Reappraisal of the Traditional Wenckebach Phenomenon with a Modified Ladder Diagram

Understanding of the traditional Wenckebach phenomenon is enhanced by using a modified ladder diagram where AV conduction in any cycle is represented by a slanted line in the AV bar together with similar AV conduction lines of all the preceding cycles. The diagram facilitates calculation of the duration of RR intervals (equal to the basic PP or sinus interval minus the PR or AV increment applied to this particular cycle) and the duration of the pause (equal to 2 × PP or sinus interval minus the sum of all the increments applied to the AV delay). The modified Wenckebach diagram should help students understand the mysterious clustering of QRS complexes or “paradoxical” increase of the ventricular rate that occurs during a Wenckebach sequence. Ann Noninvasive Electrocardiol 2012;17(1):3–7     

结构变动度在住院费用构成变动中的应用

目的 探讨降低医疗费用的对策.方法 运用结构变动度和环比增长速度指标,分析2008年-2013年费用构成变动的情况.结果 费用构成变动比较合理,其他费和检查费是引起费用结构变动上升的主要费用项目,二者累积贡献率高达42.44％,护理费结构变动增幅较慢,仅为4.10％,说明在体现医生技术服务价值的同时,也应适当提高护理人员的技术服务价值,药品费、诊疗费、手术费是引起住院费用结构变动下降的主要费用项目,三者累积贡献率高达45.92％,说明了我院优化了收费结构,强化了管理意识.结论 优化医疗收入结构,有重点的控制主要因素,以较低的成本及合理收费,最大限度的满足患者医疗需求,实现医疗费用的理性回归.     

妇产科病区基础护理中存在的问题与对策

目的 了解分析基层医院妇产科病区基础护理的现状,合理制订对策,提高临床基础护理质量.方法 回顾性分析我院2008年6月至2010年8月妇产科病区的98例患者,调查其基础护理中存在的问题并提出护理对策,在实施护理对策后重新选择100例患者进行调查,评价护理对策的实施效果.结果 妇产科病区基础护理中存在的问题包括基础护理意识淡漠,护理人员配置不足,基础护理工作劳酬不明和护理职业的忠诚度不高.实施新的对策后基础护理合格率平均达94.90％,患者满意度平均达96.94％,实施前分别为73.00％和72.00％,实施前后比较差异显著.结论 加强基础护理质量管理,是市场经济体制下密切护患关系的重要举措.     

近视患者LASIK术后满意度与疗效的相关性分析

目的：回顾分析近视患者经准分子手术激光治疗后的临床客观检查结果（裸眼视力、散光及减少度数）改变；分析其对术后满意度的影响，以期提高患者术后满意度。方法：对256例（511眼）准分子激光手术患者术后随访1个月；分析其术后疗效及不同满意度之间关系。结果：术后满意度与近视度数改善程度有统计学意义；与另两项客观检查结果的改善无统计学意义，其他因素也会对术后满意度有所影响。结论：LASIK术后满意度与临床疗效密切相关，应采取综合措施改善术后满意度。     

开展疼痛评估对提高住院患者护理服务满意度的调查分析

目的：探讨开展疼痛评估对住院患者的护理服务满意度的影响。方法对2935例住院患者进行护理服务满意度调查，按开展疼痛评估前后进行分组，其中2012年7～12月开展疼痛评估前所获得的1463例病人为对照组，2013年1～6月开展疼痛评估后所获得的1472例病人为实验组，对两组病人的护理服务满意度调查结果进行比较。结果住院患者对护理服务的满意度，开展疼痛评估后明显高于开展疼痛评估前（P＜0．05）。结论开展疼痛评估可提高住院患者对护理服务的满意度。     

产妇对新生儿性别满意度对其产后出血量的影响

目的探讨产妇对新生儿性别满意度对其产后出血量的影响。方法选择2010年6月至2011年12月在温岭市妇幼保健院产科住院的单胎头位顺产的980例初产妇和528例经产妇,按照她们对新生儿性别的满意程度分为满意组和不满意组,记录产程时间,测量产时、产后2h及24h的出血量,计算产后出血的发生率。结果不满意组产后2h及24h出血量多于满意组,产后出血发生率也明显高于满意组(P<0.01),特别是不满意组经产妇产后出血率高达15.51%。结论产妇对新生儿性别的满意程度对其产后出血有一定影响,医护人员应及时发现潜在的高危因素,对新生儿性别不满意产妇进行必要的心理辅导,以减少产后出血量,降低产后出血发生率,确保产妇的身心健康。     

A Cognitive-Behavioral Therapy Group Intervention for Hypersexual Disorder: A Feasibility Study

BackgroundThe proposed criteria of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition for hypersexual disorder (HD) included symptoms reported by patients seeking help for excessive and out-of-control non-paraphilic sexual behavior, including sexual behaviors in response to dysphoric mood states, impulsivity, and risk taking. Although no prior studies of cognitive-behavioral therapy (CBT) for the treatment of HD have been performed, CBT has been found effective for dysphoric mood states and impulsivity.AimTo investigate the feasibility of a CBT manual developed for HD explored through symptom decrease, treatment attendance, and clients’ treatment satisfaction.MethodsTen men with a diagnosis of HD took part in the CBT group program. Measurements were taken before, during, and at the end of treatment and 3 and 6 months after treatment.OutcomesThe primary outcome was the Hypersexual Disorder: Current Assessment Scale (HD:CAS) score that measured the severity of problematic hypersexual symptoms and secondary outcomes were the Hypersexual Disorder Screening Inventory (HDSI) score, the proportion of attended sessions, and the Client Satisfaction Questionnaire (CSQ-8) score.ResultsMain results were significant decreases of HD symptoms from before to after treatment on HD:CAS and HDSI scores and a decrease in the number of problematic sexual behaviors during the course of therapy. A high attendance rate of 93% and a high treatment satisfaction score on CSQ-8 also were found.Clinical ImplicationsThe CBT program seemed to ameliorate the symptoms of HD and therefore might be a feasible treatment option.Strengths and LimitationsThis study provides data from a CBT program for the treatment of the specific proposed criteria of HD. Because of the small sample and lack of a control group, the results can be considered only preliminary.ConclusionAlthough participants reported decreased HD symptoms after attending the CBT program, future studies should evaluate the treatment program with a larger sample and a randomized controlled procedure to ensure treatment effectiveness.Hallberg J, Kaldo V, Arver S, et al. A Cognitive-Behavioral Therapy Group Intervention for Hypersexual Disorder: A Feasibility Study. J Sex Med 2017;14:950–958.