BACKGROUND & AIMS: BACKGROUND:Health inequalities that affect indigenous peoples have been recently documented by international organizations such as the United Nations Permanent Forum on Indigenous Issues (UNPFII) and the Pan American Health Organization (PAHO). The Nasa reservation in Iquira (Huila) where this study was conducted has one of the highest infant mortality rates in the country. OBJECTIVE:Understanding community perspectives about the sociocultural determinants of children's health is crucial in order to develop effective and culturally appropriate public health interventions to address this pressing issue. METHODS:This study employed Community-Based Participatory Research (CBPR) as a methodological framework. Community partnerships in the form of local health committees led the process along with the academic team. Group discussions and photovoice were conducted with a criterion sampling of sages, midwives, traditional doctors, traditional massage therapist, traditional pressure taker (pulseadores), health promoters, community authorities, mothers, students, educators and other key community members. RESULTS:Grounded qualitative data analyses suggest a loss in the traditional customs and the credibility of ancestral medicine; a move from autonomy to dependence on external food sources; and increased child neglect and environmental pollution as the primary conditions associated with the increase in preventable diseases, malnutrition, and infant mortality. CONCLUSIONS:Community implications include the need to strengthen child-rearing, food production and nutritional practices in accordance with ancestral knowledge. Institutional support is sought to support the implementation of indigenous communities' life plans as well as to adjust the institutional programs offered to communities in a way that they promote ancestral identity and cultural continuity.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Parents' use of physical discipline has generated controversy related to concerns that its use is associated with adjustment problems such as aggression and delinquency in children. However, recent evidence suggests that there are ethnic differences in associations between physical discipline and children's adjustment. This study examined race as a moderator of the link between physical discipline and adolescent externalizing behavior problems, extending previous research beyond childhood into adolescence and considering physical discipline at multiple points in time. METHODS:A representative community sample of 585 children was followed from pre-kindergarten (age 5) through grade 11 (age 16). Mothers reported on their use of physical discipline in the child's first five years of life and again during grades 6 (age 11) and 8 (age 13). Mothers and adolescents reported on a variety of externalizing behaviors in grade 11 including aggression, violence, and trouble at school and with the police. RESULTS:A series of hierarchical linear regressions controlling for parents' marital status, socioeconomic status, and child temperament revealed significant interactions between physical discipline during the child's first five years of life and race in the prediction of 3 of the 7 adolescent externalizing outcomes assessed and significant interactions between physical discipline during grades 6 and 8 and race in the prediction of all 7 adolescent externalizing outcomes. Regression slopes showed that the experience of physical discipline at each time point was related to higher levels of subsequent externalizing behaviors for European American adolescents but lower levels of externalizing behaviors for African American adolescents. CONCLUSIONS:There are race differences in long-term effects of physical discipline on externalizing behaviors problems. Different ecological niches may affect the manner in which parents use physical discipline, the meaning that children attach to the experience of physical discipline, and its effects on the adjustment of children and adolescents.

背景与目标：

BACKGROUND & AIMS: OBJECTIVES:To develop a new measure of parental discipline of children encompassing a broad array of types of discipline and modes of administration. METHODS:Parents of 12- to 19-month-old children were interviewed using a new 45-item structured survey about discipline in general pediatric clinics in North Carolina and Alabama. Demographic data describing the population studied were linked from another study in which these families were participating. Principal component analysis and confirmatory reliability analysis were used to define subscales and determine which items were retained in the survey. RESULTS:One hundred eighty-two parents were interviewed about disciplinary practices. Disciplinary subscales were robust for a number of disciplinary types (monitoring, verbal communication, modeling behavior, corporal punishment, and ignoring) and modes of administration (follow-through, consistency, positive demeanor, negative demeanor). CONCLUSIONS:The Discipline Survey is a promising new measure of parental discipline. A survey instrument to assess disciplinary practices like the one developed fills a gap and can enhance research methodology for those interested in the effects of interventions on parental discipline.

