Motivation of primary care physicians for participating in early intervention for psychosis in Japan

People with psychosis as represented by schizophrenia experience lengthy delays between the onset and the start of treatment. This duration is called Duration of Untreated Psychosis (DUP). Since it has been indicated that shorter DUP leads to their better prognosis, early intervention has been a hot topic for decades in clinical psychiatry. In Japan, as any patient can visit either specialists or primary care physicians using medical insurance, a considerable portion of psychosis patients are supposed to visit the latter first. Thus, a role of primary care physicians seems keys of success in implementation of early intervention system in the Japanese society. In this study, to clarify the motivation of physicians to participate in early intervention, we sent postal questionnaires to 4030 private clinics throughout Japan, inquiring physicians' situations around psychiatric disorders. Seven hundred and fourteen questionnaires were used for analysis (17.7%). Among these 714 respondents, 364 (51.0%) reported that they have willingness to participate in early intervention. Similarly, 494 (69.2%) were interested in psychiatric disorders, whereas only 168 (23.5%) were confident in identifying schizophrenia. The interest in psychiatric disorders was most strongly associated with their willingness to participate (Odds ratio = 3.54 by logistic regression analysis). These results, therefore, suggest that the interest in psychiatric disorders motivates them to participate in early intervention for psychosis; this has considerable implications for future approach to build up early intervention system in Japan.     

外科病区护士循证护理技能的培训方法研究

目的 探讨外科病区护士循证护理技能的培训方法.方法 选择2个外科病区的护士共计43人作为培训对象,根据循证护理4个步骤,制订提出问题、寻找循证支持、进行循证观察、临床循证应用的培训流程,按照流程对护士进行循证护理能力的培训.评价培训后的护士循证护理技能;护士获取信息资源能力;护士满意度调查.结果 培训前后护士循证护理技能比较,差异有统计学意义(P＜0.01);培训前后护士获取信息资源能力比较,差异有统计学意义(P＜0.01);95%的护士认为经过培训后提高了自身循证护理能力.结论 通过对外科病区护士进行循证护理能力的培训,达到了提高护士循证护理技能;提高护士获取信息资源能力的目的,对促进循证护理的推广应用有一定的指导意义.     

Novel method for screening for the presence of haemoglobin S in blood

A high-performance liquid chromatography (HPLC) method designed for the measurement of haemoglobin (Hb)A(1c) in blood was investigated for use as a screening method for the presence of HbS in blood. In the Bio-Rad VARIANT II HbA(1c) method, HbS was found to have a specific retention time and percentage Hb value that enabled the detection of HbS in blood. Other Hb variants did not have the same combination of retention time and percentage Hb as HbS. The HPLC method was superior to the HbS solubility test in ease of performance and readability. Also, the proposed method showed less interference than the solubility test and could be used with samples from all age groups. The proposed method takes 3 min per sample to perform and is thus suitable for large-scale screening.     

神经内科住院患者体温测量方法的探讨

目的探讨使用红外线耳温计测量神经内科住院患者体温的可行性。方法测量2009年9—12月神经内科316例住院患者的耳温、口温、腋温,对比同组患者左右耳的温度,比较耳温与口温、腋温的差异。结果患者左右两耳温度差异无统计学意义(P>0.05),患者耳温、口温和腋温3者之间差异有统计学意义,同时任何两组之间的差异均有统计学意义(P<0.05)。结论红外线耳温测量仪可以应用于神经内科住院患者测量体温,能较好反映患者体核温度,且操作简单方便,值得临床推广应用。     

外科病区护士循证护理技能的培训方法研究

目的探讨外科病区护士循证护理技能的培训方法。方法选择2个外科病区的护士共计43人作为培训对象，根据循证护理4个步骤，制订提出问题、寻找循证支持、进行循证观察、临床循证应用的培训流程，按照流程对护士进行循证护理能力的培训。评价培训后的护士循证护理技能；护士获取信息资源能力；护士满意度调查。结果培训前后护士循证护理技能比较，差异有统计学意义（P〈0．01）；培训前后护士获取信息资源能力比较，差异有统计学意义（P〈0．01）；95％的护士认为经过培训后提高了自身循证护理能力。结论通过对外科病区护士进行循证护理能力的培训，达到了提高护士循证护理技能；提高护士获取信息资源能力的目的，对促进循证护理的推广应用有一定的指导意义。     

