General vaccination willingness and current vaccination status in relation to clinical and psychological variables in patients with multiple sclerosis

BackgroundInfections can have a significant impact on morbidity and mortality in multiple sclerosis (MS) patients. Therefore, vaccinations are of immense importance. If vaccination willingness is to be increased, possible influencing factors should be identified. The aim of the present study was to investigate the status of active immunisation in MS patients in association with sociodemographic, clinical-neurological, psychopathological and personality variables using the NEO-Five Factor Inventory, the Temperament and Character Inventory-Revised and the Hospital Anxiety and Depression Scale.MethodFour hundred and four MS patients from two German neurological hospitals were examined for their vaccination attitudes, in detail, the general willingness to vaccinate and the current vaccination status of mumps, measles and rubella (MMR) as well as tetanus and influenza. We also looked at the current level of disability in relation to the current vaccination status, as well as possible associated personality and psychopathological variables.ResultsPatients with a complete MMR vaccination status were significantly younger and those with a complete influenza vaccination status were significantly older than those with related incomplete vaccination status. Tetanus vaccination status completeness did not differ depending on age and did not show substantial association with personality scores. However, influenza vaccination completeness was associated with differences in personality and psychopathological variables; extraversion, openness, novelty seeking, harm avoidance and anxiety. A reported general vaccination willingness was significantly correlated with the current completeness of tetanus and influenza vaccinations. Novelty seeking, persistence, extraversion, agreeableness, conscientiousness and neuroticism were found associated with an increased vaccination willingness. Anxiety and depression were not related to general vaccination willingness.ConclusionsNo specific personality trait could be defined on its own in relation to general vaccination willingness or complete vaccination status. Younger patients should be made more aware of influenza vaccination. Reasons for rather low vaccination rates need to be further investigated.     

残疾预防计划对肢残者重返岗位效果的研究

目的:探讨在残疾预防计划对广东地区工伤肢残者出院后结局的影响。方法:选取2018年2~7月在我院进行工伤康复的肢残患者160例,按照入院先后顺序分为观察组和对照组各80例,对照组采取传统医疗康复措施,观察组采取传统医疗康复措施+残疾预防计划措施,观察两组干预前后就业意愿评估,在出院后进行为其三个月的随访,以出院时的就业意愿、出院后三个月内成功复工率、复工后的工作满意度作为职业康复疗效测量指标研究残疾预防计划对肢残者出院结局的影响。结果:两组样本具有可比性,两组样本在干预后的就业意愿发生变化,组间差异不显著(P>0.05);观察组在三个月内成功复工率(89.6%)高于对照组(71.8%),两组差异显著(P<0.05);两组复工人员的工作满意度无显著差异(P>0.05);多元线性回归分析显示,复工人群的工作满意度受工种及公司性质的影响。结论:残疾预防计划有助于提高肢残者出院后的复工率,但对其就业意愿及工作满意度效果不明显;工种、公司性质是肢残者复工后工作满意度的主要影响因素,可以从工种、公司性质两方面设计干预措施以提高肢残者工作满意度。     

种植手术同期根向复位瓣附着龈重建的临床研究

目的探索一种简单高效的手术方法,用于增加种植体周围的附着龈宽度并且能缩短种植修复的疗程。探讨根向复位瓣附着龈重建术的效果。方法收集有种植修复需求的患者8例,但种植位点处附着龈宽度小于2 mm,行种植手术同期利用根向复位瓣技术进行附着龈重建。术后2周拆线。8周后常规种植上部修复并负荷。分别观察手术前、术后8周、修复完成即刻、修复完成1年时附着龈宽度的变化情况。结果所有患者种植体周围的附着龈宽度明显增加,修复完成1年后未见明显附着龈退缩。术后2周拆线,除1个种植位点在术后第2天因缝合线脱落致黏膜仍有炎症外,其余位点黏膜愈合良好。结论根向复位瓣附着龈重建术创伤小,并且同期种植手术可以缩短种植修复疗程,术后患者恢复效果较好。可以作为增加种植体周围附着龈宽度的简单高效的方法。     

Willingness to pay for periodontal therapy: development and testing of an instrument

