糖尿病高血压和糖尿病肾病患者血清MMP-2及TIMP-1的表达及意义

为了探讨MMP-2、TIMP-1在DMEH和DN发病中的意义,随机收集T2DM患者146例,其中SDM 57例,DMEH 38例,DN 51例,健康对照38例。用ELISA法测定MMP-2、TIMP-1的含量。结果显示,DM患者尤其是DMEH和DN患者血清MMP-2明显低于健康对照组,P均〈0.01,且随病情发展呈逐渐降低趋势。而血清TIMP-1随病情的发展则呈现明显的上升趋势,SDM、DMEH组和DN组与健康对照组比较,分别为P〈0.05,P〈0.01和P〈0.01。因此,MMP-2和TIMP-1可能参与了DMEH和DN的发生发展过程,定期检测DM患者血清MMP-2和TIMP-1的含量变化有助于DM并发症的早期诊断和疗效观察。     

The social context as a determinant of teacher motivational strategies in physical education

ObjectivesThe purpose of the study was to provide an in-depth analysis of how the Physical Education (PE) teaching context influences teachers' motivational strategies towards students.DesignQualitative semi-structured interviewsMethodsUsing Self-determination theory (Deci, E. L., & Ryan, R. M. (2000). Psychological Enquiry, 11, 227-268) as a guiding framework, semi-structured interviews of 22 PE teachers were examined using categorical content analysis.ResultsThe teachers perceived that an emphasis on student assessment and the time constraints associated with PE lessons often compelled them to use teaching strategies which conflicted with their beliefs about the most appropriate ways to motivate students. The teachers' own performance evaluations and pressure to conform to other teachers' methods also influenced the teachers' motivational strategies, but these influences were often congruent with their teaching beliefs. Additionally, the teachers discussed how perceived cultural norms associated with the teacher-student relationship impacted upon their chosen motivational strategies. These cultural norms were reported by different teachers as either in line, or in conflict with their teaching beliefs. Finally, the influence of the teachers' perceptions of their students helped produce strategies that were congruent with their beliefs, but often different to empirically suggested strategies.ConclusionsIt is important that teacher beliefs are targeted in education programs and that the teaching context aid in facilitating adaptive motivational strategies.     

Getting one's thoughts straight: A dialogical analysis of women's accounts of poorly controlled type 2 diabetes

Type 2 diabetes is a metabolic disorder characterised by chronically elevated blood glucose and a high risk of cardiovascular and other complications. Self-management is central to diabetes care and includes taking regular exercise, low-fat/sugar diet and blood glucose monitoring. However, little is understood about how people with diabetes make sense of self-management. Our aim, therefore, is to explore the process of ‘getting one's thoughts straight’ in relation to illness self-management for women with poorly controlled type 2 diabetes. Eight women were recruited from two hospitals in the North of England. Each was interviewed using a biographic-narrative method. Narratives were analysed using a dialogical approach. We use Bakhtin's concepts of voice, official and unofficial truth, and internally persuasive discourse to explore how participants considered, struggled with, and, sometimes, acted upon self-management. We demonstrate how the truth by which participants lived shifted as they encountered new perspectives and experiences. The accounts revealed tension between official, authoritative voices, typically concerned with optimal illness control and unofficial voices that speak at a lived, embodied level. In conclusion, we suggest moving beyond the notion of self-management towards a conceptualisation of life with chronic illness that includes personal goals, values and embodied experience in context.     

Learning strategies as determinants of memory deficiencies

Two tests were made of inferences about how learning strategies affect recall accuracy, and how peculiarities of strategy might account for mentally retardeds' memory deficiencies. Learning strategy was defined as the pattern of pauses generated by S as he paced himself through serial lists of letters. When given freedom to proceed as they wished, normally intelligent Ss paused increasingly the deeper they went into the list. Retarded Ss did not. It was concluded that the normals' active strategies contribute to their high primacy, while the retardeds' lack of distinctive pauses accounts for their low primacy. In the second test, the strategies were reversed. The normals were forced to abandon rehearsal; the retardeds were forced to rehearse. This resulted in greatly enhanced primacy for the retardeds, and greatly decreased primacy for the normals. In addition to showing how spontaneous strategies and forced strategies can directly influence recall accuracy, these findings suggest a reasonably simple means of mitigating short-term memory deficiencies.     

