cognitive disorders

认知障碍
  • 文章类型: Journal Article
    在过去的几年里,越来越多的解剖学证据,生理,和功能神经影像学研究越来越表明,小脑积极参与管理高阶认知功能和调节情绪反应。很明显,当儿童经历先天性或获得性小脑病变时,这些伤害会导致各种认知和情绪障碍,表现为不同的组合。这强调了小脑不仅在整个发育阶段,而且特别是在促进学习过程中的重要作用。突出了它与电机控制传统关联之外的关键重要性。此外,小脑内复杂的神经回路被认为有助于微调运动动作和协调,但也越来越认识到它们参与认知过程,如注意力,语言,和解决问题。最近的研究强调了小脑健康和完整性对于人类经验各个领域的最佳功能的重要性。
    Over the last several years, a growing body of evidence from anatomical, physiological, and functional neuroimaging studies has increasingly indicated that the cerebellum is actively involved in managing higher order cognitive functions and regulating emotional responses. It has become clear that when children experience congenital or acquired cerebellar lesions, these injuries can lead to a variety of cognitive and emotional disorders, manifesting in different combinations. This underscores the cerebellum\'s essential role not only throughout developmental stages but particularly in facilitating learning processes, highlighting its critical importance beyond its traditional association with motor control. Furthermore, the intricate neural circuits within the cerebellum are believed to contribute to the fine-tuning of motor actions and coordination but are also increasingly recognized for their involvement in cognitive processes such as attention, language, and problem solving. Recent research has highlighted the importance of cerebellar health and integrity for optimal functioning across various domains of the human experience.
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  • 文章类型: Journal Article
    空气污染是全球发病率和死亡率的重要因素,并与痴呆症风险增加有关。瑞典北部Betula队列中的先前研究表明,空气污染与痴呆症之间存在关联,以及与对照组相比,痴呆症患者独特的代谢组学特征。这项研究旨在调查空气污染是否与该队列中代谢物水平的定量变化有关,以及未来的痴呆状态是否会改变这种关联。
    使用高空间分辨率模型和实测数据对短期和长期暴露于空气污染进行了评估。分别分析了汽车尾气和木烟对空气的污染。对321名参与者进行了代谢组学分析,包括58份来自痴呆患者的血清样本和一个年龄相匹配的对照组,性别,和教育水平,使用核磁共振波谱。
    在任何代谢物与任何短期或长期暴露于空气污染的措施之间没有发现统计学上的显着关联。然而,有趋势可能提示长期和短期空气污染暴露与乳酸和葡萄糖代谢产物之间存在关联.值得注意的是,尽管该队列中长期和短期空气污染暴露之间缺乏相关性,但仍观察到了这些关联.在参与者中,木烟造成的空气污染之间的关联也有趋势,这些参与者后来会发展为痴呆症,表明取决于城市/农村因素的潜在影响。
    虽然没有发现明显的关联,数据中观察到的趋势表明,空气污染暴露与乳酸和葡萄糖代谢产物的变化之间存在潜在的联系。这些发现为低暴露环境中空气污染与代谢标志物之间的联系提供了一些新的见解。然而,解决现有的局限性对于提高该领域未来研究的鲁棒性和适用性至关重要。后来患上痴呆症的参与者的明显关联可能表明城市/农村因素的影响,保证进一步调查。
    UNASSIGNED: Air pollution is a significant contributor to morbidity and mortality globally and has been linked to an increased risk of dementia. Previous studies within the Betula cohort in Northern Sweden have demonstrated associations between air pollution and dementia, as well as distinctive metabolomic profiles in dementia patients compared to controls. This study aimed to investigate whether air pollution is associated with quantitative changes in metabolite levels within this cohort, and whether future dementia status would modify this association.
    UNASSIGNED: Both short-term and long-term exposure to air pollution were evaluated using high spatial resolution models and measured data. Air pollution from vehicle exhaust and woodsmoke were analyzed separately. Metabolomic profiling was conducted on 321 participants, including 58 serum samples from dementia patients and a control group matched for age, sex, and education level, using nuclear magnetic resonance spectroscopy.
