What is the effect of regular group exercise on maternal psychological outcomes and common pregnancy complaints? An assessor blinded RCT

Objectiveto examine the effects of supervised group exercise on maternal psychological outcomes and commonly reported pregnancy complaints.Designan observer-blinded randomized controlled trial.SettingNorwegian School of Sport Sciences, Oslo, Norway.Participants105 sedentary, nulliparous pregnant women, mean age 30.7(±4.0) years, pre-pregnancy BMI 23.8 (±4.3), were assigned to either exercise (n=52) or control group (n= 53) at mean gestation week 17.7 (±4.2).Interventionthe exercise intervention followed ACOG guidelines and included a 60 minutes general fitness class, with 40 minutes of endurance training/aerobic and 20 minutes of strength training and stretching/relaxation, performed at least twice per week for a minimum of 12 weeks.Measurementsoutcome measures were assessed through standardized interviews pre- and post-intervention (gestation week 36.6, ±0.9), and included psychological variables related to quality of life, well-being, body image and pregnancy depression, as well as assessment of 13 commonly reported pregnancy complaints.Findingspost-intervention, using intention to treat (ITT) analysis, women randomized to exercise rated their health significantly better compared to women in the control group (p=0.02) and reported less fatigue related to everyday activities (p=0.04). Women with complete exercise adherence (≥24 sessions) had significantly better scores on measurements of feelings related to sadness, hopelessness and anxiety (p<0.01), compared to the control group. Contradictory, the control group reported higher life enjoyment (p<0.01). There were no significant group differences in body-image or pregnancy depression. With respect to analysing pregnancy complaints according to ITT, no differences between the groups were found. A comparison of the women who attended ≥19 (80%, n=21) or ≥24 (100%, n=14) exercise sessions with the control-participants, showed that fewer women in the exercise group reported nausea/vomiting and numbness/poor circulation in legs.Key conclusion and implication for practiseparticipation in regular group exercise during pregnancy contributed to improvements in some variables related to maternal well-being and quality of life. Women with high exercise adherence had significantly better results on several health variables reaping the highest benefits. A qualitative study exploring the barriers of women in achieving recommended amount of activity may be necessary to understand this population and developing better clinical practice educational tools.     

医院门急诊管理的思考与分析：从病人的抱怨而想起

调查门、急诊病人的抱怨资料,结合管理中存在的问题进行分析,强调医院管理者要把病人的抱怨放在心上有针对性地改进自己的工作尤其是注重服务质量的改善和提高。只有树立“病人至上”的理念,医院才能获得成功。     

量化质评指标在主任查房质量监控中的应用

目的：探讨如何确保主任查房及主任查房记录的质量。方法：拟定《临床科主任查房及查房记录量化评估指标》,根据指标抽查大内科８３份危重疑难病例、住院病历、主任查房记录并作出评估。结果：按《评估指标》抽查结果提示,按量化指标对临床科主任查房及记录质量的评估具有一定的实用性质及可行性。结论：只要能严格按照《评估指标》的要求,做到制度落实,诊治及学术水平高新化,注意教学,做好医护监督及病历质控,记录规范化,就     

大鼠胃的主细胞分离纯化培养及功能测定

目的通过建立分离纯化大鼠胃的主细胞培养系统,为进一步深入研究主细胞的生理调节和病理变化提供新的方法。方法采用链霉蛋白酶的消化、淘析法分离纯化大鼠胃的主细胞。主细胞的纯化率在光镜下根据细胞的大小、结构和颜色计算。用血红蛋白法测定胃蛋白酶。在主细胞的短期培养系统中,主细胞的最佳功能状态通过比较胆囊收缩素（ＣＣＫ－８）、卡巴可林和异丙肾上腺素在不同培养时间的刺激状态下,主细胞分泌胃蛋白酶原的量而定。结果     