背景与目标：

BACKGROUND & AIMS: :In a 1991 editorial in The FASEB Journal, Robert W. Krauss commented on a recent report of the Presidential Advisory Committee on the Future of the U.S. Space Program (Augustine report). He concluded that, although a manned mission to Mars with life sciences as the priority was endorsed by the Committee, it failed to deal realistically with one huge gap; biological sciences have never been given high priority. According to Krauss, this left a void that will cripple, perhaps fatally, any early effort to ensure long-term survival on any mission of extended duration. The gap included insufficient flight time for fundamental biological space research and insufficient funds. Krauss expressed his opinions 15 years ago. Have we better knowledge of space biology now? This question becomes more acute now that President George W. Bush recently proposed a manned return to the moon by 2015 or 2020, with the moon to become our staging post for manned missions to Mars. Will we be ready so soon? A review of the progress in the last 15 years suggests that we will not. Because of the Columbia disaster, flight opportunities for biological sciences in shuttle spacelabs and in Space Station laboratories compete with time for engineering problems and construction. Thus, research on gravity, radiation, and isolation loses out to problems deemed to be of higher priority. Radiation in deep space and graded gravity in space with on board centrifuges are areas that must be studied before we undertake prolonged space voyages. Very recent budgetary changes within National Aeronautics and Space Administration threaten to greatly reduce the fundamental space biology funds. Are we ready for a trip to Mars? Like Krauss 15 years ago, I think not for some time.

背景与目标： : 在《FASEB杂志》的1991社论中，罗伯特·W·克劳斯 (Robert W. Krauss) 评论了总统咨询委员会最近关于美国太空计划未来的报告 (奥古斯丁报告)。他得出的结论是，尽管以生命科学为优先事项的载人火星飞行任务得到了委员会的认可，但它未能现实地解决一个巨大的差距。生物科学从未得到高度重视。根据克劳斯 (Krauss) 的说法，这留下了一个空白，可能会致命地削弱任何早期的努力，以确保任何长期任务的长期生存。差距包括基础生物空间研究的飞行时间不足和资金不足。克劳斯15年前就发表了自己的意见。我们现在对空间生物学有更好的了解吗？现在这个问题变得更加尖锐，因为乔治·W·布什总统最近提议载人返回月球2015年或2020，月球成为我们载人火星任务的集结地。我们会这么快就准备好了吗？回顾过去15年的进展表明，我们不会。由于哥伦比亚灾难，航天飞机spacelabs和空间站实验室的生物科学飞行机会与工程问题和建设时间竞争。因此，对重力，辐射和隔离的研究失去了被认为具有更高优先级的问题。在进行长时间的太空航行之前，必须研究深空中的辐射和带有离心机的太空重力。国家航空航天局最近的预算变化有可能大大减少基本的空间生物学资金。我们准备好去火星旅行了吗？就像15年前的克劳斯一样，我认为一段时间没有。

BACKGROUND & AIMS: OBJECTIVE:The OECD countries are facing a set of core challenges; an increasing elderly population; increasing number of chronic and lifestyle-related diseases; expanding scope of what medicine can do; and increasing lack of medical professionals. Pervasive healthcare asks how pervasive computing technology can be designed to meet these challenges. The objective of this paper is to discuss 'pervasive healthcare' as a research field and tries to establish how novel and distinct it is, compared to related work within biomedical engineering, medical informatics, and ubiquitous computing. METHODS:The paper presents the research questions, approach, technologies, and methods of pervasive healthcare and discusses these in comparison to those of other related scientific disciplines. RESULTS:A set of central research themes are presented; monitoring and body sensor networks; pervasive assistive technologies; pervasive computing for hospitals; and preventive and persuasive technologies. Two projects illustrate the kind of research being done in pervasive healthcare. The first project is targeted at home-based monitoring of hypertension; the second project is designing context-aware technologies for hospitals. Both projects approach the healthcare challenges in a new way, apply a new type of research method, and come up with new kinds of technological solutions. 'Clinical proof-of-concept' is recommended as a new method for pervasive healthcare research; the method helps design and test pervasive healthcare technologies, and in ascertaining their clinical potential before large-scale clinical tests are needed. CONCLUSION:The paper concludes that pervasive healthcare as a research field and agenda is novel; it is addressing new emerging research questions, represents a novel approach, designs new types of technologies, and applies a new kind of research method.