    UNASSIGNED: No statistically significant associations were found between any metabolites and any measures of short-term or long-term exposure to air pollution. However, there were trends potentially suggesting associations between both long-term and short-term exposure to air pollution with lactate and glucose metabolites. Notably, these associations were observed despite the lack of correlation between long-term and short-term air pollution exposure in this cohort. There were also tendencies for associations between air pollution from woodsmoke to be more pronounced in participants that would later develop dementia, suggesting a potential effect depending on urban/rural factors.
    UNASSIGNED: While no significant associations were found, the trends observed in the data suggest potential links between air pollution exposure and changes in lactate and glucose metabolites. These findings provide some new insights into the link between air pollution and metabolic markers in a low-exposure setting. However, addressing existing limitations is crucial to improve the robustness and applicability of future research in this area. The pronounced associations in participants who later developed dementia may indicate an influence of urban/rural factors, warranting further investigation.
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  • 文章类型: Journal Article
    镉(Cd)引起的神经毒性由于其对中枢神经系统的潜在不利影响而日益受到关注。Cd是一种释放到环境中的重金属,通过几个工业过程。污染空气会对社区的健康造成威胁,水,和土壤。镉在大脑和其他神经组织中积累,由于其延长的生物半衰期,引起人们对其对神经系统的影响的担忧。Cd可以进入神经元,因此增加了活性氧(ROS)的产生,并损害了它们的抗氧化防御能力。Cd破坏神经元中的钙(Ca2+)平衡,影响线粒体的功能,并触发细胞死亡途径。由于这些途径,许多受环境因素影响的神经系统疾病的发展路径,尤其是Cd,如阿尔茨海默病(AD)和肌萎缩侧索硬化症(ALS)。存在与长期暴露于Cd相关的认知缺陷。记忆障碍存在于动物和人类中。Cd在关键时期改变了大脑的功能和性能。在关键的大脑发育阶段,Cd暴露会造成终身后果。与各种危险因素的相互作用增加了对神经毒性作用的易感性。Cd对神经元功能和行为构成风险,可能导致神经退行性疾病,如帕金森病(PD)和AD以及认知问题。本文对Cd引起的神经毒性进行了全面的概述,包括风险评估,不利影响水平,照亮错综复杂的道路。
    Cadmium (Cd) induced neurotoxicity has become a growing concern due to its potential adverse effects on the Central Nervous System. Cd is a Heavy Metal (HM) that is released into the environment, through several industrial processes. It poses a risk to the health of the community by polluting air, water, and soil. Cd builds up in the brain and other neural tissues, raising concerns about its effect on the nervous system due to its prolonged biological half-life. Cd can enter into the neurons, hence increasing the production of Reactive Oxygen Species (ROS) in them and impairing their antioxidant defenses. Cd disrupts the Calcium (Ca2+) balance in neurons, affects the function of the mitochondria, and triggers cell death pathways. As a result of these pathways, the path to the development of many neurological diseases affected by environmental factors, especially Cd, such as Alzheimer\'s Disease (AD) and Amyotrophic Lateral Sclerosis (ALS) is facilitated. There are cognitive deficits associated with long exposure to Cd. Memory disorders are present in both animals and humans. Cd alters the brain\'s function and performance in critical periods. There are lifelong consequences of Cd exposure during critical brain development stages. The susceptibility to neurotoxic effects is increased by interactions with a variety of risk factors. Cd poses risks to neuronal function and behavior, potentially contributing to neurodegenerative diseases like Parkinson\'s disease (PD) and AD as well as cognitive issues. This article offers a comprehensive overview of Cd-induced neurotoxicity, encompassing risk assessment, adverse effect levels, and illuminating intricate pathways.
