Health/Illness transition and telehealth: a concept analysis using the evolutionary method

TOPIC: Telehealth as an alternative to hospitalization. PURPOSE: Exploring the health/illness transition that occurs when an acutely ill client may be discharged into the home with telehealth in place of hospitalization or in an effort to promote an earlier discharge from the hospital. SOURCE: Published literature. CONCLUSION: The concept of the health/illness transition using telehealth has not been researched. Qualitative methods of research using interviews could enhance the knowledge in selecting appropriate individuals and nursing interventions to enhance the clients' transition from the hospital to the home with telehealth.     

If you are pregnant and smoke,admission to hospital may damage your baby's health

Summary

• ? It is recognized that smoking adversely affects the outcome of pregnancy. However, clinical experience suggested that women admitted to hospital during pregnancy smoked more than when they were at home.
• ? Forty-one women who were over 20 weeks pregnant, who smoked and had been in hospital for 2 days or more were interviewed using a structured schedule.
• ? The women had made a significant reduction in their cigarette consumption during pregnancy but on admission to hospital the number of cigarettes smoked had almost returned to the pre-pregnancy level. Boredom was seen as the main factor contributing to this increase.
• ? Strategies for reducing the effects of admission to hospital on smoking behaviour are suggested.

     

Complementary and integrative medicine: An observational study on pediatric clinicians’ knowledge,beliefs and practices

ObjectiveComplementary and Integrative Medicine (CIM) is a group of diverse health care therapies that often serve as adjuncts to conventional medical treatments. Our aim for this study was to evaluate the current knowledge, beliefs and practices of pediatric clinicians regarding CIM.MethodsClinicians from the pediatric unit of a large US based teaching hospital in Connecticut were surveyed, through self-administered questionnaires.ResultsWe sampled 70 participants with a response rate of 99 %. Of the 70, 32 were Registered Nurses, 9 were Attendings, 7 were Fellows, 15 were Residents and 4 were Nurse Practitioners. Regarding use, 24 % had referred a patient to a CIM practitioner, 43 % reported using CIM while 47 % had a family member who had used CIM in the past year. Respondents were most familiar with massage (70 %) and yoga (69 %) least familiar with Ayurvedic medicine (20 %) and Qi Gong (24 %). Regarding attitude, 67 % believed that some CIM therapies hold promise for the treatment of symptoms while 59 % believed that incorporation of CIM would increase patient satisfaction. Most of the respondents indicated that they did not have easy access to clinical information on many CIM treatment modalities. Nurses were more familiar (p = 0.024), had more positive attitudes and beliefs (p = 0.001) and thought CIM therapies had a higher impact (p = 0.002) on patient care compared to physicians, even when controlled for gender.ConclusionThis study highlights the need to bridge the gap in evidence based medicine and clinician’s knowledge with the rise in CIM use. It also stresses the need for standardized learning competencies in the field of PIM.     

中国睡眠呼吸知识的普及情况调查

睡眠医学与呼吸系统密切相关,睡眠呼吸暂停事件是常见的睡眠障碍相关疾病的表现之一。睡眠呼吸暂停事件与心、脑血管疾病、内分泌疾病等密切相关,严重影响人类的健康和生活质量。虽然随着睡眠呼吸医学教育的普及,睡眠呼吸暂停低通气综合征等相关疾病逐渐引起我们的重视,然而不同群体对呼吸睡眠的认知因专业背景、宣传普及范围和力度等存在不同的水平差异。本次拟开展不同群体的教育和认知情况调查研究,初步了解中国睡眠呼吸市场的普及情况。     

