Risk Factors for Geo-Helminthiasis in Children Aged 6 - 36 Months in a Rural Health District in Cameroon

Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target population, which are school-age children. The objective was to determine the prevalence and the risk factors associated with geo-helminthiasis in children aged 0 to 3 years in a rural health district. Method: From December 2020 to May 2021, a descriptive and analytical cross-sectional study of 376 children between 6 and 36 months was carried out in the Akonolinga health district. This was a cluster sampling in 4 health areas. Stool samples were collected and analysed using the mini-FLOTAC method. The results expressed as the number of eggs per gram of stool. A questionnaire on socio-demographic and lifestyle data was administered to the parents. The Chi-squared test was used to measure the association between geo-helminth infection and the data collected. A multivariate analysis using logistic regression was performed (p 0.05). Results: The prevalence of STH was 19.4% (Ascaris lumbricoides: 16% and Trichuris trichiura: 8%). Risk factors were: consumption of contaminated water (AOR = 1.93 [1.03 - 3.6];p = 0.040), early contact of the child with the ground (before age of 4 months) (AOR = 4.9 [2.1 - 11.37];p .001), habit of walking barefoot (AOR = 2.91 [1.1 - 7.97];p = 0.038), and living in a habitat with unpaved ground (AOR = 7.4 [1.55 - 35.7];p = 0.012). Conclusion: The prevalence of STHs in infants was high. Preventive chemotherapy should be extended to this age-group, and other measures intensified.

United States Healthcare Data Breaches: Insights for NIST SP 800-66 Revision 2 from a Review of the NIST SP 800-66 Revision 1

Healthcare security and privacy breaches are occurring in the United States (US), and increased substantially during the pandemic. This paper reviews the National Institute of Standards and Technology (NIST) publication base as an effective solution. The NIST Special Publication 800-66 Revision 1 was an essential standard in US healthcare, which was withdrawn in February 2024 and superseded by SP 800-66 Revision 2. This review investigates the academic papers concerning the application of the NIST SP 800-66 Revision 1 standard in the US healthcare literature. A systematic review method was used in this study to determine current knowledge gaps of the SP 800-66 Revision 1. Some limitations were employed in the search to enforce validity. A total of eleven articles were found eligible for the study. Consequently, this study suggests the necessity for additional academic papers pertaining to SP 800-66 Revision 2 in the US healthcare literature. In turn, it will enhance awareness of safeguarding electronic protected health information (ePHI), help to mitigate potential future risks, and eventually reduce breaches.

Activity of the Fungicide JS399-19 Against Fusarium Head Blight of Wheat and the Risk of Resistance

This report reviews the characteristics of JS399-19, a novel cyanoacrylate fungicide. JS399-19 strongly inhibits the mycelial growth of the fungal plant pathogens of the genus Fusarium and exhibits great potential in controlling Fusarium head blight （FHB） on wheat and other cereals. The mode of action of JS399-19 is evidently different from that of benzimidazole （for example, carbendazim） and other sort of fungicides, making it a possible replacement for carbendazim in China to manage carbendazim-resistant subpopulations of Fusarium graminearum and F. asiaticum. JS399-t9 has excellent protective and curative activity against these pathogens. Incorrect use of this fungicide, however, is likely to select for resistance. Among JS399-19-resistant mutants of F. asiaticum induced in the laboratory, the resistant level of mutants was high and the phenotype of resistance against JS399-19 was conferred by a major gene by genetic analysis. The fitness of laboratory-induced JS399-19-resistant mutants of F. asiaticum was nearly equal to that of their parents. JS399-19 lacks cross resistance with other sort fungicides. To control FHB with JS399-19 and to delay the development of the fungicide-resistance, farmers should use tank mixtures containing JS399-19 and carbendazim, metconazole, tebuconazole, or prothioconazole.

