Contemporary university students are confronted with multiple challenges,including academic pressure,employment anxiety,and interpersonal conflicts.Traditional approaches to heart-to-heart talks often exhibit limitati...Contemporary university students are confronted with multiple challenges,including academic pressure,employment anxiety,and interpersonal conflicts.Traditional approaches to heart-to-heart talks often exhibit limitations,such as“over-reliance on problem etiology”and“the marginalization of student agency,”which hinder their effectiveness in addressing students’individualized needs and enhancing the efficacy of counselors’work.Grounded in the solution-focused approach(SFA),this study employs a literature review methodology to systematically examine the core tenets of SFA-namely,its“solution-oriented perspective”and emphasis on“accumulating small changes”-as well as key techniques such as empowerment-oriented questioning and action reinforcement.Integrating these elements with the specific context of university counseling dialogues,the paper constructs a three-stage application framework encompassing“pre-session preparation,in-session implementation,and post-session follow-up.”This framework is designed to enhance the pertinence and effectiveness of heart-to-heart talks by clarifying conversation goals,focusing on student resources,detailing action steps,and reinforcing outcomes.It aims to provide counselors with actionable guidance while also offering interdisciplinary theoretical support for improving the quality of ideological and political education and mental health counseling in universities.Ultimately,the framework seeks to strengthen students’agency and autonomous problem-solving capabilities.展开更多
Objective： To evaluate the efficacy and feasibility of the transradial approach for primary percutaneous coronary intervention （PCI） in patients with acute myocardial infarction（AMI）. Methods： 195 patients with ...Objective： To evaluate the efficacy and feasibility of the transradial approach for primary percutaneous coronary intervention （PCI） in patients with acute myocardial infarction（AMI）. Methods： 195 patients with acute myocardial infarction were randomly divided into two groups according to the different PCI operation pathways. 105 cases were assigned to the transfemoral artery group and 90 cases to the transradial artery group. We analyzed the data from the two groups, including the achievement ratio of paracentesis, cannulation time, the time from local anesthesia to the first time balloon inflation, the time of the total procedure, achievement ratio of PCI, incidence rate of vascular complications, total duration of hospitalization, and the six-month follow-up results in both groups. Results： Our results showed that the achier ement ratio of arteriopuncture, cannulafion time and the time from local anesthesia to the first time balloon inflation in the transradial and transfemoral groups were 98.9% vs. 100%, 3.15 ± 1.56min vs. 2.86 ± 0.97 min, and 18.56 ± 4.37 min vs. 17.75 ± 3.21 min, respectively. These differences between the two groups were not statistically significant. The total operating time was 29.75 ± 4.38 rain for the transradial group and 27.89 ± 3.95 min（P 〈 0.05） for the transfemoral group. The operation achievement ratio in the transradial group was 96.7%, and 96.2% in the transfemoral group. The incidence of puncture point complications was 2.2% in the transradial group and 11.4% in the transfemoral group, and this difference was significant. The duration of hospitalization was 10.56 ± 2.85 days for the transradial group and 13.78 ± 3.15 days（P 〈 0.05） for the transfemoral group. At the six-month follow-up, the rate of survival without cardiac event was 86.1% vs. 86.4% respectively in the transradial and transfemoral groups（P 〉 0.05）. Conclusion： The transradial approach was as effective as the transfemoral approach, and there were fewer puncture point complications as well as a shorter span of hospitalization in the transradial group. PCI via the transradial approach is safe, effective and feasible in patients with AMI.展开更多
