Objectives:This study aimed to identify facilitators and barriers to parent-child communication in pediatric palliative care,providing insights for medical professionals developing targeted interventions to enhance pa...Objectives:This study aimed to identify facilitators and barriers to parent-child communication in pediatric palliative care,providing insights for medical professionals developing targeted interventions to enhance parent-child communication and improve its effectiveness.Methods:Whittemore and Knafl’s integrative review method was employed to guide a systematic search for literature in six databases(Medline,Embase,CINAHL Complete,PsycINFO,Web of Science,and Cochrane Library).Peer-reviewer articles published in the English language from inception to December 2023.All of the identified studies were screened,extracted,and analyzed independently by two researchers.Results:Twenty-four articles were included.Thefindings of the relevant studies were analyzed using thematic analysis.Four themes were identified as facilitators:legacy-making,resilience training programs,guidance from the healthcare team,and positive communication.Seven themes were identified as barriers:denial,being unprepared and evasive,mutual protection,being overwhelmed by painful emotions and overloaded with information,incorrect views of medical professionals and parents,negative communication,and cultural context.Conclusions:Parents and professionals should avoid myths about protecting the child and encourage open communication that respects the child’s wishes.The specialized pediatric palliative care team should carefully monitor parent-child communication,determine if any obstacles exist,and design more interventions to enhance it.展开更多
BACKGROUND: Cerebral arterial stenosis can cause cerebral hypoperfusion, and than result in the decline of cognitive function, whereas the cognitive dysfunction induced by different cerebral arterial stenosis have dif...BACKGROUND: Cerebral arterial stenosis can cause cerebral hypoperfusion, and than result in the decline of cognitive function, whereas the cognitive dysfunction induced by different cerebral arterial stenosis have different manifestations and types. OBJECTIVE: To observe the differences of cognitive and memory dysfunctions in patients with cerebral arterial stenosis of different types. DESIGN: A comparative observation. SETTING: Affiliated Hospital of Jining Medical College. PARTICIPANTS: Forty-two outpatients or inpatients with cerebral arterial stenosis were selected from the Department of Neurology, Affiliated Hospital of Jining Medical College from February 2005 to January 2006, including 25 males and 17 females. There were 18 cases of internal carotid arterial stenosis, 14 cases of vertebrobasilar arterial stenosis and 10 cases of whole cerebral arterial stenosis. The diagnostic standards for cerebral arterial stenosis were identified according to North American Symptomatic Carotid Endarterectomy Trial (NASCET). Meanwhile, 18 healthy physical examinees were enrolled as the control group, including 10 males and 8 females, aged 58-80 years old. All the enrolled subjects were informed and agreed with the detection and evaluation. METHODS: ① The memory function was evaluated using revised Wechsler memory scale for adults, including long-term memory (experience, orientation and counting), short-term memory (visual recognition, picture memory, visual regeneration, association and thigmesthesia) and sensory memory (forward and backward recitation of numbers). The scale scores were turned to memory quotients. The higher the scores, the better the memory function. ② The cognitive function was evaluated using revised Wechsler adult intelligence scale: It consisted of eleven subtests, including six language scales (information, digit span, vocabulary, arithmetics, apprehension, similarity) and five operation scales (picture completion, picture arrangement, block design, geometric design, digit-symbol test). The intelligence quotients were obtained. The higher the scores, the better the cognitive function. MAIN OUTCOME MEASURES: Results of memory and cognitive function test in patients with cerebral arterial stenosis of different types. RESULTS: All the 42 patients with cerebral artery stenosis and 11 healthy subjects were involved in the final analysis of results. ① Results of memory function test: The memory function was worse in the arterial stensis groups than in the control group (P < 0.05-0.01). There were very significant differences in the scores of orientation, association and picture memory between the internal carotid arterial stenosis group and control