A Study of Health Prescribing for Children with Tourette’s Disorders in Children’s Health Education Specialty Care Clinics

Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Methods:Applying the evidence-based nursing model and nursing intervention theory based on the survey research by searching China Knowledge Network,Wanfang Database and Wipro Chinese Science and Technology Journal Database,the study collected the literature on the health prescription intervention research in children’s Tourette’s disorders health education in children’s health education of specialized nursing outpatient clinic for review and combined with the specialty characteristics to formulate“Children’s Tourette’s Disorder Health Education Prescription.”Results:Tourette’s syndrome in children is a common pediatric neurological disorder,mainly manifested as involuntary,rapid and repeated muscle twitching and vocal tics,which brings serious psychological pressure and life disturbance to the affected children.Conclusion:For children with Tourette’s syndrome,healthcare professionals should give enough care and understanding to the children and their parents,provide timely and effective health education to them,help them improve their bad behavioral habits,establish correct cognitive attitudes,enhance self-confidence,improve patient compliance,reduce the frequency of recurrence,reduce the incidence of complications and promote children’s physical and mental health development.

Health Technology and U.S. Medicare Policy in the Late 20th Century

Much of the history of the American Social Welfare movement has been directed to the identification and development of entitlement programs needed to strengthen the health and economy of even the neediest members of the society. The emergence of health technologies have precipitated and supported policy advances. The Medicare Act （Title XVIII the United States Social Security Act of 1935） as such an entitlement program, was originally directed to resolving the health coverage concerns of the elderly without families or finances to afford coverage. The program entered crises periods over rising costs and continuity of funding concerns. Many have been assisted, in the U.S., in addition to the aged population, by the development of Medicare entitlements. These entitlements have emerged during periods of social need often accompanied by health technology or service delivery innovation. The program benefits more than its constituents and contributes to the health of the overall society. This paper will provide both a historical overview of the conflicts and uncertainties weathered by the Medicare Act in the later quarter of the 20th Century in the U.S. （United States of America）. The paper will also explore the implications of changes in the technology of federal and state funding mechanisms along with demographic changes that offered the greatest challenges to the continuation of the Medicare Act as a mainstay of stable health coverage to millions of needy Americans, into the 21st century.

Mothers’ Knowledge of Health Caring for Premature Infants after Discharge from Neonatal Intensive Care Units in the Gaza Strip, Palestine

Background: Preterm labor is one of the most public health problems related to neonates admitted to Neonatal Intensive Care Unit (NICU). Poor knowledge among mothers about the care requirements of a preterm neonate is immediate cause for post-discharge medical problems in premature and neonates readmission to NICU. Hence, this study aims to evaluate mothers’ knowledge of caring for premature infants post-discharge from Neonatal Intensive Care Units in the Gaza strip. Methods: A Quantitative-based cross-sectional designs study was used to survey 120 mothers of preterm neonates at the time of preterm neonates discharge by face-to-face interview at Al-Shifa medical complex and Nasser hospital between February and June 2018. Results: The results showed that only about 58.4% of mothers of premature babies had good knowledge about health care needed for premature infants after discharge from NICU. Furthermore, there was no statistically significant difference between the level of knowledge and mother’s sociodemographic characteristics (P-values > 0.05). Conclusion: Mothers’ knowledge of premature infants care was not at the optimal level, which might put the newborns at risk. Therefore, the study emphasizes the necessity of thoughtful exchange of health information between team members and mothers and establishing pre- and post-discharge plans with mothers to start their healthy transition of preterm neonate to home and to ameliorate family concerns.

Impact of the Changes in Women’s Characteristics over Time on Antenatal Health Care Utilization in Egypt (2000-2008)

Objectives: This study empirically assesses the impact of the changes in women’s characteristics, empowerment, availability and quality of health services on woman’s decision to use antenatal care (ANC) and the frequency of that use during the period 2000-2008. Study Design: The study is a cross-sectional analytical study using 2000 and 2008 Egypt Demographic and Health Surveys. Methods: The assessment of the studied impact is conducted using the Zero-inflated Negative Binomial Regression. In addition, Factor Analysis technique is used to construct some of the explanatory variables such as women’s empowerment, the availability and quality of health services indicators. Results: Utilization of antenatal health care services is greatly improved from 2000 to 2008. Availability of health services is one of the main determinants that affect the number of antenatal care visits in 2008. Wealth index and quality of health services play an important role in raising the level of antenatal care utilization in 2000 and 2008. However, the impact of the terminated pregnancy on receiving ANC increased over time. Conclusions: Further research of the determinants of antenatal health care utilization is needed, using more updated measures of women’s empowerment, availability and quality of health services. In order to improve the provision of antenatal health care services, it is important to understand barriers to antenatal health care utilization. Therefore, it is advisable to collect information from women about the reasons for not receiving antenatal care.

