Clinical and prognostic properties of standardized and functional aphasia assessments.

OBJECTIVE: To compare standardized and functional aphasia tests in patients after acute stroke. DESIGN: Data were collected at baseline and at 6 months in 2 prospective single-centre studies: one observational study (study I, n=119) and one randomized trial of moclobemide vs placebo (study II, n=89). SUBJECTS: Patients with aphasia after acute stroke. METHODS: Degree of aphasia was examined using the Coefficient (Coeff) in Norsk Grunntest for Afasi (standardized) and the Amsterdam-Nijmegen Everyday Language Test (ANELT) (functional). Statistical comparisons were made using one-way analysis of variance and multivariate regression analyses. RESULTS: The degree of aphasia measured with Coeff and ANELT correlated closely throughout the study (r2=0.71-0.87, p<0.0001). In study I, 24 patients recovered completely within 6 months. A Coeff >or= 49 and ANELT >or= 3.5 predicted complete recovery equally well. Coeff was sensitive to differentiate between patients with low values on ANELT, whereas ANELT was sensitive to differentiate between patients with high Coeff values. CONCLUSION: The 2 tests show a close and consistent correlation over time and are equally sensitive to improvement. They have a similar capacity to predict complete recovery. A standardized test appears to be more suitable for patients with aphasia in the acute stage, while a functional test is more suitable in the subacute/chronic stage.     

The cultural appropriateness and diagnostic usefulness of standardized language assessments for Indigenous Australian children

Abstract

Speech-language pathologists experience uncertainty about how to interpret standardized assessment results for Indigenous Australian children. There are risks for inappropriate diagnosis: both over- and under-diagnosis of language impairment may occur due to a convergence of linguistic features which causes difficulty in distinguishing between impairment and difference. While the literature suggests that standardized assessments are inappropriate for Indigenous Australian children, there is an absence of empirical documentation to show how Indigenous children perform on standardized tests of language ability. This study examined the performance of 19 Indigenous Australian children, aged 8;01–13;08, from one school on the Clinical Evaluation of Language Fundamentals, Fourth Edition, Australian Standardized Edition. Standardized scores were compared with teacher ratings of children's oral language skills. Analysis showed poor alignment between teacher ratings and language assessment, and assessment scores were negatively influenced by features of Aboriginal English. Children rated with above average language skills presented with different linguistic profiles from the children rated with average and below average language abilities. The inappropriateness of current standardized language assessments for Indigenous children and the need for further research to guide appropriate assessment are discussed.     

Effects of gender on irritable bowel syndrome

Irritable bowel syndrome (IBS) is one of the most common functional bowel disorders, with prevalence between 10% and 15%, which predominates in female. Two-thirds of IBS patients are female, and the prevalence of condition range from 14% to 24%. In addition to sex hormone, the other factors, i.e.) visceral perception, autonomic nervous system and pharmacological treatment response, are associated with gender differences in IBS. Recent studies indicate that pain thresholds to visceral stimulation are lower in females with IBS compared with males with IBS. It is also indicated that males with IBS have greater sympathovagal balance in response to visceral stimulation. Further elucidation of gender differences in IBS may contribute to treatment of IBS.     

Effects of gender and age on paediatric headache

The aim of this study was to evaluate the impact of gender and age on headache characteristics and disability. Headache characteristics were assessed at an initial visit to a paediatric specialty care centre and five follow-up visits. A total number of 4121 patients were evaluated. Fifty-eight per cent of the sample was female. Boys were younger at their first headache and initial visit. They more frequently described headache pain as squeezing and location as top of the head. Girls reported more frequent and longer headaches. Girls more often described headache pain as sharp and location as back of the head. Age accounted for more variance than gender in headache severity, duration, frequency and disability. Gender differences exist in headache characteristics. Age is also an important factor in the variability in characteristics and disability. Longitudinal studies are needed to describe further the natural history of headaches in childhood and compare outcome between genders.     

