健康促进对产后抑郁症患者生活质量影响的研究

目的 探讨健康促进对产后抑郁症患者生活质量的影响.方法 将182例产后抑郁症患者随机分为实验组与对照组,每组各91例,实验组施行健康促进,对照组只实行常规护理,24 w后采用生活质量量表(SF-36QOL)测定其生活质量.结果 实验组生活质量非常显著高于对照组(P＜0.001).结论 健康促进提高了产后抑郁症患者的生活质量.     

健康教育路径对提高肠造口病人自我护理能力的效果观察

目的 探讨健康教育路径对提高肠造口病人自我护理能力的效果.方法 将83例肠造口病人随机分为观察组(42例)和对照组(41例,),观察组采用肠造口病人健康教育路径方法,对照组采用随机健康教育方法.结果 两组病人在自我护理能力和满意度的差异均有统计学意义(P<0.05).结论 对肠造口病人采用健康教育路径方法,能提高病人的自我护理能力和满意度.     

体表络脉是观察人体健康和疾病状况的窗口

络脉是气血运行的通道,也是病邪传入通道和病变部位。部分络脉在体表可见,其变化可反映人体气血阴阳和寒热虚实状态,也是观察人体健康和疾病状态的窗口。中医师通过观察皮肤、舌下、视网膜、虹膜、巩膜、结膜等部位络脉了解病情,糖尿病、高血压、动脉硬化等病患者在这些部位的络脉则发生明显变化。与肉眼观察相比较,用放大镜、显微镜等手段能大大提高我们的观察能力,能清晰观察到肉眼看不到的内容,更早、更准确地为我们提供疾病信息,其可作为体检、诊断的依据。     

Palliative Care Consultation Service and Palliative Care Unit: Why Do We Need Both?

Background.

Palliative care (PC) infrastructure has developed differently around the globe. Whereas some institutions consider the palliative care unit (PCU) a valuable component, others report that the sole provision of a state-of-the art palliative care consultation service (PCCS) suffices to adequately care for the severely ill and dying.

Objective.

To aid institutional planning, this study aimed at gathering patient data to distinguish assignments of a concomitantly run PCU and PCCS at a large hospital and academic medical center.

Methods.

Demographics, Eastern Cooperative Oncology Group performance status, symptom/problem burden, discharge modality, and team satisfaction with care for all 601 PCU and 851 PCCS patients treated in 2009 and 2010 were retrospectively analyzed.

Results.

Patients admitted to the PCU versus those consulted by the PCCS: (a) had a significantly worse performance status (odds ratio [OR], 1.48); (b) were significantly more likely to suffer from severe symptoms and psychosocial problems (OR, 2.05), in particular concerning physical suffering and complexity of care; and (c) were significantly much more likely to die during hospital stay (OR, 11.03). For patients who were dying or in other challenging clinical situations (suffering from various severe symptoms), self-rated team satisfaction was significantly higher for the PCU than the PCCS.

Conclusion.

This study presents a direct comparison between patients in a PCU and a PCCS. Results strongly support the hypothesis that the coexistence of both institutions in one hospital contributes to the goal of ensuring optimal high-quality PC for patients in complex and challenging clinical situations.     

Disclosure and health-seeking behaviour following intimate partner violence before and during pregnancy in Flanders, Belgium: a survey surveillance study