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  • 文章类型: Journal Article
    神经炎症是涉及多种中枢神经系统(CNS)疾病的过程,并且越来越被认为是认知障碍的关键介质。神经炎症反应,包括神经胶质激活,促炎细胞因子的产生增加,和异常的神经元信号,导致认知功能障碍。组胺是一种关键的外周炎症介质,但在神经炎症过程中也起着重要作用。组胺H3受体(H3R)在CNS中的独特定位以及通过其对非组胺能神经元上的异质受体的作用来调节其他神经递质的释放,已导致多种H3R配体的发展用于各种脑疾病。H3R拮抗剂/反向激动剂已显示出治疗多种神经炎性中枢神经系统疾病的潜力,包括神经退行性疾病,注意缺陷多动综合征和精神分裂症。在这个迷你评论中,我们简要概述了组胺能传递在这些认知障碍的神经炎症过程中的关键参与,特别关注H3R的参与。本文讨论了单靶向和多靶向H3R拮抗剂/反向激动剂治疗这些疾病的抗神经炎潜力。
    Neuroinflammation is a process involved in a variety of central nervous system (CNS) diseases and is being increasingly recognized as a key mediator of cognitive impairments. Neuroinflammatory responses including glial activation, increased production of proinflammatory cytokines, and aberrant neuronal signaling, contribute to cognitive dysfunctions. Histamine is a key peripheral inflammatory mediator, but plays an important role in neuroinflammatory processes as well. The unique localization of histamine H3 receptor (H3R) in the CNS along with the modulation of the release of other neurotransmitters via its action on heteroreceptors on non-histaminergic neurons have led to the development of several H3R ligands for various brain diseases. H3R antagonists/ inverse agonists have revealed potential to treat diverse neuroinflammatory CNS disorders, including neurodegenerative diseases, attention-deficit hyperactivity syndrome and schizophrenia. In this mini review, we provide a brief overview on the crucial involvement of the histaminergic transmission in the neuroinflammatory processes underlying these cognitive disorders, with a special focus on H3R involvement. The anti-neuroinflammatory potential of single-targeted and multi-targeted H3R antagonists/inverse agonists for the treatment of these conditions is discussed here.
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  • 文章类型: Journal Article
    了解日常生活活动的绩效和生活质量对于管理决策和研究终点很重要。使用统一的量表对于客观评估护理人员和路易体痴呆患者至关重要。与阿尔茨海默病相比,路易体痴呆患者的功能和生活质量受到的损害更大。主要是由于路易体痴呆的行为症状和运动表现的患病率较高。需要更多的纵向研究来评估因果关系是否介导了这些患者的临床特征与功能独立性和生活质量恶化的关联。
    Knowledge of performance in activities of daily living and quality of life is important for management decisions and research endpoints. The use of harmonized scales is essential for objective assessment of both caregivers and patients with dementia with Lewy bodies. Functionality and quality of life are more impaired in dementia with Lewy bodies than in Alzheimer\'s disease, mostly due to higher prevalence of behavioral symptoms and motor manifestations in dementia with Lewy bodies. More longitudinal studies are required to assess if causality mediates the associations of clinical features with functional independence and worsened quality of life in these patients.
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  • 文章类型: Case Reports
    韦尼克脑病(WE)是一种罕见的,威胁生命的情况下,硫胺素缺乏导致Kreb的周期功能障碍,乳酸在脑组织中的积累,和不可逆的认知障碍。用IV硫胺素迅速处理可以逆转该过程。经典的韦尼克共济失调三合会,内存问题,眼异常并不经常出现。凯恩的标准,这需要以下两个:饮食不足,眼部异常,认知或精神状态改变,和小脑功能障碍,对Wernicke的诊断非常敏感和特异,尤其是有酒精使用障碍的患者。再摄食综合征(RS)与WE具有相似的危险因素,包括导致营养不良的疾病状态。RS患者由于口服摄入不足一段时间后重新开始口服营养时发生的硫胺素消耗而发展为WE。我们介绍了一名最初未发现WE的患者,该患者在开始IV硫胺素治疗后出现RS。RS延长了WE的神经系统症状,并导致住院时间延长和身体明显虚弱。在我们的病人身上,我们先于RS,而不是因为它而发生。该案例强调,如果存在这些疾病之一,另一个可能紧随其后。当我们先于RS时,在两种疾病的症状缓解之前,可能需要延长静脉硫胺素治疗.
    Wernicke\'s encephalopathy (WE) is a rare, life-threatening condition in which thiamine deficiency causes dysfunction of the Kreb\'s cycle, accumulation of lactic acid in the brain tissues, and irreversible cognitive impairment. Prompt treatment with IV thiamine can reverse the process. The classic Wernicke\'s triad of ataxia, memory issues, and ocular abnormalities is not often present. Caine\'s criteria, which requires two of the following: dietary deficiencies, ocular abnormalities, altered cognition or mental status, and cerebellar dysfunction, is highly sensitive and specific for Wernicke\'s diagnosis, especially in patients with alcohol use disorder. Refeeding syndrome (RS) has similar risk factors to WE, including disease states that lead to malnutrition. Patients with RS develop WE due to thiamine depletion that occurs when oral nutrition is reinitiated after a period of poor oral intake. We present a patient with initially undetected WE who developed RS after the initiation of treatment with IV thiamine. RS prolonged the neurologic symptoms of WE and led to an extended hospital stay and significant physical debility. In our patient, WE preceded RS instead of occurring as a consequence of it. The case highlights that if one of these disorders is present, the other may not be far behind. When WE precedes RS, prolonged treatment with IV thiamine may be warranted until the symptoms of both disorders resolve.
