Long term follow-up of aneurysmectomy for recurrent ventricular tachycardia or fibrillation.

The success of aneurysmectomy in abolishing recurrent ventricular tachycardia or ventricular fibrillation has not been clearly defined. Ten patients who underwent aneurysm resection to control ventricular arrhythmias were studied before and an average of 19 (4 to 42) months following operation. All patients had moderate to large aneurysms and four had asynergy in adjacent segments. Of four patients with significant stenosis in vessels not supplying the aneurysm, three had aortocoronary bypass grafts in addition to their resection. Ambulatory Holter monitoring and a graded exercise test were performed in all patients postoperatively. There was no operative mortality. Two patients who did not have associated revascularization procedures died suddenly 1.5 and 7 months postoperatively. Of the eight survivors, despite clinical improvement, the Holter ECG revealed runs of ventricular tachycardia in three patients and frequent multifocal ventricular extrasystoles in the other five patients. No correlation was found between recurrence of the ventricular arrhythmias and aneurysm size, contraction pattern of other myocardial segments, extent of coronary disease, or the presence of congestive heart failure. In conclusion, aneurysmectomy does not abolish ventricular tachyarrhythmias and probably should be reserved for patients who remain symptomatic despite an adequate medical trial. The persistence of complex arrhythmias following operation warrants a close follow-up in these patients.     

护理工作语言艺术

护理工作不仅是技术问题,更主要的是服务态度,语言表达是服务态度的直接体现。了解是理解的基础,理解是爱的前提。语言沟通是建立和改善护患关系的有效手段,优化语言表达可提高表达效果。语言艺术是树立护士良好形象的手段,护士在与患者沟通中应使对方满意,形成一个良好的情感交流氛围。在护理工作中正确运用语言艺术是不可或缺的基本要求。通过身体动作、面部表情和服饰等来传递信息的肢体语言,是一种无声的语言,如点头、摇头、微笑、眼神等;眼神的接触是最重要的。有效的语言沟通包括真诚倾听、和气表达、积极暗示等。     

Weight cycling in adolescent Taekwondo athletes

Background

Weight reduction cycles are used by weight classed athletes in Taekwondo to make a weight category. Tension, dizziness, headaches, and confusion have been associated with rapid weight loss (RWL). There is a lack of research in weight cycling and its benefits among Taekwondo athletes.

Purpose

To investigate the rate of weight cycling in Junior Taekwondo athletes and its effect on performance.

Methods

Athletes were weighed prior to competition, then again before their first match. Body mass difference in relation to winning was compared.

Results

A significant increase from weigh-in to pre-match measurements was consistently found in both genders with no significant difference between them. Winners had a mean body mass gain (1.02 kg) which was non-significantly less than the non-winners (1.09 kg).

Conclusions

RWL practices do not define which athlete will perform better. Negative effects of weight cycling coupled with RWL has unclear performance benefits which indicates a need for further research.     

Musculoskeletal and head injuries in the Ultimate Fighting Championship (UFC)

Objectives: Mixed martial arts (MMA) has witnessed a surge in popularity worldwide. This study explores the musculoskeletal and head injuries sustained in the professional fights of the Ultimate Fighting Championship (UFC), and establishes associations between injury profiles and impactful contributory factors.

Methods: The Nevada State Athletic Commission database was screened for ringside physician reports of UFC fights between January 2016 and July 2018. Information on the fighter’s gender, weight, injury, way of finish, and match result were collected. Injury rates were calculated and statistical analyses were conducted to determine significant associations among variables. P-values <0.05 were considered significant (95% CI).

Results: A total of 291 injuries were recorded in 285 fights from nine weight divisions. The overall injury rate was 51 per 100 athletic exposures (AE). Males predominantly partook in 249 matches (87%) and had higher injury rates (54 injuries per 100 AE) than females (30 injuries per 100 AE). Decision was the most common way a match ended. Knockouts (KOs) were significantly higher in males (36%) than in females (14%, P = 0.0007). Submissions were significantly higher in females (36%) than in males (16%, P = 0.001). Head injuries (67%) were the most common injuries reported with a rate of 34 per 100 AE. Upper limb injuries were significantly higher in females (40%) than in males (14%, P = 0.0003). Lower limb injuries were significantly higher in males (19%) than in females (5%, P = 0.01). Head injuries were significantly associated with KOs (P < 0.0001). Upper limb injuries (P = 0.032) and lower limb injuries (P = 0.034) were significantly associated with matches that ended with Decision. Trend-line analyses showed that as weight division increases, overall injury rates, head injuries, lower limb injuries, and KOs’ frequency increase, whereas upper limb injuries, Submission frequency, and Decision frequency decrease.

