健康管理对高危哮喘儿童家庭单元治疗依从性作用及肺功能指标的影响

目的 分析健康管理对提高以家庭为单位的高危哮喘儿童病情控制及肺功能指标的改善作用,为儿童哮喘防治提供新的思路。方法 选取2014年1月－2016年5月在山东省立医院就诊的93例高危哮喘儿童并随机分为实验组和对照组。实验组给予常规临床治疗加全程健康管理和定期随访;对照组只给予常规临床治疗,未贯穿健康管理,嘱定期随访。结果 实验组患儿的病情控制及各项肺功能指标较之于对照组有明显改善,差异有统计学意义(P<0.05)。结论 加强高危哮喘儿童的家庭单元的防控意识,进行系统、持续的健康管理,定期随访和监测,能明显减少患儿病情发作,提高治疗依从性。     

2018 European Conference on Donor Health and Management

The third European Conference on Donor Health and Management (ECDHM) was held in Copenhagen from 5th to 7th September 2018 and was co‐organised by the ECDHM committees and European Blood Alliance. This is an international conference with a focus on ‘donor health’, including donors of blood, organs and other substances of human origin, and remains the only conference focusing exclusively on donor medicine. This overview presents a selection of research topics in relation to iron, the keynote speeches and plenary talks. The keynote speeches cover the epidemiology of donors and recipients, whole‐blood donor recruitment and retention and the safety of donors and recipients of plasma and plasma products. Talks from the plenary speakers reviewed modern multi‐omic approaches to study red cell quality and the central, perennial question of what motivates a donor to give blood and how can this be encouraged.     

Medical waste management and environmental assessment in the Rio University Hospital,Western Greece

At this study a multi-criteria model was developed to examine the available procedures, techniques and methods of handling infectious waste in the large healthcare unit of University Regional General Hospital of Patras, Western Greece. Particularly, this study examined the: a) current legislation and Directives issued for medical waste management at Greece and among the other EU-members, b) contribution of healthcare wastes (HCW) generation rate on social and economic parameters in selected European countries, c) available procedures, techniques, and methods upon the disposal of infectious wastes at the healthcare studied, and, d) propositions for integrated management of such hazardous wastes. Specifically, the Analytic Hierarchy Process (AHP) methodology was applied under pair wise comparison matrices in two stages: 1) the scale factors and the indicators, and 2) the criteria and their sub–criteria. The assessment of these pair wise matrices included the indicators and the sub–criteria. Subsequently, two pair wise comparison matrices, upon a) the “Fulfillment of environmental objectives” indicator and b) the “Energy consumption” sub criterion, were denoted. The AHP methodology yielded good results; however there is still space of improving the environmental performance. The normalized relative weights obtained for the criteria and sub criteria motivated specific actions that have to be handled. Particularly, the results indicated a very good value in environmental management criteria due the values obtained for the commitment towards the environmental policy standards and the waste management procedures. However, further improvements on staff awareness (such as development programs to enhance sensitivity) and more green purchasing suppliers, should be further addressed.     

Genomic targeting by recombinase‐mediated cassette exchange in the spotted wing drosophila,Drosophila suzukii

Drosophila suzukii is a significant pest of stone and small fruits. The genome of this species has been sequenced and manipulated by transposon‐mediated transformation and CRISPR/Cas9 gene editing. These technologies open a variety of possibilities for functional genomics and genetic modifications that might improve biologically based population control strategies. Both of these approaches, however, would benefit from genome targeting that would avoid position effects and insertional mutations associated with random transposon vector insertions, and the limited DNA fragment insertion size allowed by gene editing. Here, we describe an efficient recombinase‐mediated cassette exchange (RMCE) system for D. suzukii in which heterospecific lox recombination sites were integrated into the genome by transposon‐mediated transformation and subsequently targeted for double recombination by a donor vector in the presence of Cre recombinase. Three loxN/lox2272 landing site lines have previously been created in D. suzukii, and quantitative PCR determined that polyubiquitin‐regulated enhanced green fluorescent protein expression is least susceptible to position effect suppression in the 443_M26m1 line. We presume that RMCE target sites may also be inserted more specifically into the genome by homology‐directed repair gene editing, thereby avoiding position effects and mutations, while eliminating restrictions on the size of donor constructs for subsequent insertion.     

Le malentendu dans les activités sexuelles à l’adolescence : un signe de sexualité préoccupante ?

