• 【术前MRI对浸润性小叶乳腺癌的重复手术: 其他原位癌和背景实质增强的作用。】 复制标题 收藏 收藏
    DOI:10.1016/j.ejrad.2017.02.045 复制DOI
    作者列表:Preibsch H,Richter V,Bahrs SD,Hattermann V,Wietek BM,Bier G,Kloth C,Blumenstock G,Hahn M,Staebler A,Nikolaou K,Wiesinger B
    BACKGROUND & AIMS: OBJECTIVES:Analysing the influence of additional carcinoma in situ (CIS) and background parenchymal enhancement (BPE) in preoperative MRI on repeated surgeries in patients with invasive lobular carcinoma (ILC) of the breast. METHODS:Retrospective analysis of 106 patients (mean age 58.6±9.9years) with 108 ILC. Preoperative tumour size as assessed by MRI, mammography and sonography was recorded and compared to histopathology. In contrast-enhanced MRI, the degree of BPE was categorised by two readers. The influence of additionally detected CIS and BPE on the rate of repeated surgeries was analysed. RESULTS:Additional CIS was present in 45.4% of the cases (49/108). The degree of BPE was minimal or mild in 80% of the cases and moderate or marked in 20% of the cases. In 17 cases (15.7%) at least one repeated surgery was performed. In n=15 of these cases, repeated surgery was performed after BCT (n=9 re-excisions, n=6 conversions to mastectomy), in n=2 cases after initial mastectomy. The initial surgical procedure (p=0.008) and additional CIS (p=0.046) significantly influenced the rate of repeated surgeries, while tumour size, patient age and BPE did not (p=ns). CONCLUSIONS:Additional CIS was associated with a higher rate of repeated surgeries, whereas BPE had no influence.
    背景与目标:
  • 【通过临床能力而不仅仅是文化能力来解决精神卫生差异: 在提供循证心理康复服务时需要评估社会文化问题。】 复制标题 收藏 收藏
    DOI:10.1016/j.cpr.2008.07.006 复制DOI
    作者列表:Yamada AM,Brekke JS
    BACKGROUND & AIMS: :Recognition of ethnic/racial disparities in mental health services has not directly resulted in the development of culturally responsive psychosocial interventions. There remains a fundamental need for assessment of sociocultural issues that have been linked with the expectations, needs, and goals of culturally diverse consumers with severe and persistent mental illness. The authors posit that embedding the assessment of sociocultural issues into psychosocial rehabilitation practice is one step in designing culturally relevant empirically supported practices. It becomes a foundation on which practitioners can examine the relevance of their interventions to the diversity encountered in everyday practice. This paper provides an overview of the need for culturally and clinically relevant assessment practices and asserts that by improving the assessment of sociocultural issues the clinical competence of service providers is enhanced. The authors offer a conceptual framework for linking clinical assessment of sociocultural issues to consumer outcomes and introduce an assessment tool adapted to facilitate the process in psychosocial rehabilitation settings. Emphasizing competent clinical assessment skills will ultimately offer a strategy to address disparities in treatment outcomes for understudied populations of culturally diverse consumers with severe and persistent mental illness.
