Is there a trend of decreasing prevalence of TMD-related symptoms with ageing among the elderly?

Objective. Older adults have not been studied as much as younger ones regarding prevalence of TMD-related symptoms. The aim was to assess the prevalence of TMD-related symptoms in two population samples, 70 and 80 years old. Materials and methods. Identical questionnaires were in 2012 sent to all subjects born in 1932 and 1942 living in two Swedish counties. The response rate was 70.1%, resulting in samples of 5697 70- and 2922 80-year-old subjects. The questionnaire comprised 53 questions. Answers to questions on problems regarding TMD-related symptoms and awareness of bruxism were analysed. Results. Twelve per cent of the women and 7% of the men in the 70-year-old group reported some, rather great or severe problems regarding TMD pain. In the 80-year-olds the prevalence was 8% and 7%, respectively. Subjects who had problems with TMJ sounds reported difficulty to open the jaw wide 6-times and TMJ pain 10–13-times more frequently than subjects without such problems. Changes of taste and awareness of bruxism were the only variables significantly associated with TMD symptoms in both age groups. Number of teeth was not significantly associated with any of the TMD-related symptoms. Conclusions. Most of the elderly subjects had no severe problems with TMD-related symptoms, but 12% of the 70-year-old women reported some, rather great or severe problems. The marked gender difference at age 70 had disappeared in the 80-year-old group. The prevalence was lower among the 80- compared with the 70-year-old subjects of both sexes. The results support the comorbidity between TMD-related symptoms and general health problems.     

晚期癌症病人需求评估问卷的综合评价

[目的]评价“晚期癌症病人需求评估体系”问卷的科学性。[方法]采用问卷调查法,以作者研究构建的“晚期癌症病人需求评估问卷”和英国圣克利斯多弗医院“临终关怀结果评估量表——病人问卷”为调查工具,选取西安地区两所三级甲等医院7个临床科室中住院癌症病人96例和非癌症病人40例为调查对象,进行问卷调查。[结果]①本次调查问卷回收率为98.0%,重复测量回收率87.5%(35/40),完成率为97.9%,完成问卷时间为13.0min±3.5min,调查对象对调查问卷的评估认为好的占82.0%。②两次测量总分值相关系数为r=0.827,生理、心理、精神和社会4个方面的相关系数分别为0.823、0.636、0.796、0.875。③问卷在4个领域的Cronbach’sα系数分别为:生理需求0.7219,心理需求0.6412,精神需求0.7502,社会需求0.8275。④经主成分及因子分析,得到载荷较大的12个因子,基本涵盖了生理、心理、精神、社会4个方面。⑤与“临终关怀结果评估量表——病人问卷”的相关系数为0.87。⑥该问卷在社会需求方面有较好的区分度。[结论]“晚期癌症病人需求评估问卷”有较好的可行性,较高的信度和效度,可以用于晚期癌症病人需求评估。     

125例强制戒毒人员HIV抗体检测结果及对HIV感染态度调查分析

目的 了解强制戒毒人员艾滋病病毒(HIV)感染情况及对HIV感染态度,探讨吸毒人群中HIV感染人员的干预策略.方法 对125例强制戒毒人员进行HIV抗体检测;组织强制戒毒人员对HIV感染态度进行问卷调查.结果 125例强制戒毒人员中有5例HIV抗体阳性(占4.00%),32.80%的吸毒人员对艾滋病感染有恐惧、忧虑;如被告知感染HIV,34.40%的人选择怕拖累家人,不想回家;怕被周围人嫌弃的达60.00%.结论 关注已经感染HIV的吸毒人员强制戒毒期满后的生存环境和生活质量,加强强制戒毒人员出所后的管理刻不容缓.     

Developing a questionnaire to measure nurses' attitudes towards hospitalized older people

A number of studies have used generic measures to evaluate nurses' attitudes toward hospitalized older people. Those measures do not consider the context in which nurses meet older people and the influence that this may have on nurses' attitudes. The aims and objectives of the study were to develop a questionnaire from focus group data to evaluate nurses' attitudes towards hospitalized older people. To evaluate the psychometric properties of the questionnaire the design included a qualitative and quantitative phase. The method used for the qualitative phase was focus group interviews with the intention of identifying the phenomena that may indicate nurses' attitudes towards older people. The quantitative phase included the development and psychometric testing of an attitudinal questionnaire. Samples for the qualitative phase included Registered Nurses from the care of older people setting; Registered Nurses from the acute setting; nursing students and nurse teachers. The sample for the quantitative phase included nursing students (numbering 355). Ten themes were identified through thematic analysis. Eighty items were extrapolated from the qualitative analysis and used to formulate a questionnaire which was then distributed to the nursing students. On analysis, the reliability was 0.78. Further analysis using Principal Components Analysis (P.C.A.) with orthogonal rotation indicated that 45 items loaded on to eight factors. Results of the quantitative analysis indicated that there was a strong correlation between the thematic analysis and the P.C.A. The results would suggest that there may be important and relevant domains that are worthy of further study into nurses' attitudes towards older people. If the domains identified are useful for identifying negative attitudes towards older people, then strategies can be implemented to try and reduce negative attitudes in clinical practice.     

