Identifying service needs of children with disruptive behavior problems using a Nominal Group Technique

Abstract A recent study used both qualitative and quantitative methods to examine families' perceptions of service needs for children with disruptive behavior problems. Focusing on the qualitative component of the study, the present paper discusses the modified Nominal Group Technique used in focus groups attended by carers living in rural, regional or metropolitan contexts. Three questions posed to each focus group sought to identify families' concerns about health facilities and/or related support services currently available to them, the benefits they perceived in these services and the changes needed to make these services more appropriate or accessible to them. Major themes in the responses relating to each of these questions included concerns about a lack of, or perceived need for, access to help/support, benefits in schools that accommodated the needs of the children, and support from the community. Families' recommendations for change included increased access to health care advice, information and/or support systems.     

早期给予早产儿更多表面活性剂

对两个时期(1994年4月1日至1996年3月31日期间和1999年4月1日至2001年3月31日期间)胎龄不足32周的早产儿进行表面活性剂治疗的情况进行比较。结果显示给予表面活性剂治疗的百分率从41%显著增加到54%,出生后1h内给药的百分率从13%增加到了60%。局部地区的数据收集及反馈有助于对     

全髋关节和半髋关节置换治疗术前可活动并自理的囊内移位性股骨颈骨折患者随机对照试验

背景：半髋和全髋关节置换术常用于治疗囊内移位性的股骨颈骨折，但是每一种方法都有缺点，对这些骨折的最佳治疗方法仍存在争议。方法：前瞻性随机研究，对81例移位性术前可活动并生活独立的股骨颈骨折患者，随机行全髋或半髋关节置换术。患者平均年龄75岁。结果采用Oxford髋关节评分来评价，并对最近的X线片作评估。结果：平均随访3年，半髋关节置换组平均行走距离为1．17英里（1．9km），全髋关节置换组平均行走距离为2．23英里（3．6km）；半髋关节置换组平均Oxford髋关节评分为22.3分，而全髋关节置换组平均Oxford髋关节评分为18．8分。全髋关节置换组患者较半髋关节置换组患者行走距离较远（p=O．039），Oxford髋关节评分较低（较好）（p=O．033）。32例生存的半髋关节置换患者中，有20例在最后随访时X线片上出现髋臼磨损表现。半髋关节置换组没有出现髋关节脱位，而全髋关节置换组发生3例脱位。在半髋关节置换组，2例翻修改行全髋关节置换，3例出现髋臼严重磨损须翻修。在全髋关节置换组，1例由于股骨假体下沉而作翻修。结论：在该前瞻性随机研究中，对在术前可活动并生活独立的囊内移位性股骨颈骨折患者，全髋关节置换较半髋关节置换具有较好的短期临床结果和更少的并发症。可信水平：治疗性研究，Ⅰ级。进一步可信度参见作者介绍。