延续护理干预对慢性乙型肝炎患者抗病毒治疗依从性的影响

目的:探讨延续护理干预对提高慢性乙型肝炎患者院外抗病毒治疗依从性的效果.方法:选取我院慢性乙型肝炎患者90例列为观察,根据随机化分组原则分为对照组(45例)和观察组(45例),对照组患者出院时给予出院常规指导,观察组患者出院时实施延续护理干预,出院3个月后统计分析两组患者出院后抗病毒治疗的依从性优良率.结果:经统计显示,观察组患者在院外抗病毒治疗依从性优良率为95.56％(43/45)明显优于对照组的73.33％(33/45),P＜0.05.结论:慢性乙型肝炎患者院外抗病毒治疗应用延续护理干预对提高依从性效果显著,值得推广应用.     

个性化延续护理在老年脑卒中出院患者跌倒预防中的应用效果

目的探讨个性化延续护理在老年脑卒中出院患者跌倒预防中的应用效果。方法选取2017年1月至2018年1月我院的102例老年脑卒中出院患者,随机分为观察组和对照组,各51例。对照组实施常规出院指导,观察组采用个性化延续护理。对比两组患者的跌倒发生率、护理依从性和健康状况评分。结果观察组的跌倒发生率为9.80%,低于对照组的27.45%(P<0.05)。观察组出院6个月、12个月的护理依从性评分优于对照组(P<0.05)。出院12个月,观察组的健康状况评分明显优于对照组(P<0.05)。结论个性化延续护理能够有效降低老年脑卒中出院患者的跌倒发生率,提高其护理依从性,改善其健康状况。     

微信随访式延伸性护理对慢性乙肝患者服用抗病毒药物依从性的影响

目的:分析微信随访式延伸性护理对慢性乙肝患者服用抗病毒药物依从性的影响。方法:将2017年5月～2018年5月出院的200例慢性乙肝患者作为研究对象,采取随机分组的形式将其分为两组,一组为对照组实施常规护理,一组为实验组实施微信随访式延伸性护理,对护理效果进行分析。结果:①在护理前两组患者的治疗依从性没有差异,无统计学意义(P>0.05);护理后实验组患者治疗依从性明显优于对照组患者,具有差异(P<0.05);两组患者护理后依从性均优于护理前,具有差异(P<0.05)。②在护理后实验组患者生活质量评分均优于对照组患者,具有差异(P<0.05)。③在护理后实验组患者护理满意度98.0%高于对照组患者护理满意度88.0%,具有差异(P<0.05)。结论:微信随访式延伸性护理有效的提高了慢性乙肝患者服用抗病毒药物依从性、生活质量与护理满意度,值得推广。     

延续护理对急性心肌梗死出院患者服药及复诊依从性的影响研究

目的:研究与分析延续护理对急性心肌梗死出院患者服药及复诊依从性的影响。方法:将2016年1月-2017年12月期间本院住院治疗的120例急性心肌梗死患者随机分为对照组(常规急性心肌梗死护理组)60例与观察组(延续护理组)60例。比较两组出院后不同时间的服药及复诊依从性、患者及家属对护理的满意度。结果:出院后1个月及3个月观察组的服药及复诊依从性高于对照组,患者及家属对护理的满意度也高于对照组(P0.05)。结论:延续护理有助于改善急性心肌梗死出院患者服药及复诊依从性,更受患者及家属的认可,临床应用价值较高。     

应用微信对高血压出院患者行延续护理的效果

目的:探讨应用微信对高血压出院患者行延续护理的结果方法:选择2015年1月-2016年1月高血压患者治疗后血压平稳出院的1 10患者为研究对象,随机分为试验组和对照组,两组患者在治疗期间均进行常规的健康宣教指导,出院后对照组按照常规进行随访,试验组患者则加入微信群,此群定期向患者发送疾病相关健康教育知识与信息,通过互动给予个性化干预,于出院后6个月进行再评估.结果:两组一般情况比较差异无统计学意义(P＞0.05).出院后6个月试验组患者对疾病相关知识掌握,服药依从性和主观幸福感均优于对照组,差异具有统计学意义(P＜0.05)结论:应用微信对高血压患者出院后行延续护理效果较好,值得推广.     

