trajectories

轨迹
  • 文章类型: Journal Article
    触摸是一种普遍的非语言动作,经常被浪漫的伴侣用来表达彼此的感情和关怀。当夫妻面临许多新的压力源和转移的优先事项时,对触摸的态度可能在关系紧张的时期尤其相关,例如过渡到父母身份。新的父母夫妇(N=203)在六个时间点(两个产前)在线完成了自我报告措施。我们测试了夫妻对触摸的态度(触摸厌恶,触摸的感情,情绪调节的触觉)在基线(妊娠中期20周)预测了他们从妊娠中期到产后12个月的性行为和情感行为的频率。双方都对触摸持更积极的态度(即,对于情感和情绪调节)和对触摸的较低厌恶态度,在怀孕中期测量,预测夫妇在产后3个月的性行为和多情行为的频率和多样性。触摸态度通常不能预测性行为或深情行为的频率或种类的变化程度,只有一个例外:非出生父母“在怀孕中期对情绪调节的触摸更积极的态度,预测夫妇的情感行为在整个怀孕期间下降速度较慢。研究结果强调了新父母对触摸的态度与其随后的性行为和深情行为之间的联系,特别是在产后早期。新父母需要驾驭新颖的性变化,而触摸等非语言策略可能有助于促进亲密和关怀。
    Touch is a universal nonverbal action often used by romantic partners to demonstrate affection and care for each other. Attitudes toward touch might be particularly relevant across periods of relational strain-such as the transition to parenthood-when couples face many novel stressors and shifting priorities which can interfere with their sexual and affectionate experiences. New parent couples (N = 203) completed self-report measures online across six time-points (two prenatal). We tested whether couples\' attitudes toward touch (touch aversion, touch for affection, touch for emotion regulation) at baseline (20 weeks mid-pregnancy) predicted their frequency of sexual and affectionate behaviors from mid-pregnancy through 12-month postpartum. Both partners\' more positive attitudes toward touch (i.e., for affection and emotion regulation) and lower aversive attitudes toward touch, as measured in mid-pregnancy, predicted couples\' higher frequency and variety of sexual and affectionate behaviors at 3-month postpartum. Touch attitudes generally did not predict the degree of change in the frequency or variety of sexual or affectionate behaviors, with one exception: non-birthing parents\' more positive attitudes toward touch for emotion regulation in mid-pregnancy predicted a slower decline in couples\' affectionate behaviors across pregnancy. Findings underscore a link between new parents\' attitudes toward touch and their subsequent sexual and affectionate behaviors, particularly in the early postpartum period. New parents need to navigate novel sexual changes and a nonverbal strategy such as touch might be useful to promote intimacy and care.
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  • 文章类型: Journal Article
    背景:通常观察到儿童和青少年抑郁症状的纵向模式存在群体差异。然而,对成人心理健康的影响尚不清楚.本研究对儿童和青少年抑郁轨迹研究进行了系统综述,并对其对成人抑郁症状和障碍的纵向影响进行了荟萃分析。
    方法:一项系统搜索确定了12项纵向研究(12项队列,N=35,058),在18岁之前进行了协调以识别常见症状轨迹。在同一组中进行随访检查,以估计与成人抑郁症状和障碍的纵向关联。使用随机效应荟萃分析。
    结果:纳入的研究确定低(70.3%),中度(17.9%),高(9.5%),症状轨迹增加(9.5%)和减少(5.1%)。发现这些轨迹可以预测成年期症状和疾病的变化:低,Dx=4.5%,95%CI2.7-6.8%,Sx=8.33,SD=6.30;中度,Dx=20.9%,CI11.9-31.5%-Sx=18.13,SD=3.38;高,Dx=34.4%CI17.2-54.0%-Sx=38.80,SD=7.75;增加,Dx=38.3%,CI12.7-67.5%-Sx=24.73,SD=18.64;下降,Dx=15.4%,CI10.5-20.9%-Sx=17.00,SD=12.18。
    结论:对于某些轨迹效应,置信区间很宽。高轨迹的预测效果存在显著的队列间异质性,这表明需要进一步研究以识别影响变异的特征。
    结论:低症状轨迹预测较低的成人抑郁症状和障碍。计划有效地针对适度的减少,High,增加和减少轨迹可能会防止成年早期的问题。
    BACKGROUND: Group differences in longitudinal patterns of child and adolescent depressive symptoms are commonly observed. However, the implications for adult mental health are unclear. This study presents a systematic review of child and adolescent depressive symptom trajectory research and meta-analysis of their longitudinal effects on adult depressive symptoms and disorders.
