餐饮从业人员健康素养及从业知识新媒体干预效果评价

 目的 验证健康素养对餐饮从业人员食品安全知识的影响作用,评价手机APP软件对餐饮从业人员健康素养水平的干预效果,为制定特定职业人群健康素养干预方法提供依据。方法 于2018年6-12月采取社区试验方法抽取上海市闵行区大、中、小型餐饮单位的餐饮从业人员,按单位类别随机纳入干预组和对照组,干预组进行健康素养新媒体干预活动,并于干预前、后分别调查了对照组的446和443人,干预组的441和440人,比较两组餐饮从业人员健康素养水平及食品安全知识得分的变化情况。结果 干预前干预组和对照组的健康素养3个维度、6类健康问题和总体水平差异均无统计学意义（P均>0.05）;干预后干预组健康素养3个维度、6类健康问题和总体水平分别为86.59%、51.59%、56.14%、73.86%、74.55%、42.95%、89.77%、36.14%、50.68%和48.86%,均明显高于对照组的51.46%、33.63%、30.02%、43.34%、59.82%、23.25%、63.33%、14.22%、28.89%和27.77%,差异均有统计学意义（P均<0.01）;干预前后,干预组组内健康素养水平比较差异有统计学意义（P<0.01）。干预前干预组和对照组的食品安全8个方面知识得分和总分差异均无统计学意义（P均>0.05）;干预后干预组食品安全知识总分为（14.73±1.93）分,高于对照组的（8.67±1.77）分,差异有统计学意义（P<0.001）;干预前后,干预组组内的食品安全总得分比较差异有统计学意义（P<0.001）。结论 新媒体工具干预可有效提高餐饮从业人员的健康素养,健康素养的提高也促进了其食品安全知识水平的提升。     

Summer research program for medical students

The decrease in the number of physician investigators is a serious national problem. Direct participation in research by medical students is widely regarded as a valuable component of medical education and as a stimulus to a career in research. A voluntary summer research program was implemented at the Medical College of Ohio at Toledo with student participation exceeding 20 percent for the classes entering in 1980 and 1981 and reaching 40 percent for the freshman class that entered in 1982. The research program was planned along with implementation of a new four-year curriculum. First-year students were encouraged to participate in research projects during the summer between their first and second year. Interested students were matched with faculty members by mutual agreement. An evaluation of the program based on publications and presentations by medical students and on responses of students and faculty members to a questionnaire was made.     

Physical and psychological health problems among Japanese family caregivers

The authors commenced research in 2005 with the goal of on constructing a health support system for primary caregivers. This ongoing study aims to develop a health support program and construct a system of regional assistance based on examining the health situation of family caregivers. Furthermore, it aims to present proposals that will put the minds of citizens at ease in respect to their ability to live in a super aging society. A survey was conducted with 213 male and female caregivers and a control group of 477 community residents not engaged in care. This paper collates the various research findings reported in journals and conference presentations by the authors. Among both male and female caregivers, blood pressure levels required regulation. Among female caregivers, grip strength and musculoskeletal symptoms were worse than those in the control group, even when participants were matched for age. We attempted to determine the characteristics of caregivers who have strong feelings of responsibility and obligation toward their provision of care. Age was a significantly higher factor in the group with stronger feelings in that regard. The group with weaker feelings of responsibility and obligation was younger. The percentage of participants who were caring for a spouse, living with a spouse, had no secondary caregivers, or were providing all-day care, was significantly higher in the group with stronger feelings of responsibility and obligation. There was no significant difference between the groups in the mean total score on the J-ZBI-8 that measures burden of care. As the aging population of Japan grows larger, support for caregivers with physical and psychological health problems, and at the very least, concern of government administrators and the general public, will assume greater importance.     

