儿童父母口腔健康素养研究进展

第四次全国口腔健康流行病学调查结果显示, 我国12岁儿童恒牙和5岁儿童乳牙的龋患率分别为34.5%和70.9%, 较10年前明显上升。父母的口腔健康素养对儿童口腔健康和口腔相关生活质量起决定性作用。本文对儿童父母口腔健康素养的相关概念及意义、促进口腔健康素养和口腔/总体健康一体化的框架、口腔健康素养的评估工具、父母口腔健康素养水平及影响因素、父母口腔健康素养对儿童口腔健康的影响以及提高父母口腔健康素养的策略进行综述, 为提高儿童父母的口腔健康素养提供参考。     

慢性病患者口腔健康素养的研究进展

口腔问题是一个严重的公共卫生问题, 有些微生物长期定植于口腔中, 可能会加重慢性病患者的疾病状况, 而提高口腔健康素养可以改善口腔健康状况。本文阐述了口腔健康素养的概念、评估工具、水平现状、影响因素及干预措施, 探索慢性病患者的口腔健康问题, 为临床深入开展口腔健康素养的相关研究提供参考。     

青少年固定正畸患者口腔健康自我管理能力的研究进展

综述了青少年固定正畸患者口腔健康自我管理能力的研究进展。具体内容包括青少年固定正畸患者口腔健康自我管理能力的现状、影响因素、评估工具和方法以及其重要意义。认为科学地评价青少年正畸患者的口腔健康管理能力是进行有效干预的前提,但目前亟需一套科学、有效的评估、测量工具,从而为开展有针对性的干预提供依据。     

基于COSMIN指南对糖尿病患者健康素养评估工具的系统评价

目的 系统评价糖尿病患者健康素养评估工具的方法学质量和测量属性质量，为医护人员选择最佳评估工具提供依据。方法 系统检索PubMed、Embase、CINAHL、Web of Science、中国知网、维普数据库、万方数据库及中国生物医学文献数据库中有关糖尿病患者健康素养评估工具的研究，检索时限为建库至2022年12月31日。由2名研究者独立进行文献筛选和资料提取，采用基于共识的健康测量工具遴选标准（consensus-based standards for the selection of health measurement instruments,COSMIN）系统评价指南对纳入的评估工具进行评价，形成最终推荐意见。结果 共纳入15项研究，包含12种糖尿病患者健康素养评估工具。其中，韩国糖尿病健康素养量表（Korean Health Literacy Scale for Diabetes Mellitus,KHLS-DM）和15条目糖尿病计算测试量表（Diabetes Numeracy Test-15,DNT-15）具有满意的内容效度和内部一致性，为A级推荐；3条目健康素养筛查问卷...     

老年人口腔健康相关生活质量影响因素的研究进展

阐述老年人口腔健康相关生活质量测量工具,从口腔健康问题、社会人口学、心理、口腔健康知信行方面综述老年人口腔健康相关生活质量影响因素的研究进展以及提高老年人口腔健康相关生活质量干预性研究,旨在发现影响因素中的可控因素和老年人自身的特点,为医务工作者制定改善老年人口腔健康相关生活质量干预措施提供理论依据.     

朝鲜族老年高血压患者健康素养及其影响因素分析

目的 分析朝鲜族老年高血压患者健康素养水平及其影响因素.方法 利用一般情况问卷、高血压相关健康素养评估工具等对334例朝鲜族老年高血压患者进行结构式访谈,并测量其收缩压、舒张压、身高、腰围、空腹血糖等.结果 本次受调查的朝鲜族老年高血压患者健康素养得分平均为(85.0±71.6)分,其中约有2/3的研究对象(65.0％)属于健康素养缺乏范围,约1/4的研究对象(25.4％)属于健康素养充足范围;经济地位(SES)和年龄进入健康素养多元回归方程(Cum.R2=0.347).结论 朝鲜族老年高血压患者健康素养问题较为突出,经济地位和年龄是影响其健康素养水平的重要因素.     

糖尿病患者电子健康素养研究进展

目的 综述糖尿病患者电子健康素养的评估、影响因素及干预,为制定干预措施提供依据。方法 检索国内外相关文献,对糖尿病患者电子健康素养的水平、评估工具及影响因素进行归纳,并从干预的内容、方式、结果等维度综述干预措施。结果 我国糖尿病患者电子健康素养水平较低,尚未有高质量的针对我国糖尿病患者的评估工具;影响因素包括人口统计因素、自我效能、技术因素、社会支持等;电子健康素养培训是主要的干预方法。结论 未来的研究应开发出高质量的针对糖尿病患者电子健康素养测量工具,进而构建本土化的糖尿病患者电子健康素养培训方案,促进我国糖尿病患者电子健康素养和自我管理水平的提升。     

糖尿病患者健康素养特异性评估工具的研究进展

文章对国内外糖尿病患者健康素养特异性评估工具进行综述,从主观、客观、主观与客观相结合3个方面对评估工具的主要内容、评分标准及测量属性等进行阐述,分析并比较现有评估工具存在的问题并提出建议,以期为引进、开发和应用相关测评工具提供借鉴。     

慢性肾脏病患者健康素养测评工具研究进展

慢性肾脏病常发展成为终末期肾病,造成严重的医疗负担,使用健康素养测评工具可以有效识别低健康素养的慢性肾脏病患者,使医务人员对其尽早进行干预,以提高其健康素养水平,临床意义重大。文章阐述了慢性肾脏病患者的健康素养定义和内涵、国内外慢性肾脏病患者健康素养测评工具的研究现状及展望,旨在为我国慢性肾脏病患者健康素养测评工具的开发以及提高慢性肾脏病患者健康素养水平的干预研究提供依据。     

慢性牙周炎患者口腔健康相关生活质量研究现状

检索相关文献,就慢性牙周炎患者口腔健康相关生活质量现状、口腔健康相关生活质量测评工具、口腔生活质量影响因素进行综述,旨在为提高慢性牙周炎患者的口腔健康相关生活质量提供参考。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.