Challenges in Cardiovascular Risk Prediction and Stratifi cation in Women

There has been an appropriate focus,since the turn of the 21 st century,on sex-and gender-specifi c cardiovascular disease(CVD)as increasing evidence suggests that there are substantial differences in the risk factor profi le,social and environmental factors,clinical presentation,diagnosis,and treatment of ischemic heart disease in women compared with men.As a result of increased awareness,detection,and treatment of ischemic heart disease in women,there has been signifi cant reduction(greater than 30%)in cardiovascular mortality,and in 2013,more US men than US women died of CVD.Nevertheless,continued efforts are required as CVD remains the leading cause of cardiovascular morbidity and death of women in the Western world,and in women younger than 55 years there has been a rise in cardiovascular mortality.In this article,we review several of the contributing factors that continue to cause challenges in accurate risk prediction and risk stratifi cation in women.

BAX G(-248)A Gene Polymorphism and Its Association with Risk of Non-Small Cell Lung Cancer—A Case Control Study

Pro-apoptotic Bcl-2 protein BAX is an important member of mitochondrial dependent apoptosis regulation and ultimately plays a pivotal role in malignancies. A promoter G(-248)A polymorphism in the TP53 binding region of BAX results in differential binding capacity of TP53 protein there by regulating its expression, which has been found to be associated with different clinical outcomes in various malignancies. Presently we aimed to analyze the possible impact of the BAX G(-248)A polymorphism on the risk and other clinical features of non-small cell lung cancer in Indian population. The BAX promoter polymorphism was analyzed in blood samples of 320 subjects with 1:1 case/control ratio by primer-introduced restriction analysis PCR and survival curves were plotted using Kaplan-Meier analysis. It was observed that more than 3-fold increased risk of developing non-small cell lung cancer was associated with homozygous AA genotype of BAX G(-248)A promoter polymorphism in Indian population, with more predominant in smokers with pack-year > 45 (heavy) and using cigarette or huka as their smoking source than homozygous GG genotype. Significant associations was observed between TNM stage (p = 0.037) and histological type (0.02), of non-small cell lung cancer patients with the polymorphism. Patients homozygous for A allele exhibited a significant poor overall survival compared with patients displaying GA + AA or GA or GG genotype [median survival 6.0 vs 9.0, 11.0, and 30.0 months, respectively (p < 0.0001)]. Adenocarcinoma and advanced stage patients with AA genotype showed lower median survival time than squamous cell carcinoma and early stage non-small cell lung cancer patients (median 3.0 and 5.0 vs 8.0 and 9.0 months, respectively). We conclude that the genetic polymorphism G(-248)A in the TP53 binding promoter region of pro-apoptotic genes BAX may contribute to the risk of developing non-small cell lung cancer in Indian population and also may be an important factor for adverse clinical outcome for patients with non-small cell lung cancer.

Stratified Cox Regression Analysis of Survival under CIMAvax^(■)EGF Vaccine

Background: The Center of Molecular Immunology (CIM) is a center in Cuba devoted to the research, development and manufacturing of biotechnological products. CIMAvax?EGF is a vaccine for the treatment of non-small cell lung cancer patients (NSCL). Purpose: The aim of this work is to evaluate the effects of some potential prognostic factors on the overall survival of patients treated with CIMAvax?EGF vaccine, based on data collected in a phase II and a phase III clinical trials. Methods: The stratified Cox regression model is used to evaluate the effects of these prognostic factors, based on separate analysis for each trial, and on the combined data from both trials. Results: Patients with Performance status 0 or 1, with IV stage of tumor and male under 60 years obtain more benefit in terms of overall survival if they receive CIMAvax?EGF. Conclusions: Vaccinated group has a better performance if patients have a performance status 0 or 1, stage IV and age under 60 years. These prognostic factors influence overall survival in a positive way for those patients that received CIMAvax?EGF.