Intensive care environment: Perspective of relatives of critically ill patient sustained by health technology

The intensive care unit(ICU)is a complex setting by nature,and some have described it as bizarre due to its numerous sirens that sound when anything is dangerous,constant activity,equipment,bright lights,and high fatality rate.The demands placed on nurses to care for critically ill patients in this environment frequently prevent nurses and other health‑care professionals from acknowledging the feelings of patient’s relatives or family caregivers,resulting in a hostile environment from the patient’s relative’s perspective.When a patient’s family enters the ICU,they feel that hospital administrators do little to nothing to alleviate their discomfort and fear.Despite research demonstrating the importance of providing a homely environment for patients’families,In Nigeria ICU is still far behind how a conventional ICU environment should be structured to accommodate patient’s relations in the unit.The goal of this study was to look at the patient’s relative’s perspective on providing care for a critically ill patient in an ICU,with a focus on the unit’s complexity and overall experience.Based on the findings of this study,we recommend that hospital administrators ensure that the environment of the upcoming ICU is designed to meet the needs of patient’s relatives by addressing identified environmental concerns,like caring neglect,by providing a friendly and stress‑free environment.

Women’s Perception Concerning Health Care in the Post-Partum Period: A Meta-Synthesis

This meta-synthesis presents the results of qualitative studies on puerperal perception concerning woman’s care in the post-partum period. Four databases were researched using keywords such as “postnatal care” (or) “postpartum period”, (and) “care”, “women”, “perception”, “qualitative research”, “women’s health services”, “community health services”, “allied health personnel”, “primary health care”, resulting in 9 articles for analysis. Six themes were identified: interpersonal relationship, information, communication, attending the necessities, service organization and other supports. Results report mainly on the unsatisfactory professional care for women, appreciating the form of dealing with promptness and the timing to be attended;trust;content, coherence and the way to inform;clarification of doubts;friendly conversation and clinical assistance. The professional workload was restricted on postpartum period care quality. There were gaps found in clinical practice and in dialogical communication and information on women’s health necessities.

Going the Distance A telemedicine company uses technology to meet Africa’s rural medical needs with prime health care

We have a scarcity of health care professionals in the rural areas and therefore we can offer medical services from a distance to the underserved rural population.

Cost-effectiveness of Crohn's disease post-operative care

AIM: To define the cost-effectiveness of strategies, including endoscopy and immunosuppression, to prevent endoscopic recurrence of Crohn’s disease following intestinal resection.METHODS: In the “POCER” study patients undergoing intestinal resection were treated with post-operative drug therapy. Two thirds were randomized to active care (6 mo colonoscopy and drug intensification for endoscopic recurrence) and one third to drug therapy without early endoscopy. Colonoscopy at 18 mo and faecal calprotectin (FC) measurement were used to assess disease recurrence. Administrative data, chart review and patient questionnaires were collected prospectively over 18 mo.RESULTS: Sixty patients (active care n = 43, standard care n = 17) were included from one health service. Median total health care cost was $6440 per patient. Active care cost $4824 more than standard care over 18 mo. Medication accounted for 78% of total cost, of which 90% was for adalimumab. Median health care cost was higher for those with endoscopic recurrence compared to those in remission [$26347 (IQR 25045-27485) vs $2729 (IQR 1182-5215), P < 0.001]. FC to select patients for colonoscopy could reduce cost by $1010 per patient over 18 mo. Active care was associated with 18% decreased endoscopic recurrence, costing $861 for each recurrence prevented.CONCLUSION: Post-operative management strategies are associated with high cost, primarily medication related. Calprotectin use reduces costs. The long term cost-benefit of these strategies remains to be evaluated.

“I Felt Defeated. I Felt Helpless”: Social Determinants of Health Influencing the Cancer Survivorship of a Young Latina Mother

Social determinants of health (SDOH) contribute to cancer disparities among young Latina women (<50 years) residing in the counties along the US-Mexico border. These SDOH are particularly burdensome to young Latina mothers diagnosed with cancer while they are raising school-age children. Conexiones, a culturally adapted program designed to improve mother and child adjustment to maternal cancer, was piloted with diagnosed Latina mothers residing in border counties in New Mexico and Texas. The purpose of this case analysis was to highlight the SDOH affecting a young Latina mother’s cancer survivorship in the U.S.-Mexico border region. The participant’s Conexiones education sessions were recorded, transcribed, translated to English, back translated to Spanish to establish accuracy, and inductively coded. The participant’s baseline survey indicated she was a young (<50 years), married, Spanish-speaking Latina mother diagnosed with breast cancer while raising a teenage daughter. Seventeen SDOH themes affecting the participant’s cancer experience were identified in the cancer-related emotional triggers she reported across five Conexiones sessions. These themes were organized using Yanez’s conceptual model of determinants of cancer outcomes in Hispanics (i.e., socioeconomic, healthcare, cultural context, and psychosocial). Findings provide direction for cultural adaptations of evidence-based programs.