    METHODS: A systematic search identified 12 longitudinal studies (12 cohorts, N = 35,058) that were harmonized to identify common symptom trajectories prior to age 18 years. Examination of follow-up in the same groups was made (at average age 20.5 years) to estimate longitudinal associations with adult depressive symptoms (Sx) and disorders (Dx), using random effects meta-analyses.
    RESULTS: The included studies identified Low (70.3 %), Moderate (17.9 %), High (9.5 %), Increasing (9.5 %) and Decreasing (5.1 %) symptom trajectories. These trajectories were found to predict variation in symptoms and disorders in adulthood: Low, Dx = 4.5 %, 95 % Confidence Interval [CI] 2.7-6.8 %, Sx [Mean] = 8.33, Standard Deviation [SD] = 6.30; Moderate, Dx = 20.9 %, CI 11.9-31.5 % - Sx = 18.13, SD = 3.38; High, Dx = 34.4 % CI 17.2-54.0 % - Sx = 38.80, SD = 7.75; Increasing, Dx = 38.3 %, CI 12.7-67.5 % - Sx = 24.73, SD = 18.64; Decreasing, Dx = 15.4 %, CI 10.5-20.9 % - Sx = 17.00, SD = 12.18.
    CONCLUSIONS: Confidence intervals are wide for some trajectory effects. There was significant between-cohort heterogeneity in predictive effects for High trajectories, suggesting the need for further research to identify characteristics influencing variation.
    CONCLUSIONS: Low symptom trajectories forecast lower adult depression symptoms and disorders. Programs effectively targeting reductions in Moderate, High, Increasing and Decreasing trajectories will likely prevent problems in early adulthood.
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  • 文章类型: Journal Article
    婴儿期和幼儿期是饮食过渡的时期。在此期间,早期接触特定食物和建立饮食习惯可以塑造长期的食物偏好,并对健康产生持久影响。这项研究旨在研究澳大利亚儿童从出生到3岁的含糖饮料(SSB)摄入量的纵向轨迹,并确定影响这些轨迹的早期生活和社会经济因素。来自健康微笑健康儿童出生队列研究的母婴二联组(n=934)在4个月时对他们每周摄入SSB的频率进行了采访,8个月,1年,2年,和3岁的年龄点。进行了基于小组的轨迹建模分析,以确定澳大利亚儿童中SSB摄入的轨迹。进行了多变量逻辑回归,以确定结果轨迹的母婴相关预测因子。随着年龄的增长,SSB的摄入量显示出两个不同的二次轨迹(高和低)。虽然这两个轨迹在整个过程中保持独特,两组的SSB消费在4个月至2岁之间持续增加,随后稳定下来.与低SSB消费者(75%)相比,高SSB消费者(25%)更有可能生活在有三个或更多孩子的家庭中(相对风险(RR):1.59,95CI:1.02-2.48),母亲受教育程度低(左学校<12年-RR:1.75,95CI:1.09-2.81;完成12年-RR:1.57,95CI:1.02-2.81),并居住在高度/最社会经济弱势的地区(高度弱势-RR:1.89,95CI:1.13-3.18;最弱势-RR:2.06,95CI:1.25-3.38)。儿童的SSB摄入模式是在生命的早期建立的,因为他们从婴儿期过渡到学龄前,在儿童早期建立的摄入轨迹受到社会经济因素的强烈影响。因此,旨在限制SSB摄入和改善儿童营养的干预措施应在生命早期进行.
