高职护生护理人文关怀能力现状调查及分析

目的了解高职护生护理人文关怀能力现状,并对影响因素进行分析,为培养和提高护生护理人文关怀能力提供参考。方法选择我院三年制2016级护生118名、初中起点五年制2014级护生110名为调查对象,采用护理人文关怀能力量表进行调查。结果高职护生护理人文关怀能力量表得分为(115.69±15.54)分,其主要影响因素有学制、与父母的关系、与同学的关系、与家人打电话的频率以及是否热爱护理专业等。结论高职护生护理人文关怀能力处于较低水平,学校应分析相关影响因素,加强护理专业人文教育,提高护生护理人文关怀能力。     

本科男护生人文关怀能力现况及影响因素分析

目的调查本科男护生人文关怀能力现况并分析其影响因素。方法2019年10月至2020年1月,采用随机抽样法抽取山东省某高校本科男护生135人,利用人文关怀能力量表进行问卷调查。结果本科男护生人文关怀能力量表得分为(177.51±22.33)分,低于国内常模的(191.04±19.49)分,处于中等水平,其中认知维度得分为(74.33±14.39)分,勇气维度得分为(50.66±12.92)分,耐心维度得分为(52.53±7.81)分,耐心维度得分率最低。多元逐步回归分析显示,本科男护生人文关怀能力的影响因素主要为选择护理专业的原因、学校人文科学教育情况、人文关怀相关理论了解情况、感知学校的人文关怀氛围、感知见习或实习医院的人文关怀氛围、感知老师和同学的关心、感知学校的学习提升等。结论本科男护生人文关怀能力提升空间较大。护理教育者应重视本科男护生的人文关怀教育,因人制宜,因材施教,培养具有人文关怀能力、满足临床护理需求的护理专业人才。     

在护理管理学教学中融入人文关怀教育的实践研究

目的探索培养人文关怀能力的教育模式,推动护理人文教育质量发展,为培养具有较高人文关怀品质的应用型护理人才提供依据。方法采用护理人文教育模式,以本校医学院护理专业学生(共297人)为研究对象,在护理管理学课程中融入人文关怀能力的教育,以护生人文关怀品质问卷和教学反馈问卷评价其效果。结果护生的人文关怀品质总分干预后比干预前有所提高,但无显著性差异(P>0.05);干预后人文关怀能力和人文关怀感知维度得分较干预前有所提高,且有显著性差异(P<0.05)。99.7%的护生对人文关怀教学给予正性评价;55.6%的护生表示喜欢这种教学,17.8%的护生表示很喜欢这种教学。结论在护理管理学教学中融入人文关怀教育,得到护生的认可,但是护生人文关怀品质没有得到显著改变,仅在人文关怀能力和人文关怀感知方面有所突破。在接下来的教学中,有待进一步探索人文关怀能力培养方式,全面提升护生人文关怀品质。     

基于微课的护理人文关怀教学模式应用效果研究

目的为有效提高本科护生人文关怀能力,在基础护理学课程教学中应用基于微课的护理人文关怀教学模式,采用情境教学、叙事教学、成立关怀小组等策略。方法教学前后应用护士人文关怀品质调查问卷、关爱能力评价表对89名本科护生进行调查,并依据基础护理学实践考核中人文关怀部分成绩对护生人文关怀能力进行评价。结果各评价指标后测得分均高于前测,且差异具有显著性(P<0.05)。结论基于微课的护理人文关怀教学模式能有效提高护生人文关怀能力,在培养护生人文关怀素养方面发挥重要作用。     

在《急救护理》教学中对护生进行人文关怀能力培养的效果观察

目的：探讨在《急救护理》教学中对护生进行人文关怀能力培养的效果,为护生人文关怀能力培养教育提供参考依据。方法：将200名在我校就读的护生随机分为A组和B租,每组各100名护生,为A组护生在《急救护理》教学中进行人文关怀能力培养,为B组护生进行《急救护理》教学,对比分析两组护生的人文关怀能力。结果：与B组护生相比较, A组护生的人文关怀能力较强,差异显著（P<0．05）,有统计学意义。结论：在《急救护理》教学中对护生进行人文关怀能力培养对提高其人文关怀能力的效果显著,对护生人文素质修养的提高及其自身发展产生了积极的意义。     