group (P < 0.01). There were also very significant differences in the scores of counting, logic memory, forward and backward recitation of numbers, visual regeneration, visual recognition and thigmesthesia between the vertebrobasilar arterial stenosis group and control group (P < 0.01). Except experience and visual regeneration, there were significant very differences in the scores of the other tests between the whole cerebral arterial stenosis group and control group (P < 0.01). The memory quotient was obviously lower in the vertebrobasilar arterial stenosis group than in the internal carotid arterial stenosis group [(72.31±26.46), (87.38±21.86) points, P < 0.05], and it was the lowest in the whole cerebral arterial stenosis group [(63.74±25.25) points]. ② Results of cognitive function test: The cognitive function was worse in the arterial stensis groups than in the control group (P < 0.05-0.01). There were very significant differences in the scores of apprehension, arithmetics, similarity, digit-symbol test, picture completion and block design between the internal carotid arterial stenosis group and control group (P < 0.01). There were also very significant differences in the scores of backward recitation of numbers, vocabulary and geometric design between the vertebrobasilar arterial stenosis group and control group (P < 0.01). Except information, there were significant very differences in the scores of the other tests between the whole cerebral arterial stenosis group and control group (P < 0.01). The intelligence quotient was obviously lower in the internal carotid arterial stenosis group than in the vertebrobasilar arterial stenosis group [(72.65±23.39), (81.34±25.46) points, P < 0.05], and it was the lowest in the whole cerebral arterial stenosis group [(65.98±27.34) points]. CONCLUSION: Different cerebral arterial stenosis can induce different cognitive dysfunctions. The main manifestation of the patients with internal carotid arterial stenosis was the declined cognitive function, and that in patients with vertebrobasilar arterial stenosis was the declined memory, and the decrease of total intelligence was more obvious in the formers than in the latters, whereas the decrease of total memory quotient was more obvious in the patients with vertebrobasilar arterial stenosis; The cognitive and memory dysfunction were the most serious in patients with whole cerebral arterial stenosis.展开更多
The Intrinsic structural disorder (ISD) of native EWS and its fusion oncogenic proteins, including EWS/FliI, EWS/ATF1 and EWS/ZSG, was estimated by different Predictors. The ISD difference between the wild type and th...The Intrinsic structural disorder (ISD) of native EWS and its fusion oncogenic proteins, including EWS/FliI, EWS/ATF1 and EWS/ZSG, was estimated by different Predictors. The ISD difference between the wild type and the oncogenic fusions found in the CTD is due to the fusion partner, usually a transcription factor (TF). A disordered region was found in the sequence (AA 132 - 156) of the NTD (EAD) of EWS, consisting of the longest region free of Y motifs. The IQ domain (AA 258 - 280), a Y-free region, flanked by two Y-boxes, is also disordered by all used Predictors. The EWS functional regions RGG1, RGG2 and RGG3 are predominantly disordered. A strong dependence was found between the structure of EWS protein and its oncogenic fusions, and their estimated ISD. The oncogenic function of the fusions is related to a decreased ISD in the CTD, due to the fused TF. The Predictors shown that the different isoforms have similar profiles, shifted with some amino acids, due to the translocations. On the bases of the prediction results, an analysis was made of the EWS sequence and its functional regions with increased ISD to make a relationship sequence-disorder-function that could be helpful in the design of antitumor agents against the corresponding malignances.展开更多
Personality disorders are a class of mental disorders involving enduring maladaptive patterns of behaving,thinking,and feeling which profoundly affect functioning,inner experience,and relationships.This work focuses o...Personality disorders are a class of mental disorders involving enduring maladaptive patterns of behaving,thinking,and feeling which profoundly affect functioning,inner experience,and relationships.This work focuses on three Cluster B personality disorders(PDs)(Borderline,Narcissistic,and Antisocial PDs),specifically illustrating how relational dysfunction manifests in each condition.People with Borderline Personality Disorder(BPD)experience pervasive instability in mood,behavior,self-image,and interpersonal patterns.In