川崎病患儿静脉注射免疫球蛋白抵抗的影响因素评估及IVIGR风险预测模型构建

目的 探究川崎病(KD)患儿静脉注射免疫球蛋白抵抗(IVIGR)的影响因素,并构建IVIGR预测模型,为KD患儿风险分层护理提供依据。方法 纳入2020年4月至2023年4月在嘉兴市第二医院诊治的KD患儿为研究对象。根据KD患儿是否发生IVIGR分为IVIGR组和非IVIGR组。采用逐步多因素Logistic回归探究KD患儿发生IVIGR的独立影响因素,构建KD患儿IVIGR预测模型。采用受试者工作特征曲线(ROC)、校准曲线和决策曲线评估IVIGR预测模型的预测能力、校准能力和临床净获益。结果 研究共纳入120例KD患儿,IVIG组22例,非IVIGR组98例。多因素Logistic回归结果显示,红细胞压积、总胆红素、乳酸脱氢酶和C-反应蛋白/白蛋白比值是KD患儿发生IVIGR的独立影响因素(P <0.05)。建立的KD患儿IVIGR风险预测模型ROC曲线下面积为0.858,具有良好的预测能力、校准能力和临床净获益。结论 IVIGR风险预测模型可用于KD患儿发生静脉注射IVIGR的预测,是实现风险分级护理的简单实用的工具。

Predictive role of interleukin-6 and CAT score in mechanical ventilation in patients with chronic obstructive pulmonary disease at the acute exacerbation stage in the emergency department

BACKGROUND:The study aimed to evaluate the predictive role of interleukin-6(IL-6)and chronic obstructive pulmonary disease(COPD)assessment test(CAT)score in mechanical ventilation(MV)in COPD patients at the acute exacerbation stage in the emergency department(ED).METHODS:For a one-year period,among adult patients in the ED who met the criteria of acute exacerbation of COPD,158 who received MV within 48 hours after admission were compared to 294 who didn't require MV within the same period after admission.IL-6 level and CAT score were compared between the two groups.The predicted value of IL-6 and CAT score was assessed by logistic regression analysis and a receiver operating characteristic(ROC)curve.RESULTS:The IL-6 and CAT scores in the 158 MV patients were much higher than those without.IL-6 and CAT scores were independent predictors of MV within 48 hours using logistic regression analysis(IL-6:odds ratio[OR]1.053,95%confidence interval[CI]1.039–1.067,P<0.001;CAT score:OR 1.122,95%CI 1.086–1.159,P<0.001).The combination of IL-6 and CAT scores(area under ROC curve[AUC]0.826,95%CI 0.786–0.866,P<0.001)improved the accuracy of predicting MV within 48 hours when compared with IL-6(AUC 0.752,95%CI 0.703–0.800,P<0.001)and CAT scores alone(AUC 0.739,95%CI 0.692–0.786,P<0.001).The sensitivity and specificity were 69.6%,74.1%,75.32%and 63.6%,respectively.CONCLUSION:The combined of IL-6 and CAT scores is useful for evaluating the risk of COPD patients at acute exacerbation in ED,and can provide a predictive value for MV or not within 48 hours.

