健康教育是整体护理的重要环节

系统化整体护理模式是继功能制护理、责任制护理之后的一种新型的科学护理模式。其特点是按照护理程序的科学工作方法，为病人解决问题［１］。我院内科病房作为医院整体护理模式病房的试点，从１９９５年１２月开始实行系统化整体护理，通过一年半的工作实践，从中体会到...     

精神科护士在整体护理模式病房中的角度转变

系统化整体护理是以现代护理观为指导,以护理程序为核心,将护理临床业务和护理管理的各个环节系统化的工作模式。实施系统化整体护理是我国护理改革的系统化方案,当前许多医院建立了整体护理模式病房,结果模式病房的病人满意度高于其他病房。在实施过程中,护士的角色转变,对现代护理观的认识、接受和运用程度,对于促进系统化整体护理的开展起了至关重要的作用。     

转变护理模式实施以病人为中心的系统化整体护理的体会

护理工作如何从传统的以疾病为中心的护理模式,向以病冬为中心的系统化整体护理模式转变,以适应 新的医学模式和医学发展的需要,本文从模式病房试点方面进行了探索。     

系统化整体护理模式病房的工作体会

随着医学科学的迅速发展,护理模式也在不断地改变。我们心内科从96年起建立系统化整体护理模式病房。现谈几点体会。 1 思想观念的转变要建立一个系统化整体护理模式病房,最重要的是要在我们护士中树立以病人为中心,创一流护理服务质量和信念,明确护士的职责,端正工作态度,提高     

当前医院推行整体护理面临的困难与对策

以病人为中心、以人的健康为中心的整体护理是全球护理事业发展的共同趋势。转变护理模式 ,推行整体护理 ,创建模式病房 ,提高护理质量 ,是我国护理工作走向科学化、规范化、标准化的必然要求。1　整体护理在我国的开展情况及取得的成效我国自 1995年开展整体护理试点以来 ,卫生部要求将整体护理纳入“以病人为中心”的医院总体改革之中。通过 5年多持续深入的发动和开展 ,创建了一大批先进模式病房 ,培养了一大批优秀护士 ,护理技术和护理质量有了明显提高。安徽医科大学附属医院有 70 %以上的病区创建了模式病房 ,科室之间形成了比规范管…     

系统化整体护理模式的实施与专业护士培训的意义

系统化整体护理专业人员的培训、模式病房的建设、新护理模式的实施逐步展开。模式病房实施和运行过程中,护理管理者和护理工作者观念更新不快,管理经验不足,护理知识面狭窄,加之护理人员缺编,是目前亟待解决的问题。系统化整体护理模式病房的建设为系统化整体护理工作提供了有利条件,系统化整体护理的最终目标不仅仅是建立模式病房,更重要的是普及系统化整体护理病房。系统化整体护理个体化病房的建设是今后护理学科发展的方向。     

《预防医学情报杂志》征订启事

随着医学模式的转变，早在90年代中期护理界就提出了“系统化整体护理”这一现代护理模式，现在很多二、三级医院也都基本上全面实施。我院于1997年9月在二个病房试点，随之很快在全院全面展开。几年来。随着不断的探索、实践、总结，护理工作确实得到了很大改观，使“整体护理”这一新模式完全得到了人们的认可，特别是护理队伍思想观念、护理理念的转变，使护理工作跃上了一个崭新的台阶，护理工作得到了病人、病人家属、医生以及护士自己的全面肯定。为了能给基层医院的护理同仁们一点启示，现将这几年的经验教训总结如下：     

全面提高护理人员素质是实行整体护理的关键

我国的护理模式,正逐步从以疾病为中心向以病人为中心的方向转变。实行系统化整体护理,是深化改革临床护理工作,与国际护理接轨的必由之路。在各级医院建立整体护理模式病房,最终实现整体护理,是护理事业发展的必然趋势。系统化整体护理要求护士除了执行医嘱外,还要根据护理诊断,按护理程     

新生儿病房整体护理实践初探

我院通过半年的充分准备和筹划,于1999年3月份率先在新生儿病房试行实施整体护理,建立了适合新生儿特点的模式病房。通过半年多的运行,已初建成效。现将情况报告如下。1 转变观念,提高认识过去的护理模式只是以疾病为中心,护士整天围着医嘱和常规转,忽略了心理社会因素对疾病的影响以及人与环境的相互影响。实施系统化整体护理强调以病人为中心,把病     

