Evaluation of an Australian intervention to encourage breast feeding in primiparous women

Breast feeding has nutritional, immunologic and antiallergicadvantages for the infant. Although it has been widely recommendedthat infants be exclusively breast fed until 4–6 monthsof age, only about half of all Australian babies currently receiveextended breast feeding. The present study evaluated an intensiveprogramme designed to increase the proportion ofprimi-parousmothers who breast fed for 4 months or longer. Women who registeredwith the hospital at least 20 weeks before delivery and whointended to breastfeed were eligible for the study. Two hundredand thirty-five women were allocated to receive either usualcare or an intensive breast feeding programme when they registeredwith the hospital. The intensive programme consisted of writtenmaterials, and group and individual sessions with a lactationcounsellor. It also included a visit from a breastfeeding consultantwhile in hospital after the birth and contact on return home.Women were followed up 6 weeks and 4 months after delivery.There were no significant differences in breastfeeding ratesbetween the control and intervention groups at either follow-uppoint. Breast feeding until 4 months was more likely among womenwhose baby did not receive a bottle feed while still in hospitaland who did not smoke, use the combined oral contraceptive pillor introduce solid food before 4 months. Those mothers who enjoyedand felt satisfied with breastfeeding were more likely to continueto 4 months. It seems likely that programmes designed to increasebreastfeeding will need to address underlying factors such ashospital policy rather than simply providing more health education.     

Cohen syndrome: fertility in a female patient

In this report we describe fertility in an adult female with Cohen syndrome. She gave birth to a son, now 1.5 years old, with discrete facial stigmata and slight psychomotor retardation.     

Burns during pregnancy: a gloomy outcome

The effect of burns on fetal and maternal survival is known to be detrimental. This prospective study describes the performance of pregnant burned patients who were managed and followed up for fetal and maternal outcomes at Ain Shams University's burn unit and Maternity Hospital during the period from October 1995 to September 1996. During the 12-month period, 27 pregnant burned patients were managed. Fetal and maternal mortality correlated with the total body surface area (TBSA) burned, the mortality rate being 63 per cent for both mothers and fetuses in the 25–50 per cent TBSA group. A fetal loss of 56 per cent with no maternal loss were recorded in the 15–25 per cent TBSA group. Experience in dealing with pregnant burned patients proves that early surgical excision and skin grafting, with timely termination of pregnancy are the best lines of treatment. Prevention or minimizing the effects of the burns may be achieved by proper education and guidance of the pregnant woman.     

精神病患者家属的心理分析及护理

作者采用询问交谈的方法对精神病患者家属的心理状态进行了调查分析，大多数精神病患者家属存在着焦虑、急躁、自卑、厌恶、矛盾、无能为力等心理。同时，针对性地提出了以安慰、鼓励、心理启发、支持为主的护理方法和措施。     

Belt device for simplified CT-guided puncture and biopsy: A technical note

A new radiolucent device for increased accuracy of CT-guided fine-needle punctures permits precise determination of the optimum angle, depth, and position of the fine needle, which can be preset from the data supplied on the CT monitor. Puncture and repeat scans for controlling the tip of the needle can be performed with the patient in a stationary position. The device is designed as a belt that holds a needle holder sheath and a goniometric scale, both of which can be moved to varying positions around the patient.     

The Mental Health of Homeless Children

The literature addressing the mental health of homeless children is critically reviewed. Higher rates of behavioral, emotional, and cognitive problems have been reported for this population, but research results are qualified by significant methodological problems. Minimal attention has been given to the development and evaluation of specific intervention and prevention strategies. Recommendations are made for conducting research that will overcome previous methodological problems and focus more directly on identifying risk and protective mechanisms within the population of children exposed to homelessness.     

以中医神志学说辨析百合病

运用神魂魄意志五神与五藏、五官、五体的配属关系．结合文献对百合病命名、病位、症状、病机及愈期判断加以探讨。提出百合病属中医神志失和类病变，由热病伤阴，余邪未尽．心肺阴虚，神志失养，加之情怀不畅，气郁不舒，百脉失调，形神失和而发病。     

Is dietary counselling effective in increasing dietary calcium,protein and energy intake in patients with osteoporotic fractures? A randomized controlled clinical trial

To determine the feasibility of increasing the calcium, protein and calorie intake of osteoporotic fracture patients by repeated dietary counselling delivered by a dietitian, a randomized controlled trial was conducted. Among 189 patients presenting with osteoporotic fractures to an Orthopaedics and Traumatology Department of a large regional hospital, 98 patients were randomized to the intervention group and 91 were randomized to the control group (with usual care). Intervention group received three sessions of dietary counselling with tailored made recommendations over a period of 4 months, while the control group only received dietary assessment and pamphlets on the prevention of osteoporosis. Almost all subjects in both intervention and control groups had calcium intake below the recommended level of 1000 mg at baseline. Half and 60% of subjects in both groups had total energy and protein intake below recommended levels respectively. The mean weights of control and intervention groups at baseline were 51.5 and 50.9 kg respectively, while the body mass index (BMI) were 22.6 (kg m(-2)) and 22.6 (kg m(-2)) respectively. After dietary intervention, significant increase of intake was seen in calcium intake (P = 0.0095 by t-test) in the intervention group. No significant increase was seen in protein or calorie intake. No significant change was observed in the body weight or BMI although there was a positive trend in the intervention group for all these parameters. We concluded that there was general malnutrition in Chinese elderly who presented with osteoporotic fractures. Dietary calcium could be increased by repeated professional dietary counselling. Future studies with longer duration and more objective clinical outcomes will be helpful to further demonstrate the long-term effects of dietary intervention on osteoporosis and other chronic diseases.     

心理咨询门诊与普通专科门诊抽样对照分析

目的调查本院心理咨询门诊与普通专科门诊就诊疾病谱的差异,了解两者在精神分裂症治疗上的差异以及对预后的影响。方法以1/20抽取1995～2002年间的门诊病例进行统计分析,其中心理咨询门诊病例79份,普通专科门诊病例143份。自行设计表格对就诊者的性别、年龄、初诊诊断和服药、住院情况进行统计,比较两者就诊疾病谱的差异,以及两者在精神分裂症治疗上的差异和对预后的影响。结果(1)心理咨询门诊就诊者以心境障碍和神经症为主(分别达25%和27%),普通专科门诊以精神分裂症为主(48%,t=14．66,P＜0．005)；(2)在精神分裂症的治疗上,心理咨询门诊第二代抗精神病药(SGAs)的应用率较高(50%vs 14%,P＜0．005),两处就诊者的预后也存在差异。结论心理咨询门诊与普通专科门诊在初诊中存在一定的分工；两者对精神分裂症治疗存在差异,这种差异可能直接导致精神分裂症的预后,我国有待建立规范的精神分裂症治疗指南；全社会对非重性精神疾病的重视程度仍有待加强。