孕期规范化诊疗和管理对双胎妊娠结局的影响分析

目的 探讨双胎妊娠孕期规范化诊疗和管理对妊娠结局的影响。方法 回顾性分析2015年1月至2018年1月在民勤县中医院进行早孕建档的61例双胎妊娠孕妇的临床资料。比较分析孕期给予常规检查（A组）与规范化诊疗和管理（B组）对孕妇的分娩方式及并发症发生、围产儿结局和并发症发生的影响。结果 A组31例,B组30例。B组孕妇的剖宫产率和早产率低于A组（P＜0.05）,流产、妊娠高血压、糖耐量异常和贫血的发生率两组差异无统计学意义（P＞0.05）;B组围产儿生长受限发生率低于A组（P＜0.05）,但新生儿死亡、新生儿窒息、低体重儿、双胎输血和胎儿畸形两组差异无统计学意义（P＞0.05）;B组的母婴同室率、1 min和5 min Apgar评分高于A组,入NICU率低于A组（均P＜0.05）。结论 双胎妊娠孕期实施规范化诊疗和管理可显著降低剖宫产率和早产率,且可降低胎儿的生长受限发生率,提高母婴同室率和1 min、5 min Apgar评分,显著改善双胎妊娠的母儿结局。     

标准化营养干预对代谢综合征影响的研究

<正>随着经济发展和生活方式改变,代谢综合征(metabolic syndrome,MS)的患病率增高,我国的MS的患病率为14%～16%,且MS患者发生心血管事件的风险比无MS患者显著增高,主要临床结局是糖尿病和冠心病,应及早防治[1]。     

Effects of communication training on real practice performance: a role-play module versus a standardized patient module

This study investigated the effectiveness of modules involving standardized patients and role-plays on training communication skills. The first module involved standardized patients and an Objective Structured Clinical Examination (OSCE); the second module consisted of peer role-plays and a written examination. A randomized posttest-only control group design with first-year nursing students was used. The intervention group received one-to-one communication training with direct oral feedback from the standardized patient. The control group had training with peer role-playing and mutual feedback. The posttest involved students' rating their self-efficacy, and real patients and clinical supervisors evaluated their communication skills. No significant differences were found between self-efficacy and patient ratings. However, the clinical supervisors rated the intervention group's communication skills to be significantly (p < 0.0001) superior. Assessments by clinical supervisors indicate that communication training modules including standardized patients and an OSCE are superior to communication training modules with peer role-playing.     

Effects of gender on stress ulcer formation in rats

In the experimental stress literature, the results of investigations have not shown a specific sex-dependent vulnerability to stress ulceration. The aim of this study was to evaluate the importance of sex differences on stress ulcer development. Related to gender, the contributing factors for stress ulcer production such as luminal acidity, sialic acid as an marker of gastric mucosal protection, oxygen (O2)-derived free radicals and endogenous antioxidant defence mechanisms were also investigated. Fifty Wistar Albino rats weighing about 230 g and aged 7 or 8 months were divided equally into five groups: Group I normal male rats, group II castrated male rats, group III normal female rats in estrus phase, group IV normal female rats in diestrus phase and group V castrated female rats. Cold restraint model was used for 6 hours to produce stress ulcer. No statistically significant difference was found out between groups in view of gross and histopathologic damage. There was no significant difference between groups according to gastric luminal acidity, gastric mucosal sialic acid, gastric malonaldehyde (MDA) and catalase values. Gastric superoxide dismutase (SOD) activity was significantly lower in Group I in comparison to those of Group III and IV. Sex differences do not interfere stress ulcer formation. SOD activity in rat gastric tissue has varied significantly by hormonal milieu.     

规范化病区管理对预防压疮发生的作用

目的通过规范化管理,减少压疮发生。方法规范全体护理人员压疮防护知识,强调病人皮肤的评估及评估后处理,规范交接班管理,严格奖惩制度,规范护理文件书写记录。结果经过规范化管理,明显降低了压疮发生率。结论进行规范化培训,提高预防意识是防止压疮发生的有力保证;重视皮肤交接班管理,是预防压疮发生的有效手段;严格奖惩制度,有利于团体成员提高压疮防护的积极性;及时的护理记录可作为一种法律依据,维护护士自身权益。通过以上规范化管理,可以有效防止压疮发生。     

规范化病区管理对预防压疮发生的作用

目的 通过规范化管理,减少压疮发生.方法 规范全体护理人员压疮防护知识,强调病人皮肤的评估及评估后处理,规范交接班管理,严格奖惩制度,规范护理文件书写记录.结果 经过规范化管理,明显降低了压疮发生率.结论 进行规范化培训,提高预防意识是防止压疮发生的有力保证;重视皮肤交接班管理,是预防压疮发生的有效手段;严格奖惩制度,有利于团体成员提高压疮防护的积极性;及时的护理记录可作为一种法律依据,维护护士自身权益.通过以上规范化管理,可以有效防止压疮发生.     