探讨儿童慢性顽固性咳嗽与支原体感染的关系及临床治疗观察

Objective To explore the relation between chronic and persistent cough of children and MP infection and clinical observation and treatment.Methods Retrospective Study of the 55 children chronic and persistent cough cases, with a clinical features as pneumonia MP infection, in my hospital from March 2005 to March 2008.Results ①Clinical Feature:major symptom of these 55 children chronic cough cases is chronic and persistent cough.58%(32/55)of the cases showed no symptoms in their lungs.②Peripheral Blood:85％(47/55)cases showed no obvious changes in peripheral blood, with their WBC ranging from(4～10)×109/Land their eosinophile granulocyte increased.③Special Test:47.27%(26/55)IgM (MP-IgM)antibody positive,83.64%(46/55)cased showed pneumonia MP DNA specificity after PcR Test.④X-Rate Report:Results varied.Conclusion Pneumonia MP Infection is one of the pathogeny causing chronic and persistent cough of children.Treating the infection is a very important solution in curing chronic and persistent cough of children.     

Thyroid cancer review 2: management of differentiated thyroid cancers

This is the second review article on thyroid cancer dealing with the common differentiated types that comprise 90% of thyroid cancers. Despite clinical management guidelines offered by a number of organisations including the British Association of Otolaryngologists and Head and Neck Surgeon, The British Thyroid Association, The American Association Of Endocrinologists, The American Thyroid Association and the National Cancer Centre Network, debate regarding the management of differentiated thyroid cancer continues. This is because of the absence of good quality research evidence as a consequence of the natural history of this disease.     

Sysmex KX-21血细胞分析仪复检规则的制定与评价

目的 建立血细胞分析仪的复检规则,以求合理、有效地使用血细胞分析仪,同时为使用三分群血细胞分析仪的实验室复检标准的制定提供参考依据.方法 根据医院及KX-21血细胞分析仪的特点,结合国际血液学复检专家组推荐的血细胞复检规则,制定血细胞显微镜复检标准.通过对1 700例标本血涂片进行姥微镜检查,包括人工白细胞分类和细胞形态观察,评价仪器和手工检查结果的一致性以及规则的可行性.结果 根据本复检规则和涂片镜检阳性评定标准[1]对检测结果进行统计分析,复检率为33.76%(574/1 700),真阳性率为11.88%(202/1 700),假阳性率为21.88%(372/1 700),真阴性率为64.29%(1 093/1 700),假阴性率为1.94%(33/1 700),未漏检原幼细胞.结论 国际血液学复检专家组推荐的血细胞复检规则对三分群血细胞分析仪复检规则的制定亦有指导意义.本研究制定的KX-21血细胞分析仪的复检规则符合本实验室特点.     

Oral infections related to radiation and immunosuppressive therapy

Abstract. The frequency of oral infection complications after cytotoxic chemotherapy andradiochemotherapy is significant, often contributing to serious septic infectious complications. Generally, the more intense the cytotoxic therapy, the more common are the oral infection complications. In the present review, the spectrum of oral infections related to radiation and immunosuppressive therapy are evaluated and the different local and systemic treatment modalities are presented.     

Sysmex KX-21血细胞分析仪复检规则的制定与评价

目的 建立血细胞分析仪的复检规则,以求合理、有效地使用血细胞分析仪,同时为使用三分群血细胞分析仪的实验室复检标准的制定提供参考依据.方法 根据医院及KX-21血细胞分析仪的特点,结合国际血液学复检专家组推荐的血细胞复检规则,制定血细胞显微镜复检标准.通过对1 700例标本血涂片进行姥微镜检查,包括人工白细胞分类和细胞形态观察,评价仪器和手工检查结果的一致性以及规则的可行性.结果 根据本复检规则和涂片镜检阳性评定标准[1]对检测结果进行统计分析,复检率为33.76%(574/1 700),真阳性率为11.88%(202/1 700),假阳性率为21.88%(372/1 700),真阴性率为64.29%(1 093/1 700),假阴性率为1.94%(33/1 700),未漏检原幼细胞.结论 国际血液学复检专家组推荐的血细胞复检规则对三分群血细胞分析仪复检规则的制定亦有指导意义.本研究制定的KX-21血细胞分析仪的复检规则符合本实验室特点.     

