谈特殊病区HIV患者集中静脉采血

目的总结高效率集中采集HIV患者静脉血标本.方法回顾性总结389例患者静脉采血,从采血前准备、怎样选择静脉、采血时的体位配合,到扎止血带、穿刺技巧、拔针,以及防标本溶血,预防职业暴露及交叉感染.结果一次性成功采血89.5%,标本符合要求100%,未发生职业暴露及交叉感染.结论从吸毒的艾滋病患者静脉采血难于常人,采血过程及其前后准备与处理均须?小心谨慎.参4.     

Effects of social capital on the health quality of the rural elderly in Xihaigu,China: a hierarchical linear model analysis

Based on the analysis and measurement of the social capital and the health quality and structure of the elderly people, this paper examined the effects of social capital on the health quality of the elderly as well as its composition. The examination was conducted by applying a hierarchical linear model (HLM) and using survey data obtained in the Xihaigu area of Ningxia Province in 2017. The empirical results showed that individual social capital had a significant influence on the health of the rural elderly, but the impacts were different on its composition. Village social capital should improve both the physical and mental health quality of the elderly through building mutual trust and promoting stability, unity and a harmonious living environment. In addition, factors such as mode of habitation, diet, medical approaches, intergenerational interactions, and village geographical location also affect the health quality of the elderly.     

Team-Based Risk Assessment and Action Plans as Participatory Methods for Safe Patient Handling in Two Swedish Municipal Care Homes for the Elderly

Objective. We investigated the usefulness of a team-based risk assessment method in patient transfer situations in municipal care homes for the elderly. Methods. Evaluation of risk assessment and action plans carried out in 2009. Focus group interviews with care givers and one-to-one interviews with managers and occupational therapists. Results. The evaluation showed that action plans and interventions were developed for each resident with identified risk connected with movement/transfer in daily life. Twenty-six patients (28%) of a total number of 94 were assigned to the “no risk” category regarding movement/transfer situations in daily life. The other 68 patients (72%) required further interventions, which were documented in action plans. The interviews indicated that the approach of team-based risk assessment and action plans was perceived as a functional participatory method aiming to improve daily life and work. Conclusion. Systematic team-based risk assessment and action plans benefit staff as well as residents at care homes for the elderly.     

室内环境与高龄者血压的关联性——以大连市供暖季为例

对中国大连市供暖季住宅室内环境与高龄者血压的关联性进行了调查研究,具体包括住宅热湿环境（温度、相对湿度）、化学污染（CO₂、CO、甲醛和TVOC）、物理污染（PM_2.5）和生物污染（附着真菌）与高龄者血压的关联性.研究表明,城市和农村住宅供热方式不同是导致住宅室内热环境舒适度差异的主要原因.在大连农村,处于室外的厕所与室内形成的大温差使得农村高龄者患心血管疾病的诱发风险比城市更高.城市高龄者的平均血压比农村低且波动小.城市住宅室内温湿度与血压均存在关联（P<0.01）,农村室内温湿度对血压的影响程度不如城市明显.另外,室内空气质量参数并未发现与血压存在显著关联.     

Self-reported falls and fall-related injuries among persons aged>or=65 years--United States, 2006

PROBLEM: In 2005, 15,802 persons aged>or=65 years died from fall injuries. How many older adults seek outpatient treatment for minor or moderate fall injuries is unknown. METHOD: To estimate the percentage of older adults who fell during the preceding three months, the Centers for Disease Control and Prevention (CDC) analyzed data from two questions about falls included in the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey. RESULTS: Approximately 5.8 million (15.9%) persons aged>or=65 years reported falling at least once during the preceding three months, and 1.8 million (31.3%) of those who fell sustained an injury that resulted in a doctor visit or restricted activity for at least one day. DISCUSSION: This report presents the first national estimates of the number and proportion of persons reporting fall-related injuries associated with either doctor visits or restricted activity. SUMMARY: The prevalence of falls reinforces the need for broader use of scientifically proven fall-prevention interventions. IMPACT ON INDUSTRY: Falls and fall-related injuries represent an enormous burden to individuals, society, and to our health care system. Because the U.S. population is aging, this problem will increase unless we take preventive action by broadly implementing evidence-based fall prevention programs. Such programs could appreciably decrease the incidence and health care costs of fall injuries, as well as greatly improve the quality of life for older adults.     

Functional outcomes of motor vehicle crash thoracic injuries in pediatric and adult occupants

Objective: Characterization of the severity of injury should account for both mortality and disability. The objective of this study was to develop a disability metric for thoracic injuries in motor vehicle crashes (MVCs) and compare the functional outcomes between the pediatric and adult populations.

Methods: Disability risk (DR) was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank for the most frequently occurring Abbreviated Injury Scale (AIS) 2–5 thoracic injuries. Occupants with thoracic injury were classified as disabled or not disabled based on the FIM scale, and comparisons were made between the following age groups: pediatric, adult, middle-aged, and older occupants (ages 7–18, 19–45, 46–65, and 66+, respectively). For each age group, DR was calculated by dividing the number of patients who were disabled and sustained a given injury by the number of patients who sustained a given injury. To account for the effect of higher severity co-injuries, a maximum AIS adjusted DR (DR_MAIS) was also calculated for each injury. DR and DR_MAIS could range from 0 to 100% disability risk.

