Objective To investigate the effect of training courses of evidence-based medicine (EBM) on the knowledge, skill, attitude and behavior of medical postgraduates and to explore the barriers to evidence-based practice (EBP), so as to provide knowledge to improve further EBM teaching and EBP. Methods A total of 110 medical postgraduates of Sichuan University who selected EBM courses in the autumn semester of 2004 were given questionnaires that combined both open and closed questions. The KAB (knowledge, attitude and behavior) of EBM and barriers to EBP were compared before and after the training courses. Results Differences were observed in KAB of EBM and barriers to EBP after the training courses, compared to the assessments done before the courses. In “Knowledge”: there was a significant increase in the understanding of specific terms in EBM after the training courses (75% of the items showed a statistically significant improvement). This was especially marked for “absolute risk”, “systematic review”, “meta-analysis” and “publication bias” (Plt;0.01). We also found an improvement in familiarity with medical search engines (Plt;0.05). In “Attitude”: the mean scores for most items (55%) were relatively high both before and after the training courses (gt;4), and a significant improvement was observed in 2 items. These were “Strong evidence is lacking to support most of the interventions I use with my patients” and “EBP needs to take into account patient preferences” (Plt;0.01). The mean scores of 2 items were relatively low both before and after the training courses (lt;3). These were “the adoption of EBP places an reasonable demand on physical therapists” and “EBP does not take into account the limitations of my clinical setting”. Another 2 items had mean scores close to 5: “I need to increase the use of evidence in my daily practice” and “I am interested in learning or improving the skills necessary to incorporate EBP into my practice”. In terms of “Behavior”: the medical postgraduates continued not to think highly of the use of literature after the training courses. About 60% of the postgraduates did not read any literature related to their specialties at all. Although searching of MEDLINE and other electronic databases was relatively frequent (gt;6 times/month: 60.3% before training and 65.7% after training), using professional literature and research findings in the process of clinical decision-making was not equal (gt;6 times/month: 29% before training and 35.1% after training). No significant difference was observed in applying clinical practice guidelines before and after the training courses. As for “Barriers”: the postgraduates considered “poor ability to critically appraise literature” as the most important barrier both before and after the training courses. The second and third most important barriers were different compared to after the training courses. The barrier of “lack of research skills” was larger than that of “lack of information resources” before the training courses, but after that the course, the order of these was reversed. Conclusion The knowledge of medical postgraduates increased significantly after the current training courses of EBM. Some improvement was also found in attitude and behavior. The top three barriers to EBP were “Poor ability to critically appraise literature”, “Lack of information resources”, and “Lack of research skills”
Objective To investigate the prevalence of behavior problems in twins aged 10-16 years, and to provide a theoretical basis for the prevention and treatment of twins’ behavior problems. Methods Sixty-four pairs of twins aged 10-16 years in Chengdu city participated in this study. The Child Behavior Checklist (CBCL), completed by parents, was used to assess behavior problems. The prevalence of behavior problems in twins and the distribution characteristics for boys and girls and zygosities were estimated. Results The prevalence of behavior problems in the twins in this study was 6.25%. This was lower than the prevalence in a nationwide non-twins epidemiologic survey (P=0.0045). No significant difference was found in the prevalence of behavior problems between boys and girls and between different zygosities (P=0.891; P=0.258). Social problems were the main behavior problems noted in these twins, accounting for 38%. Conclusions The prevalence of behavior problems in twins aged 10-16 years is lower than that of non-twins. Social problems are the most common behavior problems in the twins in this study.