ObjectivesThe adolescence corresponds to this existential period when the violence in its creative and destructive functions is the mainspring at the same time and challenge. During this time of passage, the young has to negotiate with himself, his family and the others. Stage of transformation and transfer, revival of multiple psychic conflicts, the adolescence sees the sexuality penetrating the reality of the body. In this context in which the rising sexual activity is associated with a concern, the misunderstanding occupies a central place in the sense where most of the time the protagonists involved in acting him hardly took the opportunity to speak to itself and to get on. Behind a misunderstanding, there are on one side facts and the other one a subject which put them in act.Patients and methodsThe article develops a clinical label involving three adolescents, a boy and two girls. Misunderstandings quickly appear about activity of sexual nature. The excitement gets involved in the fears not without generating of the ambivalence. The mutual incomprehension contains a potential trauma. It is then relevant to intervene without wanting inevitably to define the truth in its material translation of the reality. A type of dense and flexible care gives encouraging results as for the reduction of the traumatisation of a particular event. We move forward stage by stage by proposing times of meeting with a rhythm enough steady and by lending us if necessary as media of expression. Yet it is hardly always well-to-do to act not in the haste but with density and speed in the interest of some of the others. It is essential to take into account at the same time relational stakes, their impacts on the individualities, and the psychic dimensions appropriate to every protagonist. A collective and personal historian can develop in these testing moments of crisis on basis of an intervention such as sketched here, by considering repercussions at the level of the socio circle of acquaintances.ResultsThe approaches which establish themselves on the only reality of the behaviour risk to evacuate the subject which puts the qualified act of worrying. For us we suggest dreading the subjective dimension by examining the question of the sexuality from the point of view of the functioning of a personality. In other words, the question is not only of knowledge which is the act which was put, but to know which committed it. We thus watch to construe the subjective impact of the act, by reminding that the human being becomes established as subject of his speech and as agent of his act. The misunderstanding also constitutes an original media of meeting of the teenager in question. We propose a categorization of worrisome sexual activities by underlining that, in number of scenarios, the young person shows elements of several categories: a/the young people in sexual life without restraint; b/the young people confronted with the constraint of the anxiety; c/the young people led by an intense need for love; d/the young people committing sexual abuses; e/the young people showing a perversion. Besides, we shall not evoke rare disturbing sexual activities put aside by the young people in the psychotic functioning. The care leans on two concepts-keys, on one hand, the succession of two different phases, that are the evaluation and the treatment and on the other hand, the complementarity of several epistemology as well as the work in network. We advocate the establishment of a partnership envelope based on the collaboration and the respect of the principles of the shared secret.ConclusionsThe misunderstanding can reveal a worrisome sexual activity in the adolescence. Indeed let us limit the current trends “to tax” any sexual act of aggression, and his author of “abuser”, and the addressee to act him of “victim”! To limit, we determine what belongs to the physical, sexual exploration, including the consensus of the protagonists, what goes out again from the pathology. The distinction is essential at the risk otherwise to stigmatize certain young people in full constructive run-up by gathering in a single troop of the different profiles from each other. The misunderstanding represents a beautiful opportunity of meeting of a young person in the inviting to a correct interpretation of the facts, by taking into account the place they occupy in the psychic and relational functioning.     

The need for new control strategies for particulate matter in parenterals

An undesirable characteristic in lyophilized parenteral products is the potential presence of particulate matter in the final product, which may affect patient safety. In this study, quality risk management tools described in the International Conference on Harmonization Guideline Q9 were used to estimate the risks for a pharmaceutical manufacturing line, based on three critical quality attributes: (1) visible particulate matter; (2) lyo-cake collapse traces; and (3) lyo-cake melt-back traces. Together with a Process Failure Mode Effect Analysis (PFMEA), an input-output analysis of the individual unit operations identified seven major material classes of extrinsic particulate matter. In addition to the process assessment, an experimental investigation of the location of impurities in lyophilized products was performed. To that end, intentionally contaminated vials were examined to locate the particulate matter and its possible migration. The results emphasize the importance of a full transmission mode release testing since the particles may enter the interior of the lyo-cake. A theoretical explanation of the observed impurity locations is provided.     

酒泉市0～6岁儿童健康工作评价和改进方法研究

目的通过对2013—2017年酒泉市0～6岁儿童健康状况进行分析,了解酒泉市儿童保健服务状况,找出存在问题,研究改进方法和措施,为酒泉市适应"全面两孩政策"新形势提供有效保障。方法对2013—2017年酒泉市妇幼卫生年报及5岁以下儿童死亡报告卡进行整理及统计学处理。结果 2013—2017年酒泉市0～6岁儿童保健服务指标逐年提升并保持稳定。2017年与2013年相比较,3岁以下儿童系统管理率提升了0.04%,新生儿疾病筛查率上升了2.89%,新生儿听力筛查率上升了2.14%,新生儿死亡率下降了32.97%,婴儿死亡率下降了25.93%,5岁以下儿童死亡率下降了24.14%;儿童保健主要指标市(区)级与县级相比较有波动。结论酒泉市5岁以下儿童死亡率还有下降空间,儿童健康工作存在区域差异,今后工作重点是积极争取政府部门的重视和支持,改善儿童生存环境和医疗资源,加强市(区)级儿童保健服务能力,重视儿童保健团队建设,提升重点人群主动接受卫生保健服务的意识,保障儿童生命安全、提高儿童健康水平。