BACKGROUND & AIMS: :Maternal diabetes can cause fetal macrosomia and increased risk of obesity, diabetes, and cardiovascular disease in adulthood of the offspring. Although increased transplacental lipid transport could be involved, the impact of maternal type 1 diabetes on molecular mechanisms for lipid transport in placenta is largely unknown. To examine whether maternal type 1 diabetes affects placental lipid metabolism, we measured lipids and mRNA expression of lipase-encoding genes in placentas from women with type 1 diabetes (n = 27) and a control group (n = 21). The placental triglyceride (TG) concentration and mRNA expression of endothelial lipase (EL) and hormone-sensitive lipase (HSL) were increased in placentas from women with diabetes. The differences were more pronounced in women with diabetes and suboptimal metabolic control than in women with diabetes and good metabolic control. Placental mRNA expression of lipoprotein lipase and lysosomal lipase were similar in women with diabetes and the control group. Immunohistochemistry showed EL protein in syncytiotrophoblasts facing the maternal blood and endothelial cells facing the fetal blood in placentas from both normal women and women with diabetes. These results suggest that maternal type 1 diabetes is associated with TG accumulation and increased EL and HSL gene expression in placenta and that optimal metabolic control reduces these effects.

背景与目标： : 母体糖尿病会导致胎儿巨大儿，并增加后代成年后肥胖，糖尿病和心血管疾病的风险。尽管可能涉及胎盘脂质转运增加，但母体1型糖尿病对胎盘脂质转运分子机制的影响尚不清楚。为了检查母体1型糖尿病是否影响胎盘脂质代谢，我们测量了1型糖尿病女性 (n = 27) 和对照组 (n = 21) 胎盘中脂质和脂肪酶编码基因的mRNA表达。糖尿病女性胎盘中胎盘甘油三酯 (TG) 浓度和内皮脂肪酶 (EL) 和激素敏感性脂肪酶 (HSL) 的mRNA表达增加。与糖尿病和代谢控制良好的女性相比，糖尿病和代谢控制不佳的女性的差异更为明显。糖尿病妇女和对照组的胎盘脂蛋白脂肪酶和溶酶体脂肪酶的mRNA表达相似。免疫组织化学显示，正常妇女和糖尿病妇女胎盘中面向母体血液的合体滋养层细胞中的EL蛋白和面向胎儿血液的内皮细胞。这些结果表明，母体1型糖尿病与胎盘中TG积累以及EL和HSL基因表达增加有关，而最佳的代谢控制会降低这些影响。

BACKGROUND & AIMS: This paper presents and discusses selected findings from a study of health-seeking strategies in relation to sexual health among a group of female sex workers in Calcutta, India. Background information on sex work and sexually transmitted disease in Calcutta is followed by the presentation of findings pertaining to women's understandings of (sexual) health, treatment-seeking and service utilisation. In the urban context where health services are readily available, patterns of initial treatment-seeking are shown to be generally (biomedically) appropriate, but subsequent "non-compliant" therapeutic practices give cause for concern. Conventional approaches to the study of "health-seeking behaviour" are reviewed in the light of these findings and questions raised about the appropriateness of approaches that focus on initial choice of treatment type and/or assume processes of health-seeking to be determined primarily by cultural "beliefs" about illness. Inherent biomedical and culturalist biases in the orientation of such research are shown to produce an analytic neglect of the dual influences of material life conditions and people's perceptions of health, rather than illness, upon health-related strategies. Recommendations are made for operational research and policy formulation on the provision of effective sexual health services, and implications are drawn for the scope of interventions and applied research directed at improving sexual health.

