Postpartum quality of life and mental health in women with heart disease:Integrated clinical communication and treatment

BACKGROUND Postpartum quality of life(QoL)in women with heart disease has been neglected.AIM To improve clinical communication and treatment,we integrated medical data and subjective characteristics to study postpartum QoL concerns.METHODS The study assessed QoL 6 wk after birth using the 12-Item Short-Form Health Survey.The Edinburgh Postnatal Depression Scale,Cardiac Anxiety Questionnaire,European Heart Failure Self-Care Behavior Scale,and a self-designed questionnaire based on earlier research were also used to assess patient characteristics.Patient data were collected.Prediction models were created using multiple linear regression.RESULTS This retrospective study examined postpartum QoL in 105 cardiac patients.Postpartum QoL scores were lower(90.69±13.82)than those of women without heart disease,with physical component scores(41.09±9.91)lower than mental component scores(49.60±14.87).Postpartum depression(33.3%),moderate anxiety(37.14%),pregnancy concerns(57.14%),offspring heart problems(57.14%),and life expectancy worries(48.6%)were all prevalent.No previous cardiac surgery,multiparity,higher sadness and cardiac anxiety,and fear of unfavorable pregnancy outcomes were strongly related to lower QoL(R^(2)=0.525).CONCLUSION Postpartum QoL is linked to physical and mental health in women with heart disease.Our study emphasizes the need for healthcare workers to recognize the unique characteristics of these women while developing and implementing comprehensive management approaches during their maternity care.

Scarcity and Mental Health—Multiple Mediators of Sleep Quality and Life Satisfaction

Background:In the current social environment,scarcity,as a universally present objective state,profoundly impacts individuals’decision-making and health through the subjective feeling it induces,known as a“scarcity mindset.”Particularly,the feeling of scarcity related to money and sleep time is not only widespread but also directly linked to an individual’s mental health.Purpose:This study aims to delve into the relationship between the feeling of scarcity and mental health,with a specific focus on the relationship between the feeling of money scarcity or sleep time scarcity and mental health,as well as the role of sleep quality or life satisfaction in this relationship.Procedure:We determined the sampling quotas based on the population and economic development levels of each province in the“China Statistical Yearbook(2021)”(National Bureau of Statistics,2021).Participants were selected using the Probability Proportional to Size(PPS)sampling method.Data was collected by distributing online questionnaires to participants,and the relationships between the main variables were explored using structural equation modeling.Results:1.In China,the feeling of sleep time scarcity is stronger than the feeling of money scarcity among the public.2.The feeling of money scarcity is positively correlated with depression and anxiety,whereas the feeling of sleep time scarcity is only positively correlated with depression.3.The feeling of scarcity mainly leads to depression and self-denial through reducing life satisfaction,and it leads to anxiety through reducing sleep quality.Conclusion:The feeling of scarcity in money and sleep time is related to different dimensions of mental health.Therefore,reasonably planning financial allocation and ensuring an adequate amount of sleep can reduce the sense of scarcity,thereby improving mental health.Additionally,improving sleep quality and increasing life satisfaction can alleviate the adverse effects of scarcity on mental health.

Changes in acute and late toxicity and patient-reported health-related quality of life following radiotherapy in women with breast cancer:A 1-year longitudinal study