本科护生人文关怀能力调查及相关因素分析

目的:了解本科护生人文关怀能力现状,分析其相关影响因素,为护理人文关怀教育提供依据。方法:采用人文关怀能力评价量表对3个年级480名本科护生进行便利整群抽样问卷调查。结果:护生人文关怀能力评分为180.31±23.60,护生年龄越小得分越高(P0.01);人文关怀能力自我评价较高者评分高于自我评价较低者(P0.01)。结论:部分本科护生的人文关怀能力仍需提高,学校应加强对护生的人文关怀引导和教育。     

内科护理教学中培养护生关怀能力的实践与评价

目的 分析内科护理教学中培养护生关怀能力的实践效果.方法 选取护生60名作为研究对象,随机将其均分为人文关怀教学组(观察组,n=30)与传统教学组(对照组,n=30),对2组教学结果 进行对比.结果 对照组护生教学前后关怀意识得分比较[(63.5±7.0)分vs(65.0±7.5)分],差异无统计学意义;观察组护生教学前后关怀意识得分比较[(63.2±6.8)分vs(70.0±8.0)分],差异有统计学意义(P<0.05);教学后观察组与对照组关怀意识得分差异有统计学意义[(65.0±7.5)分vs(70.0±8.0)分](P<0.05).结论 在内科护理教学中培养护生关怀能力,有助于护生深入了解护理人文关怀能力的意义,提高护生关怀意识.     

反思日记在护理高职生人文关怀能力培养中的应用

目的探索在护理教育中应用反思日记的方法,并验证反思日记在护生人文关怀能力培养中的应用效果。方法在高职护生教育中应用反思日记法,通过问卷调查验证其效果。结果课程结束后,两组护生的人文关怀能力S1、S2、S6、S8维度得分和总分比较,存在显著性差异(P<0.05);实验组护生在课程开始前与课程结束后人文关怀能力S1、S3、S4、S6、S7、S8维度得分和总分比较,存在显著性差异(P<0.05)。结论应用反思日记可以更好地培养护生的人文关怀能力。     

专升本护理新生临床综合能力现状及对高校教学的启示

目的：调查某市2021级护理专升本新生的临床综合能力,为深化专升本护理教学改革提供依据。方法：使用自编的一般信息调查问卷和护理本科生临床综合能力调查问卷,对某市2021级专升本护理新生192人进行问卷调查,并对结果进行统计学分析。结果：专升本护理新生临床综合能力各条目均分为(6.97±1.11)分,总体水平较低,其中10.42%的专升本护生临床综合能力完全达标,60.42%的专升本护生基本达标,29.17%的专升本护生不达标;临床综合能力各维度中得分最高的是临床管理能力,然后依次是职业心理素质、临床沟通能力、健康教育能力、临床处置能力、临床教学能力,得分最低的是临床科研能力。结论：专升本护理新生入学时临床综合能力水平较低,在本科阶段应重点加强临床科研能力、临床教学能力和临床处置能力培养,满足临床对综合型、应用型护理人才的需求。     

标准化病例在实习护生人文关怀能力测评的有效性

目的:评价标准化病例(SC)对实习护生人文关怀能力测评的有效性。方法:选取100名实习护生,随机分为甲、乙2组各50人。甲组采用SC测评,乙组采用国内学者编制的护理专业大学生人文关怀能力量表测评;再对护生所护理患者进行满意度调查。比较2组得分与患者满意度的符合程度,分析SC测评的有效性。结果:乙组问卷调查的健康教育、科学解决健康问题、协助满足基本需求评分均高于甲组SC测评得分(P<0.05);得分前15名和得分中20名护生中,乙组人文关怀能力SC总分均高于问卷自测的甲组(P<0.01),而2组得分后15名护生中人文关怀能力总分差异无统计学意义(P>0.05)。2组人文关怀能力评分前、中和后的护生患者满意度评分分布差异均无统计学意义(P>0.05)。甲组患者满意度低(平均分≤1)的3例护生测试得分均在后15名,而测试得分前15名的护生中,患者满意度均较高;乙组测试得分前15名中,有1名护生护理的患者满意度低(平均分≤1)。结论:SC测评实习护生的人文关怀能力更加准确、有效,可以作为实习护生在人文关怀能力的结业及上岗前评价依据之一。     

Discontinuation of use and switching of antidepressants: influence of patient-physician communication

