中重度阿尔茨海默病20例家庭护理干预

目的:探讨中重度阿尔茨海默病(AD)的护理方法.方法:将42名中重度AD患者随机分为护理干预组20例及常规护理组22例,干预组除常规护理外,出院后给予家庭参与护理模式.比较两组并发症情况.结果:干预组并发症出现率为10.0%,常规护理组并发症出现率为40.9%,经χ2检验,两组比较有显著性差异(P＜0.05).结论:对中重度AD患者采取家庭护理干预可减少并发症的出现率,有效提高患者生活质量.     

开展孕妇学校对产科质量的作用

目的探讨开展孕妇学校对产科质量的作用。方法将自愿参加孕妇学校的427例产妇作为干预组，以讲座、座谈会、现场示范等形式向孕妇提供孕前、孕期、分娩等全方位的科学指导，随机抽取未参加孕妇学校的418例产妇作为对照组。对比2组孕妇的知识掌握以及产时配合、分娩结局等情况。将自愿参加孕妇学校的427例产妇作为干预组。结果参加孕妇学校的产妇接受专业指导后，孕期相关知识有不同程度的提高（p〈0.05）；干预组产妇孕期营养不良、产时难产、产褥期护理不当发生情况比对照组减少，2组产妇异常情况经χ2检验，除孕期口腔疾病无显著性差异外，其他均有显著性差异（p〈0.05）。结论开展孕妇学校可有效降低孕产期发病率，提高产科质量。     

护理干预对前列腺电切术后患者舒适改变的影响

目的:探讨护理干预对前列腺电切术后患者舒适改变的作用.方法:将84例前列腺电切术后患者按入院先后顺序分为对照组和干预组各42例.对照组给予常规护理和指导;干预组在常规护理的基础上,同时进行心理、排便、排尿、膀胱冲洗、饮食、运动等方面的护理干预.比较两组患者术后发生尿量阻塞、继发出血、术后尿失禁不适感的情况.结果:两组尿管的阻塞率经χ2检验,有显著差异(P<0.05),术后继发出血情况无显著差异(P>0.05),非器质性疾病引起的不适感存在极显著性差异(P<0.01).结论:护理干预能有效缓解前列腺电切术后患者的紧张情绪和降低术后不适感,促进其康复.     

早期干预对护理特殊脐带的效果观察

目的 探讨对特殊脐带实施早期护理干预的效果.方法 将有特殊脐带的72例新生儿随机分为干预组和对照组.对照组给予常规脐部护理方法;干预组对其进行二次剪脐时间、剪脐技巧、剪脐后配合应用脐带结扎保护带持续包扎、出院时发放消毒用品及出院前教会产妇及家属正确护理新生儿脐部等实施的一系列早期护理干预措施.结果 两组新生儿脐部感染经x<'2>检验,有显著性差异,P<0.005.结论 对有特殊脐带的新生儿脐部护理实施早期干预,可明显降低新生儿脐部感染的发生率.     

对家庭成员进行育婴知识培训在预防新生儿疾病中的效果观察

目的探讨开展住院新生儿家庭成员育婴知识培训的效果。方法选取400例新生儿为干预组,在住院期间即对其家庭成员进行个体化护理知识培训,并进行考核;另设立400例新生儿为对照组,未对其家庭成员进行护理知识培训。结果家庭成员接受专业培训后,新生儿护理技能均有不同程度提高;2组各项指标比较,均有显著性差异(P<0.01);干预组新生儿呼吸道疾病、皮肤脓疱、脐炎、红臀的发病人数均少于对照组,2组比较,有显著性差异(P<0.01)。结论开展家庭成员育婴知识培训,可提高育婴水平,有效降低新生儿发病率。     

脑梗死病人康复期的家庭护理

目的探讨家庭护理对提高出院后脑梗死病人康复的意义。方法采用历史对照法将2002年3月~2002年12月期间的93例脑梗死康复期病人分为两组,2002年3～5月为未家庭护理组29例,2002年6~12月为家庭护理组64例,分别对两组病人的功能恢复和复发率进行比较。结果出院6个月后,家庭护理组与未家庭护理组的症状改善和复发情况经χ2检验均有显著性差异(P<0.05),家庭护理组优于未家庭护理组。结论家庭护理延续了康复期脑梗死病人从医院到家庭支持护理,有效地促进了脑梗死康复期病人的康复。     

