Cell therapy and satellite centers: The cardiovascular cell therapy research network experience

Due to the changing population in patients with myocardial infarction, recruiting patients in clinical trials continues to challenge clinical investigators. The Cardiovascular Cell Therapy Research Network (CCTRN) chose to expand the reach and power of its recruitment effort by incorporating both referral and treatment satellite centers. Eight treatment satellites were successfully identified and they screened patients over a two year period. The result of this effort was an increase in recruitment, with these treatment satellites contributing 30% of the patients to two of the three Network studies. The hurdles that these satellite treatment centers faced and how they surmounted them provide instruction to clinical research groups eager to expand to satellite systems and to health care practitioners who are interested in taking part in multicenter clinical trials.     

Usage of an online healthy lifestyle program by pregnant women attending midwifery practices in Amsterdam

OBJECTIVE: To determine reach, attrition and program engagement and their associations with user characteristics for an online healthy lifestyle program for pregnant women. METHODS: From March to August 2006, 1382 pregnant women visiting 20 midwifery practices in Amsterdam were invited to enroll in a healthy lifestyle program through registration on the program website (at home). User characteristics were self-reported upon enrollment, while program use was objectively monitored until January 2007. RESULTS: Seventeen percent (n=238) of the women who received information from their midwife enrolled. Most women were highly educated (68%) and already had a healthy lifestyle. About half of them (52%) continued to use the program throughout their pregnancy. Less lower than higher educated women continued using the program (45% vs. 63%, p=0.02). When e-mails were opened almost all lifestyle topics were accessed (85%), but links to related websites were used less often (12%). CONCLUSION: The healthy lifestyle program did not reach a substantial proportion of the target population. Only 9% of those invited continued to use the program throughout their pregnancies. In addition to that there was selective enrollment and selective attrition. This research confirms that disadvantaged women, who need the intervention most, are least easily reached.     

乡镇无偿献血招募措施探讨

对石家庄市17个县区及下辖乡镇无偿献血宣传招募工作实践经验进行总结,宣传招募措施包括转变组织管理模式,依托县区卫生主管部门推动;抓住关键人物,强化宣传招募;宣传方式多样化;利用网络面向年轻人进行宣传招募等。促进了乡镇无偿献血工作模式的改进,保障了临床用血需求。     

不同方式招募的男男性行为人群HIV感染高危性行为比较分析

【摘要】 目的 分析镇江市不同方式招募的男男同性性行为人群（MSM）的HIV感染高危性行为差异,为艾滋病的精准防控提供数据支持。方法 2020年4 - 6月通过疾病预防控制中心（CDC）自愿咨询检测（VCT）门诊和社区组织（CBO）两种方式在镇江范围内招募MSM人群作为研究对象,采用统一调查问卷收集目标人群的一般人口学特征、药物滥用、HIV检测史和高危性行为等信息。卡方检验或Fisher确切概率法检验分析不同途径招募的MSM人群之间相关特征的差异。结果 两种方式共招募641例MSM,其中CBO招募442例占68.95%,CDC招募199例占31.05%;CBO招募的MSM中,20岁以下占比（6.56%）显著高于CDC招募方式（1.01%,χ2 = 9.20,P = 0.002）;CDC 招募的MSM人群使用卫生专业机构和新型网络媒体接受毒品潜在危害信息宣教的比例分别为7.54% （15例）和16.58%（33例）,均显著高于CBO组［3.39%（15例）,χ2 = 5.28,P = 0.022;9.50%（42例）,χ2 = 6.66,P = 0.010］。CBO招募的MSM群交性行为发生率为25.21%（30例）,与女性发生无保护性行为的比例为47.51%（210例）,均显著高于CDC招募组［7.50%（6例）,χ2 = 10.13,P = 0.001;27.64%（55例）,χ2 = 22.35,P < 0.001］,而CBO招募者中异性恋的比例（2.04%,9例）、不清楚性伴HIV感染状态的比例（22.40%,99例）、无保护肛交性行为发生率（39.82%,176例）均显著低于CDC招募的MSM人群［6.53%（13例）,χ2 = 8.37,P = 0.004; 39.70%（79例）,χ2 = 20.48,P < 0.001;57.29%（114例）,χ2 = 16.90,P < 0.001］。 CBO招募的MSM曾经做过HIV检测的比例为74.43%（329例）,最近1次HIV检测途径为CDC的比例为23.10%（76例）,HIV感染率为5.20%（23例）,均显著低于CDC组［80.90%（161例）,χ2 = 3.19,P = 0.074;57.14%（92例）,χ2 = 99.41,P < 0.001;13.07%（26例）,χ2 = 21.85,P < 0.001］。结论 通过CBO和CDC两种方式招募的MSM人群在人口学、行为学上互补,具有一般MSM人群的代表性,应根据人群的不同特点制定艾滋病具体防控措施。     

Is the grass any greener? Canada to United States of America nurse migration

Aim:  Little or no attempt has been made to determine why nurses leave Canada, remain outside of Canada, or under what circumstances might return to Canada. The purpose of this study was to gain an understanding of Canadian-educated registered nurses working in the USA.
Data sources:  Data for this study include the 1996, 2000 and 2004 USA National Sample Survey of Registered Nurses and reports from the same time period from the Canadian Institute for Health Information.
Findings:  This research demonstrates that full-time work opportunities and the potential for ongoing education are key factors that contribute to the migration of Canadian nurses to the USA. In addition, Canada appears to be losing baccalaureate-prepared nurses to the USA.
Discussion:  These findings underscore how health care policy decisions such as workforce retention strategies can have a direct influence on the nursing workforce. Policy emphasis should be on providing incentives for Canadian-educated nurses to stay in Canada, and obtain full-time work while continuing to develop professionally.
Conclusion:  Findings from this study provide policy leaders with important information regarding employment options of interest to migrating nurses.
Study limitations:  This study describes and contrasts nurses in the data set, thus providing information on the context of nurse migration from Canada to the USA. Data utilized in this study are cross-sectional in nature, thus the opportunity to follow individual nurses over time was not possible.     

