• 【公共卫生管理学院:程序设计和成功的关键因素。】 复制标题 收藏 收藏
    DOI:10.1097/00124784-200609000-00002 复制DOI
    作者列表:Orton S,Umble KE,Rosen B,McIver J,Menkens AJ
    BACKGROUND & AIMS: :The Management Academy for Public Health is a team-based training program jointly offered by the School of Public Health and the Kenan-Flagler Business School at the University of North Carolina at Chapel Hill. This 9-month program teaches public health managers how to better manage people, information, and finances. Participants learn how to work in teams with community partners, and how to think and behave as social entrepreneurs. To practice and blend their new skills, teams develop a business plan that addresses a local public health issue. This article describes the program and explains the findings of the process evaluation, which has examined how best to structure and deploy a team-based method to create more effective, more entrepreneurial public health managers. Findings indicate that recruitment and retention are strong, program elements are relevant to learners' needs, and learners are satisfied with and value the program. Several specific benefits of the program model are identified, as well as several elements that support business plan success and skills' application on the job. On the basis of these findings, four success factors critical for developing similar programs are identified.
    背景与目标: :公共卫生管理学院是一项基于团队的培训计划,由北卡罗来纳大学教堂山分校的公共卫生学院和Kenan-Flagler商学院联合提供。这个为期9个月的课程向公共卫生经理讲授如何更好地管理人员,信息和财务。参与者学习如何与社区合作伙伴一起工作,以及如何思考和表现为社会企业家。为了练习和融合他们的新技能,团队制定了解决当地公共卫生问题的商业计划。本文介绍了该程序,并说明了过程评估的结果,该过程评估了如何最好地构建和部署基于团队的方法来创建更有效,更具创业精神的公共卫生经理。调查结果表明,招聘和留住人才的能力很强,计划要素与学习者的需求相关,学习者对计划感到满意和重视。确定了计划模型的几个特定优点,以及支持业务计划成功和技能在工作中应用的几个要素。根据这些发现,确定了开发类似程序的四个成功因素。
  • 【代表性的全科医学样本中晚期失眠的危险因素。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Morgan K,Clarke D
    BACKGROUND & AIMS: BACKGROUND:Insomnia is widely reported and widely treated in general practice, yet relatively little research has focused on the natural history of the condition in primary care settings. As a result, there is at present little information to enable clinicians to assess insomnia risk, or anticipate outcomes in older general practice populations.

    AIM:To estimate, using 8-year longitudinal data, the risk of insomnia onset associated with selected health and lifestyle factors.

    METHOD:Survivors from a nationally representative sample (n = 1042) of elderly people originally interviewed in 1985 were reassessed in 1989 (n = 690) and 1993 (n = 410). At the first follow up in 1989, 84 new cases of insomnia were identified (a weighted incidence rate per person per year at a risk of 3.1%; 95% CI = 2.7-3.5). In logistic regression analyses controlling for age and sex, the risk of insomnia onset was then assessed in relation to the selected factors.

    RESULTS:Three factors assessed in 1985 were significantly and independently related to incident insomnia: psychometric ratings consistent with depressed mood odds ratio (OR) = 4.41; 95% CI = 3.32-5.43); health index scores indicating lower physical health status (OR = 1.19; 95% CI = 1.06-1.31 per unit change in scale score); and moderate and low levels of physical activity (OR = 1.91 and 2.14; 95% CI = 1.91-3.62 and 2.14-3.64 respectively). However, although depressed mood represented a major risk factor, the most likely source of risk was physical rather than mental ill-health.

    CONCLUSIONS:Psychiatric, somatic and lifestyle factors significantly and independently increase the risk of insomnia in older general practice patients. In predicting incident sleep disturbance, these factors exceed in importance the age and sex of patients.

    背景与目标: 背景:失眠在一般实践中得到广泛报道和广泛治疗,但相对较少的研究集中在初级保健机构中病情的自然史上。因此,目前尚无足够的信息可帮助临床医生评估失眠风险或预期较老的全科医生人群的结局。

    AIM :使用8年纵向评估数据,与选定的健康和生活方式因素相关的失眠风险。

    方法:对来自全国代表性样本(n = 1042)最初在1985年接受采访的老年人的幸存者进行了重新评估。在1989年(n = 690)和1993(n = 410)。在1989年的首次随访中,发现了84例新的失眠病例(加权平均每人每年的发病率,风险为3.1%; 95%CI = 2.7-3.5)。在控制年龄和性别的逻辑回归分析中,然后根据所选因素评估了失眠的风险。

    结果:1985年评估的三个因素具有显着性和独立性发生失眠:心理测验评分与沮丧的情绪几率之比(OR)= 4.41; 95%CI = 3.32-5.43);健康指数得分,表明身体健康状况较低(OR = 1.19; 95%CI =单位得分变化每单位1.06-1.31);中度和低度的体育活动(OR分别为1.91和2.14; 95%CI分别为1.91-3.62和2.14-3.64)。但是,尽管情绪低落是主要的危险因素,但最可能的危险来源是身体而不是精神疾病。

    结论:精神,躯体和生活方式因素显着且独立增加老年全科患者失眠的风险。在预测事件性睡眠障碍时,这些因素的重要性超过了患者的年龄和性别。

  • 【在口腔鳞状细胞癌的浸润性肿瘤前评估组织生物学因素(恶性分级和AgNOR含量)的预后价值。】 复制标题 收藏 收藏
    DOI:10.1038/bjc.1997.263 复制DOI
    作者列表:Piffkò J,Bànkfalvi A,Ofner D,Bryne M,Rasch D,Joos U,Böcker W,Schmid KW
    BACKGROUND & AIMS: Tumour cells at the invasive front of carcinomas have been found to differ substantially from the rest of tumour cells in a variety of human cancers. The present multivariate survival analysis of 94 oral squamous cell carcinomas (OSCCs) revealed that both the argyrophilic nucleolar organizer regions-associated protein (AgNOR) content of invading tumour cells and a multiparametric histopathological tumour front grade were significantly and independently associated with tumour-related death, irrespective of conventional Broders' grade and clinical stage of the tumours. High tumour front scores and AgNOR content at the invasive OSCC front thus seem to reflect increased malignant potential. Proliferative activity, assessed by standardized AgNOR analysis, most probably represents one of the biological features underlying the usefulness of evaluating the invasive tumour front.

