Long-term effect

长期效果
  • 文章类型: Journal Article
    已经记录了几种手术技术来接近和修复上半规管裂开综合征(SCDS)。这些技术包括跨中颅窝,乳突,内窥镜入路,和圆窗加固(RWR)。RWR需要放置有或没有软骨的结缔组织,并围绕圆窗小生境,限制圆窗的移动,以最小化第三窗口效应,并将骨迷宫恢复到更接近其正常状态。我们采用了多层RWR技术,2例患者术后明显改善,效果持续3.7年。这里,我们提出了临床发现,外科手术,和多层RWR的有效性。该技术由于其高效性,可以作为SCDS手术治疗的初始选择,更持久的效果,和最小的手术并发症的风险。
    Several surgical techniques have been documented for approaching and repairing superior semicircular canal dehiscence syndrome (SCDS). These techniques encompass the trans-middle cranial fossa, transmastoid, endoscopic approaches, and round window reinforcement (RWR). RWR entails the placement of connective tissue with or without cartilage and around the round window niche, restricting the round window\'s movement to minimize the 3rd window effect and restore the bony labyrinth closer to its normal state. We employed the multilayer RWR technique, resulting in significant postoperative improvement and long-lasting effects for 3.7 years in 2 cases. Here, we present the clinical findings, surgical procedures, and the effectiveness of multilayer RWR. This technique can be the initial choice for surgical treatments of SCDS due to its high effectiveness, longer-lasting effect, and minimal risk of surgical complications.
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  • 文章类型: Journal Article
    背景:我们的研究旨在揭示裸盖菇素(PSI)治疗难治性抑郁症(TRD)的特殊功效背后的未知机制。关注具有TRD表型的Wistar-Kyoto(WKY)大鼠和Wistar(WIS)大鼠作为规范比较,我们调查了对PSI的行为和神经可塑性相关反应,努力揭示其抗抑郁作用的独特特征。
    目的:我们着手评估急性和长期PSI给药对WKY和WIS大鼠的行为影响,采用新型物体识别(NORT),社会互动(SI),强迫游泳测试(FST)。我们的次要目标涉及探索神经可塑性相关参数的应变特异性改变,包括脑源性神经营养因子(BDNF)和活性调节细胞骨架相关蛋白(Arc)。
    方法:在单次PSI给药后进行急性和长期评估,我们应用行为测试和生化分析来测量血清BDNF水平和前额叶皮质神经可塑性相关参数.进行统计分析以辨别大鼠品系之间的显着差异,并评估PSI对行为和生化结果的影响。
    结果:我们的发现揭示了WKY和WIS大鼠之间的显著行为差异,表明前者的被动行为和社会退缩。PSI在这两个菌株中都表现出明显的亲社会和抗抑郁作用,每个都有其独特的时间轨迹。值得注意的是,我们确定了BDNF相关信号的菌株特异性变异,并观察了WKY大鼠Arc表达的调节。
    结论:我们的研究描绘了WKY和WIS大鼠品系之间的情绪相关行为细微差别,强调两组中PSI的抗抑郁药和亲社会特性。观察到的变化的不同时间模式和确定的菌株特异性神经可塑性改变提供了对TRD表型和支持PSI功效的机制的有价值的见解。
    BACKGROUND: Our study aimed to unravel the unknown mechanisms behind the exceptional efficacy of Psilocybin (PSI) in treating treatment-resistant depression (TRD). Focusing on Wistar-Kyoto (WKY) rats with a TRD phenotype and Wistar (WIS) rats as a normative comparison, we investigated behavioral and neuroplasticity-related responses to PSI, striving to shed light on the distinctive features of its antidepressant effects.
    OBJECTIVE: We set out to assess the behavioral impact of acute and prolonged PSI administration on WKY and WIS rats, employing Novel Object Recognition (NORT), Social Interaction (SI), and Forced Swimming Test (FST). Our secondary objectives involved exploring strain-specific alterations in neuroplasticity-related parameters, including brain-derived neurotrophic factor (BDNF) and activity-regulated cytoskeleton-associated protein (Arc).
