Effectiveness of aromatherapy with inhaled lavender essential oil and breathing exercises on ECT-related anxiety in depressed patients

Background and aims Electroconvulsive therapy (ECT) is considered a safe, effective, and significant treatment in patients suffering from a major depressive disorder. Anxiety caused by this invasive treatment may impose several side effects on patients. The purpose of this study was to evaluate the effectiveness of aromatherapy with inhaled lavender essential oil and breathing exercises on ECT-related anxiety in depressed patients.Methods In this randomized controlled clinical trial, 90 depressed patients were selected and divided into three groups: aromatherapy, breathing exercise, and routine care using a random allocation method. Before undergoing ECT, the aromatherapy group was exposed to the inhaled lavender essential oil (n = 30), the breathing exercise group performed the breathing exercises (n = 30), and the routine care group received routine care (n = 30). Before (20 min) and after the intervention (30 min later), patients' anxiety was assessed using Beck Anxiety Inventory.Results After the intervention, the results revealed that anxiety score changes were statistically significant among the three groups (p < 0.001). In addition, it was found that the patients’ mean anxiety scores significantly decreased in the aromatherapy and breathing exercise groups compared to with the pre-intervention scores (p < 0.001).Conclusion Aromatherapy with inhaled lavender essential oil and breathing exercises can be considered by clinical nurses as simple, applicable, and effective interventions to reduce ECT-related anxiety in depressed patients.     

360度评价在住培学员岗位胜任力评价中的应用

目的运用360度评价对我院住培学员的岗位胜任力进行评价,对学员岗位胜任力的现状进行探讨分析。方法使用问卷调查表分别从专业基地教学主任、学员指导教师、同专业学员及学员本人的角度,对2017级222名住培学员的岗位胜任力进行360度评价,利用SPSS22.0对数据进行统计分析。结果连续两年的测评,住院学员8类岗位胜任力的自评和他评得分低于满分,学员在临床基本能力、医患沟通能力、掌握与运用医学知识、团队合作能力4项内容的评分,差异有统计学意义(P<0.05);同时学员在临床基本能力、医生职业精神与素质、医患沟通能力、掌握与运用医学知识、团队合作能力5项内容的评分较上一年相比,差异也有统计学意义(P<0.05)。结论调查结果提示360度评价可帮助住培学员提高岗位胜任力,后续培训应围绕调查结果和以岗位胜任力为导向来调整与设置,需增加人文属性内容的培训以及再量化培训测评内容、指标和进一步完善考评反馈机制。     

Psychotic experiences in the context of depression: The cumulative role of victimization

Previous studies have reported an association between depression and psychotic experiences, but little is known about what drives this co-occurrence. This study tests the hypothesis that exposure to trauma and bullying may strengthen the relation between depression and psychotic experiences. A total of 799 college students completed self-report questionnaires on psychotic experiences, depression, bullying, and sexual trauma. Hierarchical linear regression analyses were conducted to test the direct relationship between depression and psychotic experiences, as well as interactions. Approximately 20% of respondents reported a history of being bullied, and 7% reported exposure to childhood sexual trauma. There was a significant direct relationship between depression and psychotic experiences. The association between depression and psychotic experiences was significantly stronger among respondents who were victims of both bullying and sexual violence compared to those who experienced either exposure alone, or who were not exposed to either form of victimization. These findings suggest that cumulative exposure to trauma and victimization may contribute to the co-occurrence of depression and psychotic experiences. History of victimization should be assessed among individuals with depressive symptoms to improve treatment plans and outcomes.     

美国的卫生系统科学教育及其思考

卫生系统科学(health system science,HSS)是研究卫生系统如何为患者提供卫生保健、患者如何接受和获得卫生保健以及卫生系统如何促进健康的科学。作为美国医学会的核心创新成果之一,HSS教育于2013年开始在美国医学院校试行。HSS与基础医学和临床医学相协同、互补,在患者保健和群体保健中发挥着重要的作用。本文介绍了美国的卫生系统科学的产生、其所包含的知识模块以及在美国医学院校中的实施情况;同时,结合我国医学教育的现状,对我国医学院校开展卫生系统科学教育进行了思考。     

