我还能活多久?

或许你正值芳年华月、风华正茂,从未来得及想象生命尽头向自己慢慢逼近的感觉;那种似乎死神就在街的转角处、巷子尾的感觉。你看着自己一步一步正朝着生命的尽头靠近,虽不知生命之弦何时会"嘭"地一声断裂,却清楚知道,这根弦已经绷得不能再紧了。此时,你是否会觉得恐惧,不知所措?作者作为医师,看着患者身临此境,却也在重症面前束手无策。医师有责任让患者了解自己的病情,但是从口中吐出的实情,对于患者而言,永远都似刑判般残酷。     

茶果皮多糖理化性质、体外抗氧化活性及对α-葡萄糖苷酶的抑制作用(英文)

研究目的:利用响应面优化茶果皮多糖(TFPP)提取条件,用乙醇分级分段得到4个多糖组分(TFPP-0、TFPP-20、TFPP-40和TFPP-60),并研究其理化性质、抗氧化活性和对α-葡萄糖苷酶抑制作用,为综合高效利用茶果皮多糖资源提供理论基础。创新要点:1.首次将茶果皮作为一种潜在生物资源研究;2.首次研究茶果皮多糖这一功能成分;3.将工艺优化、理化性质和生物活性结合研究。研究方法:三因素三水平响应面设计(见表1),傅里叶转换红外光谱法分析茶果皮粗多糖的功能团结构(见图3),高效液相色谱法检测单糖组分(见表2),2,2'-氨基-二(3-乙基-苯并噻唑啉-6-磺酸)二铵盐(ABTS)自由基清除法(见图4a)和铁离子还原能力法(FRAP)(见图4b)分析茶果皮多糖抗氧化活性。重要结论:1.茶果皮多糖是一种水溶性的酸性杂多糖蛋白复合物;2.乙醇分级是一种有效多糖分离手段;3.茶果皮多糖具有出色的生物活性;4.茶果皮资源可以作为一种可再生生物资源进行深度的开发。     

From Central Guidance Unit to Student Support Services Unit: The Outcome of a Consultation Process in Trinidad and Tobago

In this article, we report on a multiyear consultation project between a consulting team based in the United States and the Ministry of Education in Trinidad and Tobago. The project was initiated with a request for training in counseling for secondary school students but ended with the training of personnel from the Ministry of Education in diagnosis and assessment at the elementary school level. Outcomes included manuals with national norms on phonemic awareness, oral reading fluency, and parent and teacher rating scales for the elementary-age students in Trinidad and Tobago and on a depression screener and an anxiety measure for secondary school students. Details on the consultation process are discussed as are lessons learned.     

Providing students with voice and choice: lessons from intervention research on autonomy-supportive climates in physical education

This article examines the latest thinking about autonomy-supportive climates within physical education. The basis for the inclusion of these climates are self-determination and achievement goal theories which suggest that a teacher's motivating style towards students can be conceptualised along a continuum that ranges from highly controlling to highly autonomy supportive. In general, autonomy-supportive teachers facilitate, whereas controlling teachers interfere with, the congruence between students' self-determined inner motives and their classroom activity. Drawing upon research involving interventions at pre-school, primary and secondary school levels, the paper examines how 27 studies that demonstrate providing pupils with opportunities to become self-directed leads to higher levels skill attainment, physical activity and perceived competence. Implications for curriculum, pedagogy and assessment are addressed and directions for future research are noted.     

Aerobic plus resistance training was more effective in improving the visceral adiposity,metabolic profile and inflammatory markers than aerobic training in obese adolescents

Abstract

The purpose of this study was to determine whether aerobic plus resistance training (AT + RT) is more effective than aerobic training (AT) at reducing inflammatory markers and cardiovascular risk in obese adolescents. A total of 139 obese adolescents were enrolled, aged 15–19 years, body mass index (BMI) ≥ 95th percentile and participated in 1 year of interdisciplinary intervention. They were randomised into two groups: AT (n = 55), AT + RT (n = 61). Blood samples were collected to analyse glycaemia, insulin, the lipid profile, leptin and adiponectin concentrations. Insulin resistance was measured by homeostasis model assessment of insulin resistance index (HOMA-IR). The AT + RT group showed better results with regard to decreased body fat mass, low-density lipoprotein concentration (LDL-c) levels, subcutaneous and visceral fat and increased body lean mass. Indeed, a reduction of hyperleptinaemia and an increase in adiponectin concentrations, promoting an improvement in the leptin/adiponectin ratio, was observed. Important clinical parameters were improved in both types of exercise; however, AT + RT was more effective in improving the visceral adiposity, metabolic profile and inflammatory markers than AT alone, suggesting clinical applications for the control of intra-abdominal obesity and cardiovascular risk in the paediatric population.     

