Physical activity correlates for Native Hawaiians and Pacific Islanders in the mainland United States

Native Hawaiian and Pacific Islander (NHPI) people are an understudied population that demonstrates high obesity rates and low physical activity levels. This study's aim was to examine possible correlates of physical activity in NHPI adults. Height and weight were recorded in N=100 NHPIs (46.9±5.4 years; 56% males) following completion of an anonymous questionnaire addressing health behaviors (physical activity, smoking, diet), psychosocial characteristics (social support, barriers, stage of change), neighborhood environment attributes, and knowledge of physical activity recommendations. This study sample demonstrated low physical activity (20% met recommendations) and fruit and vegetable (F&V) consumption (1% met recommendations), and a high prevalence of overweight or obesity (94%). After adjusting for gender and education, F&V intake was the only significant correlate of physical activity (p<.001). Common correlates of physical activity did not generalize to NHPIs. Further investigations of culturally-specific correlates are needed so that physical activity interventions can be culturally tailored for NHPIs.     

Assessing Hepatitis B Knowledge Among Native Hawaiians and Pacific Islanders in San Diego

Journal of Immigrant and Minority Health - Asian-Americans and Pacific Islanders comprise 6% of the U.S. population, but 50% of chronic hepatitis B cases and have a cancer mortality that is 60%...     

Physical Activity Among Native Hawaiians and Pacific Islanders: A Systematic Review and Meta-Analysis

Objective

To examine the proportion of Native Hawaiian and Pacific Islander (NHPI) meeting recommended physical activity guidelines for Americans (PAG) and determine differences in physical activity (PA) by sex and between NHPI and Asians when data are disaggregated.

Food Security Status of Native Hawaiians and Pacific Islanders in the US: Analysis of a National Survey

ObjectiveTo document food insecurity prevalence among a nationally representative sample of Native Hawaiian and Pacific Islander (NHPI) adults and compare differences in food security status across races/ethnicities in the US.MethodsUsing 2014 National Health Interview Survey and 2014 NHPI–National Health Interview Survey data, food insecurity among the NHPI population is described and food security status across racial/ethnic groups is compared using Rao-Scott chi-square and multinomial logistic regression.ResultsFood insecurity prevalence was 20.5% among NHPI adults, and NHPI had significantly higher odds of experiencing low and very low food security than white individuals. Food insecurity among Hispanic individuals, black people, and other races/ethnicities was also significantly higher than that among white people. Significant variation in food security status was observed by race/ethnicity (P < .001).Conclusions and ImplicationsThis study provides documentation of food insecurity prevalence among NHPI adults and will inform chronic disease and nutrition research and programs conducted with NHPI communities in the US.     

Challenges in Identifying Native Hawaiians and Pacific Islanders in Population-Based Cancer Registries in the U.S.

Lack of disaggregated data for Native Hawaiians and Pacific Islanders (NHPIs) in the U.S. has resulted in severe gaps in understanding health disparities and unique health needs of NHPIs. Telephone interviews were conducted with 272 cancer patients identified by a population-based cancer registry. The self-reported NHPIs status was compared with that identified by the registry. Sensitivity, Specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were calculated. Alternative NHPIs identification methods were explored. The registry had acceptable sensitivity (89%), specificity (96%) and NPV (99%), but low PPV (62%) in identifying NHPIs. Using additional information on surname and birthplace from the registry improved the identification of NHPIs, but either increased the false positive or decreased the counts of true NHPIs cases. Improved data collection methods and practices in identifying NHPIs in population-based cancer registries are needed and caution in interpreting cancer data for NHPIs is warranted.     

27例重型颅脑外伤患者的麻醉处理体会

目的探讨重型颅脑外伤患者麻醉处理以及救治方案。方法对27例重型颅脑外伤患者的麻醉处理以及救治方案进行回顾性分析。结果全部27例患者中,6例康复,11例遗留不同程度神经功能障碍,8例死于术后脑功能障碍以及并发的多系统器官功能衰竭,2例于术中死亡。结论术前全面了解患者颅脑外伤的严重程度,评估危险因素,有针对性地预防术中可能出现的并发症,选择合适的麻醉方法、药物和监测,围术期对患者并发症进行积极治疗,是提高急性颅脑外伤患者存活率的重要因素。     

重度颅脑外伤患者早期采用高压氧的治疗效果

目的探讨重度颅脑外伤患者早期采用高压氧治疗的效果。方法收集2013年3月至2015年12月我院诊治的重度颅脑外伤患者50例为研究对象,根据患者是否早期采用高压氧治疗分为治疗组30例和对照组20例,采用格拉斯哥昏迷评分法(GCS)、日常生活能力量表(ADL)及格拉斯哥预后评分法(GOS)评定两组患者的疗效。结果治疗前两组的GCS、ADL评分比较无统计学差异(P>0.05);治疗后治疗组的GCS、ADL评分均显著高于对照组(P<0.05)。治疗组的总有效率(93.33%)显著高于对照组(70.00%),P<0.05。结论重度颅脑外伤患者早期采用高压氧治疗可改善患者的神经功能症状,提高临床疗效。     