OBJECTIVES: The objectives were to estimate the prevalence of physical and sexual intimate partner violence (IPV) among a regional sample of the general obstetric population as the lifetime prevalence, as the 1-year period prevalence before pregnancy, and as the prevalence during the index pregnancy; to assess the rates of disclosure and help-seeking behaviour with IPV; and to determine the acceptability of screening for IPV. STUDY DESIGN: A multi-centred survey surveillance study was carried out among pregnant women attending five large hospitals in the province of East Flanders, Belgium as a regional probability sample of the general obstetric population. Data were collected through an anonymous, written questionnaire that included the Abuse Assessment Screen and additional questions on the circumstances of the most recent episode of physical or sexual violence, on disclosure and help-seeking behaviour, on reporting assault to the police, and on the acceptability of routine screening for IPV. RESULTS: The sampling frame consisted of 1362 women who received the questionnaire at the antenatal service during a 2-month study period, of which 537 (mean age 29.4 years, S.D. 4.09) returned the envelope (response rate 39.4%). The lifetime prevalence of IPV was estimated to be 10.1% (95% CI 7.7-13.0%) and the period prevalence of IPV during pregnancy and/or in the year preceding pregnancy 3.4% (95% CI 2.1-5.4%). There was a significant difference in the reported lifetime prevalence of IPV between women attending with a partner and those who came to the prenatal visit unattended by their partner in particular (6.8% versus 13.9%, p=0.010). Overall, only 19.2% (23 out of 120) and as few as 6.6% (4 out of 61) of the victims of physical and sexual abuse respectively sought medical care by consulting a general practitioner, gynaecologist, or an emergency department. Routine screening for IPV by a general practitioner or gynaecologist was found to be largely acceptable. CONCLUSIONS: In our highly medicalised society, women experiencing partner violence rarely disclose abuse to the widely available health care services, unless they are directly asked about it, which appears an acceptable practice. Hence, there is a definite need to improve women's awareness regarding abuse and their help-seeking behaviour at a public health level.     

Recommendations for reducing risks of infection associated with suction collection procedures.

It is recognized that risks are incurred when health care workers contact various body fluids. The handling of suction collection equipment poses a risk because it is one way workers may come in contact with these fluids. Minimizing the risks associated with suction procedures can be accomplished if appropriate policies and procedures can be developed in health care facilities.     

Magnesium metabolism in blood and the whole body in man using 28magnesium.

Studies of magnesium kinetics in plasma, red cells, and the whole-body with ²⁸Mg are described. The observations in plasma were analyzed with a three-compartment model and those in red cells with a two-compartment model. An integral approach, using the occupancy principle, was used in the analysis of the whole-body observations. At 120 hr after intravenous administration of ²⁸Mg, exchangeable magnesium calculated by the dilution principle was only 23% of total body magnesium. There was good agreement between the estimates of exchangeable magnesium based on plasma and “spot” urine ²⁸Mg activity. Exchangeable magnesium, as estimated by compartmental analysis and the occupancy principle, was only 12.5%–15% of total body magnesium. These results suggest the existence of magnesium compartments in the body with turnover half-periods of at least 63–181 days that cannot be investigated adequately with the short-lived tracer, ²⁸Mg. A possible mechanism for the observed pattern of red cell uptake of ²⁸Mg in vivo is suggested in which magnesium enters these cells only during erythropoiesis and is then lost progressively from circulating red cells during the aging process. Present results suggest that the concentration of magnesium in reticulocytes may be 3.9 times greater than the mean red cell concentration. Magnesium may leave red cells exponentially with age; a half-period of 22.4 days is suggested.     

Nosocomial pseudoepidemics and pseudoinfections: an increasing problem.

The infection control practitioner often relies on microbiologic data in order to conduct nosocomial infection surveillance and control activities. On the basis of a review of the medical literature, false positive culture and stained smear results representing pseudoinfection are being reported with greater frequency. Documented cases and clusters of pseudoinfectons are reviewed, and the epidemiologic characteristics and methods for detection and prevention of this increasingly recognized problem are discussed.     

紫外衍生-高效液相色谱法测定保健食品和饮料中的三氯蔗糖

目的 建立保健食品和饮料中三氯蔗糖的柱前紫外衍生-高效液相色谱测定方法。方法 样品经水浸提、离心后,取样液与苯甲酰氯在碱性介质中反应生成具有紫外吸收的衍生产物,然后用高效液相色谱法分析。色谱条件:分离柱为C18柱（250 mm×4.6 mm,4 μm),流动相为甲醇-水( 95∶5,V/V),检测波长为232 nm。以保留时间定性,标准曲线法定量。 结果 三氯蔗糖在0.05～1.00 μg范围内,与色谱峰面积有良好的线性关系（r=0.999 8）,方法检出限为0.001 25 μg。方法加标回收率为97.4%～102.0%,相对标准差均小于5.0%,方法的日内精密度和日间精密度分别为1.52%和4.04%。结论 该方法简便快速、分离效果好,准确度高,不需要特殊检测器,适用于保健食品和饮料中三氯蔗糖的快速测定。