Behavior

行为
  • 文章类型: Journal Article
    我们旨在根据COSMIN和GRADE指南验证CMPS-SF。四名经过培训的评估人员评估了52只狗的208个视频(术前M1,疼痛峰值M2,疼痛和镇痛峰值后1小时(救援)-M3和拔管后24小时-M4),分为阴性对照(n=10),软组织手术(n=22),和骨科手术(n=20)。这些视频是随机的,并且对它们的拍摄时间一无所知,分两个阶段进行评估,相隔21天根据验证性分析,CMPS-SF是一维尺度。观察者内部可靠性在0.80和0.99之间,观察者之间的可靠性在0.73和0.86之间。CMPS-SF与其他一维量表(≥0.7)之间的相关性证实了标准的有效性。得分之间的差异是M2≥M3>M4>M1(反应性),并且该量表具有结构效度(手术犬术后疼痛评分高于对照组)。内部稠度为0.7(克朗巴赫α)和0.77(麦当劳ω),除“A(ii)-注意伤口”外,项目总相关性在0.3和0.7之间。特异性和敏感性分别为78-87%和74-83%,分别。排除项目B(iii)的活动性,抢救镇痛的截止点为≥5或≥4,等级分类很高,确认量表的有效性。
    We aimed to validate the CMPS-SF according to COSMIN and GRADE guidelines. Four trained evaluators assessed 208 videos (pre-operative-M1, peak of pain-M2, 1 h after the peak of pain and analgesia (rescue)-M3, and 24 h post-extubation-M4) of 52 dogs, divided into negative controls (n = 10), soft tissue surgeries (n = 22), and orthopedic surgeries (n = 20). The videos were randomized and blinded as to when they were filmed, and were evaluated in two stages, 21 days apart. According to confirmatory analysis, the CMPS-SF is a unidimensional scale. Intra-observer reliability was between 0.80 and 0.99 and inter-observer reliability between 0.73 and 0.86. Criterion validity was confirmed by the correlation between the CMPS-SF and other unidimensional scales (≥0.7). The differences between the scores were M2 ≥ M3 > M4 > M1 (responsiveness), and the scale presented construct validity (higher postoperative pain scores in dogs undergoing surgery versus control). Internal consistency was 0.7 (Cronbach\'s α) and 0.77 (McDonald\'s ω), and the item-total correlation was between 0.3 and 0.7, except for \"A(ii)-Attention to wound\". Specificity and sensitivity were 78-87% and 74-83%, respectively. The cut-off point for rescue analgesia was ≥5 or ≥4 excluding item B(iii) mobility, and the GRADE classification was high, confirming the validity of the scale.
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  • 文章类型: Journal Article
    背景:提供临床指南的智能手机应用程序等移动健康平台无处不在,然而,它们对指南依从性的长期影响尚不清楚.2016年,抗生素指南应用程序,叫做SCRIPT,是在奥克兰市医院介绍的,新西兰,在智能手机上向临床医生提供当地抗生素指南。
    目的:我们旨在评估在智能手机应用中提供抗生素指南是否导致处方者对抗生素指南依从性的持续改变。
    方法:我们使用中断的时间序列研究分析了被诊断患有社区获得性肺炎的成年人在入院的前24小时内的抗生素指南依从率(即,3、12和24个月)。
    结果:依从性从基线时的23%(46/200)增加到3个月时的31%(73/237)和12个月时的34%(69/200),在应用实施后24个月减少到31%(62/200)(P=.07与基线相比)。然而,在X线检查时,肺实变患者的依从性持续增加(基线时9/63,14%;3个月后23/77,30%;12个月后32/92,35%;24个月后32/102,31%;与基线相比P=.04).