    背景与目标: 已经发现,在多种人类癌症中,处于癌症侵袭性前沿的肿瘤细胞与其余肿瘤细胞有很大的不同。目前对94例口腔鳞状细胞癌(OSCC)的多因素生存分析表明,侵袭性肿瘤细胞的嗜银性核仁组织者区域相关蛋白(AgNOR)含量和多参数组织病理学肿瘤分级均与肿瘤相关死亡显着且独立相关,与常规Broders的肿瘤分级和临床分期无关。因此,在侵袭性OSCC前沿,较高的肿瘤前沿评分和AgNOR含量似乎反映出恶性潜能的增加。通过标准化AgNOR分析评估的增殖活性很可能代表了评估侵袭性肿瘤前沿有用性的生物学特征之一。

  • 【肝移植受者巨细胞病毒感染危险因素的多因素分析。】 复制标题 收藏 收藏
    DOI:10.1016/0016-5085(90)90352-2 复制DOI
    作者列表:Gorensek MJ,Carey WD,Vogt D,Goormastic M
    BACKGROUND & AIMS: :Thirty-three consecutive liver-transplant recipients were prospectively studied over a 37-mo period for evidence of cytomegalovirus infection. Sixteen (48%) episodes of cytomegalovirus infection were identified; 9 were primary infections and 7 were recurrent infections. Beginning with patient 8, gamma-globulin prophylaxis was routinely administered to most patients. Twelve potential risk factors for cytomegalovirus infection were evaluated and included pretransplant cytomegalovirus serological status of donor and recipient; recipient's age, sex, race, and liver disease; number and type of blood products transfused; type and intensity of immunosuppression; and occurrence of rejection. The Cox proportional hazards model identified positive donor cytomegalovirus serology as the single most important risk factor for subsequent development of cytomegalovirus infection, regardless of recipient cytomegalovirus serological status. In addition, use of gamma-globulin prophylaxis seemed to be protective against the occurrence of disseminated cytomegalovirus disease.
    背景与目标: :在37个月内对33例连续肝移植接受者进行了前瞻性研究,以发现巨细胞病毒感染的迹象。鉴定出十六例(48%)巨细胞病毒感染; 9例是原发性感染,7例是复发性感染。从患者8开始,常规对大多数患者进行了γ-球蛋白的预防。对巨细胞病毒感染的十二种潜在危险因素进行了评估,包括供体和受体移植前巨细胞病毒的血清学状况。接受者的年龄,性别,种族和肝脏疾病;输血产品的数量和类型;免疫抑制的类型和强度;和拒绝的发生。 Cox比例风险模型将阳性供体巨细胞病毒血清学确定为随后发展成巨细胞病毒感染的唯一最重要的危险因素,而与受体巨细胞病毒血清学状况无关。另外,使用γ-球蛋白预防似乎可以预防弥漫性巨细胞病毒病的发生。
  • 【准确衡量非法药物的消费,价格和市场的行为和经济方面的潜力。】 复制标题 收藏 收藏
    DOI:10.1016/j.drugalcdep.2006.08.005 复制DOI
    作者列表:Johnson BD,Golub A
    BACKGROUND & AIMS: :There are numerous analytic and methodological limitations to current measures of drug market activity. This paper explores the structure of markets and individual user behavior to provide an integrated understanding of behavioral and economic (and market) aspects of illegal drug use with an aim toward developing improved procedures for measurement. This involves understanding the social processes that structure illegal distribution networks and drug users' interactions with them. These networks are where and how social behaviors, prices, and markets for illegal drugs intersect. Our focus is upon getting an up close measurement of these activities. Building better measures of consumption behaviors necessitates building better rapport with subjects than typically achieved with one-time surveys in order to overcome withholding and underreporting and to get a comprehensive understanding of the processes involved. This can be achieved through repeated interviews and observations of behaviors. This paper also describes analytic advances that could be adopted to direct this inquiry including behavioral templates, and insights into the economic valuation of labor inputs and cash expenditures for various illegal drugs. Additionally, the paper makes recommendations to funding organizations for developing the mechanisms that would support behavioral scientists to weigh specimens and to collect small samples for laboratory analysis-by providing protection from the potential for arrest. The primary focus is upon U.S. markets. The implications for other countries are discussed.