    Infancy and early childhood are periods of dietary transition. Early exposure to specific foods and the establishment of dietary habits during this period can shape long-term food preferences and have lasting effects on health. This study aimed to examine the longitudinal trajectories of sugar-sweetened beverage (SSB) intake in Australian children from birth to age 3 years and identify early-life and socioeconomic factors influencing those trajectories. Mother-infant dyads (n = 934) from the Healthy Smiles Healthy Kids birth cohort study were interviewed on their weekly frequency of SSB intake at 4-month, 8-month, 1-year, 2-year, and 3-year age points. Group-based trajectory modelling analysis was performed to identify trajectories for SSB intake among Australian children. A multivariable logistic regression was performed to identify the maternal and child-related predictors of resulting trajectories. The intake of SSBs showed two distinct quadratic trajectories (high and low) with age. While the two trajectories remained distinctive throughout, the SSB consumption for both groups consistently increased between 4 months and 2 years of age and subsequently stabilised. Compared to low SSB consumers (75%), the high SSB consumers (25%) were significantly more likely to be living in households with three or more children (relative risk (RR): 1.59, 95%CI: 1.02-2.48), had low maternal education (left school < year 12-RR: 1.75, 95%CI: 1.09-2.81; completed year 12-RR: 1.57, 95%CI: 1.02-2.81), and resided in highly/the most socioeconomically disadvantaged areas (highly disadvantaged-RR: 1.89, 95%CI: 1.13-3.18; most disadvantaged-RR: 2.06, 95%CI: 1.25-3.38). Children\'s SSB intake patterns are established early in life as they transition from infancy to preschool age, and the trajectories of intake established during early childhood are strongly influenced by socioeconomic factors. Hence, interventions targeted to limit SSB intake and improve nutrition amongst children should occur in early life.
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  • 文章类型: Journal Article
    目的:癌症治疗功能评估项目(FACT-GP5)有可能从患者的角度提供对全球治疗耐受性的理解。FACT-GP5的纵向评估和数据缺失非随机(MNAR)带来的挑战尚未得到探索。评估了FACT-GP5对缺失数据假设的稳健性以及FACT-GP5对关键副作用的响应性。
    方法:在随机分组中,双盲研究(NCT00065325),绝经后女性(n=618)激素受体阳性(HR+),晚期乳腺癌患者接受氟维司坦或依西美坦治疗,并每月完成FACT检测,为期7个月.累积链路混合模型(CLMM)适合评估:(1)FACT-GP5的轨迹和(2)FACT-GP5对CTCAE等级的响应性,东部肿瘤协作组(ECOG)绩效状态量表,以及事实的关键副作用。对随机缺失(MAR)假设进行了敏感性分析。
    结果:报告不良副作用的几率随着时间的推移而增加。副作用困扰(FACT-GP5)水平与其他FACT项目的严重程度之间存在积极的人内关系,以及ECOG绩效状态和不良事件通用术语标准(CTCAE)等级。缺少FACT-GP5评估的数量影响了FACT-GP5的轨迹,但不影响FACT-GP5与其他项目之间的关系(恶心[FACT-GP2]除外)。
    结论:结果支持FACT-GP5的反应性。一般来说,FACT-GP5对缺失评估的反应性稳健.应该考虑不幸,然而,当评估FACT-GP5随时间的变化时。
    背景:NCT00065325。
    2003.