背景与目标：

BACKGROUND & AIMS: AIM:The purpose of the present study was to highlight the effects of hospital reform introduced in Norway 2002 on patient rehabilitation. BACKGROUND:The Norwegian hospital reform is an activity-controlled financing system with diagnosis-related groups (DRG). METHOD:A multi-case study with embedded design methods was used. Document analysis and interviews are sources of evidence. RESULTS:The rehabilitation service offered a treatment service that was inadequately funded. The focus of the rehabilitation team was negatively affected by the lack of organization. The different patient groups did not receive optimal and individualized rehabilitation as required by individual treatment plans. There were two different levels of rehabilitation at the hospitals. CONCLUSIONS:The financing system did not provide for a differentiated treatment service tailored to each patient's individual plan, as stipulated by health policy. An increase in the number of patients receiving rehabilitation in the health authorities was not accompanied by an increase in allocated resources, leading to an insufficient overall rehabilitation service. The organizations included in the case study were not those who finance specialized rehabilitation at specialized rehabilitation centres. IMPLICATIONS FOR NURSING MANAGEMENT:Specially trained nurses are strategically placed to shape and influence funding of rehabilitation programmes through leadership.

背景与目标：

BACKGROUND & AIMS: :Based on work conducted by Laurentian University's School of Nursing and Centre for Continuing Education in Sudbury, Ontario, Canada, working in conjunction with community partners, this article looks at the findings of an analysis of nurses' writing activity in a university-level web-based module for evidence of critical thinking using Johns' Model of Structured Reflection (1995). Also considered are student-teacher interactions and discipline-specific writing. The findings suggest that high levels of critical thinking by nurse learners and growth in thinking and writing competence over time can occur in an online setting. Further highlighted are the role of the instructor, assignment design, and support in fostering such development.

背景与目标： : 基于Laurentian大学护理学院和加拿大安大略省萨德伯里继续教育中心与社区合作伙伴合作开展的工作，本文着眼于在大学级别的基于web的模块中分析护士的写作活动的结果，该模块使用约翰斯的结构化反思模型 (1995) 来证明批判性思维。还考虑了学生与教师的互动和针对特定学科的写作。研究结果表明，护士学习者的批判性思维水平很高，随着时间的推移，思维和写作能力的增长可能会在在线环境中发生。进一步强调了讲师，作业设计和支持在促进此类发展中的作用。

BACKGROUND & AIMS: :Although public opinion is important in deciding what is valued by society, governments have determined that scientific expertise is required to evaluate potential environmental effects of genetically modified (GM) crops. We suggest how to evaluate rigorously the environmental effects of GM crops in the context of a scientific investigation. Following a disciplined scientific approach to environmental risk assessment (ERA) for GM crops should help resolve controversy in identifying and addressing risk.

背景与目标： : 尽管公众舆论在决定社会重视什么方面很重要，但政府已经确定需要科学专业知识来评估转基因作物的潜在环境影响。我们建议如何在科学调查的背景下严格评估转基因作物的环境影响。遵循严格的科学方法对转基因作物进行环境风险评估 (ERA)，应有助于解决识别和解决风险方面的争议。

BACKGROUND & AIMS: :Prolonged exposure of humans and experimental animals to the altered gravitational conditions of space flight has adverse effects on the lymphoid and erythroid hematopoietic systems. Although some information is available regarding the cellular and molecular changes in lymphocytes exposed to microgravity, little is known about the erythroid cellular changes that may underlie the reduction in erythropoiesis and resultant anemia. We now report a reduction in erythroid growth and a profound inhibition of erythropoietin (Epo)-induced differentiation in a ground-based simulated microgravity model system. Rauscher murine erythroleukemia cells were grown either in tissue culture vessels at 1 x g or in the simulated microgravity environment of the NASA-designed rotating wall vessel (RWV) bioreactor. Logarithmic growth was observed under both conditions; however, the doubling time in simulated microgravity was only one-half of that seen at 1 x g. No difference in apoptosis was detected. Induction with Epo at the initiation of the culture resulted in differentiation of approximately 25% of the cells at 1 x g, consistent with our previous observations. In contrast, induction with Epo at the initiation of simulated microgravity resulted in only one-half of this degree of differentiation. Significantly, the growth of cells in simulated microgravity for 24 h prior to Epo induction inhibited the differentiation almost completely. The results suggest that the NASA RWV bioreactor may serve as a suitable ground-based microgravity simulator to model the cellular and molecular changes in erythroid cells observed in true microgravity.

