Development of a measure of collective efficacy within personal networks: A complement to self-efficacy in self-management support?

ObjectiveTo develop and evaluate the Collective Efficacy of Networks (CENS) questionnaire to measure perceived collective efficacy within personal social networks.MethodsA mixed methods approach was used, guided by theory and with extensive input from adults with long-term conditions who completed the initial questionnaire (n = 78) with test-retest assessed at 2 weeks (n = 68). A second sample (n = 85) completed a postal questionnaire including CENS, theoretically linked constructs (self-efficacy, social support) and health outcomes (loneliness, mental and physical health).ResultsPrincipal components analysis demonstrated a two-factor structure with 12-items selected to represent Network responsiveness (8 items, Cronbach’s alpha = 0.896) and Access to collective efficacy (4 items, Cronbach’s alpha = .773). Good test-retest reliability was established for both subscales (r_icc = .793–.853). Network responsiveness was associated with self-efficacy (r = 342, p = . < 001) and social support (r = .407, p < .001) and predicted reduced loneliness. Access to collective efficacy significantly predicted better mental health; the predictive validity of the subscales improved when combined with self-efficacy.ConclusionThe CENS is an acceptable and psychometrically robust measure of collective efficacy in personal social networks.Practice implicationsMeasuring collective efficacy with self-efficacy will provide useful information for researchers and policymakers interested in capacity for self-management and social determinants of behaviour change.     

Crise du Levothyrox® : également un Phénomène Psychogénique Collectif ?

The Levothyrox^®“crisis” is a phenomenon on a scale never before seen in France. The intention behind the change in formulation of Levothyrox^® was linked to a determination on the part of the health authorities to improve the stability of the active ingredient and therefore the management of hypothyroidism in approximately three million patients in France. Poor communication management has led to extensive incidence and reporting of side effects. Notwithstanding the fact that these side effects are real for a limited number of patients, the media coverage that has been given to this phenomenon raises questions about its underlying causes and the possibility of a collective psychogenic phenomenon of which it has all the characteristics.     

群体性侵袭与肿瘤的研究进展

群体性侵袭是肿瘤细胞重要的运动形式之一,其在肿瘤侵袭转移过程中的作用日益受到关注。群体性迁移是胚胎发育过程中重要的运动模式。与此相似,近年来研究显示癌细胞以群体方式侵袭转移在恶性肿瘤中普遍存在。群体性侵袭参与癌细胞播散和转移的机制正逐渐被揭示。对肿瘤群体性侵袭的深入研究,有助于发现新的抑制肿瘤侵袭转移的干预途径。     

深圳市集体用餐人群膳食能量状况调查

[目的]全面了解深圳市某医院集体用餐人群的膳食营养及所摄入能量的状况,以评价本市居民能量需要得到满足的程度。[方法]从某单位筛选出合格的成年男女各20人,进行膳食调查,记录每餐膳食种类和数量等,包括零食、夜宵等进食情况。[结果]调查发现,集体用餐人群人均摄入的能量(1598.3±255.4)kcal(女性)和(2000.8±308.1)kcal(男性),均达不到推荐摄入量。膳食纤维(8.76±1.49)g(女性)和(10.29±1.79)g(男性),亦与RNI相差甚远。[结论]集体用餐人群的膳食结构不够合理,膳食结构单一,摄入的营养素不够均衡,应注意膳食结构的平衡,并加强营养教育工作。     

乌鲁木齐市学龄前集体儿童健康状况调查

目的:通过对乌鲁木齐市学龄前集体儿童健康状况调查,了解和评定乌鲁木齐市学龄前集体儿童生长发育状况,探讨存在的问题并提出干预措施,以提高儿童健康水平。方法:采用分层整群抽样方法从乌鲁木齐市所属9个区中随机抽取3个区的9所幼儿园中1483名3～6岁儿童,测量体重和身高,检测龋齿患病情况及血红蛋白含量,并采用统计学方法分析乌鲁木齐市学龄前儿童体重、身高的均值与2005年我国9城市比较。结果:乌鲁木齐市学龄前儿童中所有年龄组男、女童体重、身高测定值均为男童大于女童,且均高于2005年9城市标准。营养不良、贫血、肥胖及龋齿的患病率分别为0.9%、6.1%、9.6%及40.6%,不同年龄龋齿患病率差异有统计学意义(P<0.05)。结论:乌鲁木齐市学龄前集体儿童体格发育良好,肥胖患病率高于其他城市,应加强健康教育,严格按照疾病的防治常规制订防范措施,做到早期预防和早期发现,综合防范,群防群治,减少疾病的患病率,提高儿童健康水平。     