    METHODS: Conducting post-acute and extended assessments after a single PSI administration, we applied behavioral tests and biochemical analyses to measure serum BDNF levels and neuroplasticity-related parameters in the prefrontal cortex. Statistical analyses were deployed to discern significant differences between the rat strains and assess the impact of PSI on behavioral and biochemical outcomes.
    RESULTS: Our findings uncovered significant behavioral disparities between WKY and WIS rats, indicating passive behavior and social withdrawal in the former. PSI demonstrated pronounced pro-social and antidepressant effects in both strains, each with its distinctive temporal trajectory. Notably, we identified strain-specific variations in BDNF-related signaling and observed the modulation of Arc expression in WKY rats.
    CONCLUSIONS: Our study delineated mood-related behavioral nuances between WKY and WIS rat strains, underscoring the antidepressant and pro-social properties of PSI in both groups. The distinct temporal patterns of observed changes and the identified strain-specific neuroplasticity alterations provide valuable insights into the TRD phenotype and the mechanisms underpinning the efficacy of PSI.
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  • 文章类型: Journal Article
    背景:长期暴露于颗粒物(PM)与来自大人群队列的全部位癌症死亡率之间潜在因果关系的证据仍然有限,并且传统统计方法存在残留的混杂问题。
    目的:我们的目的是利用因果推断方法研究中国南方长期PM暴露与全部位癌症死亡率之间的潜在因果关系。
    方法:我们使用了中国南方的一个队列,从2009年到2015年招募了580,757名参与者,并跟踪到2020年。使用经过验证的时空模型生成了PM1,PM2.5和PM10浓度的年平均值。我们采用了因果推断方法,边际结构Cox模型,基于观察性数据评估长期暴露于PM与全部位癌症死亡率之间的关联.
    结果:随着PM1,PM2.5和PM10的增加1µg/m3,所有部位癌症的风险比(HR)和95%置信区间(CI)为1.033(95%CI:1.025-1.041),1.032(95%CI:1.027-1.038),和1.020(95%CI:1.016-1.025),分别。与PM1每增加1µg/m3相关的消化系统和呼吸系统癌症死亡率的HR(95%CI)为1.022(1.009-1.035)和1.053(1.038-1.068),分别。此外,不活跃的参与者,从不吸烟的人,或者居住在周围绿色度较低的地区的人更容易受到PM暴露的影响,全部位癌症死亡率的HR(95%CI)为1.042(1.031-1.053),1.041(1.032-1.050),和1.0473(1.025-1.070),分别为PM1每增加1µg/m3。PM1的影响在低暴露组中比在一般人群中更明显,多重敏感性分析证实了结果的稳健性。
    结论:这项研究提供了证据,表明长期暴露于PM可能会增加所有部位癌症死亡的风险,强调改善空气质量对预防癌症的潜在健康益处。
    BACKGROUND: Evidence of a potential causal link between long-term exposure to particulate matter (PM) and all-site cancer mortality from large population cohorts remained limited and suffered from residual confounding issues with traditional statistical methods.
    OBJECTIVE: We aimed to examine the potential causal relationship between long-term PM exposure and all-site cancer mortality in South China using causal inference methods.
    METHODS: We used a cohort in southern China that recruited 580,757 participants from 2009 through 2015 and tracked until 2020. Annual averages of PM1, PM2.5, and PM10 concentrations were generated with validated spatiotemporal models. We employed a causal inference approach, the Marginal Structural Cox model, based on observational data to evaluate the association between long-term exposure to PM and all-site cancer mortality.
    RESULTS: With an increase of 1 µg/m³ in PM1, PM2.5, and PM10, the hazard ratios (HRs) and 95% confidence interval (CI) for all-site cancer were 1.033 (95% CI: 1.025-1.041), 1.032 (95% CI: 1.027-1.038), and 1.020 (95% CI: 1.016-1.025), respectively. The HRs (95% CI) for digestive system and respiratory system cancer mortality associated with each 1 µg/m³ increase in PM1 were 1.022 (1.009-1.035) and 1.053 (1.038-1.068), respectively. In addition, inactive participants, who never smoked, or who lived in areas of low surrounding greenness were more susceptible to the effects of PM exposure, the HRs (95% CI) for all-site cancer mortality were 1.042 (1.031-1.053), 1.041 (1.032-1.050), and 1.0473 (1.025-1.070) for every 1 µg/m³ increase in PM1, respectively. The effect of PM1 tended to be more pronounced in the low-exposure group than in the general population, and multiple sensitivity analyses confirmed the robustness of the results.
