公开课-关爱惟士
公开课
澳大利亚名校UTAS《预防认知症》大型网络免费公开课于5月15日再次开启

课程注册地址:https://mooc.utas.edu.au/landing/pdcv

2018年5月15日,由澳大利亚四大历史名校之一的塔斯马尼亚大学(University of Tasmania)Wicking 认知症研究和教育中心所推出的《预防认知症》大型开放式网络免费公开课将再次开启。




全世界所有关心和希望了解认知症的人们都可以通过在线教育的方式学习四周的课程(每周约2小时)了解认知症预防的最前沿知识,并获得由该机构颁发的结业证书(电子版)。


关爱惟士(CAREVISIONS)作为中国认知症干预的顶级专业机构之一,有幸与Wicking研究中心合作,成为在中国推广该项目与课程的唯一指定合作伙伴。


如果你从事的正好是与认知症或老年人护理相关的工作,如果你有亲人需要照顾,或仅希望对认知症有详细科学的了解,马上注册成为一名学员!


(点击或复制以下链接于浏览器,立刻开启注册学习)

课程将于5月15日开始

https://mooc.utas.edu.au/landing/pdcv


点击立即注册按钮(红色按钮 

(文章下方有详细的注册指导视频)


课程时间 

课程周期 4周

注册截止时间:

2018年5月25号(星期五) 下午3:00 

课程开始:

2018年5月15日(星期二)早上7:00

课程结束:

2018年6月29日(星期五)下午3:00


费用免费

整个社会——从家庭和家庭护理员到医疗从业者,都深感认知症之害,它们包括丧失行动和认知能力。最近的研究指出,如果对潜在的可变风险因素加以留心,大约三分之一的认知症案例可以被避免。学习逐渐成为如何预防的关键。


课程概述


《预防认知症》是大型在线公开课程,也称慕课(MOOC),这个课程为学习者提供了关于认知症风险及保护性因素的大学教育。这一免费课程为学习者提供了展望全球社区认知症前景及互动的机会,学习过程中无需作业与考试,但有简单的小测验。


随着全球人口的老龄化,认知症是已成为一个主要的社会健康问题。是否有可能降低认知症的风险呢?相当大比例的风险与高度老龄化及遗传因素有关,最新研究表明减少认知症可变风险因素,会降低认知症的易感性。《预防认知症》慕课(MOOC)借鉴全世界最专业的背景知识,调研了认知症的可预防因素。



课程中你将有机会参与在线讨论,并且还可以参与到该领域的最新研究中来,帮助我们确认降低认知症风险的最有效方法。在《预防认知症》慕课(MOOC)结束时,还有机会对自己的认知症潜在风险进行评估。


《预防认知症》课程适合任何人 - 无论是对大脑健康和降低认知症风险感兴趣的个人,还是医疗专业人员,临床医师,老年护理服务照护者或卫生保健政策专业人员, 都可以参加此课程 - 本课程旨在提供方便吸引不同背景的人参与学习。


为了确保学习者能够从本课程中获得最大程度收益,学习者需要每周花费大约2小时的时间学习并完成相关课程活动。4周时间里将每周发布一次课程内容,共计6周可访问课程(另外提供2周时间追踪(或审核)内容)。成功完成最终测验后,学习者将有资格下载结业证书。


授课纲要


模块1  认知症可以预防吗?


预防认知症的一些重要概念


认知症的定义及导致认知症发生的相关疾病介绍


认知症在全球范围内的影响


认知症主要不可改变及可改变的风险因素


遗传对认知症风险的影响


对个体和群体进行认知症风险测量



模块2 -认知症风险-它并不全在你的大脑里


血管中的危险因素与认知症之间相关性的支持例证


体力活动和饮食对认知症风险的影响


吸烟和饮酒对认知症风险的影响



>>>>

模块3   健康和思维活跃的头脑


生活方式与认知症风险相关性的支持例证


抑郁症对认知症风险的影响


受教水平对认知症风险的影响


“认知储备”概念


>>>>

模块4 -  预防性干预


个人和群体预防认知症策略


提倡健康生活方式


做什么来能降低患认知症的风险


目前预防认知症的研究进展





常见问题


《预防认知症》MOOC慕课有益于谁?

《预防认知症》慕课(MOOC)有益于社会健康及卫生机构专业人员,老龄护理服务提供者,卫生政策专业人士和任何对大脑健康或认知症有兴趣的人士。


每周需要抽出多少时间上课?

学习者每周大约需要花2小时参与课程内容和活动,为期4周。


该课程有任何必备条件吗?

不用。你不必具备任何前提知识,我们希望可以为各行各业及不同教育水平的人提供有用的信息。由于该课程完全采用网络授课,所以完成该课程需要具备基本的电脑技能。你还需要一个邮箱地址用来填报mooc.utas.edu.au网站上的个人信息并进行注册。


我能获得结业证书吗?

可以。如果你完成了所有课程,并成功通过测验,将能够下载免费的结业证书。请注意该证书为电子版。



参加慕课能算作我持续专业发展(CPD)记录的一部分吗?

持续专业发展(CPD)所需的时长和学分要求根据职业和国别各有不同,有的国家将其称为延续教育学分制度(CEUs)。关于这点请向您当地培训机构或职业机构咨询获得CPD必备条件的相关信息。你的结业证书上还会注明非CPD认可的10个学分小时。


mooc是什么?

MOOC是大型公开式网络课程的英文首字母缩写——一种最近被全球重点大学和学府广泛接受的世界教育发展模式。预防认知症MOOC提供免费的线上学习机会,还同诸如澳大利亚塔斯马尼亚大学等机构合作,任何人士都可进入的开放空间里分享其专业知识。


我可以参加哪些研究?

参加预防认知症课程的人将有机会参与研究,以帮助我们改善课程及研究开发资源和干预措施,帮助人们降低患认知症的风险。研究参与是完全自愿的,无论你选择参加还是不参加,都不会影响你在MOOC中的参与。这项研究得到了塔斯马尼亚大学社会科学人类研究伦理委员会的批准,我们将会在MOOC中提供更多的详细信息。


如果我不能参加一段时间的课程,这是不是一个问题?

课程内容以一周时间为单位提供,不过你可以自由地以自己的速度学习课程。如果你能在其他几周补上时间,就不可能是个大问题。一些研究项目的参与可能只出现在课程前两周里。


注意事项:


课程现在不会正式开放,直到2018年5月15日开放,并于2018年6月29日结束课程。


填写报名表时请一定用拼音/英文填写中文姓名,这样完成课程后才能确保正确打印证书。如果使用汉字,证书将不能被正确打印。 


测试题目是英文的,我们建议大家用百度及谷歌等翻译软件翻译。 


如果注册使用的电子邮件在申请时被封锁或禁止,请直接给我们发邮件,我们将尽快通知UTAS,他们将会解锁您的申请邮箱。(我们把重要信息在这个页面上,以确保大家都知道)。


在注册时,需要验证你们的电子邮件地址。 


所有从UTAS收到的电子邮件都是英文的,很抱歉我们不能对其进行更改。

视频将通过YouKu播放以英文显示,我们会提供中文版文字版本说明。(注:UTAS网站上的视频有时在中国会被封锁


项目背景

J.O & J.R Wicking 信托(股权信托)公司为Wicking 认知症研究和教育中心提供核心资金。Wiking 中心是塔斯马尼亚大学一流的学术机构。该机构开设以认知症看护、成因及预防为主题的高精研究,采用领先的线上学习技术,致力于解决认知症带来的全球影响。



《预防认知症》mooc合作伙伴


《预防认知症》MOOC(慕课)由澳大利亚塔斯马尼亚大学的Wicking 中心发起,它涵盖的专业知识来自在痴呆症预防领域处于全球领先的高校科研人员,这些高校包括剑桥大学、墨尔本大学、蒙纳士大学、阳光海岸大学、悉尼大学和澳大利亚国立大学。


注册指导


下方链接视频可以帮您指导如何注册

https://v.qq.com/x/page/r0649ag78ua.html
塔斯马尼亚大学预防认知症MOOC
2018-05-11
(1)欢迎加入预防认知症课程-Welcome to the Preventing Dementia MOOC

《预防认知症》MOOC-引导篇


课程视频http://player.youku.com/embed/XMzYwNDQzMTY1Mg



Dr. Maree Farrow

Maree Farrow 博士


My name is Maree Farrow and I am the Senior Academic Lead for Dementia MOOCs at the Wicking Dementia Research and Education Centre at the University of Tasmania.

