Effects of Crede's method on urine voiding within the first 8 h after surgery among post‐haemorrhoidectomy patients: a comparison study

Urinary retention is a common complication among patients after haemorrhoidectomy. Although Crede's method is recommended for urinary retention in nursing practice textbooks, its effects require further examination. The purpose of this study was to investigate the rate of urine voiding within the first 8 h following haemorrhoidectomy and to examine the effects of Crede's method on this postoperative outcome. A two‐group comparison study was conducted. All participants were over 20 years of age, and each had undergone haemorrhoidectomy. Outcome measurements included patients' self‐reported urine voiding within 8 h of surgery, personal demographics and disease‐related data. Before the surgical procedure, participants were divided into Crede's group and non‐Crede's group, and written educational materials were given. Patients in the Crede's group were taught Crede's method for application in the event that they were unable to void urine after haemorrhoidectomy. The non‐Crede's group patients were taught traditional methods without Crede's method. We examined urine voiding within the first 8 h after haemorrhoidectomy. The mean rate of urine voiding within 8 h of surgery was 60·9% overall, with 91·3% (21/23) in the Crede's group and 30·4% (7/23) in the non‐Crede's group reporting successful voiding. After controlling for the two groups' personal characteristics and disease‐related variables, age, educational level and perioperative fluid administration were treated as covariates and included in the multinomial logistic regression model. The odds ratio of urine voiding within the first 8 h after surgery was 52·70‐fold higher in the Crede's group than in the non‐Crede's group (p < 0·01). This study shows that Crede's method is an effective strategy to aid in urine voiding within the first eight postsurgical hours among patients following haemorrhoidectomy. Clear and concise information about urinary retention and related management strategies should be given to patients before haemorrhoidectomy.     

Simultaneous Determination of Six Quaternary Ammonium Alkaloids in Coptidis Rhizoma by UPLC

Objective To establish a new, rapid, and reliable reversed-phase ultra performance liquid chromatography (RP-UPLC) method for the simultaneous determination of six quaternary ammonium alkaloids (QAAs) in Coptidis Rhizoma. Methods The effect of different experimental parameters on the analysis of QAAs by RP-UPLC was evaluated. Results Optimal resolution was achieved with an Acquity UPLC BEH C18 column using a gradient elution profile and a mobile phase consisting of water spiked with 10 mmol/L ammonium bicarbonate (A, pH adjusted to 10.0 by ammonia water) and acetonitrile (B), at a flow rate of 0.30 mL/min and wavelength of 345 nm. The column temperature was set at 30 ℃. The proposed method was found to be reproducible, precise, and rapid according to the method validation. Conclusion The proposed method, which is compatible with MS analysis and the preparation of QAA, provides some helpful insights into the quality control of Coptidis Rhizoma.     

Testing a parametric function against a non‐parametric alternative in IV and GMM settings

Summary This paper develops a specification test for functional form for models identified by a conditional moment restriction, including IV and GMM settings. The framework is one where the moment restriction is specified as a function of data, a finite‐dimensional parameter vector and a non‐parametric function (an infinite‐dimensional parameter vector). The null hypothesis is that the moment restriction does not depend on the non‐parametric function. The test is relatively easy to implement and its asymptotic distribution is known. The test performs well in simulation experiments.     

临床教学伦理困境下的实习教学方法改革

随着病人主体意识和维权意识的增强,传统的床边教学法常因难于兼顾患者与学生双方的权益而不能充分开展。为了解决临床实习教学面临的难题,我院开展了集床边教学、模拟教学和网络教学等方法于一体的"多位一体"实习教学法的研究和实践。结果显示该模式能更好地兼顾患者与学生的权益,增加学生学习训练的机会,比单纯床边教学法效果更好。     

Oral health needs in individuals with trisomy 18 and trisomy 13: Implications for dental professionals

The purpose of this study was to examine oral health needs and dental care in individuals with trisomy 18 and trisomy 13 (full, mosaic, partial and other, mixed types). Primary feeding method was also examined. Data was collected from a parent‐completed, mixed method survey (TRIS Survey). Mean age in months was 120.2 (range 38 to 394 months) and 133 (range 36 to 405 months), respectively, for trisomy 18 and trisomy 13 individuals. Results indicated the majority of individuals received routine dental care from their family dentist. Approximately 80% in both groups needed some form of specialized dental care. Close to 25% and 30% of trisomy 18 and trisomy 13 individuals, respectively, required hospital admission for specialized dental care. Responses indicated the presence of excessive plaque and tooth decay across the groups with a higher incidence for individuals with trisomy 13. Although not the primary form of intake, over half of the individuals received oral feedings. Implications for dental care and management are provided along with the need for additional research to confirm or disconfirm this study's findings.     

