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1.
目的 开展养老机构志愿者预立医疗照护计划培训并评价其效果。方法 应用基于Bloom目标教学理论构建的养老机构志愿者预立医疗照护计划培训内容,结合《预立医疗照护计划》知识教育手册、《我的五个愿望》手册、案例视频等教具,通过角色扮演、案例讨论等方式对53名养老机构志愿者进行培训。培训前后使用养老机构志愿者预立医疗照护计划知信行及自我效能问卷对志愿者进行调查,根据志愿者角色扮演表现评价其预立医疗照护计划沟通技能。结果 培训前后志愿者预立医疗照护计划认知、态度、行为意愿及自我效能差异有统计学意义(P<0.05,P<0.01),培训后75.47%志愿者预立医疗照护计划沟通技能达合格及以上水平。结论 预立医疗照护计划培训能改善养老机构志愿者的预立医疗照护计划知信行及自我效能感,培养其预立医疗照护计划沟通能力。  相似文献   
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目的:评估中国新疆和田地区居民干眼的患病率和潜在的相关危险因素。

方法:2019-01/09在中国新疆和田地区采取立意抽样的方法选取105个村18~98岁居民共计6 027人作为受试者,并进行横断面研究。调查者采用眼表疾病指数(OSDI)问卷的方式收集干眼主观症状,检查荧光素染色泪膜破裂时间(FBUT)及泪液分泌试验(Schirmer Ⅰ试验)来收集客观体征,从而分析干眼患病率及其危险因素。

结果:从中国新疆和田地区居民中招募18~98岁共6 339名受试者进行相关眼部检查和问卷调查,其中有效问卷6 027份,有效回收率为95.08%。6 027名受试者中干眼检出率为40.37%(2 433/6 027),其中男性、女性干眼检出率分别为36.47%(846/2 320)、42.81%(1 587/3 707); 18~24岁、25~34岁、35~44岁、45~54岁、55~64岁、≥65岁干眼检出率分别为13.77%、15.67%、33.31%、46.35%、47.65%、53.50%。根据干眼严重程度分为轻度干眼、中度干眼及重度干眼,它们的构成比依次为80.11%、19.03%、0.86%。

结论:干眼在研究人群中的患病率为40.37%,女性干眼患病率高于男性,且随年龄的增加干眼患病率呈上升趋势,高龄和女性是干眼的危险因素。  相似文献   

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Muñoz-Rojas  G  García-Lorenzo  B  Esteve  D  Trias  S  Caellas  D  Sanz  M  Mellado  R  Peix  T  Sampietro-Colom  L  Pou  N  Martínez-Pallí  G  Ferrando  Carlos 《Journal of clinical monitoring and computing》2022,36(5):1263-1269
Purpose

The occurrence of adverse events (AE) in hospitalized patients substancially increases the risk of disability or death, having a major negative clinical and economic impact on public health. For early identification of patients at risk and to establish preventive measures, different healthcare systems have implemented rapid response systems (RRS). The aim of this study was to carry out a cost-effectiveness analysis of implementing a RRS in a tertiary-care hospital.

Methods

We included all the patients admitted to Hospital Clínic de Barcelona from 1 to 2016 to 31 December 2016. The cost-effectiveness analysis was summarized as the incremental cost-effectiveness ratio (incremental cost divided by the incremental effectiveness of the two alternatives, RRS versus non-RRS). The effectiveness of the RRS, defined as improvements in health outcomes (AE, cardiopulmonary arrest and mortality), was obtained from the literature and applied to the included patient cohort. A budget impact analysis on the implementation of the RRS from a hospital perspective was performed over a 5-year time horizon.

Results

42,409 patients were included, and 448 (1.05%) had severe AE requiring ICU admission. The cost-effectiveness analysis showed an incremental cost (savings) of EUR ??1,471,101 of RRS versus the non-RRS. The budgetary impact showed a cost reduction of EUR 896,762.00 in the first year and EUR 1,588,579.00 from the second to the fifth year.

Conclusions

The present analysis shows the RRS as a dominant, less costly and more effective structure compared to the non-RRS.

  相似文献   
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Background

Melatonin is an indole hormone secreted primarily by the pineal gland that showing anti-oxidant, anti-inflammatory and anti-apoptotic capacity. It can play an important role in the pathophysiological mechanisms of various diseases. In this regard, different studies have shown that there is a relationship between Melatonin and Multiple Sclerosis (MS). MS is a chronic immune-mediated disease of the Central Nervous System.

Aim

The objective of this review was to evaluate the mechanisms of action of melatonin on oxidative stress, inflammation and intestinal dysbiosis caused by MS, as well as its interaction with different hormones and factors that can influence the pathophysiology of the disease.

Results

Melatonin causes a significant increase in the levels of catalase, superoxide dismutase, glutathione peroxidase, glutathione and can counteract and inhibit the effects of the NLRP3 inflammasome, which would also be beneficial during SARS-CoV-2 infection. In addition, melatonin increases antimicrobial peptides, especially Reg3β, which could be useful in controlling the microbiota.

Conclusion

Melatonin could exert a beneficial effect in people suffering from MS, running as a promising candidate for the treatment of this disease. However, more research in human is needed to help understand the possible interaction between melatonin and certain sex hormones, such as estrogens, to know the potential therapeutic efficacy in both men and women.

  相似文献   
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BackgroundThe optimal regimen for intravenous administration of intraoperative fluids remains unclear. Our goal was to analyze intraoperative crystalloid volume administration practices and their association with postoperative outcomes.MethodsWe extracted clinical data from two multicenter observational studies including adult patients undergoing colorectal surgery and total hip (THA) and knee arthroplasty (TKA). We analyzed the distribution of intraoperative fluid administration. Regression was performed using a general linear model to determine factors predictive of fluid administration. Patient outcomes and intraoperative crystalloid utilization were summarized for each surgical cohort. Regression models were developed to evaluate associations of high or low intraoperative crystalloid with the likelihood of increased postoperative complications, mainly acute kidney injury (AKI) and hospital length of stay (LOS).Results7,580 patients were included. The average adjusted intraoperative crystalloid infusion rate across all surgeries was to 7.9 (SD 4) mL/kg/h. The regression model strongly favored the type of surgery over other patient predictors. We found that high fluid volume was associated with 40% greater odds ratio (OR 1.40; 95% confidence interval1.01-1.95, p = 0.044) of postoperative complications in patients undergoing THA, while we found no associations for the other types of surgeries, AKI and LOSConclusionsA wide variability was observed in intraoperative crystalloid volume administration; however, this did not affect postoperative outcomes.  相似文献   
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肿瘤免疫治疗主要通过解除免疫抑制作用与增强免疫应答反应来实现对其有效治疗.纳米技术能够提高免疫刺激分子的聚集度与作用力,在完成局部免疫调节的基础上有效治疗癌症.嵌合抗原受体T细胞(CAR-T)是肿瘤免疫治疗中的一种有力手段,能够对肿瘤患者的T细胞进行转化处理,令其成为可表达嵌合肿瘤细胞表面抗原受体的CAR-T细胞,随后将相应的CAR-T细胞回输至肿瘤患者体内,并通过特异性识别、杀伤肿瘤细胞的方式,有效杀灭肿瘤病毒.将纳米技术应用至CAR-T肿瘤免疫治疗中,有望提高肿瘤免疫治疗的疗效与安全性.本文就纳米技术在CAR-T肿瘤免疫治疗中的应用进展进行综述.  相似文献   
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