The men’s health center:Disparities in gender specific health services among the top 50“best hospitals”in America

Objective:Gender-specific integrated health services have long existed in the arena of women’s health care,but men’s health centers(MHCs)have only recently emerged as a novel practice model.Here,we seek to evaluate the prevalence and format of MHCs found in the leading academic medical centers in the United States.Methods:The US News&World Report’s Top 50 Ranked Hospitals for Urology was used as our cohort.Data were gathered on the presence of MHCs and types of providers and conditions treated.An equivalent search was performed for women’s health centers(WHCs).Results:Sixteen of 50(32%)promoted some type of MHC,compared to 49 of 50(98%)offering a WHC.Eight of the top 15 ranked institutions(53%)had an MHC compared to eight of 35(23%)remaining programs.Six of 16 MHCs incorporated providers from a variety of medical disciplines,including urologists,internists,endocrinologists,cardiologists,and psychologists,while another six of 16 MHCs were staffed solely by urologists.Eight of 16 provided services for exclusively urologic issues,four of 16 offered additional services in treatment of other medical conditions,and four of 16 did not specify.

Limitations and possibilities on health assessment to women in violence situation

The aim was to know how health assessment to women in violence situation is developed. Literature review on LILACS and MEDLINE databases was conducted in April 2013 with the descriptors: “domestic violence” and “women’s health”, on a 1994-2012 timeframe. Statistics characterization and content theme analysis of the scientific production were developed. Results showed that the assessment is permeated by institutional limitation and an approach strictly clinical that makes identification and diagnosis of violence difficult, reinforcing invisibility in health care. Professional assessment is influenced by socio-cultural and the naturalization of the phenomena, which is not considered a public health issue. Technical knowledge is insufficient, making the possibility of promoting violence cycle rupture difficult. However, we envisage reception as a possibility to assess female demands. We conclude the need to include the theme in health undergraduate courses and also the urgency of this learning experience to support a multidisciplinary and intersectoral work web. Thus, rethinking assessment as a way of (re)organizing how health care is structured in order to compose an assessment web to women and guarantee reception of their demands is needed. Else, constructing competence allied to coping public policy to the problem and guaranteeing a human and full assistance will stay only on the academic field, constituting itself as a limit on protecting life of these women and their families.

Therapeutic termination of pregnancy and women’s mental health:Determinants and consequences

The therapeutic termination of pregnancy(TToP)is an induced abortion following a diagnosis of medical necessity.TToP is applied to avoid the risk of substantial harm to the mother or in cases of fetal unviability.This type of induced abortion is provided after the second semester of gestation if fetal illness or the pregnancy cause physical danger or pathological mental distress to the mother.Sociocultural and economic determinants could influence the desire for children and family planning in couples,as well as the use of effective contraception and the choice to perform an induced abortion.Also,pre-existing mental health problems could affect the decision between carrying on a problematic pregnancy or having TToP.Furthermore,the TToP is a reproductive event with an important traumatic burden,but also with an intrinsic therapeutic effect and it can produce different psychological and psychopathological effects on women and couples.The aim of this review is to evaluate what demographic,reproductive and psychopathological determinants are involved in the choice of undergoing a TToP in women.Also,we will examine both positive and negative consequences of this procedure on women’s mental health,underlying which factors are related to a worse outcome in order to provide the best clinical support to vulnerable groups.

健康教育图文册的构建及在食管癌患者术后康复护理的应用

目的基于知识可视化构建健康教育图文册,并探讨其用于食管癌患者术后康复护理的效果。方法将116例食管癌手术患者按照入院时间顺序分组,试验组58例,采用由研究团队基于知识可视化构建的健康教育图文册进行术后健康教育;对照组58例,实施常规健康教育。出院时评价两组自我护理能力、恐惧疾病进展、术后康复指标及患者满意度。结果试验组自我护理能力总分显著高于对照组,疾病进展恐惧总分显著低于对照组,术后胸腔引流管留置时间、胃管留置时间显著短于对照组,患者满意度得分显著高于对照组(均P<0.05)。结论将健康教育图文册应用于食管癌术后患者,可提升患者自我护理能力及满意度,改善疾病恐惧水平,促进食管癌术后患者术后康复。