养生护理干预对社区慢病患者生活质量的影响

目的探讨分析养生护理干预对社区慢病患者生活质量的影响,以制定更优的社区慢病护理方案。方法选取我社区2012年5月~2014年5月就诊的102例慢性病患者为研究对象,随机分为观察组和对照组各51例,对照组患者采用常规社区护理,观察组患者在对照组基础上,增加针对性的养生护理干预,干预周期持续4w。结果观察组患者WHOQOL-BREF生活质量评估的生理、心理、社会关系及环境四个领域部分评分均高于对照组患者,经t检验,差异有显著性(P<0.05);观察组患者对护理干预的满意度(94.1%)高于对照组患者(76.5%),经χ2检验,其差异有显著性(P<0.05)。结论养生护理干预可以更有效的提升社区慢病患者生理、心理、社会关系及环境全方面的生活质量,更加符合患者与家属的护理需求,值得广泛应用。     

护理干预对2型糖尿病患者遵医行为的影响

将100例2型糖尿病患者随机分为干预组和对照组各50例,对照组给予一般性护理,干预组在饮食、运动、药物治疗等方面进行护理干预.给予护理后,干预组血糖控制情况与护理前比较有显著性差异(P<0.01);遵医行为与对照组比较有极显著性差异(P<0.01).说明护理干预能提高患者生活质量和保健意识.     

产妇分娩过程中体位干预对降低新生儿发生缺氧缺血性脑病的效果观察

目的探讨产妇体位干预对分娩过程中新生儿缺氧缺血性脑病发病影响的临床价值。方法将1008例产妇随机分为干预组516例和对照组492例,干预组按常规护理的同时给予体位干预措施,对照组只按常规护理,不作体位指导,统计2组分娩过程中新生儿缺氧缺血性脑病的发病率及病情程度,并进行比较。结果干预组新生儿缺氧缺血性脑病的发生率为9.30%,对照组新生儿缺氧缺血性脑病的发病率为16.26%,2组比较差异有非常显著性(P<0.01)。2组新生儿缺氧缺血性脑病病情程度比较差异有非常显著性(P<0.01)。结论体位干预可明显地降低分娩过程中新生儿缺氧缺血性脑病的发病率及减轻病情程度,对提高人口素质具有非常重要的现实意义。     

护理干预对肝穿刺术后疼痛的影响

目的:通过对肝脏穿刺术患者实施护理干预的效果观察,摸索出减轻患者穿刺术后疼痛的有效护理措施。方法:随机抽取本院肝穿刺术患者52例,分为护理干预组和对照组,分别观察记录术后疼痛情况,并对其结果进行t检验和χ2检验。结果:护理干预组患者比对照组患者的疼痛程度减轻、疼痛持续时间缩短,且有显著性差别(P<0.01)。结论:对肝穿刺术患者采取科学、合理的护理干预措施,有利于减轻其疼痛。     

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.     

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.     

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.     

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.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Prospects for the control of neglected tropical diseases by mass drug administration

The prospects for the control of neglected tropical diseases, including soil-transmitted helminthiasis, shistosomiasis, lymphatic filariasis, onchocerciasis and trachoma, through mass drug administration, are exemplified by the elimination of the trachoma as a public-health problem in Morocco. In spite of this and other striking successes, mass drug administration programs are faced with major challenges resulting from suboptimal coverage and lack of efficacy. At current suboptimal coverage rates, programs may need prolongation for an extended period, increasing costs and undermining sustainability. Community participation through health education and information appears to be crucial to improve coverage and to achieve sustainability. Implementation of complementary measures, such as vector control, improved hygiene and environmental sanitation, are important to further control transmission and to prevent re-emergence of the infection and, again, may only be achieved effectively through community-based initiatives. To reduce costs and to relieve pressure on the health system, combining neglected tropical disease programs in areas where diseases coexist and integration with existing control programs for malaria, tuberculosis and HIV/AIDS is advocated. The risk of developing drug resistance is of particular concern in view of the lack of alternative drugs, and reduced treatment efficacy due to emerging resistance is evident for the soil-transmitted helminths and onchocerciasis. Given the risk for the development of drug resistance and the need for a high degree of participation, close attention should be paid to the monitoring of the coverage and efficacy of the different program components.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Bacterial meningitis: an update of new treatment options

The outcome of bacterial meningitis critically depends on the rapid initiation of bactericidal antibiotic therapy and adequate management of septic shock. In community-acquired meningitis, the choice of an optimum initial empirical antibiotic regimen depends on the regional resistance patterns. Pathogens resistant to antibacterials prevail in nosocomial bacterial meningitis. Dexamethasone is recommended as adjunctive therapy for community-acquired meningitis in developed countries. In comatose patients, aggressive measures to lower intracranial pressure <20 mmHg (in particular, external ventriculostomy, osmotherapy and temporary hyperventilation) were effective in a case–control study. Although many experimental approaches were protective in animal models, none of them has been proven effective in patients. Antibiotics, which are bactericidal but do not lyse bacteria, and inhibitors of matrix metalloproteinases or complement factor C5 appear the most promising therapeutic options. At present, vaccination is the most efficient method to reduce disease burden. Palmitoylethanolamide appears promising to enhance the resistance of the brain to infections.