介入放射技术在妇产科临床运用探讨

目的探讨介入放射技术在妇产科临床诊断与治疗的应用可行性与安全性．方法临床34例患者，16例为剖宫产术后反复大出血者，3例为顽固性功能性子宫出血者，10例为晚期官颈癌者，5例为子宫肌瘤者。34例经Scldinger介入放射技术诊断与治疗。结果经介入放射技术诊断与治疗，34倒不同的患者得到及时、准确、有效的诊断与治疗，未见并发症和后遗症。结论介入放射技术在妇产科临床运用安全、有效。     

规范培训在内外科护理兼职教师教学效果中的作用

目的 采取试讲、统筹安排等措施对内外科护理兼职教师进行培训,探讨规范培训在教学效果中的作用.方法 将2008～2009学年聘用的35位内外科兼职教师设为空白对照组,将2009～2010学年聘用的39位兼职教师设为实验组,实验组采取规范化培训和实践,采用自行设计的问卷向在校专职护理教师和授课对象对两组兼职教师的教学效果进行评价,并随机抽取2008～2009学年和2009～2010学年的二年级护生,比较期末考试的理论成绩和操作成绩.结果 经过培训后内外科护理兼职教师在语言表达、引进医院先进技术和知识、提高护生综合分析能力等方面有所提高,2009～2010学年二年级学生的理论成绩和操作成绩也有所提高,差异有显著意义.结论 外聘教师有着丰富的临床经验,但也存在教学模式、教学手段、基础知识、质量管理等不足,需对外聘教师进行各项教学规范化培训和实践,以提高教学能力和教学效果.     

加强对人类健康影响重大的内分泌代谢病防治

以联合国名义直接作出决议的疾病只有艾滋病和糖尿病,国际糖尿病联盟(IDF)发表的新的糖尿病防治指南,展现了在糖尿病预防与诊治方面的最新进展。甲状腺疾病流行病学、临床及实验室研究和长期随访,填补了我国在世界卫生保健数据库中的空白。     

Does Nutrition Counseling Affect Glycosylated Hemoglobin and Estimated Glomerular Filtration Rate in Patients With Diabetes and Stage 3 Chronic Kidney Disease?

This study evaluated glycosylated hemoglobin (HbA_1c) and estimated glomerular filtration rate (eGFR) for adult patients with diabetes and stage 3 chronic kidney disease after disease and nutrition counseling interventions were performed. A retrospective electronic medical record audit was used (n = 88) during a 12-month period. Use of the paired samples t test at 3 and at 6 months after the initial counseling visit reflected a statistically significant improvement in the HbA_1c at 3 and at 6 months (mean outcome, 0.000; P < .05), and the eGFR at 6 months (mean outcome, 0030; P < .05). These outcomes support implementation by advanced practitioners.     

Drugs and Medical Devices: Adverse Events and the Impact on Women’s Health

A large number of medications and medical devices removed from the market by the US Food and Drug Administration over the past 4 decades specifically posed greater health risks to women. This article reviews the historical background of sex and gender in clinical research policy and describes several approved drugs and devices targeted for use in women that have caused major morbidity and mortality. The intended population for the medications and devices, population affected, approval process, and the basic and legal actions taken against the medication/drug company are also discussed. It is recognized that women are still at risk for harm from unsafe medications and devices, and continued improvements in legislation that promotes inclusion of sex and gender into the design and analysis of research will improve safety for both men and women.     

Examining Grade Inflation and Considerations for Radiologic Sciences: A Literature Review

Grade inflation is defined as an increase in the number of “A” grades being awarded to students. This may lead to students who have the grade but not necessarily the skill to prove that they have mastered the content. Causes such as consumerism, faculty job retention, conflict avoidance, increases in faculty workload, and lack of clear grading standards have led some to question the importance of grades. Ramifications of grade inflation include degrees that may become meaningless, students who may be unable to perform in the workplace and, in the cases of medical professionals, patients who may be put in potentially life-threatening situations. Suggestions for mitigating this trend are increasing faculty training, creating objective student assessments, and evaluating students on their overall character. Because no studies in radiologic sciences currently exist, examining grade inflation in this field is critical. Faculty and student perceptions of grade inflation in radiologic sciences should also be examined to discover if this phenomenon exists. If grade inflation is discovered to be a problem, radiologic science educators should follow the recommendations presented in this review to mitigate this trend.     