背景与目标： 本文介绍并讨论了印度加尔各答一群女性性工作者与性健康有关的寻求健康策略研究的部分发现。关于加尔各答性工作和性传播疾病的背景信息之后，介绍了与妇女对 (性) 健康，寻求治疗和服务利用的理解有关的发现。在容易获得医疗服务的城市环境中，最初寻求治疗的方式通常 (在生物医学上) 是适当的，但是随后的 “不合规” 治疗方法引起了人们的关注。根据这些发现和提出的有关方法的适当性的问题，对 “寻求健康行为” 研究的常规方法进行了审查，这些方法侧重于治疗类型的初始选择和/或假设寻求健康的过程主要由关于疾病的文化 “信仰” 决定。这种研究方向上固有的生物医学和文化主义偏见被证明是对物质生活条件和人们对健康而不是疾病的看法对健康相关策略的双重影响的分析忽略。提出了有关提供有效性健康服务的业务研究和政策制定的建议，并对旨在改善性健康的干预措施和应用研究的范围提出了影响。

BACKGROUND & AIMS: :Bioelectrical fetal heart activity being recorded from maternal abdominal surface contains more information than mechanical heart activity measurement based on the Doppler ultrasound signals. However, it requires extraction of fetal electrocardiogram from abdominal signals where the maternal electrocardiogram is dominant. The simplest technique for maternal component suppression is a blanking procedure, which relies upon the replacement of maternal QRS complexes by isoline values. Although, in case of coincidence of fetal and maternal QRS complexes, it causes a loss of information on fetal heart activity. Its influence on determination of fetal heart rate and the variability analysis depends on the sensitivity of the heart-beat detector used. The sensitivity is defined as an ability to detect the incomplete fetal QRS complex. The aim of this work was to evaluate the influence of the maternal electrocardiogram suppression method used on the reliability of FHR signal being calculated.

背景与目标： : 从母体腹部表面记录的生物电胎儿心脏活动比基于多普勒超声信号的机械心脏活动测量包含更多信息。但是，它需要从母体心电图占主导地位的腹部信号中提取胎儿心电图。抑制母体成分的最简单技术是消隐程序，该程序依赖于用等值线值代替母体QRS复合物。尽管在胎儿和母体QRS复合物重合的情况下，它会导致有关胎儿心脏活动的信息丢失。它对确定胎儿心率和变异性分析的影响取决于所使用的心跳检测器的灵敏度。敏感性定义为检测不完整胎儿QRS复合物的能力。这项工作的目的是评估所使用的母体心电图抑制方法对所计算的FHR信号可靠性的影响。

BACKGROUND & AIMS: :It is well reported in the epilepsy literature that use of antiepileptic drugs (AEDs) leads to bone loss. Validated instruments were administered to assess knowledge, health behavior, quality of life, and stigma, to determine their effects on self-efficacy for osteoprotective and self-management behaviors. This adult epilepsy population had a mean age of 45, with 20 years of AED exposure. Fifty subjects were Caucasian and 44 were non-Caucasian. By one-way ANOVA, there were significant differences in self-efficacy based on ethnicity, medical assistance, status, and seizure frequency. Differences in knowledge based on ethnicity, education, and income were also noted. Regression analysis revealed that the factors that most predict self-efficacy for calcium, exercise, and self-management do not parallel each other. Age and ethnicity were predictive of self-efficacy for epilepsy self-management only. Medical management factors varied among the models. Overall quality of life was a positive predictor for both calcium and exercise self-efficacy.

背景与目标： : 癫痫文献中有很好的报道，使用抗癫痫药物 (aed) 会导致骨质流失。使用经过验证的仪器来评估知识，健康行为，生活质量和污名，以确定它们对骨保护和自我管理行为的自我效能的影响。该成年癫痫人群的平均年龄为45岁，AED暴露时间为20年。50名受试者是高加索人，44名是非高加索人。通过单因素方差分析，基于种族，医疗救助，状态和发作频率的自我效能存在显着差异。还注意到基于种族，教育和收入的知识差异。回归分析表明，最能预测钙，运动和自我管理自我效能的因素并不相互平行。年龄和种族仅能预测癫痫自我管理的自我效能。各模型之间的医疗管理因素各不相同。总体生活质量是钙和运动自我效能的积极预测指标。

BACKGROUND & AIMS: :Health care workers' perceptions of patient suffering have not been well studied. Patients and health care workers were invited to answer a single, open-ended question. To develop a survey tool that could be validated and used for future research, what health care workers thought causes or caused the most suffering for patients was compared with what patients actually identified as the cause of their worst suffering. Health care workers underestimated loss and significantly underestimated physical nonpainful symptoms as causes of maximal suffering. Communication, emotional, and systems issues were often overestimated by health care workers. Health care workers may not accurately perceive what causes the worst suffering for patients. More studies are needed.