扬州市农村社区糖尿病自我管理项目实施效果评价

目的评价扬州市农村社区实施糖尿病自我管理项目6个月后的效果。方法按照以社区为基础的随机对照试验研究设计,将246例糖尿病患者随机分成干预组和对照组,干预组患者接受6个月的糖尿病自我管理健康教育项目课程。6个月后比较两组患者自我管理行为、自我效能、健康状况和卫生服务利用方面的变化。结果干预后两组患者自我管理行为中的认知性症状管理实践及与医生交流评分间差别有统计学意义(P<0.01);症状管理自我效能和疾病共性管理自我效能间差别有统计学意义(P<0.01);健康状况评价指标的9个方面(整体健康自评、精力、健康担忧、疲劳、气短、疼痛、疾病对患者生活影响、情绪低落及社会活动/角色受限)得分间差别有统计学意义(P<0.05)。干预后6个月内,两组患者看门诊次数和急诊次数间差别有统计学意义(P<0.05)。结论农村社区糖尿病自我管理项目实施6个月后,增加了参加者的自我管理知识,培养了健康的行为,改善了躯体和精神部分健康状况、自我效能,减少看门诊次数和看急诊次数。     

A medical school fellowship program for minority high school students

The effectiveness of a research program for minority high school students was evaluated. The program, supported by funding from the National Institutes of Health, was begun in 1982; during the subsequent five years, there were 59 applicants and 38 participants in the program. Of the responding 20 participants, 12 were pursuing careers in science and medicine, and half of the 16 respondents with career plans reported that the program had influenced their career decisions. Overall and in each year, black male students were underrepresented in both the applicant pool and the participants as compared with the metropolitan high school population.     

The medical and psychosocial impact of comprehensive care on adolescent pregnancy and parenthood

To assess the medical and psychosocial effects of services provided by a comprehensive adolescent pregnancy and parenthood program, 125 adolescents who received care from a comprehensive program were compared with 135 adolescents who received care from community health providers. Few differences were found in pregnancy outcome measures. At 12 and 26 months after delivery, however, the intervention group scored significantly better on composite measures encompassing medical, psychosocial, and parenting events than did the comparison group, even after accounting for possible confounding factors. This suggests that comprehensive care has little effect on pregnancy outcomes for those adolescents who are already receiving prenatal and nutritional services, but does have a significant effect on events occurring during the first and second postpartum years.     

南京市下关区社区高血压患者自我管理项目实施效果评价

目的:评价社区高血压患者自我管理项目的效果?方法:按照以群落为基础的随机对照试验研究设计,将738例高血压患者分成干预组和对照组,干预组患者接受高血压自我管理健康教育项目课程,9个月后比较两组在自我管理行为?健康状况?卫生服务利用?心血管系统和并发症等方面的差异?结果:干预后两组患者自我管理行为中的认知性症状管理实践及按照要求规律服药间差别有统计学意义(P < 0.01);干预后两组的门急诊次数?健康状况评价指标?心功能分级和并发症方面统计均有差异(P < 0.05)?结论:南京市高血压自我管理项目的实施,增加了参加者的自我管理知识,培养了健康的行为,改善了躯体和精神部分健康状况?自我效能,减少就诊次数,缓解症状和预后?     

Surveillance de la santé à l''école maternelle.

In contrast to the traditional program of health assessment of schoolchildren based on periodic physical examination, the program described in this paper is based on the integration of information and data obtained by observation through the school year from parents, teachers and the school nurse, who coordinates the program. The numbers and the types of problems and the date on which they were identified are compared in an experimental group of 557 kindergarten children and a matched control group of 498 children in whom the traditional program was maintained. For problems of hearing, enuresis, learning and behaviour the number of cases detected was significantly greater in the experimental group than in the control group. Each element of the proposed program is analysed and the advantages of an integrated approach to health assessment of schoolchildren are underlined.     

