Objective:To amendment a tool of theory of mind (TOM) tests that can be applied to children with autism spectrum disorder (ASD) in mainland China,and assess the ability of ToM of children with ASD.Methods:The items of the ToM tests were revised by observing and recording events of children's life.Totally 200 normal children were selected in line with the standard from kindergarten to Grade 6 for formal tes-ting.With 156 valid data,Pearson correlation coefficient and Cronbach α coefficient were established for the test.Three experts were invited to make sure the content validity.Researchers randomly selected 30 normal children for retest purpose after 2 months.Twenty five children with ASD were tested and compared with normal children's test scores.Results:The revised test included 39 entries,which was divided into three sub-tests,42 points in total.The correlation coefficient of three subtests of the tests was 0.54-0.77,the correlation coefficient between the test and the subtest was 0.62-0.93 (Ps ＜ 0.01).The scores of three experts for the test were 114,108,and 105.The total scores and subtest scores were lower in children with ASD than in normal children (Ps ＜0.01).The Cronbach a coefficient of the test was 0.84,Cronbach a coefficients for three subtest were 0.83,0.80,and 0.78,respectively.The retest reliability was 0.84,and reliabilities for three subtest were 0.75,0.74,and 1.00.Conclusion:The revised Theory of Mind Tests for Children with Autism Spectrum Disorder are fulfilled mostly in line with psychometric testing requirement.It might be a selection to measure the ability of theory of mind of children with ASD in mainland China.

ObjectiveTo review the effect of response interruption and redirection intervention on vocal stereotypy in children with autism spectrum disorder (ASD). MethodsLiteratures on response interruption and redirection intervention for vocal stereotypy in children with ASD were retrieved from databases of EBSCO, PubMed, Web of Science, CNKI, and Wanfang data. The information of the literatures was extracted to conduct a scoping review. ResultsA total of 16 English literatures were included. All researches employed a single-subject time series study design. A total of 41 children with ASD were involved. Significant differences were found in levels of basic verbal functioning of children with ASD. Vocal stereotypy was characterized by both verbal and nonverbal forms. Most of the reviewed researches used experimental functional assessment to analyze the function of vocal stereotypy. In most cases, the function of vocal stereotypy was automatic reinforcement. Iwata et al.'s paradigm was dominantly adopted in performing experimental functional assessment across researches. Other related paradigms developed based on Iwata et al.'s paradigm to make operating process more concise were also used for experimental functional assessment in reviewed researches. Response disruption and redirection was often conducted in individualized setting, with a few researches conducted in special education classes. The time and frequency of interventions varied widely across subjects due to the levels of impairment in vocal stereotypy and other behaviors. According to a comparison of the effects of traditional response interruption and redirection and its morphing procedures, it was found that changing the content of the redirection task, reducing the number of redirection tasks, and varying the duration of execution did not impact the improvement of vocal stereotypy. Based on the comparisons of response interruption and redirection with matched stimuli, response cost, verbal manipulation training, and medication, it was found that both response interruption and redirection and other methods (except for medication) could reduce vocal stereotypy and promote the emergence of appropriate behaviors in children with ASD. Combining response interruption and redirection with other techniques, such as stimulus matching and response costs, yielded more favorable improvement of vocal stereotypy in children with ASD. ConclusionASD children with vocal stereotypy show different levels of functional language, and vocal stereotypy is generally characterized by both verbal and nonverbal formats. The function of vocal stereotypy is mostly automatic reinforcement. Response interruption and redirection as a behavioral intervention is mostly conducted in individualized setting, and the time and frequency of interventions depend on the levels of vocal stereotypy and other behaviors problems. Changing the content and number of redirection instructions does not significantly influence the improvement of vocal stereotypy in children with ASD. Other intervention methods such as matching stimulus and response cost are able to reduce vocal stereotypy in children with ASD, but response interruption and redirection used in conjunction with these methods show more favorable improvements. Response interruption and redirection interventions can not only reduce vocal stereotypy in children with ASD, but also increase appropriate vocalizations, task engagement and command obedience.