Computer‐based scaffolding to facilitate students' development of expertise in academic writing

Research on expert performance suggests that deliberate practice provides optimal opportunities for expertise development. This study examined whether the provision of computer‐based scaffolding (CBS) guiding deliberate practice facilitates students' development of writing expertise. A CBS environment escribo was designed to externally support expert writing activities, generate feedback and offer opportunities to practise corrected performance in academic writing. There were two testing times. First, the effects of practising writing with escribo were compared with the effects of a practice‐only situation without support. Second, a post‐test comprised composing an essay discussing an academic position without scaffolding. Results revealed that the escribo group at both testing times wrote essays of better comprehensibility than students in the practice‐only group. Furthermore, at both testing times the escribo group expended significantly more time on prewriting. These findings suggest that CBS guiding deliberate practice may be a promising means to facilitate the development of writing expertise.     

A design-based research case study documenting a constructivist ID process and instructional solution for a cross-cultural workforce

As the need for instructing a globalized workforce increases, instructional designers must embrace the constraints and the opportunities these projects provide in order to move the field of cross-cultural instructional design (ID) forward. Cross-cultural projects offer multiple avenues for growth in ID practice, overcoming cultural barriers, and a venue to apply and test contemporary models, methodologies, and theories in ID. This design-based research case study employed a rapid prototyping methodology and the constructivist ID model, Layers of Negotiation, to collect critical cultural information for the design of this cross-cultural instruction. Instructional strategies deemed effective for instructing an unskilled workforce in Dubai, United Arab Emirates, included job aids, situated learning and apprenticeship principles consisting of modeling, coaching and scaffolding. Use of the constructivist ID model and instructional solution for a cross-cultural workforce for The Dubai Mall are presented. Evaluation results indicate the success of the instructional strategies varied dependent upon worker culture, and the sequential nature of the instructional strategies.     

House proud: an ethnography of the BC Gay and Lesbian Archives

Located in the Vancouver apartment of gay liberation activist and retired professional librarian Ron Dutton, the BC Gay and Lesbian Archives continues to be a major repository of lesbian, gay, bisexual and transgender (LGBT) historical materials in British Columbia, Canada, after 40 years of activity. This paper draws on ethnographic fieldwork to examine the motivations behind, perceptions of and activities associated with maintaining the BC Gay and Lesbian Archives as a “semipublic” organization that provides archival services for the public in a private home. By creating a textured account of the BC Gay and Lesbian Archives as a home-based organization, this paper articulates an LGBT, community-based approach to archiving. The findings demonstrate that locating an archives in a private home involves a constant negotiation between issues of the public/private divide of what is considered accessible and inaccessible, sustainable and unsustainable, safe and unsafe. This article also articulates how home-based archiving more broadly challenges the divide between personal and institutional archives and contributes to scholarship pertaining to personal, autonomous, grassroots and social movement archives.     

An Analysis of Anatomy Education Before and During Covid-19: May–August 2020

Coronavirus disease 2019 (Covid-19) created unparalleled challenges to anatomy education. Gross anatomy education has been particularly impacted given the traditional in-person format of didactic instruction and/or laboratory component(s). To assess the changes in gross anatomy lecture and laboratory instruction, assessment, and teaching resources utilized as a result of Covid-19, a survey was distributed to gross anatomy educators through professional associations and listservs. Of the 67 survey responses received for the May–August 2020 academic period, 84% were from United States (US) institutions, while 16% were internationally based. Respondents indicated that in-person lecture decreased during Covid-19 (before: 76%, during: 8%, P < 0.001) and use of cadaver materials declined (before: 76 ± 33%, during: 34 ± 43%, P < 0.001). The use of cadaver materials in laboratories decreased during Covid-19 across academic programs, stand-alone and integrated anatomy courses, and private and public institutions (P ≤ 0.004). Before Covid-19, cadaveric materials used in laboratories were greater among professional health programs relative to medical and undergraduate programs (P ≤ 0.03) and among stand-alone relative to integrated anatomy courses (P ≤ 0.03). Furthermore, computer-based assessment increased (P < 0.001) and assessment materials changed from cadaveric material to images (P < 0.03) during Covid-19, even though assessment structure was not different (P > 0.05). The use of digital teaching resources increased during Covid-19 (P < 0.001), with reports of increased use of in-house created content, BlueLink, and Complete Anatomy software (P < 0.05). While primarily representing US institutions, this study provided evidence of how anatomy educators adapted their courses, largely through virtual mediums, and modified laboratory protocols during the initial emergence of the Covid-19 pandemic.     

Into the Unknown: Examining Neural Representations of Parent–Adolescent Interactions

The parent–adolescent relationship is important for adolescents’ emotion regulation (ER), yet little is known regarding the neural patterns of dyadic ER that occur during parent–adolescent interactions. A novel measure that can be used to examine such patterns is cross-brain connectivity (CBC)—concurrent and time-lagged connectivity between two individuals’ brain regions. This study sought to provide evidence of CBC and explore associations between CBC, parenting, and adolescent internalizing symptoms. Thirty-five adolescents (mean age = 15 years, 69% female, 72% Non-Hispanic White, 17% Black, 11% Hispanic or Latino) and one biological parent (94% female) completed an fMRI hyperscanning conflict discussion task. Results revealed CBC between emotion-related brain regions. Exploratory analyses indicated CBC is associated with parenting and adolescent depressive symptoms.