    研究人员一直在探索使用单一问题,FACT-GP5(“我被治疗的副作用困扰”),从患者的角度快速了解药物耐受性。这项研究探讨了这个问题是否可以捕获治疗期间耐受性的变化,如果患者错过了评估,这是否会影响对耐受性的解释。在我们的研究中,我们发现FACT-GP5可用于了解治疗期间耐受性的变化.在解释结果时,缺少对FACT-GP5的评估是很重要的。FACT-GP5可能是捕获患者对药物耐受性的有用问题。
    OBJECTIVE: The Functional Assessment of Cancer Therapy item (FACT-GP5) has the potential to provide an understanding of global treatment tolerability from the patient perspective. Longitudinal evaluations of the FACT-GP5 and challenges posed by data missing-not-at-random (MNAR) have not been explored. Robustness of the FACT-GP5 to missing data assumptions and the responsiveness of the FACT-GP5 to key side-effects are evaluated.
    METHODS: In a randomized, double-blind study (NCT00065325), postmenopausal women (n = 618) with hormone receptor-positive (HR+), advanced breast cancer received either fulvestrant or exemestane and completed FACT measures monthly for seven months. Cumulative link mixed models (CLMM) were fit to evaluate: (1) the trajectory of the FACT-GP5 and (2) the responsiveness of the FACT-GP5 to CTCAE grade, Eastern Cooperative Oncology Group (ECOG) Performance Status scale, and key side-effects from the FACT. Sensitivity analyses of the missing-at-random (MAR) assumption were conducted.
    RESULTS: Odds of reporting worse side-effect bother increased over time. There were positive within-person relationships between level of side-effect bother (FACT-GP5) and severity of other FACT items, as well as ECOG performance status and Common Terminology Criteria for Adverse Events (CTCAE) grade. The number of missing FACT-GP5 assessments impacted the trajectory of the FACT-GP5 but did not impact the relationships between the FACT-GP5 and other items (except for nausea [FACT-GP2]).
    CONCLUSIONS: Results support the responsiveness of the FACT-GP5. Generally speaking, the responsiveness of the FACT-GP5 is robust to missing assessments. Missingness should be considered, however, when evaluating change over time of the FACT-GP5.
    BACKGROUND: NCT00065325.
    UNASSIGNED: 2003.
    Researchers have been exploring the use of a single question, FACT-GP5 (“I am bothered by side effects of treatment”), as a quick way to learn about drug tolerability from the patients’ perspective. This study explores if this single question can capture changes in tolerability during treatment, and if the assessment is missed by patients, whether that impacts the interpretation of tolerability. In our study, we found that the FACT-GP5 can be used to understand how tolerability changes during treatment. Missing assessments of the FACT-GP5 are important to account for when interpreting results. The FACT-GP5 may be a useful question for capturing the patient experience of drug tolerability.
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  • 文章类型: Journal Article
    母亲虐待儿童(CM)的经历与母婴心理健康有关。然而,关于儿童心理健康和产妇CM病程的证据很少。因此,这项研究旨在根据母亲CM暴露和母亲心理健康比较儿童心理健康的轨迹。我们纳入了来自乌尔姆SPATZ健康研究的327名母亲和她们的单胎孩子,前瞻性出生队列研究。儿童心理健康状况由4、5、6和7岁的力量和困难问卷(SDQ)确定,母亲CM由儿童创伤问卷(CTQ)确定。结果显示,母亲CM与儿童更多的行为和情绪困难有关,这种趋势随着儿童年龄的增长而增加。在这段时间内,产妇心理健康问题的总和介导了这种联系。男性儿童性行为与儿童和母亲的更多心理健康问题有关。这些结果为母亲CM对后代心理健康轨迹的相关性提供了重要的初步见解,并强调了母亲心理健康的慢性和严重程度的重要性。需要对青春期和成年期进行更长时间随访的队列进行进一步的前瞻性研究。
    Maternal experience of child maltreatment (CM) has been associated with maternal and child mental health. However, evidence about the course of child mental health and maternal CM is scarce. Therefore, this study aims to compare trajectories of mental health in children according to maternal CM exposure and maternal mental health. We included 327 mothers and their singleton child from the Ulm SPATZ Health Study, a prospective birth cohort study. Child mental health was determined by the Strength and Difficulties Questionnaire (SDQ) at the age of 4, 5, 6, and 7 years and maternal CM by the Childhood Trauma Questionnaire (CTQ). Results display that maternal CM is associated with more behavioural and emotional difficulties in children, a trend that tends to increase with older child age. The sum of maternal mental health problems across this time course mediates this association. Male child sex is associated with more mental health problems in the child and the mother. These results provide an important first insight into the relevance of maternal CM on the trajectories of mental health in the offspring and highlight the importance of chronicity and severity of maternal mental health. Further prospective research in cohorts with longer follow-ups up into adolescence and adulthood is needed.