Primary-school-based art therapy: exploratory study of changes in children’s social,emotional and mental health

ABSTRACT

AIM: This exploratory mixed methods study aimed to inform future research by investigating if teachers and children from one primary school perceived any changes in children’s social, emotional and mental health difficulties following art therapy and if so, what the children perceived as helpful about the sessions. METHODS: The study included 45 children and 10 class teachers within one UK primary school. The researchers analysed routine questionnaires from teachers and a children's evaluation interviews, triangulating these with data from a teacher focus group. RESULTS: The findings show significant and medium effect sizes for positive teacher-rated changes in children’s overall stress, conduct, hyperactivity, and procsocial behaviour and a large effect on perceived impact of children’s difficulties on their lives. Teacher-rated emotional distress and peer problems showed small changes that did not reach statistical significance. The positive changes were corroborated by the teachers' and children's qualitative reports. Aspects of art therapy which children found particularly helpful were; making and thinking about art; expressing, thinking and learning about thoughts and feelings; and sessions being fun. CONCLUSION: The study highlighted perceived positive changes and no negative changes in children’s SEMH difficulties. However, future research is necessary to examine clinical effectiveness.

Plain-language summary

In this article we describe a research study which aimed to explore if teachers and children perceived any changes to children’s social, emotional or mental health difficulties after the children attended art therapy within their primary school. We were also interested in learning from the children if they thought anything in particular had been helpful about their art therapy sessions in order to inform future research and the development of this particular approach to art therapy.

The art therapists asked the class teachers to fill out a Strengths and Difficulties Questionnaires at the beginning and end of art therapy. The class teachers also attended a focus group so we could learn more about their general observations of the children before and after attending art therapy. The art therapists also interviewed the children to learn if they perceived any changes since coming to art therapy and if so, what in particular they thought had helped bring about these changes.

We found that statistical analysis of the questionnaire scores mostly agreed with what the teachers and children said and that there was generally some positive change to the social, emotional and mental health difficulties the children had been experiencing. The teachers also let us know that some of the children still had residual problems. The children emphasised that making and thinking about art along with expressing, thinking and learning about thoughts and feelings had been particularly helpful. It was also important to the children that the sessions were fun.

In conclusion, the teachers and children in this primary school perceived art therapy as helpful to the children and that it merits further research in order to develop the approach used by the art therapists and to see if it is effective in larger research studies including more children, schools and art therapists.     

腹腔镜下核除子宫肌瘤后两种缝合方法的临床探讨

目的研究分析采用两种缝合方法对于腹腔镜下核除子宫肌瘤的临床治疗效果。方法该择该院2011年12月—2013年12月收治140例子宫肌瘤患者作为研究对象,将所有患者按照随机数字法分为观察组和对照组两组,每组各70例。对照组患者在摘除肌瘤之后采用间断缝合术,观察组患者采取连续缝合子宫术。对比观察两组患者在手术时间、术中出血量、疼痛恢复时间、出院时间以及排气时间情况的比较。结果观察组患者在手术时间、术中出血量以及疼痛恢复时间均明显短于对照组,差异有统计学意义（P〈0.05）。两组患者在出血时间、排气时间情况的差异无统计学意义（P〉0.05）。结论对于腹腔镜下核除子宫肌瘤后采取连续缝合子宫术能够有效缩短手术时间,降低术中出血量,值得临床推广运用。     

A new concept of the contraction–extension property of the left ventricular myocardium

ObjectivesUsing newly developed ultrasonic technology, we attempted to disclose the characteristics of the left ventricular (LV) contraction–extension (C–E) property, which has an important relationship to LV function.MethodsStrain rate (SR) distribution within the posterior wall and interventricular septum was microscopically measured with a high accuracy of 821 μm in spatial resolution by using the phase difference tracking method. The subjects were 10 healthy men (aged 30–50 years).ResultsThe time course of the SR distribution disclosed the characteristic C–E property, i.e. the contraction started from the apex and propagated toward the base on one hand, and from the epicardial side toward the endocardial side on the other hand. Therefore, the contraction of one area and the extension of another area simultaneously appeared through nearly the whole cardiac cycle, with the contracting part positively extending the latter part and vice versa. The time course of these propagations gave rise to the peristalsis and the bellows action of the LV wall, and both contributed to effective LV function.The LV contraction started coinciding in time with the P wave of the electrocardiogram, and the cardiac cycle was composed of 4 phases, including 2 types of transitional phase, as well as the ejection phase and slow filling phase. The sum of the measurement time duration of either the contraction or the extension process occupied nearly equal duration in normal conditions.ConclusionThe newly developed ultrasonic technology revealed that the SR distribution was important in evaluating the C–E property of the LV myocardium. The harmonious succession of the 4 cardiac phases newly identified seemed to be helpful in understanding the mechanism to keep long-lasting pump function of the LV.