促进2型糖尿病患者行为的可持续性改变:澳大利亚美好生活俱乐部的自我健康管理计划的评价

本文分析了澳大利亚美好生活俱乐部18个月的监测数据。美好生活俱乐部是澳大利亚联邦政府资助的“分担卫生服务项目”的一个研究项目,旨在促进50岁及以上糖尿病患者的慢性病自我管理。该项目的干预措施是跨理论行为改变模型和通过电话的动机谈话技术。在患者参加项目的基线、第6个月、第18个月收集数据。数据包括人口学信息、慢性病种类、健康行为、对健康的认识、锻炼程度、功能状态、自我效能、情绪状态、服务利用,以及9个目标行为的改变阶段。本文报告了150名接受18个月监测的患者数据。结果表明,在8个自我评价的症状中,有6个症状明显改善,差异有统计学意义。接受干预的患者对自我健康管理的信心在短期内明显增强。患者的卫生服务利用呈现减少趋势,但无统计学差异。卫生服务利用没有减少的原因,归因于参加者之间卫生服务利用方式的差异较大。参加项目第6个月时,患者行走的活动量增加,但第18个月时回到基线水平。这些发现表明,动机谈话技术能够在行为改变的最初阶段发挥作用,不过如果要长期地维持行为改变,则需要确定个体化和结构性的策略。     

水中分娩对婴儿健康影响的前瞻性研究

目的:了解水中分娩对婴儿健康的影响。方法:采用配对前瞻性队列研究,选取456例无禁忌证的孕产妇及其新生儿为对象,其中228例孕妇为水中分娩组,228例孕妇为传统分娩组,2组按照自愿选择水中分娩进行配对,分别在产后1 个月、6 个月及12 个月进行随访,了解婴儿的健康状况。结果:2组在新生儿体质量、Apgar评分、新生儿住院期间和1个月内健康状况、婴儿1～6个月和7～12个月随访疾病的发生率差异均无统计学意义（P>0.05）。结论:水中分娩对婴儿是安全可靠的。     

Evaluation of the careers of graduates of the University of Manitoba's BSc (Medicine) program.

The careers of graduates who had taken the BSc (Medicine) (BScMed) program at the University of Manitoba, Winnipeg, between 1950 and 1975 were compared with those of matched classmate controls to determine whether the program had any influence on the research careers of the graduates. More BScMed graduates than control subjects chose an academic career (49% v. 21%), achieved specialty certification (83% v. 65%), and obtained grants (51% v. 18%) and personal awards (37% v. 18%). The BScMed graduates also had significantly more publications than the control subjects. Although part of the difference between the two groups may be explained by the tendency of students who were more inclined toward an academic career to enter the BScMed program, it was evident that the program has a substantial effect on promoting the development of clinical investigators.     

口腔健康教育对改善医学专科院校新生口腔健康知识及行为的效果评价

目的：评价3种口腔健康教育形式对改善医学专科院校新生口腔健康意识、行为及口腔卫生的效果。方法：选取医学专科院校新生1022名,将其随机分为4组,相同内容用不同形式进行口腔健康教育,即第1组开展知识讲座（讲座组）、第2组播放宣教视频录像（视频组）、第3组组织学生现场自学（自学组）、第4组为对照组;分别在健康教育前和2个月后,采用问卷调查和牙菌斑染色的方法评价不同教育形式前后新生口腔健康意识和行为知晓率的变化及菌斑指数对比。结果：经过不同形式的口腔健康教育,观察对象在口腔健康行为和知识方面大部分有改善（ P ﹤0.05）,讲座组和视频组菌斑指数较干预前有改善（ P ﹤0.05）,自学组与对照组无变化（ P ﹥0.05）。3个组间效果比较,讲座组效果最明显（ P ﹤0.05）,且有最多的学生愿意接受该种方式。结论：口腔健康教育对医学专科院校新生的口腔健康状况、口腔健康意识和行为有积极的促进作用。     

