Challenges facing HIV-positive persons who use drugs and their families in Vietnam

It is hypothesized that persons who use drugs (PWUD) in Vietnam who are also HIV-positive may face additional challenges in psychosocial outcomes, and these challenges may extend to their family members. In this study, we examined depressive symptoms, stigma, social support, and caregiver burden of HIV-positive PWUD and their family members, compared to the outcomes of HIV-negative PWUD and their family members. Baseline, 3-month, and 6-month assessment data were gathered from 83 PWUD and 83 family members recruited from four communes in Phú Th? Province, Vietnam. For PWUD, although we observed a general decline in overall stigma over time for both groups, HIV-positive PWUD consistently reported significantly higher overall stigma for all three periods. Depressive symptoms among family members in both groups declined over time; however, family members of HIV-positive PWUD reported higher depressive symptoms across all three periods. In addition, family members of HIV-positive PWUD reported lower levels of tangible support across all three periods. Caregiver burden among family members of HIV-positive PWUD increased significantly over time, whereas the reported burden among family members of HIV-negative PWUD remained relatively unchanged. The findings highlight the need for future interventions for PWUD and family members, with targeted and culturally specific strategies to focus on the importance of addressing additional stigma experienced by PWUD who are HIV-positive. Such challenges may have direct negative impact on their family members' depressive symptoms, tangible support, and caregiver burden.     

载脂蛋白E基因多态性与脑梗死的相关性分析

目的　探讨载脂蛋白 E基因多态性与脑梗死的关系。方法　通过聚合酶链反应 -限制性片段长度多态性 (PCR- RFL P)分析结合 DNA直接银染技术检测 6 6例脑梗死 (CI)患者的载脂蛋白 E(Apo E)基因型 (其中家系中有明确脑梗死先证者的家族聚集性脑梗死 (FMACI)亚组 2 6例 ,家系中无脑卒中史的非家族聚集性脑梗死 (NF-MACI)亚组 4 0例 ) ,并与 90例健康对照组比较 ,同时检测血脂、脂蛋白 (a) [L P(a) ]及部分载脂蛋白。结果　脑梗死组ε3/4基因型频率明显高于对照组 (P<0 .0 1) ,ε3/3基因型频率明显低于对照组 (P<0 .0 1) ;两脑梗死亚组之间的ε3/4/ε3/3基因型频率虽有上升 /下降趋势 ,但未发现明显的统计学差异 ;FMACI组高密度脂蛋白 (HDL )水平明显低于 NFMACI组 (P<0 .0 5 )。结论　 Apo E基因多态性与脑梗死的发生有关 ,ε4等位基因是脑梗死的易感因子 ,ε3等位基因对脑梗死的发生有保护作用 ;Apo E基因多态性和 HDL水平双重作用于家族聚集性脑梗死的发生。     

Inappropriate social and sexual responses to a female student by male patients with dementia and organic brain disorder

Little attention has been directed toward inappropriate social and sexual approaches by patients with dementia diagnoses and organic disorders of the brain. A female student who approached patients who had dementia and organic brain disorders was frequently approached and touched in a sexual manner that was distressing to her and led her to believe that she was behaving in a manner that elicited these responses. It is recommended that students and volunteers be prepared for experience in settings with patients with these diagnoses through individual or group discussion, training and role playing as a way of enhancing their experiences and avoiding unnecessary feelings of guilt and embarrassment.     

北京地区精神分裂症患者家属情感表达测查报告

目的;探讨北京地区的住院精神分裂症患者家属情感表达方式及测查方法的实用性、测查工具应用的一致性。方法：经过训练的研究人员,采用费氏修订的ＣＦＩ－ＣＶ访谈提纲,对１７１例住院精神分裂症患者家庭的２８４位家属进行访谈和录音,并将录音打印成文字资料。     

车祸致颅脑损伤患者家属心理健康状况与社会支持相关性研究

目的 了解车祸致颅脑损伤患者家属的心理健康状况和社会支持状况,探讨其相关性。方法 采用自编一般资料调查表、症状自评量表（SCL - 90）和社会支持量表（SSRS）,对225名到精神专科医院就诊的车祸致颅脑损伤患者家属进行问卷调查。结果 车祸致颅脑损伤患家属的SCL - 90总分为（178.45±82.56）分, SCL - 90总分、阳性项目数和9个因子分均显著高于肿瘤患者家属和全国常模(P＜0.05)。社会支持总分为（38.52±8.23）分,社会支持水平与家属的心理健康状况呈显著的负相关（r = - 0.416, P＜0.05）。多元线性回归分析显示,社会支持总分可以负向预测家属的心理健康状况（β = - 0.399,P＜0.05）。结论 车祸致颅脑损伤患者家属的心理问题发生率较高,应从个人、家庭和社会层面为家属提供社会支持资源。     

70岁以上离休干部卫生保健的相关性调查

目的了解70岁以上离休干部生活质量及其影响因素,为制订相应的卫生保健措施提供科学依据。方法采用问卷调查和体格检查相结合的方法,对济南部队3所干休所109名70岁以上离休干部进行调查。数据用STATA7.0软件包分析。结果本次调查表明,本组70岁以上离休干部生活质量良、中、差分别占21.10%、60.55%、18.35%。在调查的19种因素中,主要影响因素顺次为:生活习惯、健康状况、体检状况、日常生活功能、年龄、独居或与家人同住、生活满意度、社会交往、心理健康、婚姻、家庭和睦情况。结论70岁以上离休干部的生活质量较差,应针对其影响因素制定相应的医疗保健措施,提高离休老年人的生活质量和健康水平。     