Spouses' responses to the dietary nonadherence of their partners managing diabetes

The association between patients' dietary nonadherence and spouses' involvement in patients' diabetes diet was examined, with spouses' anxiety about nonadherence considered as a mediator of this association. Daily diary data from 128 older adult patients with type 2 diabetes and their spouses were analyzed using multilevel models. Results revealed that on days when patients reported less adherence to their diabetes diet than usual, spouses reported greater anxiety about patients' diabetes management, which, in turn, was related to greater spousal persuasion and pressure the same day. The association between patients' nonadherence and diet‐related support on the same day was not mediated, however, through spouses' anxiety. The findings contribute to an understanding of spouses' responses to patients' nonadherence to their diabetes regimen.     

Protection Motivation Theory and Adolescents' Perceptions of Exercise1

Coping strategies endorsed by adolescents in dealing with a potential threat to their health were assessed in a study which investigated components of protection motivation theory. Year 9 and 10 high school students were presented with information about cardiovascular disease risk and the role of exercise in maintaining cardiorespiratory fitness. Three components specified by the theory were manipulated: response efficacy (effectiveness of exercise in preventing cardiovascular disease), response costs (costs associated with taking up a regular program of exercise) and self-efficacy (belief in ability to carry out a program of exercise) in a 2 × 2 × 2 factorial design with two levels (high vs. low) of each variable. It was hypothesized that such information would affect participants' perceptions of response efficacy, response costs, self-efficacy, and their selection of coping strategies. Six dependent variables were investigated: two adaptive coping strategies (behavioral intention to exercise, rational problem solving) and four maladaptive strategies (avoidance, wishful thinking, hopelessness, arid fatalism). Manipulation checks found significant differences between the high and low conditions of each independent variable. Adaptive strategies were strongly endorsed, whereas endorsement of the maladaptive strategies ranged from minimal to complete disagreement. Participants in the high self-efficacy condition indicated stronger intentions to exercise. Students in the low response efficacy condition demonstrated more endorsement of hopelessness and fatalism than did students in the high response efficacy condition. When exercising status was included as a fourth independent variable, it was found that active adolescents endorsed the adaptive coping strategies more strongly than did inactive adolescents. The cognitive coping strategies adopted by adolescents when dealing with perceived threats to their health may be influenced by information on the efficacy of relevant behavior, by perceptions of their ability to perform such behavior, and by their actual involvement with the behavior of concern.     

The roles of self-regulation and partner regulation on romantic relationship quality

Research into self-regulation and partner regulation strategies has largely involved parallel lines of research, thus, it is difficult to determine the relative contribution of both forms of regulation when it comes to relationship outcomes. Therefore, the question remains as to which form of regulation is more strongly associated with relationship quality; is it more important to focus on adaptive self-regulation or adaptive strategies to regulate one's partner? The current research addresses this important gap by comparing the relative associations of adaptive self-regulation and adaptive partner regulation strategies on romantic relationship quality. A community sample of mixed gender couples (N = 114) who were predominantly satisfied with their current relationships – but nonetheless still experienced relationship conflict – were administered self-report assessments of various self-regulation and partner regulation strategies as well as a measure of relationship quality. Couples also participated in a videotaped discussion of an unresolved relationship issue that was scored by trained coders for verbal and nonverbal indicators of self-regulation and partner regulation strategies. Actor–partner interdependence modeling revealed that for both men and women, adaptive self-regulation strategies were positively associated with their own evaluations of relationship quality as well as their partner's relationship quality. In contrast, engaging in adaptive partner regulation strategies was not significantly associated with men's or women's own, or their partner's relationship quality. Findings highlight the importance of focusing on self-regulation in relationships, as it is these strategies, over partner regulation strategies, that have more positive implications for the relationship quality experienced by typically satisfied couples.     