儿科创建整体护理模式病房的体会

我科创建模式病房,开展系统化整体护理工作半年多来,无论是护理质量,还是病人的满意度都有了很大的提高,并收到了很好的社会效益和经济效益。现将体会介绍如下。1 全员动员,更新观念,学习有关系统化整体护理的理论知识。在创建模式病房的准备阶段,护理部主任及护士长多次组织全科护士进行更新观念的强化教育,使大家在思想上有个清楚的认识,开展系统化     

Cholera in Haiti and other Caribbean regions, 19th century

Medical journals and other sources do not show evidence that cholera occurred in Haiti before 2010, despite the devastating effect of this disease in the Caribbean region in the 19th century. Cholera occurred in Cuba in 1833-1834; in Jamaica, Cuba, Puerto Rico, St. Thomas, St. Lucia, St. Kitts, Nevis, Trinidad, the Bahamas, St. Vincent, Granada, Anguilla, St. John, Tortola, the Turks and Caicos, the Grenadines (Carriacou and Petite Martinique), and possibly Antigua in 1850-1856; and in Guadeloupe, Cuba, St. Thomas, the Dominican Republic, Dominica, Martinique, and Marie Galante in 1865-1872. Conditions associated with slavery and colonial military control were absent in independent Haiti. Clustered populations, regular influx of new persons, and close quarters of barracks living contributed to spread of cholera in other Caribbean locations. We provide historical accounts of the presence and spread of cholera epidemics in Caribbean islands.     

Interdisciplinary health professional education: a historical review

A historical review was conducted to examine the advances made, nationally and internationally, in interdisciplinary health professional education since the mid-1960s. One hundred and nineteen articles were reviewed and divided by decade into the following subheadings: models, courses, communication/group process issues, and international perspectives. Twenty-seven articles, categorized as models, defined the conceptual field, described curriculum and program development, or provided a framework for evaluation.Thirty-two articles dealt with interdisciplinary courses, focusing on objectives, content areas, or innovative methods. Nine articles contributed contenton interdisciplinary communication and group process issues, from which guidelines were abstracted. Fifty-one articles contributed an international perspective, leading to the recognition that interdisciplinary health professional education, practice, and research is a global movement.This revised version was published online in October 2005 with corrections to the Cover Date.     

Major and trace element compositions of the UICC standard asbestos samples

Major and trace element compositions for chrysotile (2 samples), amosite, crocidolite, and anthophyllite UICC standard asbestos samples have been determined using UV-visible spectrophotometry, atomic absorption spectometry, flame photometry, volumetric analysis, and gravimetric analysis for major elements and x-ray and optical spectrometry for trace elements. The trace element data are for Li, S, Cl, Sc, V, Cr, Co, Ni, Cu, Zn, Ga, Rb, Sr, Zr, Nb, Ba, La, Ce, Pb, and Th and distribution in the various mineral phases is discussed. Am. J. Ind. Med. 32:592–594, 1997. © 1997 Wiley-Liss, Inc.     

Religious and ethnic differences in health: evidence from the Health Surveys for England 1999 and 2004

Objectives. To examine the role of religion in the patterning of health inequities, and how this is related to ethnicity and socioeconomic status.

Design. Multivariate analyses using nationally representative data on self-assessed fair or poor health, longstanding limiting illness, diagnosed diabetes, diagnosed hypertension, waist–hip ratio, body mass index, current tobacco use and participating in no regular physical activity from 14,924 Christians, 4337 Muslims, 656 Sikhs, 1197 Hindus and 2682 people reporting not identifying with any religion with different ethnic backgrounds, who were interviewed as part of the Health Survey for England in either 1999 or 2004, adjusted for age, gender and socioeconomic status and periodicity.

Results. Odds ratios for general health, hypertension, diabetes, waist–hip ratio, tobacco use and physical activity speak to the importance of ethnicity in the patterning of health inequalities. But there is also evidence of an important, independent role for religion, with risks for the different health indicators varying between people with the same ethnic, but different religious, identifications. Adjusting for socioeconomic status attenuated the ethnic/religious patterning of, particularly, self-assessed health, longstanding activity-limiting illness, waist–hip ratio, body mass index and tobacco use.

Conclusions. This evidence enables greater understanding of the complexities of the relationship between ethnicity, religion and health, recognising the need to understand the heterogeneity underlying both ethnic and religious group membership and the processes producing the structural disadvantage facing certain religious and ethnic groups in the mediation of the relationship between health and ethnicity/religion.     