Context  Although current depression treatment guidelines recommend continuing antidepressant therapy for at least 4 to 9 months, many patients discontinue treatment prematurely, within 3 months. Objectives  To investigate the relationship between patient-physician communication and the continuation of treatment with antidepressants and to explore the demographics, adverse effects, therapeutic response, and frequency of follow-up visits. Design, Setting, and Patients  A total of 401 telephone interviews of depressed patients being treated with selective serotonin reuptake inhibitor (SSRI) therapy between December 15, 1999, and May 31, 2000, were conducted and 137 prescribing physicians completed written surveys from Northern California Kaiser Permanente health maintenance organization outpatient clinics. Main Outcome Measures  Patient-physician communication about therapy duration and about adverse effects; therapy discontinuation or medication switching within 3 months after start of SSRI therapy. Results  Ninety-nine physicians (72%) reported that they usually ask patients to continue using antidepressants for at least 6 months, but 137 patients (34%) reported that their physicians asked them to continue using antidepressants for this duration and 228 (56%) reported receiving no instructions. Patients who said they were told to take their medication for less than 6 months were 3 times more likely to discontinue therapy (odds ratio [OR], 3.12; 95% confidence interval [CI], 1.21-8.07) compared with patients who said they were told to continue therapy longer. Patients who discussed adverse effects with their physicians were less likely to discontinue therapy than patients who did not discuss them (OR, 0.49; 95% CI, 0.25-0.95). Patients who reported discussing adverse effects with their physicians were more likely to switch medications (OR, 5.60; 95% CI, 2.31-13.60). Fewer than 3 follow-up visits for depression, adverse effects, and lack of therapeutic response to medication were also associated with patients' discontinuing therapy. Conclusions  Discrepancies exist between instructions that physicians report they communicate to patients and what patients remember being told. Explicit instructions about expected duration of therapy and discussions about medication adverse effects throughout treatment may reduce discontinuation of SSRI use. Our finding that patients with 3 or more follow-up visits were more likely to continue using the initially prescribed antidepressant medication suggests that frequent patient-physician contact may increase the probability that patients will continue therapy.      

89SrCl2治疗恶性肿瘤骨转移的影响因素分析

目的 探讨89 SrCl2治疗恶性肿瘤骨转移的疗效影响因素.方法 选择南充市川北医学院附属医院2013年2月至2016年9月行89 SrCl2治疗的恶性肿瘤骨转移患者99例,分析患者的年龄、性别、肿瘤病理类型、89 SrCl2治疗次数、手术切除原发灶、放疗、化疗、肿瘤骨转移的病灶数量、联合止痛药状况以及碱性磷酸酶(ALP)是否会影响89 SrCl2的治疗效果.结果 89 SrCl2治疗的总有效率为63.6％.单因素分析结果显示不同肿瘤病理类型、不同治疗次数、是否联合放射治疗、是否手术切除原发灶、不同肿瘤骨转移病灶数量及是否联合止痛药患者的治疗效果进行比较,差异具有统计学意义(P<0.05).logistics回归分析显示,患者的肿瘤病理类型、89SrCl2治疗次数、手术切除原发灶、肿瘤骨转移的病灶数量及联合止痛药是影响89SrCl2疗效的独立因素(P<0.05).结论 肿瘤病理类型、89 SrCl2治疗次数、手术切除原发灶、肿瘤骨转移病灶数量以及联合止痛药能影响89 SrCl2治疗恶性肿瘤骨转移的疗效.     

