Pregnancy outcomes among visually impaired women in Washington State, 1987–2014

BackgroundWomen with visual impairment may have reduced ability to access standard care resources, however, information on their pregnancy and neonatal outcomes is limited.ObjectiveTo assess risk of adverse pregnancy and neonatal outcomes among visually impaired women in Washington State from 1987 to 2014.MethodsWe conducted a retrospective cohort study using linked Washington State birth/fetal death hospital discharge records to compare outcomes among women with and without visual impairment noted at their delivery hospitalization. Pregnancy conditions and outcomes evaluated included gestational diabetes, pre-eclampsia, labor induction and cesarean delivery. Neonatal outcomes included preterm delivery and birth weight <2500 g. We assessed length of maternal and infant delivery hospitalization. We performed Poisson regression to estimate relative risks (RR) and 95% confidence intervals (CIs) for each outcome, adjusting for year of delivery, maternal age, and parity.ResultsMost adverse pregnancy and neonatal outcomes were similar for visually impaired (N = 232) and comparison women (N = 2362). However, visually impaired women had increased risks of severe pre-eclampsia (RR 3.77, 95% CI 1.69–8.43), labor induction (RR 1.33, 95% CI 1.10–1.61) and preterm delivery (RR 1.60, 95% CI 1.06–2.42). They were also more likely to have delivery hospitalizations of 3 or more days following a vaginal (RR 1.86, 95% CI 1.41–2.47). Among cesarean deliveries, infants of visually impaired women had increased risk (RR 1.24, 95% CI 1.02–1.51) of hospitalization for 3 or more days postpartum.ConclusionOur findings may be useful for obstetric providers in counseling their visually impaired patients.     

住院病人护理需求的质性研究

目的深入了解住院病人存在的护理需求，为护士有针对性的护理服务措施提供依据。方法应用Maslow的需要层次壶论为框架访谈了江西省某医院11位住院病人和8位临床护士。结果经过分析了解到病人在住院期间可能存在的59项护理需求和病人对医院工作的一些要求。结论医院各部门和护士要重视病人的护理需求。使病人在住院期间得到高品质的护理服务。     

Prognostic benefit of beta-blockers in patients not receiving ACE-Inhibitors.

AIMS: Beta-blockers (BBs) confer significant prognostic benefit in patients (pts) with systolic chronic heart failure (CHF). However, major trials have thus far studied BBs mainly in addition to ACE-Inhibitors or angiotensin receptor blockers (ARBs) as background therapy. The magnitude of the prognostic benefit of BBs in the absence of ACE-I or ARB has not as yet been determined. METHODS AND RESULTS: We performed a meta-analysis of all placebo-controlled BB studies in patients with CHF (n>200). Trials were identified via Medline literature searches, meeting abstracts, and contact with study organizations. Results for all-cause mortality and death or heart failure hospitalization were pooled using the Mantel-Haenszel (fixed effects) method. The impact of BB therapy on all-cause mortality in CHF, in the absence (4.8%) and presence (95.2%) of ACE-I (or ARB), was determined from six trials of 13 370 patients. The risk ratio (RR) for BBs vs. placebo was 0.73 [95% confidence interval (CI) 0.53-1.02] in the absence of ACE-I or ARB at baseline, compared with a RR of 0.76 (95% CI 0.71-0.83) in the presence of these agents. When ACE-Inhibitors were analysed in the same way (pre-BB), a RR of 0.89 (0.80-0.99) vs. placebo was observed in studies of >90 days. The impact of BB therapy on death or HF hospitalization in systolic CHF, in the absence and presence of ACE-I, was determined from three trials of 8988 patients. The RR for BBs vs. placebo was 0.81 (95% CI 0.61-1.08) in the absence of ACE-I or ARB at baseline, compared with a RR of 0.78 (95% CI 0.74-0.83) in the presence of these agents. When ACE-Is were analysed in the same way (pre-BB), a RR of 0.85 (95% CI 0.78-0.93) vs. placebo was observed in studies of >90 days. CONCLUSION: The magnitude of the prognostic benefit conferred by BBs in the absence of ACE-I appears to be similar to those of ACE-Is in systolic CHF. These data therefore suggest that either ACE-Is or BBs could be used as first-line neurohormonal therapy in patients with systolic CHF. Prospective studies directly comparing these agents are required to definitively address this issue.     