Objective:The objective of this study was to investigate the frequency of acute and late toxicities,as well as changes in the quality of life(QOL)for breast cancer patients following radiotherapy(RT).Materials and Methods:A total of 108 breast cancer women were recruited for this prospective study.Data were collected at various intervals;prior to,and 1,3,6 months,and 1 year after radiation therapy.The primary outcomes were toxicity radiation therapy oncology group/European Organization for Research and Treatment of Cancer(EORTC)criteria.Our secondary outcome was QOL,measured using EORTC QLQ-C30 and Edmonton Symptom Assessment Scale.We employed Friedman’s two-way analysis to evaluate the changes in QOL over the course of 1 year.Results:The early toxicities that are most commonly experienced include pharyngeal,skin,and mucous membrane toxicity.Late toxicities frequently involve skin and submucosal toxicity.To measure patient functionality,all functional subscale scores except for the patient’s emotional state increased over time compared to pre-RT.Symptoms of the patients,which were included in the QOL symptom scale,decreased during the follow-up period,except for fatigue;however,changes in pain,insomnia,and loss of appetite did not significantly change.We identified the analogous symptom profiles in Edmonton.Although patients’overall health scores declined in the 1st and 3rd months after radiotherapy(RT),they rebounded at 6 and 12 months.Conclusion:For breast cancer patients,RT did not adversely affect functional capacity or exacerbate symptoms,but persistent fatigue did increase during the observation period.Health-care professionals ought to devise strategies to assist patients with skin toxicity and fatigue.

Implications of Dynamic Interactions between Meteorological Patterns and Surface Water Quality on Environmental Health—A Case Study of the Nairobi River

Urban areas face significant challenges in maintaining water quality amidst increasing urbanization and changing climatic patterns. This study investigates the complex interplay between meteorological variables and water quality parameters in Nairobi City, focusing on the impacts of rainfall and temperature on surface water quality. Data from multiple sources, including the Water Resources Authority, Nairobi Water and Sewerage Company, and the World Bank’s Climate Change Knowledge Portal, were analyzed to assess the relationships between meteorological variables (rainfall and temperature) and water quality parameters (such as electroconductivity, biochemical oxygen demand, chloride, and pH). The analysis reveals varying impacts of rainfall and temperature on different water quality parameters. While parameters like iron and pH show strong relationships with both rainfall and temperature, others such as ammonia and nitrate exhibit moderate relationships. Additionally, the study highlights the influence of runoff, urbanization, and industrial activities on water quality, emphasizing the need for holistic management approaches. Recommendations encompass the establishment of annual publications on Nairobi River water quality, online accessibility of water quality data, development of hydrological models, spatial analysis, and fostering cross-disciplinary research collaborations. Implementing these recommendations can enhance water quality management practices, mitigate risks, and safeguard environmental integrity in Nairobi City.

Atmospheric Pollutants in a Commercial Region of Fortaleza, Ceará, Brazil: Integration of Health, Environment and Economy in Urban Planning to Improve Air Quality

The accelerated growth of the vehicular fleet, the modernization of large urban centers, and the few adjustments to the road network in Fortaleza have intensified the problems of traffic and emissions of atmospheric pollutants, highlighting the necessity for strategic urban planning initiatives to address the escalating issues of traffic and pollution. With the objective of analyzing the indices of concentrations of atmospheric pollutants and estimating how these levels can affect human health, this work consists of a study of the analysis of air quality in the intense trade region of Fortaleza. For this, the analysis zone was divided into three perimeters (Major - Medium - Minor), where each perimeter was analyzed at 7 am, 12 noon and 5 pm. Concentrations of the type of O3, particulate matter (PM2.5 and PM10), CO2 and HCHO were collected. Our results demonstrate that most of the analyses are within the limits of current legislation;however, at certain times and perimeters, the analyses of CO2 and HCHO exceeded the established limits. In view of the above, we conclude that public policies to control air quality are necessary to reduce the damage to human health and the environment caused by pollutants.

Public satisfaction with the quality of First Health Facility Services in Indonesia: Does sociodemographic matter?

