Healthcare Clinician and Staff Perspectives on Facilitators and Barriers to Ideal Sexual Health Care to High-Risk Depressed Young Women: A Qualitative Study of Diverse Clinic Systems

Study ObjectiveThis study identified clinician and clinic staff perspectives on facilitators and barriers to providing sexual and reproductive health (SRH) care to depressed young women, a population at increased risk for adverse SRH outcomes.DesignWe conducted in-person semi-structured qualitative interviews, which were audio-recorded, transcribed, and coded by two researchers. We used thematic analysis to identify themes pertaining to care facilitators and barriers within a socio-ecological framework.SettingThis study was conducted in seven diverse clinics in the U.S. New England region.ParticipantsParticipants were 28 clinicians and staff (4/clinic), including behavioral health clinicians (n = 9), nurse practitioners (n = 7), nurses (n = 3), medical doctors (n = 3), administrative associates (n = 2), practice managers (n = 2), family planning counselor (n = 1), and medical assistant (n = 1).Main Outcome MeasuresWe queried how clinicians and clinic staff identify and manage depression and sexual risk, and what they perceive as facilitators and barriers affecting provision of ideal SRH care to depressed young women.ResultsThemes represented facilitators of and barriers to providing ideal SRH care to high-risk depressed young women at five socio-ecological levels: individual (facilitator: trust in providers; barrier: stigma experiences), interpersonal/provider (facilitator: frequent patient–provider communication; barrier: lack of time during clinic visits to build trust), clinic (facilitator: integration of care; barrier: lack of scheduling flexibility), organization/community (facilitator: training for providers; barrier: funding constraints), and macro/societal (facilitator: supportive policies; barrier: mental health stigma).ConclusionOptimizing SRH care to high-risk depressed young women necessitates attention to factors on all socio-ecological levels to remove barriers and bolster existing facilitators of care.     

应用门诊指数优化医院床位配置的思考与实践

目的合理调控床位规模，实现医院床位资源的优化配置。方法采集军队某三级甲等医院2010／2013年度医疗统计数据，以医院年门急诊实际就诊频数（门急诊人次）为数据依据，以门诊指数下限值3为标准，测算合理展开床日（位）的理论频数。同时，于2012年开始，在原有基础上着力加强门急诊建设。结果2012～2013年度加强门急诊建设后，医院的门诊指数逐渐趋于规范标准。结论依据医院门诊指数动态调控医院床位规模以实现适度规模，同时加强门急诊建设与质量管控对于实现医院床位规模的最优化，合理资源配置具有重要价值。     

对护理专业学生在手术室的带教

目的 :手术室为了使实践教学能够有计划、有组织、科学地、系统地、有效地进行 ,实行把教学作为一项系统工程进行设计和实施。使教学活动的过程依照传授知识 -掌握知识 -运用知识 (教 -学 -做 )的模式来完成。方法 :通过对实习对象的分析 ,制定临床带教计划 ,实施计划 ,评估与反馈等方法 ,让学生们全面参与手术室专业临床护理实践。结果 :把所学的理论和技能正确运用于实际工作中 ,以巩固和充实理论知识 ,进一步获得和掌握手术室护理专业技能。结论 :培养科学的思维能力、严谨的工作作风、良好的职业道德     

救助精神病患者的临床特点与护理干预

目的 :分析 72例救助精神病患者的临床资料 ,依据其特点进行针对性护理并与常规护理对照。方法 :随机将患者分成 2组 ,进行自行设计问卷调查作出评定分析。结果 :有针对性的护理救助精神病患者 ,依从性好 ,患者住院病程明显短于常规护理患者。结论 :针对救助精神病患者的临床特点进行有针对性的护理 ,可以获得更好的疗效     

