Examining health literacy among urban African-American adolescents with asthma

Objective: This exploratory study assessed health literacy among urban African-American high school students to improve understanding of the association between adolescent health literacy and asthma. Methods: We conducted a secondary data analysis of the control group (n = 181) of the Puff City randomized controlled trial (2006–2010), a web-based intervention to promote asthma management among students, grades 9 through 12. A validated self-report 3-item health literacy screening instrument was completed at final online follow-up survey. Logistic regression was used to explore the association between health literacy, demographic characteristics, quality of life, asthma management, and health care utilization. Results: Multivariate analysis revealed that an overall inadequate health literacy score was associated with students who were more likely to be younger (OR 0.61; 95% CI 0.44–0.84), not on Medicaid (OR 0.36; 95% CI 0.17–0.76), have at least one hospitalization (OR 1.29; 95% CI 1.07–1.56); and a lower overall quality of life (OR 0.75; 95% CI 0.59–0.95). Those lacking confidence in filling out medical forms, needing help reading hospital materials, and having difficulty understanding written information were more likely to not have a rescue inhaler (OR 0.49; 95% CI 0.25–0.94), have one or more emergency visits (OR 1.21 95% CI 1.02–1.43), and one or more hospitalizations (OR 1.19; 95% CI 1.01–1.41), respectively. Conclusions: The findings indicate a significant association between inadequate health literary and suboptimal asthma management. It is important to advance understanding of adolescent health literacy, especially those at-risk, as they assume asthma self-management tasks and move toward independent adult self-care.     

手术室存在的护理风险因素分析及安全管理措施的效果评价

目的：探讨手术室存在的护理风险因素及安全管理措施的效果。方法将2010年11月~2013年12月于我院手术室接受手术治疗的120例患者根据管理方法不同分为对照组与观察组各60例。观察组采用安全管理，对照组未采用安全管理。比较两组患者手术室护理风险因素发生率及护理质量。结果对照组器械因素、手术室感染因素、院内感染因素、技术因素及管理因素分别为10.00%、3.33%、6.67%、3.33%及8.33%，显著高于观察组的1.67%、0、1.67%、0及3.33%，P＜0.05；观察组护理差错率、护理纠纷率、护理满意度及护理质控评分分别为1.67%、1.67%、96.67%及（99.02±10.11）分，对照组分别为5.00%、6.67%、86.67%及（92.18±9.05）分，差异有统计学意义（P＜0.05）。结论手术室存在的护理风险因素众多，应采取必要的安全管理措施，降低护理风险发生率。     

Defining a valid day of accelerometer monitoring in adults with mental illness

IntroductionA valid day of accelerometry is commonly defined as an absolute duration of wear time. Data processing inconsistencies can arise when using absolute valid-day criteria for adults with varied waking hours. The aim was to compare the use of absolute and relative valid-day criteria in a sample of adults with mental illness.MethodsData were from 99 non-institutionalised adults with mental illness. Participants were asked to wear an ActiGraph GT3X+ accelerometer continuously for seven days, and to note sleep and non-wear times. Absolute valid-day criteria were defined as a set number of hours/day, and relative criteria as a proportion of waking hours. The mean waking duration, non-wear time, and time spent in physical activity (PA) and sedentary behaviour (SB), were derived from accelerometer data, and compared for a range of absolute and relative criteria. The potential inaccuracy of PA and SB estimates were also estimated.ResultsUse of absolute criteria systematically biased the sample toward those with longer waking hours, and resulted in a median of 86% (IQR = 47%–198%) more non-wear time than relative criteria. The potential inaccuracy of SB was from −2.5% to 0% with relative criteria, and from −2.2% to 10.6% for absolute criteria.ConclusionsFor participant samples with varied waking hours, such as adults with mental illness, a valid-day criterion should be based on the proportion of waking hours, rather than the absolute time. The specific valid-day criterion should be chosen for each study independently, and be accompanied with a measure of the non-wear time.