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  • 文章类型: Journal Article
    背景:晚年抑郁症和儿童虐待已成为主要的全球公共卫生问题,鉴于其患病率以及社会经济和健康后果。然而,以前的研究只关注儿童虐待与抑郁症状平均水平的关系。当前的研究通过同时研究儿童期家庭内和家庭外虐待对中国晚期生活中抑郁症状的年龄轨迹的影响来解决这一知识差距。
    方法:将分层线性模型应用于中国健康与退休纵向研究的数据(2011-2018年,N=12,669名45至80岁的个体,包括N=43,348人年)。抑郁症状通过CES-D-10量表测量。儿童家庭内虐待是通过身体虐待和情感忽视来衡量的,而家族外虐待是通过同伴欺凌来衡量的。在Stata16中,所有分析均按性别分别进行。
    结果:儿童家庭外同伴欺凌(β=1.628,p<0.001),在整个样本中,家庭内身体虐待(β=0.746,p<0.001)和情感忽视(β=0.880,p<0.001)与较高的晚年抑郁症状水平相关。男性和女性的同伴欺凌在抑郁症状方面的差异随着年龄的增长而扩大。在男性的一生中,身体虐待抑郁症状的差异保持稳定,但在女性中却有所增加。男性抑郁症状的情绪忽视差异随着年龄的增长而降低,而女性则先上升后下降。
    结论:这项研究的结果表明,儿童虐待不仅与晚年精神健康状况较差有关,而且随着年龄的增长,精神健康方面的不平等加剧。尤其是在同伴欺凌的受害者和女性中。
    BACKGROUND: Both late-life depression and childhood maltreatment have become major global public health issues, given their prevalence and social-economic and health consequences. However, previous studies have solely focused on the relationship of childhood maltreatment to average levels of depressive symptoms. The current study addresses this gap of knowledge by simultaneously examining the impacts of childhood intra- and extra-familial maltreatment on age trajectories of depressive symptoms in later life in the Chinese context.
    METHODS: Hierarchical linear models were applied to data from the China Health and Retirement Longitudinal Study (2011-2018, N = 12,669 individuals aged 45 to 80, comprising N = 43,348 person-years). Depressive symptoms were measured by the CES-D-10 scale. Childhood intra-familial maltreatments were measured by physical abuse and emotional neglect, while extra-familial maltreatment was measured by peer bullying. All analyses were conducted separately by gender in Stata 16.
    RESULTS: Childhood extrafamilial peer bullying (β = 1.628, p < 0.001), and intrafamilial physical abuse (β = 0.746, p < 0.001) and emotional neglect (β = 0.880, p < 0.001) were associated with higher later-life depressive symptoms levels in the whole sample. Peer bullying differences in depressive symptoms widened with age for both men and women. Physical abuse differences in depressive symptoms remained stable over the life course among men but increased among women. Emotional neglect differences in depressive symptoms decreased with age among men, while it increased first and then decreased among women.
    CONCLUSIONS: Findings in this study suggest that childhood maltreatment is not only associated with later-life poorer mental health but contributes to increasing inequalities in mental health as people age, especially among peer-bullying victims and women.
