我国医院感染监控的当务之急

我国医院感染监控的当务之急——做正确的事。只有逐步建立起一套适应本学科特点的循证医院感染控制思维模式,制定出切实可行的指南、规范,来规范医院感染控制的行为,才能做正确的事,使我国的医院感染控制工作有序、有效的进行。     

Sources of life meaning among South African university students

This study explored the sources of meaning in life among a group of 243 South African university students, using a sequential exploratory mixed methods design. First, data from semi-structured questionnaires (n=40) were subjected to qualitative content analysis; next, from the emerging themes, a quantitative questionnaire was developed and administered to 203 students. Mean scores were computed and compared across gender and cultural groups. Relationships, especially with family, as well as hope, education, achievement and religion were found to be most important sources of meaning, followed by service, creative self-expression, material possessions, hobbies, health and pets. The qualitative analysis revealed that most of these sources were valued more for their perceived instrumental utility than for their intrinsic qualities.     

正念在缓解社会排斥中的作用

从三个角度(被排斥者, 排斥者和旁观者)三个时间点(排斥发生前中后)出发, 正念是否、何时以及如何在社会排斥情境中发挥作用这一系列问题被详细论述, 并概述为一个正念和排斥相关的模型。该模型表明, 排斥发生前, 正念能够缓解被排斥者的拒绝敏感性; 减少排斥者的排斥行为; 排斥发生后, 正念能够缓解被排斥者的痛苦, 有助于旁观者的助人行为; 排斥发生时, 正念可能促进良好沟通, 减少排斥恶化的可能性。未来研究可以针对正念在社会排斥中效益发生的机制以及边界条件方面进行深入的探讨。     

The feasibility,reliability and validity of the EORTC QLQ-C30 in assessing the quality of life of patients with a symptomatic HIV infection or AIDS (CDC IV)

Abstract

The objective of this study was to evaluate the feasibility, reliability and validity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (the QLQ-C30) in a longitudinal study of the quality of life (QoL) of patients with a symptomatic HIV infection or AIDS. The OLQ-C30 is a 30-item questionnaire composed of five functional subscales. 3 symptom subscales, an overall QoL subscale, and a number of additional single item symptom measures. The questionnaire was administered serially to a sample of 156 Dutch patients. The average time to complete the questionnaire was less than 11 minutes, with most patients requiring no assistance. With one exception (role functioning subscale), the data supported the hypothesized scale structure of the questionnaire. Eight of the 9 subscales met or approached the minimal criterion for reliability (Cronbach's alpha ≤ .70) at baseline and/or follow-up. The validity of the QLQ-C30 was supported by 3 findings: (1) the correlations observed among the subscales. while statistically significant, were of only a moderate magnitude, indicating that distinct components of QoL are being assessed; (2) a number of the subscales could discriminate clearly between patients differing in stage of disease and in Karnofsky Performance Status; and (3) significant changes in QLQ-C30 scores in the expected direction, were observed over time. These results lend support to the QLQ-C30 as a reasonably reliable and valid instrument for assessing the QoL of patients with HIV infection. Additional research is needed to improve the role functioning subscale. to evaluate the QLQ-C30's concurrent validity by comparing it with other available QoL instruments, and to examine more thoroughly its responsiveness to clinically important changes in patients' health status over the entire disease and treatment trajectory.     

Changes in health status after one year for persons at-risk for and with HIV infection

Abstract

Health status is an important component of the evaluation of patient outcome in HIV infection where disease is chronic, progressive, and debilitating. This paper compares patient self-report for 9 dimensions of health status for patients followed in ATHOS (AIDS Time-Oriented Health Outcome Study). We compared changes in functioning after 12 months for 1, 524 patients with varying HIV disease severity: 238 asymptomatic, 447 symptomatic, 441 AIDS, and 398 HIV-negative individuals who are at-risk for infection.

Declines in health status were observed for all HIV-infected persons, including also asymptomatic patients. Individuals with symptomatic disease or AIDS had significant declines (p < 0.001) in physical functioning, energy, global health, pain, and increased disease symptoms, but no significant declines in health distress, cognition, or mental health. Persons with AIDS had greater declines than those with symptomatic disease. All HIV-infected individuals reported significantly fewer hours at work and more disability days than HIV-negative patients from similar risk pools. The adverse impact that HIV infection has on the health status of HIV-positive asymptomatic individuals is striking; HIV-negative individuals are more similar to HIV-positive individuals than to the general population.     

Assessing the quality of life of HIV infected persons: Clinical and descriptive information from studies with the hopes

Abstract

We have recently developed and psychometrically evaluated an HIV-specific quality of life instrument. The new instrument is called the HIV Overview of Problems-Evaluation System (HOPES) which was adapted from an established cancer-specific quality of life instrument called the CARES. In this paper we review the psychometric properties of the HOPES, examine the quality of life impact of HIV infection in a cross-sectional evaluation of 318 patients using data from the HOPES and describe other work in progress or planned using the HOPES.     

肝硬化门脉高压症断流术后感染的防治策略

肝硬化门脉高压症断流术后感染的防治策略可概括为:增强机体免疫力,重视无菌操作,预防性使用抗生素,积极治疗出现的感染。常见术后感染包括:膈下积液、脓肿,自发性腹膜炎(SBP)或腹水感染,门静脉血栓性静脉炎,切口及其他部位感染,真菌感染,脾切除术后爆发性感染和脾热。     

外科感染：古老的疾病 严峻的挑战

外科感染是人类最古老的疾病,在控制外科感染方面我们已经取得了巨大的进步,但外科感染反而变得越来越复杂,我们面临的挑战也越来越严峻。面对挑战,我们应该采取全方位的对策。     

跨物种感染是伦理上无关的吗？

目前没有确定的证据表明异种移植是安全的还是危险的。考察了关于跨物种感染的科学和哲学争论,总结出关于“跨物种感染是伦理上无关的”正反论证,提出自己的反论证。最后得出结论:跨物种感染不是伦理上无关的。并且,由于跨物种感染蕴藏的对公众的潜在的巨大风险,新的全球生命伦理学研究范式和涉及人体研究的新的伦理框架需要进一步研究。