Italian–Moldovan international nurse migration: rendering visible the loss of human capital

PALESE A., CRISTEA E., MESAGLIO M. & STEMPOVSCAIA E. (2010) Italian–Moldovan international nurse migration: rendering visible the loss of human capital. International Nursing Review 57 , 64–69
Aim:  To describe the process of the migration of Moldovan nurses to Italy.
Background:  Formerly a part of the Soviet Union, the Republic of Moldova gained independence in 1991. Currently, there are 25 848 nurses (60.6 per 10 000 inhabitants) working mainly in the public health system. Each year, around 2000 nurses leave the country in search of better working conditions and a better quality of life.
Methods:  A longitudinal study design was adopted (2006–2007). In the first phase, we contacted all known nurses living in Moldova and their available colleagues following a snowball sampling strategy. Inclusion criteria were nurses who had decided to migrate to Italy and had already prepared the migration documents and/or were awaiting their departure. In the second phase, we interviewed the same sample of nurses on arrival in Italy.
Findings:  After one year, only 25 nurses out of the 110 initially interviewed (22.7%) had arrived in Italy; none were working as nurses. The cost of the migration process incurred by each nurse was around 3278 euros, and the waiting time from the decision to leave until arrival was around 24 months.
Conclusions:  All Moldovan nurses involved in this study, once they arrived in Italy, ceased to exist from an official perspective. Policy and recommendations need to be developed to ensure the integration of Moldovan-educated nurses into the health-care system and to monitor the amount of human capital (in terms of care drain, brain drain and youth drain) that this process risks wasting.     

两种肺复张方法治疗急性呼吸窘迫综合征的效果比较

目的 探讨和比较控制性肺膨胀(sustained inflation,SI)和压力控制通气(pressure controlled ventilation,PCV)用于急性呼吸窘迫综合征(ARDS)患者肺复张的效果,及其对血流动力学和呼吸力学方面的影响.方法 对10例ARDS患者采取随机对照实验,在镇静、非肌松状态下,先后采用SI[40cmH2O(1 cmH2O=0.0981 kPa),40 s]和PCV(20 cmH2O,2 min)进行肺复张,中间间隔洗脱期.收集两种方法复张前(T0)、复张后5 min(T2)、1 h(T3)的血气分析、血流动力学指标、呼吸力学指标和复张中(T1)的呼吸力学与血流动力学指标.收集数据行单因素重复测量方差分析.结果 (1)两种方法T2和T3时点PaO2较T0均明显改善(P<0.05),方法间差异无统计学意义(P>0.05).PaCO2在各时点差异均无统计学意义(P>0.05).(2)两种方法T1时点CI均下降(P<0.05),方法间无差异(P>0.05).HR、MAP在各时点差异均无统计学意义(P>0.05).(3)两种方法T2和T3时点FRC较T0均增加(P<0.05),T1时点CS均有所改善(P<0.05),方法之间差异无统计学意义(P>0.05),Pplat在各时点差异均无统计学意义(P>0.05).结论 SI和PCV肺复张对ARDS患者PaO2、FRC、肺复张中Cs均有明显改善,肺复张对CI均有影响,两种方法效果相同.     

肺复张治疗急性A型主动脉夹层术后呼吸功能不全的临床研究

目的探讨肺复张在急性A型主动脉夹层术后呼吸功能不全的治疗效果。方法2011年4月～2013年5月笔者所在科室急性A型主动脉夹层术后呼吸功能不全患者26例,随机分为两组：对照组（n=13）,行同步间歇指令通气（SIMV）结合呼气末正压（PEEP）治疗;肺复张组（n=13）,行吸气压（IP）结合PEEP压力递减肺复张治疗,对比两组患者肺复张前后呼吸和循环参数的变化。结果肺复张组患者氧合指数（PaO2／FiO2）明显改善,并且能较好维持。肺复张期间患者的血流动力学指标保持稳定。结论肺复张是治疗急性A型主动脉夹层术后呼吸功能不全的一种安全有效的方法,采用压力递减方案能够维持血流动力学稳定。     

Reaching people with disabilities to learn about their experiences of social connection and loneliness

BackgroundPeople with disabilities experience higher rates of social isolation and loneliness than people without disabilities, but there is limited information about how these conditions are manifested in people with specific types of disabilities.ObjectivesUsing data collected as part of the second administration of the National Survey on Health and Disability (n = 2,132), our objectives were to determine if disability type and recruitment method added explanatory power to observed levels of social connectedness, after controlling for socio-demographic and environmental indicators.MethodsWe used hierarchical regression to evaluate how socio-demographic, disability, environmental, and recruitment type explained four outcome variables for different dimensions of social connectedness, including satisfaction with social activity, quantity of social connections, quality of social connections, and loneliness.ResultsAcross all models, employment status (not employed), having mental illness/psychiatric disability, lack of transportation for social needs, and recruitment type (MTurk) significantly predicted lower levels of social connectedness.ConclusionsThe study provides evidence that using alternative methods, such as MTurk, to complement conventional recruitment strategies can improve understanding of social isolation and feelings of loneliness among people with disabilities, particularly those with mental illnesses and/or psychiatric disorders who are less likely to be accessed through group affiliations, but who are at greater risk for experiencing social isolation and feelings of loneliness.