新毕业护士的心理状态调查分析及对策

为了了解新毕业护士的心理状态,采用90项症状自评量表(SCL-90)对64名新毕业护士的心理状况进行了调查。结果发现新护士在SCL-90中的各因子分均高于国内常模,主要表现为焦虑、人际关系敏感。及时了解新护士的心理状态,通过扎实基本功,培养独立处事能力,帮助新护士增强自信心,树立良好的职业意识,才能顺利度过工作适应期。     

Connective tissue growth factor as a novel therapeutic target in high grade serous ovarian cancer

Ovarian cancer is the most common cause of death among women with gynecologic cancer. We examined molecular profiles of fibroblasts from normal ovary and high-grade serous ovarian tumors to identify novel therapeutic targets involved in tumor progression. We identified 2,300 genes that are significantly differentially expressed in tumor-associated fibroblasts. Fibroblast expression of one of these genes, connective tissue growth factor (CTGF), was confirmed by immunohistochemistry. CTGF protein expression in ovarian tumor fibroblasts significantly correlated with gene expression levels. CTGF is a secreted component of the tumor microenvironment and is being pursued as a therapeutic target in pancreatic cancer. We examined its effect in in vitro and ex vivo ovarian cancer models, and examined associations between CTGF expression and clinico-pathologic characteristics in patients. CTGF promotes migration and peritoneal adhesion of ovarian cancer cells. These effects are abrogated by FG-3019, a human monoclonal antibody against CTGF, currently under clinical investigation as a therapeutic agent. Immunohistochemical analyses of high-grade serous ovarian tumors reveal that the highest level of tumor stromal CTGF expression was correlated with the poorest prognosis. Our findings identify CTGF as a promoter of peritoneal adhesion, likely to mediate metastasis, and a potential therapeutic target in high-grade serous ovarian cancer. These results warrant further studies into the therapeutic efficacy of FG-3019 in high-grade serous ovarian cancer.     

Stable nitrogen and carbon isotope ratios indicate traditional and market food intake in an indigenous circumpolar population

The transition of a society from traditional to market-based diets (termed the nutrition transition) has been associated with profound changes in culture and health. We are developing biomarkers to track the nutrition transition in the Yup'ik Eskimo population of Southwest Alaska based on naturally occurring variations in the relative abundances of carbon and nitrogen stable isotopes (δ(15)N and δ(13)C values). Here, we provide three pieces of evidence toward the validation of these biomarkers. First, we analyzed the δ(15)N and δ(13)C values of a comprehensive sample of Yup'ik foods. We found that δ(15)N values were elevated in fish and marine mammals and that δ(13)C values were elevated in market foods containing corn or sugar cane carbon. Second, we evaluated the associations between RBC δ(15)N and δ(13)C values and self-reported measures of traditional and market food intake (n = 230). RBC δ(15)N values were correlated with intake of fish and marine mammals (r = 0.52; P < 0.0001). RBC δ(13)C values were correlated with intake of market foods made from corn and sugar cane (r = 0.46; P < 0.0001) and total market food intake (r = 0.46; P < 0.0001). Finally, we assessed whether stable isotope ratios captured population-level patterns of traditional and market intake (n = 1003). Isotopic biomarkers of traditional and market intake were associated with age, community location, sex, and cultural identity. Self-report methods showed variations by age and cultural identity only. Thus, stable isotopes show potential as biomarkers for monitoring dietary change in indigenous circumpolar populations.     

The association between neighborhood characteristics and body size and physical activity in the California teachers study cohort