我是Maree Farrow,我是塔斯马尼亚大学Wicking认知症研究和教育中心的学术高级主管。


On behalf of the Wicking team, it is my great pleasure to welcome you to the Preventing Dementia Massive Open Online Course or MOOC. The Preventing Dementia MOOC was developed by the Wicking Centre in partnership with internationally leading researchers in the area of dementia prevention.

作为Wicking 中心团队的代表,我很荣幸地欢迎您加入预防认知症这一大型网络公开课,我们也称为慕课(MOOC),预防认知症慕课是由Wicking中心开发,并同众多国际先进研究学者在预防认知症研究领域合作推出的课程。


We developed this course in response to the growing global challenge of increasing numbers of people affected by dementia, and the need for improved awareness of the potential for dementia prevention. In fact, we regard dementia to be the public health issue of the twenty-first century.

全球认知症患病率日益增长,以及越来越多的人被这一疾病影响,为了面对这一严峻挑战,我们开发了这个课程,同时也希望能提高人们对预防认知症潜在的警醒。事实上,我们已经把认知症作为二十一世纪威胁人类公共健康的重大疾病。


The purpose of the Preventing Dementia MOOC is to learn about the potentially modifiable risk factors for dementia and what the current evidence suggests you can do to reduce your risk. We also want to help you to separate fact from fiction, and to understand what those headlines about the latest way to prevent dementia really mean.

预防认知症慕课的目的是让学习者学习和了解一些可被改变的认知症风险因素,以及可以降低风险因素的最新证据。我们也想帮助学习者把假想同事实分开,去理解关于预防认知症的主标题(头条)意味着什么。


Here is an overview of the dementia prevention issues you will learn about and the activities you can undertake during the Preventing Dementia MOOC.

下面会谈到在接下来的预防认知症慕课学习过程中,需要您学习和参与活动的内容概述,


In the Preventing Dementia MOOC you will learn about the important risk factors for dementia – the ones that we can’t change, and also the ones that we can do something about. We know that much of the risk for dementia is associated with ageing and genetics. Older age is in fact the biggest risk factor for dementia and the incidence of dementia increases rapidly after the age of 65.

在预防认知症慕课中,您将学习到重要的认知症风险因素-我们不能改变的风险因素,及我们可以做些什么来改变的风险因素。我们知道认知症大部分风险因素跟衰老及基因有着相当大的联系。事实上,老龄化是认知症最大的风险因素,证据证明65岁以后认知症发生几率急剧增加。


While inherited forms of dementia are very rare, genetics do play a role in everyone’s risk and that’s something that at the moment we can’t change. Our friends in the Wicking laboratory will explain how our genes and environment interact to influence our risk of dementia.

虽然因为遗传形式的认知症的情况很少,遗传学对每个人来说扮演的都是一样的风险角色,现在我们不能改变这一点。我们在Wicking中心实验室的朋友会给我们解释基因和环境是如何相互作用影响到我们的认知症风险因素。


While genes are important, it’s also estimated that around one-third of dementia cases are potentially preventable by addressing modifiable risk factors. These include things like physical inactivity, low education, and diabetes, and each of the factors will be covered in some detail during the MOOC.

虽然基因非常重要,但是它同样也可被预测-通过改变这些可改风险因素,三分之一的认知症可以被预防。这些风险因素包括:缺乏身体锻炼,低教育水平,糖尿病等,我们会在慕课中对每个因素进行详细的讲解。


The media reports a seemingly endless stream of risk factors for various conditions and dementia is no exception. However, some of these reported factors are supported by reliable evidence, while others are not, and we will explain the difference.

很多媒体报道了各种疾病的风险因素,各种各样,层出不穷,认知症也不例外。但是,报道中提到的有些因素有着可靠的事实依据,而有些却不是,我们会在课程中解释它们的不同。


In the Preventing Dementia MOOC, we’re going to focus on the most significant risk factors for dementia that are supported by the most up-to-date evidence. We’re also going to dispel some of the myths about supposed causes of dementia.

在预防认知症慕课中,我们将会专注于最有重大影响的风险因素,也就是那些被最新的证据支持的风险因素。我们也将消除您对关于认知症病因的成因的一些误解。


The MOOC is made up of four modules, or sections, and at the end of each module there is a short quiz for you to test what you’ve learned.

As part of the Preventing Dementia MOOC, you will have the opportunity be involved in online discussion forums, to share your ideas about dementia prevention, and to hear those of your fellow MOOC participants from all around the world.

慕课由四大模块或四大节组成,在每个模块的最后,会有一个小测试来检测您的学习成果。作为预防认知症慕课的一部分,您会有机会参与到线上讨论会,并可以分享您关于预防认知症的想法,也可以听到在全世界不同地方跟您一起学习的学习者的心得。


You will also have the opportunity to be involved in research related to dementia prevention. To be successful, this research relies on the participation of people like you, with an interest in improving how we develop initiatives to reduce dementia risk in our community. This research is entirely voluntary of course, and it’s entirely up to you whether you participate or not.

您也有机会参与到跟预防认知症相关的研究,研究的成功要靠每一个跟您一样,怀着浓厚兴趣并想在自己国家发展如何降低认知症风险的学习者,这个研究课目是完全自愿的,完全取决于您愿意参与与否。


If you are keen to get a measure of your own dementia risk, there will also be an opportunity to undertake an individual dementia risk assessment during the MOOC.

如果您想测量自己的认知症风险水平,在本课程中,您将有机会为自己做一个个性化认知症风险评估。


At the end of the Preventing Dementia MOOC, you will be eligible to receive your free personalised certificate of completion, and we also have some enhanced certificate options available.

在整个预防认知症慕课的最后,您将有资格获得免费的个人结业证书,我们也提供付费打印证书选项。


On behalf of the Preventing Dementia MOOC team at the Wicking Centre, I sincerely hope that you find the MOOC useful and informative, and we’re looking forward to your engagement throughout the course.

作为Wicking中心预防认知症慕课团队的代表,我衷心地希望您能发现慕课的优点并在其中获得最大收益,我们期待您自始至终地参与到这个课程中来。


翻译:关爱惟士-未经允许不得转载,违者必追究法律责任

塔斯马尼亚大学预防认知症MOOC
2018-05-21
(2)慕课操作导航-Navigating the MOOC

课程视频http://player.youku.com/embed/XMzYwNDQ0NDA4OA



Hello, my name is Shannon, and I’m a part of the academic team behind the Preventing Dementia MOOC.