背景与目标： : 医护人员对病人痛苦的看法没有得到很好的研究。邀请患者和医护人员回答一个开放式的问题。为了开发一种可以验证并用于未来研究的调查工具，将医护人员认为导致或导致患者最痛苦的原因与患者实际确定的最痛苦原因进行了比较。医护人员低估了损失，并大大低估了身体上的无痛苦症状，这是造成最大痛苦的原因。医护人员经常高估沟通，情感和系统问题。医护人员可能无法准确理解是什么导致了患者最严重的痛苦。需要更多的研究。

BACKGROUND & AIMS: :The prevalence of mRNAs coding for the sea urchin embryo regulatory factors P3A1 and P3A2 was measured by single-strand probe excess solution hybridization. P3A1 and P3A2 are not homologous proteins, though they both bind specifically to a particular cis-regulatory sequence. Interaction at this target site is known to be required for lineage-specific expression of an aboral ectoderm-specific gene and probably for several other genes as well. Genome blot hybridizations show that both factors are encoded by single-copy genes. Maternal mRNAs for both factors are present at less than 10(3) molecules per egg, which places them in the rare mRNA class. During development to the mesenchyme blastula stage, the amount of P3A1 mRNA (per embryo) increases severalfold while that of P3A2 remains approximately constant. Specification of the aboral ectoderm founder cells and of their initial patterns of gene expression must occur during early to mid-cleavage stage. Therefore, the regulatory proteins needed for this process must be produced by this stage. We show that the quantities of the P3A proteins that can be synthesized from the numbers of mRNA molecules present in the large blastomeres of the early embryo are sufficient to be functional, because these proteins will be accumulated in the nuclei. Thus maternal P3A1 or P3A2 proteins asre not required, nor were these detected in earlier studies. Furthermore, differential spatial (as well as temporal) distribution of both of these newly synthesized factor species could result from the unequal cleavage pattern utilized in the sea urchin egg.

背景与目标： : 通过单链探针过量溶液杂交测量编码海胆胚胎调节因子P3A1和P3A2的mrna的患病率。P3A1和P3A2不是同源蛋白，尽管它们都与特定的顺式调节序列特异性结合。已知该靶位点的相互作用对于外胚层特异性基因的谱系特异性表达以及其他几个基因也是必需的。基因组印迹杂交表明，这两个因子均由单拷贝基因编码。两种因子的母体mRNA在每个卵中存在的分子少于10(3) 个，这使它们处于稀有mRNA类别中。在发育到间充质囊胚阶段期间，P3A1 mRNA的量 (每个胚胎) 增加了几倍，而P3A2的量保持大致恒定。必须在早期至中期切割阶段对外胚层创始细胞及其基因表达的初始模式进行规范。因此，此过程所需的调节蛋白必须在此阶段产生。我们表明，可以从早期胚胎大卵裂球中存在的mRNA分子的数量合成的P3A蛋白的数量足以发挥功能，因为这些蛋白将积聚在细胞核中。因此，不需要母体P3A1或P3A2蛋白，在早期研究中也未检测到这些蛋白。此外，这两种新合成的因子物种的空间 (和时间) 分布差异可能是由于海胆卵中使用的不相等的卵裂模式造成的。