Quality of reporting of randomized trials as a measure of methodologic quality

Context  The evaluation of the methodologic quality of randomized controlled trials (RCTs) is central to evidence-based health care. Important methodologic detail may, however, be omitted from published reports, and the quality of reporting is therefore often used as a proxy measure for methodologic quality. We examined the relationship between reporting quality and methodologic quality of published RCTs. Methods  Study of 60 reports of placebo-controlled trials published in English-language journals from 1985 to 1997. Reporting quality was measured using a 25-item scale based on the 1996 issue of the Consolidated Standards of Reporting Trials (CONSORT). Concealment of allocation, appropriate blinding, and analysis according to the intention-to-treat principle were indicators of methodologic quality. Methodologic quality was compared between groups of trials defined by reporting quality scores of low, intermediate, and high. Reporting quality scores were compared between groups defined by high and low methodologic quality. Results  Among 23 trials of low reporting quality (median score, 9 [range, 3.5-10.5]), allocation concealment was unclear for all but 1 trial, but there were 16 trials (70%) with adequate blinding and 9 trials (39%) that had been analyzed according to the intention-to-treat principle. Among 18 trials of high reporting quality (median score, 18 [range 16.5-22.0]), there were 8 trials (44%) with adequate allocation concealment, 16 trials (89%) with adequate blinding, and 13 trials (72%) analyzed according to the intention-to-treat principle. The median reporting score was 15.0 for the 33 trials that were analyzed according to intention-to-treat principle and 14.5 for the 14 trials with on-treatment analyses (P = .67). Conclusions  Similar quality of reporting may hide important differences in methodologic quality, and well-conducted trials may be reported badly. A clear distinction should be made between these 2 dimensions of the quality of RCTs.      

Pharmacological treatment of neuropsychiatric symptoms of dementia: a review of the evidence

Kaycee M. Sink, MD; Karen F. Holden, MD; Kristine Yaffe, MD

JAMA. 2005;293:596-608.

Context  Neuropsychiatric symptoms of dementia are common and associated with poor outcomes for patients and caregivers. Although nonpharmacological interventions should be the first line of treatment, a wide variety of pharmacological agents are used in the management of neuropsychiatric symptoms; therefore, concise, current, evidence-based recommendations are needed.

Objective  To evaluate the efficacy of pharmacological agents used in the treatment of neuropsychiatric symptoms of dementia.

Evidence Acquisition  A systematic review of English-language articles published from 1966 to July 2004 using MEDLINE, the Cochrane Database of Systematic Reviews, and a manual search of bibliographies was conducted. Inclusion criteria were double-blind, placebo-controlled, randomized controlled trials (RCTs) or meta-analyses of any drug therapy for patients with dementia that included neuropsychiatric outcomes. Trials reporting only depression outcomes were excluded. Data on the inclusion criteria, patients, methods, results, and quality of each study were independently abstracted. Twenty-nine articles met inclusion criteria.

Evidence Synthesis  For typical antipsychotics, 2 meta-analyses and 2 RCTs were included. Generally, no difference among specific agents was found, efficacy was small at best, and adverse effects were common. Six RCTs with atypical antipsychotics were included; results showed modest, statistically significant efficacy of olanzapine and risperidone, with minimal adverse effects at lower doses. Atypical antipsychotics are associated with an increased risk of stroke. There have been no RCTs designed to directly compare the efficacy of typical and atypical antipsychotics. Five trials of antidepressants were included; results showed no efficacy for treating neuropsychiatric symptoms other than depression, with the exception of 1 study of citalopram. For mood stabilizers, 3 RCTs investigating valproate showed no efficacy. Two small RCTs of carbamazepine had conflicting results. Two meta-analyses and 6 RCTs of cholinesterase inhibitors generally showed small, although statistically significant, efficacy. Two RCTs of memantine also had conflicting results for treatment of neuropsychiatric symptoms.

Conclusions  Pharmacological therapies are not particularly effective for management of neuropsychiatric symptoms of dementia. Of the agents reviewed, the atypical antipsychotics risperidone and olanzapine currently have the best evidence for efficacy. However, the effects are modest and further complicated by an increased risk of stroke. Additional trials of cholinesterase inhibitors enrolling patients with high levels of neuropsychiatric symptoms may be warranted.

     

Evaluation of berries of Phytolacca dodecandra for growth inhibition of Histoplasma capsulatum var. farciminosum and treatment of cases of epizootic lymphangitis in Ethiopia

