学校健康教育人才培养的专业课程设计方案研究

我国长期以来缺乏受过系统的专业培训的学校健康教育人才,现任学校卫生保健人员无论是数量还是质量上,都难以满足学校健康事业发展的需求。2014年经教育部批准,上海市首个为中小学校培养健康教育教师的本科专业开始招生。本文根据办学2年多来对专业内涵和人才培养方案的不断深入研究的成果和经验,并结合我国实际情况和国际惯例,从学校健康教育专业人才需求、岗位任务和核心能力分析出发,对以能力为基础的本科层次中小学校健康教育人才培养的专业课程方案进行系统阐述。

3种体育锻炼方式对对立违抗性障碍（倾向）儿童的情绪及行为的影响

探索体育锻炼对对立违抗性障碍(oppositional defiant disorder,以下简称ODD)(倾向)儿童情绪及行为的影响。方法:30名ODD(倾向)儿童被分入3组:排球组(n=10)、八段锦组(n=10)及排球-八段锦交替组(n=10),接受为期8周的干预。干预前、后及随访期使用破坏性行为障碍问卷、Buss-Perry攻击性量表、Conners教师评价量表及儿童-家长关系量表进行评价。被试同时接受神经电生理(GoStop冲动任务)测试,唾液5-羟色胺(5-HT)、5-羟基吲哚乙酸(5-HIAA)和去甲肾上腺素(NE)测定。结果:1)八段锦可缓解易激惹心境、愤怒及怨恨情绪(P<0.05),但对敌意态度影响未见显著(P>0.05)。排球锻炼尽管能改善敌意态度(P<0.05),但会进一步加重易激惹心境、好争论或(和)违抗行为及愤怒情绪(P<0.05)。排球-八段锦交替锻炼仅能改善愤怒情绪及敌意态度(P<0.05)。2)排球组在Stop任务中失抑制率呈上升趋势,在Go任务中反应次数呈下降趋势;八段锦组在Stop任务中反应次数及失抑制率均明显降低。排球-八段锦交替组在Stop任务中失抑制率呈先上升后下降趋势。3)经锻炼,仅八段锦组5-HT浓度显著升高(P<0.05)。除排球组外,其他2组5-HIAA浓度均显著升高(P<0.05)。结论:1)排球运动可能不适合ODD(倾向)儿童;2)八段锦及排球-八段锦交替锻炼在改善ODD(倾向)儿童对立违抗情绪及行为方面效果相当,且可能与提升5-HT及5-HIAA表达水平有关;3)建议怨恨情绪更显著的ODD(倾向)儿童选择八段锦,敌意、易激惹表现更显著的ODD(倾向)儿童选择排球-八段锦交替锻炼。

老人跌倒,尽量避免臀部着地

跌倒已经成为我国65岁以上老年人因伤致死的首位原因,除了要积极预防跌倒,老年人还应该清楚,如果跌倒不可避免,自己应该最大程度地减轻损伤。其实,只要懂得一些“倒”的技巧,就能最大程度地减轻关节、头部等重要部位的严重损伤。老人跌倒多因环境突变引起老年人跌倒的原因是多方面的,包括生理因素:如老人视听功能、肌肉力量均下降等;疾病相关跌倒:如神经系统疾病、脑血管疾病、心血管疾病、骨关节疾病、直立性低血压、糖尿病、帕金森等;药物引起的跌倒:如服用镇静安眠药、抗精神病药、降压药、血管扩张药、降糖药等容易导致神志、精神、血压的改变,从而导致跌倒。

压疮:先分期,再治疗

在日益加剧的社会老龄化发展趋势下,各种疾病导致的长期卧床患者数量正在增加。可由于公共医疗资源有限,患者及家属又缺乏皮肤护理方面的知识,导致压疮的发生率也在逐年上升。那么,该如何防止压疮的发生?已经患了压疮又有何高效救治的方法呢?压疮不是简单的皮损压疮也叫褥疮、压力性溃疡,是指身体局部长期受压使血液循环受阻,进而引起皮肤及皮下组织缺血而发生水疱、溃疡或坏疽。

高仿真模拟人应用于心肺复苏培训效果的系统评价

目的评价高仿真模拟教学在医务人员心肺复苏培训中的应用效果。方法计算机检索2000年至2013年，Cochrane Library、Pubmed、Web of Knowledge、CBM、万方和CNKI中关于医务人员使用高仿真模拟人开展心肺复苏培训的随机对照实验和类实验研究，同时筛检纳入文献的参考文献。由2名研究者对文献质量进行严格评价和资料提取，对符合质量标准的研究进行Meta分析。结果共纳入10项类实验研究及1项RCT。质量评价结果显示，纳入研究的总体质量不高。6项研究的Meta分析显示，高仿真模拟教学与传统教学相比，心肺复苏理论知识的掌握方面比较差异无统计学意义；10项研究的Meta分析显示，高仿真模拟教学与传统教学相比，心肺复苏操作技能的掌握比较差异有统计学意义。结论高仿真模拟教学在心肺复苏操作技能的掌握方面是积极有效的，优于传统教学方法，但在理论知识的获得以及满意度、自信心方面仍需更多的研究进一步证实。