Results: The mean DR_MAIS for MVC thoracic injuries was 20% for pediatric occupants, 22% for adults, 29% for middle-aged adults, and 43% for older adults. Older adults possessed higher DR_MAIS values for diaphragm laceration/rupture, heart laceration, hemo/pneumothorax, lung contusion/laceration, and rib and sternum fracture compared to the other age groups. The pediatric population possessed a higher DR_MAIS value for flail chest compared to the other age groups.

Conclusion: Older adults had significantly greater overall disability than each of the other age groups for thoracic injuries. The developed disability metrics are important in quantifying the significant burden of injuries and loss of quality life years. Such metrics can be used to better characterize severity of injury and further the understanding of age-related differences in injury outcomes, which can influence future age-specific modifications to AIS.     

Analysis of injury mechanism of the elderly and non-elderly groups in minor motor vehicle accidents

Abstract

Objective: The purpose of this study is to investigate the injury patterns of noncatastrophic accidents by individual age groups.

Methods: Data were collected from the Korean In-Depth Accident Study database based on actual accident investigation. The noncatastrophic criteria were classified according to U.S. experts from the Centers for Disease Control and Prevention’s recommendations for field triage guidelines of high-risk automobile crash criteria by vehicle intrusions more than 12 in. on occupant sites (including the roof) and more than 18 in. on any site. The Abbreviated Injury Scale (AIS) was used to determine injury patterns for each body region. Severely injured patients were classified as Maximum Abbreviated Injury Scale (MAIS) 3 or higher.

Results: In this study, the most significant injury regions were the head and neck, extremities, and thorax. In addition, the incidence of severe injury among elderly patients was nearly 1.6 times higher than that of non-elderly patients. According to age group, injured body regions among the elderly were the thorax, head and neck, and extremities, in that order. For the non-elderly groups, these were head and neck, extremities, and thorax. Severe injury rates were slightly different for the elderly group (head and neck, abdomen) and non-elderly group (thorax, head and neck).

Conclusions: In both age groups, the rate of severe injury is proportional to an increase in crush extent zone. Front airbag deployment may have a relatively significant relationship to severe injuries.     

Assessing the relationship between global warming and mortality: lag effects of temperature fluctuations by age and mortality categories

Although interests in assessing the relationship between temperature and mortality have arisen due to climate change, relatively few data are available on lag structure of temperature-mortality relationship, particularly in the Southern Hemisphere. This study identified the lag effects of mean temperature on mortality among age groups and death categories using polynomial distributed lag models in Brisbane, Australia, a subtropical city, 1996-2004. For a 1 °C increase above the threshold, the highest percent increase in mortality on the current day occurred among people over 85 years (7.2% (95% CI: 4.3%, 10.2%)). The effect estimates among cardiovascular deaths were higher than those among all-cause mortality. For a 1 °C decrease below the threshold, the percent increases in mortality at 21 lag days were 3.9% (95% CI: 1.9%, 6.0%) and 3.4% (95% CI: 0.9%, 6.0%) for people aged over 85 years and with cardiovascular diseases, respectively. These findings may have implications for developing intervention strategies to reduce and prevent temperature-related mortality.     

天津市老年人PM2.5个体暴露化学组分特征

分别于2011年6月13日—7月2日(夏季)和11月30日—12月12日(冬季),采用颗粒物个体暴露采样器对天津市某社区101名老年人(平均年龄67岁)的PM_2.5个体暴露水平进行监测,以探讨PM_2.5个体暴露化学组分的特征. 结果表明,天津市老年人夏、冬季PM_2.5个体暴露浓度分别为(124.2±75.2)和(170.8±126.6)μg/m3. 斯皮尔曼相关分析表明,Si、NH₄+和NO₃-的暴露浓度均与PM_2.5暴露浓度显著相关(P<0.01),R(相关系数)分别为0.61、0.55和0.46. 富集因子分析表明,Cd、Zn和Pb 3种元素高度富集,受人为源的影响强烈. SO₄2-是水溶性离子中含量最高的组分,其次是NO₃-和NH₄+,在夏、冬季这3种离子暴露浓度之和分别占PM_2.5暴露浓度的34.3%和40.6%. OC是老年人PM_2.5个体暴露的主要成分之一,夏、冬季OC暴露浓度分别占PM_2.5暴露浓度的19.3%和27.4%. 老年人PM_2.5个体暴露化学组分浓度受气象因素、室内源和室外源的共同影响,季节变化明显. 冬季Al、Si、K、Ca和Fe的暴露浓度高于夏季,但大部分微量金属元素(V、Cr、Mn、Ni、Cu、Zn、As、Sb和Pb)的冬季暴露浓度却低于夏季. 方差分析表明,冬季SO₄2-、NO₃-、NH₄+、OC和EC的暴露浓度显著高于夏季(P<0.05).      

Prenatal diagnosis of thalassemia: The viewpoint of patients

Twenty-eight young people with thalassemia major expressed their opinion about prenatal diagnosis. All of them stated that they intended to marry and have children; thirteen of them (46 per cent) said that they would have also accepted a thalassemic carrier as a partner and that if married to a carrier they would have undergone prenatal diagnosis and selective abortion. All but one refused the prospect of an affected child. When asked if they would have preferred that before their birth their parents had undergone prenatal diagnosis and abortion, 19 patients (68 per cent) gave an affirmative answer. These results clearly indicate that even people affected by thalassemia major, who are the potential victims of prenatal diagnosis and selective abortion, largely accept prenatal diagnosis as a means of preventing their disease.