Risk assessment of ischemic stroke associated pneumonia

BACKGROUND:Cerebral stroke is a disease with a high disability rate and a high fatality rate.This study was undertaken to assess the risk of stroke associated pneumonia(SAP) in patients with ischemic stroke using A2DS2 score.METHODS:Altogether 1 279 patients with ischemic stroke who were treated in our department from 2009 to 2011 were retrospectively analyzed with A2DS2 score. A2DS2 score was calculated as follows:age ≥75 years=1,atrial fi brillation=1,dysphagia=2,male sex=1; stroke severity:NIHSS score 0–4=0,5–15=3,≥16=5. The patients were divided into three groups according to A2DS2 score:620 in score 0 group,383 in score 1–9 group,and 276 in score ≥10 group. The three groups were comparatively analyzed. The diagnostic criteria for SAP were as follows:newly emerging lesions or progressively infiltrating lesions on post-stroke chest images combined with more than two of the following clinical symptoms of infection:(1) fever ≥38 °C;(2) newly occurred cough,productive cough or exacerbation of preexisting respiratory tract symptoms with or without chest pain;(3) signs of pulmonary consolidation and/or wet rales;(4) peripheral white blood cell count ≥10×109/L or ≤4×109/L with or without nuclear shift to left,while excluding some diseases with clinical manifestations similar to pneumonia,such as tuberculosis,pulmonary tumors,non-infectious interstitial lung disease,pulmonary edema,pulmonary embolism and atelectasis. The incidence and mortality of SAP as well as the correlation with ischemic stroke site were analyzed in the three groups respectively. Mean± standard deviation was used to represent measurement data with normal distribution and Student's t test was used. The chi-square test was used to calculate the percentage for enumeration data.RESULTS:The incidence of SAP was significantly higher in the A2DS2 score≥10 group than that in the score 1–9 and score 0 groups(71.7% vs. 22.7%,71.7% vs. 3.7%,respectively),whereas the mortality in the score≥10 group was significantly higher than that in the score 1–9 and score 0 groups(16.7% vs. 4.96%,16.7% vs. 0.3%,respectively). The incidences of cerebral infarction in posterior circulation and cross-MCA,ACA distribution areas were signif icantly higher than those in the SAP group and in the non-SAP group(35.1% vs.10.1%,11.4% vs. 7.5%,respectively). The incidence of non-fermentative bacteria infection was signifi cantly increased in the score≥10 group.CONCLUSIONS:A2DS2 score provides a basis for risk stratifi cation of SAP. The prevention of SAP needs to be strengthened in acute ischemic stroke patients with a A2DS2 score≥10.

Analysis of risk factors for early stent thrombosis in the Chinese population:A multicenter restrospective study

BACKGROUND:The predictive scoring systems for early stent thrombosis(EST)remains blank in China.The study aims to evaluate the risk factors and conduct a prediction model of EST in the Chinese population.METHODS:EST was defined as thrombosis that occurs within the first 30 days after primary percutaneous coronary intervention(PCI).Patients from ten Chinese hospitals diagnosed as stent thrombosis(ST)from January 2010 to December 2016 were retrospectively included as the study group.A control group(1 case:2 controls)was created by including patients without ST,major adverse cardiovascular events,or cerebrovascular events during follow-up.The present study evaluated 426 patients with single-vessel lesions and ultimately included 40 patients with EST and 80 control patients,who were included to identify factors that predicted EST and to develop a prediction scoring system.The other 171 patients without integrated 1:2 pair were used for external validation.RESULTS:EST was independently associated with a low hemoglobin concentration(adjusted odds ratio[OR]0.946,95%confi dence interval[95%CI]0.901-0.993,P=0.026),a high pre-PCI Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery(SYNTAX)score(OR 1.166,95%CI 1.049-1.297,P=0.004),and a DAPT(DAPT)duration of<30 days(OR 28.033,95%CI 5.302-272.834,P<0.001).The simple EST prediction score provided an area under the curve(AUC)of 0.854(95%CI 0.777-0.932,P<0.001)with 70.0%sensitivity and 90.0%specifi city,and 0.742(95%CI 0.649-0.835,P<0.001)with 54.5%sensitivity and 81.0%specifi city for external validation dataset.CONCLUSIONS:EST may be independently associated with DAPT discontinuation within 30 days,a low hemoglobin concentration,and a high SYNTAX score.The scoring system also has a good ability to predict the risk of EST and may be useful in the clinical setting.

Risk measurement of international oil and gas projects based on the Value at Risk method

International oil and gas projects feature high capital-intensity, high risks and contract diversity. Therefore, in order to help decision makers make more reasonable decisions under uncertainty, it is necessary to measure the risks of international oil and gas projects. For this purpose, this paper constructs a probabilistic model that is based on the traditional economic evaluation model, and introduces value at risk(VaR) which is a valuable risk measure tool in finance, and applies Va R to measure the risks of royalty contracts, production share contracts and service contracts of an international oil and gas project. Besides, this paper compares the influences of different risk factors on the net present value(NPV) of the project by using the simulation results. The results indicate:(1) risks have great impacts on the project's NPV, therefore, if risks are overlooked, the decision may be wrong.(2) A simulation method is applied to simulate the stochastic distribution of risk factors in the probabilistic model. Therefore, the probability is related to the project's NPV, overcoming the inherent limitation of the traditional economic evaluation method.(3) VaR is a straightforward risk measure tool, and can be applied to evaluate the risks of international oil and gas projects. It is helpful for decision making.