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  • 文章类型: Journal Article
    认知障碍是帕金森病(PD)中常见的非运动症状。传统上,拉丁裔背景的个人在PD研究中代表性不足。尽管拉丁美洲人占美国人口的18%,在PD研究中,它们通常占不到5%的样本。新出现的证据表明,患有PD的拉丁裔人在运动症状更严重方面可能与白人非拉丁裔人存在差异,更严重的抑郁症状,与健康相关的生活质量更差。本研究的目的是调查患有PD的拉丁裔和白人非拉丁裔个体之间认知表现的差异,并检查认知表现的相关性。
    数据来自帕金森进展标志物倡议。参与者包括60名患有PD的拉丁裔个人和1,009名患有PD的白人非拉丁裔个人,所有这些人每年随访5年.参与者完成了注意力和工作记忆的神经心理学测试,处理速度,视觉空间功能,口语流利,以及即时和延迟的记忆和回忆。
    相对于患有PD的白人非拉丁裔个人,患有PD的拉丁裔个体在认知功能的全球测量上得分明显较低,处理速度的测试,以及工作记忆和注意力的测试。在拉丁裔群体中,受教育年限与这三个认知领域的表现之间的相关性最强。
    这些发现提供了拉丁裔PD患者认知功能差异的初步证据。教育劣势可能是这些差异的潜在驱动因素之一。
    UNASSIGNED: Cognitive impairment is a common nonmotor symptom in Parkinson\'s disease (PD). Individuals of Latino background are traditionally underrepresented in research on PD. Despite the fact that Latinos comprise 18% of the U.S. population, they commonly make up less than 5% of samples in studies of PD. Emerging evidence suggests that Latino individuals with PD may experience disparities relative to White non-Latinos in terms of having more severe motor symptoms, more severe depressive symptoms, and worse health-related quality of life. The purpose of the present study was to investigate differences in cognitive performance between Latino and White non-Latino individuals with PD and examine correlates of cognitive performance.
    UNASSIGNED: Data were obtained from the Parkinson\'s Progression Markers Initiative. Participants included 60 Latino individuals with PD and 1,009 White non-Latino individuals with PD, all of whom were followed annually for up to 5 years. Participants completed neuropsychological tests of attention and working memory, processing speed, visuospatial functioning, verbal fluency, and immediate and delayed memory and recall.
    UNASSIGNED: Relative to White non-Latino individuals with PD, Latino individuals with PD had significantly lower scores on the global measure of cognitive functioning, a test of processing speed, and tests of working memory and attention. Years of education was the strongest correlate of performance in these three cognitive domains among individuals in the Latino group.
    UNASSIGNED: These findings provide initial evidence of disparities in cognitive functioning among Latino individuals with PD. Educational disadvantages may be one potential driver of these disparities.