新入职护士安全文化培训及效果研究

目的 探讨在新入职护士规范化培训中开展安全文化课程的效果。方法 选取安徽省某三级甲等医院2015年、2016年186名新入职护士进行安全文化课程培训。培训内容包括患者安全文化、护理事件报告与处理、护理风险评估与处理、沟通与安全防护、临床求助能力、心理调适,共6个主题。培训集中理论授课,分组实践,并引入主题演讲、情景模拟、体验教学、小组反思讨论和临床实训演练等互动方式进行规范化培训。应用医院患者安全文化调查表、安全态度调查问卷、自我评价表及反思日记对新入职护士患者安全文化感知培训效果进行评价。结果 培训后,新入职护士医院患者安全文化平均同意率为68.56%,仍未达到优势区域;医院患者安全文化6个维度同意率较培 训前提高（P<0.001）。安全态度调查问卷各维度得分均高于培训前,差异有统计学意义（P<0.001）。自我评价表和反思日记分析显示, 安全文化课程培训提高了新入职护士的学习兴趣和学习迁移能力。结论 安全文化课程培训能有效提高新入职护士患者安全文化感知水平,促进其形成积极的安全意识,规范安全行为,构建医院安全文化氛围,保障患者安全。     

规范化新生儿输液外渗管理模式的临床应用及效果观察

目的 探讨规范化输液外渗管理模式在新生儿输液外渗防治中的应用与效果.方法 建立规范化药物静脉外渗管理体系及快速有效的跟踪处理系统,成立输液外渗管理小组,建立输液外渗评估及告知模式,规范操作流程及输液外渗后的规范化处理、报告及跟踪流程.结果 观察组患儿输液外渗的发生率及发生程度低于对照组,差异具有统计学意义(P<0.01...     

Effects of age and gender on pharmacokinetics of cefepime.

The effects of age and gender on the pharmacokinetics of cefepime were examined in 48 volunteers following administration of a single 1,000-mg intravenous dose. Male and female subjects were divided into four groups, each consisting of 12 subjects, according to their age and gender. The young subjects were between 20 and 40 years of age and elderly subjects were between 65 and 81 years of age. Serial blood and urine samples were collected from each subject and were analyzed for cefepime by validated high-pressure liquid chromatographic assays with UV detection. Key pharmacokinetic parameters were calculated by noncompartmental methods. There were no gender-related differences in elimination half-life (t1/2) and weight-normalized total body clearance (CLT), renal clearance (CLR), and steady-state volume of distribution (Vss). Statistically significant age-related effects were found for t1/2, CLT, CLR, and Vss parameters. In different study groups, Vss ranged from 0.21 to 0.24 liter/kg. The values for Vss were significant greater for elderly subjects than they were for young subjects. The cefepime t1/2 was significantly longer in elderly subjects (about 3 h) than that observed in young subjects (about 2.2 h). The mean values for CLT and CLR in the four study groups ranged from 1.11 to 1.56 and 0.99 to 1.44 ml/min/kg, respectively. In elderly subjects, the estimates for CLT and CLR were significantly lower than those observed in young subjects. Linear regression revealed good correlations between clearance values of cefepime and creatinine. The magnitude of age-related changes in the pharmacokinetics of cefepime is not significant enough to recommend dosage adjustment in elderly patients with kidney functions normal for their age.     

Disability assessments: Effects of response mode and experience

Purpose.?To what extent response mode and experience affect the assessment of disability was investigated.

Method.?An experiment was conducted in which 34 medical doctors (17 inexperienced and 15 experienced) were required to assess disability of a videotaped client. Participants either gave a probability assessment after each piece of information or only after all information had been processed (step-by-step, SBS, or end-of-sequence, EOS). They were furthermore required to indicate how confident they were of their judgement and which information was most important for their judgement.

Results.?Neither response mode nor experience affected the assessment of disability. Only experienced doctors changed their judgement after seeing the video as compared to their judgement after reading the file. Even though all doctors became more confident after seeing the video, this increase was stronger for experienced than inexperienced doctors. Experienced doctors more often mentioned limitations as the basis for their judgements and, to a lesser degree, client's motivation to return to work than inexperienced doctors.