There are several interventions for malaria control in Latin America that are in line with the principles of the Ecohealth approach. The objective of this paper was to identify interventions for malaria control with e...There are several interventions for malaria control in Latin America that are in line with the principles of the Ecohealth approach. The objective of this paper was to identify interventions for malaria control with elements from the Ecohealth approach to evidence guiding elements, limiting and facilitating factors and recommendations for future interventions. A literature search was performed in six databases： Medline, Scopus, Central, IS! Web of Knowledge, Embase and BVS-Lilacs. To complement this information, several researchers were asked to participate in in-depth interviews. Ten articles, 6 reports from 3 IDRC interventions and 1 report of the PAMAFRO project were identified. Interventions included different methodologies to help improve the environment and health of the population. Interviewees coincided in analyzing malaria as a complex disease. They argued about the importance of carrying-out partnerships with various stakeholders in order to achieve sustainability of the interventions. The Ecohealth approach implies dialogue between community and researchers; participation of different disciplines; active participation of the various stakeholders; creation and maintenance of strategic alliances in pursuit of sustainability and scaling up of interventions into public policy.展开更多
In this issue of the Journal of Geriatric Cardiology;Jing et al. showed off their near perfect results of percutaneous coronary interventions (PCI) through transfemoral approach (TFA) and transradial approach (TRA... In this issue of the Journal of Geriatric Cardiology;Jing et al. showed off their near perfect results of percutaneous coronary interventions (PCI) through transfemoral approach (TFA) and transradial approach (TRA) in the elderly Chinese patients. All patients were older.than 60years of age, with an average of 67.……展开更多
The objective of this work is to analyze the reasons why community health interventions in Africa do not consider multisectoral approaches. To achieve it, we perform a mini-review of health development policies and pl...The objective of this work is to analyze the reasons why community health interventions in Africa do not consider multisectoral approaches. To achieve it, we perform a mini-review of health development policies and plans available online in seven countries from four regions of Sub-Saharan Africa. Thus, two main reasons have been highlighted. First, national strategic plans and policies for health development, in their formulation, neither sufficiently emphasize multisectoral approaches, nor sufficiently make these approaches operational in strategies and activities. Second, the mindset of health professionals due to their initial training orientation based on the biomedical approach, stands that disease is only a result of a physiological imbalance in the body;therefore, to restore health, such an imbalance only needs sophisticated procedures and interventions to be overcome. Such an orientation completely ignores the social, cultural and economic context in which the individual lives, which has an irretrievable influence on the health imbalance. However, health, influenced by the conditions in which people are conceived, born, grow, live, work and aged, cannot be effectively improved in a sustainable way without taking into account all these conditions. Whence the importance of approaches based on every sector of human activity that influences the living conditions.展开更多
Objectives To evaluate the effectiveness and feasibility of transradial approach for primary, emergency percutaneous coronary intervention （PCI） in patients with acute myocardial infarction （AMI）. Methods One hund...Objectives To evaluate the effectiveness and feasibility of transradial approach for primary, emergency percutaneous coronary intervention （PCI） in patients with acute myocardial infarction （AMI）. Methods One hundred and ninety five patients with AMI undergone primary PCI were randomized into two groups using different catheter insertion pathways ： 105 cases by transfemoral approach and 90 cases by transradial approach. We compared data of different operating approaches in terms of success rate of access, cannulation time, the time from local anesthesia to the first balloon inflation, the total procedure time, success rate of PCI, access site complications, total duration of hospitalization, and the clinical outcomes at six-month follow-up. Results The success rate of artery puncture, cannulation time, and the time from local anesthesia to the first balloon inflation in the transradial and transfemoral groups were 98.9 % vs 100 % （P 〉0. 05）, 3.15 ± 1.56 minutes vs 2. 86 ± 0.97 minutes （P 〉0. 05）, and 18.56 ± 4. 37 minutes vs 17.75± 3.21 minutes （P 〉 0. 05 ）, respectively. Although the total procedure time was significantly shorter in the transfemoral group （27.89 ± 3.95 minutes） than in the transradial group （29.75 ±4. 38 minutes） （P 〈0. 05）, the overall PCI success rate was similar between the two groups （96.2 % vs 96. 7 % ）. Use of the transradial approach was associated with fewer access site complications （ 2. 2 % vs 11.4 %, P 〈 0. 05 ） and a shorter length of hospital stay （ 10. 6 days vs 13.8 days, P 〈 0. 05 ）. At six-month follow-up, the cumulative cardiac event-free survival rate was 86. 1% and 86. 4% （P 〉 0. 05 ）, respectively, in the transradial and transfemoral groups. Conclusions Transradial approach achieved similar effectiveness as transfemoral approach in emergency PCI. However, the use of the transradial approach decreased access complications and hospital stay. Primary PCI via transradial approach is safe, effective, and feasible in patients with AMI.展开更多