    背景与目标: :目前对药物市场活动的度量存在许多分析和方法学限制。本文探讨了市场结构和个人用户行为,以提供对非法药物使用的行为和经济(及市场)方面的综合理解,旨在开发改进的测量程序。这涉及了解构成非法分销网络和吸毒者与之互动的社会过程。这些网络是非法毒品的社会行为,价格和市场在何处以及如何相交的地方。我们的重点是仔细衡量这些活动。要建立更好的消费行为衡量标准,就必须与受试者建立更好的融洽关系,这要比一次调查更能实现,以克服扣缴和漏报的情况,并对所涉及的过程有一个全面的了解。这可以通过反复采访和观察行为来实现。本文还描述了可用于指导这一询问的分析进展,包括行为模板,以及对各种非法药物的劳动投入和现金支出的经济估值的见解。此外,该论文还向资助组织提出了建议,以开发机制,以支持行为科学家称量样本并收集小样本进行实验室分析,从而提供保护措施以防止被捕。主要重点是美国市场。讨论了对其他国家的影响。
  • 【神经性糖尿病足溃疡微生物组与临床因素有关。】 复制标题 收藏 收藏
    DOI:10.2337/db12-0771 复制DOI
    作者列表:Gardner SE,Hillis SL,Heilmann K,Segre JA,Grice EA
    BACKGROUND & AIMS: :Nonhealing diabetic foot ulcers (DFUs) are a common and costly complication of diabetes. Microbial burden, or "bioburden," is believed to underlie delayed healing, although little is known of those clinical factors that may influence microbial load, diversity, and/or pathogenicity. We profiled the microbiomes of neuropathic nonischemic DFUs without clinical evidence of infection in 52 individuals using high-throughput sequencing of the bacterial 16S ribosomal RNA gene. Comparatively, wound cultures, the standard diagnostic in the clinic, vastly underrepresent microbial load, microbial diversity, and the presence of potential pathogens. DFU microbiomes were heterogeneous, even in our tightly restricted study population, but partitioned into three clusters distinguished primarily by dominant bacteria and diversity. Ulcer depth was associated with ulcer cluster, positively correlated with abundance of anaerobic bacteria, and negatively correlated with abundance of Staphylococcus. Ulcer duration was positively correlated with bacterial diversity, species richness, and relative abundance of Proteobacteria, but was negatively correlated with relative abundance of Staphylococcus. Finally, poor glycemic control was associated with ulcer cluster, with poorest median glycemic control concentrating to Staphylococcus-rich and Streptococcus-rich ulcer clusters. Analyses of microbial community membership and structure may provide the most useful metrics in prospective studies to delineate problematic bioburden from benign colonization that can then be used to drive clinical treatment.
    背景与目标: :非愈合性糖尿病足溃疡(DFU)是糖尿病的常见且代价高昂的并发症。尽管对影响微生物负荷,多样性和/或致病性的临床因素知之甚少,但是微生物负荷或“生物负荷”被认为是延迟愈合的基础。我们使用细菌16S核糖体RNA基因的高通量测序对52例无感染临床症状的神经性非缺血性DFU的微生物群进行了分析。相比之下,伤口培养物(临床上的标准诊断方法)在很大程度上代表了微生物负荷,微生物多样性以及潜在病原体的存在。即使在我们严格限制的研究人群中,DFU微生物群也是异质的,但被分为三类,主要以优势细菌和多样性为特征。溃疡深度与溃疡簇有关,与厌氧菌的数量呈正相关,与葡萄球菌的数量呈负相关。溃疡持续时间与细菌多样性,物种丰富度和变形杆菌相对丰度呈正相关,而与葡萄球菌相对丰度呈负相关。最后,血糖控制不佳与溃疡簇有关,最差的中位血糖控制集中于富含葡萄球菌和富含链球菌的溃疡簇。在前瞻性研究中,对微生物群落组成和结构的分析可能会提供最有用的指标,以从良性定殖中确定有问题的生物负荷,然后将其用于临床治疗。
  • 【退伍军人中同时发生自杀念头和暴力冲动的危险因素。】 复制标题 收藏 收藏
    DOI:10.1037/pas0000490 复制DOI
    作者列表:Elbogen EB,Wagner HR,Kimbrel NA,Brancu M,Naylor J,Graziano R,Crawford E,VA Mid-Atlantic MIRECC Workgroup.