大家好,我是Shannon,我是预防认知症慕课的学术团队的一员。


I’d like to present an overview of how to navigate the MOOC. This presentation is intended for people who are unfamiliar with how the course works, or just need a refresher. You’re welcome to use this guide before you begin the course, or you can delve straight in and return to this video later if required.

我想介绍一下如何使用慕课。 此演示主要面向不熟悉课程操作流程或仅需要复习的参与者。 欢迎您在开始课程之前使用本指南,或者您可以先进入课程,需要时再返回到此视频。


Changing your Profile Picture

更换头像

Firstly, I'll show you how to change your profile photo. At the top right of the screen you'll see your name. Click on this and then Profile from the menu - you'll get some options. You can change your Nickname, add a little Tagline, or click this button to change your Picture. Click Upload and then Browse to where your photo is stored, and then click Choose. Once you've selected it click Add, and then Save and Close. Note that your image must be less than 1000 pixels wide and 1000 pixels high. It must be either a JPG or a GIF file and can't be any larger than 1 MB. In other words, just make sure your image isn't too large. And please, only upload an image of yourself.

首先,我会向您展示如何更换头像。 你会在屏幕右上方看到你的名字。 点击你的名字,然后从菜单中选择“我的账户”-你会看到一些选项。 你可以更改昵称,添加个性签名,或者点击按钮更改头像。 点击“上传”,浏览你所存储的照片,然后选择所要上传的照片。 选好之后点击“添加”,然后“保存”并“关闭”。 注意照片应小于1000像素×1000像素。 照片格式必须是JPG或者GIF,且不得大于1MB。 也就是说,要确保你的照片不能过大。 并且,请上传你本人的照片。


Navigation

操作导航

Now I'll give you a demonstration of this top navigation bar. This will be on all the pages within the MOOC. Clicking the left-hand button - the Home button - will always bring you back to this front page.

现在我给大家演示一下这个顶部导航栏。 它会出现在慕课所有的页面中。 点击左边的主页按钮会返回到首页。


Next is the Content button. This is probably the most important one, because it is through this that you're going to access all the content that's inside the MOOC. I'll explain more about this a little later.

接着是内容按钮。 这个可能最为重要,因为通过它你将可以访问慕课里面的所有内容。 稍后我会对此做进一步讲解。


The Discussions tool is where a list of discussion topics is located. This is where you may go to participate in text conversations with your fellow participants and Wicking experts or engage in different activities that we provide within the MOOC.

讨论工具位于讨论主题列表中。 在这里你可以与课程参与者及专家进行文本对话,或参与我们在慕课中提供的不同任务。


Next, the Grades tool is where you can see which quizzes you have successfully submitted, and the highest score you have achieved on each quiz.

接下来,在成绩工具中,你可以看到你已经成功提交的测验以及你每次测验所得的最高分数。


And finally, the Glossary tool is where we’ll list dictionary definitions of the various terms you’ll come across in the MOOC.

最后,在词汇表工具中,我们会列出你在慕课中可能遇到的词条的字典定义。


I’d now like to present an overview of the Content in the MOOC, because it’s within the content that you’ll probably spend most of your time as you learn about dementia.

现在,我想对慕课的内容部分做一个概述,因为当你在了解认知症时,你可能会花费大部分时间在这一部分。


We’ve tried to present the content in an accessible, engaging, and flexible way. We’ve simplified the navigation so that you can step through each page like a book. Whenever we present an activity to you, we’ll link to it directly so that you never have to navigate to it yourself.

我们尽量以容易理解的、有趣的以及灵活的方式来表述这一部分。 我们已经对使用导引进行了简化,这样你就可以像看书一样,浏览每一页。 当我们向你展示一个任务时,我们会直接给出任务的链接,这样你就不用再通过使用导引自己寻找了。


Once you’ve logged in and entered the course, you’ll find the Content link in the navigation bar at the top here. Click the link and you’ll land on the course overview page.

一旦登录并进入了该课程,您会在顶部的导航栏中找到内容链接 点击链接,登陆课程概述页面。


You’ll notice on the left-hand side there is a Table of Contents. We’ve split the course into weeks, so that you can roughly gauge how far you’ve progressed. Content is released weekly, and can then be accessed once you have completed certain activities.

你会注意到左手边有一个目录列表。 我们把课程分成了几周,这样你就可以大致估计自己的学习进度。 内容会按周发布,只有完成特定任务才能看到新发布的内容。


If you click the Table of Contents you'll see a list of topic pages. Within a module, you can visit any page in any order, but we highly recommend that you start from the beginning and work your way through page by page.

点击目录列表,会出现主题页面列表。 在一个模块中,您可以按任何顺序访问任何页面,但是我们强烈建议您从头开始,按顺序逐页学习。


Any pages with the word Quiz in the title will contain a link to a Quiz for you to complete.

任何带有单词“测验”的页面都会包含一个测验的链接,让你完成。


Click a link to see that page. Each page contains information that will advance your understanding of dementia. In the Introduction, we will ask you to spend some time familiarising yourself with the MOOC.

单击链接以查看该页。 每一页都包含可以促进你对认知症的理解的信息。 在引言中,我们将要求你花一些时间熟悉慕课。


Here, for example, is a map of the course modules and content. It is possible to step through the pages of the course using the buttons at either the top or the bottom of the page. This is like turning the pages of a book.

例如,这是课程模块和内容的映射。 可以使用页面顶部或底部的按钮来浏览课程页面。 就像翻书一样。


We often feature short videos of discussions within the content. You can play these videos directly on the page. If you cannot watch the video, or would prefer to read text, we have also provided transcripts for each video.

内容中会经常出现简短的讨论视频。 你可以直接在页面上播放这些视频。 如果你不能观看视频,或者更喜欢阅读文本,我们也提供了每个视频的文本资料。


If you find that the summary within the videos is too quick to read, you can pause the videos at any time. Simply click on the screen while it's playing, and click it again to continue playing. Alternatively, you can click Play or Pause at the bottom-left of the video. If you want to re-watch part of the video, you can simply drag the playerhead at the bottom of the clip to the desired location.

如果觉得视频中的摘要播放得太快,可随时暂停视频。 播放状态点击屏幕就可暂停播放,再次点击即可继续播放。 也可点击视频左下方的“播放”或“暂停”按钮来进行操作。 如果想重看视频的某部分,只需将视频下方的进度条拖到想要观看的视频位置即可。


I’m on a different page now. You will notice the activity box. Once you are ready, you can participate in discussion forums about the topic. Occasionally, we may ask you to complete a quiz.

我不在当前页面。 你会注意到任务框。 一旦准备好了,您就可以去讨论区参加这个话题的讨论。 有时,我们可能要求您完成一个小测验。


You'll notice at the top of each page a series of links that we call breadcrumbs. You can use these to locate where you are within the content.

你会注意到在每页的顶部有一系列链接,我们称它们为痕迹导航。 你能够运用它们来定位你在内容中的位置。


After the introduction, the course is divided into four modules, which will open on successive Thursdays.

在引言之后,课程被分成了四个模块,它们会在每周四相继开放。


When you have visited a topic page within a section of the course, a tick will appear next to that topic in the Table of Contents.  After all topics are viewed, you will see above the topic list a message that the section is “100% complete.” Please note that this feature is intended to allow you to keep track of where you are up to in the course. A tick on a page only shows that you have visited it, but not necessarily that you have completed all activities on that page, such as watching a video or submitting a quiz.  To confirm whether you have successfully submitted a quiz, please check under “Grades.”