MIDAS and HIT-6 French translation: reliability and correlation between tests

The aim was to evaluate the test-retest reliability of the French translation of the Migraine Disability Assessment (MIDAS) and Headache Impact Test (HIT)-6 questionnaires as applied to episodic and chronic headaches and to assess the correlation between these two questionnaires. The MIDAS and HIT-6 questionnaires, which assess the degree of migraine-related functional disability, are widely used in headache treatment clinics. The French translation has not been checked for test-retest reliability. MIDAS involves recall, over the previous 3 months, of the number of days with functional disability with regard to work and to home and social life. HIT-6 involves a more subjective and general assessment of headache-related disability over the previous 4 weeks. We expect that there may be greater impact recall bias for chronic headaches than for episodic headaches and considered it important to be able to determine if the reliability of these questionnaires is equally good for these two patient populations. Given that both questionnaires have the same objective, that of assessing headache impact, it was thought useful to determine if their results might show a correlation and if they could thus be used interchangeably. The study was approved by an external ethics committee. The subjects were patients who regularly visit the Clinique de la Migraine de Montréal, which specializes in the treatment of headaches. The MIDAS and HIT-6 questionnaires were completed by the patients during their regular visit. Twelve days later, the same questionnaires were mailed with a prepaid return envelope. Sixty-five patients were required in both the episodic and chronic headache groups, assuming an 80% questionnaire return rate. One hundred and eighty-five patients were enrolled, and 143 completed the study, 75 with episodic headaches and 68 with chronic headaches. The questionnaire return rate was 78.9%. On average, questionnaires were completed a second time 21 days after the first, with a median of 19 days. The Shrout-Fleiss intraclass correlation coefficients for MIDAS and HIT-6 were, respectively, 0.76 and 0.77 for episodic headaches and 0.83 and 0.80 for chronic headaches. The Pearson correlation coefficient between the MIDAS and HIT-6 questionnaires was 0.48 for episodic headaches and 0.58 for chronic headaches at the first compilation and 0.42 and 0.59 at the second compilation. The test-retest intraclass correlation of the French versions for both MIDAS and HIT-6 questionnaires indicates moderate reliability for episodic headache and substantial reliability for chronic headache. The correlation between the MIDAS and HIT-6 questionnaires is weak for episodic headaches, but approaches a level of 'good' for chronic headaches.     

护理继续教育现状分析及对策探讨

通过对北京三所三级甲等综合性医院在岗护士进行问卷调查,搜集有关护理人员基本情况和继续教育方面的资料并进行分析,结果表明大多数临床护士年轻、学历低、缺乏新知识和学习机会,根据这一现状并借鉴国外护理继续教育经验和临床需求,提出探讨性建议:提高对护理继续教育重要性的认识,进一步完善护理继续教育体制,建立激励机制等,以期切实搞好护理继续教育,以利我国护理事业发展。     

A longitudinal study to determine association of various maternal factors with neonatal birth weight at a tertiary care hospital

Background

Neonatal birth weight is a powerful predictor of infant growth and survival and maternal factors like poor knowledge and insufficient dietary intake are significant risk factors. Other preventable determinants like pre pregnant BMI <18.5, low gestational weight gain (GWG) and anemia are also associated with low birth weight. This study was carried out to identify the impact of these maternal factors with risk of low birth weight (LBW).

Methods

A longitudinal study was carried out on 124 booked antenatal cases at a tertiary care center. A validated protocol containing socio demography, food frequency and anthropometry was administered at the 3rd trimester. Birth weight of the newborn was noted after delivery.

Results

26.28% children had low birth weight (<2500 g), 14.6% mothers were thin (BMI < 18.5), 55.3% mothers had a weight gain of less than 9 kgs and 45.5% were anemic. 81.81% mothers with BMI >18.5 and 28.92% women who were educated till high school had a baby with LBW. Most mothers consumed milk and vegetables daily and a few consumed non vegetarian foods but quality and quantity of food were grossly inadequate. GWG levels and Hb levels were significantly different in different birth weight groups and also were significantly associated with low birth weight.

Conclusion

Quality and quantity of maternal dietary intake during pregnancy, even in normal weight mothers (BMI > 18.5), are important determinants of birth weight. Nutritional counseling for mothers during the antenatal period is the cornerstone for healthy mother and healthy child.