    BACKGROUND & AIMS: :Suicide and violence are significant problems in a subset of Iraq/Afghanistan-era veterans. This study investigates how posttraumatic stress disorder (PTSD) and resilience in veterans are associated with suicidal ideation and violent impulses while controlling for known covariates of both adverse outcomes. Structured clinical interviews were conducted of N = 2,543 Iraq/Afghanistan-era U.S. veterans. Compared with veterans denying suicidal ideation or violent impulses (n = 1,927), veterans endorsing both (n = 171) were more likely to meet diagnostic criteria for PTSD, report childhood abuse, combat exposure, physical pain symptoms, and drug misuse, and less likely to endorse self-direction/life purpose. Veterans reporting concurrent suicidal ideation and violent impulses had higher odds of misusing drugs and reporting pain symptoms relative to veterans reporting suicidal ideation only (n = 186) and had lower odds of endorsing self-direction/life purpose compared with veterans reporting violent impulses only (n = 259). The findings underscore the importance of examining drug abuse, physical pain symptoms, and self-direction/life purpose, as well as PTSD and history of trauma, in the context of clinical assessment and empirical research aimed at optimizing risk management of suicide and violence in military veterans. (PsycINFO Database Record
    背景与目标: 自杀和暴力是伊拉克/阿富汗时代退伍军人中一个重要的问题。这项研究调查了创伤后应激障碍(PTSD)和退伍军人的适应力如何与自杀意念和暴力冲动相关联,同时控制了两种不良结局的已知协变量。对N = 2,543名伊拉克/阿富汗时代的美国退伍军人进行了结构化的临床采访。与否认自杀意念或暴力冲动的退伍军人相比(n = 1,927),同时支持这两种方式的退伍军人(n = 171)更可能符合PTSD的诊断标准,并报告了儿童期虐待,战斗暴露,身体疼痛症状和滥用药物的情况,且更少可能认同自我指导/人生目标。与仅报告有自杀倾向的退伍军人相比,报告同时发生自杀意念和暴力冲动的退伍军人比仅报告有自杀意念的退伍军人滥用药物和报告疼痛症状的几率更高(n = 186),并且认可自我指导/人生目标的几率比仅报告暴力冲动的退伍军人低( n = 259)。这些发现强调了在临床评估和实证研究的背景下,检查药物滥用,身体疼痛症状和自我指导/生活目的,以及创伤后应激障碍和创伤史的重要性,旨在优化自杀和暴力行为的风险管理。退伍军人。 (PsycINFO数据库记录
  • 【猫鼬粪便中碳氮稳定同位素的鉴别因素。】 复制标题 收藏 收藏
    DOI:10.7717/peerj.3436 复制DOI
    作者列表:Montanari S
    BACKGROUND & AIMS: :Stable isotope analysis of feces can provide a non-invasive method for tracking the dietary habits of nearly any mammalian species. While fecal samples are often collected for macroscopic and genetic study, stable isotope analysis can also be applied to expand the knowledge of species-specific dietary ecology. It is somewhat unclear how digestion changes the isotope ratios of animals' diets, so more controlled diet studies are needed. To date, most diet-to-feces controlled stable isotope experiments have been performed on herbivores, so in this study I analyzed the carbon and nitrogen stable isotope ratios in the diet and feces of the meerkat (Suricata suricatta), a small omnivorous mammal. The carbon trophic discrimination factor between diet and feces (Δ13Cfeces) is calculated to be 0.1 ± 1.5‰, which is not significantly different from zero, and in turn, not different than the dietary input. On the other hand, the nitrogen trophic discrimination factor (Δ15Nfeces) is 1.5 ± 1.1‰, which is significantly different from zero, meaning it is different than the average dietary input. Based on data generated in this experiment and a review of the published literature, carbon isotopes of feces characterize diet, while nitrogen isotope ratios of feces are consistently higher than dietary inputs, meaning a discrimination factor needs to be taken into account. The carbon and nitrogen stable isotope values of feces are an excellent snapshot of diet that can be used in concert with other analytical methods to better understand ecology, diets, and habitat use of mammals.
    背景与目标: 粪便的稳定同位素分析可为追踪几乎所有哺乳动物的饮食习惯提供一种非侵入性的方法。虽然通常收集粪便样本用于宏观和遗传研究,但稳定同位素分析也可用于扩展对物种特定的饮食生态学的了解。尚不清楚消化如何改变动物饮食的同位素比率,因此需要更严格的饮食研究。迄今为止,大多数日粮对粪便控制的稳定同位素实验都是在食草动物上进行的,因此在这项研究中,我分析了杂食性小型猫鼬(Suricata suricatta)的日粮和粪便中碳和氮的稳定同位素比。饮食与粪便之间的碳营养辨别因子(Δ13Cfeces)计算为0.1±1.5‰,与零无显着差异,反过来与饮食投入也无差异。另一方面,氮营养辨别因子(Δ15Nfeces)为1.5±1.1‰,与零显着不同,这意味着它与平均饮食投入不同。根据该实验产生的数据和对已发表文献的评论,粪便的碳同位素表征饮食,而粪便的氮同位素比率始终高于饮食投入,这意味着需要考虑歧视因素。粪便的碳和氮稳定同位素值是饮食的极好快照,可以与其他分析方法结合使用,以更好地了解哺乳动物的生态,饮食和栖息地。
  • 【全膝关节置换术后伤口感染的危险因素。】 复制标题 收藏 收藏
    DOI:10.1093/oxfordjournals.aje.a115580 复制DOI
    作者列表:Gordon SM,Culver DH,Simmons BP,Jarvis WR
    BACKGROUND & AIMS: :Wound infections are an infrequent but serious complication of total knee arthroplasty. Between January 1984 and November 1987, 20 of 243 (8.2%) patients at two affiliated hospitals developed surgical wound infections following 259 total knee arthroplasty procedures performed in clean-air operating rooms. Eighteen (90%) of the patients had deep infections; nine required removal of the prosthesis. A single surgeon (surgeon X) was associated with 18 of the procedures that had subsequent infection (risk ratio (RR) = 9.4, 95% confidence interval (CI) 2.2-39), and an investigation was carried out in an effort to explain the difference in infection rates between surgeon X and other surgeons. In a cohort study, stratified analyses identified a preoperative American Society of Anesthesiologists (ASA) physical status class greater than or equal to 3, surgeon X, and early postoperative use of a continuous passive motion device as risk factors associated with surgical wound infection following total knee arthroplasty procedures. Logistic regression analyses identified being a patient operated on by surgeon X with an ASA class greater than or equal to 3 as the only significant independent risk factor for total knee arthroplasty-associated surgical wound infections (RR = 9.3, 95% CI 2.8-31). The effect due to surgeon X could not be explained by receipt or timeliness of administration of antimicrobial prophylaxis, type of prosthesis inserted, duration of operation, postoperative use of continuous passive motion, or underlying etiology of joint disease. The authors conclude that surgical technique and patient's severity of illness were the primary determinants of surgical wound infection after total knee arthroplasty. This study demonstrates the complexity of epidemiologic investigation of surgical wound infections and the importance of considering patient severity of illness when interpreting surgeon-specific infection rates.
