Using Participatory System Dynamics Modeling to Examine the Local HIV Test and Treatment Care Continuum in Order to Reduce Community Viral Load

Achieving community‐level goals to eliminate the HIV epidemic requires coordinated efforts through community consortia with a common purpose to examine and critique their own HIV testing and treatment (T&T) care system and build effective tools to guide their efforts to improve it. Participatory system dynamics (SD) modeling offers conceptual, methodological, and analytical tools to engage diverse stakeholders in systems conceptualization and visual mapping of dynamics that undermine community‐level health outcomes and identify those that can be leveraged for systems improvement. We recruited and engaged a 25‐member multi‐stakeholder Task Force, whose members provide or utilize HIV‐related services, to participate in SD modeling to examine and address problems of their local HIV T&T service system. Findings from the iterative model building sessions indicated Task Force members’ increasingly complex understanding of the local HIV care system and demonstrated their improved capacity to visualize and critique multiple models of the HIV T&T service system and identify areas of potential leverage. Findings also showed members’ enhanced communication and consensus in seeking deeper systems understanding and options for solutions. We discuss implications of using these visual SD models for subsequent simulation modeling of the T&T system and for other community applications to improve system effectiveness.     

自体血清对腰背肌损伤修复作用的动物实验研究

研究自体血清局部注射对腰背肌损伤的治疗效果。建立动物模型,分组对照研究。共将实验动物分为四组,通过手术造成小鼠腰背部肌肉损伤。之后,在损伤的局部注射生理盐水,或原浓度的自体血清、二倍浓缩的自体血清、四倍浓缩的自体血清。在术后第2、4、7日分别测得各组小鼠腰背肌肌力,求四组小鼠腰背肌肌力的平均值及标准差,比较组内及组间的差异。最后,对实验结果进行了综合分析和讨论。自体血清局部注射处理的小鼠,肌力恢复更加明显,愈合后肌力明显增强,术后第7日各组肌力平均值具有显著性差异,以生理盐水注射组为对照组,原浓度血清组、二倍浓缩组、四倍浓缩组平均腰背肌力均高于对照组。动物模型验证了自体血清局部注射疗法在腰背肌损伤的动物模型中是有效的,可以促进腰背肌损伤的修复和愈合。     

Effects of scapular retraction/protraction position and scapular elevation on shoulder girdle muscle activity during glenohumeral abduction

According to scapulohumeral rhythm, shoulder abduction is followed through scapular upward rotation to ensure joint mobility and stability. Of interest, the shoulder abduction can be performed holding the scapula in different positions and in association with scapular elevation, with possible effects on shoulder muscle activity. Therefore, the aim of the study was to analyze the activity of relevant shoulder muscles and the activity ratios between the scapulothoracic muscles, during shoulder abduction performed in different combinations of scapular position (neutral, retracted, protracted) and scapular elevation.The electromyographic activity of middle deltoid, serratus anterior, upper, middle and lower fibers of trapezius was recorded during shoulder abduction movements executed holding the scapula in neutral, retracted and protracted position, and subsequently a shoulder elevation movement. The activation of each muscle and the scapulothoracic muscles activity ratios were determined every 15 degrees, from 15° to 120° of abduction.Scapular retraction led to higher activation of the entire trapezius muscle, whereas protraction induced higher upper trapezius, middle deltoid and serratus anterior activity, along with lower activity of middle and lower trapezius. Shoulder elevation led to higher activity of the upper trapezius and middle deltoid. Moreover, it induced lower activation of the serratus anterior and middle and lower trapezius, thus leading to high ratios between the upper trapezius and the other scapulothoracic muscles, especially between 15 and 75 degrees of abduction.This study highlights that shoulder abduction performed with scapular protraction and in combination with scapular elevation leads to increased activity of the middle deltoid and upper trapezius, resulting in imbalances between the scapulothoracic muscles that could hamper the optimal scapulohumeral rhythm. The abduction performed in the aforementioned scapular conditions also induce potential reciprocal inhibition effects between the movers and stabilizers muscles of scapula, suggesting different motor control strategies of integrating a common shoulder movement with various modification of the scapular position.     