Association of UCP3,APN,and TNF-α Gene Polymorphisms with Type 2 Diabetes in a Population of Northern Chinese Han Patients

We observed the polymorphism distribution and coaction of uncoupling protein 3（UCP3）-55C/T,adiponectin（APN）＋45T/G and tumor necrosis factor（TNF）-α-308G/A on the onset and development of T2DM in a Northern Chinese Han population of 213[100 type 2 diabete（T2DM） patients and 113 health control subjects] by polymerase chain reaction-restriction fragment length polymorphisum（PCR-RFLP） method.Results demonstrate the polymorphism of UCP3-55C/T,APN＋45T/G,and TNF-α-308G/A related to T2DM onset and developement.And the individuals carrying UCP3-55T,APN＋45G and TNF-α-308A allele had higher T2DM risk.Those results are the first report to evaluate the association of the coaction of UCP3,APN,TNF-α genes polymorphism on T2DM risk and the susceptibility of T2DM in the Northern Chinese Han population.

不同量表对脑卒中住院患者跌倒风险的预测效果比较

目的比较美国国立卫生研究院卒中量表(NIHSS)、日常生活活动能力评定量表(ADL)、Morse跌倒评估量表(MFS)、托马斯跌倒风险评估表(STRATIFY)、约翰霍普金斯跌倒风险评估量表(JHFRAT)对脑卒中住院患者跌倒风险的预测效果,为早期评估脑卒中住院患者跌倒风险提供有效工具。方法采用便利抽样法,选取2021年1月-12月北京市某医院康复科和神经内科的149例脑卒中住院患者为研究对象,由不同评估者独立使用上述5种量表对患者进行评分,采用ROC曲线下面积、约登指数、灵敏度、特异度等指标比较5种量表对脑卒中住院患者跌倒风险的预测效果。结果NIHSS、ADL、MFS的ROC曲线下面积分别为0.645、0.413、0.609,与参考线相比差异均无统计学意义(P>0.05);STRATIFY、JHFRAT的ROC曲线下面积分别为0.787、0.899,与参考线相比差异有统计学意义(P<0.05)。STRATIFY、JHFRAT的临界值分别为3分和9分时,约登指数分别为0.40和0.68,预测效果达到最佳,此时STRATIFY、JHFRAT的灵敏度、特异度分别为46.15%、93.38%和100.00%、68.38%。结论NIHSS、ADL、MFS均对脑卒中住院患者跌倒风险预测效果不佳,STRATIFY、JHFRAT均对脑卒中住院患者跌倒风险有预测价值,且JHFRAT预测效果优于STRATIFY。

基于管道护理风险评估的分层护理在肿瘤患者PICC置管后护理管理中的应用

目的 探究基于管道护理风险评估的分层护理在肿瘤患者经外周静脉置入中心静脉导管(peripherally inserted central catheter, PICC)置管后的护理效果。方法 简单随机选取2021年1月—2023年3月厦门大学附属中山医院收治的80例PICC置管患者作为研究对象,采用随机数表法分为观察组和对照组,各40例。对照组接受常规护理干预,观察组在此基础上给予基于管道护理风险评估的分层护理。对比两组干预后的护理效果、并发症发生情况、依从性和满意度以及干预前后自我护理能力。结果 干预后,观察组导管堵塞、导管打折、导管滑脱发生率明显低于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率12.50%明显低于对照组的37.50%,差异有统计学意义(P<0.05);观察组依从性和满意度均明显高于对照组,差异有统计学意义(P<0.05);观察组自我护理能力各项评分明显高于对照组,差异有统计学意义(P<0.05)。结论 将基于管道护理风险评估的分层护理应用于肿瘤患者PICC置管后,能提高护理效果和患者的依从性及满意度,降低并发症发生风险,还能提高患者的自我护理能力。