OBJECTIVES: The objective of this study was to develop and test the feasibility and validity of a willingness to pay (WTP) tool in a dental setting. METHODS: A questionnaire measured individuals' preferences among alternative treatments for periodontal disease and the maximum they would be willing to pay for their treatment of choice in terms of dental insurance premiums. The questionnaire provides detailed information, in probabilistic terms, of the risks and benefits of treatment choices for moderate to advanced adult periodontitis. It was pilot tested on 23 periodontal patients and 18 dental school faculty and staff. RESULTS: The majority (92.6%) felt the questionnaire was an accurate representation of treatments and outcomes, establishing face and content validity. In terms of construct validity, four hypotheses were tested: (1) manipulation of the outcomes of the preferred treatment led to a predictable shift in preferences for 38 subjects (92.7%); (2) although periodontal patients were not more likely to choose periodontal surgery than nonpatients (P = .14), those with a history of surgery were more likely to choose surgery again (P = .06); (3) WTP was positively related to income level (P = .05); and (4) subjects were willing to pay more for coverage for themselves than for others. Periodontal surgery was the preferred treatment for moderate to advanced periodontal disease, and was more strongly preferred than other choices (i.e., a higher WTP) for all income groups. The intraclass correlation coefficient for treatment preferences was 0.95 (P < .001) and the kappa for WTP was 0.78 (P < .001). CONCLUSION: This pilot study supports some of the criteria concerning validity of the WTP questionnaire to measure preferences for alternative periodontal therapies. Further testing on larger samples is required to confirm these results.     

湖南省贫困县农村空巢老人互助养老意愿及影响因素研究

目的了解湖南省贫困县农村空巢老人的互助养老意愿、需求及影响因素,为农村互助养老的发展定位及对策研究提供参考。方法采用分层随机整群抽样的方法选择湖南省安仁县5个乡镇50个行政村的807名空巢老人,采用自制互助养老意愿及需求问卷、社会支持评定量表、健康促进生活方式量表进行调查。结果 272人(33.71%)选择愿意接受互助养老,互助养老需求评分为3.22±0.63。Logistic回归分析显示:贫困县农村空巢老人互助养老意愿受年龄、文化程度、自理能力、目前患慢性病数量、健康促进生活方式5个因素的影响(均P0.01)。结论贫困县农村空巢老人的互助养老意愿不强,对健康服务需求较高,高龄、文化程度高、自理能力差、患慢性病数量多、健康促进生活方式水平低的农村空巢老年人互助养老意愿相对较高。需提高农村空巢老人对互助养老的认知,以促进农村养老的健康发展。     

Factors Influencing Patients’ Willingness to Pay for New Technologies in Hip and Knee Implants

Rising implant prices and evolving technologies are important factors contributing to the increased cost of arthroplasty. Assessing how patients value arthroplasty, new technologies, and their perceived outcomes is critical in planning cost-effective care, as well as evaluating new-technologies. One hundred one patients undergoing arthroplasty took part in the survey. We captured demographics, spending practices, knowledge of implants, patient willingness to pay for implants, and preferences related to implant attributes. When patients were asked if they would be satisfied with “standard of care” prosthesis, 80% replied “no”. When asked if they would pay for a higher than “standard of care” prosthesis, 86% replied “yes”. The study demonstrated that patients, regardless of their socio-economic status, are not satisfied with standard of care implants when newer technologies are available, and they may be willing to share in the cost of their prosthesis. Patients also prefer the option to choose what they perceive to be a higher quality or innovative implant even if the “out of pocket” cost is higher.     

学习《精神科护理学》对改善护理专业学生精神疾病患者歧视态度和服务意愿的影响

目的分析学习《精神科护理学》对改善护理专业学生精神疾病患者歧视态度和服务意愿的影响。方法 2014年12月便利选取南京中医药大学学习《精神科护理学》课程的护理本科三年级学生共336人,在课程学习前后分别进行"歧视精神疾病患者评估量表"和"护理服务意愿评估表"的调查。结果课程学习前,护生歧视精神疾病患者评估量表各维度得分和总分与常模比较,差异无统计学意义(均P0.05);课程学习后,护生隔离、能力维度得分和总分低于学习前,为精神疾病患者提供护理服务意愿的得分高于学习前,差异均有统计学意义(均P0.05)。结论学习《精神科护理学》可以有效改善护生对精神疾病患者的歧视和误解,后期仍应在研究结果的基础上进一步开展相应的教学改革。