Food caregivers influence on nutritional intake among admitted haematological cancer patients – A prospective study

PurposeHaematological cancer patients have an increased risk of undernourishment due to their malignancy, treatment toxicity and severe infections. This study examines whether kitchen assistants working as food caregivers increase nutritional intake and knowledge among haematological cancer patients.MethodsComparison of two cross-sectional studies with dietary assessment of patients with haematological malignancies before (N = 42) and after (N = 45) implementation of food caregivers. Secondly, a questionnaire concerning dietary counselling performed before (N = 74) and after (N = 78) the implementation.ResultsThe energy requirements were fulfilled with 76.2% (CI 95% 64.6–87.9) and 93.3% (CI 95% 82.3–104.3) of the calculated need in the before-group and the after-group, respectively (p = 0.03). The improvement was mainly due to increased energy intake through between meal snacks served by the food caregivers. There was no difference in protein intake between the two groups. The study showed that more than two-thirds of the patients in both groups had side effects like fatigue, loss of appetite, vomiting, xerostomia or taste disorder to a degree that affected nutritional intake. When adjusted for side effects, patients in the after-group increased energy intake by 22% (CI 95% 6.1–38.0) (p = 0.007). After implementation of food caregivers significantly more patients stated that they were informed about their nutritional needs, 41% in the before-group and 67% in the after-group (p = 0.001).ConclusionsEducated and trained food caregivers working at the wards increase nutritional intake and knowledge among haematological cancer patients and play an important role in the multi professional nutritional management.     

Mechanical and Biological Effects of Ultrasound: A Review of Present Knowledge

Ultrasound is widely used for medical diagnosis and increasingly for therapeutic purposes. An understanding of the bio-effects of sonography is important for clinicians and scientists working in the field because permanent damage to biological tissues can occur at high levels of exposure. Here the underlying principles of thermal mechanisms and the physical interactions of ultrasound with biological tissues are reviewed. Adverse health effects derived from cellular studies, animal studies and clinical reports are reviewed to provide insight into the in vitro and in vivo bio-effects of ultrasound.     

不同时期介入栓塞术对高分级颅内动脉瘤破裂的治疗效果探讨

目的 探讨高分级颅内动脉瘤破裂患者不同时期介入栓塞术治疗的效果和并发症发生率的影响。方法 选取本院2019年3月—2020年7月收治的86例Hunt-Hess高分级颅内动脉瘤破裂患者,采用随机数字表法分为两组,每组各43例。所有患者均行介入栓塞术治疗,对照组于发病后72～96 h内实施,观察组于发病72 h内实施。比较两组术后指标[格拉斯哥预后评分(GOS)和日常生活活动能力(BI)]、血清学指标[可溶性细胞间黏附分子1(sICAM-1)和基质金属蛋白酶9(MMP-9)]及并发症发生情况。结果 两组出院时GOS评分比较,差异无统计学意义(t=0.197,P=0.847);观察组出院3个月时BI评分为(60.42±12.84)分,高于对照组的(36.85±11.54)分,(t=8.953,P＜0.001),观察组术后3个月MMP-9为(432.22±28.29)ng/mL、sICAM-1为(404.21±24.41)μg/L,低于对照组的(491.33±29.20)ng/mL、(534.69±28.54)μg/L,(t值分别为9.534、22.783,P值均＜0.01)。观察组并发症发生率为11.64%,低于对照组的32.57%,(χ2=6.515,P=0.011)。结论 高分级颅内动脉瘤破裂患者于发病72 h内实施介入栓塞术治疗效果较佳,可降低并发症发生率,利于患者预后。     

一元过氧乙酸清除消化内镜生物膜的效果

目的调查临床重复使用内镜的生物膜污染情况,检测一元过氧乙酸对内镜污染生物膜的清除效果。方法按照《医院消毒卫生标准》GB15982-2012中方法检测2019年8-10月临床200例次重复使用的内镜消毒后的消毒效果,采用活菌计数法检测内镜生物膜污染情况。分别采用一元过氧乙酸、戊二醛清除生物膜,监测生物膜的去除效果。结果高水平消毒前提下,经检测30%的内镜出现生物膜;一元过氧乙酸对生物膜的清除率均>99%,戊二醛对生物膜的清除效率仅为62%,差异有统计学意义(P<0.05)。一元过氧乙酸连续使用14天后,所有内镜均未形成生物膜,与戊二醛组对比菌落计数,差异有统计学意义(P<0.05)。结论一元过氧乙酸可有效清除内镜生物膜,并可预防控制生物膜的生成。     

Profound barriers to basic cancer care most notably experienced by uninsured women: Historical note on the present policy considerations

America is considering the replacement of Obamacare with Trumpcare. This historical cohort revisited pre-Obamacare colon cancer care among people living in poverty in California (N = 5,776). It affirmed a gender by health insurance hypothesis on nonreceipt of surgery such that uninsured women were at greater risk than uninsured men. Uninsured women were three times as likely as insured women to be denied access to such basic care. Similar men were two times as likely. America is bound to repeat such profound health care inequities if Obamacare is repealed. Instead, Obamacare ought to be retained and strengthened in all states, red and blue.     

