BACKGROUND & AIMS: OBJECTIVE:This study reviewed whether participants who were given a continence education package, which included a Continence Educational Brochure (CEB), and who indicated that they were bothered by incontinence symptoms changed health-seeking behaviors about their incontinence problem because of being given the brochure. METHOD:This study used a descriptive and exploratory design. Participants were given the CEB and asked to read the information. They were also asked to complete a continence questionnaire and mail this back to the research team. Participants who indicated that they were bothered by a continence problem and consented to being interviewed were telephoned 2 to 3 months later. They were asked questions to determine their actions and progress in relation to managing their continence problem and whether the CEB had influenced their behavior. SETTING AND SUBJECT:A total of 631 participants (352 females, 55.8%; 279 males, 44.2%) from 4 rural and regional settings in Victoria, Australia, participated. Of this sample, 111 participants (78 females, 70.3%; 33 males, 29.7%) who reported that they were bothered by a continence problem were interviewed 3 months after being given the CEB. RESULTS:Two thirds of the total sample of participants (n=111) sought help for their continence problem. Approximately 70.3% (n=78) continued to have a continence problem. Of this group, 84.6% were still bothered by the continence problem and 65.4% had taken action to treat their incontinence. Forty-nine participants (44.1%) indicated that they had discussed the issue of bladder or bowel problems with someone directly because of this study or the information contained in the brochure. More than 94% of participants who remembered the CEB indicated that they believed the brochure would be helpful if given to other people. CONCLUSIONS:These findings suggest that the CEB prompted individuals to discuss their continence problem and in fewer cases to seek professional help. Given these findings, distribution of a continence education package is advocated as a continence health promotion strategy.

背景与目标： 目的：本研究回顾了参加者的节制教育包，其中包括节制教育手册（CEB），并指出他们因节制失禁症状而受到困扰，从而改变了他们对失禁问题的健康寻求行为，因为他们获得了手册。
方法：本研究采用描述性和探索性设计。参加者获得了CEB的邀请，并要求阅读信息。还要求他们填写节制问卷并将其邮寄回研究团队。 2至3个月后打电话给表示自己受到节制问题困扰并同意接受采访的参与者。他们被问到问题，以确定他们在处理自控问题方面的行动和进展，以及CEB是否影响了他们的行为。
地点和主题：来自澳大利亚维多利亚州4个农村和地区性地区的631名参与者（352名女性，占55.8％； 279名男性，占44.2％）参加了该项目。在该样本中，有111名参与者报告他们受到节制问题困扰，其中有78名女性，占70.3％； 33名男性，占29.7％，在接受CEB后三个月进行了访谈。
结果：参与者（n = 111）的总样本的三分之二寻求帮助，以解决他们的节制问题。大约70.3％（n = 78）仍然存在尿失禁问题。在这一组中，仍有84.6％的人患有尿失禁问题，还有65.4％的人已经采取了行动来治疗他们的尿失禁。 49名参与者（44.1％）表示，由于该研究或小册子中包含的信息，他们直接与某人讨论了膀胱或肠道问题。记得CEB的参与者中，超过94％的参与者表示，他们认为该手册对其他人有帮助。
结论：这些发现表明，CEB促使个人讨论他们的节制问题，并在较少的情况下寻求专业帮助。鉴于这些发现，提倡分发节制教育一揽子计划作为节制健康促进策略。

BACKGROUND & AIMS: :This study aimed to clarify the effectiveness of post-operative oral care, including tooth brushing, denture cleaning and tongue cleaning, after digestive tract surgery. Subjects included 30 elderly patients aged 60-98 years (74.9 +/- 7.8 years) who underwent digestive tract surgery. Subjects were randomly divided into an intervention group and a control group. In the intervention group, the following oral care was provided daily over a 5-min period in the morning starting at baseline (day of surgery) and continued for 5 days: gargling with povidone iodine, tooth brushing, denture cleaning using a special brush and tongue cleaning using a tongue brush. In the control group, the subjects only gargled with povidone iodine. We compared the following variables between the two groups at baseline and 5 days later: the sensation of dry mouth, intra-oral gas concentration, pulmonary sounds, body temperature and bacterial flora. The number of patients with abnormal pulmonary sounds (dry or moist rales) increased from 1 to 2 in the intervention group and from 0 to 4 in the control group (P < 0.05). The average number of bacterial species per subject for the control group was 3.64 +/- 1.34 pre-operatively and 3.50 +/- 1.74 post-operatively, whereas that for the intervention group was 3.08 +/- 0.95 pre-operatively and 2.62 +/- 0.65 post-operatively. In the intervention group, there was a significant decrease in the number of bacterial species (P < 0.05). These findings indicate that post-operative oral care in elderly patients undergoing digestive tract surgery lowers the number of bacterial species found in the oral cavity. This effect, in turn, might improve respiratory function.