脑梗塞出院患者采用延续护理对其治疗依从性的影响

目的:探讨脑梗塞出院患者应用延续护理对其治疗依从性的影响。方法:选取我院2015年1月-2016年5月接收的脑梗塞患者140例,采用区组分组法分为对照组与观察组,对照组患者实施常规护理干预,观察组给予延续护理,对比两组患者出院后治疗依从性及再次住院率。结果:观察组饮食控制、运动治疗、药物治疗等依从性均好于对照组(P0.05);观察组再次住院率7.14%明显低于对照组30.00%(P0.05)。结论:脑梗塞出院患者采用延续护理其治疗依从性较好,且再次住院率低,具有一定应用价值。     

延续护理和品管圈活动对老年股骨粗隆骨折术后康复的影响

目的:探讨延续护理和品管圈活动对老年股骨粗隆骨折术后康复的影响.方法:将46例患者随机分成对照组和治疗组.对照组予常规骨科护理,治疗组采取品管圈活动指导下的延续护理.出院后第1周评价出院指导掌握情况,出院后第6个月评价对患者依从性、出院后患者恢复状况和心理状态情况.结果:①治疗组患者对功能锻炼、用药知识、辅助用具使用、饮食知识和复查内容等出院指导内容掌握情况明显优于对照组(P＜0.05);②两组患者均能按时服药,差异无统计学意义(P＞0.05),但治疗组在按时复诊、按时锻炼和健康饮食方面等依从性优于对照组(P＜0.05);③两组出院后第6个月焦虑和抑郁评分较术后第ld均明显好转(P＜0.05),且治疗组改善优于对照组(P＜0.05);④出院后第6个月,治疗组Barthel指数为(64.8±19.2),明显高于对照组的(52.6±17.6)(P＜0.05).结论:延续护理和品管圈活动能够提高患者对出院指导的掌握率,提高患者的依从性,改善患者焦虑抑郁等不良心理状态,从而提高患者康复效果.     

骨科患者出院后续护理网络干预

目的：观察网络信息支持对骨科疾病出院患者进行延续护理的干预效果。方法选取在骨科住院的120例疾病患者,随机分成两组,每组60例。网络支持组在常规出院健康宣教的基础上,由延续护理小组成员利用网络信息支持对出院患者进行出院后护理,对照组延用常规的出院教育。后续护理时间为3个月,比较两组患者的疼痛情况、服药及康复锻炼依从性。结果网络支持组患者3个月复查时,疼痛强度优于对照组（P＜0．05）;服药依从性得分为（5．39±1．58）分高于对照组（4．37±1．26）分,差异显著（P＜0．05）;康复依从性得分为（51．06±1．53）分高于对照组（32．68±1．82）分,差异显著（P＜0．05）。结论运用网络信息支持对骨科疾病患者进行出院后的延续护理效果较好,值得推广。     

延续护理对空巢脑出血康复期患者治疗依从性及生存质量的影响分析

目的 :分析延续护理对空巢脑出血康复期患者治疗依从性及生存质量的影响。方法 :选取2014年12月-2016年12月我院收治的空巢脑出血康复期患者55例作为观察对象,按照1:1比例分为对照组(27例)和研究组(28例),对照组实施常规家庭护理,研究组实施延续护理,比较两组治疗依从性和生存质量的差异。结果 :研究组出院时治疗依从性评分、Barthel评分与对照组间无差异(P0.05);出院6个月后两组以上指标相比,研究组均明显高于对照组(P0.05)。结论 :延续护理可显著提高空巢脑出血康复期患者治疗依从性,改善其生存质量,临床可将其作为首选护理方案积极推广。     

延续护理对院外支气管哮喘患者治疗依从性及生活质量的影响

目的评价延续护理对院外支气管哮喘患者治疗依从性及生活质量的影响。方法选取我院确诊为支气管哮喘的120例患者,随机分为干预组和对照组各60例,对照组采用一般护理,干预组在此基础上采用延续护理,比较两组患者出院前1天及出院后6个月的服药依从性、哮喘控制情况(ACT)以及生命质量。结果干预前两组患者服药依从性、ACT、生命质量得分均无显著差异(P>0.05)。干预后干预组患者的用药依从性、ACT得分、生命质量得分均显著优于对照组,差异具有统计学意义(P<0.05)。结论在支气管哮喘管理中实行延续护理可提高患者用药依从性,改善患者的生活质量,促进症状的控制。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.