Objective:To analyze the effect of solution-focused approach on advanced schistosomiasis(AS).Methods:10 cases of patients with AS that were treated with a solution-focused approach were included in our study.The indic...Objective:To analyze the effect of solution-focused approach on advanced schistosomiasis(AS).Methods:10 cases of patients with AS that were treated with a solution-focused approach were included in our study.The indicators before and after the intervention were measured(knowledge mastery,prevention and treatment compliance,personal behavior,self-care ability,management satisfaction,complication rate).Results:After analyzing pre-and post-intervention indicators,statistical significance was found(P<0.05).The intervention received a satisfaction rate of 80.00%,with a complication rate of 10.00%.Conclusion:Using a solution-focused approach for ankylosing spondylitis(AS)patients can enhance their understanding and attitude toward disease prevention and treatment,improve their behaviors and self-care ability,resulting in high satisfaction and reduced complications.展开更多
This paper describes the current status of percutaneous coronary intervention (PCI) for totally occluded coronary arteries. Chronic total occlusion is associated with 10%-20% of all PCI procedures. Results show that o...This paper describes the current status of percutaneous coronary intervention (PCI) for totally occluded coronary arteries. Chronic total occlusion is associated with 10%-20% of all PCI procedures. Results show that opening an occluded vessel, especially one supplying a considerable area of myocardium, may be beneficial for a patient's angina relief and heart function. We describe the devices used currently in re-canalization such as new wires, microcatheters (including Tonus and Cosair) and intravascular ultrasound guidance. Different techniques to improve the success rate and reduce complications are discussed in detail.展开更多
AIM： Pancreatic pseudocysts （PPC） as a complication of pancreatitis are approached only in the case of abdominal pain, infection, bleeding, and compression onto the gastrointestinal tract or biliary tree. METHODS：...AIM： Pancreatic pseudocysts （PPC） as a complication of pancreatitis are approached only in the case of abdominal pain, infection, bleeding, and compression onto the gastrointestinal tract or biliary tree. METHODS： From 02/01/2002 to 05/31/2004, all con- secutive patients with symptomatic PPC who underwent an interventional endoscopic approach were evaluated in this pilot case-series study： Group （Gr.） Ⅰ-Primary percutaneous （external）, ultrasound-guided drainage. Gr. Ⅱ- Primary EUS-guided cystogastrostomy. Gr. Ⅲ-EUS-guided cystogastrostomy including intracystic necrosectomy. RESULTS： （=＂follow up＂： n = 27）： Gr. Ⅰ （n = 9; 33.3%）： No complaints （n = 3）; change of an external into an internal drainage （n = 4）; complications： （a） bleeding （n = 1） followed by 3 d at ICU, discharge after 40 d; （b） septic shock （n = 1） followed by ICU and several laparotomies for programmed lavage and necrosectomy, death after 74 d. Gr. Ⅱ （n = 13; 48.1%）： No complaints （n = 11）; external drainage （n = 2）; complications/problems out of the 13 cases： 2nd separate pseudocyst （n = 1） with external drainage （since no communication with primary internal drainage）; infection of the residual cyst （n = 1） ＋ following external drainage; spontaneous PPC perforation （n = 1） ＋ following closure of the opening of the cystogastrostomy using clips and subsequently ICU for 2 d. Gr. Ⅲ （n = 5; 18.5%）： No complaints in all patients, in average two endoscopic procedures required （range, 2-6）. CONCLUSION： Interventional endoscopic management of pancreatic pseudocysts is a reasonable alternative treatment option with low invasiveness compared to surgery and an acceptable outcome with regard to the complication rate （11.1%） and mortality （3.7%）, as shown by these initial study results.展开更多