    背景与目标: :伤口感染是全膝关节置换术的一种罕见但严重的并发症。在1984年1月至1987年11月之间,两家附属医院的243名患者中有20名(8.2%)在清洁空气手术室中进行了259次全膝关节置换手术后出现了手术伤口感染。 18名(90%)患者患有深部感染;九个需要去除假体。一名外科医生(外科医生X)与18例随后感染的手术相关联(风险比(RR)= 9.4,95%置信区间(CI)2.2-39),并进行了调查以解释X外科医师和其他外科医师之间的感染率差异。在一项队列研究中,分层分析将术前美国麻醉师学会(ASA)身体状况等级大于或等于3,X医师和术后早期使用连续被动运动装置作为与总手术后伤口感染相关的危险因素膝关节置换手术。 Logistic回归分析确定是由ASA级大于或等于3的X外科医师手术的患者,是全膝关节置换相关手术伤口感染的唯一重要独立危险因素(RR = 9.3,95%CI 2.8-31) 。不能通过接受抗生素预防措施的及时性,插入的假体的类型,手术的持续时间,术后持续使用被动运动或关节病的病因来解释外科医生X的影响。作者得出结论,手术技术和患者疾病的严重程度是全膝关节置换术后手术伤口感染的主要决定因素。这项研究证明了外科伤口感染的流行病学调查的复杂性,以及在解释外科医生特定感染率时考虑患者疾病严重性的重要性。
  • 【成人严重烧伤后影响心理,社会和健康结局的因素:队列研究方案。】 复制标题 收藏 收藏
    DOI:10.1136/bmjopen-2017-017545 复制DOI
    作者列表:Druery M,Newcombe PA,Cameron CM,Lipman J
    BACKGROUND & AIMS: INTRODUCTION:The goal of burn care is that 'the quality of the outcome must be worth the pain of survival'. More research is needed to understand how best to deliver care for patients with burns to achieve this aim. Loss of independence, function as well as loss of income for patients with burns and carers cause a significant burden at both individual and societal levels. Much is being done to advance knowledge in the clinical care field; however, there has been a paucity of research exploring psychosocial outcomes. This paper describes the study background and methods, as implemented in an Australian cohort study of psychosocial outcomes after major burn injuries. METHODS AND ANALYSIS:In this inception cohort study, a target sample of 230 participants, aged 18 years or over, admitted to a single statewide burns centre with a burn injury are identified by hospital staff for inclusion. Baseline survey data are collected either in person or by telephone within 28 days of the injury and participants then followed up with telephone interviews at 3, 6 and 12 months postburn. Injury and burns treatment information is collected from medical records. Social support is measured as a predictor variable using the Multidimensional Scale of Perceived Social Support. Outcome data are collected via standardised measures in the domains of Quality of Life (SF-12, EQ-5D, BSHS-B), depression (PHQ-9), post-traumatic stress disorder (PCL-C, PAS), community integration (CIQ-R) and Quality-Adjusted Life Years (EQ-5D). Additional survey questions measure life satisfaction, return to work and public services utilisation at 12 months postinjury. Data analysis methods will include analysis of variance, Pearson correlation and hierarchical multiple regression analyses. ETHICS AND DISSEMINATION:Hospital-based and University of Queensland Human Research Ethics Committees have approved the protocol. Results from the study will be disseminated at national and international conferences, in peer-reviewed journals and in a doctoral thesis. TRIAL REGISTRATION NUMBER:Australia New Zealand Clinical Trials Registry (ACTRN12616000828426). Retrospectively registered on 23 June 2016; pre-results.