基于风险评估的分层干预模式用于老年髋关节置换患者术后干预中的效果

目的分析在老年髋关节置换术患者术后采用基于风险评估的分层干预模式的效果。方法选取2020年5月至2022年4月在都昌县第二人民医院接受髋关节置换术的40例老年患者,以随机分组法将符合纳入标准的患者分入对照组与观察组,每组20例。对照组执行常规治疗方案,观察组执行基于风险评估的分层干预模式。观察并比较两组患者的临床护理效果。结果髋关节评分对比显示,护理前两组评分结果差异不明显(P>0.05),护理后观察组评分结果高于对照组(P<0.05);抑郁自评量表(SDS)、焦虑自评量表(SAS)评分对比显示,护理前,两组SDS、SAS评分差异不明显(P>0.05),护理后观察组SAS、SDS评分低于对照组(P<0.05);并发症发生率结果显示观察组发生率低于对照组(P<0.05)。结论基于风险评估的分层干预模式应用于老年髋关节置换术中,可有效改善患者的髋关节功能,优化患者的不良心理状况,将患者术后并发症率控制在一定范围,对于促进患者术后康复具有积极的作用。

宫颈浸润性复层产黏液性癌的临床病理学特征并文献复习

目的探讨发生于宫颈的浸润性复层产黏液性癌(invasive stratified mucin-producing carcinoma,ISMC)的临床病理学特征、诊断及鉴别诊断。方法收集5例病理诊断为ISMC或含有ISMC成分的宫颈腺癌,回顾性分析临床及影像学资料等,行HE、免疫组化染色及宫颈HPV基因分型检测,并结合相关文献对ISMC的临床病理学特征、免疫表型、HPV基因分型及治疗预后等进行讨论。结果4例患者检测出高危型HPV,余1例未行该检测。ISMC镜下表现为肿瘤细胞呈巢团状弥漫浸润性生长,上皮巢内见数量不等微小囊腔形成,周边上皮细胞呈栅栏状排列,囊腔内可见中性粒细胞、坏死物或黏液分布。免疫组化显示所有病例P16和CK7均弥漫强阳性,CEA(4/5)阳性,CK5/6和P63阴性或局灶阳性,AB-PAS特殊染色显示有黏液。结论ISMC是一种少见的具有独特组织学的HPV相关性宫颈浸润性腺癌,黏液型,与HPV相关性宫颈浸润性腺癌、普通型和鳞状细胞癌相比,ISMC更具有侵袭性的生物学行为和不良预后,更易发生远处转移,因此正确识别ISMC对临床和病理医师尤为重要。

跌倒风险评估下的分层护理对老年血液病住院患者预防跌倒及知信行的作用

目的观察跌倒风险评估下的分层护理对老年血液病住院患者预防跌倒的效果以及预防跌倒知信行的影响。方法研究对象为2021年5月—2022年6月在医院住院治疗的血液病老年患者86例,按照组间基本特征具有可比性的原则分为对照组和观察组,每组43例。对照组实施临床常规护理,观察组患者实施以跌倒风险评估为指导的分层护理。对比分析两组患者跌倒发生率、知信行评分以及尊严评分。结果观察组患者住院期间跌倒发生率13.95%(6/43),低于对照组的32.56%(14/32),差异具有统计学意义(P<0.05)。护理干预前,两组患者跌倒知信行调查量表、尊严测评量表评分比较,差异无统计学意义(P>0.05)。护理干预后,两组跌倒知信行调查量表评分均升高,尊严测评量表评分降低;组间比较,观察组跌倒知信行调查量表评分高于对照组,尊严测评量表评分低于对照组,差异均有统计学意义(P<0.05)。结论在老年血液病患者中实施以跌倒风险评估为指导的分层护理可有效降低跌倒发生率,提高患者预防跌倒知信行以及尊严水平。