    背景与目标: : 认识到精神卫生服务中的族裔/种族差异并没有直接导致对文化有反应的心理社会干预措施的发展。仍然需要对与患有严重和持续精神疾病的文化多样性消费者的期望,需求和目标相关的社会文化问题进行评估。作者认为,将社会文化问题的评估纳入社会心理康复实践是设计与文化相关的经验支持实践的一步。它成为从业者可以检查其干预措施与日常实践中遇到的多样性的相关性的基础。本文概述了对文化和临床相关评估实践的需求,并断言通过改善对社会文化问题的评估,可以增强服务提供商的临床能力。作者提供了一个概念框架,用于将社会文化问题的临床评估与消费者的结果联系起来,并引入了一种评估工具,以促进社会心理康复环境中的过程。强调合格的临床评估技能将最终提供一种策略,以解决患有严重和持续性精神疾病的文化多样性消费者的研究不足人群的治疗结果差异。
  • 【背景二甲双胍单药治疗2型糖尿病患者卡格列净与安慰剂和西格列汀的疗效和安全性比较: 一项随机试验.】 复制标题 收藏 收藏
    DOI:10.1007/s00125-013-3039-1 复制DOI
    作者列表:Lavalle-González FJ,Januszewicz A,Davidson J,Tong C,Qiu R,Canovatchel W,Meininger G
    BACKGROUND & AIMS: AIMS/HYPOTHESIS:The aim of this work was to evaluate the efficacy and safety of canagliflozin vs placebo and sitagliptin in patients with type 2 diabetes who were being treated with background metformin. METHODS:This randomised, double-blind, four-arm, parallel-group, Phase 3 study was conducted at 169 centres in 22 countries between April 2010 and August 2012. Participants (N = 1,284) with type 2 diabetes aged ≥ 18 and ≤ 80 years who had inadequate glycaemic control (HbA1c ≥ 7.0% [53 mmol/mol] and ≤10.5% [91 mmol/mol]) on metformin therapy received canagliflozin 100 mg or 300 mg, sitagliptin 100 mg, or placebo (n = 368, 367, 366, 183, respectively) for a 26 week, placebo- and active-controlled period followed by a 26 week, active-controlled period (placebo group switched to sitagliptin [placebo/sitagliptin]) and were included in the modified intent-to-treat analysis set. Randomisation was performed using a computer-generated schedule; participants, study centres and the sponsor were blinded to group assignment. The primary endpoint was change from baseline in HbA1c at week 26; secondary endpoints included changes in HbA1c (week 52) and fasting plasma glucose (FPG), body weight, and systolic blood pressure (BP; weeks 26 and 52). Adverse events (AEs) were recorded throughout the study. RESULTS:At week 26, canagliflozin 100 mg and 300 mg reduced HbA1c vs placebo (-0.79%, -0.94%, -0.17%, respectively; p < 0.001). At week 52, canagliflozin 100 mg and 300 mg demonstrated non-inferiority, and canagliflozin 300 mg demonstrated statistical superiority, to sitagliptin in lowering HbA1c (-0.73%, -0.88%,-0.73%, respectively); differences (95% CI) vs sitagliptin were 0% (-0.12, 0.12) and -0.15% (-0.27, -0.03), respectively. Canagliflozin 100 mg and 300 mg reduced body weight vs placebo (week 26: -3.7%, -4.2%, -1.2%, respectively; p < 0.001) and sitagliptin (week 52: -3.8%, -4.2%, -1.3%, respectively; p < 0.001). Both canagliflozin doses reduced FPG and systolic BP vs placebo (week 26) and sitagliptin (week 52) (p < 0.001). Overall AE and AE-related discontinuation rates were generally similar across groups, but higher with canagliflozin 100 mg. Genital mycotic infection and osmotic diuresis-related AE rates were higher with canagliflozin; few led to discontinuations. Hypoglycaemia incidence was higher with canagliflozin. CONCLUSIONS/INTERPRETATION:Canagliflozin improved glycaemia and reduced body weight vs placebo (week 26) and sitagliptin (week 52) and was generally well tolerated in patients with type 2 diabetes on metformin. CLINICAL TRIAL REGISTRY:ClinicalTrials.gov NCT01106677 FUNDING: This study was supported by Janssen Research & Development, LLC.
    背景与目标:
  • 【制定和验证患者报告的医师文化能力衡量标准。】 复制标题 收藏 收藏
    DOI:10.1177/1077558706290946 复制DOI
    作者列表:Thom DH,Tirado MD
    BACKGROUND & AIMS: :While cultural competency is widely promoted, the lack of a measure of cultural competency limits our ability to evaluate interventions and to understand the effects of cultural competency on health care quality. Based on a conceptual framework of cultural competency derived from expert focus groups, we developed a patient-reported measure of physician culturally competent communication behaviors that we validated in a group of 429 adult primary-care patients with diabetes and/or hypertension and their 53 physicians. Construct validity was supported by a moderate association with both patient satisfaction (r = .32, p < .001) and patient trust (r = .53, p < .001). Predictive validity was supported by an association with a decrease in blood pressure among hypertensive patients (r = -.18; p < .05). This new measure may be useful in assessing levels of culturally competent provider behavior and investigating associations between provider cultural competency and health care processes and outcomes.
