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1.
Lauren Tingey Britta Mullany Rachel Chambers Ranelda Hastings Angelita Lee Anthony Parker 《AIDS care》2015,27(9):1087-1097
Potential for widespread transmission of HIV/AIDS among American Indian (AI) adolescents exists, yet no evidence-based interventions (EBIs) have been adapted and evaluated with this population. Intensive psychoeducation may improve knowledge and decision-making which could potentially translate to reductions in HIV risk behaviors. A peer group randomized controlled comparison of an adapted EBI vs. control was delivered over an eight-day summer basketball camp in one reservation-based tribal community to adolescents ages 13–19. Outcome data were gathered immediately post-camp and at 6 and 12 months follow-up. Self-selected peer groups were randomized to intervention (n = 138) or control (n = 129) conditions for a total sample of 267 participants (56.2% female), mean age 15.1 years (SD = 1.7). Intervention participants had better condom use self-efficacy post-camp (Adjusted Mean Difference [AMD] = ?0.75, p < 0.005) and at 6 (AMD = ?0.44, p < 0.005) and 12 months (AMD = ?0.23, p < 0.05) follow-up. Intervention participants also had higher HIV prevention and transmission knowledge (post-camp: AMD = 0.07, p < 0.01; 6 months: AMD = 0.06, p < 0.01) were more likely to believe condoms prevent sexually transmitted infections (post-camp: RR = 1.41, p < 0.005; 6 months: RR = 1.34, p < 0.05), to talk with an adult about HIV/AIDS (post-camp: RR=1.78, p < 0.005; 6 months: RR = 1.14, p < 0.005), had higher partner negotiation efficacy related to substance use during sex (post-camp: AMD = 0.37, p < 0.01), and were more likely to intend to use a condom (post-camp: RR = 1.39, p < 0.01). The adapted intervention had short- and medium-term impacts on AI adolescent risk for HIV/AIDS, but attenuated at 12 months. Intervention delivery through a community-based camp is feasible and acceptable with strong retention. Additional study is needed to evaluate the adapted intervention's impact on sexual risk behaviors and if booster sessions and parent involvement translate to long-term impacts. 相似文献
2.
《Vaccine》2020,38(3):570-577
IntroductionPediatric pneumococcal pneumonia complicated by parapneumonic pleural effusion/empyema (PPE/PE) remains a major concern despite general immunization with pneumococcal conjugate vaccines (PCVs).MethodsIn a nationwide pediatric hospital surveillance study in Germany we identified 584 children <18 years of age with bacteriologically confirmed PPE/PE from October 2010 to June 2018. Streptococcus pneumoniae was identified by culture and/or PCR of blood samples and/or pleural fluid and serotyped.ResultsS. pneumoniae was identified in 256 of 584 (43.8%) children by culture (n = 122) and/or PCR (n = 207). The following pneumococcal serotypes were detected in 114 children: serotype 3 (42.1%), 1 (25.4%), 7F (12.3%), 19A (7.9%), other PCV13 serotypes (4.4%) and non-PCV13 serotypes (7.9%). Between October 2010 and June 2014 serotype 1 (38.1%) and serotype 3 (25.4%) were most prevalent, whereas between July 2014 and June 2018 serotype 3 (62.7%) and non-PCV13 serotypes (15.7%) were dominant. Compared to children with other pneumococcal serotypes, children with serotype 3 associated PPE/PE were younger (median 3.2 years [IQR 2.1–4.3 years] vs. median 5.6 years [IQR 3.8–8.2 years]; p < 0.001) and more frequently admitted to intensive care (43 [89.6%] vs. 48 [73.8%]; p = 0.04). Seventy-six of 114 (66.7%) children with pneumococcal PPE/PE had been vaccinated with pneumococcal vaccines. Thirty-nine of 76 (51.3%) had received a vaccine covering the serotype detected. Thirty of these 39 breakthrough cases were age-appropriately vaccinated with PCV13 and considered vaccine failures, including 26 children with serotype 3, three children with serotype 19A and one child with serotype 1.ConclusionFollowing the introduction of PCV13 in general childhood vaccination we observed a strong emergence of serotype 3 associated PPE/PE in the German pediatric population, including a considerable number of younger children with serotype 3 vaccine breakthrough cases and failures. Future PCVs should not only cover newly emerging serotypes, but also include a more effective component against serotype 3. 相似文献
3.