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  • 文章类型: Journal Article
    背景:关于成人CRS早期危险因素的证据,以及整个生命过程中的哮喘和过敏史,是有限的。
    目的:研究儿童呼吸道感染/过敏性疾病之间的关系,以及整个生命过程中的哮喘和过敏以及中年时的CRS。
    方法:数据来自基于人群的塔斯马尼亚纵向健康研究(TAHS)队列,首次研究于1968年,年龄在6-7岁(n=8583),并连续进入中年(n=3609)。使用公认的流行病学定义,参与者在53岁时被分配了CRS严重程度亚型:无鼻窦炎/CRS(参考);仅过去的医生诊断;没有医生诊断的当前症状;以及有当前症状的医生诊断的CRS.与7岁时的感染性/过敏性呼吸道疾病的关系,以及以前发表的7至53岁的哮喘过敏轨迹,使用多变量回归进行检查。
    结果:在中年,5.8%报告了目前的CRS症状,2.5%的医生诊断。与有症状的医生诊断的CRS相关的儿童状况包括频繁的头部感冒(多项比值比[mOR]=2.04(95%置信区间[95%CI]:1.24,3.37)),频发扁桃体炎(mOR=1.61[95%CI:1.00,2.59])和当前儿童哮喘(mOR=2.23[95%CI:1.25,3.98])。以晚发性或持续性哮喘和过敏为特征的生命过程轨迹与中年的所有CRS亚型有关;早发性持续性哮喘和过敏(mOR=6.74,95%CI:2.76,16.4);晚发性哮喘过敏(mOR=15.9,95%CI:8.06,31.4),晚发性花粉热(mOR=3.02,95%CI:1.51,6.06)与有症状的医生诊断的CRS相关。
    结论:目前的哮喘,7岁时频繁的头部感冒和扁桃体炎可能预示着一个易感儿童,他在中年时患有CRS的风险较高,并且可能从更密切的监测和/或积极的管理中受益.并发哮喘和过敏密切相关,是成人CRS的潜在可治疗特征。
    BACKGROUND: Evidence on the early life risk factors of adult CRS, and the history of asthma and allergies across the life course, is limited.
    OBJECTIVE: To investigate relationships between respiratory infective/allergic conditions in childhood, and asthma and allergies across the life course and CRS in middle age.
    METHODS: Data were from the population-based Tasmanian Longitudinal Health Study (TAHS) cohort, first studied in 1968 when aged 6-7 years (n = 8583) and serially followed into middle age (n = 3609). Using a well-accepted epidemiological definition, participants were assigned a CRS-severity subtype at age 53: no sinusitis/CRS (reference); past doctor diagnosis only; current symptoms without doctor diagnosis; and doctor-diagnosed CRS with current symptoms. Relationships with infective/allergic respiratory illnesses at age 7, and previously published asthma-allergy trajectories from 7 to 53 years, were examined using multinominal regression.
    RESULTS: In middle age, 5.8% reported current CRS symptoms with 2.5% doctor-diagnosed. Childhood conditions associated with symptomatic doctor-diagnosed CRS included frequent head colds (multinomial odds ratio [mOR] = 2.04 (95% confidence interval [95% CI]: 1.24, 3.37)), frequent tonsillitis (mOR = 1.61 [95% CI: 1.00, 2.59]) and current childhood asthma (mOR = 2.23 [95% CI: 1.25, 3.98]). Life course trajectories that featured late-onset or persistent asthma and allergies were associated with all CRS subtypes in middle age; early-onset persistent asthma and allergies (mOR = 6.74, 95% CI: 2.76, 16.4); late-onset asthma allergies (mOR = 15.9, 95% CI: 8.06, 31.4), and late-onset hayfever (mOR = 3.02, 95% CI: 1.51, 6.06) were associated with symptomatic doctor-diagnosed CRS.