流式细胞术检测临床实体瘤细胞周期蛋白表达的方法研究

目的探讨cydin／DNA双参数流式细胞术及流式细胞术分选后的免疫沉淀蛋白质印迹技术和共聚焦显微镜技术检测临床实体瘤细胞周期蛋白表达的可行性、科学性和优越性，为肿瘤的细胞周期分析提供科学有效的技术支持。方法运用cydin／DNA双参数流式细胞术及流式细胞术分选后的免疫沉淀蛋白印迹技术和共聚焦显微镜技术检测临床实体瘤细胞周期蛋白的表达。并与传统的免疫组织化学切片法进行比较。结果流式细胞术可以准确地对细胞周期蛋白在临床实体瘤中的表达进行定性、定量、定位的分析，较为系统地反映了细胞周期蛋白在临床实体瘤中的表达特性和肿瘤的生物学特性。结论Cyclin／DNA双参数流式细胞术及流式细胞术分选后的免疫沉淀蛋白质分析技术和共聚焦显微镜技术是一种科学有效的检测临床实体瘤细胞周期破坏特性的技术和方法。     

糖尿病门诊对患者自我管理的作用

目的 :帮助糖尿病患者提高自我管理水平 ,减少并发症的发生。方法 :开设糖尿病门诊 ,指导患者治疗 ,自我监测 ,预防等 ,并对接受门诊指导的 12 6例患者的自我管理知识 ,指导效果进行初步评价。结果 :通过开展健康教育指导 ,12 6例患者不同程度地掌握了糖尿病的相关知识及自我监控的能力。结论 :糖尿病门诊是能有效地提高患者自我管理水平的健康教育方法     

Effects of atmosphere of incubation on recovery of bacteria and yeasts from blood cultures in Tryptic soy broth

A comparison was made of the results of blood cultures between 1974 and 1981 in unvented and transiently vented bottles of Tryptic soy broth under vacuum with CO2. A total of 14,646 isolates were available for statistical analysis. Significantly more isolates of Staphylococcus epidermidis, Staphylococcus aureus, Bacillus, Escherichia, Pseudomonas, Klebsiella, Serratia, Acinetobacter, Alcaligenes, Neisseria, and Candida were recovered from the vented bottle. Significantly more isolates of Corynebacterium, Haemophilus, Flavobacterium, Moraxella, Bacteroidaceae, and Peptostreptococcus were recovered from the unvented bottle.     

结直肠癌364例临床病理特征分析

目的:探讨分析结直肠癌的临床病理特征及发病特点,为临床选择治疗方案提供依据。方法:回顾性分析2000～2006年收治的364例结直肠癌临床及病理资料,比较其性别、年龄、主要症状、肿瘤部位、组织类型、病理分级及临床病理分期的差异。结果:本组最常见症状为血便及大便次数增多,好发部位位于直肠,组织学类型以腺癌为主,淋巴结转移与肿瘤的分化程度、浸润程度及Dukes分期有关。结论:明确结直肠癌的临床病理特征有助于诊断和治疗。     

Relevance of Pulmonary Alveolar Echinococcosis

BackgroundPulmonary alveolar echinococcosis (PAE) is a chronic disease caused by Echinococcus multilocularis with very low incidence in developed countries.MethodsThis single-center, retrospective study included 34 patients who were diagnosed with PAE between January 2001 and February 2019 (15 males, 19 females, mean age: 52.4 ± 15.8 years, age range: 28–78 years) in Ataturk University Medical School, Erzurum, Turkey.ResultsThe liver was the primary involved organ in all cases. Pulmonary involvement was detected in 13.0% (34/261) of all cases with hepatic alveolar echinococcosis (AE), and three patients (8.8%) had both pulmonary metastasis and brain metastasis. The route of spread to the lungs based on radiological data was hematogeneous in 25 patients (73.5%), transdiaphragmatic in three patients (8.8%) and both hematogeneous and transdiaphragmatic in six patients (17.7%). AE showed bilateral involvement in 19 patients (55.9%), whereas only the right lung was involved in 12 patients (35.3%) and the left lung in three patients (8.8%). Of the patients, five underwent surgery due to PAE and 29 patients received medical therapy with albendazole. A total of three patients died during the follow-up period (2, 5 and 10 years after the diagnosis of PAE), while 31 patients continued with follow-up and treatment for a mean duration of 5.4 ± 3.8 years (1–14 years).ConclusionsPatients with hepatic AE must, as a matter of course, be screened for possible lung involvement. Albendazole therapy may slow down disease progression in patients with widespread pulmonary involvement who are not eligible for surgery.