Objective:To investigate individual characteristics related to satisfaction with the quality of First Health Facility Services(FHFS)in Indonesia.Methods:This cross-sectional study analyzes national representation data.Meanwhile,the study involved 9846 representative respondents in 2019.Respondent’s satisfaction with FHFS based on the five dimensions of service quality(SERVQUAL)is a dependent variable.Independent variables consist of sex,marital status,age,education,employment,insurance ownership,and economics.The study used multivariate logistic regression to explain the relationship between individual characteristics and FSHS quality.Results:77.3%Respondents were satisfied with FHFS,with the highest order of satisfaction dimensions being assurance(59.4%),empathy(57.3%),reliability(53.6%),responsiveness(52.7%),and then tangibility(49.1%).Multivariate logistic analysis showed that divorce was 1.48 more likely than never-married to be satisfied(95%CI 1.17-1.87).Employees were 0.77 less likely than the unemployed to get satisfied(95%CI 0.70-0.86).Respondents with higher education was 0.82 less likely than those with primary education to be satisfied(95%CI 0.67-0.99).Meanwhile,respondents who had government-run insurance were 1.61 more likely than uninsured to be satisfied(95%CI 1.42-1.80).Moreover,the rich were 0.82 less likely than the poor to get satisfied(95%CI 0.73-0.92).Conclusions:Community satisfaction with FHFS is generally high,though some areas could be improved.Demographic factors are still strongly related to satisfaction ratings.The government can assess the quality of services in accordance with standards and disseminate information about service standards for primary facilities to all levels of society,ensuring that service satisfaction is rated as good by all groups.

Evolution of the Quality of the Partogram in 96 Health Care Facilities of 3 Provincial Health Divisions in the Democratic Republic of the Congo

The partogram is an accurate labor monitoring tool for reducing maternal and perinatal mortality due to prolonged labor and dystocia. The aim of this study is to assess how the quality of the partogram has evolved in health care institutions (HCI in short) that have benefited from the primary health care support project (ASSP in short) after formative supervision. This is a descriptive study by periodic clinical audit between 2020 and 2022, carried out in 96 HCI in 3 provincial health divisions (DPS in short) of DR Congo. Each photographed partogram page was sent to the project’s central level for review by a team of experts (3 obstetric gynecologists and 3 midwives). The compliance rate for completing partograms in the 96 health facilities of the 3 DPS was 86.8%. The rate of traceability of labor continuity was 88.2%, and that of traceability of acts, incidents and treatments during labor was 87.1%. Finally, the compliance rate for filling out partograms in the immediate post-partum period was 81%. A clear improvement was noted between the January 2020 and March 2022 assessments.

Quality Provision of Comprehensive Sexuality Education and Sexual and Reproductive Health in Resource Constrained Higher Education Institutions: A Case of Mukuba University

In an effort to ensure that Institutions of Higher Learning provide quality Comprehensive Sexuality Education (CSE) and Sexual and Reproductive Health (SRH) at the level of Universities and Colleges, indeveloping countries such as Zambia, some universities have engaged in offering programmes and services in CSE and SRH. However, the provision of such programmes has had some limitations in terms of resources to ensure quality delivery. As a result, there was a need to examine the provision of CSE and SRH in a resource constrained Mukuba University. The study has three research objectives: 1) to examine the CSE and SRH programmes and services that are available at Mukuba University;2) to determine the actual resources available for the University to ensure quality provision of CSE and SRH to students;3) to use views and opinions of students and academics to examine the extent to which the CSE and SRH are reflected as standards by UNESCO and universities and colleges. The study took a pragmatic philosophy stance and convergent parallel research design of mixed methods;the primary approach is qualitative which will be analysed using thematic analysis, while the quantitative approach was secondary and the data was analysed using descriptive statistics. The study envisaged some implications that include the rise in communicable diseases such as Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS), gender based violence, general lack of information on matters relating to CSE and SRH among students at Mukuba University. The policy implication is that policy makers will be able to formulate policies that address the needs and challenges of students in providing quality CSE and SRH programmes and services for a university that is constrained with resources. The study found that there was a need to contextualize the quality provision of CSE and SRH at an institutional level, for instance, Mukuba University has created an enabling environment for quality provision of CSE and SRH activities and programmes through training of the stakeholders. Further, it was found that in any successful programme, it is expected to meet certain challenges that might in some cases make it difficult to implement the programme as envisaged. In other words, this study has revealed that there are some drawbacks as well as lessons that Mukuba University could learn from other universities that offer CSE and SRH. The study provides a synergistic conceptual model that could be used in the implementation of CSE and SRH in colleges and universities for sustainability. It is hoped that this study has proved that even with limited resources a university can provide CSE and SHR programmes and services without depending on support from other external funders and cooperating partners.