正确对待差异构建和谐病房

在构建和谐病房的实践中,充分认识到差异对其的影响。总结影响和谐病房构建中差异存在的主要形式有五点：不同医生之间差异的存在;不同患者之间差异的存在;医患间情感体验的差异;疗效追求的差异;社会环境理解的差异。提出了加强人文教育、注重医患交流、开展岗位评议活动三条解决方式,使病区环境实现了和谐统一的喜人局面。     

Posture,muscular tone and visual attention in 5 month‐old infants

The present paper aims at studying the relationships between posture, muscle tone and visual attention in 5 month‐old infants. To this end, a specially designed seating arrangement made it possible to vary posture while keeping constant the spatial relationship between eyes and stimuli. Five month‐olds were placed in the reclining position (30°) or in a more erect position (60°). The more erect the posture, the more difficult it should be for the infant to maintain a straight body axis. Muscle tone was evaluated, and infants distinguished in terms of whether they were hypertonic or hypotonic. It was hypothesised that in a more erect position hypotonic children, who experience more difficulties in maintaining posture, should organise their visual exploration in ways different from those considered to be hypertonic. To test it, pairs of three‐dimensional stimuli were presented in the distal visual field for one group (N=48) and in the proximal visual field in another group (N=32) for 2 min in each posture. The dynamical organisation of attention was evaluated through the number and duration of fixations on each target, the number of shifts from one target to the other (alternations) and the number of repetitions (back to the previous target). Results showed that visual behaviour was significantly affected by the distance at which stimuli were presented. Infants spent more time in visual exploration when the object was within reach than when it was out of reach. Although posture was shown to play a role in the organisation of visual exploration, no link with muscle tone was found, a surprising result which is discussed. Copyright © 2002 John Wiley & Sons, Ltd.     

Les deux faces de la construction sociale du harcèlement moral - Nouveaux regards et nouvelles réalités dans le monde du travail

This paper focuses on the emergence of the concept of bullying at work in western societies since the nineties. The authors investigate two hypothesis : bullying is associated with new conceptions of social relations and bullying is associated with new work realities. The paper demonstrate that the two hypothesis are complentary.     

EFFECTS OF RESPONSE SPACING ON ACQUISITION AND RETENTION OF CONDITIONAL DISCRIMINATIONS

Pigeons were exposed to a repeated acquisition procedure in which no delays were imposed and rate of responding was relatively high. They also were exposed to conditions in which delays were arranged between trials within chains or between completed chains, and rates of responding were lower. Number of trials, rate of reinforcement, difficulty of the discrimination, and motivating operations were held constant. Terminal accuracy was highest under the no‐delay condition, in which rate of responding was highest. Effects of trial spacing on retention were mixed and depended on whether delays were imposed between trials within chains or between completed chains. These findings provide basic‐research support for the rapid presentation of trials in direct instruction and for rate building in precision teaching.     

“面部反馈假设”的检验研究

该研究让被试做人为表现的面部表情并填写情绪分化量表,对“面部反馈假设”进行检验。结果表明:(1)愤怒表情显著地增强了被试怒体验的强度;(2)面部表情的反馈具有两重性:即既有分化性的反馈效果,它能增强与其相应的情绪体验的强度,而且又有加强或减弱“愉快—不愉快”维度上相反极的情绪体验;(3)面部表情反馈的发生无需以“自我知觉”作为中介。     

Learning what from where: Effects of spatial regularity on nonspatial sequence learning and updating

The current study examined the influence of redundant stimulus features on our ability to build and update representations of our environment. We hypothesized that our ability to process redundant spatial features would speed our ability to adapt to changing nonspatial regularities. Using a computerized version of the children's game “rock–paper–scissors”, undergraduates were instructed to win as often as possible against a computer opponent. The computer's plays were repeating sequences of five choices that were presented either with spatial regularity (i.e., “rock” would always appear on the left, “paper” in the middle, and “scissors” on the right) or without spatial regularity (i.e., the items were equally likely to appear in any of the three locations). Once participants learned a sequence, the computer switched to a different sequence without participants being informed that a switch had occurred. Redundant spatial regularity improved a participant's ability both to learn sequences of plays and to update their plays to reflect new computer sequences. Our results suggest that our perceptual system is sensitive to redundant spatial stimulus features and that this information can improve learning and updating.