    CONCLUSIONS: This study provided evidence that long-term exposure to PM may elevate the risk of all-site cancer mortality, emphasizing the potential health benefits of improving air quality for cancer prevention.
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  • 文章类型: Journal Article
    这个随机的,双盲,实验研究调查了每天锻炼前补充四周的效果(200毫克咖啡因,3.3g肌酸一水合物,3.2gβ-丙氨酸,6克瓜氨酸苹果酸,和5gBCAA)与安慰剂(等热量麦芽糊精)在厌氧(跳跃,冲刺,敏捷性,和基于运行的无氧冲刺测试:RAST)和有氧(Yo-Yo间歇恢复测试1级)性能,以及在赛季中训练有素的篮球运动员的身体成分和选择性肌肉损伤/与健康相关的血液标记。篮球运动员18名(年龄:24.4±6.3岁,身高:185.7±8.0厘米,重量:85.7±12.8kg,体脂:16.5±4.2%)被随机分为两组:锻炼前补充剂(PWS,n=10)或安慰剂(PL,n=8)。与PL相比,PWS消耗增加了有氧性能(PWS:8±6%;PL:-2±6%;p=0.004)。峰显著下降(F=7.0;p=0.017),平均值(F=10.7;p=0.005),和最小功率(F=5.1;p=0.039)补充4周后,两组。组间无其他显著变化(p>0.05)。总之,当前PWS在四个星期内的消耗似乎对赛季中训练有素的篮球运动员的有氧表现产生了积极影响。然而,它似乎并不能减轻观察到的无氧功率下降,也不影响跳跃的表现,冲刺,和敏捷性,或改变身体成分或选择性肌肉损伤/健康相关的血液标记。
    This randomized, double-blinded, experimental study investigated the effects of a four-week daily pre-workout supplementation (200 mg caffeine, 3.3 g creatine monohydrate, 3.2 g β-alanine, 6 g citrulline malate, and 5 g BCAA) vs. placebo (isocaloric maltodextrin) on anaerobic (jumping, sprinting, agility, and the running-based anaerobic sprint test: RAST) and aerobic (Yo-Yo intermittent recovery test level 1) performance, as well as on body composition and selective muscle damage/health-related blood markers in well-trained basketball players during the in-season period. Eighteen basketball players (age: 24.4 ± 6.3 years, height: 185.7 ± 8.0 cm, weight: 85.7 ± 12.8 kg, body fat: 16.5 ± 4.2%) were randomly assigned into two groups: pre-workout supplement (PWS, n = 10) or placebo (PL, n = 8). PWS consumption increased aerobic performance (PWS: 8 ± 6%; PL: -2 ± 6%; p = 0.004) compared to PL. A significant decrease was observed in peak (F = 7.0; p = 0.017), average (F = 10.7; p = 0.005), and minimum power (F = 5.1; p = 0.039) following 4 weeks of supplementation in both groups. No other significant changes were observed between groups (p > 0.05). In conclusion, the consumption of the current PWS over a four-week period appears to positively influence the aerobic performance of well-trained basketball players during the in-season period. However, it does not appear to mitigate the observed decline in anaerobic power, nor does it affect performance in jumping, sprinting, and agility, or alter body composition or selective muscle damage/health-related blood markers.
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  • 文章类型: Journal Article
    背景:对于药物治疗难以治疗的重度过敏性鼻炎(AR)患者,建议进行手术治疗。鼻内镜下鼻后神经切除术(PNN)主要用于改善重度常年性AR的鼻漏,然而,缺乏对其长期预后的研究。
    目的:本研究旨在探讨PNN的长期预后。
    方法:在PNN后至少1年对17名患者(12名男性和5名女性)进行问卷调查。鼻部症状和药物治疗,以及调查时患者对手术的满意度,得分了。此外,比较术后时间>5年和<5年的患者的评分。
    结果:手术后鼻部症状和药物评分明显改善。术后>5年和<5年的患者术前和术后鼻部症状和药物评分均无显著差异。患者对手术的满意度与术后时间无相关性。
    结论:PNN改善了重度常年性AR患者的鼻部症状和药物评分。此外,研究结果表明,PNN对常年AR的长期作用持续>5年。J.Med.投资。71:62-65,二月,2024.