BACKGROUND & AIMS: OBJECTIVE:This study reviewed whether participants who were given a continence education package, which included a Continence Educational Brochure (CEB), and who indicated that they were bothered by incontinence symptoms changed health-seeking behaviors about their incontinence problem because of being given the brochure. METHOD:This study used a descriptive and exploratory design. Participants were given the CEB and asked to read the information. They were also asked to complete a continence questionnaire and mail this back to the research team. Participants who indicated that they were bothered by a continence problem and consented to being interviewed were telephoned 2 to 3 months later. They were asked questions to determine their actions and progress in relation to managing their continence problem and whether the CEB had influenced their behavior. SETTING AND SUBJECT:A total of 631 participants (352 females, 55.8%; 279 males, 44.2%) from 4 rural and regional settings in Victoria, Australia, participated. Of this sample, 111 participants (78 females, 70.3%; 33 males, 29.7%) who reported that they were bothered by a continence problem were interviewed 3 months after being given the CEB. RESULTS:Two thirds of the total sample of participants (n=111) sought help for their continence problem. Approximately 70.3% (n=78) continued to have a continence problem. Of this group, 84.6% were still bothered by the continence problem and 65.4% had taken action to treat their incontinence. Forty-nine participants (44.1%) indicated that they had discussed the issue of bladder or bowel problems with someone directly because of this study or the information contained in the brochure. More than 94% of participants who remembered the CEB indicated that they believed the brochure would be helpful if given to other people. CONCLUSIONS:These findings suggest that the CEB prompted individuals to discuss their continence problem and in fewer cases to seek professional help. Given these findings, distribution of a continence education package is advocated as a continence health promotion strategy.

背景与目标：

BACKGROUND & AIMS: :A survey of pediatric otolaryngologists about voice disorders in children suggests that approximately 1% of children examined were noted to have voice problems, and in only one fifth of these children (0.2%) were the voice problems related to professional use of the voice, such as singing. Direct flexible laryngoscopy was the sole method of examination for 80% of the children examined by these pediatric specialists. Voice therapy for 6 months was generally recommended (88%). The survey represents an estimated clinical experience of > 160,000 children per year, and it achieved a response rate of 40% of pediatric otolaryngologists (48/120). Results suggest that the use of video and stroboscopy for examination of the pediatric voice would enhance understanding and assure correct diagnosis and treatment.

背景与目标： : 对儿童耳鼻喉科医生进行的一项关于儿童语音障碍的调查表明，大约1% 的被检查儿童有语音问题，其中只有5分之1儿童 (0.2%) 的语音问题与专业使用语音有关，例如唱歌。直接柔性喉镜检查是由这些儿科专家检查的80% 儿童的唯一检查方法。通常建议语音治疗6个月 (88%)。该调查代表了每年> 160,000名儿童的估计临床经验，并且达到了小儿耳鼻喉科医生的40% (48/120)。结果表明，使用视频和频闪镜检查小儿语音将增强理解并确保正确的诊断和治疗。

BACKGROUND & AIMS: :Medial preoptic area (MPOA) and ventral bed nucleus of the stria terminalis (VBST) neurons are involved in maternal behavior, but the neural sites to which the maternally relevant neurons project have not been determined. Since MPOA and VBST neurons express Fos during maternal behavior, we used a double-labeling immunocytochemical procedure to detect both Fos and a retrograde tracer, wheat germ agglutinin (WGA), in order to determine where these Fos neurons project. On Day 4 postpartum, fully maternal females were separated from their litters. On Day 5, WGA was iontophoretically injected into one of the following regions known to receive MPOA and/or VBST input: Lateral septum, medial hypothalamus at the level of the ventromedial nucleus, lateral habenula, ventral tegmental area, retrorubral field, or periaqueductal gray. On Day 7, females received a 2-h test with either pups or candy, after which they were perfused and their brains were processed for the detection of Fos and WGA. As expected, females tested with pups had more Fos-containing neurons in the MPOA and VBST than did females tested with candy. After WGA injections into several brain sites, the number of double-labeled cells observed in the MPOA and VBST was greater for the maternal females when compared to the non-maternal females. Therefore, these results pinpointed neural circuits that were activated during maternal behavior. For the maternal females, Fos-containing neurons in the MPOA projected most strongly to the medial hypothalamus at the level of the ventromedial nucleus and to the lateral septum, while Fos-containing neurons in the VBST projected most strongly to the retrorubral field, ventral tegmental area, and medial hypothalamus. Although relatively few MPOA and VBST neurons which expressed Fos during maternal behavior projected to the periaqueductal gray, these Fos-expressing neurons made up a relatively large proportion of the MPOA and VBST projection to the periaqueductal gray. This study suggests that MPOA and VBST efferents project to a variety of regions to promote full maternal responsiveness.

