Metabolic syndrome following a first episode of psychosis: results of a 1-year longitudinal study conducted in metropolitan Lisbon,Portugal

ObjectiveWe aimed to assess the prevalence and course of metabolic syndrome (MetS) and the associated metabolic parameters during the year following a first episode pf psychosis (FEP).MethodsWe performed a 1-year longitudinal observation of 60 patients who experienced FEP. MetS was defined using the modified definition of the National Cholesterol Education Program Adult Treatment Panel III. We assessed the metabolic parameters and socio-demographic and psychopathological data for the participants.ResultsThe mean age of the participants was 27.1 years, and 33.3% of them were women. There was an increase in the prevalence of MetS from 6.7% to 11.7% during the year following the baseline assessment during the year following the baseline assessment (p = 0.250). There were also significant increases in the prevalences of abnormal triglyceride concentration, waist circumference, and high-density lipoprotein (HDL)-cholesterol concentration during this period. In addition, there was a considerable worsening of the metabolic profile of the participants. No baseline parameters were identified to be predictors of MetS over the 1-year follow-up period.ConclusionsWe can conclude that metabolic abnormalities are common in patients with FEP and that these rapidly worsen during the first year following the diagnosis of FEP. Studies on interventions are needed to reduce metabolic risk to cardiovascular diseases following the FEP.     

Preferences and attitudes of young Chinese clinicians about using a shared decision making tools for communicating cardiovascular risk

ObjectiveThis study assesses the attitudes and preferences of Chinese clinicians toward their involvement in shared decision making (SDM).MethodsFrom May 2014 to May 2015, 200 Chinese clinicians from two hospitals were enrolled to complete a survey on their attitude towards SDM. We conducted the survey via face-to-face interviews before and after an educational intervention on SDM among young Chinese clinicians. The clinicians were asked to give the extent of agreement to SDM. They also gave the extent of difficulty in using decision aids (DAs) during the SDM process. The variation in the range of responses to each question before and after the SDM intervention was recorded. The frequency of changed responses was analyzed by using JMP 6.0 software. Data were statistically analyzed using Chi-square and Mann–Whitney U tests, as appropriate to the data type. Multiple logistic regressions were used to test for those factors significantly and independently associated with preference for an approach for each scenario.ResultsOf the 200 young Chinese clinicians sampled, 59.0% indicated a preference for SDM and a desire to participate in SDM before receiving education or seeing the DA, and this number increased to 69.0% after seeing the DA with the sample video of the SDM process on Statin Choice. However, 28.5% of the respondents still reported that, in their current practice, they make clinical decisions on behalf of their patients. The clinicians who denied a desire to use the DA stated that the main barriers to implement SDM or DA use in China are lack of time and knowledge of SDM.ConclusionsMost young Chinese clinicians want to participate in SDM. However, they state the main barriers to perform SDM are lack of experience and time. The educational intervention about SDM that exposes clinicians to DAs was found to increase their receptivity.     

Development and evaluation of a hearing aid manual in the Malay language

Objective: This study aimed to (a) translate a hearing aid (HA) manual into Malay language and revise the translated manual based on best practice guidelines; (b) compare the effectiveness of the translated and the revised Malay HA manuals in helping individuals to perform HA management tasks.

Design: Cross-sectional, randomised, single-blinded study.

Study sample: An Oticon-Dynamo HA manual was translated and revised based on best practice guidelines. Ninety participants aged 55?years and above participated in this study. They were randomly assigned into the control group (received translated manual) and the experimental group (received the revised translated manual). The Hearing Aid Management (HAM) test, which was developed in a previous study, was conducted to evaluate participant’s ability to perform HA management tasks using the translated and the revised version of Malay HA manual.

Results: The revised Malay HA manual had a lower reading grade level relative to the initial translated Malay HA manual. The ability to perform HA management tasks was better in the experimental group (mean = 12.2, SD = 1.15) versus the control group (mean = 8.7, SD = 2.11).

Conclusion: Further revision of existing HA manuals based on best practice guidelines is recommended to help individuals better manage their HAs.     

Outcome prediction for Bonebridge candidates based on audiological indication criteria

ObjectiveTo re-evaluate current indication criteria and to estimate the audiological outcomes of patients with Bonebridge bone conduction implants based on preoperative bone conduction thresholds.MethodsWe assessed the outcome of 28 subjects with either conductive or mixed hearing loss (CMHL) or single-sided deafness (SSD) who were undergoing a Bonebridge implantation. We used linear regression to evaluate the influence of preoperative bone conduction thresholds of the better/poorer ear, indication group, and language (German- and French-speaking patients) on aided sound field thresholds. In addition, aided word recognition scores at 65 dB sound pressure level were fit with a logistic model that included preoperative bone conduction thresholds of the better/poorer ear, indication group, and language as effects.ResultsWe found that both aided sound field thresholds and word recognition were correlated with the preoperative bone conduction thresholds of the better hearing ear. No correlation between audiological outcomes and the preoperative bone conduction thresholds of the poorer ear, language, or indication group was found.ConclusionBone conduction thresholds of the better hearing ear should be used to estimate the outcome of patients undergoing Bonebridge implantation. We suggest the indication criteria for Bonebridge candidates considering maximal bone conduction thresholds of the better ear at 38 dB HL to achieve an aided sound field threshold of at least 30 dB hearing level and an aided word recognition score of at least 75% for monosyllabic words.     

群体性伤病临床急救分析

对群体性伤病的临床资料进行分析,研究多种原因导致的突发性群体伤病在急诊急救中的救治特点以及相关的实施经验,对常见的各种群体伤病的发病特点、救治方案进行认识,认识群体性伤病具有关联性、随机性以及影响性,同时在实施救治的过程中还要相互配合。     

质性探讨医学生院前急救能力现状及相关教育培养策略

目的:探索提高医学生院前急救能力的教育对策,为加强医学生急救综合能力培养提供参考。方法：运用质性研究中现象学研究方法,对急诊医师、红十字会人员、高校教师及医学生共15例进行半结构式访谈,利用Colaizzi现象学7步分析法分析资料。结果：访谈共提炼出3个主题：医学生院前急救综合能力存在不足,院前急救教育仍有待完善,高校教师、急诊医师等多教育角色在院前急救教育中的作用应各有侧重。结论：医学生的急救知识、操作技能以及应急综合素质存在不足,应根据时代需求优化师资队伍,完善医学急救教育的课堂设置及考核方式,逐步建立高校与公共卫生机构的教学联系机制。     

25例小儿蛇咬伤的急救与护理

目的小儿被蛇咬伤在儿科历年来极罕见。但随着人们的生活水平提高,小儿外出草地游玩的机会增多及小儿好奇心大和贪玩,家长看管不严、居住生活在田野环境等原因,被蛇咬伤的机会增多,特别是在夏秋季节。人被蛇咬伤后,蛇毒迅速进入人体内,主要引起中枢神经系统和循环系统中毒,短时问内即可危及生命。因此,蛇咬伤后必须立即采取有效的急救护理措施,以挽救患儿的生命。     

护理部面对成批伤员急救的护理管理对策

目的医院面对成批伤员急救时,护理部采取正确的护理管理对策,确保成批伤员的抢救成功率。方法通过3批烧伤伤员抢救成功后,对临床抢救的实践经验进行了总结。结果3批伤员抢救成功。结论护理部根据成批伤员的特点,迅速启动紧急预案,及时实施护理管理对策,确保成批伤员的抢救成功。