背景与目标： : 人类和实验动物长时间暴露于改变的太空飞行重力条件对淋巴和红系造血系统有不利影响。尽管可以获得有关暴露于微重力的淋巴细胞的细胞和分子变化的一些信息，但对可能导致红细胞生成减少和由此导致的贫血的红系细胞变化知之甚少。现在，我们报告了在基于地面的模拟微重力模型系统中红细胞生长的减少和对促红细胞生成素 (Epo) 诱导的分化的深刻抑制。Rauscher鼠红白血病细胞在1 x g的组织培养容器中或在NASA设计的旋转壁容器 (RWV) 生物反应器的模拟微重力环境中生长。在两种条件下均观察到对数增长; 然而，模拟微重力的倍增时间仅为1 x g时的一半。未检测到细胞凋亡的差异。在培养开始时用Epo诱导导致在1xg下约25% 的细胞分化，这与我们先前的观察结果一致。相反，在模拟微重力开始时用Epo诱导仅导致这种分化程度的一半。值得注意的是，在Epo诱导之前，细胞在模拟微重力下生长24小时几乎完全抑制了分化。结果表明，NASA RWV生物反应器可以用作合适的地面微重力模拟器，以模拟在真实微重力下观察到的红系细胞的细胞和分子变化。

BACKGROUND & AIMS: AIM:This study aimed at determining the association of father's and mother's (parental) substance use disorder (SUD) and discipline styles and son's neurobehavior disinhibition (ND) with son's SUD from childhood (age 10-12) to young adulthood (age 19). It was hypothesized that (1) parental discipline styles and son's ND mediate the association between parental SUD and son's SUD, (2) son's ND mediates the association between parental discipline styles and son's SUD, and (3) parental discipline styles mediate the association between ND and SUD in the son. METHODS:Two-hundred-sixty-three families including a 10-12 year-old son and both parents participated in the study. RESULTS:(1) mother's discipline styles predicted father's discipline styles, (2) son's ND predicted mother's instilling guilt positively and father's punishment negatively, (3) son's ND mediated the association between father's SUD and punishment and son's SUD, and (4) mother's SUD predicted son's ND and SUD. CONCLUSIONS:The reciprocal prediction between son's ND and father's punishment and prediction of father's punishment by mother's punishment point to the need for family-based interventions that take into account the quality of specific dyadic interactions pertaining to discipline behaviors that amplify the risk for SUD in male children.

背景与目标：

BACKGROUND & AIMS: :The current review summarizes scientific knowledge concerning sex differences in world-record performance and the influence of sport discipline and competition duration. In addition, the way that physiological factors relate to sex dimorphism is discussed. While cultural factors played a major role in the rapid improvement of performance of women relative to men up until the 1990s, sex differences between the world's best athletes in most events have remained relatively stable at approximately 8-12%. The exceptions are events in which upper-body power is a major contributor, where this difference is more than 12%, and ultraendurance swimming, where the gap is now less than 5%. The physiological advantages in men include a larger body size with more skeletal-muscle mass, a lower percentage of body fat, and greater maximal delivery of anaerobic and aerobic energy. The greater strength and anaerobic capacity in men normally disappear when normalized for fat-free body mass, whereas the higher hemoglobin concentrations lead to 5-10% greater maximal oxygen uptake in men with such normalization. The higher percentage of muscle mass in the upper body of men results in a particularly large sex difference in power production during upper-body exercise. While the exercise efficiency of men and women is usually similar, women have a better capacity to metabolize fat and demonstrate better hydrodynamics and more even pacing, which may be advantageous, in particular during long-lasting swimming competitions.