高血压患者152例住院治疗的护理研究

目的探索高血压患者住院治疗的医疗护理方式对有效控制血压的影响。方法将患者分为A组和B组,2组治疗用药相同,采用的医疗护理方式不同。A组80例,采用药物治疗护理、非药物治疗护理、其他治疗护理等3种护理方式。B组72例,采用药物治疗护理、非药物治疗护理2种护理方式。①高血压药物治疗护理:根据药物制剂给药,按时按量用药,根据病情选用药物与用药剂量。②高血压非药物治疗护理:改善食物结构,增加适当的体力活动,有氧锻炼,减轻精神压力,保持心理平衡。③高血压的其他治疗护理:降血脂指导,抗血小板干预,血糖控制,康复按摩,心理辅导。结果 A组收缩压平均降低(34±8)mm Hg(1mm Hg=0.133kPa),B组收缩压平均降低(19±5)mm Hg,比A组低(15±3)mm Hg;A组舒张压平均降低(14.0±2.0)mm Hg,B组舒张压平均降低(9.0±1.0)mm Hg,比A组低(5.0±1.0)mm Hg,治疗效果A组优于B组。高血压患者对护理依从性:年龄大者、文化程度高者、农民的依从性好。结论坚持防治相结合的原则,建立有效的护理干预措施,提高患者依从性,全面拓展护理工作,高血压能够得到有效控制与降低。     

297例住院儿童意外伤害情况分析

目的 探讨住院儿童意外伤害发生的类型及影响因素。 方法 收集某医院１９９４－１９９７年期间所有因意外伤害事故而入院的２９７例０－４岁儿童的资料。 结果 男性病例数明显高于女性，１￣４岁幼儿为意外伤害事故发生的高峰年龄段。意外伤害类型及排位在０￣４岁婴幼儿中主要为烧烫伤、跌落、车祸；５￣１４岁儿童中主要为车祸、跌落、烧烫伤。１／３住院儿童完全痊愈，约２／３住院儿童留下后遗症。 结论 意外伤害事故的发     

精神疾病患者住院费用分析

本文通过调查近5年来山东省精神卫生中心精神疾病患者的住院费用情况,了解其现状,探讨其影响因素,为政府制定相关精神卫生政策提供科学依据。     

Behavioural, emotional and family functioning of hospitalized children in China and Hong Kong

PURPOSE: This study examined behavioural and emotional problems, social competence and family functioning of hospitalized Chinese children in Hong Kong and the Chinese Mainland. METHOD: A sample of 210 hospitalized children (ages 2-11 years) and their families participated in the study. The families were from a cross-section of geographical areas in Hong Kong (two hospitals) and the Chinese Mainland (five hospitals). Parents completed an age-appropriate Chinese version of the Child Behaviour Checklist and the Family Assessment Device. Multiple regression models were used to examine predictors of children's behaviour problems. RESULTS: Behavioural patterns appeared to be specific to the developmental stage. Children had greater problems when their families demonstrated poorer affective involvement. Hospitalized children on the Chinese Mainland experienced more internalizing and externalizing behaviour problems than those in Hong Kong. Sick children, according to their parents, however, demonstrate some resiliency based on social and academic competency factors. CONCLUSIONS: Hospitalized Chinese children manifest behavioural, emotional and family problems that vary by region, the child's development and gender. Problems predominantly of an internalizing nature characterized this group. The findings support the need for culturally appropriate behavioural assessments and interventions with hospitalized children.     

Hospitalized burns in Finland: 36 305 cases from 1980–2010

To analyse the epidemiology of burns in Finland, a comprehensive study was conducted among all hospitalized burn patients between 1980 and 2010. All patients with burn injury as the main diagnosis, 36 305 cases in total, treated in the public and private sectors, were included.Patient data were obtained from the Finnish Hospital Discharge Register (FHDR). The incidence of hospitalized injuries declined from over 30 to 17 per 100 000 persons. Men were at higher risk than women in all age groups. Children aged under ten years were overrepresented throughout the period and the highest incidence was found among one year old boys. The median total length of stay shortened from seven days in 1980–1995 to five days in 1996–2010. The annual number of hospitalized patients is recently under 1000 cases (17/100 000). The male predominance (70%) did not change but the age group with the most injuries shifted from 20–39 years to 40–59 years. Injuries were most common during the summer months.This study of all hospitalized burn injuries of one entire country shows similar tendency of diminishing numbers and rising age of burn victims as in other western countries. The FHDR is a reliable source of data in epidemiological studies but precise recording of E- and N-codes in the registry would enable the accurate analysis of types and extent of injury.