Objective:To evaluate the berries of Phytolacca dodecundra(P.dodecandra) for its effect on Histoplasma cupsulatum var.farciminosum(HCF) and for the treatment of cases of epizootic lymphangitis(ELi.Methods:Samples were collected from un-ruptured nodules of cases of EL at Debre Zeit and Akaki(central Ethiopia).Mycologieal culture and isolation of HCF were performed at the Akliln Lemma Institute of Pathobiology.Phytochemical screening was done for n-butanol extract of P.dodecandra to delect alkaloids,saponins,phenolic compounds and flavonoids.The minimum inhibitory concentrations(MICs) and minimum fungicidal concentrations(MFCs) ol aqueous and n-butanol extracts of P.dodecandra against FICF were determined by agar dilution assay.For the in vivo trial.5%simple ointment was prepared from n-butanol extract and applied topically to 24(twelve early and twelve moderate) cases of F.L.Results:Phytochemical screening showed that n-butanol extract ol P.dodecandra was positive lor alkaloids.saponins and phenolic compounds but negative for flavonoids.The MFCs of n-butanol and aqueous extracts of P.dodecandra were(0.039%-0.078%) and(0.625%-1.250%),respectively.The MFCs of n-butanol and aqueous extracts of P.dodecandra were(0.078%t-0.156%)and(1.250%-2.500%),respectively.The MIC and MFC of ketoconazole(positive control) was(1.200×10~(-5)%-2.500×10~(-5)%) and(5.000× 10~(-5)%-1.000×10~(-4)%),respectively while growth was observed on free medium(negative control).From the total of 24 treated cases of EL,14(58.3%) responded lo treatment;however,10(41.7%) did not respond to treatment.There was no significant difference in the degree of response to treatment between early and moderate cases(χ~2=0.086:P=0.408.Conclusions:It can be concluded that n-butanol extract of P.dodecandra demonstrates antifungal effects while the aqueous extract shows no antifungal activity.     

Effect of awareness of a randomized controlled trial on use of experimental therapy

Context  Use of experimental therapies during but outside of randomized controlled trials (RCTs) has not been studied. Objective  To determine whether initiation of an RCT leads to increased use of the experimental therapy outside the trial. Design and Setting  Data on national apheresis use during 3 Canadian RCTs for multiple sclerosis (1986-1988), thrombotic thrombocytopenic purpura (1982-1988), and myeloma cast nephropathy (1998-2000) were obtained from 19 major medical centers in Canada. The multiple sclerosis and myeloma cast nephropathy trials had data on apheresis use for 3 years prior to and during the trials, which permitted a time-series analysis to determine the impact of the RCTs on the use of apheresis. The ongoing myeloma cast nephropathy trial provided data on the number of patients inside and outside of the RCTs in trial and nontrial centers. Initial and follow-up questionnaires were sent to 24 Canadian physicians in trial and nontrial centers to determine if they had noted an increase in apheresis activity during the trials and, if so, their explanation for it. Main Outcome Measure  Change in number of patients undergoing apheresis for thrombotic thrombocytopenic purpura, multiple sclerosis, and myeloma cast nephropathy prior to and during the respective RCTs compared with all patients undergoing apheresis during the same periods. Results  During all 3 RCTs, there were large increases in use of apheresis. The majority of the increased use of apheresis was outside of the trials: for multiple sclerosis, 30 of 49 patients per year (61% of increase); thrombotic thrombocytopenic purpura, 49 of 56 patients per year (72% of increase); and myeloma cast nephropathy, 60 of 72 patients per year (57% of increase). The myeloma cast nephropathy study noted that this increase occurred in both nontrial and trial centers. Among questionnaire respondents (n = 22; 92% response rate), most physicians noted an increase in apheresis activity during the trials and attributed it to a "jumping-the-gun" phenomenon. Conclusions  During 3 Canadian RCTs, apheresis increased, but most of the increase occurred outside the trials. This behavior during an RCT, in the absence of clear efficacy, can be termed jumping the gun.      

Evaluation of anti-inflammatory potential of leaf extracts of Skimmia anquetilia

Objective

To evaluate anti-inflammatory potential of leaf extract of Skimmia anquetilia by in-vitro and in-vivo anti-inflammatory models.

Methods

Acute toxicity study was carried out to determine the toxicity level of different extract using acute toxic class method as described in Organization of Economic Co-operation and Development Guidelines No.423. Carrageenan (1% w/w) was administered and inflammation was induced in rat paw. The leaf extracts of Skimmia anquetilia were evaluated for anti-inflammatory activity by in-vitro human red blood cell (HRBC) membrane stabilization method and in-vivo carrangeenan-induced rat paw edema method.