院前亚低温治疗重型颅脑损伤的应用研究

目的 研究院前亚低温对重型颅脑损伤患者的脑保护作用.方法 将由急救车送至本院的86名重型颅脑损伤患者采用随机数字表法随机分成两组:院前亚低温组和晚期亚低温组.院前亚低温组患者入院前保持患者鼻咽部温度33℃～35℃,入院或手术后改为亚低温治疗仪(降温毯)进行亚低温治疗4天后自然复温.晚期亚低温组患者在入院或手术后开始使用亚低温治疗仪进行同样的亚低温治疗作为对照.同时监测两组的脑温、生命体征、颅内压力、并发症和GOS评分.结果 院前亚低温组在治疗后24、48和72 h的颅内压分别为(17.38±4.88mmHg,18.40±4.50 mmHg,16.40±4.13 mmHg)均较晚期亚低温组(20.63±3.00 mmHg,21.80±6.00 mmHg 18.81±4.50 mmHg)明显降低(P＜0.05);院前亚低温组恢复良好率、病死率与晚期亚低温组相比较有显著差异(P ＜0.05),预后(GOS评分4～5分)明显好于晚期亚低温组(P＜0.05);院前亚低温组未发生与亚低温治疗相关的严重并发症.结论 院前亚低温用于重型颅脑损伤患者的治疗,具有降低颅内压、改善预后的作用.     

开颅术联合高压氧对重型颅脑损伤患者昏迷指数的影响

目的探讨开颅术联合高压氧对重型颅脑损伤患者昏迷指数的影响。方法选择2009年1月—2011年10月在我院住院治疗的60例重型颅脑损伤患者,按照随机数字表法将患者分为对照组和观察组,每组30例。在常规药物治疗基础上,对照组采用开颅术治疗,观察组采用开颅术联合高压氧治疗,术后对两组患者的临床疗效、昏迷指数(Glasgow comascale,GCS)评分,并与高压氧治疗前、治疗4周及治疗3个月随访时治疗结果分级(GOS)进行对比分析。结果观察组和对照组临床有效率分别为86.67%(26/30)和76.67%(23/30),两组患者临床有效率比较差异有显著性(P<0.05);高压氧治疗后1周GCS评分无明显差异,第2、3、4周高压氧治疗后GCS评分比较有统计学差异(P<0.05);两组患者第4周、3个月随访阶段的GOS预后评分比较有统计学意义(P<0.05)。结论开颅术联合高压氧治疗不仅对重型颅脑损伤患者早期意识改善和预后有显著效果,而且提高了患者的生活质量,可以促使患者早日康复。     

重型颅脑损伤患者呼吸机相关性肺炎的病原菌分布及耐药性分析

目的 明确重型颅脑损伤患者呼吸机相关性肺炎(VAP)的病原菌分布及耐药性特点,以期指导临床合理用药.方法 对175例重型颅脑损伤患者在机械通气治疗48 h后,采用一次性无菌吸痰管,经气管插管采集下呼吸道分泌物,作细菌培养、鉴定及药敏试验.结果 122例VAP患者下呼吸道分泌物培养出病原菌316株,病原菌分布:革兰阴性杆菌227株,占71.8%,主要为鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌,革兰阳性球菌50株,占15.8%,主要为金黄色葡萄球菌、表皮葡萄球菌、肠球菌属,真菌39株,占12.4%,主要为白色假丝酵母菌.结论 重型颅脑损伤患者机械通气治疗时易并发医院肺部感染,主要病原菌为革兰阴性杆菌且存在较严重的耐药现象,混合感染现象严重,应进行病原学监测,以提高治疗成功率.     

重型颅脑外伤患者肺部医院感染的危险因素和监控研究

目的探讨重症监护病房(ICU)重型颅脑外伤患者肺部医院感染的危险因素,探索其预防和控制的措施.方法对我院2001年1月～2004年12月的755例重症颅脑外伤ICU患者,肺部感染危险因素的分析.结果医院感染率为33.04%,例次感染率42.6%;引起肺部医院感染有显著性意义的危险因素有高龄、住院时间过长,呼吸机运用、气管切开、休克、基础病、激素等.结论针对危险因素,采取有效措施降低感染率.     