relationships,they tend to alternate between extremes of over-idealization and devaluation.Intense fear of abandonment,fluctuating affect,inappropriate anger,and black/white thinking deeply influence how they navigate personal relationships,which are often unstable,chaotic,dramatic,and ultimately destructive.They have a fundamental incapacity to self-soothe the explosive emotional states they experience as they oscillate between fears of engulfment and abandonment.This leads to unpredictable,harmful,impulsive behavior and chronic feelings of insecurity,worthlessness,shame,and emptiness.Their relationships are explosive,marked by hostility/contempt for self and partner alternating with bottomless neediness.Manipulation,lying,blaming,raging,and“push-pull”patterns are common features.Individuals with Narcissistic Personality Disorder(NPD)exhibit a long-standing pattern of grandiosity and lack of empathy.They have an exaggerated sense of self-importance,are self-absorbed,feel entitled,and tend to seek attention.Scarcely concerned with others’feelings,they can be both charming and exploitative.Oversensitive to criticism,they are prone to overt or covert rage,gaslighting and self-referential thinking.Antisocial Personality Disorder(APD)is marked by impulsive,callous,and irresponsible behavior with no regard to be manipulative,parasitic,aggressive,cold,cruel,and self-serving.In addition to analyzing relational dysfunction in each disorder,this paper presents three relational case studies(BPD-couple,NPD-parent/child,APD-various relations)and discusses treatment implications.展开更多
Objective:The study is to analyze the influence of parent-child relationship on pupils’learning motivation,and to explore the mediating mechanism of teacher-student relationship in parent-child relationship and learn...Objective:The study is to analyze the influence of parent-child relationship on pupils’learning motivation,and to explore the mediating mechanism of teacher-student relationship in parent-child relationship and learning motivation.Method:This study conducted a questionnaire survey on 213 pupils in Grades 5 and 6 in two schools in Beijing using Pianta’s teacher-student relationship scale revised by Qu,Dornbush’s parent-child intimacy scale revised by Zhang and the learning motivation scale adapted by Hu.Results:Gender,grade,whether they are the only child and to be a class cadre or not show significant differences in some dimensions of parent-child relationship,teacher-student relationship and learning motivation.The total scores of parent-child relationship,teacher-student relationship and learning motivation are positively correlated,and some sub dimensions are also significantly correlated.Parent-child relationship and teacher-student relationship have a significant positive predictive effect on learning motivation,and parent-child relationship has a significant positive predictive effect on teacher-student relationship.Teacher-student relationship plays a mediating role in the influence of parent-child relationship on learning motivation.Conclusions:Parent-child relationship can promote the relationship between teachers and students,and then enhance pupils’learning motivation.展开更多
<strong>Background:</strong> Nurses play a central role in the treatment of inpatients with anorexia, where bonding is a key factor. The inpatient-nurse relationship is based on a confident alliance charac...<strong>Background:</strong> Nurses play a central role in the treatment of inpatients with anorexia, where bonding is a key factor. The inpatient-nurse relationship is based on a confident alliance characterized by important factors such as trust, confidentiality, responsiveness, genuineness, and consistency. <strong>Aim and Research Question:</strong> The aim of this study was to describe patients’ in-depth experiences of their relationship with nurses when hospitalized for anorexia. The research question was: How do women hospitalized due to anorexia nervosa experience the nurse-patient relationship? <strong>Method:</strong> A hermeneutic approach with in-depth interviews was employed. Five women with previous experience of inpatient care for anorexia were interviewed. <strong>Findings:</strong> The findings summarized how the women experienced the relationship with professional nurses in a ward characterized by a high degree of structure. The main theme Balancing feelings of emotional contradictions in the patient-nurse relationship was described by two sub-themes;Opening up for a care relationship in a rigid and structured ward atmosphere and Fluctuating in a paradox of conflicting feelings. <strong>Discussion:</strong> From the patients’ perspective, balancing the patient-nurse relationship when an inpatient involves conflicting emotional challenges. Structured interventions are perceived as effective by the patients, although they may be ambivalent about them. Therefore, a good relationship depends on the establishment of emotional and stable interaction with the nurses. <strong>Implications for Nursing Practice:</strong> Patients need interventions based on safe and competent quality care. A hermeneutic approach may improve the nurses’ ability to meet these patients in their lifeworld and establish a confident relationship. Special education related to anorexia care should be a priority in nursing.展开更多