基于共享决策的医护-家属联动干预对胃癌患者的影响

目的:探讨基于共享决策的医护-家属联动干预对胃癌患者的影响。方法:选择2017年1月1日~2020年1月31日在胃肠外科治疗的胃癌患者106例,采用随机信封法分为观察组58例和对照组48例;对照组实施常规营养支持与护理,观察组在对照组基础上实施基于共享决策的医护-家属联动干预模式;比较两组干预前后治疗依从性,心理状态[采用焦虑自评量表(SAS)和抑郁自评量表(SDS)],恢复时间,各项营养指标变化[包括人血白蛋白(ALB)、前白蛋白(PRE)、转铁蛋白(TRF)]及并发症发生情况。结果:干预后,两组治疗依从性均高于干预前(P<0.05),且观察组高于对照组(P<0.05);干预后,两组SAS、SDS评分均低于干预前(P<0.05),且观察组低于对照组(P<0.05);观察组肛门排气时间、胃肠道功能恢复时间、下床活动时间及住院时间均短于对照组(P<0.01,P<0.05);出院后,两组ALB、PRE、TRF水平均高于干预前(P<0.05),且观察组高于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论:将基于共享决策的医护-家属联动干预模式应用于胃癌患者的护理中,能提高患者治疗依从性,缓解焦虑、抑郁情绪,改善营养指标水平,降低并发症发生率,对促进患者恢复具有重要意义。     

家属参与式全方位护理干预在动脉瘤性蛛网膜下腔出血患者中的应用价值

目的 探究家属参与式全方位护理干预在动脉瘤性蛛网膜下腔出血患者中的应用价值.方法 由本院2012年2月至2015年收治的动脉瘤性蛛网膜下腔出血患者中选取90例进行本次实验研究,采取随机双盲法将患者分为观察组(45例)和对照组(45例),对照组患者实施临床常规护理,观察组患者实施家属参与式全方位护理干预,对比两组患者再出血率、并发症情况、护理满意度、住院时间,并采取汉密尔顿焦虑量表(HAMA)及汉密尔顿抑郁量表(HAMD)评估患者的心理状况.结果 观察组患者再出血率为0.00％,总并发症率为4.44％,总满意率为95.56％,对照组分别为11.11％、17.78％、77.78％,观察组再出血率及总并发症率显著低于对照组,总满意率高于对照组,住院时间明显短于对照组[(41.24±3.45)d vs.(49.56±4.34)d],两组比较差异有统计学意义(P＜ 0.05);护理干预前两组患者均存在一定焦虑、抑郁情绪,HAMA、HAMD评分相近;护理干预后各组评分均改善,观察组改善程度优于对照组,差异有统计学意义(P＜0.05).结论 家属参与式全方位护理干预在动脉瘤性蛛网膜下腔出血患者中效果极好,患者再出血率及并发症率显著降低,心理状况改善,患者恢复快,满意度高,具有极高临床应用及推广价值.     

急诊患者家属心理需求的调查研究和护理

目的分析急诊患者家属心理需求的特点。方法分析我院2009年7月至2010年12月370例急诊患者家属的心理需求。结果重症急诊患者家属的心理上的需求显著高于一般急诊患者的家属,差异具有统计学意义(P<0.01);自费患者的家属心理上的需求仅略高于公费患者的家属,差异没有明显差异性(P>0.05);女性家属心理需求显著高于男性家属(P<0.05)。心理上的需求的程度和年龄呈正比例关系,和文化程度的高低呈负比例关系。离退休人员的心理需求高于其他人员的心理需求。结论满足患者家属心理需求可以使患者能在最好的生理以及心理状态下接受诊治和护理,能早日康复。     

Experimental and Analytical Research on Flexural Behavior of Concrete-Filled High-Strength Steel Tubular Members

Using high-strength steel (yield strength f_y ≥ 460 MPa) in concrete-filled steel tubes is expected to provide a superior bearing capacity by achieving light weight and efficient construction, but the existing design limitation on diameter-to-thickness (D/t) ratios for concrete-filled high-strength steel tubular (CFHST) members inevitably obstructs its wide application. In this study, aiming at the application of circular CFHST members using Q690 steel (f_y ≥ 690 MPa), a total of 15 CFHST beams were examined using a three-point loading test to investigate the failure mode, bearing capacity and plasticity evolution. Subsequently, finite element models (FEMs) were established to analyze the full-range curves, composite effect, failure mechanism and influences of key parameters including material strengths, D/t ratios, and shear-span ratios. A simplified calculation method for bearing capacity was finally proposed and verified. The results indicate that the full-range performance of tested CFHST members with out-of-code D/t ratios have ductile behavior, though they fail through the mode of steel fracture and concrete cracks in the tension zone as well as through local buckling in the compression zone; out-of-code CFHST members (e.g., D/t = 120) can perform reasonable composite behavior because of contact pressure larger than 2.5 MPa, where a thin-walled steel tube experiences an arch failure mechanism similar to core concrete at a trussed angle of 45°; the simplified bearing capacity model achieves a mean value of 0.97, and can be accepted as a primary tool to perform structural design and performance evaluation.