Effects of health concept model-based detailed behavioral care on mood and quality of life in elderly patients with chronic heart failure

BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.

Impact of River Water Quality on Public Health in Perspective of Asian Rivers:A Case Study of Buriganga River,Bangladesh

Water pollution is one of the current global problems.So many countries are suffering from this problem specifically most South Asian and Southeast Asian countries,and Bangladesh is one of those countries that are suffering from water pollution.Furthermore,the city of Bangladesh,Dhaka is one of the most densely populated cities in the world and overpopulation is showing a negative impact on the water quality now.Most of the rivers are very polluted around Dhaka city because of anthropogenic causes.This study focused on Buriganga river pollution and its impact on public health.This study intended to find out the major cause of Buriganga river pollution and the health status of the community living beside the Buriganga river.Also the study identified all the common diseases which people are suffering from around the Buriganga river area.Then the study compared the results with other southeast Asian countries so that it can make the relationship and can make it easier to understand the current situation of water pollution on public health in East Asia and Southeast Asia regions.During the research work,it was noticed that the Buriganga river is very polluted due to human activities.The transportation system,fishing,and waste canals from industries become the primary reasons behind Buriganga’s current condition.Also irresponsibility of both the environmental department and civil society is the major factor in Buriganga river pollution.The hygienic level was also not in a good condition because so many wastes like plastic materials and other daily use materials were thrown out into the river.That’s why public health conditions around the Buriganga river become vulnerable nowadays.So policies have to be implemented from the right perspective and the institutions have to be strong enough to handle all the issues regarding the Buriganga River.

Effect of health education based on information-motivationbehavioral skills model on patients with unilateral vestibular dysfunction

BACKGROUND Vestibular dysfunction(VH)is a common concomitant symptom of late peri-pheral vestibular lesions,which can be trauma,poisoning,infection,heredity,and neurodegeneration,but about 50%of the causes are unknown.The study uses the information-motivation-behavioral skills(IMB)model for health education,effectively improve the quality of life,increase their self-confidence,reduce anxiety and depression,and effectively improve the psychological state of patients.AIM To explore the effect of health education based on the IMB model on the degree of vertigo,disability,anxiety and depression in patients with unilateral vestibular hypofunction.METHODS The clinical data of 80 patients with unilateral vestibular hypofunction from January 2019 to December 2021 were selected as the retrospective research objects,and they were divided into the control group and the observation group with 40 cases in each group according to different nursing methods.Among them,the control group was given routine nursing health education and guidance,and the observation group was given health education and guidance based on the IMB model.The changes in self-efficacy,anxiety and depression,and quality of life of patients with unilateral VH were compared between the two groups.RESULTS There was no significant difference in General Self-Efficacy Scale(GSES)scale scores between the two groups of patients before nursing(P>0.05),which was comparable;after nursing,the GSES scale scores of the two groups were higher than those before nursing.The nursing group was higher than the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the scores of Hospital Anxiety and Depression Scale(HADS)and anxiety and depression subscales between the two groups before nursing(P>0.05).After nursing,the HADS score,anxiety,and depression subscale scores of the two groups of patients were lower than those before nursing,and the nursing group was lower than the control group,and the difference was statistically significant(P<0.05).After nursing,the Dizziness Handicap Inventory(DHI)scale and DHI-P,DHI-E and DHI-F scores in the two groups were decreased,and the scores in the nursing group were lower than those in the control group,and the difference was statistically significant(P<0.05).CONCLUSION Health education based on the IMB model can effectively improve patients'quality of life,increase self-efficacy of patients with unilateral vestibular hypofunction,enhance patients'confidence,enable patients to resume normal work and life as soon as possible,reduce patients'anxiety and depression,and effectively improve patients'psychological status.

