疗重症药疹副作用及并发症的影响分析

目的 分析联合护理对大剂量糖皮质激素冲击治疗重症药疹副作用及并发症的影响.方法 对我院收治的42例重症药疹患者采用整群随机抽样法分成对照组和观察组各21例,两组患者均应用大剂量糖皮质激素治疗,同时接受健康宣教、皮肤护理等常规护理,观察组在上述基础上联合采用护理干预.观察两组患者血压升高、消化道出血、水电解质紊乱、肝肾功...     

Long-term exposure of male and female mice to 50 Hz magnetic field: effects on fertility

The effect of an extremely low frequency (ELF) magnetic field on the fertility of adult male and female Swiss mice was investigated. Adult male and female mice were exposed to a 50 Hz sinusoidal magnetic field at approximately 25 microT (rms) for 90 days before they were mated with unexposed counterparts. There were no exposure related effects on the fertility of male or female mice. The number of implantation sites, viable fetuses, and the total number of resorptions were not significantly affected in females impregnated by males exposed to the 50 Hz magnetic field as compared with the control group. The number of implantation sites, viable fetuses and the total number of resorptions in exposed females were also not statistically different from the control group. There were no significant effects on the weights of the testes, seminal vesicles, preputial gland or body weights of males exposed to 50 Hz magnetic field. Furthermore, body and uterine weights were not affected in females exposed to 50 Hz field; however, ovarian weight was significantly increased in females exposed to the same field. These results suggest that exposure of male and female mice to low frequency magnetic field had no adverse effects on fertility and reproduction in mice.     

Challenges of Work–Life Balance for Women Physicians/Mothers Working in Leadership Positions

BackgroundFemale leadership in medicine is still disproportionately small, which might be due to the barriers of combining work and family.ObjectivesThe aim of this study was, first, to perform a strengths, weakness, opportunities, and threats (SWOT) analysis and, second, to create a strategic concept for career development.MethodsIn this study, all women in leadership positions in the health care system in Vienna, Austria, with at least 1 child (n = 8), were interviewed about the advantages and disadvantages of gender with regard to career development, the strengths and weaknesses of female leadership, and their work–life balance. Different factors that influenced the work–life balance were specified, and career strategies to realize adequate solutions were developed.ResultsThe sporadic focus on career advancement, time-consuming child care, responsibility for family life, and a woman's tendency toward understatement were barriers to career development. Work–family enrichment has a positive spillover effect that spreads positive energy and helps to balance the work–life relationship. For each individual, the allocation and interaction of different resources such as time, money, scope of decision making, and physical, emotional, and social resources, were essential to maintain the individual work–life balance.ConclusionsIn addition to the existing “glass ceiling,” the predominant responsibility for child care is still borne by the woman. However, mentoring programs, coaching, networking, and support of the partner or of other people help to strengthen female “soft” skills and achieve a work–life balance.     

Effects of new ways of working on work hours and work location,health and job-related outcomes

ABSTRACT

New ways of working (NWW) is a type of work organization that is characterized by temporal and spatial flexibility, often combined with extensive use of information and communication technologies (ICT) and performance-based management. In a three-wave intervention study, we examined the effects of NWW on both the organization of work (changes in control over time and place of work; working hours and work location; and other key job characteristics), and on employees’ outcomes (work–nonwork balance; health and well-being; and job-related outcomes). We applied a quasi-experimental design within a large Dutch financial company (N = 2,912). We studied an intervention group (n = 2,391) and made comparisons with a reference group (n = 521). There were three study waves: (i) one/two months before, and (ii) 4 months and (iii) 10 months after implementation of NWW. Repeated measures analyses of covariance (involving 361 participants from the intervention group and 80 participants from the reference group) showed a large and significant shift from hours worked at the office to hours worked at home after implementation of NWW. Accordingly, commuting time was reduced. Employees remained working on week days and during day time. Psychosocial work-characteristics, work–nonwork balance, stress, fatigue, and job-related outcomes remained favourable and largely unaffected, but the health score in the intervention group decreased (medium effect). These findings suggest that the implementation of NWW does not necessarily lead to changes in psychosocial work characteristics, well-being or job-related outcomes.     

个性化干预对乳腺癌手术患者负性情绪和睡眠质量的影响

目的：研究个性化护理干预对乳腺癌手术患者负性情绪和睡眠质量的影响。方法：选取2013 年1 月-2015 年1 月我院收治 的乳腺癌手术患者100 例,根据术后干预方式不同,将患者分为研究组和对照组,每组各50 例。对照组患者给予常规护理,研究 组患者给予个性化护理。应用焦虑自评量表（SAS）评价患者的焦虑情况,应用抑郁自评量表（SDS）评价患者的抑郁情况,应用匹 兹堡睡眠质量指数（PSQI）评价患者的睡眠质量,并比较两组患者对护理的满意度。结果：研究组护理满意度显著高于对照组,差 异具有统计学意义（P＜0.05）;两组干预前SAS、SDS 和PSQI 评分无统计学差异（P＞0.05）;干预后两组SAS、SDS 和PSQI 评分 均显著降低,且研究组低于对照组,差异具有统计学意义（P＜0.05）。结论：个性化护理干预能显著改善乳腺癌手术患者的负面情 绪,提高患者的睡眠质量。     

Sex-specific genotype-by-environment interactions for cuticular hydrocarbon expression in decorated crickets, Gryllodes sigillatus: implications for the evolution of signal reliability