当你在课程的某一节查看了一个主题页后,该主题对应的目录旁边就会出现一个标记。 当你查看了所有主题之后,主题列表上方会出现一条消息,显示此节“100%完成”。请注意这个功能是为了方便你跟踪自己在课程中的完成情况。 页面上的标记只能说明你查看过该页,并不代表你已经完成了该页的所有任务,比如观看一段视频或者提交了小测验。 可通过在“成绩”下查询分数,来确认自己是否已经成功提交了测验。


So that’s a quick overview of Content within the Preventing Dementia MOOC.

以上是预防认知症慕课内容的快速概述。


Discussion Boards

讨论板

Next I’d like to present an overview of the Discussions tool in the MOOC, because it is a vital part of the way that we communicate during the course.

接下来,我想对慕课中的讨论工具进行概述,因为这些工具是我们在课程中交流的重要组成部分。


Discussion topics allow you to interact with your peers and get guidance from academic staff in a way that is similar to what would happen in a university class tutorial. You can get feedback on your ideas, be exposed to new ideas and perspectives, and discuss important aspects of the material you are learning and its implications.

讨论主题促使您与同伴进行互动,并能够获得同大学课堂一样的学术人员的指导。 您的想法能够得到反馈,您能够接触新的想法和观点,并讨论您正在学习的材料的重要内容及其含义。


So how do you get to the Discussions? Well, once you’ve logged in to the course you’ll find in the top, navigation bar a link called Discussions. Just click on this link and you’ll be taken to the list of discussion topics.

那么如何进行讨论呢? 当登录进课程,在顶部导航栏有个名为“讨论”的链接。 点击这个链接,就会进入讨论主题列表。


You’ll notice a number of topics. The first ones are general topics.

你将会看到很多话题。 首先出现的是一般性话题。


Use the ‘Your Course Feedback’ discussion to highlight any feedback that you consider important regarding any aspect of the course. All participants will be able to see your comments.

对课程任何方面你认为很重要的反馈,可以通过“你的课程反馈”进行讨论。 所有参与者都能看到你的意见。


The Social Space discussion is a place to chat, or to have off-topic conversations with your peers.

社交空间讨论是一个聊天或与同伴进行非话题讨论的场所。


There is also a Technical Issues topic where you might want to report computer problems related to the MOOC. It’s certainly worth having a look in here to see whether somebody else has answered your problem. If you have figured out how to solve a problem yourself then you are more than welcome to report your solution here.

还有一个是有关技术问题的,您可能需要报告与慕课有关的计算机问题。 可以在这里查看是否已经有人回答了你的问题。 如果你的问题得到了解决,那么非常欢迎你在这里报告自己的解决方案。


So what does a discussion topic look like?

那么讨论话题是什么样子的呢?


I’ll enter the ‘Social Space’ topic as an example. So I just click on the link and you’ll notice that we have a thread in here already.

作为一个例子,我将进入“社会空间”话题。 点击链接,你就会发现我们已经有了一个帖子。


To start a thread, click the Start a New Thread button. Now, just like writing an email, you need to enter a subject and then the message. Then, when you’ve finished, press the Post button.

点击“创建新帖”按钮,开始创建帖子。 现在,就像写电子邮件一样,你需要输入一个主题,然后输入信息。 完成后,按下“发布”按钮。


Only create threads when you’re certain that no other thread covers that same topic; that is, only create a new thread when you’re starting a new conversation. Often you’ll be responding to threads that are already there.

确保您所创建帖子的同一主题未被其它帖子涵盖;也就是说,只有在您开始新会话时才创建新帖子。 通常你会对已有帖子进行回复。


If you want to make a reply to somebody else's thread, click on the message subject line. You are taken to a new page, where you can click Reply to Thread. You can fill in the message just as you would when you're posting the first message of a new thread.

如果您想要回复其他人的帖子,则点击信息主题栏。 然后打开新页面,点击“回帖”按钮。 就如发表一个新帖子的首条信息时,输入所需的信息。


To return to the list of messages within a discussion topic, you can click on the View Topic breadcrumb up here, or you can jump back even further and list all of the discussions using the Discussions List breadcrumb.

您可以通过点击此处的“查看话题”导航按钮返回到某个讨论话题的信息列表,或者您可以后退更多并且通过讨论列表导航功能来列出所有讨论话题。


Now, eventually there will be perhaps hundreds of threads with thousands of messages, and you’ll need ways of managing those. The fastest way to look for a particular thread or message is to search for it. In the top-right corner of the topic list and thread list is the search box. You can enter the name of a person or a snippet from the message, and the messages or threads which match will be returned.

最终可能有数百个帖子附带数千条信息,你可能需要一些方法来管理这些帖子和信息。 查找某个特定帖子或信息,最快的方法就是搜索。 搜索框位于主题列表和帖子列表的右上角。 输入人名或信息的字段,匹配的信息或帖子将会出现。


A handy tip is to search for your own name. That will bring up all your messages within a particular discussion board. This may include replies to someone else’s thread. If you then click on “clear search” you will be able to see other replies within each thread.

一个小窍门就是搜索你自己的名字。 将会出现你在某特定讨论板中的所有信息。 其中可能包含了对其他人的帖子的回复。 点击“清除搜索”,将会出现每个帖子中的其他回复。


You can subscribe to any post or thread. For any post or thread that you have created, the platform will automatically subscribe you to this thread. That means, you will be notified if anyone writes back to you. Click on the Subscribe to this thread and make sure the box is ticked if you want to follow any of the conversations. You will see a notification alert under the Bell symbol if someone replies to you.

您可以订阅任何帖子或线程。 对于您创建的任何帖子或线程,平台将自动订阅您的线程。 也就是说,如果有人写信给你,你会得到通知。 单击此线程的“订阅”,并确保如果您想执行任何会话,则该框被勾选。 如果有人回复你,你会在铃铛符号下看到通知提醒。


There are ways that you can sort your messages or threads. You can flag the ones that are important to you by selecting the drop-down arrow beside the name and selecting Flag Thread or Flag Post. This is useful later when you want to filter messages to just those that you’ve flagged, by clicking Flagged like so. Likewise, you can filter to just those messages that haven’t been read.

你可以通过下列方法对信息或线程进行排序。 选择名称旁边的下拉箭头,选择重要的线程或帖子,对其做出重要标记。 通过单击这样的标记,可以很容易筛选出标记过的重要信息。 同样,您也可以筛选出那些未被读取的信息。


So, there are a few tips in how to manage your discussions, but you also need to know about netiquette, which is a term that means how to behave online. Even when you’re anonymous, you need to be respectful of others. We’re sure you will be, but nonetheless we will be monitoring activity to ensure that everybody remains polite and respectful during the discussions.

以上是关于如何管理自己在讨论中的行为的一些建议,同时你还需要了解网络礼仪,即,在网上如何表现。 即使你是匿名的,你也需要尊重他人。 我们相信你会这样做,但我们还是会对其进行监控,以确保大家在讨论中都能保持礼貌和尊重。


You need to remember that the messages you post are open to anyone in the world, so only say what you would ever be willing to share publicly. You need to consider whether the information you are discussing is confidential or private.