    背景与目标: : 尽管文化能力得到了广泛推广,但缺乏文化能力的衡量标准限制了我们评估干预措施和了解文化能力对医疗质量的影响的能力。基于来自专家焦点小组的文化能力概念框架,我们开发了一种患者报告的医生文化能力沟通行为的措施,我们在一组429名患有糖尿病和/或高血压的成人初级保健患者及其53名医生中进行了验证。结构效度与患者满意度 (r = 0.32,p <.001) 和患者信任 (r = 0.53,p <.001) 之间的中度关联支持。与高血压患者血压降低相关的预测效度得到支持 (r = -.18; p <.05)。这项新措施可能有助于评估具有文化能力的提供者行为水平,并调查提供者文化能力与医疗保健过程和结果之间的关联。
  • 【当存在较大背景脑活动时,一种用于MEG源重建的新型自适应波束形成器有效。】 复制标题 收藏 收藏
    DOI:10.1109/TBME.2006.878119 复制DOI
    作者列表:Sekihara K,Hild KE 2nd,Nagarajan SS
    BACKGROUND & AIMS: :This paper proposes a novel prewhitening eigenspace beamformer suitable for magnetoencephalogram (MEG) source reconstruction when large background brain activities exist. The prerequisite for the method is that control-state measurements, which contain only the contributions from the background interference, be available, and that the covariance matrix of the background interference can be obtained from such control-state measurements. The proposed method then uses this interference covariance matrix to remove the influence of the interference in the reconstruction obtained from the target measurements. A numerical example, as well as applications to two types of MEG data, demonstrates the effectiveness of the proposed method.
    背景与目标: : 本文提出了一种新型的预白化特征空间波束形成器,适用于存在大背景脑活动时的脑磁图 (MEG) 源重建。该方法的先决条件是仅包含来自背景干扰的贡献的控制状态测量是可用的,并且可以从这种控制状态测量中获得背景干扰的协方差矩阵。然后,所提出的方法使用此干扰协方差矩阵来消除从目标测量获得的重建中的干扰的影响。一个数值示例以及在两种类型的MEG数据中的应用证明了该方法的有效性。
  • 【更正: 晚期癌症患者中与健康相关的生活质量及其社会经济和文化预测因素: 来自印度海得拉巴的方法横断面调查的证据。】 复制标题 收藏 收藏
    DOI:10.1186/s12904-020-0519-1 复制DOI
    作者列表:Jacob J,Palat G,Verghese N,Kumari P,Rapelli V,Kumari S,Malhotra C,Teo I,Finkelstein E,Ozdemir S
    BACKGROUND & AIMS: :Following publication of the original article [1], the corresponding author reported an error on the name of the fourth author.
    背景与目标: : 在原始文章 [1] 发表后,通讯作者报告了第四作者的姓名错误。
  • 7 American Roma: A Cultural Care Case Study. 复制标题 收藏 收藏

    【美国罗姆人: 文化关怀案例研究。】 复制标题 收藏 收藏
    DOI:10.1177/1043659619899995 复制DOI
    作者列表:Ares TL
    BACKGROUND & AIMS: :This case study depicts the cultural conflict that occurred when an American Roma (Gypsy) woman delivered her baby at a small hospital that had no knowledge or experience with the Roma culture. The case is analyzed based on the three modes of nursing actions and decisions for culturally congruent nursing care, an important tenet of Leininger's culture care theory. Culture care preservation and maintenance efforts included enabling family presence, respecting the culture's moral code, and acknowledging child-rearing norms. Cultural care accommodation and negotiation focused on the patient's hospital room accommodation, negotiating adherence to identification and security measures, and formulating the discharge plan. Cultural care repatterning and restructuring was not attempted. Recommendations for nursing practice are made based on this case, migration trends, and recent cultural changes.