Analysis of status and influencing factors of mental health in patients with systemic lupus erythematosus

BACKGROUND Systemic lupus erythematosus(SLE)is a heterogeneous autoimmune disorder with varied clinical courses and prognoses,not only did the patients suffer from physical impairment,but also various physical and psychiatric comorbidities.Growing evidence have suggested that mental disorders in SLE patients,can lead to various adverse consequences.AIM To explored the features and influencing factors of mental health in patients with SLE and clarifying the correlations between mental health and personality characteristics and perceived social support.The results would provide a basis for psychological intervention in patients with SLE.METHODS The clinical data of 168 patients with SLE admitted at the First Affiliated Hospital of Hainan Medical University between June 2020 and June 2022 were collected.Psychological assessment and correlation analysis were conducted using the Symptom Checklist-90(SCL-90)and Perceived Social Support Scale,and the collected data were compared with the national norms in China.The relevant factors influencing mental health were identified by statistical analysis.A general information questionnaire,the Revised Life Orientation Test,and Short-Form 36-Item Health Survey were employed to assess optimism level and quality of life(QoL),respectively.RESULTS Patients with SLE obtained higher scores for the somatization,depression,anxiety,and phobic anxiety subscales than national norms(P<0.05).A correlation was identified between total social support and total SCL-90 score or each subscale(P<0.05).The factors significantly affecting patients’mental health were hormone dosage and disease activity index(DAI)(P<0.05).The average optimism score of patients with SLE was 14.36±4.42,and 30 cases were in the middle and lower levels.A positive correlation was found between optimism level and QoL scores.CONCLUSION Patients with SLE develop psychological disorders at varying degrees,which are significantly influenced by hormone dosage and DAI.Patients’mental health should be closely monitored during clinical diagnosis and treatment and provided adequate support in establishing positive,healthy thinking and behavior patterns and improving their optimism level and QoL.

Effects of strengthening prospective nursing practice on sleep quality,anxiety,and depression of awake patients in intensive care unit

BACKGROUND The intensive care unit(ICU)is a specialized hospital department.Awake patients in the ICU frequently encounter adverse psychological states,such as anxiety and fear,often accompanied by poor sleep quality.This situation has garnered significant attention within the medical community.AIM To investigate the impact of prospective nursing intervention strategies on the sleep quality and negative emotional state of conscious ICU patients.METHODS One hundred and twenty ICU awake patients admitted to our hospital were selected and randomly divided into control(n=60)and observation(n=60)groups.Patients in the control group were cared for using the conventional nursing model,while patients in the observation group were cared for using the prospective nursing model.Sleep improvement was assessed using the International Standardized Sleep Efficiency Formula and Pittsburgh Sleep Quality Index(PSQI).The PSQI,Generalized Anxiety Disorder 7-item(GAD-7)scale,Self-Depression Scale(SDS),and satisfaction before and after treatment were used to assess the negative emotional states of patients under the two care models.RESULTS Patient satisfaction in the observation group was significantly higher than in the control group.The GAD-7 and SDS scores in the observation group were significantly lower than those in the control group,and the total effective rate of sleep improvement in the observation group was significantly higher than in the control group.After treatment,the PSQI scores of the two groups significantly decreased(P<0.05).The decrease in the observation group was more significan than that in the control group,and the difference between the two groups was statistically significant.CONCLUSION Prospective nursing interventions can improve sleep quality and psychological levels and significantly affect conscious patients in the ICU,which is worthy of clinical application.

Assessing the relationship between health literacy intervention and hypertension self-management:A 7-year systematic review from January 2016 to December 2022

Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with HTN.The study design was a systematic review of empirical research articles using a well-defined strategy.Online journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the study.Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research type.Out of 180 studies initially identified in the database search,20 studies were ultimately included in the review.The findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care practices.This review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.