你需要记住,你发布的信息对世界上任何人都是开放的,所以只谈论你愿意公开分享的信息。 你需要考虑你正在讨论的信息是很机密的还是隐私的。


Below this video you’ll find a link to a page which contains further information on netiquette and the expectations we have of how the discussion boards should be used. Please take the time to read through it, as it will help ensure that everyone has an enjoyable time using the discussion boards.

本视频下面有一个网页链接,该网页包含关于网络礼仪的更多信息和我们对于如何使用该讨论板的期望。 请花时间仔细阅读,这将有助于确保大家能愉快地使用该讨论板。


So, there you have it. That’s an overview of the Discussions system.

好了,就讲这么多。 这就是该讨论系统的总体情况。


翻译:关爱惟士-未经允许不得转载,违者必追究法律责任

塔斯马尼亚大学预防认知症MOOC
2018-05-21
(3)测验-Quizzes

课程视频:http://player.youku.com/embed/XMzYwNDQ3NjAxMg


I’d now like to present an overview of the quizzes in the MOOC, because it’s these quizzes which we'll use to assess your knowledge of dementia.

现在我想介绍一下慕课中的小测验,因为这是我们用来评估认知症知识的测验。


The important quizzes come at the end of modules 1, 2, 3 and 4. In those you have unlimited attempts, but you must score 70% or more in your highest attempt to progress on to the next module. We don’t enforce a time limit on these quizzes.

重要的测验在模块1, 2, 3和4的末尾出现。 这些测验没有测试次数限制,但是你必须取得70%或更高的分数,才能进入下一个模块。 这些测验也没有时间限制。


So, when will you need to do a quiz? Once you’ve logged in to the course and you've navigated through the content you’ll come across a task box similar to this one, and that indicates it is time to take a quiz.

那么,什么时候需要做个测验呢? 当登录课程浏览了内容后,会出现一个类似于这个的任务框,这表明是时候进行一次测验了。


Whenever you come across this, click the button, and your page will reload with the quiz.

每当遇到这个,单击按钮,页面即可重新加载试题。


You’ll land on the description page, which details how the quiz works before you actually attempt it. You’ll see under Time Allowed that you have unlimited attempts; along with this it will give an estimated time for completion - again, that is not enforced.

你将打开说明页,该页面详细说明了在你真正尝试答题之前如何操作。 你会发现在允许时间内你可不限次数地进行练习;同时,还会给出预计完成的时间-这也不是强制性的。


Under attempts you’ll see how many times you’ve already attempted this quiz.

在练习过程中,你会看到你已练习的次数。


So, read through these instructions carefully, and when you’re ready, you'll click the Start Quiz button, and then OK, to begin.

因此,请仔细阅读本说明。阅读完毕后,可单击“开始测试”按钮,然后点击“确定”,开始测试。


To look more closely at the quiz function, let’s consider the simple, one question quiz in the Introduction. This quiz actually serves two purposes, it is a Practice quiz to ensure you know how to use the quiz function. It also gives you the opportunity to decide whether or not you give consent for us to use the information, or data, that you provide during your participation in the MOOC in our research. Research participation is entirely voluntary and your decision will not affect your participation in the MOOC in any way.

为了更深入了解测试的功能,我们来看一下引言中里的一个试题测验。 该测试实际上有两个目的,这是一个实践测试,确保你了解如何使用测试功能。 另一个目的是让你有这一个机会,决定你是否同意我们使用你在参加我们慕课调研时提供的信息或数据。 调研是完全自愿的,你的决定不会对你参与慕课有任何影响。


To start with, click on ‘Go to quiz’ and this will take you to the quiz page.

首先,点击“去测验”按钮,进入测验页面。


For this particular quiz, there is only one question, with a possible answer either ‘yes’ or ‘no.’ Please select the one that indicates your preference. Regardless of whether you want to give us your consent or not, you will need to complete this quiz. There are no incorrect answers as we are simply asking you for a ‘Yes’ or ‘No’ on whether you want to give your consent.

这个特定的测验只有一个问题,回答“是”或“否”。请任选其一表明你的意愿。 不论你是否同意,你都得完成这个测验。 答案没有对错,因为我们就是想知道你是否同意。


In later quizzes, there will be around ten questions.   As well as yes/no questions, there may be multiple choice, true or false, or a single word answer (it will be necessary to spell this correctly, but you will be able to check spelling if required).

在稍后的测验中,大概会有十个问题。 除了是/否问题外,还可能有多选、判断或用一个单词回答问题(单词需拼写正确,但是如果需要,你可以检查拼写)。


As you progress through the quiz, we would recommend that you save your answers as you go. There is a 'save' button associated with every question, and you can either click that after putting in your answer, or you can scroll right down to the bottom and save all of your answers in one go.

测验中,建议你把答案保存下来。 每一个问题都有一个“保存”按钮,你可以在输入答案后点击它,或者你可以向下滚动到底部并保存所有答案。


You’ll notice that there's a floppy disk icon beside each question, and in the left-hand column, which shows you which ones you've saved.

你会注意到每个问题旁边都有一个软盘图标,在左边的列中显示你保存了哪些图标。


You can change your mind about any questions, whether you’ve saved them or not. When you’ve finished the quiz, you’ll need to submit your answers to us. You may have saved as you went along, but you still won’t have submitted them.

你可以对答案进行修改,不管是否已经保存。 当你完成测验时,你需要把答案提交给我们。 你可能已经保存了,但并不代表你已经提交了。


Click 'Go to Submit Quiz.'

点击“提交测验”。


If you have neglected to answer some questions, and then you hit 'submit', you’ll be met with a prompt and a list of those questions you haven’t answered. You can click ‘Submit Quiz,’ in which case you’ll get 0 for those unanswered questions, or you can click on the link for each question to return to it and fill it in.

如果你遗漏了某些问题就点击“提交”,你将看到一个提示和一个列表列明你未回答的问题。 你可以点击“提交测验”,这样你未回答的问题将得0分,或者你可以点击每个问题的链接,返回到该问题并填写答案。


So, once they’re all answered, click on ‘Go To Submit Quiz,’ but beware, once you have submitted your answers, you can’t change any of them. You can, of course, attempt the whole quiz again. If you’re unsure, though, click on any of the question numbers in the left-hand column to return to any questions you’d like to retry.

因此,回答完所有问题后再点击“提交测验”,但注意,一旦你提交了答案,你就无法再进行任何更改。 当然,你可以重新参加全部测验。 如果你没把握,点击左栏中的任一问题编号,返回到你想重新回答的问题。


Once you’re absolutely ready, click 'Submit Quiz', and then confirm that you do indeed want to submit your quiz.

一旦你准备好了,点击“提交测验”,然后确认你确实想提交你的测验。


Once you’ve submitted a quiz, you’ll be presented with a page that summarises how you went.  If you got a question correct, you will see a score of 1/1 next to the question number, if incorrect you will see 0/1.  The total score will appear at the bottom of the summary report. I can navigate back to the content, and if the quiz has been successfully submitted and the required score achieved, the next unit would become available to me when released. You can also click on View Feedback to view some feedback on the questions of the quiz, particularly on those questions that you did not answer correctly.

一旦你提交了测验,你会得到一个总结你的进展的页面。 如果你有一个问题回答正确,你会看到问题编号旁边出现分数1/1,如果不正确,你会看到0/1。 总成绩将出现在总结报告的底部。 返回到内容,如果测验已经成功提交并获得所需的分数,将获准进入已经发布的下一单元。 你也可以点击查看反馈来查看问题的反馈,尤其是那些你回答错了的问题。


That completes my overview of quizzes.