Workshop report: Nucleic acid delivery devices for HIV vaccines: Workshop proceedings,National Institute of Allergy and Infectious Diseases,Bethesda, Maryland,USA, May 21, 2015

On May 21st, 2015, the U.S. National Institute of Allergy and Infectious Diseases (NIAID) convened a workshop on delivery devices for nucleic acid (NA) as vaccines in order to review the landscape of past and future technologies for administering NA (e.g., DNA, RNA, etc.) as antigen into target tissues of animal models and humans. Its focus was on current and future applications for preventing and treating human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) disease, among other infectious-disease priorities. Meeting participants presented the results and experience of representative clinical trials of NA vaccines using a variety of alternative delivery devices, as well as a broader group of methods studied in animal models and at bench top, to improve upon the performance and/or avoid the drawbacks of conventional needle-syringe (N–S) delivery. The subjects described and discussed included (1) delivery targeted into oral, cutaneous/intradermal, nasal, upper and lower respiratory, and intramuscular tissues; (2) devices and techniques for jet injection, solid, hollow, and dissolving microneedles, patches for topical passive diffusion or iontophoresis, electroporation, thermal microporation, nasal sprayers, aerosol upper-respiratory and pulmonary inhalation, stratum-corneum ablation by ultrasound, chemicals, and mechanical abrasion, and kinetic/ballistic delivery; (3) antigens, adjuvants, and carriers such as DNA, messenger RNA, synthesized plasmids, chemokines, wet and dry aerosols, and pollen-grain and microparticle vectors; and (4) the clinical experience and humoral, cellular, and cytokine immune responses observed for many of these target tissues, technologies, constructs, and carriers. This report summarizes the presentations and discussions from the workshop (https://web.archive.org/web/20160228112310/https://www.blsmeetings.net/NucleicAcidDeliveryDevices/), which was webcast live in its entirety and archived online (http://videocast.nih.gov/summary.asp?live=16059).     

250例海洛因依赖者HIV、HPV、HSV-2、TP感染调查分析

目的 了解海洛因依赖者人类免疫缺陷病毒（HIV）、尖锐湿疣（HPV）、单纯疱疹病毒（HSV-2）、梅毒螺旋体（TP）感染情况.方法 HIV初筛用ELISA法,阳性标本采用免疫印迹法,HPV和HSV-2采用金标免疫斑点法,TP用ELISA法.结果 海洛因依赖者感染HIV、HPV、HSV-2、TP分别占2.8%、13.2%、14%、10.4%.非海洛因依赖者感染HIV、HPV、HSV-2、TP分别占0%、1.0%、2.0%、3.0%.海洛因依赖者与非海洛因依赖者各病原微生物感染情况相比,均有显著性差异.结论 由于海络因依赖者无菌意识淡薄,有共用注射器行为及性乱史,感染HIV、HPV、HSV-2、TP的机率比其他人群高.     

Blood concentrations of methionine, selenium, beta-carotene, and other micronutrients in a case-control study of arsenic-induced skin lesions in West Bengal, India

Previous studies have suggested that susceptibility to arsenic toxicity could be influenced by micronutrients, in particular selenium, methionine, and beta-carotene. A case-control study was conducted in West Bengal, India, in a region known to have groundwater arsenic contamination, to determine whether differences in micronutrient status contribute to susceptibility to arsenic-induced skin lesions. Micronutrient status was assessed by blood levels of specific micronutrients and metabolic indicators. Blood was obtained from 180 cases with skin lesions and 192 controls. Blood assays measured micronutrients and carotenoids (folate, selenium, vitamin B12, vitamin B6, retinol, alpha-tocopherol, lutein/zeaxanthin, beta-carotene, lycopene, beta-cryptoxanthin) and metabolic indicators such as glucose, cholesterol, transthyretin, amino acids, and proteins potentially associated with methylation (cysteine, homocysteine, methionine, glutathione). The distributions of nutrient concentrations were similar in cases and controls. The median selenium concentrations in cases and controls were both 1.15 micromol/L, and there was little evidence of differences in other micronutrients. Odds ratios (ORs) for arsenic-induced skin lesions were estimated for each quartile of nutrient concentrations, using the quartile with the highest nutrient level as the referent group. There were no clear trends associated with deficiencies of any micronutrient or metabolic indicator. For decreasing quartiles of selenium, the OR estimates were 1.00, 0.67, 0.99, 0.80; P=0.81; for methionine, the OR estimates were 1.00, 0.83, 0.78, 0.72; P=0.29. For beta-carotene, the ORs were 1.00, 0.53, 0.51, 0.96, demonstrating no increased risk at the lower quartiles. The measured micronutrients and metabolic indicators investigated do not appear to modify the risk of developing arsenic-induced skin lesions. The lack of any trend of increasing risk with lower selenium, vitamin E, and beta-carotene concentrations has important implications for proposed therapeutic interventions. The emphasis of interventions should be on reducing arsenic exposure.     