Assessment of Rainwater Quality in Warri and Environ, Southern Nigeria for Domestic Purposes

The study aimed at assessing the physiochemical characteristics of rainwater in Warri and it environ was investigated. Pb, Zn, Cd, Cu and Cr concentrations in rainwater from roof and non-roof sources were determined using Atomic Absorption Spectrophotometry. Three geospatial locations comprising Jakpa, Udu, and Ubeji were selected based on prevailing anthropogenic activities. The rainwater samples were systematically collected from (aluminum) roof and non-roof sources for the months of April, June, and August and October 2022, treated and analyzed in the laboratory for sixteen physicochemical parameters. Results were statistically analyzed using ANOVA, and T-test for the determination of the level of relationships and variations across geospatial locations. Significant correlations (r = 0.72) exist between Cr in rainwater from roof and non-roof sources. Implying point-source contaminations and may be emanating from the influence of roof materials. Furthermore, high concentrations of Cd and Pb in roof source above WHO standards were mostly in Jakpa and Ubeji. Calculated Health Risk Index (HRI) for children and adult is greater than 1. The results showed that most samples from the locations are considered not safe (HRI > 1) especially for Cd, which means that there are potential health risks consuming rainwater from Jakpa, Udu and Ubeji. Therefore, there is need for prompt sensitization program to dissuade people from directly drinking rainwater from these locations.

Investigating the Air Quality Parameters in Louisiana’s Industrial Corridor: A Baton Rouge Case Study

In a local context, sustainable development entails utilizing the current resources—material and immaterial, measurable and immeasurable, popular and unpopular—of the community in a manner that avoids overexploitation and ensures intergenerational equity. This approach prioritizes the safety and health of local citizens, placing communal productivity above corporate profitability. This research aims to assess air quality surrounding 28 chemical industry sites in Baton Rouge, Louisiana, to understand the environmental and health impacts of industrial pollutants, with a focus on environmental justice. Air quality pollutants, including PM2.5, PM10, O3, NO2, CO, and SO2, were monitored for 75 days during the Summer, using the BreezoMeter app. Python, Mapize, and QGIS software technologies were utilized for data analysis and visualization. Findings indicate a reduction in NO2 and CO levels, compared to existing literature. However, the persistent challenge of particulate matter suggests areas for further environmental management efforts. Additionally, the research suggests a significant disparity in air pollution exposure, probably affecting marginalized communities. Although the nature of the study might not fully capture annual pollution trends, the findings highlight the urgent need for the chemical industry to adopt efficient production methods and for policymakers to enhance air quality standards and enforcement, particularly in pollution-sensitive areas. The disproportionate impact of air pollution on vulnerable communities calls for a more inclusive approach to environmental justice, ensuring equitable distribution of clean air benefits and community involvement in pollution management decisions.

Technology and Health持续质量改进模式在医院卫生管理中的应用价值研究

探讨持续质量改进模式在医院卫生管理中的应用价值。选取2020年1月—2022年7月收治的100例住院患者为研究对象,以2021年1月为时间节点,此前实施常规院内卫生管理(对照组),参与患者50例;2021年1月后医院卫生管理中实施持续质量改进模式(观察组),参与患者50例,均由50名专科医护人员进行卫生管理,随即针对不同卫生管理模式下医务人员的综合能力、院内不良事件发生概率、患者对院内管理满意度、卫生管理质量进行对比评估。经数据对比,观察组医护人员综合能力中,其卫生知识考评积分、卫生质量评分、监督评估积分均较对照组高(P<0.05);同时观察组院内感染、手卫生不合格、废料处理不及时、自我防护不到位等不良事件发生率低于对照组(P<0.05);观察组患者对其所处模式的满意度显著高于对照组(P<0.05);观察组卫生管理质量评估积分中,其安全管控、作业实操、手卫生/消杀、多重耐药菌处理、废料处置等专项积分均较对照组高(P<0.05)。研究发现,通过在医院卫生管理中为患者实施持续质量改进模式,可显著提高院内医护人员个人能力,强化对院内卫生管理重视程度,增加患者对卫生常识的认知,提高患者治疗满意度,降低医护人员错误操作、不当行为的发生率,有着较高临床应用价值。

