Mobile daily diaries to characterize stressors and acute health symptoms in an environmental justice neighborhood

Low-income communities and communities of color face multiple, cumulative environmental and social burdens. Methods development in environmental justice research has largely focused on spatial and quantitative approaches. Less attention has been paid to developing methodologies that help collect information on everyday stressors and quality of life experiences for residents in overburdened communities. Mixed methods approaches can be one way to structure study designs that help consider how residents experience environmental and socioeconomic impacts in a localized community context. In neighborhoods burdened by cumulative stressors, traditional cross-sectional epidemiological research designs can also be challenging, as well as limited or narrow in their application. However, repeat sampling of measures within a vulnerable population can approach a quasi-experimental design and help consider variations within residents in a single neighborhood as well as better parse relationships between exposures and outcomes. Through a community-academic partnership with university partners, local community partners, and a local promotores de salud (community health workers) network, we pilot tested a novel mobile daily diary approach in both English and Spanish in an urban, predominantly immigrant community in South Los Angeles as a potential method to collect information on daily stress, environmental quality, and health status/symptoms. We collected resident responses via a once per day 7-day SMS/text messaging survey. We sought to gather granular data on daily resident experiences of air pollution and environmental hazards. Residents reported acute health symptoms and stressors, with repeat measures demonstrating how residents might rank, categorize, or cope with stressors. We find that residents in environmental justice communities record variation in their daily diary responses and document changes in environmental quality, stressors, and odors. Refining this type of method could enable a more rigorous examination of co-occurrences of environmental quality and acute health symptoms. This approach supports the inclusion of residents in the research process and helps more systematically integrate open-ended environmental health relevant data in environmental justice efforts. Used with measured data such as air monitoring or health measures, mixed methods generated data can help support efforts that aim to alleviate sources of daily stress, alongside efforts to reduce overall pollution burdens. Mobile daily diaries can be one way to capture variable responses to environmental quality, acute health symptoms, and stressors.     

水蛭分子鉴定方法的研究进展

水蛭基原复杂、市场混乱、传统方法难以有效鉴别,临床用药的安全性无法保障。分子鉴定方法根据生物间的分子特征差异进行鉴定,不受自然环境、生长发育阶段等外部因素影响,具有快速、准确、客观的特点。目前应用于水蛭的分子鉴定方法有:基于核酸的RAPD技术、SSR技术、DNA条形码技术和基于蛋白质的SDS-PAGE技术、同工酶分析技术,本文在简述水蛭不同分子鉴定方法研究进展的基础上,对水蛭不同分子鉴定方法的技术和应用特点进行比较,最后对DNA宏条形码技术、Target-sequencing技术、电化学传感检测技术在水蛭混合物,特别是中成药中水蛭成分的鉴定进行展望,旨在为水蛭鉴定方法的深入研究提供参考和借鉴。     

中医特色护理技术干预混合痔术后疼痛临床研究

目的:观察在常规术后治疗与护理基础上加用中药熏洗结合针刺、耳穴贴压的综合特色护理技术干预混合痔吻合器痔上黏膜环切术(PPH)术后疼痛的效果。方法:将110例PPH术后患者随机分为对照组和观察组各55例。2组术后患者均行常规补液、抗炎、止血等对症处理,术后第1天起常规每天清洁换药,应用吲哚美辛栓术后纳肛,肛泰软膏适量外涂肛周,口服氨酚双氢可待因片,高锰酸钾坐浴,并予疼痛护理、饮食指导、排便指导等护理措施。观察组加予中药熏洗、针刺、耳穴贴压等中医护理技术。2组疗程均为5天。采用视觉模拟评分法(VAS)分别于术后12 h、1天、2天、3天和5天评价疼痛情况,记录术后5天的氨酚双氢可待因片用量;术后1天、3天、5天评定创面水肿、渗液、便血和尿潴留的症状积分。结果:术后1天、3天、5天,2组VAS评分均较术后12 h下降(P<0.01),观察组术后1天、3天、5天的VAS评分均低于对照组(P<0.01)。术后3天、5天,2组症状积分均较术后1天下降(P<0.01),观察组术后3天、5天的症状积分均低于对照组(P<0.01)。术后5天的氨酚双氢可待因片使用量观察组为(8.62±2.11)片,少于对照组的(12.37±2.53)片(P<0.01)。结论:在常规术后治疗与护理的基础上加用中医综合特色护理技术,能更为有效地减轻混合痔PPH术后疼痛,减少镇痛药物的使用,减少术后其他并发症的发生,从而有利于患者的恢复。     

Contextualizing the lived experience of quality of life for persons with spinal cord injury: A mixed-methods application of the response shift model

Objective: The objective of this study was to gain greater insight into individuals’ quality of life (QOL) definitions, appraisals, and adaptations following spinal cord injury (SCI).

Design: A mixed-methods design, applying the Schwartz and Sprangers response shift (RS) model. RS is a cognitive process wherein, in response to a change in health status, individuals change internal standards, values, or conceptualization of QOL

Setting: Community-dwelling participants who receive medical treatment at a major Midwestern medical system and nearby Veterans’ Affairs hospital.

Participants: A purposive sample of participants with SCI (N?=?40) completed semi-structured interviews and accompanying quantitative measures.

Interventions: Not applicable.

Outcome Measures: Qualitative data were analyzed using content analysis to identify themes. Analysis of variance were performed to detect differences based on themes and QOL, well-being, and demographic and injury characteristics.

Results: Four RS themes were identified, capturing the range of participant perceptions of QOL. The themes ranged from complete RS, indicating active engagement in maintaining QOL, to awareness and comparisons redefining QOL, to a relative lack of RS. Average QOL ratings differed as a function of response shift themes. PROMIS Global Health, Anxiety, and Depression also differed as a function of RS themes.

Conclusion: The RS model contextualizes differences in QOL definitions, appraisals, and adaptations in a way standardized QOL measures alone do not.