基于Caprini危险分级分层护理模式预防老年膝关节置换术后下肢深静脉血栓的应用观察

目的 探讨基于Caprini危险分级分层护理模式在预防老年膝关节置换术后下肢深静脉血栓(DVT)中的应用效果。方法 将本院2021年6月至2022年6月收治的131例行膝关节置换术的老年患者按抽签法分为对照组65例和观察组66例,对照组予常规护理,观察组予基于Caprini危险分级分层护理,为期1个月,观察两组患者DVT发生风险、DVT发生率、下肢静脉血流情况及相关血液指标变化。结果 干预1月后,观察组DVT风险等级程度低于对照组,差异有统计学意义(P<0.05);观察组DVT发生率为1.52%,对照组DVT发生发生率为10.77%,观察组下肢DVT的发生率低于对照组,差异有统计学意义(P<0.05)。干预1个月后,观察组患者股静脉、腘静脉及胫后静脉血流流速均高于对照组,差异有统计学意义(P<0.05)。干预1个月后,观察组患者D-二聚体(D-D)及纤维蛋白原(FIB)水平均低于对照组,差异有统计学意义(P<0.05)。结论 对行膝关节置换术的老年患者采取基于Caprini危险分级分层护理,能有效改善患者下肢静脉血流流速,抑制血液高凝状态,降低DVT发生风险。

分析护士分层管理对提高内科护理质量的影响

目的探讨对内科护理人员给予护士分层管理后对护理质量等产生的影响。方法选取2020年3月—2022年7月菏泽市定陶区中医医院的28名内科护理人员作为研究对象;以投掷硬币法作为护理管理研究分组依据,展开所有内科护理人员不同组别划分;其中施以传统护理管理的设为参照组(n=14);施以护士分层管理的设为研究组(n=14);对比两组内科护理人员护理质量评分(基础护理措施、护理文书书写、病区管理、护理安全)、护理管理满意度评分(管理态度、管理环节、配合程度、管理效果)、综合能力(护理操作和专业知识评分)、护理风险事件发生率。结果研究组护理人员基础护理措施、护理文书书写、病区管理、护理安全评分高于参照组,差异有统计学意义(P<0.05);研究组护理人员管理态度、管理环节、配合程度及管理效果评分高于参照组,差异有统计学意义(P<0.05);研究组护理人员护理操作及专业知识评分高于参照组,差异有统计学意义(P<0.05);研究组护理人员护理风险事件发生率与参照组比较,差异无统计学意义(P>0.05)。结论医院针对内科在实施护理管理期间,同传统护理管理比较,护士分层管理措施的合理运用,可将护理质量显著提高,将护理满意度显著提升,提高护理人员的综合能力,并有效降低护理风险事件发生率。

基于养蚕环境样本检测的流行病学调查方法

家蚕病害流行规律是蚕病防控的技术基础和依据。根据家蚕病原微生物为归因危险度极高流行因子的特点,设计了分层抽样法和光学显微镜检测方案,对12 059个养蚕环境样本进行病原微生物检测和流行病学的过程性分析。结果表明:病原微生物的检出率在不同蚕区和不同蚕室环境样本间存在较大差异,不同养蚕技术水平农户部分蚕室环境样本间的差异显著(P<0.05);在养蚕前的清洁消毒方面,养蚕技术水平较高的农户与养蚕技术水平较低的农户间并不存在明显差异;在家蚕饲养过程及上蔟后的病源物扩散管理方面,养蚕技术水平较高的农户比养蚕技术水平较低的农户具有更高的管理水准。由此认为:病源物扩散控制是目前家蚕病害防治中需要得到进一步重视的工作,重视家蚕饲养过程中的病害防控技术实施可以减少病害流行。桑树害虫、蚕沙坑、蚕室内地面和蚕室前地面是病源物扩散控制及清洁消毒技术实施的重要靶标或范围。