A number of prominent solution-focused brief therapists have expressed the view that, to its detriment, this school of therapy tends to downplay emotion. Accordingly, we contend that, given that emotion is a primal bi...A number of prominent solution-focused brief therapists have expressed the view that, to its detriment, this school of therapy tends to downplay emotion. Accordingly, we contend that, given that emotion is a primal binding force, the bonding component of the crucially important therapeutic alliance risks being compromised in the current practice of this approach. We further argue that the prioritization of the depiction of actions that accompany the emotion expressed by the client over the actual participation in this emotion by the therapist tends to superficialize therapeutic communication. This is especially likely to happen when the therapist lapses into a formulaic, action-soliciting interrogatory mode in response to the emotion expressed by the client. In addition, we claim that the incorporation of emotion- and body-based approaches into the solution-focused canon could remedy the affective lacuna referred to above. We note, however, that such a modification would most likely face stiff resistance from some of the gatekeepers of solution-faced therapy, in particular those who subscribe to the “surface-only” descriptive approach advocated by the philosopher Ludwig Wittgenstein. And yet, the effectiveness of depth-oriented therapies, such as sensorimotor psychotherapy and somatic experiencing, is supported by neurophysiological considerations. Finally, we suggest that these therapies, and even creativogenic elements of psychoanalysis, can actually synergize solution-focused brief therapy through the generation of affect-laden images, sensations and thoughts that lend themselves to the realization of outcomes desired by the client, which is the raison d’etre of solution-focused brief therapy. This paper pleads for the incorporation of the above-noted depth approaches into solution-focused brief therapy with a view to augmenting its effectiveness through a stronger therapeutic bond owing to an increased emotional engagement on the part of the therapist.展开更多
Objective: To analyze the impact of motivational nursing under the solution-focused approach on health behaviors in surgical care for bladder cancer patients. Methods: A sample of 72 bladder cancer patients who underw...Objective: To analyze the impact of motivational nursing under the solution-focused approach on health behaviors in surgical care for bladder cancer patients. Methods: A sample of 72 bladder cancer patients who underwent surgical treatment from September 2024 to September 2025 was randomly divided into groups using a random number table. Group A received motivational nursing under the solution-focused approach, while Group B received conventional nursing. Health behavior scores and complication indicators were compared between the two groups. Results: Group A had higher scores on the Health-Promoting Lifestyle Profile II (HPLP-Ⅱ) than Group B, with p < 0.05. The postoperative complication rate in Group A was lower than that in Group B, with p < 0.05. Conclusion: For bladder cancer patients undergoing surgery, receiving motivational nursing under the solution-focused approach can improve health behaviors, alleviate negative emotions, and is highly feasible and effective.展开更多
Colorectal anastomotic leakage(CAL) remains a major complication after colorectal surgery. Despite all efforts during the last decades, the incidence of CAL has not decreased. In this review, we summarize the availabl...Colorectal anastomotic leakage(CAL) remains a major complication after colorectal surgery. Despite all efforts during the last decades, the incidence of CAL has not decreased. In this review, we summarize the available strategies regarding prevention, prediction and intervention of CAL and categorize them into three categories: communication, infection and healing disturbances. These three major factors actively interact during the onset of CAL. We aim to provide an integrated approach to CAL based on its etiology. The intraoperative air leak test, intraoperative endoscopy, radiological examinations and stoma construction mainly aim to detect and to prevent communication between the intra- and extra-luminal content. Other strategies including postoperative drainage, antibiotics, and infectious-parameter evaluation are intended to detect and prevent anastomotic or peritoneal infection. Most currently available interventions for CAL focus on the control of communication and infection, while strategies targeting the healing disturbances such as lifestyle changes, oxygen therapy and evaluation of metabolic biomarkers still lack wide clinical application. This simplified categorization may contribute to an integrated understanding of CAL. We strongly believe that this integrated approach should be taken into consideration during clinical practice. An integrated approach to CAL could contribute to a better understanding of the etiology of CAL and eventually better patient outcome.展开更多
