Predictors of Unmet Dental Need in Children With Autism Spectrum Disorder: Results From a National Sample

ObjectiveUnmet dental need in children with autism spectrum disorder (ASD) is common. We tested hypotheses that lacking a medical home or having characteristics of more severe ASD is positively associated with having unmet dental need among children with ASD.MethodsUsing data from the 2009 to 2010 National Survey of Children with Special Health Care Needs, we analyzed 2772 children 5 to 17 years old with ASD. We theorized that unmet dental need would be positively associated with not having a medical home and having characteristics of more severe ASD (eg, parent reported severe ASD, an intellectual disability, communication, or behavior difficulties). Prevalence of unmet dental need was estimated, and unadjusted and adjusted odds ratios, 95% confidence intervals, and P values were computed using survey methods for logistic regression.ResultsNationally, 15.1% of children with ASD had unmet dental need. Among children with ASD, those without a medical home were more apt to have unmet dental need than those with a medical home (adjusted odds ratio, 4.46; 95% confidence interval, 2.59–7.69). Children with ASD with intellectual disability or greater communication or behavioral difficulties had greater odds of unmet dental need than those with ASD without these characteristics. Parent-reported ASD severity was not associated with unmet dental need.ConclusionsChildren with ASD without a medical home and with characteristics suggestive of increased ASD-related difficulties were more apt to have unmet dental need. Pediatricians might use these findings to aid in identifying children with ASD who might not receive all needed dental care.     

血友病患者健康教育需求调查与对策

目的了解血友病患者对健康教育的需求,并制定出相对应的健康教育方式。方法采用自制调查表的方法对92例患者进行问卷调查。结果94.6%的患者对健康教育的需求为需要或非常需要。结论通过对健康教育需求的调查,采取一系列行之有效的措施,增强了患者战胜疾病的信心,也极大地提高了血友病的防治效果。     

清远市及周边地区护理人才市场需求调查分析

目的：了解广东省清远市及周边地区护理专业人才市场需求情况,为学院招生规模、专业设置和培养模式适应市场需求提供客观依据。方法：走访6家清远市市属医院、9家县属医院、9家镇级医院等共58个医疗机构。采用问卷形式对用人单位进行应届毕业护士需求情况调查。结果：不同层次的医院对护理专业人才准入的条件不同,需求量不同。市、县级医院以招聘本科和高职护生为主,民营医院主要招收高职护生,镇级医院和私人门诊多需要中专护生。结论：高职护士需求量较大,可维持招生规模,稳步发展,同时为学生提供全面发展的平台,以提高其综合素质。建议对清远市经济欠发达地区的生源,适当降低录取分数线,试行“定向培养”。护理中专毕业生县级以上医院就业空间较小,要适当控制招生规模。     

农村孕产妇住院需求与护理满意度相关分析

目的根据农村孕产妇在住院不同阶段的护理需求，进行有针对性的护理工作，以提高护理质量和患者满意度。方法将孕产妇300例按入院待产时间先后分成对照组、观察组各150例。对照组给予传统式护理；观察组进行住院护理需求调查，按调查结果调整护理内容，满足孕产妇人院待产期、分娩期、产褥期、出院前期的需要。两组出院前进行满意度调查。结果观察组护理满意度较对照组有显著提高，x^2=8．86，P〈0．005。结论根据孕产妇不同时期的需求特点，采取有针对性的护理工作，能更好地满足孕产妇的护理需求，从而提高孕产妇对护理工作的满意度。     

分级管理模式下主管护士培训需求调查分析

目的:了解目前主管护士对培训的需求情况,为主管护士培训课程的设置提供依据。方法:采用自行设计的主管护士培训需求调查问卷,对该院的175名主管护士进行调查。结果:主管护士对培训内容中操作技能、教学能力和理论知识的需求程度较高,在需求程度上不同学历、职称、科室的人员有统计学差异(P<0.05)。结论:根据调查结果应对主管护士进行有计划、有目的、有针对性的培训,帮助她们更好地完成临床护理工作,提高整体护理质量。     

