Using Trauma-Informed Care to Address Sexual Assault and Intimate Partner Violence in Primary Care

Interpersonal trauma has long-lasting effects on mental and physical health and is associated with acute and chronic negative health outcomes. Primary care providers can improve health care outcomes by using trauma-informed care to recognize, acknowledge, and respond appropriately to trauma survivors. Routine trauma screening in the primary care setting should be done in a safe environment and with a team approach. This article will offer guidance on screening for and responding to sexual assault and intimate partner violence using trauma-informed principles with the goal of promoting health and healing for survivors.     

Innovative Strategies to Facilitate Safe Assessment and Intervention for Intimate Partner Violence During a Pandemic and Beyond

The COVID-19 pandemic has made it necessary to find innovative strategies that facilitate safe, private assessment and intervention for intimate partner violence (IPV). IPV is a major source of morbidity and mortality, with women experiencing a lifetime prevalence rate of 22%. Screening pregnant individuals for IPV during the COVID-19 pandemic became critical because a 20% rise in IPV during the pandemic has been estimated. A multidisciplinary stakeholder panel created a process using technology to address this concern. An infographic poster with IPV screening questions and a Quick Response (QR) code was displayed in bathrooms in the perinatal service area. The infographic allowed respondents to signal a safety concern, launching an individualized plan of care to address their needs privately. The pandemic has highlighted how much work needs to be done to ensure that people who experience IPV continue to obtain access to support and health care.     

提升“湘九味”品牌价值 高质量发展湖南中药材产业

湖南省历经8年聚力打造“湘九味”中药材品牌，已逐渐形成品牌品种引领的产业链发展模式。为达成湖南省中药材产业链千亿发展目标，梳理了“湘九味”品牌培育历程，厘清并阐释了相关概念，分析了产业发展现状及问题，研判了大健康应用背景下未来的中药材产业的发展趋势，并提出相关发展建议。     

Manejo de la enfermedad de Parkinson y otros trastornos del movimiento en mujeres en edad fértil: Parte 1

IntroductionThe main challenge of Parkinson's disease in women of childbearing age is managing symptoms and drugs during pregnancy and breastfeeding. The increase in the age at which women are having children makes it likely that these pregnancies will become more common in future.ObjectivesThis study aims to define the clinical characteristics of women of childbearing age with Parkinson's disease and the factors affecting their lives, and to establish a series of guidelines for managing pregnancy in these patients.ResultsThis consensus document was developed through an exhaustive literature search and a discussion of the available evidence by a group of movement disorder experts from the Spanish Society of Neurology.ConclusionsParkinson's disease affects all aspects of sexual and reproductive health in women of childbearing age. Pregnancy should be well planned to minimise teratogenic risk. A multidisciplinary approach should be adopted in the management of these patients in order to take all relevant considerations into account.     

Neuropsychological outcomes after thalamic deep brain stimulation for essential tremor

IntroductionNon-motor DBS outcomes have received little attention in ET relative to PD. This study examines neuropsychological outcomes in ET following thalamic VIM DBS.MethodsFifty patients completed neuropsychological evaluations preoperatively and approximately seven months postoperatively. Cognition and mood changes were analyzed at the group level and individual level. Additional associations with treatment, disease, and demographic characteristics were assessed.ResultsSignificant cognitive decline was not observed at the group level. At the individual level, 46% of patients demonstrated at least subtle overall cognitive decline (≥1SD on at least one test within at least two domains). Mild decline (≥1SD) was seen in 10%–29.17% of patients on individual tests across all cognitive domains, with highest rates in verbal memory. Substantial cognitive decline (≥2SD) occurred in less than 9% of the sample across all tests. Factors related to cognitive decline included higher DBS parameter settings, older age of ET onset, intracranial complications, and inability to reduce ET medications postoperatively. Depression and anxiety did not change when accounting for questionnaire items that could be falsely elevated by tremor.ConclusionSubstantial cognitive decline after VIM DBS is rare in patients with ET. However, subtle decrements can occur across cognitive domains and particularly in verbal memory. DBS parameter settings may relate to cognitive decline. Further research is needed to better understand possible associations with electrode lateralization and other variables that could also relate to disease progression and test-retest effects. Symptoms of depression and anxiety remain stable.     

某医疗机构核医学工作场所劳务派遣保洁人员的职业健康管理

近几年，"劳务派遣"成了医疗机构终末消毒、保洁、垃圾回收等工作新的用工形式。由于多数用工单位和用人单位不清楚对劳务派遣人员职业健康管理中各自应承担的责任和义务，以至于劳务派遣工在劳动过程中应享有的劳动保护权益未获得切实保障。本文就某医疗机构核医学工作场所劳务派遣保洁人员的职业健康管理监督案例进行讨论。     

神经外科住院患者人文关怀感知与护士关怀实践的对比研究

目的了解神经外科住院患者及护士对护士人文关怀的感知与评价差异,为更好地实施人文关怀护理服务提供参考。方法选取86例神经外科住院患者及92名神经外科护士作为研究对象,分别使用关怀行为量表进行问卷调查。结果患者与护士对护士人文关怀的总体评分分别为4.77±0.84、4.86±0.60,无统计学差异(P>0.05),双方均在“尊重患者”及“联系患者”2个维度评分较低。在“支持和保证”维度,患者对护士人文关怀的感知水平显著低于护士自评结果(P<0.01)。结论护患双方均对护士关怀行为的评价较好且双方在对护士关怀行为的整体认知上存在较高的一致度,但护士对患者心理层面的关怀相对不足,患者对护士在“支持和保证”相关关怀行为方面具有较高的期待。护士需要进一步改进与提升人文关怀质量。