Integrated assessment of river health based on water quality, aquatic life and physical habitat

The health conditions of Liao River were assessed using 25 sampling sites in April 2005, with water quality index, biotic index and physical habitat quality index. Based on the method of cluster analysis （CA） for water quality indices, it revealed that heavily polluted sites of Liao River are located at estuary and mainstream. The aquatic species surveyed were attached algae and benthic invertebrates. The result showed that the diversity and biomass of attached algae and benthic index of biotic integrity （B-IBI） were degrading as the chemical and physical quality of water bodies deteriorating. Physiochemical parameters, BODs, CODcr, TN, TP, NH3-N, DO, petroleum hydrocarbon and conductivity, were statistically analyzed with principal component analysis and correlation analysis. The statistical results were incorporated into the integrated assessing water quality index, combining fecal coliform count, attached algae diversity, B-IBI and physical habitat quality score. A comprehensive integrated assessing system of fiver ecological health was established. Based on the systimetic assessment, the assessed sites are categorized into 9 ＂healthy＂ and ＂sub-healthy＂ sites and 8 ＂sub-sick＂ and ＂sick＂ sites.

Assessment of disease specific knowledge and health-relatedquality of life among United States military veterans withinflammatory bowel disease

AIM To evaluate the association between patientdisease knowledge of inflammatory bowel disease （IBD）and health related quality of life （HRQoL） and identifypatient and disease related predictors of patientknowledge of IBD.METHODS： We performed a cross-sectional study ofIBD patients with an established diagnosis of IBD longerthan 3 mo prior to enrollment. The Crohn＇s and colitisknowledge score （CCKNOW） and short inflammatorybowel disease questionnaire （SIBDQ） were selfadministeredto assess patient knowledge of IBDand HRQoL, respectively. Demographic and diseasecharacteristics were abstracted from the electronicmedical record. The correlation between CCKNOWand SIBDQ scores was assessed by a linear regressionmodel. Associations of patient knowledge and thevariables of interest were calculated using ANOVA.RESULTS： A total of 101 patients were recruited.Caucasian race, younger age at diagnosis, and having a college or post-graduate degree were significantlyassociated with higher CCKNOW scores. Patients withCD had higher CCKNOW scores compared to patientswith ulcerative colitis and inflammatory bowel diseasetype unclassified, P 〈 0.01. There was no significantcorrelation between overall CCKNOW and SIBDQ scores（r^2 = 0.34, P = 0.13）. The knowledge sub-domain ofdiet in CCKNOW was negatively correlated with HRQoL（r^2 = 0.69, P 〈 0.01）.CONCLUSION： IBD diagnosis at a younger age inaddition to Caucasian race and higher education weresignificantly associated with higher knowledge aboutIBD. However, patient knowledge of IBD was notcorrelated with HRQoL. Further studies are required tostudy the effect of patient knowledge of IBD on otherclinical outcomes.

The Monte Carlo-Based Uncertainty Health Risk Assessment Associated with Rural Drinking Water Quality

In this study, Triangular Fuzzy-number of the Fuzzy Set Theory was introduced to reform parameters of those previous health risk assessment (HRA) models, Monte Carlo simulation parameter was applied to lower the randomness and fuzziness of the HRA system, and the Monte Carlo-United States Environmental Protection Agency (MC-EPA) model was employed to evaluate the health risk associated with water quality (HRWQ), so as to solve the uncertainty HRA associated with rural drinking water quality. Results showed that the water in Mingshan was contaminated mainly by Cr(VI), nitrate, fluoride and Fe. The health risk primarily embodied in the carcinogenic risk (CR) caused by Cr(VI) that generally exceeds the limit while little non-carcinogenic toxic effected presents. However, non-carcinogenic risk (NCR) in some water resources was high, exceeding the limit “1”. The results revealed the health risk level of the water quality and the health risk degree caused by the pollutants, providing scientific support for the management of the HRWQ of the WR. It also indicated the significance of MC-EPA model’s application.