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  • 文章类型: Journal Article
    神经纤维瘤病1型(NF1型)是一种常染色体显性疾病,具有典型的临床表现,如皮肤损伤,Lisch结节,视路胶质瘤,和神经纤维瘤,由NF1基因的突变引起的。视觉诱发电位(VEP)是视觉皮层对视觉刺激的电生理反应的量度。VEP在NF1型的病理生理学中的作用非常复杂,需要进一步的研究。
    我们检查了VEP正常和改变的NF1型患者之间的差异,并分析了P100潜伏期延长与疾病严重程度之间的相关性。
    两组:对照组和NF1型患者研究组。在对照组分析的基础上,获得了正常VEP发现116ms的阈值,并将研究组分为VEP正常和改变的亚组。我们继续研究亚组之间疾病临床表现的差异,之后,我们根据Riccardi量表检查P100潜伏期的延长与临床表现的严重程度之间是否存在相关性。在SPSS28.0程序中使用Pearson卡方检验和Spearman相关性检验进行统计分析,具有统计学意义的水平p=0.05和p=0.001。
    在VEP异常的组中,我们发现视神经胶质瘤的发生率有统计学意义(p=0.008),肿瘤(p=0.032),癫痫(p=0.043),和认知障碍(p=0.028),而其他临床体征在两组中的患病率相同.在P100潜伏期的延长与临床表现的严重程度之间观察到中度强相关性(rs=0.665)。
    我们的结果显示了VEP在NF1型临床表型描述中的重要作用。该研究的作者建议将VEP纳入为1型NF患者设计的诊断算法中。
    UNASSIGNED: Neurofibromatosis type 1 (NF type 1) is an autosomal dominant disease with typical clinical manifestations, such as skin lesions, Lisch nodules, optic pathway gliomas, and neurofibromas, caused by the mutation of the NF1 gene. Visual evoked potentials (VEP) present a measure of the electrophysiological response of visual cortex to a visual stimulus. The role of VEP in the pathophysiology of NF type 1 is very complex and requires additional research.
    UNASSIGNED: We examined the differences between NF type 1 patients with normal and altered VEP and analyzed the correlation between the prolongation of P100 latency and disease severity.
    UNASSIGNED: Two groups were formed: a control group and a study group with NF type 1 patients. Based on the control group analysis, a threshold value for a normal VEP finding of 116 ms was obtained, and it was used to divide the study group into subgroups with normal and altered VEP. We proceeded with examining the differences in clinical manifestations of the disease between the subgroups, after which we checked if there is a correlation between the prolongation of the P100 latency and the severity of the clinical picture according to the Riccardi scale. Statistical analysis was performed using the Pearson chi-square test and the Spearman correlation test in the program SPSS 28.0, with levels of statistical significance p = 0.05 and p = 0.001.
    UNASSIGNED: In the group with the abnormal VEP we found a statistically significant more frequent occurrence of optic tract glioma (p = 0.008), tumors (p = 0.032), epilepsy (p = 0.043), and cognitive disorders (p = 0.028), while the other clinical signs had an equal prevalence in both groups. A moderately strong correlation (r s = 0.665) was observed between the prolongation of P100 latency and the severity of the clinical picture.
    UNASSIGNED: Our results showed the important role of VEP in the description of clinical phenotypes of NF type 1. The authors of the study propose VEP to be included in the diagnostic algorithms designed for patients with NF type 1.
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  • 文章类型: Journal Article
    术后认知功能障碍(POCD)是一个主要的问题,尤其是在老年人中。这项研究使用了老年小鼠的社会隔离(ISO)和多组学分析来研究POCD发展的潜在机制。将老年小鼠分为两组:ISO和配对住房(PH)。油酰胺和大麻素受体2型(CB2R)拮抗剂AM630腹膜内给药,而Foxq1腺相关病毒(AAV)载体直接注射到海马中。随后进行胫骨髓内手术以建立POCD模型。包括Y迷宫的行为测试,露天试验,术后2天进行新物体识别。评估海马和血清炎性细胞因子。手术后,ISO小鼠表现出增强的认知障碍和不断升级的炎症标志物。整合转录组和代谢组学分析显示,PH小鼠海马和血清中的油酰胺浓度升高,相关研究表明Foxq1基因与油酰胺水平之间存在密切关系。虽然油酰胺给药和Foxq1基因过表达显著改善了小鼠术后认知表现和全身炎症,CB2R拮抗剂AM630阻碍了这些增强。Foxq1基因和油酰胺可能对减轻POCD至关重要。虽然可能通过CB2R介导的途径起作用,这些因素可能会调节神经炎症并减弱海马内的促炎细胞因子水平,显著提高术后认知能力。这项研究为未来研究靶向Foxq1-油酰胺-CB2R轴的治疗方法奠定了基础。以预防或减轻POCD为最终目标。
    Postoperative cognitive dysfunction (POCD) is a major concern, particularly among older adults. This study used social isolation (ISO) and multiomics analyses in aged mice to investigate potential mechanisms underlying POCD development. Aged mice were divided into two groups: ISO and paired housing (PH). Oleamide and the cannabinoid receptor type 2 (CB2R) antagonist AM630 were administered intraperitoneally, while Foxq1 adeno-associated viral (AAV) vector was injected directly into the hippocampus. Intramedullary tibial surgeries were subsequently performed to establish the POCD models. Behavioral tests comprising the Y-maze, open field test, and novel object recognition were conducted 2 days after surgery. Hippocampal and serum inflammatory cytokines were assessed. Following surgery, ISO mice demonstrated intensified cognitive impairments and escalated inflammatory markers. Integrative transcriptomic and metabolomic analysis revealed elevated oleamide concentrations in the hippocampus and serum of PH mice, with associative investigations indicating a close relationship between the Foxq1 gene and oleamide levels. While oleamide administration and Foxq1 gene overexpression substantially ameliorated postoperative cognitive performance and systemic inflammation in mice, CB2R antagonist AM630 impeded these enhancements. The Foxq1 gene and oleamide may be crucial in alleviating POCD. While potentially acting through CB2R-mediated pathways, these factors may modulate neuroinflammation and attenuate proinflammatory cytokine levels within the hippocampus, substantially improving cognitive performance postsurgery. This study lays the groundwork for future research into therapeutic approaches targeting the Foxq1-oleamide-CB2R axis, with the ultimate goal of preventing or mitigating POCD.
