气垫床不同充气程度及不同翻身间隔时间预防压疮的效果观察

目的探讨气垫床不同充气程度配合不同翻身间隔时间预防压疮的效果。方法选择在本科住院的压疮高危患者160例随机分为A、B、C、D四组,各40例,A、B组患者应用充气程度为80%的气垫床,分别每2h、4h翻身1次,C、D组患者应用充气程度为100%的气垫床,分别每2h、4h翻身1次,观察、评估患者的皮肤变化及压疮发生情况。结果 A、B、C、D四组Ⅰ期压疮的发生数分别为1例、0例、6例、4例,A组和C组、B组和D组的压疮发生率比较,差异有统计学意义(P0.05);A组与B组、C组和D组的压疮发生率比较,差异无统计学意义(P0.05)。结论应用充气程度为80%的气垫床预防压疮的效果优于充气程度为100%的气垫床,且翻身间隔时间可延长至4h。     

Psychological distress and professional help‐seeking: a prospective national study

The study focuses on use of different healthcare providers in connection with elevated levels of psychological distress. The study used a prospective design based on two waves of a national health survey. Participants were Icelandic citizens, age 18–75, randomly drawn from the National Register (N = 1592). Distressed individuals chose a wide range of providers. The choice of provider was based in part on the type of distress experienced, although most individuals turned to the general medical sector. Psychophysiological symptoms were primarily related to visiting physicians (other than psychiatrists). Depression was related to visiting psychiatrists, and anxiety was related to visiting psychiatrists, psychologists and nurses. Anger/aggression was primarily related to visiting clergy. Between 10% and 16% of distressed individuals did not receive any help from the formal healthcare system within 1 year. Studies addressing professional help‐seeking for psychological distress should closely consider the various factors facilitating and hampering use of health services for different forms of distress.     

Clinical competence in developmental‐behavioural paediatrics: Raising the bar

For our specialist paediatric workforce to be suitably equipped to deal with current childhood morbidity, a high level of competence in developmental‐behavioural paediatrics (DBP) is necessary. New models of training and assessment are required to meet this challenge. An evolution of training in DBP, built around the centrepiece of competency‐based medical education, is proposed. Summative assessment based upon entrustable professional activities, and a menu of formative workplace‐based assessments specific to the DBP context are key components. A pilot project to develop and implement these changes is recommended.     

661例正畸患者第三磨牙发育的X线研究

目的：研究青少年第三磨牙发育程度及萌出方向。方法：通过对全颌曲面断层片的观察将661例正畸患者第三磨牙牙胚发育程度分级。结果：6岁时男女均无M3牙胚出现，女孩第三磨牙发育比男孩早，下颌比上颌早；萌出方向下颌近中倾斜向出现率高，上颌远中倾斜向出现率高。结论：错He畸形的发生与第三磨牙发育的关系密切，应予以密切关注。