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1.
ObjectivePregnancies complicated by fetal heart defects often undergo a planned delivery prior to term by either induction of labour or cesarean delivery to ensure optimal availability of neonatal care. We aimed to assess whether such planned deliveries achieve their goal of better perinatal care.MethodsWe conducted a retrospective case-control study of pregnancies complicated by isolated fetal cardiac defects, without other fetal comorbidities, managed at a single fetal medicine unit over a 10-year period. Only pregnancies delivered past 37 weeks gestation were included. Patients undergoing elective delivery for care planning reasons only were compared with patients in whom planned delivery was clinically indicated and patients who laboured spontaneously. Obstetric and perinatal outcomes were recorded.ResultsOf the 180 pregnancies included in the study, 59 (32.8%) were in the elective group, 49 (27.2%), in the indicated group, and 72 (40%), in the spontaneous group. Mean gestational age at delivery was 39.0 ± 1.1 weeks overall and did not differ between the groups. For the elective group, only 35.6% of deliveries occurred during office hours, which was similar to the 2 other groups. The rate of adverse obstetric or postnatal outcomes was not statistically significantly different between groups.ConclusionTimed delivery at term does not seem to be associated with an increased risk of poor perinatal outcomes. It may improve perinatal care by providing proximity to a neonatal intensive care unit and convenience for patients and providers.  相似文献   
2.
近视眼是影响我国儿童青少年眼健康的焦点问题。远视储备是眼球发生近视前的屈光状态, 是眼轴长度与角膜及晶状体等参数之间动态匹配的结果, 对于近视眼防控意义重大。我国一直缺乏儿童眼球发育参数的指导依据以及遗传因素影响的参考资料, 尤其针对上述参数在儿童眼球正视化过程中变化规律的总结。为了促进儿童青少年近视眼防控工作的标准化, 规范人群筛查和临床治疗, 使社会各界对近视眼的预防干预和评价有据可依, 中华预防医学会公共卫生眼科分会基于我国不同地区儿童青少年的屈光不正调查数据, 针对我国学龄儿童正视眼在不同年龄段眼球远视储备、眼轴长度和角膜曲率的参考区间及相关遗传因素达成共识性意见。  相似文献   
3.
目的 了解护理硕士专业学位研究生人文执业能力现状及影响因素,为开展护理教育提供参考。方法 采用一般资料问卷、护士人文执业能力量表和护士职业价值观量表对300名护理硕士专业学位研究生进行调查。结果 护理硕士专业学位研究生的人文执业能力得分为(100.61±13.40)分;多元线性回归显示,婚姻状况、读研前临床护理工作年限、家人的关心程度和职业价值观是护理硕士专业学位研究生人文执业能力的主要影响因素(均P<0.05)。结论 护理硕士专业学位研究生人文执业能力有待加强,护理教育者应制订针对性培养方案,强化学生的人文护理意识、培训人文关怀技能、营造人文关怀氛围和注重职业价值观的引导,以提升护理硕士专业学位研究生人文执业能力水平。  相似文献   
4.
BackgroundInduction of labor continues to become more common. We analyzed induction of labor and timing of obstetric and anesthesia work to create a model to predict the induction-anesthesia interval and the induction-delivery interval in order to co-ordinate workload to occur when staff are most available.MethodsPatients who underwent induction of labor at a single medical center were identified and multivariable linear regression was used to model anesthesia and delivery times. Data were collected on date of birth, race/ethnicity, body mass index, gestational age, gravidity, parity, indication for labor induction, number of prior deliveries, time of induction, induction agent, cervical dilation, effacement, and fetal station on admission, date and time of anesthesia administration, date and time of delivery, and delivery type.ResultsA total of 1746 women met inclusion criteria. Associations which significantly influenced time from induction of labor to anesthesia and delivery included maternal age (anesthesia P <0.001, delivery P =0.002), body mass index (both P <0.001), prior vaginal delivery (both P <0.001), gestational age (anesthesia P <0.001, delivery P <0.018), simplified Bishop score (both P <0.001), and first induction agent (both P <0.001). Induction of labor of nulliparous women at 02:00 h and parous women at 04:00 or 05:00 h had the highest estimated probability of the mother having her first anesthesia encounter and delivering during optimally staffed hours when our institution’s specialty personnel are most available.ConclusionsTime to obstetric and anesthesia tasks can be estimated to optimize induction of labor start times, and shift anesthesia and delivery workload to hours when staff are most available.  相似文献   
5.
目的 探讨磁性医院管理在基层托管二级民营医院的实践效果.方法 将磁性医院管理应用于托管二级民营医院:培养护理管理者领导力、建立有效激励机制、构建支持性工作环境、打造磁性医院关爱文化等,增强临床护士凝聚力.比较实施前后护士职业价值观、离职意愿及离职率状况.结果 实施磁性医院管理实践后,临床护士职业价值观评分显著高于实施前,离职意愿评分显著低于实施前(均P<0.05);离职率由2017年33.05%降至2020年6.19% (P<0.01).结论 磁性医院管理能引导临床护士建立正确的职业价值观,降低护士离职意愿及离职率.  相似文献   
6.