    结论:抗生素指南应用程序提高了总体依从性,但这并没有持续下去。在肺实变患者中,坚持的增加是持续的。
    Mobile health platforms like smartphone apps that provide clinical guidelines are ubiquitous, yet their long-term impact on guideline adherence remains unclear. In 2016, an antibiotic guidelines app, called SCRIPT, was introduced in Auckland City Hospital, New Zealand, to provide local antibiotic guidelines to clinicians on their smartphones.
    We aimed to assess whether the provision of antibiotic guidelines in a smartphone app resulted in sustained changes in antibiotic guideline adherence by prescribers.
    We analyzed antibiotic guideline adherence rates during the first 24 hours of hospital admission in adults diagnosed with community-acquired pneumonia using an interrupted time-series study with 3 distinct periods post app implementation (ie, 3, 12, and 24 months).
    Adherence increased from 23% (46/200) at baseline to 31% (73/237) at 3 months and 34% (69/200) at 12 months, reducing to 31% (62/200) at 24 months post app implementation (P=.07 vs baseline). However, increased adherence was sustained in patients with pulmonary consolidation on x-ray (9/63, 14% at baseline; 23/77, 30% after 3 months; 32/92, 35% after 12 month; and 32/102, 31% after 24 months; P=.04 vs baseline).
    An antibiotic guidelines app increased overall adherence, but this was not sustained. In patients with pulmonary consolidation, the increased adherence was sustained.
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  • 文章类型: Journal Article
    在COVID-19大流行期间,在遵守CDC建议的健康和安全指南方面,不同人群的选择行为存在不一致.目前的研究旨在确定儿童时期经历的父母教养方式与CDCCOVID-19健康指导的意见/行动之间可能存在的相关性。对大学生进行了一项旨在衡量童年经历的自我报告调查,父子关系,和COVID-19大流行行为。认同独裁育儿的参与者在COVID行为衡量标准上得分更高,表明与确定为权威父母的参与者相比,依从性更高。此外,观察到COVID行为测量的性别和种族类别差异。具体来说,在COVID行为测量中,非裔美国人/黑人参与者的得分高于白人或其他种族识别参与者。最后,在COVID行为测量中,被认定为非洲裔美国人/黑人或其他种族的女性得分高于被认定为非洲裔美国人/黑人或其他种族的男性。这些发现开始阐明一些变量,这些变量可能在遵守健康指南的选择行为中起作用。对这些变量的进一步调查可以告诉我们在选择行为中起什么作用,以及在向公众传达有关健康指南的信息时如何更好地整合这些知识。
    During the COVID-19 pandemic, there has been inconsistency in choice behavior across people with regards to compliance with health and safety guidelines suggested by the CDC. The current study aimed to identify a possible correlation between parenting style experienced during childhood and opinions/actions regarding CDC COVID-19 health guidance. College students were given a self-report survey aimed to measure childhood experience, parent-child relationship, and COVID-19 pandemic behavior. Participants that identified with Authoritarian parenting scored higher on the COVID Behavior measure, indicating a higher degree of compliance compared to participants that identified with Authoritative parenting. Additionally, gender and race category differences on the COVID Behavior measure were observed. Specifically, African American/Black participants scored higher than White or Other race identifying participants on the COVID Behavior measure. Lastly, females identifying as African American/Black or Other race scored higher than males identifying as African American/Black or Other race on the COVID Behavior measure. These findings begin to illuminate some of the variables that might play a role in choice behavior with regard to compliance to health guidelines. Further investigation into these variables could inform us about what plays a role in choice behavior and how better to integrate this knowledge when messaging the public about health guidelines.
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  • 文章类型: Journal Article
    The Canadian 24-Hour Movement Guidelines for Children and Youth (\"Guidelines\") not only pioneered the notion of an integrated movement continuum from sleep to vigorous-intensity physical activity but also introduced a new branded Guideline visual identity.
    This study evaluated youths\' (N = 46) attention to and thoughts about the Guidelines and the brand.
    A cross-sectional between-participants randomized intervention design was used.
    Canadian youth between 10 and 17 years of age comprised the study sample.