    背景与目标: : 此案例研究描述了一名美国罗姆人 (吉普赛) 妇女在一家对罗姆人文化没有知识或经验的小医院分娩时发生的文化冲突。根据Leininger文化护理理论的重要宗旨,基于文化一致护理的三种护理行动和决策模式对案例进行了分析。文化关怀的保护和维护工作包括使家庭存在,尊重文化的道德准则以及承认育儿规范。文化关怀的住宿和谈判重点是患者的病房住宿,协商对识别和安全措施的遵守,并制定出院计划。没有尝试对文化护理进行重组和重组。根据这种情况,迁移趋势和最近的文化变化提出了护理实践建议。
  • 【慢性病自我护理的跨文化评估: 一项心理测量评估。】 复制标题 收藏 收藏
    DOI:10.1016/j.ijnurstu.2019.103422 复制DOI
    作者列表:De Maria M,Matarese M,Strömberg A,Ausili D,Vellone E,Jaarsma T,Osokpo OH,Daus MM,Riegel B,Barbaranelli C
    BACKGROUND & AIMS: BACKGROUND:Self-care refers to behaviors that individuals adopt to prevent or maintain the stability of an illness (self-care maintenance), to monitor signs and symptoms (self-care monitoring), and to respond to signs and symptoms of an illness exacerbation (self-care management). A generic measure of self-care, the Self-Care of Chronic Illness Inventory, based on the Theory of Self-Care of Chronic Illness, was developed for use in individuals with any number and type of chronic conditions. OBJECTIVE:The current study investigated the measurement equivalence of the Self-Care of Chronic Illness Inventory in individuals from three different cultural groups. We were interested in determining if Italians, Swedes, and Americans interpret the measure in a conceptually similar way. METHODS:This cross-sectional study enrolled 1629 patients, 784 recruited in Italy, 438 in Sweden and 407 in the United States. Self-care (self-care maintenance, self-care monitoring and self-care management) was measured with the Self-Care of Chronic Illness Inventory. A multi-group confirmatory factor analytic approach was used to assess the equivalence of the measures across the three countries. Configural, metric, scalar and strict invariance were tested through a series of nested models where increasingly stringent equality constraints were posited. RESULTS:Participants were mostly males (56.3%), older adults (69.8%) and had at least two chronic conditions. Results indicated that three out of four measurement equivalence levels were partially or totally supported in all three of the Self-Care of Chronic Illness Inventory scales. The partial scalar invariance level was reached for self-care maintenance [χ2(50) = 63.495, p = 0.095; RMSEA = 0.022, p = 0.999, 90% CI = 0.000 0.038; CFI = 0.981; TLI = 0.977; SRMR = 0.036], self-care monitoring [χ2(22) = 28.770, p = 0.095; RMSEA = 0.024, p = 0.978, 90% CI = 0.000 0.046; CFI = 0.996; TLI = 0.995; SRMR = 0.054], and self-care management [χ2(51) = 91.334, p = 0.001; RMSEA = 0.048, p = 0.576, 90% CI = 0.031 0.063; CFI = 0.949; TLI = 0.937; SRMR = 0.047] scales. CONCLUSIONS:These findings suggest that patients in the three countries used an identical cognitive framework or mental model when responding and used the 1-5 Likert response scale in an almost identical way, almost without bias. In spite of sociocultural differences, patients in these countries seem to share the same fundamental view of self-care. The results of the Self-Care of Chronic Illness Inventory will be comparable in these countries.
    背景与目标:
  • 【背景强度的变化会影响非小细胞肺癌中基于PET的总肿瘤体积描绘: 对个体化信息的需求。】 复制标题 收藏 收藏
    DOI:10.1016/j.radonc.2013.08.033 复制DOI
    作者列表:Chen GH,Yao ZF,Fan XW,Zhang YJ,Gao HQ,Qian W,Wu KL,Jiang GL
    BACKGROUND & AIMS: PURPOSE:Efficient tumor volume delineation by the combined use of PET/CT scanning is necessary for the proper treatment of non-small cell lung cancer (NSCLC). To understand the effect of variation in background intensity on PET-based gross tumor volume (GTV) delineation, we determined the background standard uptake values (SUVs) in normal lung, aorta (blood pool), and liver tissues and determined GTVs using different methods. METHODS:Thirty-seven previously untreated patients with pathologically confirmed NSCLC underwent PET/CT scanning with (18)F-fluorodeoxyglucose ((18)F-FDG). To obtain (18)F-FDG uptake values in normal tissues, regions of interest in the lung lobes (left upper, left lower, right upper, right middle, and right lower), aorta, and liver zones (left, intermediate, and right) were measured. The coefficient of variation (CV) of the SUV was measured for each normal structure. The CT-based GTV (GTV(CT)) was considered as the standard to which all PET-based GTVs were compared, and the correlation coefficient was analyzed to compare GTV obtained by the various delineation methods. Linear and logarithmic regression analyses were used to determine the relationship between GTV(CT) and GTV(PET). RESULTS:Normal lung tissue showed a significantly lower SUV and less stability than tissue of the aorta or liver. For the lung, aorta, and liver, the maximum SUV (SUV(max)) was 0.82 ± 0.32, 2.35 ± 0.37, and 3.24 ± 0.50 (CV: 38.79%, 15.82%, and 15.30%) and average SUV (SUV(ave)) was 0.49 ± 0.18, 1.68 ± 0.32, and 2.34 ± 0.36 (CV: 36.38%, 18.92%, and 15.44%), respectively. The SUVs of the lung varied from lobe to lobe. The GTV delineation method using the SUV(ave) of the lung lobe in which the tumor was found as background in the source-to-background ratio (SBR) method showed the best correlation with the volume of CT-based GTV (r=0.81). CONCLUSIONS:Our results show vast variation in the SUV among normal tissues, as well as in the different lung lobes. The tumor volume delineated using the SBR method correlated well with the CT-based tumor volume. We conclude that it is reasonable and precise to contour GTV in patients with NSCLC after taking into account the background intensity of the lung lobe in which the tumor is found.