目的评价健康行动过程取向(health action process approach,HAPA)理论联合正念减压干预康复手段对直肠癌放化疗患者的康复效果,为临床康复方案提供循证依据。方法检索中国知网(China national knowledge infrastructure,CNKI)、维普中...目的评价健康行动过程取向(health action process approach,HAPA)理论联合正念减压干预康复手段对直肠癌放化疗患者的康复效果,为临床康复方案提供循证依据。方法检索中国知网(China national knowledge infrastructure,CNKI)、维普中文科技期刊数据库、WanFang、中国生物医学文献数据库(Chinese biomedical literature database,CBM)、PubMed、Embase、Cochrane Library共7个大数据库及中国临床试验注册中心、美国临床试验注册中心,纳入采用HAPA理论联合正念减压干预治疗直肠癌放化疗患者的随机对照试验,检索时限为建库至2024年7月,对符合纳入标准的文献进行Meta分析。结果本研究共纳入28篇文献,其中相比于西药常规护理,采用HAPA理论联合正念减压干预对Meta分析结果的贡献最大,贡献度为25.0%。在临床总有效率方面的Meta分析结果比较,HAPA理论联合正念减压干预优于单纯HAPA理论干预(95%CI为1.45~2.49)、单纯正念减压(95%CI为1.65~2.99)及西药常规护理(95%CI为3.65~6.36)。针对连续性结局指标,以标准化均数差(standardized mean difference,SMD)为效应量分析:相比于西药常规护理,HAPA理论联合正念减压干预在生活质量、癌因性疲劳、焦虑抑郁以及睡眠障碍改善率的连续性指标中的效应量最优(SMD=-1.82、-1.65、-1.73、-1.69、-1.58,均P<0.05)。不同干预措施的临床总有效率的累积排序曲线下面积(surface under the cumulative ranking curve,SUCRA)排序为:HAPA理论联合正念减压干预(91.30%)>单纯HAPA理论干预(65.70%)>单纯正念减压(52.40%)>西药常规护理(30.60%)。结论HAPA理论联合正念减压的干预方案对直肠癌放化疗患者的康复效果均优于单一干预措施及西药常规护理,可作为临床优选康复方案。展开更多
Objectives: To evaluate the feasibility, efficiency, and safety of the transradial approach(TRA) for cerebral angiography versus the transfemoral approach(TFA) in patients.Methods: In this trial, 2314 patients underwe...Objectives: To evaluate the feasibility, efficiency, and safety of the transradial approach(TRA) for cerebral angiography versus the transfemoral approach(TFA) in patients.Methods: In this trial, 2314 patients underwent cerebral angiography, with 1085 patients undergoing the procedure via radial access and 1229 via transfemoral access. The arterial puncture time, operation success rate,oppression time on puncture points, local vascular complication incidence(including bleeding, hematoma, and pseudoaneurysm), deep venous thrombosis of lower limbs(DVT), and bradycardia/hypotension were observed and compared between the two groups.Results: Of the patients who underwent cerebral angiography via radial access, the procedure was successful in1070 patients;compared with 1219 patients with transfemoral access, there was no significant difference(P > 0.05) in the success rate or the arterial puncture time. Radial access patients were less likely to present with oppression time on puncture points, local vascular complications, DVT, and bradycardia/hypotension compared with femoral access patients.Conclusions: For patients undergoing cerebral angiography, radial and femoral approaches are both safe and effective. However, the lower rate of local vascular complications may be a reason to use the radial approach.展开更多
In the evolving landscape of cardiac rehabilitation(CR),adopting digital technologies,including synchronous/real-time digital interventions and smart applications,has emerged as a transformative approach.These technol...In the evolving landscape of cardiac rehabilitation(CR),adopting digital technologies,including synchronous/real-time digital interventions and smart applications,has emerged as a transformative approach.These technologies offer realtime health data access,continuous vital sign monitoring,and personalized educational enhanced patient self-management and engagement.Despite their potential benefits,challenges and limitations exist,necessitating careful consideration.Synchronous/real-time digital CR involves remote,two-way audiovisual communication,addressing issues of accessibility and promoting home-based interventions.Smart applications extend beyond traditional healthcare,providing real-time health data and fostering patient empowerment.Wearable devices and mobile apps enable continuous monitoring,tracking of rehabilitation outcomes,and facilitate lifestyle modifications crucial for cardiac health maintenance.As digital CR progresses,ensuring patient access,equitable implementation,and addressing the digital divide becomes paramount.Artificial intelligence holds promise in the early detection of cardiac events and tailoring patient-specific CR programs.However,challenges such as digital literacy,data privacy,and security must be addressed to ensure inclusive implementation.Moreover,the shift toward digital CR raises concerns about cost,safety,and potential depersonalization of therapeutic relationships.A transformative shift towards technologically enabled CR necessitates further research,focusing not only on technological advancements but also on customization to meet diverse patient needs.Overcoming challenges related to cost,safety,data security,and potential depersonalization is crucial for the widespread adoption of digital CR.Future studies should explore integrating moral values into digital therapeutic relationships and ensure that digital CR is accessible,equitable,and seamlessly integrated into routine cardiac care.Theoretical frameworks that accommodate the dynamic quality of real-time monitoring and feedback feature of digital CR interventions should be considered to guide intervention development.展开更多