Objectives. We considered interactions between physical activity and body mass index (BMI) and neighborhood factors.Methods. We used recursive partitioning to identify predictors of low recreational physical activity (< 2.5 hours/week) and overweight and obesity (BMI ≥ 25.0 kg/m²) among 118 315 women in the California Teachers Study. Neighborhood characteristics were based on 2000 US Census data and Reference US business listings.Results. Low physical activity and being overweight or obese were associated with individual sociodemographic characteristics, including race/ethnicity and age. Among White women aged 36 to 75 years, living in neighborhoods with more household crowding was associated with a higher probability of low physical activity (54% vs 45% to 51%). In less crowded neighborhoods where more people worked outside the home, the existence of fewer neighborhood amenities was associated with a higher probability of low physical activity (51% vs 46%). Among non–African American middle-aged women, living in neighborhoods with a lower socioeconomic status was associated with a higher probability of being overweight or obese (46% to 59% vs 38% in high–socioeconomic status neighborhoods).Conclusions. Associations between physical activity, overweight and obesity, and the built environment varied by sociodemographic characteristics in this educated population.The prevalence of overweight and obesity has reached epidemic levels in the United States. The most recent national prevalence data report that 68% of US adults are overweight or obese.¹ This prevalence poses a significant public health problem given that obesity is a risk factor for many chronic conditions and certain cancers.^1–3 Because of the health benefits of physical activity in preventing and treating overweight and obesity, increasing physical activity has become a public health priority.⁴With these high levels of overweight and obesity in the United States,¹ researchers have begun to search for neighborhood factors, including the built environment, that may influence physical activity and overweight or obesity. The built environment comprises the physical attributes of a person''s surroundings, including the existence and condition of sidewalks and walking trails for walking and other types of recreation, the spatial configuration of street networks, the availability of health-promoting resources, and the number of walkable destinations. The research to date suggests that elements of the built environment influence physical activity and levels of overweight or obesity.^5–7 Most studies, however, have focused on relatively specific geographic areas (e.g., a given city or county), have not assessed the influence of the built environment across different sociodemographic groups, and have not considered interactions between individual and neighborhood factors.We aimed to determine the association between measures of the built environment and physical activity levels and body mass index (BMI, defined as weight in kg divided by height in m²) across geographically and sociodemographically diverse neighborhoods. We applied recursive partitioning, a tree-based classification method, to identify both independent associations and interactions between these variables in a large, established cohort of California women.     

Perceptions, expectations, and attitudes about communication with physicians among Chinese American and non-Hispanic white women with early stage breast cancer

Purpose

Asian Americans have consistently reported poorer communication with physicians compared with non-Hispanic Whites (NHW). This qualitative study sought to elucidate the similarities and differences in communication with physicians between Chinese and NHW breast cancer survivors.

Methods

Forty-four Chinese and 28 NHW women with early stage breast cancer (stage 0-IIa) from the Greater Bay Area Cancer Registry participated in focus group discussions or individual interviews. We oversampled Chinese women because little is known about their cancer care experiences. In both interview formats, questions explored patients' experiences and feelings when communicating with physicians about their diagnosis, treatment, and follow-up care.

Results

Physician empathy at the time of diagnosis was important to both ethnic groups; however, during treatment and follow-up care, physicians' ability to treat cancer and alleviate physical symptoms was a higher priority. NHW and US-born Chinese survivors were more likely to assert their needs, whereas Chinese immigrants accepted physician advice even when it did not alleviate physical problems (e.g., pain). Patients viewed all physicians as the primary source for information about cancer care. Many Chinese immigrants sought additional information from primary care physicians and stressed optimal communication over language concordance.

Conclusions

Physician empathy and precise information were important for cancer patients. Cultural differences such as the Western emphasis on individual autonomy vs. Chinese emphasis on respect and hierarchy can be the basis for the varied approaches to physician communication we observed. Interventions based on cultural understanding can foster more effective communication between immigrant patients and physicians ultimately improving patient outcomes.     

Improving community support for HIV and AIDS prevention through national partnerships.

If the transmission of human immunodeficiency virus (HIV) is to be prevented, the environment in which people live should predispose them to engage in and sustain safe behaviors. Too often in public health, the range of organizations that make up that environment are overlooked, and prevention strategies are limited to familiar medical and public health institutions. Improvement in public health does not occur in isolation, apart from the other institutions of society--and so it is with the HIV-AIDS epidemic. Education; business and labor; religion; government; voluntary, civic, and social organizations; and the media can all serve as facilitators or as barriers to creating the environment--at the national, regional, State, or local level--that will prevent and control the spread of HIV infection and AIDS and support the needs of those already infected. Collectively, they become a comprehensive HIV prevention network with access to and influence on the total public. One of the most significant benefits of this network is the multiplier effect on the limited resources of public health. Therefore, as part of its HIV and AIDS prevention strategy, the Centers for Disease Control (CDC) has developed national partnerships to involve the leadership of business, labor and industry, religious institutions and organizations, and voluntary organizations in HIV and AIDS prevention and service. Some of these partnerships are federally funded, others are not. The national partnership program described in this paper has produced increased resources for HIV education and services and has demonstrated the synergistic benefits resulting from public and private cooperation in addressing the HIV epidemic.