Collective self-esteem and the onset of chronic conditions and reduced activity in a longitudinal study of aging

Collective self-esteem (CSE) is an individual's self-evaluation as a member of social groups. It is thought to promote health and well-being in later life by moderating the harmful effects of losing personal control over these experiences. In this study of 144 community-dwelling older adults in Manitoba, Canada, among those with lower health-related perceived control, respondents with higher CSE at baseline developed significantly fewer chronic conditions over the next 6 years. An expected negative relationship between age and activity level, which respondents higher in CSE showed, was not observed among respondents with lower CSE, whose activity level in the sample age range (78-98 years) was already very low. Higher CSE thus appeared to delay the decline of activity and chronic health that would otherwise accompany age and the absence of perceived control.     

Radiation exposures of cancer patients from medical X-rays: how relevant are they for individual patients and population exposure?

X-ray procedures have a substantial impact not only on patient care but also on man-made radiation exposure. Since a reliable risk-benefit analysis of medical X-rays can only be performed for diagnosis-related groups of patients, we determined specific exposure data for patients with the ten most common types of cancer. For all patients with the considered cancers undergoing medical X-ray procedures in a maximum-care hospital between 2000 and 2005, patient- and examination-specific data were retrieved from the hospital/radiology information system. From this data, the cumulative 5-year effective dose was estimated for each patient as well as the mean annual effective dose per patient and the mean patient observation time for each cancer site. In total, 151,439 radiographic, fluoroscopic, and CT procedures, carried out in 15,866 cancer patients (age, 62 ± 13 years), were evaluated. The mean 5-year cumulative dose varied between 8.6 mSv (prostate cancer) and 68.8 mSv (pancreas cancer). Due to an increasing use of CT scans, the mean annual effective dose per patient increased from 13.6 to 18.2 mSv during the 6-year period. Combining the results obtained in this study for a particular hospital with cancer incidence data for Germany, we estimated that cancer patients having X-ray studies constitute at least 1% of the population but receive more than 10% of the total effective dose related to all medical X-ray procedures performed nationwide per year. A large fraction of this dose is radiobiologically ineffective due to the reduced life expectancy of cancer patients.     

针对性健康教育对糖尿病足患者伤口愈合疗效的观察

目的 探讨针对性健康教育对糖尿病足患者伤口愈合的效果.方法 选择116例糖尿病足患者,随机分为A组(60例)和B组(56)例.A组:对患者采取一对一的针对性心理护理;B组:1次/周进行健康教育集体讲座.观察2组心理护理前后FPG、HbAlc的变化及伤口愈合情况.结果 临床总有效率A组明显优于B组.结论 对糖尿病足患者进行针对性健康教育能提高患者的认知和遵医行为,促进伤口愈合,其疗效明显优于集体健康教育模式.     

河南省结核病耐药监测中的经验教训

目的　回顾性分析河南省两轮结核病耐药监测(drug resistance sarvillence DRS)的经验教训,供开展DRS工作的同道参考、借鉴。方法 分析2次耐药监测总结资料和有关问题的专题报告,或查阅有关的实验数据;对主要问题作对比分析,列表统计;经主要参与者讨论提出经验教训或改进的建议。结果 (1)用药史不清可造成复治病例混入初治组,导致初始耐药率假性升高。故应对用药史分级复核,督导检查,培训时强调。(2)寒冷季节、地区运送痰标本加防腐剂溴化十六烷基吡啶(CPB),易出现结晶、培养不长与污染;改在县级直接作培养而不用CPB,可大量减少不生长与污染,并产生更大社会效益。(3)首次在县级作结核菌培养时,设备的检修、更新、供电的保证和应急措施,接种培养的严格技术培训都应先行充分准备以防止污染、烤干、不生长等问题。(4)DRS中出现对复治病例和少数初治病例的跳选。与培训讲解不清、错误理解或想减少工作量有关。加强培训教育和严格督导检查,及时发现、纠正跳选,才能保证标本代表性和科学性。(5)采用亮光源放大镜判读培养基上菌落并2人以上复核,以及用N·N-二甲基甲酰胺替代甲醇作利福平溶剂,制作药敏培养基,使初期质控结果的敏感性过高,特异性过低问题得以纠正,使之迅速达WHO合格标准。结论 重视并认真实施WHO《DRS指南》要求的三个原则——样本代表性,抗结核用药史准确性,实验室技术正确性与质控达标,是DRS动作成功的基础。