    CONCLUSIONS: Current asthma, frequent head colds and tonsillitis at age 7 could signal a susceptible child who is at higher risk for CRS in mid-adult life and who might benefit from closer monitoring and/or proactive management. Concurrent asthma and allergies were strongly associated and are potential treatable traits of adult CRS.
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  • 文章类型: Journal Article
    我们调查了专业承诺随时间的发展及其与新手护士工作经验的关系。我们使用了基于每周报告的定量承诺分数和经验的定性描述的纵向混合方法。具体来说,我们研究了承诺轨迹的转折点,并分析了转折点的定性特征。为了确定一个转折点,我们首先为每个人计算了一个平滑的轨迹,并将每个点超过该平滑轨迹的95%间隔定义为例外。其次,我们探讨了在斜率效价或承诺强度方面的例外点之后,承诺发展是否发生了变化。样本由18名新手护士组成。其中三分之二揭示了至少一个转折点,因此,新手护士的专业承诺发展的特点是高峰和低谷,其次是承诺发展的变化。分析表明,积极承诺发展之后的转折点通常具有积极的经验。这些经历通常与亲密关系或能力有关。消极发展所伴随的转折点并不一致:它们可能是积极的,负,或模棱两可的经历。许多负面经验都涉及负面的组织问题。我们得出的结论是,承诺发展与经验的积极或消极特征之间没有简单的关系。在解释承诺变化时,应考虑经验的背景和基本含义。
    We investigated the development of professional commitment over time and its relation to work experiences of novice nurses. We used a longitudinal mixed-method approach based on weekly reported quantitative commitment scores and qualitative descriptions of experiences. Specifically, we examined turning points in commitment trajectories and analyzed qualitative characteristics of the turning point. To determine a turning point, we firstly computed a smoothed trajectory for each individual and defined each point beyond the 95% interval of this smoothed trajectory as exceptional. Secondly, we explored whether the commitment development changed after an exceptional point with regard to the slope-valence or commitment strength. The sample consisted of 18 novice nurses. Two third of them revealed at least one turning point, thus the professional commitment development of novice nurses was characterized by peaks and dips that were followed by changes in the commitment development. The analysis showed that turning points followed by positive commitment development typically were characterized by positive experiences. These experiences often concerned relatedness or competence. Turning points followed by a negative development were not consistent: they could be positive, negative, or ambiguous experiences. Many of the negative experiences concerned negative organizational issues. We concluded that there is not a simple relation between commitment development and positive or negative characteristics of an experience. The context and underlying meaning of the experiences should be taken into account to interpret the commitment changes.
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  • 文章类型: Journal Article
    背景:儿童肥胖是心血管疾病不良的危险因素,新陈代谢,和呼吸健康。使用纵向数据检查社会生态因素对体重轨迹的影响的研究是有限的,经常检查单一措施(例如,靠近公园),并且没有检查肥胖儿童的具体轨迹。方法:我们检查了1518名儿童对体重的影响,6-12岁,使用体重指数(BMI)标准患有肥胖症。BMI斜率轨迹被归类为减少,扁平,或增加,中位随访2.1年。我们检查了社会生态暴露,按农村和城市环境分层,使用人口普查区域来绘制指数,包括食物获取,靠近公园,归一化差异植被指数,和面积剥夺指数(ADI)。我们使用序数逻辑回归来检查社会生态因素与BMI轨迹之间的关联。结果:在1518名儿童中,360(24%)的BMI轨迹下降,其余的轨迹平坦(23%)或增加(53%)。农村地区的儿童更有可能生活在高度不利的地区,85%,与城市儿童相比,46%。在多变量序数模型中,生活在ADI较低的人口普查区的BMI斜率增加组有0.78(95%CI0.61-0.99)较低的几率,没有其他社会生态因素相关。结论:与建筑环境指标相比,面积剥夺指数捕获了一系列资源和社会背景,与BMI轨迹无关。有必要开展进一步的工作,研究如何在高贫困地区制定有效的干预措施。