以上就是关于测验的概述。


Thank you, and I hope that you enjoy participating in the Preventing Dementia MOOC.

谢谢大家,我希望你们喜欢参与预防认知症慕课。


翻译:关爱惟士-未经允许不得转载,违者必追究法律责任

塔斯马尼亚大学预防认知症MOOC
2018-05-21
(4)模块1---认知症可以预防吗?Can Dementia be Prevented?

课程视频http://player.youku.com/embed/XMzYwNDQ3Nzk5Mg



Prof. Carol Brayne

Carol Brayne 教授


We all hope to have prevention. Medical practitioners treat people, and we deal with diseases and disorders when they're present, but most people understand that it's better to think about prevention.

我们都希望能预防所有疾病。生病了我们找医生,需要他们来处理我们的各种疾病和状况,但很多人心知肚明,最好的方法是预防。


Well, what do we mean by prevention? We mean trying to stop something, a disease, happening at all, and in ageing we know that dementia becomes very much more common and there's a sense that it might be inevitable, but there's also evidence that it might not be as inevitable as we had thought. So although the increase in dementia is very related to age in our populations, there is some evidence that we can reduce our risks of developing dementia, so in some terms that could be viewed as prevention.

那么,预防的意思是什么呢?它指的是尝试去阻止疾病的发生发展,认知症随着社会老龄化已经变得越来越常见,普遍认为它是不可逆的,不过同时也有证据显示它在某些方面并不像我们想象中那样不可逆转。尽管认知症和衰老存在相关性,但是有证据显示,认知症的风险是可以被降低的,所以从这个角度说,认知症可以被预防。


So we understand that dementia, particularly in the oldest old where it's most common, is a mixture of classical Alzheimer's type, which most people have heard of, but also of vascular changes. And that's related to earlier life, what we call non-communicable diseases, which includes things like heart disease and diabetes. Now we've got very good understanding of how to prevent those disorders in the population and those relate to both individually-based prevention but also predominantly to societally-based activities or interventions, such as the smoking bans and trying to reduce excessive alcohol and so on. So these are all factors which can improve health earlier in life and reduce the risk of the risk factors for dementia, and so we have pretty good evidence on those.

我们知道认知症,最常见于一些高龄老年群体,它是以最为熟知的阿尔茨海默病为典型代表加上血管病变的一类综合征。认知症在早期与一些像心脏病和糖尿病这样的非传染病相关。现在我们早已知道如何预防这些疾病,包括个体水平为基础的预防以及像禁烟令、建议减少过量饮酒等等这样基于社会水平的活动或者干预手段。这些是可以在早期提高健康水平减少认知症患病风险的因素,当然我们有很多有力的证据来支持以上观点。


I've been working in the field of dementia research for 30 years and for decades I thought that we could not reduce our risk of dementia because it was so closely associated with age. But, when we did the research that suggested that - well, which showed that dementia prevalence, that is the proportion of people who had dementia at any given age, has gone down, I realised that we do have the potential to reduce our risk. It does not mean that we will eradicate dementia because what it means is that we still have a lot of dementia in the oldest old because age is such a powerful risk factor. Because we're living longer, we have more people in the oldest age groups. So we can't prevent all dementia but we might reduce our risk at particular ages.

我已经在认知症研究领域工作了30年,在几十年里,我一直在思考我们之所以不能降低认知症风险,是因为它跟年龄老化有着极大的关系。但是,当我们在研究那些课题时-它显现出认知症的发展趋势,就是认知症在任何年龄阶段的发病几率,并显示下降趋势,因此我意识到我们有可能降低认知症风险。这不是说可以根除认知症,毕竟相当多的认知症是发生在老年阶段,年龄衰老对认知症是非常强大的风险因素。因为我们的寿命增长,我们有老年群体也随之增大。因此我们不能预防所有的认知症,但是我们或许可以在特殊的年龄阶段降低认知症的发病风险。


Researchers for decades have been looking at the risk factors for dementia in a variety of different ways. A lot of these have been what we call cohort studies, which is following people over time who start out without dementia and then, having examined what their risk factors, or what might be risk factors, are at baseline, we then follow them up over time and identify who gets dementia or who meets diagnostic criteria for dementia over time and who doesn't.

做了多年研究的学者们,应用大量不同的方法去寻找认知症风险因素。大多数应用的是我们称之为“队列研究”的方法,即全称追踪初始并不是认知症的患者,了解他们已有的或者可能的风险因素,这是基线阶段,然后我们从始至终随访这些病人,确定谁患有认知症或者谁满足诊断标准或者谁不符合标准。


Those studies have looked at risk factors close to the expression of dementia and have looked at midlife risk factors as well, and also life course risk factors. Putting all of that together requires systematic reviewing and there have been several exercises in systematic reviewing of the risk factors for dementia in the last decade. One of those identified seven risk factors and it was a very rigorous look at the world literature and it came up with seven, and they included things from across the life course, such as low educational attainment, midlife obesity and hypertension, and then depression and diabetes, and so-called lifestyle behaviours such as smoking.

这些研究所涉及的风险因素都是和认知症的症状相关的,也涉及中年期或者生命全周期风险因素。把它们整理在一起是需要做系统回顾审查,最近十年已经对认知症患病风险因素做了很多系统回顾审查。其中七个已确定风险因素浮出水面,我们仔细地查询了全球范围内的文献,文献也显示为七个风险因素,它所包括的因素贯穿整个生命周期,比如像低受教水平、中年肥胖、高血压、抑郁症以及糖尿病,也包括了我们常提到的不良生活方式-比如吸烟。


That exercise has been done in the US as well, as well as the Lancet Commission, and the exact risk factors have been sort of changed a little bit, so there's the addition recently of midlife hearing loss in particular.

美国以及柳叶刀委员会也做了相关类似的实验,他们对风险因素做了轻微的改动,他们特别增加了一个风险因素:中年期听力丧失。


If you put all of those risk factors together and try to understand how they operate in different populations, looking at the exposure of the population to the particular risk factors, you can calculate what proportion of people might - what proportion of dementia might be attributed to that risk factor or those risk factors. Now the risk factors cluster. Once you take that clustering into account, all of the different exercises come up with roughly a third of dementia that might be prevented if we assume a causal relationship between the risk factors and dementia. So the ultimate message from those analyses is that, if we pay attention to those risk factors across the life course, we might reduce dementia by about a third over time.

如果你把这些所有风险因素进行归纳,尝试去搞清楚它们是如何作用于不同的群体里,找到具备这些风险因素的群体,你可以计算出比例 -一个或多个风险因素在多大比例上导致认知症发生。现在我们把这些风险因素进行归纳,现在我们把所有风险因素考虑进去,假设风险因素同认知症之间存在因果关系,所有不同的实验都显示出大约三分之一的认知症可以被预防。所以最终分析得出的信息就是,如果在全生命周期中能够注意这些风险因素,那么我们或许可以逐渐降低三分之一的认知症。


Speaking from a public health perspective, the idea of removal of one risk factor doesn't work terribly well in populations. What we need to do is look at the clustering of the risk factors and see which sectors of the population are at risk with different profiles of those risks, and what is our knowledge about how to address those risks in those populations and in the population at large. So, for example, smoking has reduced enormously and perhaps that is a single risk factor example where we have had a huge effect, but that has been done through legislation and whole-society action. But something as complicated as midlife obesity, midlife hypertension and consequently stroke and so on are much more complicated. So unless we create environments in which we can be healthy and optimise our ageing and our brain health, we're unlikely to be able to affect those particular risks in a big way for the populations.