背景与目标： : 视前区 (MPOA) 和纹状体 (VBST) 神经元的腹床核参与母体行为，但尚未确定与母系相关的神经元投射到的神经部位。由于MPOA和VBST神经元在母体行为中表达Fos，因此我们使用双标记免疫细胞化学程序来检测Fos和逆行示踪剂小麦胚芽凝集素 (WGA)，以确定这些Fos神经元的投射位置。产后第4天，将完全的产妇与产仔分开。在第5天，将WGA离子电渗注射到以下已知接受MPOA和/或VBST输入的区域之一: 外侧隔膜，腹内侧核水平的下丘脑内侧，外侧habenula，腹侧被盖区，脑后野，或导水管周围灰色。在第7天，雌性接受了2小时的幼崽或糖果测试，然后对其进行灌注，并对其大脑进行处理以检测Fos和WGA。正如预期的那样，与用糖果测试的雌性相比，用幼崽测试的雌性在MPOA和VBST中具有更多的含Fos的神经元。在将WGA注射到多个大脑部位后，与非母体女性相比，在MPOA和VBST中观察到的双标记细胞数量更多。因此，这些结果确定了在母体行为期间激活的神经回路。对于母体女性，MPOA中含Fos的神经元最强烈地投射到腹内侧核水平的下丘脑内侧和外侧隔，而VBST中含Fos的神经元最强烈地投射到脑后野，腹侧被盖区和下丘脑内侧。尽管在投射到导水管周围灰色的母体行为中表达Fos的MPOA和VBST神经元相对较少，但这些表达Fos的神经元在MPOA和VBST投射到导水管周围灰色的比例相对较大。这项研究表明，MPOA和VBST传出剂投射到各个地区，以促进孕产妇的全面反应。

BACKGROUND & AIMS: :Priority setting of health interventions is often ad-hoc and resources are not used to an optimal extent. Underlying problem is that multiple criteria play a role and decisions are complex. Interventions may be chosen to maximize general population health, to reduce health inequalities of disadvantaged or vulnerable groups, ad/or to respond to life-threatening situations, all with respect to practical and budgetary constraints. This is the type of problem that policy makers are typically bad at solving rationally, unaided. They tend to use heuristic or intuitive approaches to simplify complexity, and in the process, important information is ignored. Next, policy makers may select interventions for only political motives. This indicates the need for rational and transparent approaches to priority setting. Over the past decades, a number of approaches have been developed, including evidence-based medicine, burden of disease analyses, cost-effectiveness analyses, and equity analyses. However, these approaches concentrate on single criteria only, whereas in reality, policy makers need to make choices taking into account multiple criteria simultaneously. Moreover, they do not cover all criteria that are relevant to policy makers. Therefore, the development of a multi-criteria approach to priority setting is necessary, and this has indeed recently been identified as one of the most important issues in health system research. In other scientific disciplines, multi-criteria decision analysis is well developed, has gained widespread acceptance and is routinely used. This paper presents the main principles of multi-criteria decision analysis. There are only a very few applications to guide resource allocation decisions in health. We call for a shift away from present priority setting tools in health--that tend to focus on single criteria--towards transparent and systematic approaches that take into account all relevant criteria simultaneously.