背景与目标： : 当前的评论总结了有关世界纪录表现中的性别差异以及体育学科和比赛持续时间的影响的科学知识。此外，还讨论了生理因素与性别二态性的关系。直到20世纪90年代，文化因素在快速提高女性相对于男性的表现方面发挥了重要作用，但在大多数项目中，世界上最好的运动员之间的性别差异保持相对稳定，大约为8-12%。例外的是上半身力量是主要贡献者的事件，这种差异超过12%，而超耐力游泳现在的差距小于5%。男性的生理优势包括更大的体型，更多的骨骼肌质量，更低的体脂百分比以及更大的无氧和有氧能量的最大输送。当对无脂肪体重进行归一化时，男性的更大力量和无氧能力通常会消失，而较高的血红蛋白浓度会导致具有这种归一化的男性的最大摄氧量增加5-10%。男性上半身肌肉质量的百分比较高，导致上半身运动期间动力产生的性别差异特别大。尽管男性和女性的运动效率通常相似，但女性具有更好的代谢脂肪的能力，并表现出更好的流体力学和更均匀的起搏，这可能是有利的，特别是在长期游泳比赛中。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: This article explores the concept of quality of life. Current understandings of quality of life are considered in relation to the notion of discipline-specificity. The authors contend that different disciplines require distinct definitions of quality of life and that research which informs practitioners about quality of life needs to be discipline-specific and theory-based. The contribution of the human becoming theory to knowledge and understanding of quality of life in nursing science is explored, drawing on insights from theory-guided practice and research.

背景与目标： 本文探讨了生活质量的概念。当前对生活质量的理解与学科特异性的概念有关。作者认为，不同的学科要求对生活质量有不同的定义，而向从业者提供有关生活质量的研究必须针对特定学科和基于理论。借鉴理论指导的实践和研究的见解，探讨了人类成为理论对护理科学中生活质量的认识和理解的贡献。

BACKGROUND & AIMS: A small axial flow ventricular assist device (VAD) measuring 3 inches long and 1 inch in diameter is in development. The pump consists of a spinning inducer/ impeller, a flow straightener (FLS), and a diffuser enclosed in a cylindrical flow tube. The impeller has rod-shaped permanent magnets embedded within its 6 blades and is activated magnetically by the motor stator which is positioned outside the flow tube. At the completion of a previous study, the FLS was identified as a thrombogenic area. The aim of the present study was to evaluate the thrombogenicity of redesigned FLSs (swept-back and bulbous types), compared with standard type (STD) FLS. A total of 15 pumps (STD, n = 7; swept-back, n = 4; and bulbous, n = 4) were sequentially implanted into 4 calves paracorporeally in a short-term ex vivo test. The STD and bulbous FLSs experienced thrombus formation, but the swept-back FLS was thrombus free during a 48 h screening test.

背景与目标： 正在开发一种小型轴流心室辅助装置 (VAD)，该装置测量3英寸长且直径1英寸。该泵由旋转诱导器/叶轮，流量矫直器 (FLS) 和封闭在圆柱形流量管中的扩散器组成。叶轮具有嵌入在其6个叶片内的棒状永磁体，并且由位于流管外部的电机定子磁性地激活。在先前的研究完成时，FLS被确定为血栓形成区域。本研究的目的是评估与标准类型 (STD) FLS相比，重新设计的FLS (后掠型和球状型) 的血栓形成性。在短期离体测试中，总共将15个泵 (STD，n = 7; 后掠，n = 4; 和球茎，n = 4) 依次植入到4个小牛中。性病和球状FLS发生血栓形成，但在48小时的筛查测试中，后掠FLS无血栓。

BACKGROUND & AIMS: :The rapid and effective response to a bioterrorist event requires the coordinated efforts of trained personnel from different agencies. This article describes the design and implementation of a 1-week cross-disciplinary course employing problem-based learning (PBL) for professionals with backgrounds in public health, fire/emergency medical services (EMS), law enforcement, emergency management, and hospital administration. The curriculum provided opportunities for professionals from different disciplines to meet and learn the priorities and resources of partner agencies. In course evaluations, participants rated the training highly and found it applicable to their work and a good use of time and training resources. PBL techniques were successful in fostering cross-agency communication, thereby showing promise as an effective training method for meeting local and national emergency preparedness objectives.

背景与目标： : 对生物恐怖事件的快速有效反应需要来自不同机构的训练有素的人员的协调努力。本文介绍了为期1周的跨学科课程的设计和实施，该课程采用基于问题的学习 (PBL)，面向具有公共卫生，消防/紧急医疗服务 (EMS)，执法，应急管理和医院背景的专业人员管理。该课程为来自不同学科的专业人员提供了满足和学习伙伴机构的优先事项和资源的机会。在课程评估中，参与者对培训进行了高度评价，并发现它适用于他们的工作，并充分利用了时间和培训资源。PBL技术成功地促进了跨机构沟通，从而显示出有望成为实现地方和国家应急准备目标的有效培训方法。