Conclusion: MMA has a high injury rate. Gender, way of finish, and weight play an important role in predicting fight outcomes and injury profiles. Injury prevention policies must be entertained to limit injury risk in MMA.     

The meaning of playing-related musculoskeletal disorders to classical musicians

In creating and performing music, musicians can experience health problems from the high physical and psychological demands of their profession. Musculoskeletal disorders related to playing are painful, chronic and disabling conditions which are prevalent among classical musicians. The widespread study of the prevalence, etiology, and management of playing-related musculoskeletal disorders (PRMDs) is a recent development known as performing arts medicine. Despite the rapid development of this new field, it is unclear how musicians identify themselves as injured, and how they make decisions about what, if anything, to do about these disabling injuries. The aims of our study were two-fold. First, we aimed to provide musicians with the opportunity to define a PRMD in their own words. Second, we sought to understand the subjective meaning of the PRMD experience to musicians. Two key informants identified 30 study participants in Ontario and Quebec, Canada. As a form of data triangulation, participants included 27 musicians and three health professionals. Data were collected in semi-structured interviews which lasted, on average, 40 min. Data were transcribed, and were manually coded and analyzed. Participants defined a PRMD as pain and other symptoms which are chronic, are beyond their control, and which interfere with their ability to play their instrument at their usual level. Participants distinguished between "normal", mild everyday aches and pains, and a PRMD. Although a PRMD is not a medically serious or life-threatening illness, it is devastating to musicians physically, emotionally, socially, and financially. The overall theme of suffering captures the meaning of these problems which threaten the identity of the musician. The findings of this study are consistent with other studies of the experience of work-related musculoskeletal disorders, and other illnesses.     

A humanism for nursing?

Humanism has appeared intermittently in the nursing literature as a concept that can be used in understanding nursing. I return to the concept in response to noticing the term appearing in the context of health humanities, where it is loosely associated both with humanities and being humane. I review the usage and critiques of humanism in both nursing and medical literature and then re‐evaluate what the idea of humanism might hold for nursing, trying to avoid the traps of an over‐determination of the human subject, or dichotomizing nursing as art or science, technology or caring. I draw on writings on humanism primarily from Emmanuel Levinas and Edward Said to emphasize strands in humanism of obligation towards others and of critical discernment within history and culture directed towards democratic practices. I discuss in passing the strong association in the UK particularly between humanism and scientism as a note of caution about the plurality of the term humanism. I conclude that humanism is a tradition that does offer productive ways of thinking about nursing with the proviso that it ought to be treated carefully as a problematic tradition and not as a new essence for nursing.     

采用一步制粒法影响清开灵颗粒孔隙率因素的探讨

目的:探讨一步制粒机中影响清开灵颗粒孔隙率的因素;方法:采用一步制粒法对影响孔隙的因素进行试验;结果:对孔隙率影响大小的顺序为供液速率＞排风频率＞进风温度,并在优选的条件下试验,发现润湿粘附剂的浓度与孔隙率成反比;结论:采用一步制粒技术可形成孔隙率大的颗粒,大大提高了药物的溶出速率.     

Does participation in art classes influence performance on two different cognitive tasks?

Objectives: Effects of two mentally stimulating art interventions on processing speed and visuo-spatial cognition were compared in three samples.

Method: In a randomized 10-week art intervention study with a pre-post follow-up design, 113 adults (27 healthy older adults with subjective memory complaints, 50 healthy older adults and 36 healthy younger adults) were randomly assigned to one of two groups: visual art production or cognitive art evaluation, where the participants either produced or evaluated art. ANOVAs with repeated measures were computed to observe effects on the Symbol-Digit Test, and the Stick Test.

Results: Significant Time effects were found with regard to processing speed and visuo-spatial cognition. Additionally, there was found a significant Time × Sample interaction for processing speed. The effects proved robust after testing for education and adding sex as additional factor.

Conclusion: Mental stimulation by participation in art classes leads to an improvement of processing speed and visuo-spatial cognition. Further investigation is required to improve understanding of the potential impact of art intervention on cognitive abilities across adulthood.     

The value of art therapy in antenatal and postnatal care: A brief literature review with recommendations for future research

There is a very small body of literature addressing the use of the arts or art therapy in antenatal and postnatal care, and much of it is qualitative, including some rich and complex data which are worthy of discussion and consideration. Overall, it points to a promising use of supportive and therapeutic arts in this area. This article presents some background on the use of the arts specifically focusing on postnatal depression and birth trauma. It then moves on to present a brief survey of literature in the field, followed by some further reflections and discussion about further research needed to establish clinical utility and economic viability.