The Impact of Managing School-aged Children’s Diabetes: The Role of Child Behavior Problems and Parental Discipline Strategies

Models of diabetes management in children emphasize family relationships, particularly parent–child interactions. In adolescents, parental involvement in disease-specific management relates to better health and adherence. However, information about parental involvement in disease management for young children is limited and mixed. This study investigated behavior problems of school-aged children with Type 1 Diabetes Mellitus (T1DM) in association with parent discipline strategies and parents’ perceptions of (1) time spent managing diabetes and (2) the impact their child’s diabetes has on their discipline strategies. Parents of children ages 5–12 with T1DM completed standardized measures of child misbehavior, parent discipline strategies, and responded to questions regarding perceived time spent managing diabetes, and perceived impact of diabetes on ability to discipline. Results showed child mealtime misbehavior was common and associated with overreactive parental discipline. Further, overreactive discipline was also associated with reports of less time spent managing child’s illness. Child misbehavior was positively associated with parents’ perceived amount of time spent managing diabetes and with the impact of child diabetes on discipline. Findings suggest the importance of considering parent discipline strategies and child misbehavior when working with young children with diabetes.     

The Effect of Genetic Counseling for Adult Offspring of Patients with Type 2 Diabetes on Attitudes Toward Diabetes and its Heredity: A Randomized Controlled Trial

The aim of this study is to investigate the effect of diabetes genetic counseling on attitudes toward diabetes and its heredity in relatives of type 2 diabetes patients. This study was an unmasked, randomized controlled trial at a medical check-up center in Japan. Subjects in this study are healthy adults between 30 and 60 years of age who have a family history of type 2 diabetes in their first degree relatives. Participants in the intervention group received a brief genetic counseling session for approximately 10 min. Genetic counseling was structured based on the Health Belief Model. Both intervention and control groups received a booklet for general diabetes prevention. Risk perception and recognition of diabetes, and attitude towards its prevention were measured at baseline, 1 week and 1 year after genetic counseling. Participants who received genetic counseling showed significantly higher recognition about their sense of control over diabetes onset than control group both at 1 week and 1 year after the session. On the other hand, anxiety about diabetes did not change significantly. The findings show that genetic counseling for diabetes at a medical check center helped adults with diabetes family history understand they are able to exert control over the onset of their disease through lifestyle modification.     

Does rejection lead to disidentification? The role of internal motivation and avoidance strategies

Getting rejected can either push newcomers out of the group or make them try harder to become accepted. It is suggested that newcomers' internal motivation to become a group member and their strategies determine the outcomes of rejection. It was expected that in rejected newcomers, avoidance strategies (but not approach strategies) lead to stronger disidentification. Moreover, the disidentification effect of avoidance strategies is predicted to be buffered by the internal motivation to become a group member. Two studies supported these predictions. Study 1 manipulated the group's feedback (rejection vs. acceptance) and assessed internal motivation and strategies. Study 2 measured feedback and replicated the findings in the field. Thus, by the adoption of the right motivational approach, newcomers can prepare themselves not to be driven out of a new group by the almost unavoidable experiences of rejection. Copyright © 2010 John Wiley & Sons, Ltd.     

Preventing School Bullying: Investigation of the Link between Anti‐Bullying Strategies,Prevention Ownership,Prevention Climate,and Prevention Leadership

School bullying has been a major health and safety concern for teachers and students, which calls for effective strategies to address the issue. In this study, we explored individual and organisational factors that improve the effects of teachers’ use of anti‐bullying strategies in reducing or preventing student bullying. Specifically, we examined the moderating role of teachers’ psychological ownership of their school's anti‐bullying system in the relationship between teacher‐reported use of anti‐bullying strategies and student‐reported bullying incidents. We also investigated how principals’ bullying prevention leadership, rated by a group of directors who are the immediate subordinates of these principals, inspires teachers’ psychological ownership of their school's anti‐bullying system through building teachers’ shared perceptions of a bullying prevention climate. Results of multilevel analyses of multisource data from 2,123 teachers, 407 directors, and 15,967 students in 110 junior and senior high schools indicated that the impact of teacher‐reported use of anti‐bullying strategies on student‐reported bullying incidents was strengthened when teachers have a high level of psychological ownership of their school's anti‐bullying system. Further, principals’ bullying prevention leadership was significantly positively related to teachers’ psychological ownership of their school's anti‐bullying system through teachers’ shared perceptions of a bullying prevention climate.     