基于信息化平台的社区人群糖尿病干预模式的构建和评价

目的 以社区糖尿病前期人群为对象,以充分利用社会资源为目标,构建经济、适用的糖尿病行为干预新型模式.方法 通过系统分析和德尔菲法建立针对糖尿病前期人群的行为干预项目;根据流行病学实验的方法,在重庆主城区慢病控制试点社区开展干预试验.将522例糖尿病前期患者随机分为试验组和对照组,根据“知-信-行”的行为干预理论,试验组对象在接受社区常规健康管理服务的基础上,增加新型行为干预项目,同时接受定期社区现场活动和信息化平台交流活动;对照组对象只接受常规社区健康管理.干预实施后,定期观察试验组对象行为变化情况;半年后比较两组的行为执行情况、糖尿病的发病率、身体测量指标和实验室检测指标的变化情况.结果 从干预试验实施后的第4 ～ 24周,试验组各健康行为改变率均有不同程度的增加;半年后,试验组与对照组相比,除穴位按摩和以步代车行为外,所有要求健康行为执行强度和行为养成比例显著增加;试验组的糖尿病发病率为4.51％,对照组的糖尿病发病率为7.58％,两组糖尿病发病率差异无统计学意义(P＞0.05);与对照组相比,试验组BMI降低显著,但其他指标,如腰围、血压、血糖和糖化血红蛋白等变化差异无统计学意义(P＞0.05).结论 在现有社区慢病管理的基础上构建的糖尿病新型行为干预模式,从多个环节促进被干预者行为改变,有助于试验对象建立健康行为,提高研究对象的依从性,其在短期内已显示出降低体质量指数的效果.     

“内行病人计划”对腹膜透析患者生活质量影响的研究

目的：探讨采用“内行病人计划”的方法将腹膜透析患者培训成为内行病人,对腹膜透析患者生活质量的影响。方法选择进行腹膜透析未规范培训的患者（对照组,27例）与采用“内行病人计划”进行规范培训的患者（培训组,30例）进行治疗效果及生活质量的比较,记录患者在随访期间的住院情况、依从性及退出情况,随访时限6个月,应用SF-36生活质量评定表测评2组患者生活质量。结果通过采用“内行病人计划”的方法规范培训后,腹膜炎发生率明显降低,培训组患者生活质量明显高于对照组,差异均有统计学意义（P<0.05）,尤其是患者的自信心和社会适应能力明显提高。结论采用“内行病人计划”的方法进行规范培训,可预防各种并发症的发生,改善治疗效果,提高患者的生活质量。     

不同健康教育模式对糖尿病控制的近期效果

目的评价实施不同健康教育模式3个月后对糖尿病控制的效果。方法设计随机对照实验,将133名自愿参加健康教育的糖尿病患者随机分为实验组(n=79)和对照组(n=54)。对照组采用专业人员授课,实验组由经过培训、本身即为糖尿病患者的非专业人员授课。教育3个月后对血糖、血脂、血压和知识得分等指标进行组内和组间比较。结果两组患者教育后的各项指标均较教育前有显著改善(P均<0.05);两组患者相比,各项指标改善程度无统计学差异(P>0.05)。结论两种健康教育模式对糖尿病控制都有积极的影响,医院开展新的健康教育模式的长效性有待进一步研究。     

同步健康教育对小儿脑瘫运动功能康复的影响

目的探讨同步健康教育对小儿脑瘫运动功能康复的影响。方法将脑瘫患儿采用脑瘫粗大运动功能分级系统（GMFCS）分级后,筛选符合诊断标准和纳入标准的GMFCSⅠ-Ⅲ级的脑瘫患儿60例,随机分为治疗组和对照组（n=30）。对照组按照一般健康教育宣传模式进行常规指导。治疗组除进行一般健康教育外,责任护士根据患儿粗大运动功能情况给予家长同步健康教育,观察时间6个月。结果同步健康教育后,治疗组GM—FCSⅠ级的患儿21例,对照组13例,治疗组患儿康复至GMFCSⅠ级的比率明显高于对照组（P〈0．05）;2组患儿康复6个月后,56项粗大运动功能（GMFM）评价积分均较同步健康教育前增加（P〈0．05）,且治疗组积分增加程度较对照组明显（P〈0．05）。结论同步健康教育对小儿脑瘫运动功能的改善产生积极的影响。     