背景与目标： ：这项研究旨在阐明消化道手术后口腔护理的有效性，包括刷牙，义齿清洁和舌头清洁。受试者包括接受消化道手术的30位年龄在60-98岁（74.9 /-7.8岁）的老年患者。将受试者随机分为干预组和对照组。在干预组中，每天从基线（手术日）开始，在每天的5分钟内，每天进行以下口腔护理，并持续5天：用聚维酮碘漱口，刷牙，使用专用刷子清洁义齿和使用舌刷清洁舌头。在对照组中，受试者仅含聚维酮碘。我们在基线和5天后比较了两组之间的以下变量：口干的感觉，口内气体浓度，肺音，体温和细菌菌群。在干预组中，肺音异常（干音或湿音）的患者数量从1增加到2，在对照组中从0增加到4（P <0.05）。对照组术前平均细菌种类为3.64 /-1.34，术后为3.50 /-1.74，而干预组术前为3.08 /-0.95，术后为2.62 /-0.65。操作上。在干预组中，细菌种类的数量显着减少（P <0.05）。这些发现表明，接受消化道手术的老年患者的术后口腔护理降低了在口腔中发现的细菌种类的数量。反过来，这种效果可能会改善呼吸功能。

BACKGROUND & AIMS: BACKGROUND:Although the benefit of thrombolytic therapy in reducing mortality in acute myocardial infarction is well established, the types of bleeding and risk factors for bleeding are less well described in large trials.

METHODS AND RESULTS:We analyzed the baseline characteristics, outcomes, and incidence of bleeding by location, severity, and treatment assignment among 41,021 patients in the GUSTO-I trial of thrombolysis for acute myocardial infarction. Of the 40,903 patients for whom there were complete data, 1.2% suffered severe bleeding and 11.4% experienced moderate hemorrhage at a variety of sites. The most common sources of bleeding were procedure related. The thrombolytic regimen was strongly related to the incidence of bleeding; comparatively more bleeding was seen with the therapies of streptokinase plus intravenous heparin and the streptokinase and tissue plasminogen activator plus intravenous heparin combination. In multivariate analysis, the four most powerful independent predictors of hemorrhage were older age, lighter body weight, female sex, and African ancestry; they remained the most important predictors of bleeding when multivariate analysis was performed on patients who did not undergo invasive procedures. The presence of serious hemorrhage was associated with other undesirable outcomes (recurrent events, left ventricular dysfunction, arrhythmia, or stroke).

CONCLUSIONS:Important predictors of bleeding in this population are increased age, lighter weight, female sex, African ancestry, and experiencing invasive procedures. Other nonhemorrhagic adverse clinical outcomes were associated with moderate and severe bleeding, which was in turn associated with increased length of hospital stay and mortality at 30 days.

背景与目标： 背景：尽管溶​​栓治疗在降低急性心肌梗死死亡率方面的益处已得到广泛认可，但在大型试验中对出血的类型和出血的危险因素的描述却较少。

< strong>方法和结果：我们在GUSTO-I急性心肌梗塞试验的GUSTO-I试验中，对41,021例患者的基线特征，结局和出血发生率进行了分析，包括其位置，严重程度和治疗方案。在有完整数据的40,903名患者中，有1.2％出现严重出血，11.4％的患者在不同部位出现中度出血。最常见的出血来源与手术有关。溶栓方案与出血发生率密切相关。链激酶加静脉肝素，链激酶和组织纤溶酶原激活剂加肝素联合治疗的出血量相对较多。在多变量分析中，出血的四个最有力的独立预测因子是年龄大，体重轻，女性和非洲血统。当对未进行侵入性治疗的患者进行多变量分析时，它们仍然是出血的最重要预测指标。严重出血的存在与其他不良后果（复发事件，左心室功能障碍，心律不齐或中风）相关。

结论：该人群出血的重要预测因素是年龄增加，体重减轻，女性性别，非洲血统和经历侵入性程序。其他非出血性不良临床预后与中度和重度出血有关，这又与住院天数的延长和30天病死率有关。