    背景与目标: 简介:烧伤护理的目标是“结果的质量必须值得生存之苦”。需要更多的研究来了解如何最好地为烧伤患者提供护理以实现该目标。烧伤和照顾者患者失去独立性,功能以及收入损失,在个人和社会层面都造成了沉重的负担。为了提高临床护理领域的知识水平,正在做很多工作。然而,很少有研究探讨社会心理结果。本文描述了一项研究背景和方法,该方法在澳大利亚严重烧伤后心理社会结局队列研究中实施。
    方法和分析:在这项队列研究中,医院工作人员确定了230名年龄在18岁或以上,被纳入一个州范围内烧伤中心的烧伤中心的参与者的目标样本。基线调查数据在受伤后28天内亲自或通过电话收集,参与者在烧伤后3、6和12个月进行电话访谈。伤害和烧伤治疗信息是从医疗记录中收集的。社会支持是使用感知的社会支持多维量表作为预测变量来衡量的。通过生活质量(SF-12,EQ-5D,BSHS-B),抑郁症(PHQ-9),创伤后应激障碍(PCL-C,PAS),社区整合等领域的标准化措施收集结果数据(CIQ-R)和质量调整寿命年(EQ-5D)。额外的调查问题可衡量受伤后12个月的生活满意度,重返工作岗位和使用公共服务的情况。数据分析方法将包括方差分析,Pearson相关性和分层多元回归分析。
    道德与传播:医院和昆士兰大学人类研究伦理委员会已批准该协议。该研究的结果将在国家和国际会议,同行评审期刊和博士学位论文中进行传播。
    试验注册号:澳大利亚新西兰临床试验注册(ACTRN12616000828426)。追溯注册于2016年6月23日;结果。
  • 【睡眠障碍和相关危险因素的负担:中国艾滋病毒感染者抗逆转录病毒疗法的横断面调查。】 复制标题 收藏 收藏
    DOI:10.1038/s41598-017-03968-3 复制DOI
    作者列表:Huang X,Li H,Meyers K,Xia W,Meng Z,Li C,Bai J,He S,Cai W,Huang C,Liu S,Wang H,Ling X,Ma P,Tan D,Wang F,Ruan L,Zhao H,Wei H,Liu Y,Yu J,Lu H,Wang M,Zhang T,Chen H,Wu H
    BACKGROUND & AIMS: :This study evaluated the prevalence and factors associated with sleep disturbance in a large cohort of HIV-infected patients across China. A cross-sectional study was conducted among HIV-infected patients on antiretroviral therapy at 20 AIDS clinics. The Pittsburgh Sleep Quality Index was self-administered by subjects. Socio-demographic characteristics, medical history and HIV-related clinical data were collected. 4103 patients had complete data for analysis. Sleep disturbances were observed in 43.1% of patients. Associated factors in multivariable analysis included psychological factors: anxiety (odds ratio [OR], 3.13; 95% confidence interval [CI], 2.44-4.00; P < 0.001), depression (OR, 2.09; 95% CI, 1.70-2.57; P < 0.001), and both anxiety and depression (OR, 5.90; 95% CI, 4.86-7.16; P < 0.001); sociodemographic factors: MSM (OR, 1.26; 95% CI, 1.04-1.52; P = 0.018), being single (OR, 1.45; 95%CI 1.21-1.74; P < 0.001), higher education (OR, 1.25; 95% CI, 1.03-1.53; P = 0.025); and clinical factors: suboptimal adherence (OR,1.51; 95% CI,1.23-1.85; P < 0.001), regimen-switching (OR, 1.94; 95% CI, 1.12-3.35; P = 0.018), and antidepressant use (OR, 1.98; 95% CI, 1.47-2.67; P = 0.044). Prevalence of sleep disturbance is high in this large Chinese cohort. Associated factors appear related to psychological and social-demographic factors. Health workers may consider routinely assessing sleep disturbances among HIV-infected patients, especially in the first three months after HIV diagnosis, and referring for mental health services, which may positively impact adherence to treatment.
    背景与目标: :这项研究评估了中国一大批感染HIV的患者的患病率和与睡眠障碍相关的因素。在20个艾滋病诊所中,对接受HIV感染的患者进行了抗逆转录病毒治疗的横断面研究。匹兹堡睡眠质量指数由受试者自行管理。收集了社会人口统计学特征,病史和与艾滋病相关的临床数据。 4103例患者有完整的数据需要分析。在43.1%的患者中观察到睡眠障碍。多变量分析中的相关因素包括心理因素:焦虑(赔率[OR],3.13; 95%置信区间[CI],2.44-4.00; P <0.001),抑郁(OR,2.09; 95%CI,1.70-2.57;病历)。 (P <0.001),以及焦虑和抑郁(OR,5.90; 95%CI,4.86-7.16; P <0.001)。社会人口统计学因素:MSM(OR,1.26; 95%CI,1.04-1.52; P = 0.018),单身(OR,1.45; 95%CI 1.21-1.74; P <0.001),高等教育程度(OR,1.25; 95%CI,1.03-1.53​​; P = 0.025);临床因素:次最佳依从性(OR,1.51; 95%CI,1.23-1.85; P <0.001),方案转换(OR,1.94; 95%CI,1.12-3.35; P = 0.018),和抗抑郁药的使用(OR ,1.98; 95%CI,1.47-2.67; P = 0.044)。在这个庞大的中国人群中,睡眠障碍的患病率很高。相关因素似乎与心理和社会人口统计学因素有关。卫生工作者可以考虑常规评估艾滋病毒感染患者的睡眠障碍,尤其是在艾滋病毒确诊后的前三个月,并寻求心理健康服务,这可能会对治疗依从性产生积极影响。
  • 【有和没有肾结石病家族史的健康学童尿结石的危险因素。】 复制标题 收藏 收藏
    DOI:10.1007/s00467-012-2368-5 复制DOI
    作者列表:Sáez-Torres C,Grases F,Rodrigo D,García-Raja AM,Gómez C,Frontera G
    BACKGROUND & AIMS: BACKGROUND:The prevalence of lithiasis is increasing at all ages. This study aimed to assess the crystallization risk in urine from healthy school children and to determine urinary parameters that are most associated with it. METHODS:Urine samples were obtained from 184 children aged 5-12 years: a spot sample collected in the afternoon, and a 12-h overnight sample. Information was obtained regarding family histories of lithiasis. Urine volume, pH, and biochemical parameters of stone risk were measured. Crystallization risk was defined by the presence of specific urine conditions that had previously been associated with stone formation in vitro. RESULTS:Crystallization risk was observed in 15 % of spot urine samples and 54 % of 12-h samples. Metabolic abnormalities and a low urinary volume were more frequently detected in children with crystallization risk. Calcium excretion and calcium/citrate ratio were higher in children with a family history of lithiasis. CONCLUSIONS:We observed a high prevalence of crystallization risk in urine, especially in children with a family history of the disease. Low urinary volume was the factor most associated with increased risk. Adequate fluid intake at an early age may be a simple and effective measure to reduce the incidence of nephrolithiasis.
