遭受职业暴力的儿科医护人员生活质量状况调查

目的 分析儿科医护人员遭受职业暴力对生活质量的影响，以期为提升儿科医护人员生活质量提供参考。方法 采用分层抽样法对河南省522名儿科医护人员遭受职业暴力和生活质量情况进行调查，采用描述性分析及多元线性回归等统计方法对资料进行处理。结果 60.7%的儿科医护人员在过去1年内曾遭受职业暴力。儿科医护人员生活质量的各领域中，生理领域得分为（12.09±2.30），心理领域为（11.98±2.33），社会关系领域和环境领域分别为（12.84±2.00）和（10.32±2.57）。回归分析显示，儿科医护人员遭受职业暴力频度对生活质量的生理领域（β = - 0.222，P＜0.001）、心理领域（β = - 0.181，P＜0.001）、社会关系领域（β = - 0.112，P = 0.014）、环境领域（β = - 0.289，P＜0.001）均有消极的预测作用。结论 儿科医护人员遭受职业暴力的风险高，是儿科医护人员生活质量水平低的原因之一。。     

急诊医护人员工作场所暴力流行病学特征及影响因素

目的 调查兰州市三级医院急诊医护人员工作场所暴力的流行病学特征及影响因素，为急诊科开展医护人员工作场所暴力的职业防护提供理论依据。方法 于2022年3-7月，采用整群随机抽样的方法，选取兰州市7家公立三级医院的156名急诊科医护人员作为研究对象，使用已有问卷为模板设计本次工作场所暴力问卷并展开调查。结果 急诊科医护人员中，共有93人在过去一年里遭受过工作场所暴力，总发生率为59.62%。其中以语言暴力为主，发生率为57.05%，躯体暴力和性骚扰的发生率分别为28.85%和7.05%。暴力事件主要发生在抢救室、病房和大厅走廊，以患者及陪员共同施暴为主；施暴原因主要是酗酒或药物滥用（53.76%）、不合理要求被拒（43.01%）；医护人员采取的应对方式以忍让回避（63.44%）与耐心解释（62.37%）为主。经单因素及多因素logistic回归分析结果显示，性别、职称、是否参加防暴培训是兰州市急诊医护人员遭受工作场所暴力的独立影响因素（OR=0.452、2.964、2.336,P<0.05）。结论 急诊医护人员遭受工作场所暴力的问题普遍存在，严重影响了医护人员的身心健康，应根据暴力事...     

青海省精神专科医护人员生存质量与工作场所暴力现状的相关性研究

目的了解青海省精神专科医护人员生存质量与工作场所暴力现状的相关性及影响因素。方法采用便利抽样方法,于2018年11—12月,应用工作场所暴力问卷、简明健康状况调查问卷(SF-12)、工作满意度量表和一般资料调查表对119名医护人员进行问卷调查。结果精神专科医护人员生存质量总分为59.49±13.85,工作满意度总分为42.79±7.52,工作场所暴力发生率为78.2%。工作场所暴力发生率在不同科室医护人员和医患关系紧张程度方面差异有统计学意义(P0.05)。生存质量与工作场所暴力呈负相关关系(r=-0.352,P0.01),与工作满意度呈正相关关系(r=0.571,P0.01),工作场所暴力与工作满意度呈负相关关系(r=-0.304,P0.01)。线性回归分析显示,工作场所暴力、工作满意度、科室和医患关系是生存质量的影响因素,解释了40.5%的变异量。结论青海省精神专科医院医护人员工作场所暴力发生率高,是医护人员生存质量的重要影响因素,应重点关注医护人员遭受工作场所暴力的情况,做好防暴力措施的培训和应急预案,以提高医护人员的生存质量和工作满意度。     