Phenotypic traits that convey information about individual identity or quality are important in animal social interactions, and the degree to which such traits are influenced by environmental variation can have profound effects on the reliability of these cues. Using inbred genetic lines of the decorated cricket, Gryllodes sigillatus, we manipulated diet quality to test how the cuticular hydrocarbon (CHC) profiles of males and females respond across two different nutritional rearing environments. There were significant differences between lines in the CHC profiles of females, but the effect of diet was not quite statistically significant. There was no significant genotype-by-environment interaction (GEI), suggesting that environmental effects on phenotypic variation in female CHCs are independent of genotype. There was, however, a significant effect of GEI for males, with changes in both signal quantity and content, suggesting that environmental effects on phenotypic expression of male CHCs are dependent on genotype. The differential response of male and female CHC expression to variation in the nutritional environment suggests that these chemical cues may be under sex-specific selection for signal reliability. Female CHCs show the characteristics of reliable cues of identity: high genetic variability, low condition dependence and a high degree of genetic determination. This supports earlier work showing that female CHCs are used in self-recognition to identify previous mates and facilitate polyandry. In contrast, male CHCs show the characteristics of reliable cues of quality: condition dependence and a relatively higher degree of environmental determination. This suggests that male CHCs are likely to function as cues of underlying quality during mate choice and/or male dominance interactions.     

“知信行”模式对老年糖尿病患者睡眠质量的改善作用

目的:调查老年糖尿病患者的睡眠质量,探讨"知信行"管理模式对糖尿病患者睡眠障碍的改善作用。方法:选取100例糖尿病患者,随机分为管理组和对照组,每组50例。管理组患者采用"知信行"管理模式进行护理,对照组患者采用常规基础护理模式。采用匹兹堡睡眠质量指数量评估量表(PSQI)评价患者的睡眠质量,Piper疲劳量表(PFS)评估患者的疲劳程度。结果:护理干预前,两组患者的睡眠质量评分与疲劳程度评分无显著性差异(P0.05)。接受不同护理干预后,两组患者的睡眠质量评分与疲劳程度评分均降低,且管理组评分低于对照组,差异具有统计学意义(P0.05)。结论:"知信行"护理管理模式对老年糖尿病患者的睡眠障碍具有一定的改善作用,有助于降低患者的疲劳程度,值得临床护理推广。     

中晚期直肠癌患者的心理压力调查及干预措施探讨

目的:分析中晚期直肠癌患者的心理健康情况,探讨改善患者心理应激的干预措施,为直肠癌的临床护理工作提供可借鉴的方法。方法:选取2009年1月-2013年1月在我院接受治疗的中晚期直肠癌患者89例作为研究对象,随机分为两组。其中,对照组42例患者采用常规护理模式,而干预组47例患者在此基础上接受健康指导。分别于干预前后对患者的心理健康状况及生存质量进行问卷调查,比较并分析调查结果。结果:实施护理干预前,两组患者各项评分无显著差异(P0.05);实施护理干预后,两组患者的心理健康评分均有所改善,差异具有统计学意义(P0.05)。干预组患者接受健康指导后的各项指标评分均显著优于对照组患者,差异具有统计学意义(P0.05)。两组患者干预后的生理机能、社会功能及情感功能评分均获得提高,但干预组患者效果更为明显,差异具有统计学意义(P0.05)。结论:中晚期直肠癌患者的心理压力对预后产生消极影响,医护人员应积极对患者进行心理疏导,帮助其积极配合治疗,从而获得良好的疗效。     

An embedded longitudinal multi-faceted qualitative evaluation of a complex cluster randomized controlled trial aiming to reduce clinically important errors in medicines management in general practice

ABSTRACT: BACKGROUND: There is a need to shed light on the pathways through which complex interventions mediate their effects in order to enable critical reflection on their transferability. We sought to explore and understand key stakeholder accounts of the acceptability, likely impact and strategies for optimizing and rolling-out a successful pharmacist-led information technology-enabled (PINCER) intervention, which substantially reduced the risk of clinically important errors in medicines management in primary care. METHODS: Data were collected at two geographical locations in central England through a combination of one-to-one longitudinal semi-structured telephone interviews (one at the beginning of the trial and another when the trial was well underway), relevant documents, and focus group discussions following delivery of the PINCER intervention. Participants included PINCER pharmacists, general practice staff, researchers involved in the running of the trial, and primary care trust staff. PINCER pharmacists were interviewed at three different time-points during the delivery of the PINCER intervention. Analysis was thematic with diffusion of innovation theory providing a theoretical framework. RESULTS: We conducted 52 semi-structured telephone interviews and six focus group discussions with 30 additional participants. In addition, documentary data were collected from six pharmacist diaries, along with notes from four meetings of the PINCER pharmacists and feedback meetings from 34 practices. Key findings that helped to explain the success of the PINCER intervention included the perceived importance of focusing on prescribing errors to all stakeholders, and the credibility and appropriateness of a pharmacist-led intervention to address these shortcomings. Central to this was the face-to-face contact and relationship building between pharmacists and a range of practice staff, and pharmacists' explicitly designated role as a change agent. However, important concerns were identified about the likely sustainability of this new model of delivering care, in the absence of an appropriate support network for pharmacists and career development pathways. CONCLUSIONS: This embedded qualitative inquiry has helped to understand the complex organizational and social environment in which the trial was undertaken and the PINCER intervention was delivered. The longitudinal element has given insight into the dynamic changes and developments over time. Medication errors and ways to address these are high on stakeholders' agendas. Our results further indicate that pharmacists were, because of their professional standing and skill-set, able to engage with the complex general practice environment and able to identify and manage many clinically important errors in medicines management. The transferability of the PINCER intervention approach, both in relation to other prescribing errors and to other practices, is likely to be high.