糖尿病视网膜病变患者健康教育需求调查与对策

目的通过对糖尿病(DM)患者进行眼科健康教育的需求调查,制定护理对策,使糖尿病视网膜病变(DR)患者做到早诊断、早治疗,以保留健康的视力。方法对175例DR患者进行健康教育内容及需求调查,制定相应护理对策。结果175例DR患者中63例(36%)患者掌握有关DR的知识,接受过健康教育的患者视力明显好于未接受健康教育者。结论必要的DM教育,使患者正确认识DM,大力培养专科护士是减少DR发病的有力护理措施。     

糖尿病视网膜病变患者健康教育需求调查与对策

目的 通过对糖尿病(DM)患者进行眼科健康教育的需求调查,制定护理对策,使糖尿病视网膜病变(DR)患者做到早诊断、早治疗,以保留健康的视力.方法 对175例DR患者进行健康教育内容及需求调查,制定相应护理对策.结果 175例DR患者中63例(36%)患者掌握有关DR的知识,接受过健康教育的患者视力明显好于未接受健康教育者.结论 必要的DM教育,使患者正确认识DM,大力培养专科护士是减少DR发病的有力护理措施.     

糖尿病视网膜病变患者的认知状况调查分析

糖尿病（DM）是一种复杂的代谢性疾病，在全身代谢性疾病中引起视网膜病变的频率最高，是严重影响视力的一种眼部损害。随着人民生活水平的不断提高，糖尿病的发病率也呈增长趋势，但多数DM患者对糖尿病视网膜病变（DR）缺乏重视，导致最终丧失视力。本文通过对DR患者认知状况的调查分析，旨在有针对性进行健康教育，使患者保存视力，提高生活质量。     

糖尿病视网膜病变病人健康教育需求调查

[目的]了解糖尿病视网膜病变（DR）病人的健康教育需求，以便采取有效的教育对策。[方法]采用自行设计的问卷对96例DR病人进行调查。[结果]65％以上的DR病人对糖尿病（DM）有一定的了解，需要了解视网膜病变方面的相关知识，教育方式最好是与医护人员面谈。[结论]对DR病人的健康教育重点是DM眼病的防治教育。     

影响糖尿病视网膜病变患者早期诊治的原因与对策

调查了48例糖尿病视网膜病变(DR)患者未能早期接受眼科诊治的原因,发现主要原因为对DR不够了解,血糖控制不理想,内科医生未建议进行专科检查等.认为眼科医护人员应密切与糖尿病(DM)专科的联系,尽早对DM患者进行DR健康教育,并开展社区DR防治教育.     

糖尿病视网膜病变筛查与防治中存在的问题及对策

目的探讨糖尿病视网膜病变(diabetic retinopathy,DR)患者筛查和防治中存在的问题及对策。方法以76例糖尿病DR患者为对象,调查未能早期接受眼科诊治的原因。结果存在问题主要是患者对DR防治知识不了解、血糖控制不理想、内科医生未建议进行专科检查等。结论眼科医护人员应密切与糖尿病专科的联系,尽早对DM患者进行DR健康教育,并开展社区DR防治工作。     

糖尿病视网膜病变病人健康教育需求调查

[目的]了解糖尿病视网膜病变(DR)病人的健康教育需求,以便采取有效的教育对策.[方法]采用自行设计的问卷对96例DR病人进行调查.[结果]65%以上的DR病人对糖尿病(DM)有一定的了解,需要了解视网膜病变方面的相关知识,教育方式最好是与医护人员面谈.[结论]对DR病人的健康教育重点是DM眼病的防治教育.     

门诊糖尿病患者健康需求调查与分析

目的：调查本院门诊糖尿病（DM）专科就诊的DM患者,了解其糖尿病知识的掌握情况、血糖控制情况以及有无并发症的发生,为今后DM患者的继续教育提供依据和教育方向。方法：采用自行设计的三套问卷调查表对门诊糖尿病专科就诊的182例DM患者进行调查。结果：调查的182例DM患者中本？113例,占调查总数的62.1%,调查糖尿病知识10项,本市调查人数中知晓率最高的为糖尿病的分型,占调查总数的34.6%,血糖控制理想（包括空腹与餐后2h）的本市调查人数14例,占本市调查人数的12.4%,本市调查人数中有并发症26例,占本市调查人数的23.0%。外地（包括郊县）患者69例,占调查总数的37.9%,其中接受过糖尿病健康教育的患者仅13例,仅占调查总数的7.1%。血糖控制理想（包括空腹与餐后2h）8例,只占外地调查人数的11.6%。有并发症发生37例,占外地调查人数的53.6%。分析发现患者DM知识知晓率与其居住地、病程长短、职业、文化程度、是否接受过DM教育、是否接受过胰岛素注射有密切关系。结论：DM患者对DM健康知识的需求仍然迫切,特别是外地患者,应加强外地患者的健康教育力度,做到人文化、个性化的健康教育。     

护理干预对糖尿病视网膜病变发生发展的影响

糖尿病性视网膜病变（DR）是糖尿病（DM）最常见且严重的眼部并发症,是成人致盲的主要眼病之一。因DR的发生及严重程度与患者的生活习惯、血糖、血压、血脂等控制程度密切相关,所以对DM患者进行针对性的健康教育、科学的护理指导能有效地减少DR的发生,延缓DR的发展。     

糖尿病病人视网膜病变预防知识和行为状况调查研究

[目的]了解糖尿病（DM）病人视网膜病变（DR）的预防护理知识与行为现状。[方法]采用自行设计的调查表对361例DM病人进行问卷调查。[结果]近3/4病人对DR的认识、早期筛查知识缺乏了解,半数以上病人对DR的日常眼部护理知识缺乏了解、日常用眼行为不良,合并不同程度DR的病人对DR的认识差异有统计学意义。[结论]要特别重视DR预防护理教育,增强病人对DR的认识和眼睛的保护意识,加大对DM病人日常眼部护理知识的教育力度,使其建立健康的眼部护理行为,减少DR的发生。     

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.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

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.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

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.