背景与目标： : 卫生干预措施的优先级设定通常是临时性的，资源的使用没有达到最佳程度。潜在的问题是，多个标准发挥作用，决策很复杂。可以选择干预措施，以最大程度地提高总体人口健康水平，减少弱势或弱势群体的健康不平等，ad/或应对威胁生命的情况，所有这些都涉及实际和预算方面的限制。这是政策制定者通常不善于理性地、没有帮助地解决的问题。他们倾向于使用启发式或直观的方法来简化复杂性，在此过程中，重要的信息被忽略。接下来，政策制定者可能只出于政治动机选择干预措施。这表明需要合理和透明的方法来确定优先级。在过去的几十年中，已经开发了许多方法，包括循证医学，疾病负担分析，成本效益分析和公平性分析。但是，这些方法仅集中在单个标准上，而实际上，决策者需要同时考虑多个标准来做出选择。此外，它们并未涵盖与决策者相关的所有标准。因此，有必要开发一种多标准方法来确定优先级，并且最近确实已将其确定为卫生系统研究中最重要的问题之一。在其他科学学科中，多准则决策分析得到了很好的发展，得到了广泛的认可，并被常规使用。本文介绍了多准则决策分析的主要原理。只有很少的应用程序来指导健康中的资源分配决策。我们呼吁从目前的卫生优先事项设定工具 (往往侧重于单一标准) 转向透明和系统的方法，同时考虑到所有相关标准。

BACKGROUND & AIMS: :In the last few decades, the importance of selenium in human health has been the subject of numerous studies. It is believed that the physiological effects of selenium occur mainly through the function of selenoproteins, which incorporate selenium in the form of one or more selenocysteine residues. Recent advances in understanding the complex regulation of selenoprotein synthesis and functional characterization of several members of the selenoprotein family have contributed to an improved comprehension of the role(s) of selenium in human health and the great diversity of physiological pathways influenced by this trace element.

背景与目标： : 在过去的几十年中，硒在人类健康中的重要性一直是众多研究的主题。据信，硒的生理作用主要通过硒蛋白的功能发生，硒蛋白以一个或多个硒代半胱氨酸残基的形式掺入硒。了解硒蛋白合成的复杂调控和硒蛋白家族几个成员的功能表征的最新进展有助于更好地理解硒在人类健康中的作用以及受该微量元素影响的生理途径的多样性。

BACKGROUND & AIMS: :The health issues of young adulthood have received relatively little attention compared with those of adolescence, although the critical issues in young adulthood parallel those of adolescence. Young adults often fare worse than adolescents on health indicators, with many measures of negative outcomes--including rates of injury, homicide, and substance use--peaking during the young adult years. The contextual factors shaping health status and access to care in young adulthood differ significantly from the context of adolescence. This article synthesizes national data to present a health profile of young adults, reviewing social indicators that describe the context of young adulthood and presenting measures of health status. We examine mortality, morbidity, risky behaviors, and health care access and utilization, identifying the most significant gender and racial/ethnic disparities. The article also identifies limitations of existing data and offers suggestions for future research and health monitoring in this area. We conclude with a discussion of current efforts to address the health and well-being of young adults and argue for creating a national health agenda for young adults that includes research, programs and policies to address health issues during this period of the lifespan.

背景与目标： : 与青春期相比，成年后的健康问题受到的关注相对较少，尽管成年后的关键问题与青春期的问题平行。在健康指标上，年轻人的表现通常比青少年差，许多负面结果指标 (包括受伤，凶杀和吸毒的发生率) 在年轻人时期达到顶峰。影响成年后健康状况和获得护理的背景因素与青春期的背景有很大不同。本文综合了国家数据，以提供年轻人的健康状况，回顾了描述年轻人成年背景的社会指标，并提出了健康状况的衡量标准。我们检查了死亡率，发病率，危险行为以及医疗保健的获取和利用情况，以确定最重要的性别和种族/种族差异。本文还指出了现有数据的局限性，并为该领域的未来研究和健康监测提供了建议。最后，我们讨论了当前为解决年轻人的健康和福祉所做的努力，并主张为年轻人制定国家健康议程，其中包括研究，计划和政策，以解决这一生命周期中的健康问题。