    Participants were randomly assigned to view either branded Guidelines (n = 26) or unbranded Guidelines (n = 20). Youths\' eye-movements (e.g., dwell time, fixation count) were recorded during Guideline viewing. Participants completed a follow-up survey assessing brand perceptions and Guideline cognitions.
    The branded Guidelines neither drew greater overall attention nor led to more positive brand perceptions or Guideline cognitions compared to the unbranded Guidelines.
    Exploratory analyses provide valuable, yet preliminary insight into how branding and Guideline content may shape how Guidelines are perceived and acted upon. These findings inform an agenda for future health education resources.
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  • 文章类型: Journal Article
    自从新型冠状病毒病(COVID-19)爆发以来,政府提供了感染控制指南,以防止病毒传播。这项研究的作者研究了影响公众对COVID-19行为的因素的结构(因果关系),并验证了公众对每个结构中感染控制指南的同理心的影响。数据是通过对211名韩国成年人的自我管理问卷调查收集的。结果表明:(1)感知的经济损害易感性和严重程度对感染预防态度有积极影响,感染预防态度对感染预防行为有积极影响;(2)感知的经济损害严重程度对感染预防态度有积极影响;(3)公众对感染控制指南的共情积极调节了感知的经济损失严重程度对感染预防行为的影响以及感知的易感性对感染预防态度的影响。因此,这项研究的作者提出了以下三个建议,以防止传染病的传播:从事风险沟通,重点是潜在的病毒感染和合作,作出多方面的努力,以增加公众对感染控制指南的同情,并采取措施减轻或减少病毒大流行对公众的经济损失。
    Since the outbreak of the novel coronavirus disease (COVID-19), the government has provided infection-control guidelines to prevent the spread of the virus. The authors of this study examined the structure (causal relationship) of factors that influence public behavior toward COVID-19 and verified the effect of public empathy with infection-control guidelines in each structure. Data were collected using a self-administered questionnaire survey from 211 Korean adults. The results showed that (1) the perceived susceptibility and severity of economic damage had a positive effect on infection-prevention attitudes and infection-prevention attitudes had a positive effect on infection-prevention behaviors; (2) the perceived severity of economic damage had a positive effect on infection-prevention attitudes; and (3) public empathy with infection-control guidelines positively moderated the effect of the perceived severity of economic damage on infection-prevention behaviors and that of perceived susceptibility on infection-prevention attitudes. Accordingly, the authors of this study present the following three suggestions to prevent the spread of an infectious disease: engage in risk communication focused on a potential virus infection and cooperation, make multifaceted efforts to increase public empathy with infection-control guidelines, and implement measures to alleviate or reduce economic damage to the public in a viral pandemic.
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  • 文章类型: Journal Article
    Prader-Willi综合征(PWS)是一种罕见的神经发育遗传疾病,与特征性行为表型相关,包括严重的饮食过度和各种其他行为挑战,如脾气暴躁和焦虑。这些行为对PWS患者及其家人的日常功能和生活质量具有重大而戏剧性的影响。迄今为止,解决这些行为挑战的有效疗法已被证明是难以捉摸的,但是几种潜在的治疗方法即将出现。然而,PWS治疗研究的一个限制因素是在如何最好地定义和测量该综合征复杂和相互关联的行为特征方面缺乏共识.国际PWS临床试验联盟(PWS-CTC,www.pwsctc.org)包括专业的PWS科学家,临床医生,患者倡导组织代表专注于促进这种罕见疾病的临床试验。为了解决上述领域的差距,PWS-CTC“行为结果工作组”的成员试图对PWS的关键行为特征形成统一的理解,并就其定义和描述达成共识。本文的主要重点是提出对关键表型PWS行为的共识定义和描述,包括饮食过度,脾气暴躁,焦虑,强迫性行为,刚性,和社会认知缺陷。提供患者插图以说明这些行为的相互关联性和影响。我们还回顾了一些可用的评估工具以及正在开发的新工具,这些工具可能有助于测量PWS中的这些行为特征。