331例海洛因依赖者呼吸系统疾病调查

目的··:了解海洛因依赖者呼吸系统并发疾病的发生率及其与海洛因滥用的相关性。方法··:连续抽取1999年3月 -1999年10月在我院强制戒毒的331例海洛因依赖者病历进行回顾性调查。结果··:331例海洛因依赖者中有呼吸系统并发疾病的178例 ,占53.78 %;吸毒时间在1a以上的有呼吸系统并发疾病的比例明显高于吸毒时间低于1a者 (χ2=24.66,P<0.01);注射方式吸毒的呼吸系统并发疾病的比例明显高于单纯烫吸的 (χ2=6.35,P<0.05)。结论··:呼吸系统并发疾病是海洛因依赖人群中最常见的并发疾患。海洛因滥用方式、滥用时间与呼吸系统并发疾病有相关性。     

妇产科住院总医师培训模式的探讨

住院总医师制度是医院人才培养和医院管理的重要环节。在住院总医师培训过程中,实行主动申报和严格遴选,进行岗前培训;加强日常管理,保障医疗安全及医疗质量;强化考核,进行规范化管理,收到了良好效果。     

区分撤诉投诉与不撤诉投诉的实践及意义

医疗投诉区分撤诉投诉与不撤诉投诉对于处理涉及医学人文服务不满意的投诉具有实用价值,它最大的特点是让被投诉者有机会处理医疗投诉,还主动权于被投诉者,从而让被投诉者学会处理医疗投诉,并在实践中主动地改进工作中存在的不足,提高医学人文服务水平,提高医学沟通能力,提高患者的综合满意度。     

Quantifying spatial misclassification in exposure to noise complaints among low-income housing residents across New York City neighborhoods: a Global Positioning System (GPS) study

PurposeTo examine if there was spatial misclassification in exposure to neighborhood noise complaints among a sample of low-income housing residents in New York City, comparing home-based spatial buffers and Global Positioning System (GPS) daily path buffers.MethodsData came from the community-based NYC Low-Income Housing, Neighborhoods and Health Study, where GPS tracking of the sample was conducted for a week (analytic n = 102). We created a GPS daily path buffer (a buffering zone drawn around GPS tracks) of 200 m and 400 m. We also used home-based buffers of 200 m and 400 m. Using these “neighborhoods” (or exposure areas), we calculated neighborhood exposure to noisy events from 311 complaints data (analytic n = 143,967). Friedman tests (to compare overall differences in neighborhood definitions) were applied.ResultsThere were differences in neighborhood noise complaints according to the selected neighborhood definitions (P < .05). For example, the mean neighborhood noise complaint count was 1196 per square kilometer for the 400-m home-based and 812 per square kilometer for the 400-m activity space buffer, illustrating how neighborhood definition influences the estimates of exposure to neighborhood noise complaints.ConclusionsThese analyses suggest that, whenever appropriate, GPS neighborhood definitions can be used in spatial epidemiology research in spatially mobile populations to understand people's lived experience.     

医院管理医疗投诉的变化、热点及对策

目的 了解医疗投诉的变化、热点,为构建和谐医患关系探寻新思路.方法 对华北某医院2006~2010年361例投诉案进行统计分析.结果 医疗投诉在数量、原因、内容、方式和解决途径上都发生了变化.结论 要针对医疗投诉的变化、热点转变服务理念,建立信息公开制度,成立专门的医患纠纷调解处理机构,规范医院的医疗行为和经济行为,以...     

山东省某三级医院2021年第二季度投诉评定分析

医疗机构处理投诉应兼顾"患者至上"与"职工为本"。对受理的投诉事件进行逐项评定,合理区分投诉系医务人员个人原因、患者误解还是医院管理问题所造成,是实现这一目标的重要环节。介绍山东省某三级医院开展投诉评价的做法,以5件评定结果产生争议的投诉为例,从评价小组人员构成、评价技能储备、环节流程设计3个方面分析了影响评价结果客观性、准确性的因素,探讨了优化评价小组、实施前置培训、完善流程环节、提升沟通技巧、提供管理保障等持续改进措施。