7.
BackgroundThe current understanding of ventilator efficiency variables during ramp exercise testing in the normal Japanese population is insufficient, and the responses of tidal volume (VT) and minute ventilation (V?E) to the ramp exercise test in the normal Japanese population are not known.MethodsA total of 529 healthy Japanese subjects aged 20–78 years underwent cardiopulmonary exercise testing using a cycle ergometer with ramp protocols. VT and V?E at rest, at anaerobic threshold, and at peak exercise were determined. The slope of V?E versus carbon dioxide (V?CO2) (V?E vs. V?CO2 slope), minimum V?E/V?CO2, and oxygen uptake efficiency slope (OUES) were determined.ResultsFor males and females in their 20 s, peak VT (VTpeak) was 2192 ± 376 and 1509 ± 260 mL (p < 0.001), peak V?E (V?Epeak) was 80.6 ± 18.7 and 57.7 ± 13.9 L/min (sex differences p < 0.001), the V?E vs. V?CO2 slope was 24.4 ± 3.2 and 25.7 ± 3.2 (p = 0.035), the minimum V?E/V?CO2 was 24.2 ± 2.3 and 27.0 ± 2.8 (p < 0.001), and the OUES was 2452 ± 519 and 1991 ± 315 (p < 0.001), respectively. VTpeak and V?Epeak decreased with age and increased with weight and height. The V?E vs. V?CO2 slope and minimum V?E/V?CO2 increased with age, while conversely, the OUES decreased with age.ConclusionsWe have established the normal range of VT and V?E responses, the V?E vs. V?CO2 slope, the minimum V?E/V?CO2, and the OUES for a healthy Japanese population. Some of these parameters were influenced by weight, height, sex, and age. These results provide useful reference values for interpreting the results of cardiopulmonary exercise testing in cardiac patients.  相似文献   
8.
目的 了解新护士工作准备度及情绪劳动水平,并分析两者之间的关系,为新护士顺利进入工作角色提供参考。 方法 采用一般资料调查表、中文版毕业护士工作准备度量表及情绪劳动量表,对新疆维吾尔自治区8所三甲医院工作1年内911名护士进行调查。 结果 新护士工作准备度总分(269.54±48.70)分,情绪劳动总分(46.85±11.91)分,两者呈负相关(r=-0.235,P<0.05);控制一般资料后,情绪劳动量表的表层扮演、深层扮演维度可解释新护士工作准备度35.5%的变异(均P<0.05)。 结论 新护士工作准备度及情绪劳动均处于中等水平,表层扮演负向预测工作准备度,深层扮演正向预测工作准备度。管理者需重视新护士情绪劳动评估,重点关注倾向于表层扮演的新护士,以提高其工作准备度。  相似文献   
9.
Bedaquiline is a new ATP synthesis inhibitor developed as an anti-tuberculosis agent. It has resistance-associated variants (RAV), regardless of preceding bedaquiline exposure. Herein, we describe the case of a patient with multidrug-resistant tuberculosis (MDR-TB) who had no history of bedaquiline therapy but presented a relatively high minimum inhibitory concentration (MIC) of bedaquiline (1 μg/mL). Whole genome sequencing revealed a mutation in the resistance-associated gene Rv0678. The patient was first treated with a five-drug regimen (bedaquiline, delamanid, levofloxacin, cycloserine, and amikacin), which induced negative sputum culture conversion. Despite the successful treatment outcome, several questions remain regarding the efficacy of bedaquiline in this patient. Bedaquiline is an indispensable drug for MDR-TB treatment, but its clinical efficiency in the presence of Rv0678 mutations remains unclear. Therefore, evaluating the MIC of bedaquiline even in patients without a history of bedaquiline use is important for therapeutic regimen selection and may emphasize the importance of therapeutic drug monitoring in cases of bedaquiline RAV.  相似文献   
10.
Theory: Despite high rates of psychiatric illnesses, medical students and medical professionals often avoid psychological help. Stigma may prevent medical students from seeking psychological help when experiencing distress, which may hinder their job performance and mental health. Compassionate values—preferred principles that guide attitudes and behaviors to focus on the wellness of others—may be a relevant predictor of medical students’ perceptions of psychological help. The present study examined the association between medical students’ compassionate values, help-seeking stigma, and help-seeking attitudes in a convenience sample of medical students. Hypotheses: Rating compassionate values as more important than self-interested values will be associated with less stigma, which in turn will be associated with more positive help-seeking attitudes. Method: There were 220 medical students in their 2nd year of medical training who were recruited in-class and through e-mail between January and March of 2017 at Des Moines University. Students were provided an anonymous online link to a survey composed of validated measures assessing values, psychological distress, and stigma and attitudes related to psychological help. Results: The survey response rate was 41%, leaving a final sample of 91. For every 1 SD increase in the relative importance of compassionate values over self-interested values, help-seeking stigma decreased 0.40 SDs, and help-seeking attitudes increased 0.23 SDs. Conclusions: Prioritizing compassionate values more strongly than self-interested values is associated with medical students’ perceiving psychological help-seeking more positively.  相似文献   
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