需要层次护理对卵巢囊肿患者术后自护能力及恢复的影响

目的探讨需要层次理论对卵巢囊肿手术患者术后自护能力及恢复的影响。方法将80例卵巢囊肿手术患者随机分为观察组和对照组各40例,对照组采用常规护理,观察组采用需要层次护理,比较2组术后自护能力及恢复情况。结果观察组护理后在自我概念、自我责任、自我护理技能与对照组比较差异有统计学意义(P0.05);观察组术后肛门排气的时间、排便时间、离床活动时间、住院时间、术后并发症均与对照组比较差异有统计学意义(P0.05)。结论需要层次护理能够满足卵巢囊肿患者身心需要,提高患者术后的自护能力,加快术后康复。     

Unmet care needs and key outcomes in dementia

OBJECTIVES: To determine how unmet needs for activity of daily living tasks influenced nursing home placement, death, or loss to follow-up in dementia. DESIGN: An 18-month longitudinal design, with interviews administered every 6 months. SETTING: Eight catchment areas in the United States. PARTICIPANTS: Five thousand eight hundred thirty-one dementia patients and their caregivers were included at baseline. MEASUREMENTS: Measures of sociodemographic context of care; functional, cognitive, and behavioral status of care recipients; caregiver stress and well-being; and formal and informal resources served as covariates. The independent variables of interest were unweighted unmet care need scores and unmet need scores weighted by importance and severity in a prior sample of older consumers of long-term care. Outcomes included nursing home placement, death, and loss to follow-up. RESULTS: Cox regression models suggested that greater unmet need was predictive of nursing home placement, death, and loss to follow-up. These results were apparent when the unweighted and the weighted scores for unmet need with activity of daily living dependencies were used. CONCLUSION: Unmet need may be useful in identifying dementia care recipients at risk for nursing home placement and death. Further study of unmet need is needed to effectively assess and target intervention protocols during the course of dementia.     

颅脑损伤患者家属早期信息需求及影响因素研究

目的：研究颅脑损伤患者家属早期信息需求及影响因素。方法通过分层随机抽样,选择来自温州市三家综合医院的180名颅脑损伤患者家属,应用自制颅脑外伤患者家属信息需求量表调查家属信息需求,并分析相关影响因素。结果患者家属信息需求量表总分为(21.28±2.27)分,各维度中损伤状况得分最高为(3.56±0.31)分,医院规定得分最低为(2.61±0.48)分。患者住院时间≤3 d的家属对损伤状况、治疗措施、检查方法、家属配合及医院规定等维度的信息需求度均较住院时间>3d的家属高,差异有统计学意义(P<0.05)。重型颅脑损伤患者的家属对损伤状况、治疗措施、检查方法、医护资质、治疗费用及家属配合等维度的信息需求度均较轻中型颅脑损伤患者的家属高,差异有统计学意义(P<0.05)。初中以上文化程度的家属对治疗措施、医护资质及家属配合等维度的信息需求度均较初中及以下文化程度的家属高,差异有统计学意义(P<0.05)。颅脑损伤患者家属的信息需求满足度和其对医护工作的总体满意度呈正相关(r=0.495,P<0.01)。结论颅脑损伤患者家属早期具有很强的信息需求度。患者住院时间、患者损伤等级及家属文化程度可能会影响家属的信息需求度。满足家属的信息需求可提高其对医护工作的满意程度。     

Old and new intravenous inotropic agents in the treatment of advanced heart failure

Inotropic agents are administered to improve cardiac output and peripheral perfusion in patients with systolic dysfunction and low cardiac output. However, there is evidence of increased mortality and adverse effects associated with current inotropic agents. These adverse outcomes may be ascribed to patient selection, increased myocardial energy expenditure and oxygen consumption, or to specific mechanisms of action. Both sympathomimetic amines and type III phosphodiesterase inhibitors act through an increase in intracellular cyclic adenosine monophoshate and free calcium concentrations, mechanisms that increase oxygen consumption and favor arrhythmias. Concomitant peripheral vasodilation with some agents (phosphodiesterase inhibitors and levosimendan) may also lower coronary perfusion pressure and favor myocardial damage. New agents with different mechanisms of action might have a better benefit to risk ratio and allow an improvement in tissue and end-organ perfusion with less untoward effects. We have summarized the characteristics of the main inotropic agents for heart failure treatment, the data from randomized controlled trials, and future perspectives for this class of drugs.