精神科医护人员遭受工作场所暴力攻击的危险因素分析

目的调查精神科医护人员遭受工作场所暴力攻击(WPV)现状并分析其危险因素。方法抽取154名精神科医护人员和152名非精神科医护人员,采用一般资料调查问卷及WPV调查问卷进行调查。比较精神科与非精神科医护人员的WPV发生情况,采用单因素与logistic回归分析精神科医护人员遭受WPV的危险因素。结果 154名精神科医护人员中,有135名医护人员表示曾经遭受过至少1次WPV,发生率为87.66%,其中,语言暴力发生率为79.87%,威胁恐吓发生率为50.65%,躯体攻击发生率为26.62%,性骚扰发生率为5.84%。非精神科医护人员的语言暴力、威胁恐吓、躯体攻击发生率依次为48.68%、30.92%、11.18%,明显低于精神科医护人员(P0.05);非精神科医护人员的性骚扰发生率为7.24%,与精神科医护人员比较,差异无统计学意义(P0.05)。经单因素及logistic回归分析结果显示,学历(OR=1.203)、工龄(OR=0.465)、封闭病房(OR=1.719)、每月夜班数(OR=1.465)、接受相关培训(OR=0.510)、遭遇后上报(OR=0.461)是精神科医护人员遭受WPV的独立影响因素(P0.05)。结论精神科医护人员遭受WPV的发生率较高,发生危险因素主要与学历、工龄、夜班数、是否接受相关培训及遭遇WPV后是否上报有关。针对WPV发生危险因素制定持续性WPV防护培训,改善医护人员工作环境与患者就医环境,建立WPV防护规范与应急处理预案等是降低WPV发生风险的重要举措。     

医务人员遭受医院暴力情况及影响因素分析

目的 了解医务人员遭受医院暴力的现状,分析医院暴力行为发生的影响因素,探究医院暴力的预防措施。方法 通过问卷调查的方法收集山西省医务人员遭受医院暴力情况等相关数据,采用SPSS软件进行数据分析。结果 医院暴力事件的发生率为68.51%,其中以语言暴力为主。单因素分析结果显示,性别（x2=8.845,P=0.003）、学历（x2=39.396,P<0.001）、工作年限（x2=8.463,P=0.037）、医院级别（x2=5.612,P=0.018）、工作岗位（x2=23.813,P<0.001）、科室（x2=33.486,P<0.001）均有统计学意义。多因素logistic回归分析结果显示,与本科以下比较,本科（OR=2.687）和硕士及以上（OR=2.131）医务人员遭受医院暴力风险更大,与职能科室比较,妇产科（OR=3.623）和急诊科（OR=4.019）医务人员遭受医院暴力风险更大。结论 医务人员遭受医院暴力的风险性高,造成严重的身心伤害,有关部门应采取相应的预防措施减少暴力事件的发生。     

新疆维吾尔自治区护理人员遭受工作场所暴力现状与影响因素研究

目的调查新疆维吾尔自治区护理人员遭受工作场所暴力现状,分析影响因素。方法法使用《医疗部门工作场所暴力国家案例研究工具一调查问卷》对新疆地区4个行政区域共16所医疗卫生机构的1600名护理人员进行调查,采用二分类logistic回归模型分析护理人员遭受工作场所暴力的影响因素。结果新疆护理人员工作场所暴力发生率为68.69%,其中8.94%曾遭受身体暴力,59.75%曾遭受心理暴力。遭受身体暴力、心理暴力时,处置方式占比最高的分别是告知管理者(17.52%)、向同事诉说(22.07%),占比最低的分别是通过法律途径解决(2.31%)、向工会或协会求助(2.48%)。多因素logistic回归分析结果显示,汉族(OR=1.696)、门诊和急诊(0R=5.936)、护士长及以上职务(OR=5.980)、三级医院(OR=9.391)、大专及以下学历(0R=8.830)、每月晚班天数较多(OR=3.915)的护理人员遭受工作场所暴力风险较高。结论新疆护理人员遭受工作场所暴力发生率较高,大部分经历者处置方式仍局限于个人层面且对处置结果并不满意,工作场所暴力的发生与医院级别、科室、夜班、行政职务、学历等有关。     

儿科护士遭受工作场所暴力流行病学特征分析

[目的]了解儿科护士遭受工作场所暴力的流行病学特征及危险因素,为减少儿科护士遭受工作场所暴力的发生提供科学依据。[方法]调查广州市10所综合医院的儿科护士,依据世界卫生组织关于工作场所暴力的定义调查在调查前12个月中遭受工作场所暴力情况。[结果]调查的304名儿科护士中,有215名(70.7)在12个月内曾遭受工作场所暴力,其中心理暴力为68.8,身体暴力为16.1。暴力的类型多样,且多发于诊治护理病人时(53.1)或患者病情恶化时(20.7)。Logistic回归分析结果显示较低学历和职称的护士更容易遭受工作场所暴力侵犯。[结论]儿科护士遭受工作场所暴力问题较为严重,应采取多种措施减少儿科护士遭受工作场所暴力的机会。     