从公共健康的角度来说,仅仅根除一个风险因素的想法在大众范围很难起到很大成效。我们需要做的是观察哪些群体处于哪种风险因素中及他们不同的风险特征,还有我们的知识体系如何大范围解决这些人的风险因素。比如吸烟行为已经减少了很多,它作为一个独立的风险因素产生了很大的影响,国家通过立法及整个社会协作通过一些行动已经使其得到控制。但相比中年肥胖,中年高血压及由此造成的中风等等这些因素,情况却复杂得多。如果我们不能创造一个健康积极的环境,同时延缓衰老和强健大脑,否则我们不太可能大规模地在大众范围内改变这些风险因素。


Not only are risks very complicated in the way that they interact with each other and the behaviour - so we have behaviours, we have disorders and diseases which all interact and they're all our individual profile of risk, but also, when we look at people who have dementia, and it's most common in people aged 80 and over, so if we look in the brains of people who have died with dementia as well as the people who haven't died with dementia, we see that everybody, by the age of 85, 90, has got a mixture of pathologies and changes in their brain, which include atrophy and vascular changes and changes which could be associated with Parkinson's disease as well as the Alzheimer's disease changes, and it's rare to find somebody with a brain at the age of 100 who doesn't have at least some of these pathologies, and the relationship of those with the expression of dementia, with whether the person had dementia, becomes more complicated in the oldest age group.

这些风险因素不但复杂,而且它们之间以及它们和行为之间互相作用, -这就是为什么我们会产生问题行为,功能紊乱以及疾病,这些都是风险因素在个体水平相互作用的体现,而且当我们观察那些死去的或者健在的80岁或以上的认知症患者的大脑,85至90岁的老人出现混合性的病理病变,及可能与帕金森病以及阿尔茨海默氏病等疾病相关的大脑萎缩和血管变化,我们很少发现100岁左右的大脑中没有这些病变的,至少有一部分。高龄老人中认知症的表现和此人是否患有认知症的相互关系是更复杂的。


There is very good evidence now from a variety of different studies, from animal studies through to human studies through to population studies, that there are factors that protect us from dementia, even when we have, say, the neuropathologies that are thought to be classically associated with dementia. So there is good evidence that we can protect the population and protect individuals to some extent, or reduce their likelihood of experiencing dementia during their lives, and these factors probably need to be addressed at different times in the life course.

从动物实验到人体实验到大规模试验我们得到了一些乐观的证据,就是即使有一些和患有认知症相关的典型神经病理改变,但是也有一些保护性因素使我们可以远离认知症。我们同样有证据表明在一定程度上我们可以保护我们大众群体或者降低他们一生中患认知症的可能性,无论从群体上还是从个体上,这些因素在整个生命周期的不同阶段可能需要被强调。


So we have evidence from early life, from midlife and from later life of the kinds of things that appear to protect us from dementia. We can improve aging, we can improve brain aging and we can probably reduce the amount of dementia at any given age and we can reduce that frailty right at the end of life that is almost inevitable for all of us, but maybe reduce the time that we have to experience that through population health activities and a balance of individual and public health, if you like, actions.

所以无论是早期,还是中年到晚年,我们都有证据显示可以通过一些手段使我们远离认知症。我们通过延缓衰老,强化大脑,就有可能降低不同年龄层认知症患者的数量,使每个人在不可避免的生命尽头时减少无助及痛苦。所以我们需要整个社会开始付诸行动,通过一些公共健康活动来减少经受疾病折磨的时间,如果你愿意,行动起来!


翻译:关爱惟士-未经允许不得转载,违者必追究法律责任

塔斯马尼亚大学预防认知症MOOC
2018-05-21
(5)公共健康方法-Public Health Approaches

课程视频http://player.youku.com/embed/XMzYwNDQ4MDEwOA


Prof. Carol Brayne

Carol Brayne 教授


Public health defines prevention in several ways. There's primary prevention, secondary prevention and tertiary prevention.

公共健康对疾病预防有着不同定义。这里主要指一级预防,二级预防和三级预防。


Primary prevention is removing a cause of a disease, so the classic example is smoking and lung cancer. You remove the smoking, you remove the lung cancer that is attributed to smoking. There will be other lung cancers but they are not lung cancers caused by smoking.

第一级预防目的是消除病因,最典型的例子就是吸烟跟肺癌。如果你戒了烟或不吸烟,就等于消除了吸烟导致你患肺癌这一因素,当然会有其他原因导致肺癌,但是不会包括吸烟导致的肺癌.


Secondary prevention is early detection of a disorder at the point where you can change its natural history in a way that means the survival of the person with the early disease, or the quality of life of that person, is enhanced.

第二级预防对疾病症状进行早期检测,并在某种程度上改变这个病的自然发展,这就意味着可以提高一些早期患者的生存率,或者病人的生活质量。


Tertiary prevention is when a disorder is fully manifest, is fully there, and it's about the treatment and the interventions, the care that we can provide that will improve the quality of life of that person in the presence of the disorder, and that includes palliative care, so that includes dying as well as we can.

第三级预防是当疾病症状已经相当明显,需要对症治疗和干预,这时第三级预防重点在于提供照护并改善病人该疾病阶段的生活质量,这也包括安息护理,就是我们所说的临终关怀。


Put those all together and you have the balance of care and activity required for a society to do the best it can with the resources that it has.

总而言之,这就要求我们尽可能利用所拥有的资源为整个社会营造最佳的医疗照护环境。


Secondary prevention is effectively screening. That can be done in an intensive case identification method or it can be done at a population level. To implement screening and/or early detection, we need really rigorous evidence and that is - in the UK and many countries such as the US, there are whole commissions looking at screening evidence.

二级预防是对疾病的有效筛选。它可能是一个严重病例的确诊过程,也可能是对一个群体水平进行筛查。实施筛选或早期诊断,我们都需要严格细致的证据,这就是-在英国及其他很多国家,比如美国,都有这样的委员会在研究寻找筛查实证。


At the moment, dementia is not one of the conditions that is recommended for screening, for systematic screening in the population. At present, our research investments across the world are focused on early detection and diagnostics. The implications of this kind of research is that there will be, in the future, some sort of screening program, whether it's applied at population level or within clinic settings. So we need an evidence base that is robust enough to meet the requirements of a screening program. At present, despite massive investment, the evidence is not sufficient for that and the implications in terms of cost are enormous for societies of implementing that kind of approach. It doesn't mean it won't be possible in the future but it needs to be thought about very, very carefully.

目前,认知症不属于被推荐的人口系统性筛查疾病中。现在全世界的研究资金都致力于早期诊察和诊断研究。这类研究的意义在于未来会得到一些运用在无论是人口筛查还是临床中的检测项目。那么我们需要满足这个项目筛选的要求的一些强有力的实证。但是现在,尽管有大量的资金投入,得到的证据仍然不足以解决这个问题,而且对这个社会来说投入的费用已经很大了。但这并不意味着这种筛查技术在将来不可能出现,只是需要我们更加周全考虑。


Primary prevention; we have evidence already about the approaches that we can take to reduce the conditions that are themselves risk factors for dementia. We have evidence of reduction in the prevalence, that is the proportion of people with dementia, in many countries and the incidence, that is the new occurrence of disease in populations. So we have that evidence from the US, from the UK, from some European countries. So we have good evidence that we can change the course of people's ageing and brain ageing.