Results

The in-vitro membrane stabilizing test showed petroleum ether (PE), chloroform (CE), ethyl acetate (EE), methanol (ME) and aqueous extracts (AE) showed 49.44%, 59.39%, 60.15%, 68.40% and 52.18 % protection, respectively as compared to control groups. The in-vivo results of CE, EE and ME showed 58.20%, 60.17% and 67.53% inhibition of inflammation after 6h administration of test drugs in albino rats. The potency of the leaf extracts of Skimmia anquetilia were compared with standard diclofenac (10 mg/kg) which showed 74.18% protection in in-vitro HRBC membrane stabilization test and 71.64% inhibition in in-vivo carrangeenan-induced rat paw edema model. The ME showed a dose dependent significant (P< 0.01) anti-inflammatory activity in human red blood cell membrane stabilization test and reduction of edema in carrageenan induced rat paw edema.

Conclusions

The present investigation has confirmed the anti-inflammatory activity of Skimmia anquetilia due to presence of bioactive phytoconstitutes for the first time and provide the pharmacological evidence in favor of traditional claim of Skimmia anquetilia as an anti- inflammatory agent.     

两种抗凝剂对实验用小型猪血液生理指标的影响

目的比较分析两种抗凝剂对实验用小型猪血液生理指标的影响。方法将22只成年的实验用小型猪,分别用EDTA三钾和肝素锂抗凝采血后,用日本光电MEK-7222K血球分析仪测定血液生理指标。结果使用不同的抗凝剂,同一批样本的血液生理指标中单核细胞绝对值(MON)有差异(P0.05),平均红细胞体积(MCV)、平均红细胞血红蛋白浓度(MCHC)、血小板比积(PLT)、血小板平均体积(PCT)、血小板平均体积(MPV)、淋巴细胞绝对值(LYM)、嗜酸性粒细胞绝对值(EOS)、嗜碱性粒细胞绝对值(BAS)、淋巴细胞绝对值(LYM)%、单核细胞绝对值(MON)%、嗜酸性粒细胞百分率(EOS)%和嗜碱性粒细胞百分率(BAS)%这12个指标有显著差异(P0.01);EDTA三钾抗凝的血液生理指标中血小板比积(PLT)、中性粒细胞绝对值(NEUT)和中性粒细胞百分率(NEUT)%有性别差异(P0.05),MON、EOS、MON%和EOS%性别差异有显著性(P0.01);肝素锂抗凝的血液生理指标中血小板体积分布宽度(PDW)、中性粒细胞绝对值(NEUT)和LYM%有性别差异(P0.05),MON、EOS、MON%、NEUT%和EOS%性别差异有显著性(P0.01)。结论不同的抗凝剂对实验用小型猪血小板和白细胞分类计数参数影响显著,进行相关实验时应妥善选择血液抗凝方式。     

Association of dietary intake of fat and fatty acids with risk of breast cancer

Context  High intakes of fat and specific fatty acids, including total, animal, saturated, polyunsaturated, and trans-unsaturated fats, have been postulated to increase breast cancer risk. Objective  To determine whether intakes of fat and fatty acids are associated with breast cancer. Design and Setting  Cohort study (Nurses' Health Study) conducted in the United States beginning in 1976. Participants  A total of 88,795 women free of cancer in 1980 and followed up for 14 years. Main Outcome Measure  Relative risk (RR) of invasive breast cancer for an incremental increase of fat intake, ascertained by food frequency questionnaire in 1980, 1984, 1986, and 1990. Results  A total of 2956 women were diagnosed as having breast cancer. Compared with women obtaining 30.1% to 35% of energy from fat, women consuming 20% or less had a multivariate RR of breast cancer of 1.15 (95% confidence interval [CI], 0.73-1.80). In multivariate models, the RR (95% CI) for a 5%-of-energy increase was 0.97 (0.94-1.00) for total fat, 0.98 (0.96-1.01) for animal fat, 0.97 (0.93-1.02) for vegetable fat, 0.94 (0.88-1.01) for saturated fat, 0.91 (0.79-1.04) for polyunsaturated fat, and 0.94 (0.88-1.00) for monounsaturated fat. For a 1% increase in energy from trans-unsaturated fat, the values were 0.92 (0.86-0.98), and for a 0.1% increase in energy from omega-3 fat from fish, the values were 1.09 (1.03-1.16). In a model including fat, protein, and energy, the RR for a 5% increase in total fat, which can be interpreted as the risk of substituting this amount of fat for an equal amount of energy from carbohydrate, was 0.96 (95% CI, 0.93-0.99). In similar models, no significant association of risk was evident with any major types of fat. Conclusion  We found no evidence that lower intake of total fat or specific major types of fat was associated with a decreased risk of breast cancer.