哮喘健康教育的临床效果

目的研究哮喘健康教育各个方面对临床效果的影响，为系统规范的进行哮喘健康教育提供科学参考。方法对我院呼吸科104例哮喘病患者进行健康教育，出院时以问卷调查的方式，对患者掌握健康教育5个方面的效果进行评价。用Logistic回归分析影响复发住院率的因素。结果疾病知识、饮食注意、日常活动、正确用药和心理情绪合格率分别为43．75％，52．86％，76．68％，70．64％，67．46％；复发住院率22．12％；日常活动、疾病知识和正确用药对应的OR值为0．176，0．451，0．791，差异有统计学意义（P〈0．05），表明是复发住院的重要影响因素。饮食注意和心理情绪OR值均小于1，差异无统计学意义（P〉0．05）。结论对于哮喘的健康教育需要更加规范化，专业化，需要着重注意对日常活动、疾病知识和正确用药等方面有针对性地进行健康教育。     

Women with a BMI ≥ 30 kg/m² and their experience of maternity care: A meta ethnographic synthesis

Objectivethis paper is a report of a systematic review and meta-ethnography of the experiences of women with body mass index (BMI) ≥ 30 kg/m² and their experience of maternity care.Methodsystematic review methods identified 12 qualitative studies about women's experiences of maternity care when their BMI ≥ 30 kg/m². Findings from the identified studies were synthesised into themes, using metaethnography.Synthesis and findingsthe meta-ethnography produced four key concepts; Initial encounters, Negotiating risk, Missing out and The positive intervention, which represent the experiences of maternity care for women with BMI ≥ 30 kg/m²Key conclusionmany women with BMI ≥ 30 kg/m² appear to be dissatisfied with the approaches taken to discuss weight status during maternity encounters. When weight is not addressed during these encounters women appear to be equally dissatisfied. The absence of open and honest discussions about weight, the feeling of being denied of a normal experience, and an over emphasis on the risks imposed upon pregnancy and childbirth by obesity, leave women feeling dissatisfied and disenfranchised. Sensitive care and practical advice about diet and exercise can help women move towards feeling more in control of their weight management     

Fish consumption by children in Canada: Review of evidence,challenges and future goals

Fish consumption is of great importance to children’s health and is essential for neurodevelopment, which begins in pregnancy and continues throughout early childhood and into adolescence. However, fish consumption presents conflicting health outcomes associated with its nutritional benefits and its adverse contaminant risks, because both avoiding fish as well as the consumption of contaminated fish can potentially harm children. This may be challenging to communicate. The present review was performed to assess the current knowledge and recommendations around ‘smart’ fish-consumption decisions. Health Canada advises, as well as other advisories and guides, that fish should be consumed for its health benefits, while also informing consumers, especially women and children, to limit certain fish consumption. The current literature must attempt to handle the challenges inherent in communicating the dilemmas of children’s fish consumption. Incorporation of new knowledge translation strategies are proposed as a means to raise the level of knowledge about optimal fish consumption practices.     

初孕妇健康教育对降低难产率的影响

目的探讨初孕妇健康教育对降低难产率的影响。方法对100例愿意接受此实验的初孕妇实施健康教育,以常规围生检查的100例作对照。比较两组患者的产程时间、分娩方式及产时心理反应。结果实验组产程时间、难产率明显低于对照组（P〈0.01）。结论实施初孕妇健康教育能有效缩短产程时间和降低难产率,具有积极的作用。     

Evaluating the Health Information Technology Regional Extension Center in South Carolina

ObjectiveTo determine the impact of the South Carolina Regional Extension Center, Center for Information Technology Implementation Assistance (CITIA-SC), on physician practices engaged in the process of electronic medical record (EMR) adoption.Data sourcesData from a cross-sectional survey distributed in March 2011 to 1310 primary care practice groups throughout South Carolina was used to determine the degree of EMR adoption throughout the state (n=452 respondents; 34.5% response rate). Participation in CITIA-SC was determined by obtaining a list of practices from CITIA-SC.Study designA posttest-only design with nonequivalent groups was used to estimate the degree of EMR implementation, plans for and perceived barriers to implementation based on CITIA-SC participation.ResultsCITIA-SC practice sites faced similar barriers to EMR implementation as non-CITIA-SC participants, including initial or recurring cost of an EMR, low staff expertise with EMRs or computers, and productivity disruption. Additionally, CITIA-SC practice sites had fewer IT personnel on staff (p=0.0358) and were considering EMR implementation without a plan (p=0.0125). Despite these barriers, more practices participating in the CITIA-SC program were preparing to invest in an EMR system within one year when compared to nonparticipants (75.9% versus 28.3%, p<0.0001).ConclusionOur results indicated that the practice sites that participate in the REC had fewer IT resources and more perceived barriers to implementation. These results suggest that REC participant practice sites intend to implement an EMR, but recognize the need for technical assistance in the preparation and implementation of an EMR system.     

程序化健康教育对婴幼儿腹泻的作用

目的探讨程序化健康教育对婴幼儿腹泻的作用。方法将84例婴幼儿腹泻患儿随机分为试验组43例和对照组41例,对照组采用传统健康教育方法教育,试验组按整体护理程序对患儿及家属实施程序化健康教育。观察2组患儿家属对婴幼儿腹泻病相关知识和技能的知晓程度;2组患儿的住院时间、红臀发生情况。结果试验组患儿家属对婴幼儿腹泻病相关知识和技能的知晓程度明显优于对照组(P<0.05),且试验组患儿的平均住院时间、红臀的发生均少于对照组。结论采用程序化健康教育能明显提高患儿家属的健康知识水平,缩短患儿的平均住院时间,减少红臀发生。     

Seasonal variation in rates of emergency room visits and acute admissions following recommended infant vaccinations in Ontario,Canada: A self-controlled case series analysis

ObjectivesTo determine if birth month has an effect on the incidence of adverse events following the 2- and 12-month recommended vaccinations.Study designUsing health administrative databases, we conducted a population-based retrospective cohort study and employed a self-controlled case series analysis approach. We included children born in Ontario, Canada between April 1st 2002 and March 31st 2010 who received the diphtheria, tetanus, pertussis, inactivated poliovirus and Haemophilus influenzae type b (DTaP-IPV-Hib) vaccine recommended at 2 months and/or the measles, mumps, and rubella vaccine recommended at 12 months. We calculated the relative incidence (RI) of hospitalizations and emergency room visits within a pre-specified risk period compared to a control period following vaccination. We measured the effect of birth month using relative incidence ratios (RIRs) to compare the RI for infants born in each month to that for the month having the lowest RI.ResultsFor the 2-month vaccination, we observed the lowest and highest RIs for infants born in October and April, respectively. The RIR (95% CI) for April compared to October was 2.06 (1.59–2.67, p < 0.0001), consistent with a strong seasonal effect. For the 12-month vaccination, November births had the lowest RI, whereas August births had the highest. The RIR (95% CI) for August compared to November was 1.52 (1.30–1.77, p < 0.0001).ConclusionsOur findings suggest a seasonal effect on susceptibility to adverse events following vaccination exists. Further study will be important to elucidate potential biological and/or behavioral explanations for the seasonal effect we observed.