第一级预防;我们有通过可以降低一些风险因素来减少认知症发病几率的实证。我们也有证据显示认知症流行率的下降及同时许多国家中认知症新发病例的减少。我们从英国,美国及一些欧洲国家得到的证据证实了这一点,因此我们拥有能通过降低人类衰老以及大脑老化速度来改变病程的非常乐观的证据。


We also have evidence on how to support people when they have dementia - that's the tertiary prevention side - increasing evidence about improvements in provision of care in care homes and the nature of the interventions that we can make to support people with dementia. So at present we have an imbalance of investment into what effectively would lead to a screening program for dementia and less investment into the primary and the tertiary, and it is clear from a public health point of view that we need to rebalance that.

我们同样也有大量的证据来支持患有认知症的人群-这就是我们第三级预防-收集更多证据来帮助完善养老院疗护制度及开发非药物干预,为患有认知症的人群提供更有力的支持。但是目前我们的研究资金的不平衡影响了我们去开展认知症的筛查项目,只有少量的资金投入到一级和三级疾病预防,从公共健康的角度来说我们需要平衡这种资金投入,这一点非常毋庸置疑。


Thinking about primary prevention of dementia, we need to take into account the context in which that prevention needs to occur. We have a constellation of different risk factors which relate to early, mid and later life, and we have very many different populations across the world that are experiencing ageing, so that the kinds of primary prevention activities that we might want to undertake in Australia might be very different in different groups within the population.

关于一级认知症预防,我们需要仔细斟酌预防所需的背景。我们知道有一系列与认知症早期,中期及晚期密切相关的不同风险因素,与此同时在每个国家都有大量的不同老龄化人口,我们如想要在澳大利亚进行一级预防活动,那针对不同的群体可能方式都不一样。


So for example, those in the clusters where, say, smoking and drinking excessively or to harmful levels is more prevalent, we might want to have a different approach to one where people are already doing physical activity and already having very good diets. That might relate to increasing the educational levels or one might think about groups in the population who are socially isolated. So these are all the different types of risk factors that one needs to take into account.

举个例子,那些吸烟,饮酒过量或风险水平较高的群体中,我们可能想要采用不同的方法来帮助他们,方法会不同于那些已经在锻炼身体及有良好的饮食习惯。可能需要提升受教水平或者要考虑到是不是有群体处于社会孤立中。这些都是需要我们考虑的风险因素的不同类型。


When we think about low and middle income countries or even a country like Japan, the profile of risk factors across the life course will have been very different for the people who are entering old age now. So it is absolutely not one size fits all, but a sense of needing to understand the risk factors that are operating for different age groups in different cultures and what is the evidence base for approaching those risk factors in those cultures.

一些低收入或者中等收入国家,或者像日本这样的国家,同样的社会老龄化,因为人们的生活状态截然不同,那么对认知症风险因素的侧写就会明显不同。所以可以肯定一个适用于所有状况的万能法则是不存在的,也因此我们要更加去了解处于不同年龄人群在不同文化下所面对的种种风险因素,并且针对于这些文化差异下所产生的风险因素进行收集统计,以作为今后的证据基础。


If I was in the happy position of being in charge of the public health program in Australia, I would first want to map very carefully our knowledge of dementia in the population and different sectors of the population in different regions and different groups. I would then want to map our knowledge of the risk factor and protection factor profiles - so education is a key one there and social integration is another key one - to understand that across the population. Then I would want to bring to bear the evidence base that we have about how to change those factors and what works best, what our understanding is about what works best, at the individual level and at the population level and at the community level.

如果我在澳大利亚的公共健康项目中能够身居高位,我会首先把认知症的科普规划进来,包括不同地区、不同群体。然后我会把风险因素和保护性因素也规划进来-所以说教育是一个非常关键的内容-而另一个关键是社会融合-理解范围包括整个大众群体。最后我会给出我们当前的支持性证据,包括如何改变这些风险因素,如何做才能达到最佳效果。我们所认识到的是如何在个体水平,群体水平及社区水平上做的更好。


Then I'd want to create a community-based program which integrated that knowledge for a community and work with the community on the concerns of the community. And then, with embedded evaluation, look to see or basically implement combined interventions going from individual to population in those communities and then follow up the impact over time. So that would be integrating community and individual.

之后我想创建一个整合了社区相关知识以及基于对社区关心的相关工作的基础社区项目。然后,我们运用嵌入式的评估,观察或实施对这些社区中不同个体和群体的综合干预措施,并进行效果随访,这就是对社区和个体的整合。


What I would also do, though, is look at the life course risk factors that we know we need national action on, and with that it would need to be a very careful discussion with the commercial sector. So sugar, alcohol and tobacco would probably need national activity.

我同时还想做的是,探讨一些需要全民行动来应对的的生命周期风险因素,而这些都需要基于与相关企业部门之间所做的谨慎决策,比如关于糖,烟和酒的合理性就需要全民行动来控制。


Thinking from a whole population perspective and from the public health evidence, individually based interventions are pretty ineffective if one thinks about the resources required for individual interventions. So, for example, smoking cessation programs, although they're effective, they're nothing like as effective as doing things at community and population level, at national level. So when we think about the barriers, we need to think very carefully about each individual risk factor and what influences people's behaviours and what approaches we need to use. So a good example of the exultation to eat well is that, in socioeconomically-deprived areas of the UK, so my own nation's experience, fast food companies target opening in socioeconomically deprived areas. So the populations within those areas are at a particular disadvantage because what's available to them in their environment is an obesogenic environment. So it's very difficult to behave in a healthy way if you live in a place which has no areas for physical activity and also you don't have much money and low cost fast food outlets.

从大众群体的角度与从公共健康方面得来的统计数据来考虑,如果考量到个体干预所需的资源,进行个体基本干预效果会很不理想。举例,个体的戒烟项目,尽管它有效果,但是却不如社区,群体及整个国家层面来得有效果。由于这些不利因素,我们需要非常周全地考虑到每个不同个体的风险因素,影响个人行为的因素和其相应的对处方法。举一个恰当的例子,是饮食喜好的定位,在英国本土,快餐业把目标人群定位在这些低收入的经济底层地区。那结果就是生活在这些地区的人群被置于了一种不利的环境 — 一种容易引起肥胖的生活环境里。所以如果你生活在这样一个缺乏运动、低收入以及低成本不健康食物的地区,你很难拥有一个健康的生活方式。


So we have to work with communities and with businesses to shift the way that these things are operating within communities, because in the end businesses don't want to kill people and don't want to make their dementia risk higher. But they do need to make a profit, so we do need to think about what are the huge barriers that exist in terms of vested interests in our own ill health, and even in dementia occurrence. So we need to try to work to turn that around.

这就是为什么我们必须要和社区以及很多企业去合作,并改变他们的运营模式,因为企业经营的最终目的不是去伤害人们或者增大他们的认知症风险。但是企业需要盈利,所以我们需要能获得利益的角度去考虑关乎我们健康、甚至是认知症发生的那些巨大的障碍,所以我们需要努力改变这一切。


翻译:关爱惟士-未经允许不得转载,违者必追究法律责任

塔斯马尼亚大学预防认知症MOOC
2018-05-21