Finding the Words to Say It: The Healing Power of Poetry

My purpose in this paper is to help you experience for yourselfthe potential of poetry to heal by feeling its power throughyour own voice. Many people have an intuitive sense that voicein general and poetry in particular can be healing. We haveall experienced the comfort of soothing words. Finding the wordsto articulate a traumatic experience can bring relief. A letterbetween friends who are fighting can heal a relational wound.People are frequently moved to write a poem in times of extremity.In mainstream culture there are subjects that are not talkedabout. They are taboo. For example, each of us is going to die,but we do not talk about dying. We are all in the dialogue ofillness, death and dying, whether or not we are talking aboutit. Poetry gives us ways to talk about it. Multiple ways ofutilizing poetry for healing, growth and transformation willbe presented including the Poetry and Brain Cancer project atUCLA. Particular attention will be given to issues of Palliativecare. The reader will be directed to the scientific evidenceof the efficacy of utilizing expressive writing. The developingprofessional field of Poetry Therapy, and The National Associationfor Poetry Therapy will be discussed.     

游泳与抚触对婴儿神经行为发育效果的研究与探讨

目的 探讨游泳与抚触对婴儿神经行为发育效果的变化规律。方法 采用Oesell发育量表对游泳与抚触婴儿神经行为发育状况进行测试，同时记录婴儿神经、心理发育项目完成的月龄并设对照组，观察游泳与抚触对婴儿神经行为发育效果的关系。结果 游泳组婴儿神经、心理发育项目完成的月龄提前，两组比较差异显著P〈0.01。游泳组在大运动、精细运动及个人交往能区方面与对照组比较差异显著，P〈0．01。结论 游泳与抚触对婴儿神经行为发育有促进作用。     

Challenges in pulmonary hypertension associated with left heart disease

Introduction: Pulmonary hypertension (PH) secondary to left-sided heart disease (Group 2 PH) is a frequent complication of heart failure (HF) and is a heterogeneous phenotypic disorder that worsens exercise capacity, increases risk for hospitalization and survival independent of left ventricular ejection fraction (LVEF) or stage of HF.

Areas covered: In this review, an update of the current knowledge and some potential challenges about the pathophysiology and treatments of group 2 PH in patients with HF of either preserved or reduced ejection fraction are provided. Also, this review discusses the epidemiology and provides hints for the optimal evaluation and diagnosis of these patients to prevent misclassification of their pulmonary hypertension.

Expert opinion: There are many of areas lacking knowledge and understanding in the field of pulmonary hypertension associated to left heart disease (PH-LHD) that should be addressed in the future. Further research should be performed, in terms of pathobiology, and understanding the predisposition (genetic susceptibility and contributing factors) of the different phenotypes of this disorder. More clinical trials targeting new therapeutic options and specific PH therapies are warranted to help this increasing important patient group as the current guidelines recommend to only treat the underlying left-sided heart disease.     

加强消毒供应室管理整改和人员的培训对灭菌物品合格率的影响

Objective To study effects of strengthening rectification measures and personnel training in disinfection and supply room on the passing rate of sterilization articles. Methods The management methods were improved and the personnel were trained in disinfection and supply room. The passing rate of sterilization articles was compared with before applying them. Results The passing rate of sterilization articles after strengthening rectification and personnel training were higher than those of before applying them. The difference was statistically significant (P＜0.05) . Conclusions To strengthen rectification measures and personnel training in disinfection and supply room can improve the passing rate of sterilization articles.