中国大学生网络成瘾发生率的Meta分析

目的系统评价中国大学生网络成瘾的发生情况。方法计算机检索PubMed、EMbase、VIP、WanFang Data和CNKI数据库,搜集大学生网络成瘾发生率的横断面研究,检索时限均为建库至2020年2月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 16.0软件进行Meta分析。结果共纳入65个横断面研究,包括87702例研究对象。Meta分析结果显示,我国大学生网络成瘾总发生率为10.7%[95%CI(9.6%,11.8%)]。其中,2011~2018年网络成瘾发生率为11.7%[95%CI(10.2%,13.2%)]高于2005~2010年的9.6%[95%CI(8.1%,11.1%)];男生为14.6%[95%CI(13.1%,16.0%)]高于女生的6.9%[95%CI(5.9%,7.8%)];城镇生源为12.2%[95%CI(9.3%,15.2%)]高于农村生源的9.0%[95%CI(7.3%,10.6%)];对所学专业不满意的学生为16.2%[95%CI(5.5%,26.8%)]高于满意的学生为5.0%[95%CI(1.3%,8.8%)];学习成绩较差的学生为29.4%[95%CI(11.9%,47%)]高于成绩优秀学生的4.1%[95%CI(1.9%,6.4%)]。结论我国大学生网络成瘾发生率呈明显上升趋势,各地区大学生网络成瘾发生率存在差别,不同性别、所学专业的满意度不同及学习成绩不同的大学生网络成瘾发生率不同。

SOOJI CHIM (Koryo hand acupuncture) for perimenopausal insomnia:Evidence from actigraphy and serum hormone testing

Objective:This study is conducted to determine the effects of SOOJI CHIM(Koryo hand acupuncture,KHA)therapy on sleep structures and perimenopause symptoms among insomniacs.Methods:Totally 49 participants who met the inclusion criteria were enrolled in a two-arm randomized,placebo controlled,patients-blind trial,with 24 cases allocated to a real-KHA group and 25 cases allocated to a sham-KHA group.Patients in each group received corresponding treatment every other day,three times a week for total eight weeks.Both actigraphy and testing of serum hormones level reflected by biological markers such as follicle-stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)were performed at pre-and post-treatment.Additionally,the scores of Pittsburgh sleep quality index(PSQI)was used for assessing the subjective sleep experience of insomniacs.Meanwhile,adverse effects were monitored and recorded.Results:After eight-week treatment,the global scores of PSQI declined significantly(P<0.05)in the realKHA group but not in the sham-KHA group(P>0.05).According to the outcomes of actigraphy,a striking increase was observed in both sleep efficiency(SE)and total sleep time(TST)in the real-KHA group(both P<0.05)but not in the sham-KHA group(P>0.05).However,no significant changes of sleep awakenings(SA)in both groups was found after treatment(both P>0.05).Meanwhile,FSH and LH in the real-KHA group decreased markedly after intervention(both P<0.05)while those indicators only slightly changed in the sham-KHA group(P>0.05).The fluctuation of E2 levels were not significant in both groups(both P>0.05).No serious adverse event was reported in either real-or sham-KHA group.Conclusion:KHA may be a potential alternative therapy for improving perimenopausal insomnia via down regulating the levels of FSH and LH.

Attention network function of insomniacs improved by manual acupuncture: Evidence from Attention Network Task

Objective:To investigate if manual acupuncture can improve the primary insomnia-induced impairments of attention network function and its safety.Methods:Totally 64 eligible participants were enrolled in a randomized controlled trial,with 32 cases allocated to the treatment group and 32 cases allocated to the control group,respectively.The participants in the treatment group received real-acupuncture therapy[acupuncture at 'Five Spirits Acupoints' including Shéntíng(神庭 GV 24),Běnshén(本神 GB 13),Sìshéncōng(四神聪 EX-HN 1),Shéndào(神道 GV11)and Shénmén(神门 HT 7)]whereas participants in control group received sham-acupuncture therapy with Streitberger placebo-needle and same acupoints.Interventions were offered every two days and three times a week for total 8 weeks.Both Pittsburgh sleep quality index(PSQI)and Attention Network Task(ANT)were employed to assess the changes of sleep quality and attention network function at pretreatment and post-treatment,respectively.Meanwhile,adverse effects were monitored and recorded.Results:(1)After 8-week treatment,the total score of PSQI in the treatment group decreased from14.22±3.46 to 8.19±3.34(P<0.001),and the total score of PSQI in the control group decreased from12.84±3.90 to 11.41±3.90(P<0.05).The decrease in the treatment group was more significant than that in the control group(P<0.001).(2)After treatment,the alerting efficiency of both groups increased,the treatment group increased from 40.44±5.62 to 56.44±5.37(P<0.001),and the control group increased from 39.50±6.39 to 40.06±6.14(P<0.05).The increase in the treatment group was more significant than that in the control group(P<0.001).The total reaction time of both groups decreased,the treatment group decreased from 574.94±10.1 to 548.34±15.05(P<0.001),and the control group decreased from578.25±13.26 to 576.78±12.15(P<0.05).The decrease in the treatment group was more significant than that in the control group(P<0.001).(3)No obvious change in orienting efficiency was observed in both groups after treatment(P>0.05).(4)No serious adverse events were reported in this trial,except 2 patients from treatment group had slight hematoma after receiving acupuncture therapy.Conclusion:Acupuncture represents a safe and useful non-pharmacologic intervention option for primary insomniacs with impairments of attention network function(alertness and conflict processing/executive control).