    BACKGROUND: Surgical treatment is recommended for patients with severe allergic rhinitis (AR) refractory to medical treatment. Endoscopic posterior nasal neurectomy (PNN) is primarily performed to improve rhinorrhea in severe perennial AR, however studies on its long-term prognosis are lacking.
    OBJECTIVE: This study aimed to investigate the long-term prognosis of PNN.
    METHODS: A questionnaire survey was administered to 17 patients (12 men and 5 women) at least 1 year after PNN. Nasal symptoms and medications, as well as patient satisfaction with surgery at the time of survey, were scored. Furthermore, scores were compared between patients with postoperative periods of >5 years and <5 years.
    RESULTS: Nasal symptoms and medication scores significantly improved after surgery. There was no significant difference between patients with a postoperative period of >5 years and <5 years in both preoperative and postoperative nasal symptoms and medication scores. No correlation was found between patient satisfaction with surgery and postoperative period.
    CONCLUSIONS: PNN improved nasal symptoms and medication scores in patients with severe perennial AR. Furthermore, the study results suggest that the long-term effect of PNN for perennial AR lasts for >5 years. J. Med. Invest. 71 : 62-65, February, 2024.
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  • 文章类型: Journal Article
    背景:2013年ACC/AHA指南是脂质管理的范式转变,并确定了四个他汀类药物获益组。许多人研究了该指南的潜在影响,但很少有人调查它对MACE的潜在长期影响。此外,大多数研究也忽略了2011年12月阿托伐他汀较早释放的混杂效应.
    方法:为了评估2013年11月在美国发布的2013年ACC/AHA指南的潜在(长期)影响,我们调查了2013年ACC/AHA指南与5年MACE生存率和其他三个他汀类药物相关结局趋势变化的相关性(他汀类药物使用,最佳使用他汀类药物,和他汀类药物依从性),同时使用中断时间序列分析控制通用阿托伐他汀的可用性,称之为周氏测试。具体来说,我们进行了一项回顾性研究,使用美国全国范围内的去识别索赔和OptumLabs数据库仓库(OLDW)的电子健康记录,追踪2013年ACC/AHA指南中确定的4个他汀类药物获益组的5年MACE生存率和他汀类药物相关结局的趋势.然后,Chow检验用于辨别通用阿托伐他汀可用性和指南潜在影响之间的趋势变化。
    结果:纳入197,021例患者(ASCVD:19,060;高LDL:33,907;糖尿病:138,159;高ASCVD风险:5,895)。准则发布后,糖尿病组5年MACE生存率的长期趋势(斜率)显著改善(P=0.002).ASCVD组的最佳他汀类药物使用也显示出释放后的立即改善(截距)和长期积极变化(斜率)(P<0.001)。在所有他汀类药物获益组中,他汀类药物的使用没有显著的趋势变化,他汀类药物的依从性保持不变。尽管没有发现其他统计上显著的趋势变化,2013年ACC/AHA指南发布后,观察到总体正趋势变化或无变化.
    结论:2013年ACA/AHA指南的发布与糖尿病组的长期MACE生存率和ASCVD组的最佳他汀类药物使用的趋势改善有关。这些显著关联可能表明2013年ACA/AHA指南对一级预防组更好的健康结果具有潜在的积极长期影响,并对高风险组的他汀类药物处方行为具有直接的潜在影响。然而,需要进一步调查以确认2013年ACA/AHA指南的因果效应.
    BACKGROUND: The 2013 ACC/AHA Guideline was a paradigm shift in lipid management and identified the four statin-benefit groups. Many have studied the guideline\'s potential impact, but few have investigated its potential long-term impact on MACE. Furthermore, most studies also ignored the confounding effect from the earlier release of generic atorvastatin in Dec 2011.