Investigating How Test-Takers Change Their Strategies to Handle Difficulty in Taking a Reading Comprehension Test: Implications for Score Validation

This article investigates how test-takers change their strategies to handle increased test difficulty. An adult sample reported their test-taking strategies immediately after completing the tasks in a reading test. Data were analyzed using structural equation modeling specifying a measurement-invariant, ability-moderated, latent transition analysis in Mplus (Muthén & Asparouhov, 2011). It was found that almost half of the test-takers (47%) changed their strategies when encountering increased task-difficulty. The changes were characterized by augmenting comprehending-meaning strategies with score-maximizing and test-wiseness strategies. Moreover, test-takers' ability was the driving influence that facilitated and/or buffered the changes. The test outcomes, when reviewed in light of adjusted test-taking strategies, demonstrated a form of process-based validity evidence.     

Collective efficacy following a series of natural disasters

This article examined adolescents' reports of how they cope with a specific social stressor: authority conflict with parents. This situation was presented to 626 adolescents as part of a larger study on coping with stress. Students were requested to report on the intensity of the stress experienced, intensity of emotions, emotion regulation, perceived availability of social support, goal framing, and coping strategies used. Coping strategies split up factor-analytically into two coping patterns, namely fighting the stressor and coming to terms with the stressor. The relations between these two coping modes and various aspects of the students' mental representation of the stressor were examined. It was predicted that the way students frame the coping goal would affect their choice of coping strategies. Direct effects of coping strategy, emotion regulation and social support on intensity of stress were tested as well as moderating effects of the type of coping mode used on the relationship between emotion regulation and experienced stress. It is suggested that some youngsters consider an authority conflict with their parents as a normal aspect of daily functioning, whereas other view it as a developmental challenge.     

Coping with examinations: Exploring relationships between students' coping strategies,implicit theories of ability,and perceived control

Background Relatively little is known about the contribution of students' beliefs regarding the nature of academic ability (i.e. their implicit theories) on strategies used to deal with examinations. Aims This study applied Dweck's socio‐cognitive model of achievement motivation to better understand how students cope with examinations. It was expected that students' implicit theories of academic ability would be related to their use of particular coping strategies to deal with exam‐related stress. Additionally, it was predicted that perceived control over exams acts as a mediator between implicit theories of ability and coping. Sample Four hundred and ten undergraduate students (263 males, 147 females), aged from 17 to 26 years old (M = 19.73, SD = 1.46) were volunteers for the present study. Methods Students completed measures of coping, implicit theories of academic ability, and perception of control over academic examinations during regular classes in the first term of the university year. Results Multiple regression analyses revealed that incremental beliefs of ability significantly and positively predicted active coping, planning, venting of emotions, seeking social support for emotional and instrumental reasons, whereas entity beliefs positively predicted behavioural disengagement and negatively predicted active coping and acceptance. In addition, analyses revealed that entity beliefs of ability were related to coping strategies through students' perception of control over academic examinations. Conclusions These results confirm that exam‐related coping varies as a function of students' beliefs about the nature of academic ability and their perceptions of control when approaching examinations.     

