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摘要:目的 了解不同检测方法在耐碳青霉烯肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae, CRKP)对多黏菌素 B体外药敏检测中的差异,为临床治疗和实验室检测提供依据。方法 选择2018-2020年宁波地区临床分离的CRKP 147株,分 别采用肉汤稀释法、E-test纸片法、仪器法(N335药敏卡)和纸片法检测其体外对多黏菌素B的敏感性,分析4种药敏检测方法所 存在的差异。结果 微量肉汤稀释法、E-test法和仪器检测CRCP对多黏菌素B MIC50分别为1、1和0.5μg/mL,MIC90分别为1、 1和0.5,累积敏感率分别为97.3%、99.3%和98%,具有较高一致性和敏感性;仪器法检测CRKP对多黏菌素B的平均MIC值为 (0.82±0.16)μg/mL,明显低于标准方法的(1.39±0.27)μg/mL,差异有统计学意义(P<0.01);E-test法和仪器法的基本一致率(EA) 为92.5%和94.6%,标准符合(CA)分别为97.3%和98.6%,严重错误(VME)分别为2.7%和1.4%;重大错误(ME)和小错误(mE)均为 0;纸片法KB值与肉汤稀释法MIC值之间方差分析P>0.05,故提示KB值与MIC值不具有线性关系。结论 4种方法检测CRKP 对多黏菌素B体外具有较高敏感性;仪器法和E-test法对于多黏菌素B的敏感性检测与微量肉汤稀释法高度一致,但其中仪器法 N335药敏卡检测MIC有所降低,建议标准方法复核。  相似文献   
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ObjectiveExisting instruments for assessing health literacy skills in parents have limited scope to inform the design and evaluation of health literacy interventions. In this study we aimed to develop and validate a new performance-based measure of health literacy for Australian parents, the Parenting Plus Skills Index (PPSI). The instrument aimed to assess functional, communicative and critical health literacy skills.MethodsThe PPSI was developed in three phases: 1) Modified Delphi Expert Panel to provide feedback on 34 initial items; 2) Evaluation of psychometric properties of each item using a multidimensional item response theory model in a sample of Australian adults of parenting age (20−44 years) (N = 500); 3) Assessment of subset of items in an independent sample (N = 500).ResultsFollowing the three phases, 13 items were included in the final instrument. Participants scored on average 8.9/13 (69 %). The instrument demonstrated acceptable reliability (r = 0.70) and was significantly correlated with other performance-based health literacy instruments.ConclusionsThe PPSI is a validated 13-item performance-based instrument that assesses health literacy skills for parents in an Australian setting.Practice implicationsThe PPSI fills an important gap in available health literacy instruments that may be useful for facilitating development and evaluation of health literacy interventions.  相似文献   
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AimThis study aimed to develop and test the validity and reliability of the Knowledge, Attitudes and Practices of Incontinence-associated Dermatitis Questionnaire (KAP-IAD-Q) for Nurses.MethodsA psychometric validation design was employed. Phase I of the study entailed the development of items through an extensive literature review and a double Delphi procedure with 11 experts specialised in wound, ostomy and continence to examine content validity of the KAP-IAD-Q. Phase II involved administering the KAP-IAD-Q to a convenience sample of 263 Registered Nurses from a public hospital in Singapore to evaluate its construct validity, internal consistency and test-retest reliability.ResultsThe instrument showed acceptable content validity (S-CVI = 0.85). Exploratory factor analysis showed all 22 items demonstrated strong factor loadings >0.4 and the four factors KAP-IAD-Q explained 58.1% of total variance. The four factors were☹1) knowledge om IAD aetiology and identification, (2) knowledge on IAD risk factors; (3) attitudes, and (4) practices. The overall internal consistency was excellent (Cronbach's α = 0.913). The KAP-IAD-Q showed good overall test-retest reliability as well (ICC = 0.89 (95% CI 0.69–0.96, p < 0.001).ConclusionThe KAP-IAD-Q demonstrated good psychometric properties and is effective in measuring levels of IAD-related KAP among nurses. Further confirmation of the proposed factor structure is recommended. Future research should explore determinants of nurses’ KAP and associations between IAD knowledge, attitudes and practices.  相似文献   