    背景与目标: 背景:石斑症的患病率在各个年龄段都在增加。这项研究旨在评估健康学童尿液中结晶的风险,并确定与其最相关的尿液参数。
    方法:从184名5-12岁的儿童中获取尿液样本:下午收集现场样本,并收集12小时的过夜样本。获得了有关石尿症家族史的信息。测量尿液体积,pH值和结石风险的生化参数。结晶风险是由以前与体外结石形成有关的特定尿液条件定义的。
    结果:在15%的现货尿液样本和54%的12小时样本中观察到结晶风险。具有结晶风险的儿童更经常检测到代谢异常和尿量低。有结石病家族史的儿童的钙排泄和钙/柠檬酸比更高。
    结论:我们观察到尿液中结晶风险的患病率很高,尤其是在有该病家族史的儿童中。低尿量是与增加风险最相关的因素。早期摄入足够的液体可能是减少肾结石症发生率的一种简单有效的措施。
  • 【预测变性脊柱疾病不同手术方法中输血的因素。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Fosco M,Di Fiore M
    BACKGROUND & AIMS: BACKGROUND AND OBJECTIVES:Spine surgery frequently needs allogeneic blood transfusions to compensate for great blood loss. Autologous blood donations often are indicated to reduce homologous transfusions. In last decades interbody spinal fusion has gained popularity, being frequently performed in many spine procedures. Nevertheless, there are few studies evaluating the risk factors of additional blood transfusions in the postoperative course of degenerative spine surgery and no one concerning patients who underwent interbody fusion. MATERIALS AND METHODS:In 15 consecutive months, in the same Department of Spine Surgery 40 different elective spine surgeries were performed, divided into four groups: laminectomy alone, laminectomy with an instrumented posterolateral fusion, laminectomy with an instrumented posterolateral and interbody fusion, extensive instrumented fusion. All patients surgery-related data were respectively recorded: patient age, gender, diagnosis, preoperative hemoglobin rate, autologous blood availability, number of spinal level decompressed and fused, duration of surgery, type of surgical procedure, duration of hospital stay. These data were statistically analysed to determine whether variables could determine higher risk of blood transfusion. RESULTS:In an univariate analysis of factors influencing the need of blood transfusion, significantly greater risk of blood transfusions was observed in the female, in case of low preoperative Hb rate, longer surgical times, multiple spinal level decompressed or fused and longer duration of hospital stay. Our linear multiple regression modeling showed that patients gender and increased number of levels decompressed and levels surgically fused were significant determinants of need of blood transfusion. CONCLUSIONS:The practical value of this work can be particularly appreciated by those who are used to consider blood predonation. According to our findings blood predonation should preferably be proposed to women supposed to undergo spine instrumented fusion or a more than three levels spine decompression.
    背景与目标: 背景与目的:脊柱外科手术经常需要进行同种异体输血,以弥补大量失血。自体献血通常被指示为减少同源输血。在最近的几十年中,椎间融合术已经普及,在许多脊柱手术中经常进行。然而,很少有研究评估变性脊柱手术术后额外输血的危险因素,并且没有人涉及接受椎间融合的患者。
    材料与方法:连续15个月,在同一脊柱外科进行了40次不同的选择性脊柱外科手术,分为四组:单独的椎板切除术,经器械后外侧融合的椎板切除术,经器械后外侧和椎间融合的椎板切除术,广泛的器械融合。记录所有患者与手术有关的数据:患者年龄,性别,诊断,术前血红蛋白率,自体血液可用性,脊柱减压和融合的次数,手术时间,手术程序类型,住院时间。对这些数据进行统计分析,以确定变量是否可以确定较高的输血风险。
    结果:对影响输血需求的因素进行单因素分析,发现女性术前血红蛋白率低,手术时间较长,多处脊柱减压或融合以及住院时间较长的情况下,女性输血的风险明显增加。停留。我们的线性多元回归模型显示,患者的性别和减压水平的增加数量以及手术融合的水平是需要输血的重要决定因素。
    结论:那些习惯于考虑血液捐赠的人特别赞赏这项工作的实用价值。根据我们的发现,应该对应该进行脊柱器械融合术或三级以上脊柱减压的女性建议进行血液捐血。
  • 【脊髓损伤患者的生活方式与冠心病危险因素之间的纵向关联。】 复制标题 收藏 收藏
    DOI:10.1038/sc.2012.153 复制DOI
    作者列表:de Groot S,Post MW,Snoek GJ,Schuitemaker M,van der Woude LH
    BACKGROUND & AIMS: OBJECTIVE:To investigate: (1) the course of coronary heart disease risk factors (lipid profiles and body mass index (BMI)) in the first five years after discharge from inpatient spinal cord injury (SCI) rehabilitation and (2) the association between lifestyle (physical activity, self-care related to fitness, smoking, alcohol, body mass and low-fat diet) and coronary heart disease risk factors during that period. DESIGN:Prospective cohort study. PARTICIPANTS/METHODS:Individuals with SCI (N=130). Total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG) and BMI were determined at discharge from inpatient rehabilitation and 1 and 5 years after discharge. Using multilevel regression models, the effects of lifestyle (drinking alcohol, smoking, active lifestyle and self-care) on the lipid profiles and BMI were determined. RESULTS:After correction for lesion and personal characteristics, no changes in lipid profiles in the five years after discharge were seen, whereas the BMI increased significantly with 1.8 kg m(-2). A high percentage was at risk of cardiovascular disease due to high BMI (63-75%) or HDL (66-95%). The individuals who indicated to maintain their fitness level as good as possible and the individuals with a low BMI showed better lipid profiles. Individuals with a more active lifestyle showed higher HDL levels. Individuals who avoid smoking showed a 1.5 kg m(-2) higher BMI. CONCLUSION:Lipid profiles seem to stabilize in the years after discharge from inpatient SCI rehabilitation, whereas the BMI increased. Lifestyle factors associated with a favorable lipid profile and BMI could be identified.