目的:探讨母乳喂养时间对孤独症谱系障碍患病风险的剂量-反应关系。方法:检索中国知网、维普、万方、PubMed、EMbase、Web of Science、the Cochrane Library等数据库收集关于母乳喂养持续时间与孤独症谱系障碍相关的研究,检索时限从建...目的:探讨母乳喂养时间对孤独症谱系障碍患病风险的剂量-反应关系。方法:检索中国知网、维普、万方、PubMed、EMbase、Web of Science、the Cochrane Library等数据库收集关于母乳喂养持续时间与孤独症谱系障碍相关的研究,检索时限从建库至2022年3月。2名研究者独立筛选文献、提取资料、文献质量评价后,使用Stata 17.0软件基于限制性立方样条函数结合广义最小二乘法分析剂量-反应关系。结果:纳入文献共8篇,病例组3255例,对照组39556例。结果显示,母乳喂养时间与孤独症谱系障碍患病相关[RR=0.41,95%CI(0.28,0.53),P<0.001];且呈非线性关系,参照为从未母乳喂养,平均母乳喂养时间1个月[RR=0.92,95%CI(0.92,0.93),P<0.001]、3个月[RR=0.79,95%CI(0.78,0.80),P<0.001]、4.5个月[RR=0.71,95%CI(0.69,0.73),P<0.001]、9个月[RR=0.58,95%CI(0.57,0.60),P<0.001]、15.5个月[RR=0.52,95%CI(0.51,0.53),P<0.001]。结论:现有证据表明,母乳喂养时间与孤独症谱系障碍患病风险存在明显关联,随着母乳喂养时间的增加,患病风险降低。展开更多
文摘Objectives:This study aimed to identify facilitators and barriers to parent-child communication in pediatric palliative care,providing insights for medical professionals developing targeted interventions to enhance parent-child communication and improve its effectiveness.Methods:Whittemore and Knafl’s integrative review method was employed to guide a systematic search for literature in six databases(Medline,Embase,CINAHL Complete,PsycINFO,Web of Science,and Cochrane Library).Peer-reviewer articles published in the English language from inception to December 2023.All of the identified studies were screened,extracted,and analyzed independently by two researchers.Results:Twenty-four articles were included.Thefindings of the relevant studies were analyzed using thematic analysis.Four themes were identified as facilitators:legacy-making,resilience training programs,guidance from the healthcare team,and positive communication.Seven themes were identified as barriers:denial,being unprepared and evasive,mutual protection,being overwhelmed by painful emotions and overloaded with information,incorrect views of medical professionals and parents,negative communication,and cultural context.Conclusions:Parents and professionals should avoid myths about protecting the child and encourage open communication that respects the child’s wishes.The specialized pediatric palliative care team should carefully monitor parent-child communication,determine if any obstacles exist,and design more interventions to enhance it.
文摘BACKGROUND: Cerebral arterial stenosis can cause cerebral hypoperfusion, and than result in the decline of cognitive function, whereas the cognitive dysfunction induced by different cerebral arterial stenosis have different manifestations and types. OBJECTIVE: To observe the differences of cognitive and memory dysfunctions in patients with cerebral arterial stenosis of different types. DESIGN: A comparative observation. SETTING: Affiliated Hospital of Jining Medical College. PARTICIPANTS: Forty-two outpatients or inpatients with cerebral arterial stenosis were selected from the Department of Neurology, Affiliated Hospital of Jining Medical College from February 2005 to January 2006, including 25 males and 17 females. There were 18 cases of internal carotid arterial stenosis, 14 cases of vertebrobasilar arterial stenosis and 10 cases of whole cerebral arterial stenosis. The diagnostic standards for cerebral arterial stenosis were identified according to North American Symptomatic Carotid Endarterectomy Trial (NASCET). Meanwhile, 18 healthy physical examinees were enrolled as the control group, including 10 males and 8 females, aged 58-80 years old. All the enrolled subjects were informed and agreed with the detection and evaluation. METHODS: ① The memory function was evaluated using revised Wechsler memory scale for adults, including long-term memory (experience, orientation and counting), short-term memory (visual recognition, picture memory, visual regeneration, association and thigmesthesia) and sensory memory (forward and backward recitation of numbers). The scale scores were turned to memory quotients. The higher the scores, the better the memory function. ② The cognitive function was evaluated using