Objective:Based on the perspective of supply and demand balance, to analyze the implementation effects of primary-feature medical services measures in medical alliances.Methods:From July to September 2019, two regions with different levels of economic development were chosen, and from each region one leading hospital and two community health service centers/township hospitals were selected from its medical alliance. A total of 213 medical staff and 703 residents were surveyed, to learn their awareness and performance appraisal of these feature services.Frequency and proportion were calculated in a descriptive statistical analysis. The scores of the performance appraisal of both supply and demand sides were tested by independent sample t. Results:In the performance appraisal of such measures, the average scoring by medical staff was 4.39±0.07, and that by residents was 3.85±0.06; the residents were more concerned with service capabilities and contents, while medical staff were more concerned with service content and delivery mode; supply and demand sides were found with consensus in terms of improving the medical service quality of chronic diseases in primary level and service accessibility.Conclusions:The county-level medical alliances should focus on enhancing their capacity of primary medical services, and improving their primary service mode with the help of medical insurance institutions. Meanwhile, it is imperative to optimize the primary medical service policy in view of supply and demand balance.

Objective:To investigate the influence of angle Kappa on total high-order aberration (HOA) before and after small incision lenticule extraction (SMILE).Methods:An observational case series study was conducted.Right eyes of 98 patients with myopia and myopic astigmatism who underwent SMILE surgery at Tianjin Eye Hospital from April 2015 to May 2016 were selected.Uncorrected visual acuity (UCVA), spherical diopter and cylindrical diopter under cycloplegic condition were examined before the surgery and at l and 3 months postoperatively.The chord distance of angle Kappa was measured by Pentacam topography.Wavefront aberrations were measured by WaveScan aberrometer.Pre- and postoperative UCVA, refractive status and each HOA were analyzed.The relationship between angle Kappa and each HOA was analyzed by Pearson correlation.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Tianjin Eye Hospital (No.TJYYLL-2017-17). Written informed consent was obtained from each subject.Results:The preoperative, postoperative 1-month and postoperative 3-month UCVA (LogMAR) were 0.06±0.23, -0.03±0.07 and -0.05±0.07, respectively, showing a statistically significant difference ( F=779.330, P<0.001). There were statistically significant differences in spherical diopter, cylinder diopter and spherical equivalent (SE) between before and after operation ( F=1 107.811, 127.786, 1 191.266; all at P<0.001), and the postoperative spherical diopter, cylinder diopter and SE were significantly lower than those before surgery (all at P<0.001). At 6-mm pupil diameter, significant differences were found between postoperative total HOA, spherical aberration, coma, the third-order aberration (S3), fourth-order aberration (S4), fifth-order aberration (S5) and sixth-order aberration (S6) and the preoperative values ( F=75.915, 78.231, 66.186, 64.521, 97.161, 36.623, 28.852; all at P<0.001). The postoperative 1- and 3-month total HOA, spherical aberration, coma, S3, S4, S5 and S6 were significantly increased in comparison with those before surgery (all at P<0.05). There was a positive correlation between angle Kappa and total HOA, coma and S3 at 1 and 3 months after surgery (total HOA: r=0.357, 0.363; both at P<0.001.coma: r=0.310, 0.341; both at P<0.01.S3∶ r=0.343, 0.371; both at P<0.01). Significant differences were found in preoperative, postoperative 1-month and 3-month total HOA, coma and S3 between groups with different angle Kappa ( Fgroup=3.363, 4.277, 4.029; all at P<0.05). The postoperative total HOA, coma and S3 of the larger angle Kappa group were greater than those of the smaller angle Kappa group, with statistically significant differences between them (all at P<0.05). Conclusions:A larger angle Kappa may induce HOAs in SMILE surgery.