    背景与目标: 目的:调查:(1)住院脊髓损伤(SCI)康复出院后的最初五年中,冠心病危险因素(血脂和体重指数(BMI))的病程,以及(2)在此期间的生活方式(体育锻炼,与健身,吸烟,饮酒,体重和低脂饮食有关的自我保健)和冠心病的危险因素。
    设计:前瞻性队列研究。
    参与者/方法:具有SCI的个人(N = 130)。在住院康复出院时以及出院后1和5年测定总胆固醇(TC),高密度脂蛋白(HDL),低密度脂蛋白(LDL),甘油三酸酯(TG)和BMI。使用多级回归模型,确定了生活方式(饮酒,吸烟,积极的生活方式和自我保健)对血脂和BMI的影响。
    结果:校正病灶和个人特征后,出院后五年内血脂没有变化,而BMI显着增加,为1.8 kg m(-2)。高百分比的BMI(63-75%)或HDL(66-95%)导致罹患心血管疾病的风险较高。表示要尽可能保持健康水平的个体和BMI较低的个体表现出更好的血脂状况。生活方式更加活跃的人表现出较高的HDL水平。避免吸烟的人的BMI升高1.5 kg m(-2)。
    结论:住院SCI康复出院后的几年中,脂质分布似乎稳定,而BMI升高。可以确定与良好的脂质状况和BMI相关的生活方式因素。
  • 【食管鳞状细胞癌中促炎转录因子和非编码RNA的分子相互作用。】 复制标题 收藏 收藏
    DOI:10.1177/1010428317705760 复制DOI
    作者列表:Sundaram GM,Veera Bramhachari P
    BACKGROUND & AIMS: :Esophageal squamous cell carcinoma is the sixth most common cancer in the developing world. The aggressive nature of esophageal squamous cell carcinoma, its tendency for relapse, and the poor survival prospects of patients diagnosed at advanced stages, represent a pressing need for the development of new therapies for this disease. Chronic inflammation is known to have a causal link to cancer pre-disposition. Nuclear factor kappa B and signal transducer and activator of transcription 3 are transcription factors which regulate immunity and inflammation and are emerging as key regulators of tumor initiation, progression, and metastasis. Although these pro-inflammatory factors in esophageal squamous cell carcinoma have been well-characterized with reference to protein-coding targets, their functional interactions with non-coding RNAs have only recently been gaining attention. Non-coding RNAs, especially microRNAs and long non-coding RNAs demonstrate potential as biomarkers and alternative therapeutic targets. In this review, we summarize the recent literature and concepts on non-coding RNAs that are regulated by/regulate nuclear factor kappa B and signal transducer and activator of transcription 3 in esophageal cancer progression. We also discuss how these recent discoveries can pave way for future therapeutic options to treat esophageal squamous cell carcinoma.
    背景与目标: :食管鳞状细胞癌是发展中国家第六大最常见的癌症。食管鳞状细胞癌的侵略性,其复发趋势以及晚期诊断出的患者生存前景差,迫切需要开发针对该疾病的新疗法。已知慢性炎症与癌症易感性有因果关系。核因子κB和信号转导子及转录激活子3是调节免疫力和炎症的转录因子,并逐渐成为肿瘤起始,进展和转移的关键调节剂。尽管这些食管鳞状细胞癌中的促炎因子已针对蛋白质编码靶标进行了很好的表征,但它们与非编码RNA的功能相互作用只是最近才受到关注。非编码RNA,尤其是microRNA和长的非编码RNA,具有作为生物标志物和替代治疗靶标的潜力。在这篇综述中,我们总结了关于非编码RNA的最新文献和概念,这些非编码RNA在食管癌进展中受核因子κB和信号转导子及转录激活子3的调控。我们还讨论了这些最新发现如何为将来治疗食管鳞状细胞癌的治疗选择铺平道路。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录