    背景与目标:
  • 【遗传背景改变了2型大麻素受体缺乏症对骨量和骨转换的影响。】 复制标题 收藏 收藏
    DOI:10.1007/s00223-013-9793-8 复制DOI
    作者列表:Sophocleous A,Idris AI,Ralston SH
    BACKGROUND & AIMS: :Cannabinoid receptors and their ligands play significant roles in regulating bone metabolism. Previous studies of type 1 cannabinoid receptor-deficient mice have shown that genetic background influences the skeletal phenotype. Here, we investigated the effects of genetic background on the skeletal phenotype of mice with type 2 cannabinoid receptor deficiency (Cnr2 (-/-)). We studied Cnr2 (-/-) mice on a CD1 background and compared the findings with those previously reported in Cnr2 (-/-) C57BL/6 mice. Young female Cnr2 (-/-) CD1 mice had low bone turnover and high trabecular bone mass compared with wild-type (WT), contrasting with the situation in Cnr2 (-/-) C57BL/6 mice where trabecular bone mass has been reported to be similar to WT. The Cnr2 (-/-) CD1 mice lost more trabecular bone at the tibia with age than WT due to reduced bone formation, and at 12 months there was no difference in trabecular bone volume between genotypes. This differs from the phenotype previously reported in C57BL/6 Cnr2 (-/-) mice, where bone turnover is increased and bone mass reduced with age. There were no substantial differences in skeletal phenotype between Cnr2 (-/-) and WT in male mice. Cortical bone phenotype was similar in Cnr2 (-/-) and WT mice of both genders. Deficiency of Cnr2 has site- and gender-specific effects on the skeleton, mainly affecting trabecular bone, which are influenced by genetic differences between mouse strains. Further evaluation of the pathways responsible might yield new insights into the mechanisms by which cannabinoid receptors regulate bone metabolism.
    背景与目标: 大麻素受体及其配体在调节骨代谢中起重要作用。先前对1型大麻素受体缺陷小鼠的研究表明,遗传背景会影响骨骼表型。在这里,我们研究了遗传背景对2型大麻素受体缺乏症 (Cnr2 (-/-)) 小鼠骨骼表型的影响。我们研究了CD1背景下的Cnr2 (-/-) 小鼠,并将发现与先前在Cnr2 (-/-) C57BL/6小鼠中报道的结果进行了比较。与野生型 (WT) 相比,年轻的雌性Cnr2 (-/-) CD1小鼠的骨转换低,小梁骨量高,与Cnr2 (-/-) C57BL/6小鼠的情况相反,据报道小梁骨量与WT相似。Cnr2 (-/-) CD1小鼠由于骨形成减少,随着年龄的增长,胫骨的小梁骨损失比WT多,并且在12个月时,基因型之间的小梁骨体积没有差异。这与先前在C57BL/6 Cnr2 (-/-) 小鼠中报道的表型不同,在C57BL/6 Cnr2 (-/-) 小鼠中,随着年龄的增长,骨量增加,骨量减少。在雄性小鼠中,Cnr2 (-/-) 和WT之间的骨骼表型没有实质性差异。两种性别的Cnr2 (-/-) 和WT小鼠的皮质骨表型相似。Cnr2缺乏对骨骼有位点和性别特异性影响,主要影响小梁骨,小梁骨受小鼠品系之间遗传差异的影响。对负责途径的进一步评估可能会对大麻素受体调节骨代谢的机制产生新的见解。
  • 【129背景的小鼠对鼠疫耶尔森菌的抗性映射到1号染色体上的多个基因座。】 复制标题 收藏 收藏
    DOI:10.1128/IAI.00488-16 复制DOI
    作者列表:Tencati M,Tapping RI
    BACKGROUND & AIMS: :Yersinia pestis is a Gram-negative bacterium that is the causative agent of bubonic and pneumonic plague. It is commonly acquired by mammals such as rodents and humans via the bite of an infected flea. We previously reported that multiple substrains of the 129 mouse background are resistant to pigmentation locus-negative (pgm(-)) Yersinia pestis and that this phenotype maps to a 30-centimorgan (cM) region located on chromosome 1. In this study, we have further delineated this plague resistance locus to a region of less than 20 cM through the creation and phenotyping of recombinant offspring arising from novel crossovers in