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  • 文章类型: Journal Article
    有一种促进福祉的趋势,或者快乐和健康的状态,在医学界。历史上,住院医师在培训期间面临很高的困扰率。居住计划中的结构化福祉课程可能会将居民的心态从生存和韧性转变为以目的为中心的心态,订婚,和喜悦。
    每5周在一个机构亲自为居民提供约10个福利讲习班的原始福利课程,每学年总共有大约20个小时的课程曝光时间。幸福课程分为4个领域:认知扭曲和有问题的心态,正念和冥想,创意出口,和自我同情。接受至少1年福利课程的居民被要求回答匿名调查。对4个域中的每一个提出了4个问题。第一个和第二个问题询问了他们在研讨会之前和之后对主题的熟悉程度,熟悉程度为1-5。第三个和第四个问题询问了获得的知识对他们的职业和个人生活的影响程度,影响程度为1-5。
    在课程曝光之前,所有领域中等或更高水平知识的平均值为22.7%,课程完成后提高到77.3%。总的来说,58.6%的参与者认为该领域的知识在他们的职业生涯中具有中等或极高的影响力,在他们的个人生活中占83.6%。在健康研讨会之前和之后检查的任何领域,研究生2年级和研究生3年级居民之间都没有显着差异。
    在小组环境中实践的4域福祉课程对参与居民的个人和职业生活产生了积极影响。需要进行更大规模的进一步研究,以评估课程是否适合更广泛的医学界的需求。
    UNASSIGNED: There is a trend toward fostering well-being, or the state of being happy and healthy, within the medical community. Historically, resident physicians have faced high rates of distress during training. A structured well-being curriculum in residency programs may shift residents\' mindsets from survival and resilience to one centered on purpose, engagement, and joy.
    UNASSIGNED: An original well-being curriculum was administered to residents in person at a single institution every 5 weeks for approximately 10 well-being workshops, totaling around 20 hours of curriculum exposure during every academic year. The well-being curriculum was divided into 4 domains: cognitive distortions and problematic mindsets, mindfulness and meditation, creative outlets, and self-compassion.Residents exposed to at least 1 year of the well-being curriculum were asked to answer an anonymous survey. Four questions were asked for each of the 4 domains. The first and second questions asked how familiar they were with the topic before and after the workshops on a scale of 1-5 of familiarity. The third and fourth questions asked how much the knowledge acquired influenced their professional and personal life on a scale of 1-5 of influence.
    UNASSIGNED: Before curriculum exposure, the average for moderate or higher levels of knowledge across all domains was 22.7%, which improved to 77.3% after curriculum completion. Overall, 58.6% of participants felt the knowledge of the domains was moderately or extremely influential in their professional lives and 83.6% in their personal lives. There were no significant differences between post-graduate year 2 and post-graduate year 3 residents for any domains examined before and after the wellness workshops.
    UNASSIGNED: A 4-domain well-being curriculum practiced in a group setting positively impacted participating residents in their personal and professional lives. Further studies need to be performed on a larger scale to assess if the curriculum fits the needs of the broader medical community.
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