老年慢性阻塞性肺疾病患者应用Swanson关怀理论的健康教育实践研究

目的观察基于Swanson关怀理论的健康教育对老年慢阻肺患者治疗依从性和生活质量的影响。方法回顾性选取2021年6月—2023年6月间在亳州市人民医院接受治疗的老年COPD稳定期患者104例,依据不同干预措施将患者分为对照组和观察组,每组52例。对照组患者行常规健康教育,观察组采用基于Swanson关怀理论的健康教育。观察并比较2组干预前后患者治疗依从性、生活质量和肺功能指标值变化情况。结果干预后,观察组和对照组患者吸入药物治疗依从性量表(TAI)评分均较同组干预前升高,且观察组TAI评分高于对照组(均P<0.05);观察组和对照组患者活动能力、胸闷、精力和日常活动能力评分较同组干预前降低,且观察组上述评分均低于对照组(均P<0.05)。干预后,观察组和对照组患者FVC、FEV 1/FVC较干预前升高,且观察组高于对照组(P<0.05)。结论应用基于Swanson关怀理论的健康教育可显著改善老年慢阻肺患者的治疗依从性,提高患者的生活质量和肺功能。

帕金森病病人健康信息寻求行为水平及其相关影响因素分析

目的:探讨帕金森病(PD)病人健康信息寻求行为水平及其影响因素。方法:选取2021年1月-2022年6月在医院收治的89例PD病人为研究对象,采用健康信息寻求行为量表(HISB)评估所有病人的健康信息寻求行为水平,设计一般资料调查表,详细统计所有病人的一般资料,比较不同特征PD病人的HISB评分,重点分析PD病人健康信息寻求行为水平的影响因素。结果:经评估,89例PD病人的HISB评分为(65.83±6.32)分;不同年龄、自我效能、受教育程度及家庭关怀度PD病人的HISB评分比较,差异有统计学意义(P<0.05);多元线性回归分析结果显示,年龄大、自我效能低下、受教育程度低及家庭关怀度低均是PD病人健康信息寻求行为水平的影响因素(P<0.05)。结论:PD病人的健康信息寻求行为水平较低,年龄大、自我效能低下、受教育程度低及家庭关怀度低影响PD病人健康信息寻求行为水平,临床医务人员应根据相关影响因素制订针对性干预措施。

基于《黄帝内经》“养阳”理论探析小儿养生

阳气贯穿人生命全过程,小儿体质特殊,养阳对小儿养生尤为关键。故基于《黄帝内经》“养阳”理论,结合小儿生理病理特点,论述了阳气与小儿生长发育关系,探讨万物之生由乎阳、小儿以阳为本之理,认为小儿养阳应循时序,养护当“顺阳”“补阳”“护阳”,以达五脏调顺、阴平阳秘、驱邪防病的目的,对现今育儿保健有着积极的意义。

中美学生体质测试内涵之比较

采用文献资料等方法,对中美两国学生体质测试内涵,特别是对测试目标、测试组件、测试项目、测试管理、评价方法和奖励计划进行剖析。结果表明:(1)中美两国学生测试目标和奖励计划具有相似性;(2)两国学生体质测试项目均未含健身知识,中国重点仍是技能测试相关的指标;(3)两国测试管理方法和评价方法存在不同,中国学生测试不通过者需多次补测,美国学生则无需补测;美国评价方法是双重标准。

美国长期护理保险体系:发端、架构、问题与启示

美国是长期护理保险出现最早的国家,是补缺型和自由主义福利护理模式的突出代表,其护理保险制度建设经验对我国建立长期护理保险体系有一定借鉴意义。在介绍美国长期护理保险制度产生背景的基础上,本文重点阐释了美国长期护理保险的主要制度框架,分别从社会保险和商业保险两个维度进行了详尽介绍。研究认为美国是商业护理保险的典型代表,其护理保险体系具有混合型制度特质;此外,美国长期护理保险具有多层次、多类型、政府主导托底、公私合作等优势,但仍存在政府财政压力大等问题。在总结美国长期护理保险制度建设经验的基础上,围绕我国长期护理保险制度建设的性质、水平等问题提出了思考和建议。

美国职业卫生法规、监管及统计体系

美国是工业发达国家,是世界上最早建立“职业安全和卫生法”的国家之一。基于该法,美国确立以职业安全卫生监察局(OSHA)为执法机构、职业安全卫生复审委员会(OSHRC)为监督机构的职业卫生监管体系;同时,以劳工统计局(BLS)为统计主管机构,建立以“1904规范”为基础的企业雇主对其作业场所职业卫生记录和报告制度,并辅以两种形式的政府主动调查,形成了自下至上和自上至下相结合的调查统计体系。目前,我国职业卫生的调查统计体系尚未形成。因此,需要从工业发达国家的职业卫生法规、监管入手,以系统的方法和思路,分析其调查统计体系,学习工业发达国家的经验。研究结果认为美国的职业卫生统计体系具有上层法律及相关条例完备、组织体系职责分明、形成了政府主动调查与企业记录报告相结合的调查统计体系等明显的特点。