Mental health, pregnancy and self-rated health in antenatal women attending primary health clinics

The purpose of this study was to study the determinants of self rated health in the low-risk pregnant women of Melaka Tengah in Malaysia. A total of 387 subjects were analysed. The role of mental health, psychosocial stressors, support from husband, coping skills, socio-economic status and pregnancy characteristics in determining self- rated health were studied. Health items were taken from the Duke Health Profile. Bad obstetric history, poor mental health, stress from the family were found to be significantly associated with poor self - rated health whereas good support from the husband was related to good self - rated health.     

Self-monitoring of blood glucose among diabetes patients attending government health clinics

The aims of this study were (i) to determine the prevalence of self-monitoring of blood glucose (SMBG) among Type 2 diabetes patients attending government health clinics and (ii) to ascertain the factors influencing SMBG. Five hundred and fifty-six Type 2 diabetes patients from two government health clinics in Selangor and Negeri Sembilan were interviewed using a structured questionnaire. The total subjects of the study were 556 patients. Eighty-five patients (15.3%) of patients; performed SMBG. However, 170 subjects were included in the statistical analysis, 85 patients who were not self-monitoring were randomly selected and was compared with 85 patients who were self-monitoring. Among those who performed SMBG, the majority (83.5%) monitored less than once per day and only 16.5% monitored at least once a day. One-third of patients adjusted their medications based on their SMBG results. The higher patient's level of education (p= 0.024, CI 1.29 - 35.3); the higher total family income (p= 0.041, CI 1.26 - 4.79); the longer duration of diabetes (p<0.01, CI 2.22 - 7.29); and treatment regime which includes insulin (p< 0.001, CI 2.05 -9.24) were significant predictors of SMBG practice. Although SMBG is recognised to be useful and effective in achieving diabetes control, this study has found that only a minority of patients with diabetes performed SMBG. Hence healthcare personnel must increase awareness on the importance of SMBG and strongly promote the practice among diabetic patients.     

服务于社区医疗的智能诊疗系统开发研究

本文根据案例和规则推理的技术理论,利用物元的知识表示形式,构造出一种具有通用性的适合医学病例的表达方式。即物元思想与面向对象相结合的思想方法。并以一种医学病历为例介绍推理系统的设计流程。研究适用于社区医疗的医疗资源新途径,提高社区医务人员的医疗服务能力,改善我国社区卫生技术力量薄弱的现状。     

Frequency of symptoms of ovarian cancer in women presenting to primary care clinics

Context  Women with ovarian cancer frequently report symptoms prior to diagnosis, but distinguishing these symptoms from those that normally occur in women remains problematic. Objective  To compare the frequency, severity, and duration of symptoms between women with ovarian cancer and women presenting to primary care clinics. Design, Setting, and Patients  A prospective case-control study of women who visited 2 primary care clinics (N = 1709) and completed an anonymous survey of symptoms experienced over the past year (July 2001-January 2002). Severity of symptoms was rated on a 5-point scale, duration was recorded, and frequency was indicated as number of episodes per month. An identical survey was administered preoperatively to 128 women with a pelvic mass (84 benign and 44 malignant). Main Outcome Measures  Comparison of self-reported symptoms between ovarian cancer patients and women seeking care in primary care clinics. Results  In the clinic population, 72% of women had recurring symptoms with a median number of 2 symptoms. The most common were back pain (45%), fatigue (34%), bloating (27%), constipation (24%), abdominal pain (22%), and urinary symptoms (16%). Comparing ovarian cancer cases to clinic controls resulted in an odds ratio of 7.4 (95% confidence interval [CI], 3.8-14.2) for increased abdominal size; 3.6 (95% CI, 1.8-7.0) for bloating; 2.5 (95% CI, 1.3-4.8) for urinary urgency; and 2.2 (95% CI, 1.2-3.9) for pelvic pain. Women with malignant masses typically experienced symptoms 20 to 30 times per month and had significantly more symptoms of higher severity and more recent onset than women with benign masses or controls. The combination of bloating, increased abdominal size, and urinary symptoms was found in 43% of those with cancer but in only 8% of those presenting to primary care clinics. Conclusions  Symptoms that are more severe or frequent than expected and of recent onset warrant further diagnostic investigation because they are more likely to be associated with both benign and malignant ovarian masses.      

某县乡镇卫生院卫生人力资源配置公平性研究

目的：对某县乡镇卫生院卫生人力资源配置的公平性进行分析评价。方法首先采用卡方值方法对该县4个区的乡镇卫生院进行定性评价,然后采用基尼系数对卫生人员公平性进行定量评价。结果两种方法评价某县乡镇卫生院卫生人力资源配置均处于比较公平的状态,按人口分布的公平性优于按地理分布的公平性。结论卫生行政部门应该在保持公平性的基础上进行地区间的卫生人员优化配置。     

Reassessing mental health of women in Calcutta

The present author undertook a field survey in Calcutta on social stress and mental health covering its ten million people. The present article is a reassessment of mental health of women in Calcutta in comparison with the present impressionistic views.