Guideline for diagnosis and management of hyperlipidemia for prevention of atherosclerosis in Japan

Coronary heart disease (CHD) mortality and plasma cholesterol level have increased in Japan. There has been evidence indicating that cholesterol-lowering is effective in secondary and primary prevention of CHD. Hypercholesterolemia has been defined as over 220 mg/dl, and over 140 mg/dl for LDL-cholesterol. These levels were determined on the base of the evidence observed in Japan. The subjects are divided as follows, A: no CHD and no other risk factors, B: no CHD and at least one risk factor, C: manifest CHD. The treatment levels of LDL-cholesterol are 140 mg/dl for category A, 120 mg/dl for B and 100 mg/dl for C. Although drug therapy may be necessary when LDL-cholesterol level is over 120 mg/dl in category C, life-style modification is most important in category A and B.     

Networking for the advancement of nursing research in Europe for twenty-five years

The Work Group of European Nurse Researchers (WENR) has been networking for advancement of nursing research in Europe for 25 years. The most well-known activity of WENR is its biennial conferences organized in all parts of Europe. They have provided a unique opportunity for nurses to come together to discuss nursing research and clinical practice. Recently, WENR has published a position paper in order to reinforce its own and International Council of Nurses, World Health Organization and The Standing Committee of Nurses of the European Union (PCN) aims. The Work Group of European Nurse Researchers recommends that the recommendations of The Council of Europe report be adopted formally by national nurses associations. Future activities of WENR include promotion of infrastructures and research capacities in member countries, and planning of new scientific activities.     

Projection of the supply of and demand for board-certified nephrologists for ESRD in Taiwan

Objective Taiwan is the country where end‐stage renal disease (ESRD) is most prevalent. The purpose of this study was to investigate whether the rising demand for dialysis or transplantation as a result of ESRD can be balanced by the supply of board‐certified (B‐C) nephrologists. Methods Two Markov processes were applied for the projection of the supply of B‐C nephrologists in ESRD and for the projection of the demand from ESRD in 2020, assuming linear, exponential growth and no increase. Results The supply of B‐C nephrologists was projected at 1346 in 2020. To make allowance for the share of total time of professional activities in full‐time equivalent (FTE) for B‐C nephrologists, the demand was 1556, 962 and 2652 with assumptions of steady, linear and exponential growth, respectively. By the year 2020, 210 and 1306 additional FTE nephrologists will be required to meet, respectively, a linear and an exponential increase in demand from ESRD. Conclusions The projection of the supply of and the demand for B‐C nephrologists was made in this study using two Markov processes. The methods and results can be adopted as a reference for health manpower planning on B‐C nephrologists.     

我院护士在职教育的体会

本文针对不同层次护理人员制定不同的培训目标和计划,采取岗前培训,岗位培训(专科培训、在职分层培训、护理人才培训),自学等形式,开展护士在职教育,不断扩充更新知识,以适应现代护理工作要求。     

谷氨酰胺高效液相测定法的研究应用

目的 建立一种准确、简便、快速的高效液相色谱法，快速测定血中谷氨酰胺含量，监测给予经谷氨酰胺强化的安全肠外营养病人血清谷氨酰胺浓度并对照组比较。方法 反相Ｃ１８柱为固定相，异硫氰酸苯酯作柱前衍生剂，５０ｍｍｏｌ／Ｌ醋酸缓液（ｐＨ６．５０）－乙腈（９７．７：２．３）为流动相，进行单泵等梯度洗脱，在λ２５４ｎｍ处检测谷氨酰胺含量。结果 线性范围４０～２５００μｍｏｌ／Ｌ相关系数０．９９８，批内和比间的     

骨髓活检塑料包埋在MDS诊断中的价值

目的评估通过塑料包埋的骨髓活检技术在骨髓增生异常综合征(MDS)诊断中的价值。方法分析60例最终临床确诊MDS的病例,前30例仅行骨髓涂片检查,后30例在涂片基础上同时进行了骨髓活检检查。比较两组实验室诊断结果的准确率,分析两组间是否有差异。结果在前30例病例中,实验室诊断符合19例,不符合11例;在后30例病例中,实验室诊断符合26例,不符合4例。两组间比较,χ2=4.36,P<0.05。结论通过塑料包埋的骨髓活检在MDS的诊断中确有重要的价值。在MDS的诊断中,骨髓涂片和骨髓活检切片的结合,可以大大提高MDS诊断的准确率。     