Evidence-Based Recommendations for an Optimal Prenatal Supplement for Women in the U.S., Part Two: Minerals

The levels of many essential minerals decrease during pregnancy if un-supplemented, including calcium, iron, magnesium, selenium, zinc, and possibly chromium and iodine. Sub-optimal intake of minerals from preconception through pregnancy increases the risk of many pregnancy complications and infant health problems. In the U.S., dietary intake of minerals is often below the Recommended Dietary Allowance (RDA), especially for iodine and magnesium, and 28% of women develop iron deficiency anemia during their third trimester. The goal of this paper is to propose evidence-based recommendations for the optimal level of prenatal supplementation for each mineral for most women in the United States. Overall, the evidence suggests that optimal mineral supplementation can significantly reduce a wide range of pregnancy complications (including anemia, gestational hypertension, gestational diabetes, hyperthyroidism, miscarriage, and pre-eclampsia) and infant health problems (including anemia, asthma/wheeze, autism, cerebral palsy, hypothyroidism, intellectual disability, low birth weight, neural tube defects, preterm birth, rickets, and wheeze). An evaluation of 180 commercial prenatal supplements found that they varied widely in mineral content, often contained only a subset of essential minerals, and the levels were often below our recommendations. Therefore, there is a need to establish recommendations on the optimal level of mineral supplementation during pregnancy.     

Dynamics of cholera outbreaks in Great Lakes region of Africa, 1978-2008

Cholera outbreaks have occurred in Burundi, Rwanda, Democratic Republic of Congo, Tanzania, Uganda, and Kenya almost every year since 1977-1978, when the disease emerged in these countries. We used a multiscale, geographic information system-based approach to assess the link between cholera outbreaks, climate, and environmental variables. We performed time-series analyses and field investigations in the main affected areas. Results showed that cholera greatly increased during El Nino warm events (abnormally warm El Ninos) but decreased or remained stable between these events. Most epidemics occurred in a few hotspots in lakeside areas, where the weekly incidence of cholera varied by season, rainfall, fluctuations of plankton, and fishing activities. During lull periods, persistence of cholera was explained by outbreak dynamics, which suggested a metapopulation pattern, and by endemic foci around the lakes. These links between cholera outbreaks, climate, and lake environments need additional, multidisciplinary study.     

Self-efficacy and health behaviors toward the prevention of diabetes among high risk individuals living in appalachia

Recent clinical trials indicate that type 2 diabetes can largely be prevented through lifestyle factors. In order to identify important modalities for the prevention of diabetes in medically underserved counties of Virginia (Appalachia), a questionnaire was administered to 135 at-risk individuals, having reported at least one risk factor for diabetes. The questionnaire assessed attitudes, self-efficacy, diet, and physical activity toward the prevention of type 2 diabetes. Overall, none of the respondents reported being told by a physician that they were at risk for diabetes. Overweight was the most frequently reported risk factor (87.0%), followed by physical inactivity (67.3%). More than one-third (38.9%) reported at least three diabetes symptoms. When stratified by low and high risk level, there were no significant differences in self-efficacy, control, and healthy dietary behaviors (p < .05). High risk individuals did report having lower rates of full health insurance coverage, being less active and running out of food more frequently than low risk individuals, however. The findings suggest that cost-effective prevention efforts should incorporate physician education, include screenings, and address self-efficacy enhancing strategies toward preventing type 2 diabetes. Elena Serrano, Department of Human Nutrition, Foods, and Exercise, Virginia Tech 201 Wallace Annex Blacksburg, VA 24061-0430, USA; Jennifer Leiferman, Rocky Mountain Prevention Research Center, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Box C-245, Denver, CO 80262, USA; Sarah Dauber, Center for Pediatric Research, Eastern Virginia Medical School, Norfolk, VA, USA. Requests for reprints should be addressed to Elena Serrano, PhD, Department of Human Nutrition, Foods, and Exercise, Virginia Tech 201 Wallace Annex Blacksburg, VA 24061-0430, USA;e-mail: serrano@vt.edu