BACKGROUND:For patients in intensive care unit (ICU), mechanical ventilation is an effective treatment to survive from acute illness and improve survival rates. However, long periods of bed rest and restricted physical activity can result in side effects. This study aimed to investigate the feasibility of early rehabilitation therapy in patients with mechanical ventilation. METHODS:A randomized controlled trial was carried out. Sixty patients, with tracheal intubation or tracheostomy more than 48 hours and less than 72 hours, were admitted to the ICU of the Affiliated Hospital of Medical College, Qingdao University, from May 2010 to May 2012. These patients were randomly divided into a rehabilitation group and a control group. In the rehabilitation group, rehabilitation therapy was performed twice daily, and the training time and intensity were adjusted according to the condition of the patients. Early rehabilitation therapy included heading up actively, transferring from the supine position to sitting position, sitting at the edge of the bed, sitting in chair, transferring from sitting to standing, and ambulating bedside. The patient's body mass index, days to first out of bed, duration of mechanical ventilation, length of ICU stay, APACHE Ⅱ score, highest FiO2, lowest PaO2/FiO2 and hospital mortality of patients were all compared between the rehabilitation group and the control group. The differences between the two groups were compared using Student's t test. RESULTS:There was no significant difference in body mass index, APACHE Ⅱ score, highest FiO2, lowest PaO2/FiO2 and hospital mortality between the rehabilitation group and the control group (P>0.05). Patients in the rehabilitation group had shorter days to first out of bed (3.8±1.2 d vs. 7.3±2.8 d; P=0.00), duration of mechanical ventilation (5.6±2.1 d vs. 12.7±4.1 d; P=0.005) and length of ICU stay (12.7±4.1 d vs. 15.2±4.5 d; P=0.01) compared with the control group. CONCLUSION:Early rehabilitation therapy was feasible and effective in improving the outcomes of patients with mechanical ventilation.

Purpose: This study aimed to assess exposure to traumatic events, knowledge and attitudes concerning post-traumatic stress disorder (PTSD) and the level of resilience among nurses and paramedics working in emergency departments. Methods: Data were collected from May 22 to June 12, 2022, using a self-administered survey questionnaire. The participants comprised 135 nurses and 80 paramedics working in emergency departments. The collected data were analyzed with descriptive statistics, a t-test, and an analysis of variance with Scheffé’s test. Results: Compared with emergency room nurses, paramedics were more positive about the government’s spending on job opportunities for people with PTSD. There were no significant differences in attitude regarding government strategies and people with PTSD between nurses and paramedics. Paramedics had higher scores on the effective treatment for PTSD, while emergency room nurses showed higher scores on effective psychotherapy. General knowledge of PTSD differed according to sex (t=-2.33, p=.021) and education level (F=3.21, p=.042). Resilience scores differed significantly according to sex (t=2.02, p=.045), education level (F=4.10, p=.018), self-reported economic state (F=10.34, p<.001), and self-reported health (F=11.57, p<.001). Conclusion The findings support that emergency department nurses and paramedics are in need of self-care programs to support their mental health and indicate that intervention programs should be developed to enhance resilience in emergency department professionals.

OBJECTIVETo observe the direct effects of fenvalerate (Fen) on sperm motility in SD rats.

METHODSSperm were isolated from caudal epididymides of healthy adult male rats with the diffusion method. The motility parameters of the isolated sperm, such as VCL, VSL, VAP, BCF, STR and LIN, were monitored by computer-assisted sperm analysis (CASA) system after 1, 2 and 4 h Fen-exposure in vitro at concentrations of 0, 1, 4, 16 and 64 micromol/L respectively.

RESULTSAfter 1 and 2 h Fen-exposure, VSL, BCF, STR and LIN decreased significantly at 64 micromol/L compared with the control group. After 4 h Fen-exposure, the motility parameters VCL, VSL, BCF, STR and LIN dropped progressively at 64 micromol/L, and VCL declined markedly at 16 micromol/L. However, only VCL and STR showed alterations in a time-response manner.

CONCLUSIONFen may affect the caudal epididymal sperm and produce a direct toxic effect on sperm motility in SD rats.

Animals ; Dose-Response Relationship, Drug ; Insecticides ; toxicity ; Male ; Nitriles ; toxicity ; Pyrethrins ; toxicity ; Rats ; Rats, Sprague-Dawley ; Sperm Count ; Sperm Motility ; drug effects

PURPOSE: The purpose of this study was to identify effects of a maternal-child health education program for nurses in Tigray, Ethiopia. METHODS: One-group pre-posttest design was used. The maternal-child health (MCH) education program was given to nurses from 5 health centers in Tigray, Ethiopia. Knowledge and confidence levels were measured before and after each education session. Data were analyzed using paired t-test. RESULTS: The topics of the 5 educational sessions were family planning, antenatal care, care during labor, immunization, and integrated management of neonate, and child illness. Knowledge scores (1st: Z=3.931, p=.001; 2nd: Z=6.189, p<.001; 3rd: Z=5.658, .001, 4th: Z=8.734, .001, 5th: Z=14.167, .001) and confidence levels (1st: Z=8.467, .001; 2nd: Z=4.183, .001; 3rd: Z=4.992, .001) improved significantly. CONCLUSION: The findings of this study imply that the MCH education program for nurses was effective in developing the maternal-child health capacity of the nurses in Tigray, Ethiopia.
Child ; Education ; Education, Nursing ; Ethiopia* ; Family Planning Services ; Health Education* ; Humans ; Immunization ; Infant, Newborn ; Maternal Health Services