Objective To investigate the suicide related factors of the teenagers after trauma and further discuss the prevalence and related factors of suicide idea plan and behavior. Methods Using the general information questionnaire and the Youth Risk Behavior Survey (YRBS) to investigate the primary and secondary students in the nine worst-hit areas in Wenchuan earthquake of 2008, with cluster random sampling and the class as a sampling unit, to extract random 110 primary and middle schools and gather their general information, disaster-related cases and scores of suicide in YRBS. According to the different types of data, we used descriptive statistics,t test,Chi square test and Logistic regression analysis and respectively use single factor analysis and multivariate logistic regression analysis for suicide idea, plan and behavior. Results A total of 7 833 questionnaires were sent out and a total of 7 521 questionnaires were collected and the recovery rate was 96. 02%. Among them, there were 6 875 valid questionnaires (91.41%) and 636 invalid questionnaires. According to the investigation, the prevalence of the primary and secondary students which had seriously considered suicide was 6. 90%, which had a plan to commit suicide was 4.00% and which tried to take over the action of suicide was 2.70%. With general information for the independent variable, logistic regression analysis showed that whether there had seriously considered suicide as the dependent variable: age (OR=1.178, 95%CI 1.098 to 1.178) and changed in family structure after the earthquake (OR=1.360, 95%CI 1.360 to 1.085) were risk factors for post disaster the teenagers with suicide idea; whether there had been plan to commit suicide as the dependent variable: age (OR=1.099, 95%CI 1.050 to 1.150), the history of being buried in ruin (OR=2.155, 95%CI to 1.104 to 4.205) and changed in family structure after the earthquake (OR=1.495, 95%CI 1.128 to 1.981) were risk factors for post disaster the teenagers with suicide plan; whether took over the action of suicide as the dependent variable: male (OR=1.513, 95%CI 1.122 to 2.039) and changed in family structure after the earthquake (OR=1.555, 95%CI 1.112 to 2.175) were risk factors for post disaster the teenagers with suicide behavior. Conclusion Age and changed in family structure after the earthquake were the risk factors for suicide idea and age was positively correlated with suicidal idea. Age, had the history of being buried in ruin and changed in family structure after the earthquake were the risk factors for suicide plan and age was positively associated with suicide plan. Male and changed in family structure after the earthquake were the risk factors for suicide behavior. Among them, changed in family structure after the earthquake was the common risk factor. So there should be targeted psychological assessment and psychological rehabilitation intervention to avoid the risk of suicide among the teenagers after the disaster.
Childhood is the key period of psychological and behavioral development of children. The changes of children's psychological behavior during this period have an impact on the psychological and behavioral patterns of adolescents and even adults. Epilepsy is a chronic and recurrent disease, which affect the development emotional behavior problem of children with epilepsy seriously. This paper reviewed the influencing factors, measuring methods and intervention of emotional behavior problems in children with epilepsy so as to alleviate the negative emotion and behavior problems and provide quality of life in children with epilepsy.
ObjectiveTo analyze the development and evolution of the theoretical domains framework (TDF), behavior change wheel (BCW), and behavior change technique (BCT). MethodsThe PubMed, EMbase, EBSCO, Web of Science, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect related studies on the establishment and development of theoretical frameworks for behavior change from the inception to September 4, 2022. Two researchers independently screened the literature, extracted the data, and conducted qualitative analysis and summary. ResultsA total of 11 studies were included, and the establishment and development of TDF, BCW and BCT taxonomy was analyzed, integrated and presented in this article. ConclusionTDF, BCW and BCT taxonomy are the fundamental theoretical framework of behavior change, which can be used independently and can be mapped and integrated with each other, providing theoretical guidance for the analysis of obstacles and promoting factors in the implementation of research and the design of intervention measures, with good promotion value. However, there are few domestic applications, so expanding the application in the local environment is necessary.
ObjectiveTo systematically review the relationship between polycyclic aromatic hydrocarbons (PAHs) and emotion and behaviors in children and adolescents. MethodsThe PubMed, EBSCO, Web of Science, CBM, VIP, WanFang Data, OVFT, Proquest Psychological database and CNKI databases were electronically searched to collect studies on the relationship between PAHs and emotion and behaviors in children and adolescents from inception to October 20, 2022. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. A qualitative systematic review was then performed. ResultsA total of six cohort studies were included, five studies involving maternal exposure during pregnancy, found that maternal exposure to PAHs during pregnancy was associated with an increase in childhood anxiety/depression syndrome, attention problems, social withdrawal, social competence, social problems, orientation/regulation, withdrawal behaviors, and autism-related behaviors. Another study of exposure in school-age children found that PAHs exposure was associated with poorer attention performance in school. Results of other emotional behaviors were inconsistent, or no association was found. ConclusionCurrent evidence shows that PAHs have certain effects on emotional behaviors of children and adolescents. Due to the limited quality and quantity of the included studies, more high-quality cohort studies are required to verify above conclusion.