this region. Furthermore, our experiments have revealed that there are at least two alleles in this initial locus, both of which are required for resistance on a susceptible C57BL/6 background. These two alleles work in trans since resistance is restored in offspring possessing one allele contributed by each parent. Our studies also indicated that the Slc11a1 gene (formerly known as Nramp1) located within the chromosome1 locus is not responsible for conferring resistance to 129 mice.
    背景与目标: 鼠疫耶尔森菌是一种革兰氏阴性细菌,是鼠疫和肺鼠疫的病原体。它通常是由啮齿动物和人类等哺乳动物通过被感染的跳蚤叮咬而获得的。我们先前报道了129小鼠背景的多个亚株对色素沉着位点阴性 (pgm(-)) 鼠疫耶尔森氏菌具有抗性,并且该表型映射到位于1号染色体上的30厘摩根 (cM) 区域。在这项研究中,我们通过在该区域产生新的交叉产生的重组后代的创建和表型分析,进一步将鼠疫抗性基因座描述为小于20 cM的区域。此外,我们的实验表明,在该初始基因座中至少存在两个等位基因,这两个等位基因都是易感C57BL/6背景上的抗性所必需的。这两个等位基因在反式中起作用,因为在每个亲本贡献一个等位基因的后代中恢复了抗性。我们的研究还表明,位于染色体1基因座内的Slc11a1基因 (以前称为Nramp1) 不负责赋予129小鼠抗性。
  • 【第四阶段开放标签可行性研究方案,研究HIV-1和非酒精性脂肪肝患者肝纤维化的非侵入性标志物,随机分配接受优化背景治疗 (OBT) 加maraviroc或OBT】 复制标题 收藏 收藏
    DOI:10.1136/bmjopen-2019-035596 复制DOI
    作者列表:Bradshaw D,Gilleece Y,Verma S,Abramowicz I,Bremner S,Perry N
    BACKGROUND & AIMS: INTRODUCTION:At least 30% of people living with HIV (PLWH) infection have non-alcoholic fatty liver disease (NAFLD), which has now become a leading cause of hepatic fibrosis and cirrhosis. Management is based largely on lifestyle modifications, which are difficult to achieve, and therapeutic options are urgently needed. Maraviroc (MVC), through antagonism of CCR5 receptors, may reduce hepatic fibrosis progression and could be an effective treatment for NAFLD. However, dosing is usually two times per day, unlike most currently recommended antiretroviral therapies. This study will investigate the feasibility and acceptability of addition of MVC to combination antiretroviral therapy in PLWH and NAFLD as a treatment for NAFLD. METHODS AND ANALYSIS:This is a phase IV, randomised, open-label, non-invasive feasibility study. Sixty individuals with well-controlled HIV-1 and NAFLD will be recruited from UK HIV clinics and randomised 1:1 to receive either optimised background therapy (OBT) plus MVC or OBT alone. Follow-up will be every 24 weeks for 96 weeks. The primary outcome measures will include recruitment and retention rates, adverse events and adherence. Secondary outcomes will include changes in markers of hepatic fibrosis, including the Enhanced Liver Fibrosis score, median liver stiffness measurement and controlled attenuation parameter scores on Fibroscan, and quality of life assessments. Analyses will be performed according to intention-to-treat principles. For secondary outcomes, estimated differences and 95% CIs between the groups using a t-method will be presented for continuous variables and as exact 95% binomial CIs for categorical variables. ETHICS AND DISSEMINATION:Ethical approval was obtained through the London Dulwich UK Research Ethics Committee (reference 17/LO/2093). Results will be disseminated both through community groups and peer-reviewed scientific literature.Trial registration number SRCTN31461655. EudraCT number 2017-004141-24; Pre-results.