    Prader-Willi syndrome (PWS) is a rare neurodevelopmental genetic disorder associated with a characteristic behavioral phenotype that includes severe hyperphagia and a variety of other behavioral challenges such as temper outbursts and anxiety. These behaviors have a significant and dramatic impact on the daily functioning and quality of life for the person with PWS and their families. To date, effective therapies addressing these behavioral challenges have proven elusive, but several potential treatments are on the horizon. However, a limiting factor for treatment studies in PWS is the lack of consensus in the field regarding how to best define and measure the complex and interrelated behavioral features of this syndrome. The International PWS Clinical Trials Consortium (PWS-CTC, www.pwsctc.org ) includes expert PWS scientists, clinicians, and patient advocacy organization representatives focused on facilitating clinical trials in this rare disease. To address the above gap in the field, members of the PWS-CTC \"Behavior Outcomes Working Group\" sought to develop a unified understanding of the key behavioral features in PWS and build a consensus regarding their definition and description. The primary focus of this paper is to present consensus definitions and descriptions of key phenotypic PWS behaviors including hyperphagia, temper outbursts, anxiety, obsessive-compulsive behaviors, rigidity, and social cognition deficits. Patient vignettes are provided to illustrate the interrelatedness and impact of these behaviors. We also review some available assessment tools as well as new instruments in development which may be useful in measuring these behavioral features in PWS.
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  • 文章类型: Journal Article
    随着在行为动物中定义的神经回路中以高时空分辨率记录和操纵活动的工具的出现,行为神经科学现在的任务是建立实施和解释这些强大方法的全领域标准。构成基本神经生物学原理证明的理论框架是一个持续且经常辩论的话题。另一方面,对个别实验结果的标准化解释,以避免在实践中的虚假结论,受到的关注较少。即使在子域中,类似的分析经常被用来支持广泛不同的结论,这在一定程度上促成了大量的研究,声称细胞类型和电路的功能非常明确,而这些功能通常彼此直接不一致。在这篇评论文章中,我们讨论了在有动机行为的动物模型中记录或操纵神经活动的方法的设计和解释中的常见陷阱。我们强调在多种行为分析中整合发现的重要性,并伴随着对特殊神经元功能的温和推断,作为解析行为电路控制的标准化起点。我们的目标是激发文献中的开放和可访问的话语,以解决行为神经科学中的连续性问题。
    With the advent of tools for recording and manipulating activity with high spatiotemporal resolution in defined neural circuits in behaving animals, behavioral neuroscience is now tasked with establishing field-wide standards for implementing and interpreting these powerful approaches. Theoretical frameworks for what constitute proof of fundamental neurobiological principles is an ongoing and frequently debated topic. On the other hand, standardizing interpretation of individual experimental findings to avoid spurious conclusions in practice has received less attention. Even within subfields, similar assays are often used to support widely disparate conclusions which in part has contributed to a slew of studies claiming highly specified functions for cell types and circuits which are often in direct disagreement with one another. In this opinion piece, we discuss common pitfalls in design and interpretation of approaches for recording or manipulating neural activity in animal models of motivated behavior. We emphasize the importance of integrating findings across multiple behavioral assays concomitant with tempered inference regarding specialized neuronal functions as a standardized starting point for parsing circuit control of behavior. Our aim is to stimulate an open and accessible discourse in the literature to address issues of continuity across behavioral neurosciences.