Objective To summarize and analyze the clinical and video-EEG (VEEG) characteristics of adult sleep-related epilepsy, so as to provide evidence for clinical diagnosis, differential diagnosis and treatment. Methods The clinical data, routine EEG and long-term VEEG of 187 adult patients with sleep-related epilepsy treated in Department of Neurology, Xiangya Hospital, Central South University from January 2017 to December 2017 were retrospectively analyzed by χ2 test. Results Clinical manifestations: The duration of sleep-related epilepsy in 187 adults was concentrated in 1～10 years (101 cases, 54.01%); the frequency of seizures was mainly from several to dozens of times a year (99 cases, 52.94%); 119 cases (63.64%) had two or more types of seizures. Among the patients, 121 cases (39.29%) had focal origin, 152 cases (49.35%) had bilateral tonic clonus and 110 cases (58.82%) were treated with two or more drugs. EEG results: ① The detection rate of epileptiform discharges in routine EEG was 22.78%, and that in long-term video EEG was 80.43%. There was significant difference between the two methods (P< 0.01); ② Eighteen epileptiform discharges were monitored by routine EEG during interparoxysmal period and 111 epileptiform discharges were monitored by video EEG; and ③ Fifty-six epileptic events were monitored and all occurred in the process of long-term VEEG monitoring, 50 of them occurred in sleep (89.29%) and 6 in awake (10.71%); 45 cases (80.36%) were diagnosed as epileptic seizures, 9 cases (16.07%) were diagnosed as non-epileptic seizures, and 2 cases (3.57%) could not be determined. ④ The detection rate of epileptic discharges during sleep was higher than that during awake period in long-term VEEG monitoring (P< 0.01). The detection rate of epileptiform discharges in NREM stage I–II was the highest in sleep stage. Conclusion Sleep-related epilepsy in adults has certain clinical features and EEG manifestations. Compared with conventional EEG, long-term video-EEG can improve the detection rate of epileptiform discharges, provide diagnostic basis for the qualitative analysis of sleep-related seizures, and reflect the relationship between epileptiform discharges and sleep, and provide basis for the clinical diagnosis and treatment of sleep-related epilepsy in adults.
Objective To investigate the current status of self-management knowledge, attitude and behavior and influencing factors in patients with chronic obstructive pulmonary disease (COPD) in Qianbei area, and to analyze the influencing factors. Methods A total of 329 COPD patients were recruited and investigated with self-compiled questionnaire for self-management knowledge, attitude and behavior of chronic obstructive pulmonary disease, and SPSS 17.0 software was used to analyze the data. Results The mean score of self-management knowledge, attitude and behavior in COPD patients was 132.6±17.0, in which the scores of each dimension from high to low were as follows: smoking, medication treatment, exercise and family oxygen therapy. The analysis of stepwise regression indicated that the main influencing factors of self-management of COPD patients were age, sex, address, degree of education, course of disease and smoking. Conclusions The self-management level of the disease recognition, attitude and behavior in COPD patients should be improved, in which the knowledge is key factor to promote the health behavior of patients. So the healthy workers should pay close attention to the influence factors and apply the new thinking pattern and methods to improve the self-management ability and the quality of life of patients.
ObjectivesTo systematically review the association between pubertal development progression and emotional and behavioral problems.MethodsVIP, CNKI, CBM, WanFang Data, PubMed, Web of Science and EBSCO databases were electronically searched to collect studies on the relationship between pubertal tempo or trajectory and emotional and behavioral problems from inception to December 31st, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Qualitative methods were then used to analyze the data.ResultsA total of 14 cohort studies were included. The results showed that depression was the most studied emotional problem, and 2 of the 3 studies found a significant association between faster pubertal tempo and more depressive symptoms in juvenile males. However, no association was found in 3 of the 4 studies on juvenile females. The content of behavioral problems of included studies was broad, including internalizing and externalizing problems, substance abuse, attention problem, self-control, first-sexual experience, delinquency, conduct disorder, peer relationship, etc. However, few studies on the same behaviors, and the relationship between behavioral problems was unclear.ConclusionsThe faster pubertal tempo may be associated with depression in juvenile males. The association between pubertal tempo and behavioral problems in males and females remain to be determined by more studies.
Objective To research whether systemic family therapy is a useful intervention for behavioral problems. Methods Two hundred and seventy six children who were in the fourth grade of elementary school were assessed by family dynamics questionnaires and their parents were tested by Achenbach Child Behavioral Checklist. Fifty-seven children with behavioral problems were divided into two groups: 20 children and their parents agreed to receive systemic therapy for four weeks and 37 children and their parents who refused this therapy formed the control group.All children and their parents were reassessed after four months. Data were analyzed by SPSS 11.5. Results The characteristics of family dymanmic and children’s behavior improved significantly after systemic therapy. The "depressing and hostile family" at mosphere became "harmonious and open" (P=0.000) and this was also significantly better than the control group after therapy(P=0.000). "Self-differentiation of family members" was significantly improved after therapy (P=0.000) and also was significantly better than the control group after therapy (P=0.005). "Patient is helpless victim" changed to "Patient can do something" (P=0.000) and this was significantly better than the control group after therapy (P=0.003) . Total CBCL score decreased in the treatment group after therapy (P=0.003 for father, P=0.000 for mother). Compared with the control group. Total CBCL score also showed decreases (P=0.033 for father, P=0.014 for mother). Conclusions The techniques of systemic family therapy are practical and effective methods to intervene children’s behavioral problems.