    METHODS: To evaluate the potential (long-term) impact of the 2013 ACC/AHA Guideline release in Nov 2013 in the U.S., we investigated the association of the 2013 ACC/AHA Guideline with the trend changes in 5-Year MACE survival and three other statin-related outcomes (statin use, optimal statin use, and statin adherence) while controlling for generic atorvastatin availability using interrupted time series analysis, called the Chow\'s test. Specifically, we conducted a retrospective study using U.S. nationwide de-identified claims and electronic health records from Optum Labs Database Warehouse (OLDW) to follow the trends of 5-Year MACE survival and statin-related outcomes among four statin-benefit groups that were identified in the 2013 ACC/AHA Guideline. Then, Chow\'s test was used to discern trend changes between generic atorvastatin availability and guideline potential impact.
    RESULTS: 197,021 patients were included (ASCVD: 19,060; High-LDL: 33,907; Diabetes: 138,159; High-ASCVD-Risk: 5,895). After the guideline release, the long-term trend (slope) of 5-Year MACE Survival for the Diabetes group improved significantly (P = 0.002). Optimal statin use for the ASCVD group also showed immediate improvement (intercept) and long-term positive changes (slope) after the release (P < 0.001). Statin uses did not have significant trend changes and statin adherence remained unchanged in all statin-benefit groups. Although no other statistically significant trend changes were found, overall positive trend change or no changes were observed after the 2013 ACC/AHA Guideline release.
    CONCLUSIONS: The 2013 ACA/AHA Guideline release is associated with trend improvements in the long-term MACE Survival for Diabetes group and optimal statin use for ASCVD group. These significant associations might indicate a potential positive long-term impact of the 2013 ACA/AHA Guideline on better health outcomes for primary prevention groups and an immediate potential impact on statin prescribing behaviors in higher-at-risk groups. However, further investigation is required to confirm the causal effect of the 2013 ACA/AHA Guideline.
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  • 文章类型: Journal Article
    目的:本研究旨在探讨中国青少年暴露于地震对晚年认知功能的长期影响。
    方法:数据来自2015年中国健康与退休纵向研究(CHARLS)。我们的分析样本包括来自1937年至1966年出生的两个出生队列的4394名49至78岁的参与者:青春期暴露队列(1952年至1966年出生),和青春期非暴露队列(1937年至1951年出生)。我们将地震暴露定义为1976年唐山大地震(GTE)的暴露严重程度。我们选择社区环境特征作为我们的主要主持人。采用差异差异(DID)方法来评估GTE对晚年认知功能的长期影响。
    结果:我们发现青春期暴露于地震会导致后期认知功能得分更高(男性:β=2.18;95%CI:0.70-3.66;女性:β=1.22;95%CI:0.11-2.33)。对于男性来说,这种影响受到社区环境特征的影响,包括老年津贴计划(β=3.07;95%CI:1.94-4.19)和基本社区基础设施状况(β=1.52;95%CI:0.84-2.19)。
    结论:我们的研究支持创伤后成长理论。这一发现表明,需要关注早期生活创伤暴露的个体。此外,改善社区基础设施的条件和建立一个舒适和安全的社区环境对于促进认知功能和创伤后成长可能非常重要。
    OBJECTIVE: This study aimed to explore the long-term impacts of exposure to earthquake in adolescence on later-life cognitive function in China.
    METHODS: Data were from the 2015 China Health and Retirement Longitudinal Study (CHARLS). Our analytical sample comprised 4394 participants aged 49 to 78 from two birth cohorts born between 1937 and 1966: exposed cohort during adolescence (born between 1952 and 1966), and non-exposed cohort during adolescence (born between 1937 and 1951). We defined earthquake exposure as the exposure severity of the 1976 Great Tangshan Earthquake (GTE). We selected community environmental characteristics as our key moderators. A difference-in-differences (DID) method was employed to estimate the long-term impact of the GTE on later-life cognitive function.
    RESULTS: We found that exposure to the earthquake during adolescence resulted in higher scores of later-life cognitive function (for males: β = 2.18; 95% CI: 0.70-3.66; for females: β = 1.22; 95% CI: 0.11-2.33). For males, this impact was moderated by community environmental characteristics including the old-age allowance program (β = 3.07; 95% CI: 1.94-4.19) and the condition of basic community infrastructures (β = 1.52; 95% CI: 0.84-2.19).