    背景与目标:
  • 【镉本底浓度,以建立巴西圣保罗州土壤的参考质量值。】 复制标题 收藏 收藏
    DOI:10.1007/s10661-013-3462-2 复制DOI
    作者列表:de Oliveira VH,de Abreu CA,Coelho RM,Melo LC
    BACKGROUND & AIMS: :Proper assessment of soil cadmium (Cd) concentrations is essential to establish legislative limits. The present study aimed to assess background Cd concentrations in soils from the state of São Paulo, Brazil, and to correlate such concentrations with several soil attributes. The topsoil samples (n = 191) were assessed for total Cd contents and for other metals using the USEPA 3051A method. The background concentration was determined according to the third quartile (75th). Principal component analysis, Spearman correlation, and multiple regressions between Cd contents and other soil attributes (pH, cation exchange capacity (CEC), clay content, sum of bases, organic matter, and total Fe, Al, Zn, and Pb levels) were performed. The mean Cd concentration of all 191 samples was 0.4 mg kg(-1), and the background concentration was 0.5 mg kg(-1). After the samples were grouped by parent material (rock origin) and soil type, the background Cd content varied, i.e., soils from igneous, metamorphic, and sedimentary rocks harbored 1.5, 0.4, and 0.2 mg kg(-1) of Cd, respectively. The background Cd content in Oxisols (0.8 mg kg(-1)) was higher than in Ultisols (0.3 mg kg(-1)). Multiple regression demonstrated that Fe was primarily attributed to the natural Cd contents in the soils (R (2) = 0.79). Instead of a single Cd background concentration value representing all São Paulo soils, we propose that the concentrations should be specific for at least Oxisols and Ultisols, which are the primary soil types.
    背景与目标: : 正确评估土壤镉 (Cd) 浓度对于建立立法限制至关重要。本研究旨在评估巴西圣保罗州土壤中的背景Cd浓度,并将这些浓度与几种土壤属性相关联。使用USEPA 3051A方法评估表土样品 (n   =   191) 的总Cd含量和其他金属含量。根据第三个四分位数 (第75个) 确定背景浓度。进行了主成分分析,Spearman相关性以及Cd含量与其他土壤属性 (pH,阳离子交换能力 (CEC),粘土含量,碱,有机质和总Fe,Al,Zn和Pb含量) 之间的多元回归。所有191样品的平均Cd浓度为0.4 mg kg(-1),背景浓度为0.5 mg kg(-1)。根据母体材料 (岩石来源) 和土壤类型对样品进行分组后,背景Cd含量变化,即来自火成岩,变质岩和沉积岩的土壤分别藏有1.5,0.4和0.2 mg kg(-1) 的Cd,分别。背景Cd在Oxisols (0.8 mg kg(-1)) 中的含量高于在Ultisols (0.3 mg kg(-1)) 中的含量。多元回归表明,Fe主要归因于土壤中的天然Cd含量 (R (2)  =   0.79)。代替代表所有圣保罗土壤的单个Cd本底浓度值,我们建议该浓度应至少针对主要土壤类型的oxisol和ultisol特定。
  • 【老龄化的文化问题,特别是在性别和代际公平方面。】 复制标题 收藏 收藏
    DOI:10.1016/0277-9536(96)00113-x 复制DOI
    作者列表:Henrard JC
    BACKGROUND & AIMS: :The absence of old age as a specific social group in some cultures raises the question of ageing as a cultural construction. In this paper we will consider only problems of cultural ageing in industrial Western society and especially in some OECD countries. There, demographic changes have been characterised by ageing of populations, visible since the fifties, by feminization of later life and modifications of social network. Ageing of population including the oldest generations have made definitions of later life more politicized and have gone together with new attitudes towards ageing and elderly people giving rise to different patterns of ageism. Examination of incomes, health status, social support of the elderly shows that until today there have been persistent inequalities related to age, gender and social class in terms of resources, access to informal and formal care and value accorded to later life. These inequalities are due to differences in status and resources of elderly and trajectories of ageing, always conditioned by social locations: position in labour market and in domestic division of labour with resulting social relations. The differences vary also between countries according to their welfare regime and their social policy. In the future, the proportion of those over 65 of age and among them of those ever 80 will be greater raises the questions of health status of the oldest generations, income distribution among generations and genders, of access to informal and formal care and adequacy of the later for the frail elderly. To cope with those issues ageing and later life should be considered in a life-span perspective. Better sharing of jobs and of economic wealth, development of meaningful activities other than work may be solutions to answer to the questions addressed by an ageing population and the problems of later life.