临床医学生专业思想状况调查及影响因素分析

目的在调查分析上海交通大学医学院临床医学生专业思想状况的基础上,全面了解不同阶段、不同学制学生的专业思想发展态势,分析主要的影响因素,从而为当前的教育教学和管理提供可能的建议及对策,引导学生形成正确的专业学习观和职业发展观。方法自行设计调查问卷,在五年制学生（n=300）和八年制学生（n=180）中进行问卷调查,并对调查结果进行统计分析。结果问卷回收455份（94．8％）,其中有效问卷432份（94．9％,五年制285份,八年制147份）;就学制和年级而言,各组学生在专业思想和对专业学习的认识差异并不十分明显,但在个人职业发展的明确程度方面,不同学制学生的认识差异具有统计学意义（P〈0．05）;此外,对于个人职业发展的具体规划问题上,不同学制的学生差异性有统计学意义（P〈0．001）。结论临床医学专业学生专业思想的不稳定性和影响因素均体现在多方面,必须加强思想教育管理、心理健康教育及职业规划教育,并强化教师队伍建设,将专业思想教育融入学前教育及在校教育的各个环节。     

浅议护理专业特殊困难毕业生个性化就业指导

我国目前的社会、经济以及护理专业招生等现状,导致护理专业录取的学生中出现了一部分特殊群体,这部分特殊群体的就业,直接影响护理专业的整体培养质量和学校的社会声誉和地位。本文对护理专业特殊困难学生类型及其个性化的就业指导做了简要分析。     

Behavior therapy and sibutramine for the treatment of adolescent obesity: a randomized controlled trial

CONTEXT: Adolescent obesity is becoming a national public health problem. Weight-loss medications including sibutramine facilitate weight control in adults and could be used with obese adolescents in combination with behavior therapy (BT). OBJECTIVE: To examine whether increased weight loss in obese adolescents is induced when sibutramine is added to a family-based, behavioral weight control program. DESIGN, SETTING, AND PARTICIPANTS: Randomized, double-blind, placebo-controlled trial consisting of 82 adolescents aged 13 to 17 years with a body mass index (BMI) of 32 to 44 conducted from March 1999 to August 2002 at a university-based clinic for 6 months, followed by open-label treatment during months 7 to 12. INTERVENTIONS: For the first 6 months, participants received either BT and sibutramine or BT and placebo. From months 7 to 12, all participants received sibutramine in open-label treatment. MAIN OUTCOME MEASURES: Percentage change in BMI; systolic and diastolic blood pressure and pulse; and hunger. RESULTS: In intention-to-treat analysis at month 6, participants in the BT and sibutramine group lost a mean (SD) of 7.8 kg (6.3 kg) and had an 8.5% (6.8%) reduction in BMI, which was significantly more than weight loss of 3.2 kg (6.1 kg) and reduction in BMI of 4.0% (5.4%) in the BT and placebo group. Significantly greater reductions in hunger (P =.002) also were reported by participants who received BT and sibutramine. From months 7 to 12, adolescents initially treated with sibutramine gained 0.8 kg (10.5 kg) with continued use of the medication, whereas those who switched from placebo to sibutramine lost an additional 1.3 kg (5.4 kg). Medication dose was reduced (n = 23) or discontinued (n = 10) to manage increases in blood pressure, pulse rate, or other symptoms. CONCLUSIONS: The addition of sibutramine to a comprehensive behavioral program induced significantly more weight loss than did BT and placebo. Until more extensive safety and efficacy data are available, medications for weight loss should be used only on an experimental basis in adolescents and children.     

系统化体质干预护理方案对30例痰湿体质脑卒中患者的影响

目的：观察拟定的系统化体质干预护理方案对痰湿体质脑卒中患者的疗效、预后的影响。方法：将60例符合纳入标准的患者随机分为观察组和对照组各30例,对照组采用常规治疗,观察组在对照组基础上加用拟定的系统化体质干预护理方案进行干预,时间为1年。统计治疗前及治疗过程中两组患者体质量表积分、神经功能缺损评分、临床痊愈率、复发率变化。结果：治疗前与治疗4个月时,体质积分及神经功能缺损评分比较,两组无统计学差异（P〉0.05）;治疗8个月、12个月时,体质积分及神经功能缺损评分比较,两组有统计学差异（P〈0.05）,观察组低于对照组。治疗过程中,观察组在临床痊愈率的提高、复发率的降低方面,均优于对照组,P〈0.05。结论：应用系统化体质干预护理方案对痰湿体质脑卒中患者进行积极治疗干预,可使患者的体质偏颇状况改善,气血阴阳平和,脏腑功能协调,进而提高远期预防与治疗效果。