BACKGROUND & AIMS: OBJECTIVE:To investigate the effects of local labor market conditions and the availability of employer-sponsored health insurance on exits from the Medicaid program. DATA SOURCE:Data for this project come from a unique administrative database containing a 2 percent sample of all cases on California's Medicaid program in 1987 and a 2 percent sample of all new cases starting each year between 1987 and 1995. STUDY DESIGN:The results are estimated using a discrete duration model where the monthly exit probability is a function of demographic characteristics, local labor market variables, the probability of having employer-sponsored insurance, and fixed year and county effects. PRINCIPAL FINDINGS:Improvements in labor market opportunities (i.e., employment growth, wage growth, and increases in the availability of employer-sponsored health insurance) promote exits off the Medicaid program. A 2.5 percentage point increase in the availability of employer-sponsored insurance leads to a 6 percent increase in the probability that a completed spell lasts no more than 2 years. It would take a 2 percentage point decrease in unemployment rates or a 10 percent increase in average quarterly earnings to yield an equivalent increase in the likelihood of exiting Medicaid within 2 years. These effects are robust to the inclusion of county-level fixed effects and time effects. CONCLUSIONS:Medicaid expenditures and caseloads are sensitive to local economic fluctuations and secular trends in the availability of health insurance. Continued decreases in employer-based health insurance coverage will greatly increase the demand for public insurance coverage and the financial pressures on state governments.

背景与目标：

BACKGROUND & AIMS: The relationship between preferred objects associated with stereotypy, stereotypic behavior, and accuracy of responding during a counting task by a child with autism was analyzed. Object preference was determined by presenting the child with different sets of objects and asking him to choose one. His choices were then rank ordered into three groupslow, medium, and high preference objects. Counting performance within each of the three object groups was then analyzed in a multi-element design, alternating preference groups. Teaching with high-preference objects occasioned more stereotypic behavior and less accurate counting than teaching with medium- and low-preference objects. Thus, there exists the possibility that teaching may be less successful with certain teaching materials, especially if those materials evoke high rates of incompatible behaviors.

背景与目标： 分析了与自闭症儿童在计数任务中与刻板印象相关的首选对象，刻板行为和响应准确性之间的关系。对象偏好是通过向孩子展示不同的对象集并要求他选择一个来确定的。然后将他的选择排序为三个慢，中和高偏好对象。然后，在多元素设计 (交替的偏好组) 中分析了三个对象组中每个对象组的计数性能。与中低偏好对象的教学相比，高偏好对象的教学产生了更多的刻板行为和更不准确的计数。因此，存在使用某些教材进行教学可能不太成功的可能性，尤其是如果这些教材引起高度的不相容行为。

BACKGROUND & AIMS: INTRODUCTION:Since 2003, Iraq has struggled to build a single national health system administered by the Iraqi Ministry of Health, but politics, lack of leadership, and a cultural bias against treating soldiers in civilian hospitals have hindered access to care for members of Iraq's armed forces who are wounded in combat. METHODS:U.S. surgeons are providing trauma care for Iraqi soldiers in American field hospitals, with more than 80% of hospital bed days occupied by Iraqis. At the same time, Iraqi hospitals have been treating the many civilian casualties of violence, and the Ministry of Health has greatly improved its emergency response and management capabilities over the past year. RESULTS:Ministry of Health hospitals have adequate surgical capabilities and bed capacity to care for both civilian and security forces casualties. Faltering attempts to develop a national health policy that provides comprehensive care for Iraqi Security Forces will jeopardize Iraq's ability to assume responsibilities for the country's national defense, and could delay the withdrawal of Coalition military forces from Iraq. CONCLUSIONS:It is imperative that leadership of the new government of Iraq and the international surgical community strongly endorse the implementation of a single health care system for all Iraqis.

背景与目标：