Establishing biennial paramedic experience benchmarks

Objective. Since stroke symptoms are often vague, and acute therapies for stroke are more recently available, it has been hypothesized that stroke patients may not be treated with the same urgency as myocardial infarction (MI) patients by emergency medical services (EMS). To examine this hypothesis, EMS transport times were examined for both stroke and MI patients who used a paramedic-level, county-based EMS system for transportation to a single hospital during 1999. Methods. Patients were first identified by their hospital discharge diagnosis as stroke (ICD-9 430–436, n = 50) or MI (ICD-9 410, n = 55). Trip sheets with corresponding transport times were retrospectively obtained from the 911 center. A separate analysis was performed on patients identified by dispatchers with a chief complaint of stroke (n = 85) or MI (n = 372). Results. Comparing stroke and MI patients identified by ICD-9 codes, mean EMS transport times in minutes did not meaningfully differ with respect to dispatch to scene arrival time (8.3 vs 8.9, p = 0.61), scene time (19.5 vs 21.4, p = 0.23), and transport time (13.7 vs 16.2, p = 0.10). Mean total call times in minutes from dispatch to hospital arrival were similar between stroke and MI patients (41.5 vs 46.4, p = 0.22). Results were similar when comparing patients identified by dispatchers with a chief complaint indicative of stroke or MI. Conclusion. In this single county, EMS response times were not different between stroke and MI patients. Replication in other EMS settings is needed to confirm these findings.     

A randomized trial of traditional and golf-specific resistance training in amateur female golfers: Benefits beyond golf performance

ObjectiveCompare golf-specific resistance training (GSRT) with traditional resistance training (TRAD) with regard to golf performance and other outcome measures.DesignRandomized controlled study.SettingOutpatient gym.Participants45 female golfers were randomized into TRAD or GSRT, both of which targeted muscles active during the golf swing. Participants performed supervised training 3d^.wk⁻¹ for 10 weeks.Outcome MeasuresGolf performance, bone density, body composition, and physical performance tests.Results29 individuals (58.1 ± 2.1y; 15 TRAD, 14 GSRT) completed training. Completers were older (p = 0.048) and played golf more frequently than non-completers (p = 0.002), but were not otherwise different. Training decreased whole body fat mass (p = 0.013) and visceral fat mass (p = 0.033) across groups, but did not influence lean mass (p = 0.283) or bone mineral density (p = 0.205). Training increased driver speed (p = 0.001), driver distance (p = 0.020), and 7I distance (p < 0.001), but not 7I speed (p = 0.160), but no group or interaction effects were present. Training increased all physical performance tests (p ≤ 0.005) regardless of group, but the seated medicine ball throw was most related to baseline driver speed (r² = 0.384), and also most responsive to training (r² = 0.250).Conclusion10 weeks of supervised TRAD and GSRT provided similar improvements in body composition, golf performance, and physical performance in amateur female golfers.     

Risk of Total Knee and Hip Arthroplasty in Patients With Rheumatoid Arthritis: A 12-Year Retrospective Cohort Study of 65,898 Patients

BackgroundRheumatoid arthritis (RA) is an inflammatory disease that causes the destruction of soft tissues and cartilage around joints. Owing to the widespread use of potent disease-modifying antirheumatic drugs, the need for total knee and hip arthroplasties (TKA and THA) has been reduced in patients with RA. However, the current association between RA and either THA or TKA has not been demonstrated in large-scale epidemiological studies.MethodsWe conducted a large-scale retrospective cohort study of patients diagnosed with RA during a 12-year period (2000-2012) in Taiwan. We recruited 32,949 patients with RA and 32,949 individually propensity score-matched non-RA controls.ResultsAfter adjusting for confounding factors, we found that the risk of THA or TKA was 4.02 times higher in patients with RA than in those without RA (95% confidence interval [CI], 3.77-4.52). The risk of THA or TKA was highest in patients with RA younger than 40 years (adjusted hazard ratio, 43.18; 95% CI, 16.01-116.47). Compared with non-RA patients, patients with RA were 4.82 times more likely to undergo THA (95% CI, 3.84-6.04), 3.85 times more likely to undergo TKA (95% CI, 3.48-4.25), and 19.06 times more likely to undergo both THA and TKA (95% CI, 8.90-40.80).ConclusionThese findings document a 4.02-fold greater long-term risk of undergoing THA or TKA in RA patients relative to non-RA patients in Taiwan.