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  • 文章类型: Journal Article
    准则,由猫科动物临床医学专家组成的工作组撰写,是2010年发布的AAFP-AAHA猫科动物生命阶段指南的更新和扩展。该指南同时发表在《猫医学和外科杂志》(第23卷,第3期,第211-233页,DOI:10.1177/1098612X21993657)和《美国动物医院协会杂志》(第57卷,第2期,第51-72页,DOI:10.5326/JAHA-MS-7189)上。与早期指南相比,一个值得注意的变化是将猫的寿命分为五个阶段,有四个不同的年龄相关阶段(小猫,年轻的成年人,成熟的成年人,和高级)以及生命终结阶段,而不是前六个。这种简化的分组与宠物主人通常如何看待他们的猫的成熟和衰老过程是一致的,并为不断发展的,个性化,终身猫保健战略。该指南包括有关猫科动物健康访问的组成部分的全面表格,该表格为系统地实施猫科动物的个性化生命阶段方法提供了框架。包括管理与猫的生命阶段有关的最关键的健康相关因素的建议。这些建议在以下类别中进一步解释:行为和环境需求;消除;生命阶段营养和体重管理;口腔健康;寄生虫控制;疫苗接种;人畜共患病和人类安全;以及基于生命阶段的推荐诊断。关于克服猫主人对兽医访问的障碍的讨论提供了关于提供常规猫科动物医疗保健的最具挑战性的方面之一的实用建议。
    The guidelines, authored by a Task Force of experts in feline clinical medicine, are an update and extension of the AAFP-AAHA Feline Life Stage Guidelines published in 2010. The guidelines are published simultaneously in the Journal of Feline Medicine and Surgery (volume 23, issue 3, pages 211-233, DOI: 10.1177/1098612X21993657) and the Journal of the American Animal Hospital Association (volume 57, issue 2, pages 51-72, DOI: 10.5326/JAAHA-MS-7189). A noteworthy change from the earlier guidelines is the division of the cat\'s lifespan into a five-stage grouping with four distinct age-related stages (kitten, young adult, mature adult, and senior) as well as an end-of-life stage, instead of the previous six. This simplified grouping is consistent with how pet owners generally perceive their cat\'s maturation and aging process, and provides a readily understood basis for an evolving, individualized, lifelong feline healthcare strategy. The guidelines include a comprehensive table on the components of a feline wellness visit that provides a framework for systematically implementing an individualized life stage approach to feline healthcare. Included are recommendations for managing the most critical health-related factors in relation to a cat\'s life stage. These recommendations are further explained in the following categories: behavior and environmental needs; elimination; life stage nutrition and weight management; oral health; parasite control; vaccination; zoonoses and human safety; and recommended diagnostics based on life stage. A discussion on overcoming barriers to veterinary visits by cat owners offers practical advice on one of the most challenging aspects of delivering regular feline healthcare.
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  • 文章类型: Journal Article
    BACKGROUND: In 2018, an estimated 228 million cases of malaria occurred worldwide. Countries are far from having achieved reasonable levels of national protocol compliance among health workers. Lack of awareness of treatment protocols and treatment resistance by prescribers threatens to undermine progress when it comes to reducing the prevalence of this disease. This study sought to evaluate the degree of knowledge and practices regarding malaria diagnosis and treatment amongst prescribers working at the public health facilities of Bata, Equatorial Guinea.
    METHODS: A cross-sectional survey was conducted in October-December 2017 amongst all public health professionals who attended patients under the age of 15 years, with suspected malaria in the Bata District of Equatorial Guinea. Practitioners were asked about their practices and knowledge of malaria and the National Malaria Treatment Guidelines. A bivariate analysis and a logistic regression model were used to determine factors associated with their knowledge.
    RESULTS: Among the 44 practitioners interviewed, 59.1% worked at a Health Centre and 40.9% at the District Hospital of Bata. Important differences in knowledge and practices between hospital and health centre workers were found. Clinical diagnosis was more frequently by practitioners at the health centres (p = 0.059), while microscopy confirmation was more frequent at regional hospital (100%). Intramuscular artemether was the anti-malarial most administrated at the health centres (50.0%), while artemether-lumefantrine was the treatment most used at the regional hospital (66.7%). Most practitioners working at public health facilities (63.6%) have a low level of knowledge regarding the National Malaria Treatment Guidelines. While knowledge regarding malaria, the National Malaria Treatment Guidelines and treatment resistances is low, it was higher amongst hospital workers than amongst practitioners at health centres.