我国护士遭受工作场所暴力相关因素的Meta分析

目的探讨我国护士遭受工作场所暴力的相关因素。方法计算机检索8个中英文数据库数据库,2位评价者根据纳入与排除标准独立筛选文献、提取资料和质量评价,采用Rev Man 5.0软件进行Meta分析。结果最终纳入24项研究,共计14 185名护士。Meta分析结果显示,针对门急诊护士的工作场所暴力发生率高于住院部护士[OR=2.93,95%CI (1.82, 4.69), P0.001];护士婚姻状况[OR=1.25, 95%CI (0.93, 1.68), P=0.14]、聘用方式[OR=0.98, 95%CI (0.85,1.14), P=0.82]与工作场所暴力的发生率无关。护士学历[RD=0.01, 95%CI (-0.02, 0.05), P=0.49]、护龄[OR=0.86, 95%CI (0.73, 1.02), P=0.08]、职称[OR=1.00, 95%CI (0.70, 1.45), P=0.98]与遭受工作场所暴力的概率无关,但该结论尚需进一步研究证实。工作场所暴力会对护士心理健康和职业心理造成负面影响。结论我国护士遭受工作场所暴力与其所在科室相关,与婚姻状况、学历、护龄、职称和聘用方式无关。遭受工作场所暴力会使护士产生一般心理问题和职业心理问题。     

遭受工作场所暴力的院前急救医护人员心理状况调查

目的探讨院前急救医护人员遭受工作场所暴力后的心理压力状况。方法应用症状自评量表(SCL-90)对3所综合医院204名院前急救医护人员进行问卷调查,比较观察遭受过工作场所暴力组与未遭受暴力组的基本资料及SCL-90心理健康量表指标,并进行统计分析。结果遭受工作场所暴力者126名(61.8%),遭受工作场所暴力组在年龄(χ2=11.687,P<0.05)、随车(χ2=8.453,P<0.05)、职称(χ2=8.843,P<0.05)、上夜班(χ2=27.245,P<0.05)均小于未遭受工作场所暴力组,差异有统计学意义。遭受工作场所暴力组的医护人员产生躯体化(t=4.08,P<0.05)、强迫(t=3.52,P<0.05)、人际敏感(t=3.26,P<0.05)、焦虑(t=3.83,P<0.05)、敌对(t=3.15,P<0.05)、恐怖(t=3.62,P<0.05)、精神病性症状程度(t=3.62,P<0.05)、阳性项目数(t=3.46,P<0.05)及总分(t=3.87,P<0.05)均比未遭受工作场所暴力组高,二者差异有统计学意义,而在抑郁、偏执项目得分两组差异无统计学意义((P>0.05);遭受工作场所暴力后院前急救医护人员最常见心理症状以焦虑、抑郁、强迫症状、人际关系敏感和躯体化较突出。结论院前急救医护人员遭受工作场所暴力现象严重,建议规范院前急救流程,给予受暴者人文关怀,采取措施预防和干预工作场所暴力。     

精神科护士共情疲劳与工作场所暴力的相关性研究

目的探讨精神科护士共情疲劳与工作场所暴力之间的相关性。方法采用一般资料问卷、共情疲劳量表、工作场所暴力发生频数问卷对374名精神科护士进行调查。结果精神科护士共情疲劳各维度的得分分别为:共情满意得分为32.49±6.00,职业倦怠得分为27.32±4.42,继发性创伤应激得分为26.01±5.38。精神科护士近1年遭受过工作场所暴力的有284名,发生率为75.94%。发生形式中谩骂和威胁的所占比例较高,精神科护士的共情满意度与遭受工作场所暴力呈负相关(r=-0.294,P0.01)。而职业倦怠与遭受工作场所暴力呈正相关(r=0.151,P0.01)。结论精神科护士的共情疲劳与工作场所暴力的发生密切相关,工作场所暴力发生越频繁,共情疲劳程度越高。因此,积极采取预防工作场所暴力发生的措施是降低精神科护士共情疲劳的重要手段。     