    CONCLUSIONS: Our study supports the post-traumatic growth theory. This finding suggest that individuals with early-life traumatic exposure need to be focused on. Additionally, improving the conditions of community infrastructures and establishing a community environment with comfort and security may be pretty important for promoting cognitive function and post-traumatic growth.
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  • 文章类型: Journal Article
    尽管先前的研究表明颗粒物的健康风险增加,很少有人评估超细颗粒(UFP或PM0.1,直径≤0.1µm)的长期健康影响。这项研究评估了纽约州(NYS)长期暴露于UFP与死亡率之间的关系。包括非意外和特定原因的总死亡率,社会人口统计学差异和季节性趋势。从全面的化学运输模型和NYSVitalRecords中收集数据,我们使用四分位距(IQR)和高水平UFP(≥75%百分位数)作为与死亡率相关的指标.我们修改后的差异模型对其他污染物进行了控制,气象因素,时空混杂因素。研究结果表明,长期UFP暴露会显著增加非意外死亡率的风险(RR=1.10,95%CI:1.05,1.17),心血管死亡率(RR=1.11,95%CI:1.05,1.18),特别是脑血管疾病(RR=1.21,95%CI:1.10,1.35)和肺心病(RR=1.33,95%CI:1.13,1.57),和呼吸道死亡率(临界意义,RR=1.09,95%CI:1.00,1.18)。西班牙裔(RR=1.13,95%CI:1.00,1.29)和非西班牙裔黑人(RR=1.40,95%CI:1.16,1.68)在暴露于UFP后经历了显着更高的死亡风险,与非西班牙裔白人相比。五岁以下的儿童,老年人,非纽约市居民,冬季更容易受到UFP的影响。
    Although previous studies have shown increased health risks of particulate matters, few have evaluated the long-term health impacts of ultrafine particles (UFPs or PM0.1, ≤ 0.1 µm in diameter). This study assessed the association between long-term exposure to UFPs and mortality in New York State (NYS), including total non-accidental and cause-specific mortalities, sociodemographic disparities and seasonal trends. Collecting data from a comprehensive chemical transport model and NYS Vital Records, we used the interquartile range (IQR) and high-level UFPs (≥75 % percentile) as indicators to link with mortalities. Our modified difference-in-difference model controlled for other pollutants, meteorological factors, spatial and temporal confounders. The findings indicate that long-term UFPs exposure significantly increases the risk of non-accidental mortality (RR=1.10, 95 % CI: 1.05, 1.17), cardiovascular mortality (RR=1.11, 95 % CI: 1.05, 1.18) particularly for cerebrovascular (RR=1.21, 95 % CI: 1.10, 1.35) and pulmonary heart diseases (RR=1.33, 95 % CI: 1.13, 1.57), and respiratory mortality (borderline significance, RR=1.09, 95 % CI: 1.00, 1.18). Hispanics (RR=1.13, 95 % CI: 1.00, 1.29) and non-Hispanic Blacks (RR=1.40, 95 % CI: 1.16, 1.68) experienced significantly higher mortality risk after exposure to UFPs, compared to non-Hispanic Whites. Children under five, older adults, non-NYC residents, and winter seasons are more susceptible to UFPs\' effects.
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  • 文章类型: Journal Article
    在我们的研究中,我们使用催眠后的建议,即容易记住,以提高记忆力和持久的效果。我们在一项在线研究中测试了24名高度受暗示的参与者。参与者学习了单词列表,并在以后的识别记忆任务中回忆它们。在研究开始时,参与者被催眠,容易记忆的催眠后建议与参与者在识别记忆任务中使用的提示相关.在控制条件下,相同的参与者使用中性提示。一周后,参与者用新的单词列表重复了这两个条件。与对照条件相比,在容易记住的条件下,参与者的识别等级明显更快,更有信心,这种效果持续了一周以上。至关重要的是,提高的速度和对容易记忆状态的信心并不影响记忆准确性.这使得我们的催眠干预对经历主观记忆障碍的患者有希望。APAPSYCINFO代码:2343(学习和记忆),2380(意识状态),3351(临床催眠)。
    In our study, we use the post-hypnotic suggestion of easy remembering to improve memory with long-lasting effects. We tested 24 highly suggestible participants in an online study. Participants learned word lists and recalled them later in a recognition memory task. At the beginning of the study, participants were hypnotized and the post-hypnotic suggestion to remember easily was associated with a cue that participants used during the recognition memory task. In a control condition, the same participants used a neutral cue. One week later, participants repeated both conditions with new word lists. Participants were significantly faster and more confident in their recognition ratings in the easy-remembering condition compared to the control condition, and this effect persisted over one week. Crucially, the increased speed and confidence in the easy-remembering condition did not affect memory accuracy. That makes our hypnosis intervention promising for patients experiencing subjective memory impairments. APA PSYCINFO CODES: 2343 (Learning and Memory), 2380 (Consciousness States), 3351 (Clinical Hypnosis).
