Definition of disease duration in ankylosing spondylitis

Two definitions of the “disease duration” of ankylosing spondylitis (AS) have been used in the literature: (1) duration since first symptoms connected with AS and (2) duration since diagnosis of AS. To investigate how useful these definitions are for research, we reinvestigated the data of four surveys completed by patients with AS in the years since 1996. We found that the majority of the patients remembered the age at first symptoms with an accuracy of ≤1 year, and that the difference between both definitions (the delay in diagnosis) was between 9.8 and 10.4 years on average, with extreme values of more than 30 years being not very seldom. Because the error made using the duration since diagnosis as “disease duration” is much larger than the inaccuracy taken into account using the duration since first symptoms, only the duration since first symptoms connected with AS should be used as definition for the term “disease duration” of AS.     

精神分裂症患者生活质量与自知力及精神症状的关系

目的:探讨精神分裂症患者自知力及精神症状对生活质量的影响。方法:选取符合美国精神疾病诊断与统计手册第4版(DSM-IV)中精神分裂症诊断标准的医院门诊和住院患者共180例。采用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)、自知力评定量表(SAI)、阳性与阴性症状量表(PANSS)对患者进行评估。结果:生活质量的生理因子与依从性、疾病意识、精神症状标识及自知力总分显著负相关(r=-0.232,-0.243,-0.171,-0.274;P0.05);心理因子与疾病意识和自知力总分显著负相关(r=-0.219,-0.203;P0.01);生活质量总分与疾病意识和自知力总分负相关(r=-0.169,-0.175;P0.05),生活质量受自知力总分和阴性症状的影响(β=-0.312,P=0.000;β=-0.157,P=0.037),疾病意识对生活质量心理因子有预测作用(β=-0.291,P=0.003);生活质量总分受自知力总分的影响(β=-0.594,P=0.019)。结论:1自知力较好的患者生活质量较低;2心理因子受疾病意识的影响;3阴性症状对生活质量有影响。     

Acid-suppression Therapy Offers Varied Laryngopharyngeal and Esophageal Symptom Relief in Laryngopharyngeal Reflux Patients

It is widely accepted that laryngopharyngeal reflux requires more aggressive and prolonged therapy than gastro-esophageal reflux disease. Otolaryngologists often observe that laryngopharyngeal symptoms, such as throat clearing, hoarseness, cough, and globus pharyngeus, are slower to resolve than esophageal symptoms, such as heartburn and regurgitation. The aim of this was to provide empirical evidence to support this observation and to carry out a detailed investigation of the differences between these symptoms. Forty-five patients with laryngopharyngeal and esophageal symptoms received acid-suppression therapy that involved the continuous administration of a proton-pump inhibitor for up to 6 months. We investigated the differences in response to acid-suppression therapy between patients suffering from laryngopharyngeal and esophageal symptoms, respectively, who received upper gastrointestinal endoscopy and were assayed for serum Helicobacter pylori antibodies. The significance of the rate of symptom improvement was estimated by Kaplan-Meier analysis and the logrank test. Laryngopharyngeal symptoms improved significantly more slowly than esophageal symptoms following acid-suppression therapy (49.8 vs. 78.3%, 60 days after the start of acid suppression; P = 0.003). These differences were observed both in patients with erosive esophagitis (P = 0.008) and in H. pylori-seronegative patients (P = 0.001).     

An integrative review exploring the physical and psychological harm inherent in using restraint in mental health inpatient settings

In Western society, policy and legislation seeks to minimize restrictive interventions, including physical restraint; yet research suggests the use of such practices continues to raise concerns. Whilst international agreement has sought to define physical restraint, diversity in the way in which countries use restraint remains disparate. Research to date has reported on statistics regarding restraint, how and why it is used, and staff and service user perspectives about its use. However, there is limited evidence directly exploring the physical and psychological harm restraint may cause to people being cared for within mental health inpatient settings. This study reports on an integrative review of the literature exploring available evidence regarding the physical and psychological impact of restraint. The review included both experimental and nonexperimental research papers, using Cooper's (1998) five‐stage approach to synthesize the findings. Eight themes emerged: Trauma/retraumatization; Distress; Fear; Feeling ignored; Control; Power; Calm; and Dehumanizing conditions. In conclusion, whilst further research is required regarding the physical and psychological implications of physical restraint in mental health settings, mental health nurses are in a prime position to use their skills and knowledge to address the issues identified to eradicate the use of restraint and better meet the needs of those experiencing mental illness.     

The experience of being a psychiatric nurse in South Africa: A qualitative systematic review

Purpose

The purpose of the study was to summarize the experiences of African psychiatric nurses in their workplace by examining the findings of existing qualitative studies.

公共场所PM10和PM2.5浓度及其对从业人员上呼吸道症状的影响

目的了解广州市黄埔区各类公共场所室内PM10和PM2.5浓度水平及对从业人员上呼吸道症状的影响。方法通过分层抽样方法抽取全区4大类公共场所,包括理发美容类、商场剧院类、酒店旅馆类、酒吧KTV游戏厅类,采用便携式防爆智能数字粉尘仪AM510进行室内PM10和PM2.5浓度检测,通过单因素分析方法对各类场所室内PM10和PM2.5浓度水平进行分析。结果黄埔区4大类场所室内PM10浓度水平分别为(0.113±0.044)mg/m3,(0.085±0.022)mg/m3,(0.112±0.028)mg/m3和(0.207±0.031)mg/m3,其中酒吧KTV游戏厅室内PM10浓度超出GB/T 18883-2002标准限值(<0.15mg/m3)。全区4大类场所室内PM2.5浓度水平分别为(0.065±0.025)mg/m3、(0.050±0.013)mg/m3、(0.075±0.016)mg/m3和(0.120±0.018)mg/m3,均超出GB 3095-2012一级标准限值(<0.035mg/m3)。单因素分析及两两比较结果表明:各类场所室内PM10和PM2.5浓度水平,酒吧KTV游戏厅类最高,商场剧院类最低,差异具有统计学意义(P<0.05)。PM2.5浓度与咳嗽、咽痛和鼻炎发生率呈正相关。结论黄埔区4大类公共场所室内PM2.5污染较为严重,明显影响从业人员上呼吸道健康,应加强对这类场所监管。     

Ultrasound-Guided Versus Landmark-Guided Local Corticosteroid Injection for Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objective

To review the literature and assess the comparative effectiveness of ultrasound-guided versus landmark-guided local corticosteroid injections in patients with carpal tunnel syndrome (CTS).

Evaluation of Cognitive Behavioral Interventions and Psychoeducation Implemented by Rehabilitation Specialists to Treat Fear-Avoidance Beliefs in Patients With Low Back Pain: A Systematic Review

Objectives

To systematically locate, critically appraise, and synthesize the available evidence regarding the effectiveness of cognitive behavioral therapies (CBTs) and psychoeducation that can be implemented by rehabilitation specialists to treat fear-avoidance beliefs in patients with acute, subacute, and chronic low back pain (LBP).