OBJECTIVE: To identify the correlations between the location of multifidus atrophy and the level of lumbar radiculopathy. METHODS: Thirty-seven patients who had unilateral L4 or L5 radiculopathy were divided into 2 groups; the L4 radiculopathy (L4 RAD) group and the L5 radiculopathy (L5 RAD) group. Bilateral lumbar multifidus muscles at the mid-spinous process level of L4 vertebra (L4 MSP), the mid-spinous process level of L5 vertebra (L5 MSP), and the mid-sacral crest level of S1 vertebra (S1 MSC) were detected in T1 axial magnetic resonance imaging. The total muscle cross-sectional area of multifidus muscles (TMCSA) and the pure muscle cross-sectional area of multifidus muscles (PMCSA) were measured by a computerized analysis program, and the ratio of PMCSA to TMCSA (PMCSA/TMCSA) was calculated. RESULTS: There were no significant differences in TMCSA between the involved and the uninvolved sides in both groups. PMCSA was only significantly smaller at the S1 MSC on the involved side as compared with the uninvolved side in the L5 RAD group. The ratio of PMCSA to TMCSA was the lowest at the L5 MSP on the involved side in the L4 RAD group and at the S1 MSC on the involved side in the L5 RAD group. CONCLUSION: Our findings suggest that the most severe atrophy of multifidus muscle may occur at the mid-spinous process or mid-sacral crest level of the vertebra which is one level below the segmental number of the involved nerve root in patients with a single-level, unilateral lumbar radiculopathy.
Atrophy ; Electromyography ; Humans ; Magnetic Resonance Imaging ; Muscles ; Muscular Atrophy ; Radiculopathy ; Spine

PURPOSE: The purpose of this study was to understand the clinical instructors' role experience in college of nursing. METHODS: Two focus group interviews were held with a total of 12 clinical instructors. All interviews were recorded and transcribed as they were spoken, and the collected data were analyzed using content analysis of Downe-Wamboldt(1992). RESULTS: Three themes and six subthemes were extracted from the analysis: 1) Getting recognition of special roles as a clinical instructor: 'Recognizing the role of clinical instructor for guiding student's individual practice goals', 'Recognizing helping and supporting roles for student's successful clinical practice', 2) Having difficulty in performing the role of clinical practice instructor: 'Difficulty from the lack of knowledge and experience as a clinical practice instructor', 'Difficulty from the gap between current clinical practice and purpose of clinical nursing practice', 3) Making efforts to overcome the difficulties as a clinical instructor and accomplishing personal development: 'Making efforts to acquire personal knowledge and experience', 'Making a chance to reflect on and grow up oneself'. CONCLUSION: Clinical instructors take an important part of clinical nursing education. To improve the quality of clinical nursing education, it is needed role reestablishment and institutional support for clinical instructors on the basis of the understanding of instructors' experience.
Education, Nursing ; Focus Groups ; Humans ; Nursing* ; Qualitative Research

PURPOSE: We examined the effects of a community outreach program for maternal health in Tigray, Ethiopia, on women's knowledge about pregnancy, childbirth, postpartum care, and family planning, and assessed their participation in antenatal care, postpartum checkups, institutional childbirth, and contraceptive use. METHODS: We recruited Ethiopian women of reproductive age (15 to 49 years) in Tigray, Ethiopia. Two villages in Tigray, Kihen and Mesanu, which have similar population sizes and living environments, were chosen as the intervention and comparison groups, respectively. A two-group pretest-posttest design with cluster sampling was employed. We conducted self-report questionnaire surveys using face-to-face interviews. The 2.5-year community outreach program was developed based on Rogers' diffusion of innovation theory. It consisted of mass media use and health education for lay women in the community, along with training of health care providers, including nurses, midwives, and health extension workers, in maternal health care. RESULTS: The intervention group showed significant increases in knowledge and behaviors regarding maternal health and family planning compared to the comparison group (p < .001). In particular, there was a dramatic increase from 10.8% to 93.5% in the institutional birth rate in the intervention group. CONCLUSION: The community outreach program and health care professional training effectively improved knowledge and behaviors regarding maternal health in Ethiopian women. Mass media and interpersonal communication channels for health education may be useful health interventions in developing countries.
Birth Rate ; Community-Institutional Relations* ; Delivery of Health Care ; Developing Countries ; Diffusion of Innovation ; Ethiopia* ; Family Planning Services* ; Female ; Health Education ; Health Personnel ; Humans ; Mass Media ; Maternal Health* ; Midwifery ; Parturition ; Population Density ; Postnatal Care ; Pregnancy