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ObjectivesTo examine associations between mild cognitive impairment (MCI) and falls among primary care patients, and to investigate whether social engagement (SE) modifies these associations.DesignCross sectional analysis using baseline data from an observational cohort study.SettingPrimary care.ParticipantsCommunity-dwelling older adults (N=430) at risk of mobility decline with a mean age of 76.6 years (range 65-96y).Main Outcome MeasuresThe number of falls in the past year was reported at the baseline interview. MCI was identified using a cutoff of 1.5 SD below the age-adjusted mean on at least 2 of the standardized cognitive performance tests. SE (eg, keeping in touch with friends and family, volunteering, participating social activities…) was assessed with the Late Life Function and Disability Instrument, and required a score above the median value 49.5 out of 100.ResultsMCI was present among 42% of participants and 42% reported at least 1 fall in the preceding year. Using generalized estimating equations, MCI was associated with a 77% greater rate of falls (P<.05). There was a statistically significant interaction between SE and MCI on the rate of falls (P<.01), such that at a high level of SE, MCI was not statistically associated with falls (P=.83). In participants with lower levels of SE, MCI is associated with 1.3 times greater rate of falls (P<.01).ConclusionsWhile MCI is associated with a greater risk for falls, higher levels of SE may play a protective role.  相似文献   
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Background: Colorectal cancer is an important public health problem worldwide. Although progress in screeningand treatment has considerably improved the prognosis in the developed world, in developing countries colorectal cancermortality rate remains relatively high. Colorectal cancer screening literacy is an important initial step in overcoming thisproblem. Development of a validated assessment instrument is therefore important for implementation of appropriatehealth education programs to facilitate early detection. Objectives: This study focused on generation and validation ofa colorectal cancer screening literacy scale for Thai people in northeastern Thailand. Methods: This methodologicalstudy was carried out in two phases: (1) literature reviews and semi-structured interviews were used to select items,then the content and face validity were checked; and (2) a confirmatory factor analysis (CFA) was conducted to testconstruct validity and reliability. A self-administered questionnaire was used to collect data from Thai people aged 50-65 in June 2017. Results: For the total of 400 participants who responded (response rate 100 %), the age ranged from50 to 65 years old (mean = 57.3, SD = 4.616). The colorectal cancer screening literacy scale was designed to include6 domains and it was shown to have good internal consistency, and CFA demonstrated the model to fit data adequately(Chi-squared/degree of freedom = 1.079, p = 0.061, CFI = 1.00, GFI = 0.93, AGFI = 0.91, RMSEA = 0.014 and SRMR= 0.036). The final version of its, consisting of 57 items across the 6 domains covering key aspects of colorectal cancerscreening literacy, demonstrated good psychometric properties for this population. Conclusions: Use of the colorectalcancer screening literacy scale in Thai people could lead to improved educational programs for optimizing colorectalcancer screening.  相似文献   
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目的探讨2型糖尿病周围神经病变患者下肢腓总神经超声特征与密歇根量表(MNSI)评分之间的相关性。方法回顾分析95例2型糖尿病患者的超声资料,依据MNSI评分结果分为A组(0~3.4分)、B组(3.5~4.4分)及C组(≥4.5分)。另选30名健康志愿者作为正常对照组。对各组腓总神经的声像图特征进行比较,包括腓总神经的前后径、横径、截面积及神经束回声、"筛网状"结构、神经外膜、与毗邻组织分界。结果 A、B、C组腓总神经各形态参数与正常对照组差异均有统计学意义(P均<0.05)。与A组比较,B、C组腓总神经超声表现为神经束回声减低、"筛网状"结构模糊、神经外膜不均匀增厚、与毗邻组织分界不清的患者均明显增加(P均<0.05)。腓总神经的前后径、横径、截面积与密歇根筛查体格检查评分呈正相关(r=0.573、0.625、0.584,P均<0.05)。结论密歇根筛查量表体格检查评分与腓总神经超声形态学参数及声像图特征具有一定相关性,评分越高,腓总神经超声表现异常的可能性越大。  相似文献   
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目的研究胃肠多功能治疗仪联合复方聚乙二醇电解质散对老年功能性便秘患者的疗效。方法选择2018年1月至2018年12月住院的功能性便秘患者150例,采用随机数表法分为实验组和对照组,每组各75例。对照组给予复方聚乙二醇电解质散治疗;实验组在对照组基础上同时给与数字化电胃肠音乐治疗仪治疗。比较2组患者粪便性状评分、首次排便时间以及每次排便时间、Wexner便秘评分、生活质量自评量表、心理状态的差异。采用SPSS 22.0统计软件对数据进行分析。结果实验组患者大便的Bristol分型Ⅳ和Ⅴ型的比例分别为33.3%和28.0%,明显优于对照组。治疗后,实验组首次排便时间、每次排便所耗时间以及每周排便次数均优于对照组。治疗后,对照组和实验组的Wexner便秘评分较治疗前均明显下降,分别为(9.12±1.68)分和(7.75±1.53)分, 2组比较差异有统计学意义(P0.05)。与对照组相比,实验组的抑郁患者人数较少,且抑郁程度轻,2组差异有统计学意义(P0.05)。结论数字化电胃肠音乐治疗仪联合复方聚乙二醇电解质散治疗老年功能性便秘效果优于单药治疗,有利于老年功能性便秘患者的恢复。  相似文献   
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