An in vitro method for comparing biocompatibility of materials for extracorporeal circulation

We measured the response of fresh heparinized human blood to recirculation through circuits made of LVA (Portex Industries, Hythe, Kent, UK), SRT (Rehau UK, Langley, Slough, UK) and Tygon S-65-HL (Norton Performance Plastics, Corby, Northants, UK), as control. Circuit construction: 1/2 in. tubing, heat exchanger (Dideco D-720P), Stockert roller pump, just underoccluded, Cincinnati Sub Zero heater, circuit volume of 500 ml. Flow 3.45 l/min, 37 degrees C. Samples: at 10 min, 1, 2, 4 and 6 h. n=5 in each group; 2/5 SRT experiments were stopped at 45 and 60 min due to overpressurization. Results: Baseline activated clotting time (ACT) of 300 s, increasing in all groups as fibrinogen fell to zero with SRT and LVA. Minimum fibrinogen was 1 g/l for Tygon. Absolute thrombocytopenia occurred (SRT and LVA 60 min and Tygon 240 min). International normalized ratio (INR) in both the SRT and LVA circuits increased, but mean increase for Tygon (0.56) was smaller than the other two materials. Plasma free haemoglobin increased in all three materials; the increase was greater in the LVA circuits compared to the control. C5b9 levels increased equally in all groups. Lactoferrin levels rose equally in all groups to a maximum at 150 min. The neutrophil counts fell, mirroring the lactoferrin. The total white cell counts also fell in all groups; in the LVA circuits, the fall was significantly lower than in the control. Rapid disappearance of platelets and fibrinogen from the blood in the SRT and LVA circuits excludes them both from extracorporeal use. Paradoxically, SRT caused the least complement activation of the three materials. This method can be used to compare biocompatibility.     

Assessment of risk for HIV-1 infection for missionaries in sub-Saharan Africa

North American mission boards (N = 82) with programs in sub-Saharan Africa were surveyed to identify practices affecting risk of human immunodeficiency virus type 1 (HIV-1) infection among international staff. Thirty-four percent of participating boards thought risk for HIV-1 infection in missionaries in Africa was greater than it was for the general US population, and 53% considered it greater for overseas medical staff serving in the region than for domestic health care workers. Nevertheless, only 24% of boards had formal AIDS education programs for overseas health care workers, and 19% for nonmedical personnel going abroad. Medical care provision and acquisition were considered high-risk activities; 42% of boards with a known policy acknowledged that disposable injection equipment was routinely reused, 68% indicated that immunizations were provided abroad, and 60% admitted that inoculations were administered by indigenous health care workers. The most frequently cited specific suggestion for decreasing the risk of HIV-1 infection overseas was the implementation of a walking blood bank program. We conclude that current practices and logistic constraints make HIV-1 transmission possible. Risk reduction strategies include more comprehensive health education programs, greater adherence to universal precautions, less dependence on the indigenous Third World health care system, and implementation of innovative programs for health care delivery.     

A comparison of different compounds for TBG-blocking used in radioimmunoassay for tri-iodothyronine

The effects of several substances used for thyroxine-binding globulin blocking in the radioimmunoassay for tri-iodothyronine are described. It was found that anilino-naphthalene-sulfonic acid is the most effective inhibitor of the binding of [¹²⁵I]T₃ to serum proteins. However this substance decreases also the specific binding of the labelled hormone to the antibody. This effect could partially be avoided by the addition of plasma. The same behaviour was found for sodium salicylate, however in this case the initial binding to the antibody could be completely restored by the addition of increasing amounts of plasma. Due to these rather obscure interactions of the labelled hormone with serum proteins and the antibody using these substances a system with high pH buffer and the addition of merthiolate which inhibits also the TBG effects is recommended. There is no influence on antibody binding. Diphenylhydantoin is not useful since the substance is not stable in solution. Tetrachlorothyronine cross-reacts strongly with three different antibodies using two different synthetic lots. Therefore the substance cannot be used in the assay system. Preliminary results showed that using different assay systems the same plasma gives different values for tri-iodothyronine.     

早产儿视网膜病变筛查的护理

早产儿视网膜病变(retinopathy of prematurity, ROP)是未成熟的视网膜血管异常发育和增生导致的病变,是早产儿致盲的主要原因之一[1].对低孕周和低出生体质量的早产儿开展筛查,能早期发现和治疗ROP,减少盲童发生率.