    背景与目标: : 在某些文化中没有老年人作为特定的社会群体,这就提出了老龄化作为一种文化建设的问题。在本文中,我们将仅考虑西方工业社会,尤其是某些经合组织国家的文化老龄化问题。在那里,人口变化的特征是人口老龄化,自五十年代以来可见,后来的生活女性化和社会网络的改变。包括最古老的几代人在内的人口老龄化使人们对以后生活的定义更加政治化,并与对老龄化和老年人的新态度一起产生了不同的年龄歧视模式。对老年人的收入,健康状况,社会支持的检查表明,直到今天,在资源,获得非正式和正式护理的机会以及对以后生活的价值方面,与年龄,性别和社会阶层有关的不平等现象一直存在。这些不平等是由于老年人的地位和资源的差异以及老龄化的轨迹,总是受到社会位置的制约: 劳动力市场的地位和家庭分工以及由此产生的社会关系。各国之间的差异也因其福利制度和社会政策而异。将来,年龄在65岁以上的人以及其中80岁以上的人的比例将会增加,这将引起以下问题: 最古老的几代人的健康状况,几代人之间和性别之间的收入分配,获得非正式和正式护理的机会以及身体虚弱的老年人的适当性。为了应对这些问题,应该从寿命的角度考虑衰老和晚年生活。更好地分享工作和经济财富,开展除工作以外的有意义的活动可能是解决人口老龄化和晚年问题的办法。
  • 【文化框架、生活品质和衰老的自我。】 复制标题 收藏 收藏
    DOI:10.1177/0193945913507635 复制DOI
    作者列表:Low G,Molzahn A,Kalfoss M
    BACKGROUND & AIMS: :We used the Self-Concept Enhancement Tactician (SCENT) model to explore whether older Norwegians and Canadians would tactically self-enhance on qualities considered significant within their cultures in their self-perceptions of aging. Qualities were measured using the WHOQOL-BREF and WHOQOL-OLD. Self-perceptions of aging were measured by the Attitudes to Aging Questionnaire. The study is a secondary analysis of data collected in a larger study; 393 older Norwegians and 202 older Canadians were included. The Norwegian and Canadian group self-enhanced their perceptions of psychosocial loss based on harmonious social relationships and being part of a larger social group. For self-perceptions of physical change, both groups self-enhanced on being self-sufficient and being part of a larger social group. Our findings suggest that Norwegians and Canadians are not highly individualistic people and also provide evidence of a bicultural self-perception of aging. Nurses should consider how cultural and individual perspectives affect the care priorities of older people.
    背景与目标: : 我们使用自我概念增强战术家 (气味) 模型来探索年龄较大的挪威人和加拿大人是否会在战术上自我增强其文化内在对衰老的自我认知中被认为具有重要意义的素质。使用WHOQOL-BREF和WHOQOL-OLD测量质量。通过对衰老的态度问卷来衡量对衰老的自我认知。该研究是对更大研究中收集的数据的二次分析; 包括393名挪威老年人和202名加拿大老年人。挪威和加拿大团体基于和谐的社会关系并成为更大的社会群体的一部分,自我增强了他们对社会心理损失的看法。对于身体变化的自我感知,这两个群体都可以自给自足并成为更大的社会群体的一部分。我们的发现表明,挪威人和加拿大人不是高度个人主义的人,并且还提供了对衰老的双文化自我感知的证据。护士应考虑文化和个人观点如何影响老年人的护理重点。

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