Performance, proficiency, and value of the dietetics professional: an update

The major focus of the plan is the possible professional development activities provided by the Association and used by members. Ultimately, the Plan offers the Association and members concise and doable tactics for addressing the number one member concern of compensation and benefits.All organizational units of ADA will examine opportunities for developing tools, gathering data, and exploring tactics to build on current programs that will close the gap between performance, proficiency, and value for the profession. Likewise, members are encouraged to use ADA resources, such as the PPV Plan’s tactics to build their professional development plans. Members should also consider investigating outside services or employer resources that compliment the opportunities that ADA offers.The following Professional Development Sessions are planned for the 2003 Food and Nutrition Conference & Expo in San Antonio (October 25–28).Saturday, October 25, 20035:00–7:00 pm—Live Up to Your Dreams: Opening Session Ross Keynote Address, Dot Richardson, MDSunday, October 26, 20038:30–10:00 am—Customer Satisfaction: Creating Demands for our Services8:30–10:00 am—ADA Forum for Students and New Professionals10:30–12:00 pm—Managing your Professional Development Portfolio1:30–3:00 pm—Adding Value Through Differences: Anyone Can Become a Leader3:30–5:00 pm—The Enterprising Dietitian: Building a Diabetes Business with RN Partners3:30–5:00 pm—Business and Communications: Career Opportunities for DietitiansMonday, October 27, 20038:00–9:30 am—Positive Attitude: The Key to Success in Nutrition and Dietetics12:30–1;30 pm—ADA’s Reality Show: Real Stories, Real Members, Real Prizes2:00–3:30 pm—Communications Seminar: How to Manage your Mouth4:00–5:30 pm—You can Have it all: Leadership and Life BalanceTuesday, October 28, 20038:00–9:30 am—Gain-Gain: A New Look at Salary Negotiation10:00 am–11:00 am—Negotiation Skills for Young Professionals10:00–11:00 am—Member Forum: How to Get Involved, ADA Needs You     

Making IVF more effective through the evolution of prediction models: is prognosis the missing piece of the puzzle?

Assisted reproductive technology has evolved tremendously since the emergence of in vitro fertilization (IVF). In the course of the recent decade, there have been significant efforts in order to minimize multiple gestations, while improving percentages of singleton pregnancies and offering individualized services in IVF, in line with the trend of personalized medicine. Patients as well as clinicians and the entire IVF team benefit majorly from ‘knowing what to expect’ from an IVF cycle. Hereby, the question that has emerged is to what extent prognosis could facilitate toward the achievement of the above goal. In the current review, we present prediction models based on patients’ characteristics and IVF data, as well as models based on embryo morphology and biomarkers during culture shaping a complication free and cost-effective personalized treatment. The starting point for the implementation of prediction models was initiated by the aspiration of moving toward optimal practice. Thus, prediction models could serve as useful tools that could safely set the expectations involved during this journey guiding and making IVF treatment more effective. The aim and scope of this review is to thoroughly present the evolution and contribution of prediction models toward an efficient IVF treatment.

Abbreviations: IVF: In vitro fertilization; ART: assisted reproduction techniques; BMI: body mass index; OHSS: ovarian hyperstimulation syndrome; eSET: elective single embryo transfer; ESHRE: European Society of Human Reproduction and Embryology; mtDNA: mitochondrial DNA; nDNA: nuclear DNA; ICSI: intracytoplasmic sperm injection; MBR: multiple birth rates; LBR: live birth rates; SART: Society for Assisted Reproductive Technology Clinic Outcome Reporting System; AFC: antral follicle count; GnRH: gonadotrophin releasing hormone; FSH: follicle stimulating hormone; LH: luteinizing hormone; AMH: anti-Müllerian hormone; DHEA: dehydroepiandrosterone; PCOS: polycystic ovarian syndrome; NPCOS: non-polycystic ovarian syndrome; CE: cost-effectiveness; CC: clomiphene citrate; ORT: ovarian reserve test; EU: embryo–uterus; DET: double embryo transfer; CES: Cumulative Embryo Score; GES: Graduated Embryo Score; CSS: Combined Scoring System; MSEQ: Mean Score of Embryo Quality; IMC: integrated morphology cleavage; EFNB2: ephrin-B2; CAMK1D: calcium/calmodulin-dependent protein kinase 1D; GSTA4: glutathione S-transferase alpha 4; GSR: glutathione reductase; PGR: progesterone receptor; AMHR2: anti-Müllerian hormone receptor 2; LIF: leukemia inhibitory factor; sHLA-G: soluble human leukocyte antigen G.     