    CONCLUSIONS: It is essential to reinforce practitioners\' knowledge, treatment and diagnosis practices and use of the National Malaria Treatment Guidelines in order to improve malaria case management and disease control in the region. A specific malaria training programme ensuring ongoing updates training is necessary in order to ensure that greater experience does not entail obsolete knowledge and, consequently, inadequate diagnosis and treatment practices.
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  • 文章类型: Journal Article
    认知障碍是阿尔茨海默病(AD)和相关痴呆的标志。然而,运动衰退最近被描述为一种前驱状态,可以帮助检测有风险的个体。同样,感官变化,睡眠和行为障碍,和虚弱与患痴呆症的风险更高有关。这些临床发现,再加上人们认识到AD病理学比诊断早了很多年,提高了非认知变化可能是AD的早期和非侵入性标志物的可能性,更具有挑衅性,治疗非认知方面可能有助于预防或治疗AD和相关痴呆。
    加拿大痴呆症诊断和治疗共识会议的一个小组委员会审查了痴呆症非认知标志物的新兴证据领域。我们检查了与未来痴呆症相关的五个非认知领域的文献:运动,感官(听觉,愿景,嗅觉),神经行为,脆弱,和睡眠。建议评估的分级,发展,并使用评估系统来分配证据的强度和建议的质量。我们向初级保健诊所和专门的记忆诊所提供建议,回答以下主要问题:(1)与患痴呆症风险相关的非认知和功能变化是什么?(2)感官,电机,行为,睡眠,和虚弱标记可以作为痴呆的潜在预测因子?
    证据支持步态速度,双任务步态速度,握力,脆弱,神经精神症状,睡眠措施,听力损失是痴呆的预测因子.没有足够的证据建议评估嗅觉和视力障碍作为痴呆的预测因子。
    非认知标记可以帮助识别有认知能力下降或痴呆风险的人。这些非认知标记可能代表前驱症状,其中一些可能适合于可能延迟认知下降发作的治疗。
    BACKGROUND: Cognitive impairment is the hallmark of Alzheimer\'s disease (AD) and related dementias. However, motor decline has been recently described as a prodromal state that can help to detect at-risk individuals. Similarly, sensory changes, sleep and behavior disturbances, and frailty have been associated with higher risk of developing dementia. These clinical findings, together with the recognition that AD pathology precedes the diagnosis by many years, raises the possibility that non-cognitive changes may be early and non-invasive markers for AD or, even more provocatively, that treating non-cognitive aspects may help to prevent or treat AD and related dementias.
    METHODS: A subcommittee of the Canadian Consensus Conference on Diagnosis and Treatment of Dementia reviewed areas of emerging evidence for non-cognitive markers of dementia. We examined the literature for five non-cognitive domains associated with future dementia: motor, sensory (hearing, vision, olfaction), neuro-behavioral, frailty, and sleep. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assign the strength of the evidence and quality of the recommendations. We provide recommendations to primary care clinics and to specialized memory clinics, answering the following main questions: (1) What are the non-cognitive and functional changes associated with risk of developing dementia? and (2) What is the evidence that sensory, motor, behavioral, sleep, and frailty markers can serve as potential predictors of dementia?
    RESULTS: Evidence supported that gait speed, dual-task gait speed, grip strength, frailty, neuropsychiatric symptoms, sleep measures, and hearing loss are predictors of dementia. There was insufficient evidence for recommending assessing olfactory and vision impairments as a predictor of dementia.
    CONCLUSIONS: Non-cognitive markers can assist in identifying people at risk for cognitive decline or dementia. These non-cognitive markers may represent prodromal symptoms and several of them are potentially amenable to treatment that might delay the onset of cognitive decline.
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