    Background: Childhood obesity is a risk factor for poor cardiovascular, metabolic, and respiratory health. The studies examining influences of socio-ecologic factors on weight trajectories using longitudinal data are limited, often examine single measures (e.g., proximity to parks), and have not examined the specific trajectories of children with obesity. Methods: We examined influences on weight among 1518 children, 6-12 years of age, who had obesity using body mass index (BMI) criteria. BMI slope trajectories were categorized as decreasing, flat, or increasing, with a median of 2.1 years of follow-up. We examined socio-ecologic exposures, stratified by rural and urban settings, using census tracts to map indices, including food access, proximity to parks, normalized difference vegetation index, and area deprivation index (ADI). We used ordinal logistic regression to examine the associations between the socio-ecologic factors and BMI trajectories. Results: Among the 1518 children, 360 (24%) had a decreasing BMI trajectory with the remainder having flat (23%) or increasing (53%) trajectories. Children in rural areas were more likely to live in high disadvantage areas, 85%, compared with urban children, 46%. In the multivariable ordinal model, living in a lower ADI census tract had a 0.78 (95% CI 0.61-0.99) lower odds of being in an increasing BMI slope group, and no other socio-ecologic factor was associated. Conclusions: The area deprivation index captures a range of resources and social context compared with the built environment indicators, which had no association with BMI trajectory. Further work examining how to develop effective interventions in high deprivation areas is warranted.
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  • 文章类型: Journal Article
    多动症症状的发展轨迹存在实质性的异质性,通常在持久和缓慢之间进行区分,早期和晚期。然而,这些轨迹如何与青少年晚期功能相关,特别是,晚期发病轨迹标志着较温和的亚型仍不清楚。在早期研究了14岁以下ADHD症状轨迹的早期预测因素的基础上,我们将潜在的类增长分析应用于英国千年队列研究(N=10,262)的数据,以评估ADHD症状的发育轨迹直到17岁(从3岁开始)是否与14岁之前确定的相似,并且与同伴受害的不同程度的损害相关。心理健康,物质使用,和17岁时的犯罪结果。我们的最佳模型包括五个轨迹组,标记为未受影响(37.6%),受轻微影响(34.8%),亚临床缓解(14.4%),青少年发病(7.6%),和稳定高(5.6%)。青少年发作和稳定的高轨迹在所有结果中都受到类似损害,除了物质使用。与未受影响的个体相比,亚临床缓解个体的自尊和幸福感受到损害。到了青春期中期,起病较晚的患者与早发/持续轨迹后的患者有相似的损伤.对于那些在缓解轨迹上的人来说,剩余的损害可能仍然存在。
    There exists substantial heterogeneity in the developmental trajectories of ADHD symptoms, with distinctions often made between persistent versus remittent, and early- versus late-onset. However, how these trajectories relate to late adolescent functioning and whether, in particular, later onset trajectories mark a milder subtype remains unclear. Building on earlier work that has examined early life predictors of ADHD symptom trajectories up to age 14, we applied latent class growth analysis to data from the UK Millennium Cohort Study (N = 10,262) to evaluate whether developmental trajectories of ADHD symptoms up to age 17 (from age 3) were similar to those identified up to age 14 and associated with differing levels of impairment in peer victimisation, mental health, substance use, and delinquency outcomes at age 17. Our optimal model included five trajectory groups, labelled unaffected (37.6%), mildly affected (34.8%), subclinical remitting (14.4%), adolescent onset (7.6%), and stable high (5.6%). Adolescent onset and stable high trajectories were similarly impaired across all outcomes, other than substance use. Subclinical remitting individuals were impaired on self-esteem and well-being compared to unaffected individuals. By the end of mid-adolescence, those with a later onset have similar impairments to those following an early onset/persistent trajectory. Residual impairment may remain for those on a remitting trajectory.
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