Morphometric analysis of sperm used for IVP by three different separation methods with spatial light interference microscopy

ABSTRACT

The goal of this study was to characterize sperm populations resulting from three different methods of sperm selection used for bovine in vitro fertilization. We compared sperm selection with discontinuous Percoll gradients, Swim-Up, and electro-channel. Spatial light interference microscopy (SLIM) was used to evaluate the morphology of the spermatozoa and computer-assisted semen analysis (CASA) was used to evaluate the motility behavior of the sperm. Using these two technologies, we analyzed morphometric parameters and the kinetic (motility) patterns of frozen-thawed Holstein bull spermatozoa after sperm selection. For the first time, we have shown that these methods used to select viable spermatozoa for in vitro fertilization (IVF) result in very different sperm subpopulations. Almost every parameter evaluated resulted in statistical differences between treatment groups. One novel observation was that the dry mass of the sperm head is heavier in spermatozoa selected with the electro-channel than in sperm selected by the other methods. These results show the potential of SLIM microscopy in reproductive biology.

Abbreviations: SLIM: spatial light interference microscopy; CASA: computer aided sperm analysis; IVF: in vitro fertilization; BSA: bovine serum albumin; QPI: quantitative phase imaging; IVEP: in vitro embryo production; IACUC: institutional animal care and use committee; CSS: Certified Semen Services; AI: artificial insemination; TALP: Tyrode’s Albumin Lactate Pyruvate; MEC: medium for electro-channel; PDMS: polydimethylsiloxane; EC: electro-channel; TM, %: total motility; PM, %: progressive motility; RM, %: percentage of rapid sperm motility; VAP, μm/s: average path velocity; VSL, μm/s: straight-line velocity; VCL, μm/s: curvilinear velocity; ALH, μm: amplitude of lateral head displacement; BCF, Hz: beat cross frequency; STR, %: straightness; LIN, %: and linearity; GLS: generalized least squares; ANOVA: analysis of variance; LSD: Least Significant Difference; SPSS: Statistical Package for the Social Sciences; PCA: principal components analysis     

Hepatitis C virus infection in injection drug users in Bavaria: risk factors for seropositivity

Background: Hepatitis C Virus (HCV) infection is the most common disease among intravenous drug users (IDUs). Patients and method: All patients admitted to the detoxification unit 1991–1997 and meeting ICD-10 diagnosis of opioid dependency were tested for anti-HCV serology. Results: Thousand and forty nine patients were included in the study. About 61.3% of the IDUs were anti-HCV positive. Increasing age (PR: 1.46; 95% CI: 1.34–1.60), living with a significant other drug user (PR: 1.17; 95% CI: 1.05–1.31), history of therapy (PR: 1.62; 95% CI: 1.50–1.74), history of imprisonment (PR: 1.48; 95% CI: 1.36–1.61), history of emergency treatment (PR: 1.23; 95% CI: 1.12–1.35), additional daily consumption of benzodiazepines (PR: 1.10; 95% CI: 1.00–2.21) or alcohol (PR: 1.26; 95% CI: 1.14–1.38), frequency of injecting heroin (daily: PR: 0.86; 95% CI: 0.78–0.96; previously: PR: 1.14; 95% CI: 1.03–1.26) and type of opioid dependency (methadone: PR: 1.26; 95% CI: 1.13–1.41) were significant factors, considered as individual factors, for positive anti-HCV serology. Using multiple logistic regression we found that older age (OR: 3.54, 95% CI: 1.30–9.67), longer duration of opioid use (OR: 5.74; 95% CI: 1.82–18.13), living with a significant other drug user (OR: 1.47; 95% CI: 1.01–2.16), history of therapy (OR: 4.87; 95% CI: 1.67–14.20), history of imprisonment (OR: 1.92; 95% CI: 1.12–3.28), history of emergency treatment (OR: 1.45; 95% CI: 1.06–1.99) and additional daily consumption of alcohol (OR: 1.49; 95% CI: 1.04–2.13) remained independently associated with positive anti-HCV serology. Conclusions: These data support the need for early prevention strategies, namely, education of teachers in schools and further training of counsellors informing IDUs of what they can do to minimise the risk of becoming infected or of transmitting infectious agents to others.     

