Maternal attachment influences mother–infant styles of regulation and play with objects at nine months

We examined the association between the quality of maternal representations of attachment evaluated by the Adult Attachment Interview (AAI) and mother styles of regulating attention and emotion during free play with objects in 41 mother dyads when infants were nine months old. The secure mother dyads showed a greater duration of engagement matches, with more positive matches, and a greater capacity to move from non-matched to matched states. Secure mother dyads demonstrated greater involvement in play with objects than insecure mother dyads. Insecure mother dyads showed a greater duration of mismatches and spent more time in negative matches. Correlations between maternal AAI scores and the variables studied also showed that the maternal Passivity and Unresolved scales were associated with less adequate dyadic attention and emotion regulation, while the maternal Coherence scale was associated with more adequate dyadic attention and emotion regulation.     

自我效能增强干预联合多维宣教对哮喘患儿自我护理能力及生活质量的影响

目的:探讨自我效能增强干预联合多维宣教对哮喘患儿自我护理能力及生活质量的影响。方法:选取2017年8月—2019年8月某院收治的哮喘患儿248例为研究对象,按照入院先后顺序将其分为观察组和对照组各124例。观察组实施常规护理干预措施,对照组实施自我效能增强干预联合多维宣教模式,观察并比较两组患儿干预前后的自我护理能力、自我效能感及生活质量的变化。结果:干预后观察组患儿的自我护理能力量表(ESCA)评分明显高于对照组患儿(P<0.05);观察组患儿的一般自我效能感量表(GSES)评分明显高于对照组患儿(P<0.05);观察组患儿的哮喘生活质量评分量表(AQLQ)评分明显高于对照组患儿(P<0.05)。结论:自我效能增强干预联合多维宣教在哮喘患儿的疾病管理中具有重要作用,能够增强患儿对疾病的认知和掌握能力,提高患儿的自我护理能力及自我效能感,提高其疾病管理的主观能动性,明显改善生活质量。     

改良式艾箱灸装置在脾胃虚寒胃脘痛病人中的应用

目的:改良式艾箱灸装置在脾胃虚寒胃脘痛病人中的应用效果。方法:将2019年6月—2019年12月收治的120例脾胃虚寒胃脘痛病人随机分成观察组和对照组各60例,观察组使用改良式艾箱灸装置,对照组使用传统式艾箱灸装置,每周4次,每次40 min,4周为1个疗程,连续治疗2个疗程。记录施灸温度-时间曲线,比较两组病人临床疗效、治疗前后视觉模拟评分法(VAS)疼痛评分、止痛起效时间,评价两组病人满意度。结果:观察组病人治疗有效率、满意度高于对照组,止痛起效时间短于对照组,治疗后VAS疼痛评分低于对照组(P<0.05)。结论:脾胃虚寒胃脘痛病人使用改良式艾箱灸装置可提高临床疗效、病人满意度,缩短止痛起效时间,缓解疼痛。     

Changes in United Kingdom oral and maxillofacial surgical specialty trainees since 1995 – numbers,gender, first degrees,and nations of origin

Training in UK surgery has changed dramatically since 1995, from a relative lack of structure to time-limited and highly documented programmes. Training in oral and maxillofacial surgery (OMFS) has shared these changes and included some significant changes of its own. Minutes from the OMFS Specialty Advisory Committee (SAC) were reviewed over the last 25 years to record the number and location of newly approved posts. The General Medicine Council’s (GMC) OMFS specialist list in 2019 was combined with the records of OMFS specialists’ dental qualifications held by the General Dental Council (GDC) and augmented from a database of OMFS trainees and consultants in the UK. Data on demographics, location, and nature of the first medical or dental degree were noted for analysis.A total of 691 OMFS specialists and trainees were identified from GMC, OMFS SAC and consultant databases. Of these, 12 consultants held only dental qualification/registration. First degree data could not be obtained for 12 specialists (all male). A further 20 OMFS specialists, whose training was outside the UK, were also excluded from further analysis.In 1995 there were 95 national training posts, by 2013 there were 150. Over the last quarter of a century, there has been an increase in medicine first trainees, an increase in female trainees and specialists, and a relative decrease in OMFS trainees from the Indian subcontinent. The varied origins of the OMFS workforce has contributed to greater diversity and inclusion within the specialty. In the UK, OMFS appears to have produced the correct number of specialists whilst maintaining a high standard of training. The next change in OMFS training programmes is to deliver The Postgraduate Medical Education and Training Board’s (PMETB) recommendations. As we move to achieve this it is imperative that as new doors open, we do not close others.     

再定位垫治疗颞下颌关节盘可复性移位伴间断性 锁结患者的临床观察

目的 观察再定位垫治疗颞下颌关节盘可复性移位伴间断锁结患者的临床疗效。方法 选取2017年12月至2018年6月大连市口腔医院颞下颌关节门诊接诊的34例患者（男9例,女25例,平均年龄31岁）,经MRI确诊为颞下颌关节盘可复性移位伴间断性锁结,采用再定位垫治疗,治疗期限为6个月,治疗后1个月和3个月进行随访,比较戴用再定位垫3个月、6个月,取下垫后1个月和3个月复查时的关节弹响,疼痛程度、颞下颌关节功能障碍指数和紊乱指数。结果 治疗结束时,34例患者中32例（94.12%）弹响完全消失,1个月复查时,弹响消失患者占88.24%,3个月复查时,弹响消失患者占76.46%;治疗开始后3个月患者疼痛主诉与治疗前相比有明显下降;颞下颌关节功能障碍指数、肌肉压痛指数和颞下颌关节功能紊乱指数均有显著下降。结论 再定位垫治疗关节盘移位伴间断性锁结,在短期内可有效消除关节弹响,缓解疼痛症状,解除功能障碍,利于关节盘获得良好的盘突关节。     

Does time of CCI measurement affect the evaluation of platelet transfusion effectiveness?

The measurement of corrected count increment at 1-h post-transfusion (CCI-1 h) of platelet concentrate (PC) transfusion is recommended, but in the revised Japanese Guideline (2017) it was changed to “after 10-min to 1-h”, following the revision of the guidelines from Western countries. Here, we aimed to investigate on the feasibility to apply the CCI measured at 10-min or 30-min post-transfusion as the surrogate of CCI-1 h. Peripheral blood was collected at 10-min, 30-min and 1-h post-transfusion of PC and the effectiveness of the transfusion was analyzed based on the CCI. In the period from December 2017 to February 2020, 8 patients, who received multiple PC transfusion (total 208) at our institution, were analyzed. We performed the univariate analyses to examine the relationship between CCI value and the categorical variables, p-value <0.1 was obtained for gender (p = 2.91 × 10^?19), fever after transfusion (p = 0.0163). The qualitative variables, namely measurement time (p = 0.0553), also showed p-value <0.1. Using these factors as covariates in the mixed effect model, we found that the measurement time (p = 0.0007) had a significant effect on the CCI value when looking at fixed effects. Although there is a tendency for decreased CCI values with time progression, the slope of the change in the mixed model was -0.00307, indicating that the CCI difference among the 3 measurements was small. Here we provide evidence that CCI measured at 10-min and 30-min post-transfusion give results comparable to those measured at 1-h post-transfusion, under the Japanese practice of platelet transfusion, which relies on 100 % single-donor apheresis PC, and ABO-identical whenever possible.