revised Wechsler adult intelligence scale: It consisted of eleven subtests, including six language scales (information, digit span, vocabulary, arithmetics, apprehension, similarity) and five operation scales (picture completion, picture arrangement, block design, geometric design, digit-symbol test). The intelligence quotients were obtained. The higher the scores, the better the cognitive function. MAIN OUTCOME MEASURES: Results of memory and cognitive function test in patients with cerebral arterial stenosis of different types. RESULTS: All the 42 patients with cerebral artery stenosis and 11 healthy subjects were involved in the final analysis of results. ① Results of memory function test: The memory function was worse in the arterial stensis groups than in the control group (P < 0.05-0.01). There were very significant differences in the scores of orientation, association and picture memory between the internal carotid arterial stenosis group and control group (P < 0.01). There were also very significant differences in the scores of counting, logic memory, forward and backward recitation of numbers, visual regeneration, visual recognition and thigmesthesia between the vertebrobasilar arterial stenosis group and control group (P < 0.01). Except experience and visual regeneration, there were significant very differences in the scores of the other tests between the whole cerebral arterial stenosis group and control group (P < 0.01). The memory quotient was obviously lower in the vertebrobasilar arterial stenosis group than in the internal carotid arterial stenosis group [(72.31±26.46), (87.38±21.86) points, P < 0.05], and it was the lowest in the whole cerebral arterial stenosis group [(63.74±25.25) points]. ② Results of cognitive function test: The cognitive function was worse in the arterial stensis groups than in the control group (P < 0.05-0.01). There were very significant differences in the scores of apprehension, arithmetics, similarity, digit-symbol test, picture completion and block design between the internal carotid arterial stenosis group and control group (P < 0.01). There were also very significant differences in the scores of backward recitation of numbers, vocabulary and geometric design between the vertebrobasilar arterial stenosis group and control group (P < 0.01). Except information, there were significant very differences in the scores of the other tests between the whole cerebral arterial stenosis group and control group (P < 0.01). The intelligence quotient was obviously lower in the internal carotid arterial stenosis group than in the vertebrobasilar arterial stenosis group [(72.65±23.39), (81.34±25.46) points, P < 0.05], and it was the lowest in the whole cerebral arterial stenosis group [(65.98±27.34) points]. CONCLUSION: Different cerebral arterial stenosis can induce different cognitive dysfunctions. The main manifestation of the patients with internal carotid arterial stenosis was the declined cognitive function, and that in patients with vertebrobasilar arterial stenosis was the declined memory, and the decrease of total intelligence was more obvious in the formers than in the latters, whereas the decrease of total memory quotient was more obvious in the patients with vertebrobasilar arterial stenosis; The cognitive and memory dysfunction were the most serious in patients with whole cerebral arterial stenosis.
文摘The Intrinsic structural disorder (ISD) of native EWS and its fusion oncogenic proteins, including EWS/FliI, EWS/ATF1 and EWS/ZSG, was estimated by different Predictors. The ISD difference between the wild type and the oncogenic fusions found in the CTD is due to the fusion partner, usually a transcription factor (TF). A disordered region was found in the sequence (AA 132 - 156) of the NTD (EAD) of EWS, consisting of the longest region free of Y motifs. The IQ domain (AA 258 - 280), a Y-free region, flanked by two Y-boxes, is also disordered by all used Predictors. The EWS functional regions RGG1, RGG2 and RGG3 are predominantly disordered. A strong dependence was found between the structure of EWS protein and its oncogenic fusions, and their estimated ISD. The oncogenic function of the fusions is related to a decreased ISD in the CTD, due to the fused TF. The Predictors shown that the different isoforms have similar profiles, shifted with some amino acids, due to the translocations. On the bases of the prediction results, an analysis was made of the EWS sequence and its functional regions with increased ISD to make a relationship sequence-disorder-function that could be helpful in the design of antitumor agents against the corresponding malignances.