BOOK REVIEWS

Book reviewed in this article: John M. Last (ed.): [Maxcy-Roseneau] Public Health and Preventative Medicine Walter W. Holland, Roger Detels and George Knox (eds): Oxford Textbook of Public Health Glenn Gritzer and Arnold Arluke: The Making of Rehabilitation: A Political Economy of Medical Specialization, 1890–1980 Anselm Strauss, Shizuko Fagerhaugh, Barbara Suczek, and Carolyn Wiener: Social Organization of Medical Work C. Russell and T. Schofield: Where it Hurts Anthony Clements (ed.): Infant and Family Health in Australia A, Howe et al.: Veteran Beneficiaries in Nursing Homes: A Three State Comparative Study. Australian Institute of Multicultural Affairs: Community and Institutional Care for Aged Migrants in Australia. Research Findings Giles Darvill and Brian Munday (eds.): Volunteers in the Personal Social Services A. Stewart Truswell: ABC of Nutrition MP Vessey and J Muir Gray, (eds): Cancer Risks and Prevention. R. Nery: Cancer; An Enigma in Biology & Society. F.B. Christiansen, M.W. Feldman: Population Genetics. Colin Grant: Australian Hospitals: Operation and Management A Work in America Institute Policy Study: Improving Health-Care Management in the Workplace. A.F. Long and S. Harrison (eds.): Health Services Performance; Effectiveness and Efficiency. Derek Llewellyn-Jones: Everywoman: A Gynaecological Guide For Life.     

Books Reviews

Book reviewed in this article: Australia, House of Representatives Standing Committee on Aboriginal Affairs: Aboriginal Health. G. Goldstein, H. Hunt and B. Sharkey: Aboriginal Health Workers in New South Wales 1971–1979 Anna L. Howe: Towards an Older Australia Anthea Tinker: The Elderly in Modern Society David Hobman, (ed.): The Impact of Ageing: Strategies for Care. Elizabeth Prichard et al (eds.): Home Care: Living with Dying. Tom Arie (ed.): Health Care of the Elderly Lucien Israel: Conquering Cancer (Allen Lane London 1978) Wendy D. Squyres (ed.): Patient Education: An Inquiry into the Art. A. & J. Borushek: The complete Australian Heart Disease prevention manual with diet guide. Robert Lewy: Preventive Primary Medicine: Reducing the Major Causes of Mortality. John Geyman: Family Practice: Foundation of Changing Health Care R.C.G.P.: Health and Prevention in Primary Care. Report of a Working Party, Council of the Royal College of General Practitioners. Health Commission of New South Wales and Medicheck Referral Centre: Psychosocial problems of Sydney adults Nancy Wansbrough and Philip Cooper: Open Employment after Mental Illness. David Goldberg and Peter Huxley: Mental Illness in the Community: The Pathway to Psychiatric Care. R. J. Flynn & K. E. Nitsch (eds.): Normalisation, Social Integration and Community Services Joseph Halpern et al: The Myths of Deinstitutionalization Charles Anthony Butterworth and David Skidmore: Caring for the Mentally Ill in the Community Robert Maxwell: International Comparisons of Health Needs and Services Peter A. West: The Nation's Health and the N.H.S. Alan Williams: Health Service Objectives P. R. Jones: Doctors and the BMA. June Martin: The Reluctant Patient: Studies in the Psychology of Patients who Avoid Treatment Vicente Navarro: Class Struggle, The State and Medicine: An Historical and Contemporary Analysis of the Medical Sector in Great Britain Peter Davis: The Social Context of Dentistry Concise Medical Dictionary (Oxford University Press 1980) Peter Dally and Joan Gomez: Obesity and Anorexia Nervosa; A question of shape. Lindsay Davidson (ed): Tropical Immunology. Research for Development Seminar Three F. C. Pampel: Social Change and the Aged.