OBJECTIVE: To evaluate the changes of bladder management methods after the discharge from hospital, and to identify the problems associated with their method changes of bladder management after the discharge. METHOD: The subjects of this study were 128 spinal cord injury patients with a neurogenic bladder dysfunction who were admitted to the hospital and received the neurogenic bladder management and training. We reviewed the medical records of these patients for the management methods of neurogenic bladder and interviewed the patients whether they are still using the same methods after the discharge. RESULTS: The number of patients who were doing the intermittent catheterization at the time of discharge from hospital was markedly reduced after the discharge and most of the patients in this group have switched to the external collecting device method, using Cred, Valsalva or tapping method. The reasons of this change were that the intermittent catheterization method was not only difficulty and complicated but also restricted their social activities. CONCLUSION: We concluded that a long term close follow up and continuous encouragement are very important in the management of neurogenic bladder patients who are discharged with the intermittent catheterization method.
Catheterization ; Catheters ; Follow-Up Studies ; Humans ; Medical Records ; Spinal Cord Injuries ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder, Neurogenic*

OBJECTIVETo compare primary anastomosis after intraoperative colonic defecation and Hartmann procedure for obstructive left colon cancer.

METHODSClinical data of 68 patients who underwent emergent laparotomy for left colon cancer with acute bowel obstruction between January 2000 and January 2008 were analyzed retrospectively.

RESULTSPrimary resection and anastomosis with intraoperative defecation was performed in 43 patients and Hartmann's procedure in 25 cases. Patients in both groups were comparable in terms of age, gender, nutritional status, underlying diseases, tumor location and stage, etc. The morbidity and mortality in the two groups were 25.6% vs 28.0% (P=0.761) and 2.3% vs 4.0% (P=0.369), respectively, and the differences were not statistically significant. The length of hospital stay (including first resection operation and second admission for colostomy closure) was (16.6+/-7.8) d in the primary anastomosis group and (24.6+/-9.4) d in the Hartmann procedure group, and the difference was statistically significant (P=0.002). The costs of hospitalization in the two groups were CNY 50,192.8+/-39,727.4 and CNY 58,382.1+/-30,304.9 (P=0.020).

CONCLUSIONPrimary resection with intraoperative colonic defecation is safe and effective, and should be considered as an alternative to Hartmann procedure for obstructive left colon cancer in selected patients.

Aged ; Anastomosis, Surgical ; methods ; Colectomy ; methods ; Colon ; surgery ; Colonic Neoplasms ; surgery ; Defecation ; Female ; Humans ; Intestinal Obstruction ; etiology ; surgery ; Male ; Middle Aged ; Proctocolectomy, Restorative ; Retrospective Studies

OBJECTIVETo describe the temporal trends in the mortality rate of gastric cancer during the period of 1988 and 2010, and to predict the gastric cancer mortality between 2016 - 2020.

METHODSThe data of gastric cancer mortality in Linzhou city between 1988 and 2010 was extracted from the cancer registry, including a total of 11 714 cases, covering 22 447 073 person-years. The mortality rate of gastric cancer of each 5-year period was calculated by sub-site and gender. Age-standardized rate (ASR) was calculated using the Chinese standard population in 1982. Intrinsic estimator (IE) model was used to fit the mortality trend by sub-site and gender, and to predict the mortality of gastric cancer in Linzhou city between 2016 and 2020.

RESULTSFrom 1988 to 2010, the gastric cancer mortality in Linzhou city was 52.18/100 000 (11 714/22 447 073) with the ASR at 49.23/100 000; the mortality in male was 67.02/100 000 (7678/11 455 512) with ASR at 68.68/100 000 while the mortality in female was 36.72/100 000 (4036/10 991 561) with ASR at 32.12/100 000. The mortality of cardia carcinoma was 27.87/100 000 (6257/22 447 073) with the ASR at 26.37/100 000; while the mortality of non-cardia carcinoma was 24.31/100 000 (5457/22 447 073) with the ASR at 22.86/100 000. The ASR of gastric cancer during 1988 - 1990 was 63.37/100 000 (1653 cases) and decreased by 28.34%, to 45.41/100 000 (2622 cases) during 2006 - 2010. The IE model showed that the birth cohort effect decreased greatly. The mortality risk of cardia carcinoma in population born after 1950s, decreased significantly; and the mortality risk of non-cardia carcinoma in population born in 20 century continually decreased. The death of gastric cancer among the population over 30 years old was predicted to be 3626 cases, increasing by 40.60% compared with the number between 2006 and 2010 (2579 cases). Among them, the mortality of cardia carcinoma increased by 51.89% (predicted number between 2016 and 2020 was 2456 cases, and 1617 cases between 2006 and 2010), and the mortality of non-cardia carcinoma increased by 21.62% (predicted number between 2016 and 2020 was 1170 cases, and 962 cases between 2006 and 2010).

CONCLUSIONThe mortality rate of gastric cancer in Linzhou city showed a decreasing trend during the period of 1988-2010, being mainly attributed to the cohort effect. However, the mortality will still increase in the future, between 2016 and 2020.

Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Female ; Forecasting ; Humans ; Male ; Middle Aged ; Registries ; Stomach Neoplasms ; epidemiology ; mortality