文摘Personality disorders are a class of mental disorders involving enduring maladaptive patterns of behaving,thinking,and feeling which profoundly affect functioning,inner experience,and relationships.This work focuses on three Cluster B personality disorders(PDs)(Borderline,Narcissistic,and Antisocial PDs),specifically illustrating how relational dysfunction manifests in each condition.People with Borderline Personality Disorder(BPD)experience pervasive instability in mood,behavior,self-image,and interpersonal patterns.In relationships,they tend to alternate between extremes of over-idealization and devaluation.Intense fear of abandonment,fluctuating affect,inappropriate anger,and black/white thinking deeply influence how they navigate personal relationships,which are often unstable,chaotic,dramatic,and ultimately destructive.They have a fundamental incapacity to self-soothe the explosive emotional states they experience as they oscillate between fears of engulfment and abandonment.This leads to unpredictable,harmful,impulsive behavior and chronic feelings of insecurity,worthlessness,shame,and emptiness.Their relationships are explosive,marked by hostility/contempt for self and partner alternating with bottomless neediness.Manipulation,lying,blaming,raging,and“push-pull”patterns are common features.Individuals with Narcissistic Personality Disorder(NPD)exhibit a long-standing pattern of grandiosity and lack of empathy.They have an exaggerated sense of self-importance,are self-absorbed,feel entitled,and tend to seek attention.Scarcely concerned with others’feelings,they can be both charming and exploitative.Oversensitive to criticism,they are prone to overt or covert rage,gaslighting and self-referential thinking.Antisocial Personality Disorder(APD)is marked by impulsive,callous,and irresponsible behavior with no regard to be manipulative,parasitic,aggressive,cold,cruel,and self-serving.In addition to analyzing relational dysfunction in each disorder,this paper presents three relational case studies(BPD-couple,NPD-parent/child,APD-various relations)and discusses treatment implications.
基金Collaborative education project of industry university cooperation of the Ministry of Education of China:Research on practice teaching of the competency of future mental health teachers based on virtual reality(No.202102080005).
文摘Objective:The study is to analyze the influence of parent-child relationship on pupils’learning motivation,and to explore the mediating mechanism of teacher-student relationship in parent-child relationship and learning motivation.Method:This study conducted a questionnaire survey on 213 pupils in Grades 5 and 6 in two schools in Beijing using Pianta’s teacher-student relationship scale revised by Qu,Dornbush’s parent-child intimacy scale revised by Zhang and the learning motivation scale adapted by Hu.Results:Gender,grade,whether they are the only child and to be a class cadre or not show significant differences in some dimensions of parent-child relationship,teacher-student relationship and learning motivation.The total scores of parent-child relationship,teacher-student relationship and learning motivation are positively correlated,and some sub dimensions are also significantly correlated.Parent-child relationship and teacher-student relationship have a significant positive predictive effect on learning motivation,and parent-child relationship has a significant positive predictive effect on teacher-student relationship.Teacher-student relationship plays a mediating role in the influence of parent-child relationship on learning motivation.Conclusions:Parent-child relationship can promote the relationship between teachers and students,and then enhance pupils’learning motivation.
文摘<strong>Background:</strong> Nurses play a central role in the treatment of inpatients with anorexia, where bonding is a key factor. The inpatient-nurse relationship is based on a confident alliance characterized by important factors such as trust, confidentiality, responsiveness, genuineness, and consistency. <strong>Aim and Research Question:</strong> The aim of this study was to describe patients’ in-depth experiences of their relationship with nurses when hospitalized for anorexia. The research question was: How do women hospitalized due to anorexia nervosa experience the nurse-patient relationship? <strong>Method:</strong> A hermeneutic approach with in-depth interviews was employed. Five women with previous experience of inpatient care for anorexia were interviewed. <strong>Findings:</strong> The findings summarized how the women experienced the relationship with professional nurses in a ward characterized by a high degree of structure. The main theme Balancing feelings of emotional contradictions in the patient-nurse relationship was described by two sub-themes;Opening up for a care relationship in a rigid and structured ward atmosphere and Fluctuating in a paradox of conflicting feelings. <strong>Discussion:</strong> From the patients’ perspective, balancing the patient-nurse relationship when an inpatient involves conflicting emotional challenges. Structured interventions are perceived as effective by the patients, although they may be ambivalent about them. Therefore, a good relationship depends on the establishment of emotional and stable interaction with the nurses. <strong>Implications for Nursing Practice:</strong> Patients need interventions based on safe and competent quality care. A hermeneutic approach may improve the nurses’ ability to meet these patients in their lifeworld and establish a confident relationship. Special education related to anorexia care should be a priority in nursing.