Conclusions.?The results suggest that assessments of disability are largely based on the initial representation that is formed after reading the file. The main pitfall is that the final representation is based on general beliefs rather than on actual client information. For training and support this would mean that doctors should be made aware of the extent to which their assessment is anchored in the case at hand.     

规范化培训对低年资护士执业能力的影响

目的探讨规范化培训对低年资护士执业能力的影响。方法通过对178名低年资护士培训需求的调查分析,制订培训计划,确立培训目标,制订考核量表,实施规范化培训,比较培训前后护士的执业能力。结果规范化培训后,护士在理论知识、专业技术水平、护理观察能力、健康教育能力、应急能力、感染防护能力、规避纠纷能力7个方面得分较培训前提高,差异具有统计学意义(P0.01)。结论规范化培训是提高护士执业能力的有效途径。     

鼻内镜下鼻窦术后出院患者实施规范化延续护理的效果

目的：探讨对鼻内镜下鼻窦术后出院患者实施规范化延续护理的效果。方法选取2012年1月-2013年1月收治的鼻内镜下鼻窦炎鼻息肉手术患者80例,按照随机数字分组法分为观察组和对照组各40例,对照组采取常规护理及出院指导,观察组给予规范化延续护理措施,比较两组干预效果。结果观察组治疗有效率为97．5％,对照组为85．0％,两组比较差异有统计学意义（χ2＝2．23,P＜0.05）。观察组发生鼻腔粘连2例,发生率为5．0％;对照组发生鼻腔粘连6例,上颌窦口狭窄1例,眶内出血1例,并发症发生率为20．0％,两组比较差异有统计学意义（χ2＝3．45,P＜0．05）。结论对鼻内镜下鼻窦术后出院患者实施规范化延续护理可有效提高患者治疗有效率,减少并发症发生,值得临床推广应用。     

Effects of gender on blood flow correlates of naming concrete entities

A cross-cohort PET analysis was performed in 62 normal subjects (31 men and 31 women) to address the issue of whether men and women have different physiologic correlates of naming visually presented concrete entities. The subjects named nonunique concrete entities in one or more conceptual categories and also performed a face orientation decision task. A second analysis was performed in 24 additional subjects to assess whether there were gender effects related to the face orientation decision task and to constrain the interpretation of the first analysis. Male subjects engaged the left inferotemporal region and several other left hemisphere regions more than female subjects did during visual naming. Areas showing more activity in female subjects included the right inferior frontal gyrus and right precentral cortex, regions that were less active in visual naming than in the face orientation decision task. In other words, the male subjects engaged the latter regions less or deactivated them more than female subjects. The results can be interpreted as showing a greater modulation of activity in both hemispheres for men compared to women. Although the gender effects we found are smaller than the task effects, they are not negligible for the purposes of performing and interpreting functional imaging studies.     

北京市属医院护士规范化培训效果评价

目的 :探讨北京市属医院护士进行规范化培训的效果,以期为规范化培养方案的修订及深入开展提供依据。方法:选取4家北京市属三级甲等综合医院,采用整群抽样法抽取这4家医院2013年新入职护士进行一年的规范化培训,通过问卷调查法对培训效果进行评价。结果 :规范化培训一年后,调查对象的核心能力总分为(80.89±11.42)分,高于培训前的总分(77.97±11.27),差异有统计学意义(P0.05)。中专、大专学历的调查对象在培训前后核心能力总得分无统计学差异。本科及以上学历的调查对象,培训后核心能力总得分有所提高(P0.05)。结论 :规范化培训对提升护士的核心能力有积极作用,但是培训效果可能需要一段较长的时间才能完全显现。     

Effects of traumatic events, social support, and self-efficacy on adolescents' self-health assessments

The purpose of this study was to examine the relationship between adolescents' exposure to traumatic events and their self-health assessments, and to examine the protective effects of social support and self-efficacy on this relationship. Survey results (N = 1,427) indicated that experiencing violent and nonviolent negative life events and being exposed to a disaster were inversely associated with adolescents' positive health assessments. As social support and self-efficacy decreased, adolescents' health assessments worsened. Female and Black adolescents had less favorable health assessments than their male and White counterparts. Findings suggest that traumatic events are predictive of adolescents' health assessments and that social support and self-efficacy prevent adolescents' health assessments from declining following traumatic events.