The use of deep and surface learning strategies among students learning English as a foreign language in an Internet environment

Background. The learning context is learning English in an Internet environment. The examination of this learning process was based on the Biggs and Moore's teaching‐learning model ( Biggs & Moore, 1993 ). Aim. The research aims to explore the use of the deep and surface strategies in an Internet environment among EFL students who come from different socio‐economic backgrounds. The results of the research may add an additional level to the understanding of students' functioning in the Internet environment. Sample. One hundred fourty‐eight Israeli junior and high school students participated in this research. Methods. The methodology was based on special computer software: Screen Cam, which recorded the students' learning process. In addition, expert judges completed a questionnaire which examined and categorized the students' learning strategies. Results. The research findings show a clear preference of participants from all socio‐economic backgrounds towards the surface learning strategy. The findings also showed that students from the medium to high socio‐economic background used both learning strategies more frequently than low socio‐economic students. Conclusions. The results reflect the habits that students acquire during their adjustment process throughout their education careers. A brief encounter with the Internet learning environment apparently cannot change norms or habits, which were acquired in the non‐Internet learning environment.     

Mothers,fathers, and the crisis of newborn intensive care

At hospital discharge of their infant from a newborn intensive care unit, 50 mothers and fathers were interviewed and completed questionnaires. There were significant within-couple correlations for appraisals of the harm that ensued from this crisis, perceptions of personal control over the infant's recovery, and expectations about the infant's future health and development. Mothers perceived more personal control, mobilized more social support, and used more escapist coping strategies than did fathers. Mothers and fathers exhibited different patterns of relations between their own coping strategies and emotional well-being. But, neither the coping strategies used by one's spouse nor differences between spouses in the use of individual coping strategies correlated with emotional well-being. Analysis of parents' perceived differences between their own and their partner's coping strategies suggested the possibility of mutually helpful, complementary strategies of coping with this problem.     

Predicting alternative strategies for preserving a belief in a just world: The case of repressive coping style

Researchers suggest that observers of innocent suffering will negatively evaluate the victim as a strategy for maintaining their belief in a just world. We propose an alternative class of strategies and test whether individual differences in repressive coping style predict the type of strategy people will use. In the first two studies, we exposed repressors versus nonrepressors to victims whose suffering should pose a high versus low threat to the need to believe in a just world. Repressors had a greater tendency to positively reappraise the high threat victim's suffering. Nonrepressors had a greater tendency to negatively evaluate the high threat victim. A third study replicated the results for the high threat conditions and suggested that repressors' positive reappraisal is not because of a tendency to minimize suffering. Our research (i) demonstrates a class of strategies for preserving the belief in a just world other than negatively evaluating the victim and (ii) is among the first to examine directly an individual difference predictor of alternative just‐world preservation strategies. Copyright © 2011 John Wiley & Sons, Ltd.     

Social and Emotional Processes in the Classroom Setting: A Goal Approach

Goals can be defined as cognitive- and as value-related motivational constructs. Consequently, both goal elaboration and personal valuing of goals are emphasized as critical determinants of motivated action. From this perspective, it is argued that goals play an influential role in students' cognitions, and in their social and emotional processes. I explore students' strategies for dealing with potentially stressful classroom circumstances in relation to their goals by examining students' reactions to imagined specific academic stressors, focusing on their emotions, behavior, and goals. Four distinct strategies were defined: strategic flexible action, strategic rigid action, passive behavior, and disorganized behavior. It is suggested that (a) goals play a major role in articulating and integrating behaviors and emotions within a whole strategy, (b) particular combinations of goal characteristics - goal-setting, personal goal valuing, and goal difficulty - are required for successful coping, and (c) both productive behavior and emotional regulation are predicted by specific goal characteristics.     

O rem 自护理论消除帕金森退化反应的应用前景

由于帕金森的发病率逐年上升,并对患者生理、心理、社会等方面造成影响,本文对国内外O rem自护理论消除退化反应的相关文献以及在帕金森疾病中的应用前景进行报道。使用检索电子数据库以及查阅期刊文献。结果发现随着疾病的进展,帕金森会诱发机体一系列的退化反应,这严重影响了患者的生理、心理以及生活质量。大量文献报道了O rem自护理论在消除高血压、糖尿病等慢性疾病退化反应中的应用,但很少文献提及O rem自护理论在消除帕金森退化反应中的应用。笔者认为O rem自护理论有望在消除帕金森退化反应中应用。