Health Indicators of Native Hawaiian and Pacific Islanders in the United States

This study aimed to describe health indicators and behaviors of Native Hawaiian and Pacific Islander (NHPI) adults and to compare findings to previous reports on US NHPI and the US population. A sample of N = 100 (56 M, 44 F) NHPI adults aged 40–59 years completed an anonymous questionnaire addressing education and household income, tobacco use, physical activity, fruit and vegetable (F&V) consumption, cancer screening and health status. Objective measures of height and weight were taken to calculate body mass index (BMI). The study sample consisted of 49% current smokers and the majority was not meeting guidelines for physical activity (80%) or F&V consumption (99%). Cancer screening rates ranged from 0 to 57% and were higher among females. Mean BMI was 33.9 ± 7.5 kg/m² and 95% were overweight or obese. While 36.7% were hypertensive, only 11.1% were taking prescribed medication. Compared to both the general US population and available data for US NHPI, study participants reported higher prevalence of obesity and chronic conditions (hypertension, high cholesterol, diabetes, and angina/CHD) and lower levels of physical activity, F&V consumption and cancer screening rates. Study findings contribute to the limited knowledge regarding health behaviors of US NHPI. Comparisons to US data increase evidence of NHPI health disparities, while comparisons to previous NHPI studies emphasize the magnitude of unhealthy lifestyle behaviors and subsequent adverse health conditions for this particular sample. Further improvements to community outreach and recruitment strategies could successfully encourage high-risk individuals to participate in health promotion and behavior intervention studies to improve NHPI health behaviors.     

Sexual Function in Men with Traumatic Brain Injury

Traumatic brain injury has been linked with higher incidence of sexual problems. As there have been few published reports regarding sexual functioning in men with traumatic brain injury in Latin America, this study sought to compare sexual measures in men with traumatic brain injury with healthy controls. The hypotheses that males with TBI would experience significantly lower indices of sexual functioning compared to unaffected individuals and that increased age and injury severity would predict lower sexual functioning among participants with TBI were tested. Seventy-one Spanish-speaking Colombian men with a history of moderate to severe TBI who were at least 6 months post-injury, and 71 healthy controls participated by completing the Sexual Desire Inventory, International Index of Erectile Function, Index of Premature Ejaculation, Sexual Quality of Life Questionnaire, Index of Sexual Satisfaction. SPSS 22 was used to analyze the results. When compared to matched controls, males with TBI had significantly lower overall and dyadic sexual desire, sexual satisfaction and sexual quality of life. Erectile functioning, ejaculation control, satisfaction with ejaculation control were reported to by lower in the TBI group than in the control group. Almost 44% of participants with TBI had moderate to severe erectile dysfunction, whereas nearly 10% of the control group had the same.     

急性创伤性脑损伤患者AQP4的表达及其与预后的关系

目的 对比检测不同损伤程度和损伤后不同时间脑外伤患者的水通道蛋白4 (AQP4)的表达差异,探讨AQP4与临床预后的关系. 方法 94例急性创伤性脑损伤患者手术清除脑组织标本为研究对象.根据术前格拉斯哥(GCS)评分将患者分为不同的程度损伤组,其中中度损伤组(GCS评分9～12分)36例,重度损伤组(GCS评分3～8分)42例,特重度损伤组(GCS评分低于3分)16例,另外根据患者受伤后距住院的时间差不同将患者分为三组,≤6h组51例,6～12 h组24例,≥12 h组19例.取手术清除的创伤区脑组织标本,用免疫组化法检测不同损伤程度以及损伤后不同时间的AQP4的表达情况. 结果 1.中度损伤组患者脑组织标本在光镜下观察脑细胞以及血管内皮细胞轻度肿胀;重度以及特重度损伤组脑细胞和血管内皮细胞明显肿胀,血管周围间隙明显增宽,损伤时间越长,脑组织以及血管内皮损伤越严重.2.脑组织中AQP4阳性表达信号为细胞膜或细胞浆棕黄色染色.随损伤程度加重,AQP4表达增强,在特重度损伤组AQP4表达最强(0.336±0.037 OD),高于重度损伤组(0.237±0.031 OD)和中度损伤组(0.185±0.024 OD),比较差异均有统计学意义(P＜0.05).3.随着伤后时间的延长,损伤部位脑组织AQP4表达量逐渐增多.≥12 h组AQP4表达最强(0.436±0.038OD),高于6～12 h组(0.297±0.021 OD)和≤6h组(0.213±0.034 OD),比较差异有统计学意义(P＜0.05). 结论 急性创伤性脑外伤脑组织中AQP4的表达强度与脑损伤病情程度密切相关,抑制AQP4的活性有可能减轻脑损伤后脑水肿的程度.     

我国癌症患者心理护理现状及展望

本文结合癌症患者的心理护理,介绍心理护理的概念、原则及意义,癌症患者常见心理反应类型,并针对我国当前对癌症患者心理护理中存在的不足,参考国外同领域发展最新成果,提出癌症患者临床护理的未来趋势。癌症患者的临床治疗护理康复中,心理护理将日益受到重视。针对不同类型的心理反应,大量信效度良好的测量工具将提供客观的辅助评估,除一般的支持性心理治疗外,以认知行为治疗等为代表的新技术将应用于心理护理实践,对癌症患者的心理护理也进一步拓展至癌症患者的照顾者,体现对患者社会支持系统的综合强化。