Quality of life in stroke survivor–caregiver dyads: a new conceptual framework and longitudinal study protocol 下载免费PDF全文
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《Urological Science》2015,26(2):144-146
Hydronephrosis with an undetermined pathology is a common condition detected in imaging studies. In urological clinical practice, it is a persistent dilemma to predict whether this condition will progress to result in the deterioration of renal function. Perfusion pressure flow study of the upper urinary tract, known as the Whitaker test, provides an alternative diagnostic tool for solving this condition. Perfusion pressure flow study has been criticized for its invasiveness, nonphysiological approach, and inconsistency in predicting outcomes. However, it continues to be used to evaluate difficult or equivocal cases and to provide an objective assessment of the upper urinary tract. 相似文献
5.
目的 探讨电针复合靶控输注(Target Controlled Infusion, TCI)在单肺通气食管癌开胸手术麻醉中的应用价值。方法 选取于我院拟行单肺通气食管癌开胸切除手术患者60例作为研究对象。随机将其分为试验组与对照组,对照组30例采取气管插管全麻及TCI靶控输注维持麻醉深度,试验组30例则在对照组方案基础上辅助电针麻醉,记录两组患者手术麻醉时间、药物用量、苏醒时间、并发症;以及术前(TⅠ)、插管前即刻(TⅡ)、插管后1 min(TⅢ)、切皮即刻(TⅣ)、去骨时(TⅤ)、拔管即刻(TⅥ)时平均动脉压(MAP)、平均心率(HR)、BIS值;术前、术后1天、术后3天简易智能精神状态检查量表(MMSE);并于麻醉诱导前(T0)、手术开始2 h(T1)、术后1天(T2)、术后3天(T3)时抽取患者外周静脉血检测IL-1β、IL-6、IL-10、TNF-α浓度。结果 试验组手术用时、麻醉时间略低于对照组,但差异无统计学意义(P>0.05),试验组异丙酚、舒芬太尼用量以及苏醒时间均明显低于对照组(P<0.05);TⅡ时两组平均动脉压(Mean Arterial Pressure, MAP)、心率(Heartrate, HR)较术前明显降低,且试验组MAP明显低于对照组(P<0.05),但两组TⅡ时HR比较无显著差异(P>0.05);TⅢ、TⅥ时对照组MAP、HR明显高于TⅠ时,而试验组MAP、HR与TⅠ比较无显著差异(P>0.05)。术后1天、3天试验组简易智能精神状态检查量表(Mini-Mental State Examination, MMSE)评分低于对照组,有显著性差异(P<0.05)。T1、T2、T3时试验组白介素-1β(IL-1β)、白介素-6(IL-6)、肿瘤坏死因子(Tumor Necrosis Factor-α, TNF-α)水平明显低于对照组(P<0.05),白介素-10(IL-10)水平明显高于对照组(P<0.05)。结论 采用电针复合TCI靶控输注麻醉方案可有效提升单肺通气食管癌开胸手术麻醉效果,能够降低患者术后认知功能障碍发生风险。 相似文献
6.
Recognizing and managing a deteriorating patient: a randomized controlled trial investigating the effectiveness of clinical simulation in improving clinical performance in undergraduate nursing students 下载免费PDF全文
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9.
Christopher N. Cooley Tyler J. Beranek Matthew A. Warpinski Robert Alexander Amanda O. Esquivel 《The American journal of emergency medicine》2019,37(2):199-203
Introduction
In the United States there has been a large increase in participation in lacrosse for both males and females. The purpose of this study was to analyze the number of head injuries, injury rates (calculated using the reported number of participants) and types of head injuries that are seen in emergency departments in the United States.Methods
We compared injuries between male and female lacrosse participants. This was a retrospective study using a publicly available database produced by the US Consumer Product Safety Commission and information about lacrosse participation from US Lacrosse.Results
A linear regression was performed and showed a positive correlation between number of head injuries to males and time from 2002 to 2010 (R2?=?0.823; p?=?0.001). While the number of injuries to the head in female lacrosse participants was not significant. There was a negative correlation between the number of head injuries to males from 2010 to 2016 (R2?=?0.800; p?=?0.007), but again, there was no significance for female injury count (R2?=?0.417; p?=?0.117). Other significant differences between head injuries in males and females included the mechanism of injury and the type of injury recorded.Conclusion
The most recent data from 2010 to 2016, suggest that both males and females have had a decrease in injury rate. However the total number of female head injuries is not significantly decreasing and as the sport continues to grow there will likely be more total head injuries and visits to the emergency department. 相似文献10.