The observer effect in a hospital setting - Experiences from the observed and the observers

BackgroundObservation studies are used in health care research, e.g. to explore behaviors of patients or health care professionals in hospitals. A methodological challenge in observation studies is the observer effect, as it can jeopardize the quality of a study.ObjectivesTo capture different dimensions of the observer effect through health care professionals' and patients' experiences, and their reactions to being observed in a hospital setting, and in addition, observers' experiences from performing an observation study.MethodFour focus group interviews (health care professionals and observers) and 10 individual interviews (patients) were conducted with participants from a Norwegian observation study focusing on medication communication at a hospital ward. In all 26 persons were interviewed, whereof 3 were observers (pharmacist, pharmacy students). Data were collected between September 2019 and January 2020 and analyzed by an inductive, thematic analysis approach.ResultsFive main themes were identified; Experiencing being observed; Temporarily adapting medication communication behavior; Consequences for the patients; To interact or not - reflections on the relations and Observing the observers. Respondents reported some observer effects, but also that these diminished with time. Even though minimal interaction was used as a strategy, observers and the observed still built rapport.ConclusionsThe observer effect in relation to medication communication seemed to be small and temporary in this specific hospital setting, among other things as staff and patients were used to extra persons (e.g. students) being around. Medication communication in hospital settings is a complex behavior, and appears to not be strongly impacted by the presence of observers, especially with a long observation time. It is important for researchers to monitor and record the observer effect in the specific setting of the study. This can be done by interviews with the observed and the observers by someone not connected to the observation study.     

良性前列腺增生采用双极等离子适配器予以经尿道前列腺等离子切除术治疗的观察

目的:分析良性前列腺增生予以经尿道前列腺等离子切除术治疗的观察。方法:选择2017年1月~2020年1月本院收治的良性前列腺增生患者共60例,数字表随机分2组每组30例,对照组的患者给予传统开放前列腺切除术治疗,观察组采取双极等离子适配器经尿道前列腺等离子切除术。比较两组效果。结果:观察组出血量、冲洗膀胱时间和住院时间低于对照组,治疗后两组患者国际前列腺症状评分、生活质量以及最大尿流率均优于治疗前,观察组并发症发生率低于对照组,P<0.05。两组手术成功率均是100.00%,P>0.05。结论:经尿道前列腺等离子切除术对于良性前列腺增生的治疗效果确切,可减少出血和并发症,加速恢复。     

基于微视频健康宣教对初产妇产后康复效果的影响

目的　探究微视频健康宣教对初产妇产后康复效果的影响。方法　选择2019年3月至2021年3月瑞金市人民医院收治的60例初产妇为本次研究对象，采用双盲法分为两组，各30例。对照组年龄（30.34±2.22）岁，接受常规干预；观察组年龄（30.25±2.15）岁，基于对照组进行微视频健康宣教。比较组间康复指标及产后抑郁情况、性功能、盆底肌力恢复情况。计量资料组间比较采用独立样本t检验，组内采用配对t检验，计数资料用χ²检验。结果　观察组子宫复旧时间、恶露持续时间、泌乳时间、爱丁堡产后抑郁量表（EPDS）评分分别为（7.02±1.02）周、（5.21±0.81）d、（2.71±0.32）d、（5.05±0.72）分、（145.52±10.26）ml，均低于对照组［（8.01±1.15）周、（7.36±1.05）d、（3.52±0.52）d、（7.65±1.02）分、（123.21±9.15）ml］，泌乳量多于对照组，差异均有统计学意义（均P<0.05）。干预前，两组初产妇性高潮、性交痛、性欲、阴道润滑、性生活满意度、性唤起评分及总分比较，差异均无统计学意义（均P>0.05）；干预后，观察组性高潮、性交痛、性欲、阴道润滑、性生活满意度、性唤起评分及总分均高于对照组，差异均有统计学意义（均P<0.05）。观察组产后盆底肌力3～5级恢复率分别为26.67%（8/30）、33.33%（10/30）、30.00%（9/30），均高于对照组的6.67%（2/30）、10.00%（3/30）、6.67%（2/30），1～2级恢复率分别为3.33%（1/30）、6.67%（2/30），均低于对照组的40.00%（12/30）、36.67%（11/30），差异均有统计学意义（均P<0.05）。结论　初产妇产后予以微视频健康宣教可促进产后相关指标的改善，改善性功能及盆底肌力，应用效果显著。