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  • 文章类型: Journal Article
    背景:二十一世纪日益复杂的患者护理是由跨专业的医疗保健团队提供的。跨专业合作可以在跨专业教育中教授。然而,是否可以通过跨专业教育来实现合作能力的长期变化尚未得到充分研究。我们的研究问题是:跨专业教育干预后一年内,跨专业合作和跨专业合作技能的动机如何变化?它们如何相互关联?
    方法:在一年期间,本科医学和护理学生参加了四个跨专业(干预)或单专业(对照组)教育课程。以自决理论为理论框架。使用学业自我调节问卷计算跨专业合作的自主和受控动机分数,之前(T1),直接后(T2)和干预后一年(T3)。在T3,学生还填写了跨专业协作能力实现情况调查(ICCAS),通过回顾性测试前/测试后设计来衡量协作能力的感知成就。我们使用线性混合效应模型来分析动机得分,并对动机与能力之间的关系进行线性回归。
    结果:在跨专业组中,参与者的自主动机得分在T2明显较低。T1.控制动机得分在T3明显高于T1.在单职业组中,T2的受控动机得分显着高于跨职业组。感知能力与较高的自主动机得分有关。在T3,跨专业小组的学生之间的跨专业协作能力似乎有所增长。
    结论:在干预后,跨专业协作能力的增长至少持续了一年,并且可以通过ICCAS进行衡量。IPE学生的增长明显高于UPE学生。在跨专业合作的动机得分中发现的少数差异可能是由于不同时间点的护生与医学生的不平衡所致。这一发现表明,基于课堂的IPE可以在干预后至少长达一年的时间内促进护理和医学生的跨专业协作技能。
    BACKGROUND: The increasingly complex patient care in the twenty-first century is delivered by interprofessional health care teams. Interprofessional collaboration can be taught during interprofessional education. However, whether a long-term change in collaborative competencies can be achieved by interprofessional education has not been studied sufficiently. Our research questions were: How does motivation for interprofessional collaboration and interprofessional collaborative skills change up to one year after an interprofessional educational intervention? How are they related to each other?
    METHODS: During a one-year period, undergraduate medical and nursing students attended four interprofessional (intervention) or uniprofessional (control group) education sessions. Self-determination Theory was used as the theoretical framework. Autonomous and controlled motivation scores for interprofessional collaboration were calculated using the Academic Self-Regulation Questionnaire, before (T1), directly after (T2) and one year post-intervention (T3). At T3, the students also filled out the Interprofessional Collaborative Competencies Attainment Survey (ICCAS), which measured the perceived attainment of collaborative competencies by a retrospective pre-test/post-test design. We used linear mixed effects models to analyse the motivation scores and linear regression for the relation between motivation and competence.
    RESULTS: In the interprofessional group, autonomous motivation scores of the participants were significantly lower at T2 vs. T1. Controlled motivation scores were significantly higher at T3 vs. T1. Controlled motivation scores for T2 were significantly higher in the uniprofessional group than in the interprofessional group. Perceived competence was related to higher autonomous motivation scores. At T3 the interprofessional collaborative competencies seemed to have grown more among students in the interprofessional group.
    CONCLUSIONS: The perceived growth in interprofessional collaboration competence lasted at least up to one year after the intervention, and was measurable with the ICCAS. The growth was significantly more in the IPE students than in the UPE students. The few differences found in motivation scores for interprofessional collaboration were probably caused by an imbalance of nursing versus medical students over the different time points. This finding indicates that classroom based IPE can contribute to interprofessional collaboration skills of nursing and medical students at least up to one year after an intervention.
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