基金Fundamental Research Funds for the Central Universities,Beijing Electronic Science and Technology Institute“Research on the Model of Building a Positive Academic Atmosphere in Universities Under the Framework of Comprehensive Moral,Intellectual,Physical,Aesthetic,and Labor Education”(Grant No.3282024036)。
文摘Contemporary university students are confronted with multiple challenges,including academic pressure,employment anxiety,and interpersonal conflicts.Traditional approaches to heart-to-heart talks often exhibit limitations,such as“over-reliance on problem etiology”and“the marginalization of student agency,”which hinder their effectiveness in addressing students’individualized needs and enhancing the efficacy of counselors’work.Grounded in the solution-focused approach(SFA),this study employs a literature review methodology to systematically examine the core tenets of SFA-namely,its“solution-oriented perspective”and emphasis on“accumulating small changes”-as well as key techniques such as empowerment-oriented questioning and action reinforcement.Integrating these elements with the specific context of university counseling dialogues,the paper constructs a three-stage application framework encompassing“pre-session preparation,in-session implementation,and post-session follow-up.”This framework is designed to enhance the pertinence and effectiveness of heart-to-heart talks by clarifying conversation goals,focusing on student resources,detailing action steps,and reinforcing outcomes.It aims to provide counselors with actionable guidance while also offering interdisciplinary theoretical support for improving the quality of ideological and political education and mental health counseling in universities.Ultimately,the framework seeks to strengthen students’agency and autonomous problem-solving capabilities.
基金support from the Editorial Department of the Journal of Nanjing Medical Univrsity
文摘Objective： To evaluate the efficacy and feasibility of the transradial approach for primary percutaneous coronary intervention （PCI） in patients with acute myocardial infarction（AMI）. Methods： 195 patients with acute myocardial infarction were randomly divided into two groups according to the different PCI operation pathways. 105 cases were assigned to the transfemoral artery group and 90 cases to the transradial artery group. We analyzed the data from the two groups, including the achievement ratio of paracentesis, cannulation time, the time from local anesthesia to the first time balloon inflation, the time of the total procedure, achievement ratio of PCI, incidence rate of vascular complications, total duration of hospitalization, and the six-month follow-up results in both groups. Results： Our results showed that the achier ement ratio of arteriopuncture, cannulafion time and the time from local anesthesia to the first time balloon inflation in the transradial and transfemoral groups were 98.9% vs. 100%, 3.15 ± 1.56min vs. 2.86 ± 0.97 min, and 18.56 ± 4.37 min vs. 17.75 ± 3.21 min, respectively. These differences between the two groups were not statistically significant. The total operating time was 29.75 ± 4.38 rain for the transradial group and 27.89 ± 3.95 min（P 〈 0.05） for the transfemoral group. The operation achievement ratio in the transradial group was 96.7%, and 96.2% in the transfemoral group. The incidence of puncture point complications was 2.2% in the transradial group and 11.4% in the transfemoral group, and this difference was significant. The duration of hospitalization was 10.56 ± 2.85 days for the transradial group and 13.78 ± 3.15 days（P 〈 0.05） for the transfemoral group. At the six-month follow-up, the rate of survival without cardiac event was 86.1% vs. 86.4% respectively in the transradial and transfemoral groups（P 〉 0.05）. Conclusion： The transradial approach was as effective as the transfemoral approach, and there were fewer puncture point complications as well as a shorter span of hospitalization in the transradial group. PCI via the transradial approach is safe, effective and feasible in patients with AMI.
文摘There are several interventions for malaria control in Latin America that are in line with the principles of the Ecohealth approach. The objective of this paper was to identify interventions for malaria control with elements from the Ecohealth approach to evidence guiding elements, limiting and facilitating factors and recommendations for future interventions. A literature search was performed in six databases： Medline, Scopus, Central, IS! Web of Knowledge, Embase and BVS-Lilacs. To complement this information, several researchers were asked to participate in in-depth interviews. Ten articles, 6 reports from 3 IDRC interventions and 1 report of the PAMAFRO project were identified. Interventions included different methodologies to help improve the environment and health of the population. Interviewees coincided in analyzing malaria as a complex disease. They argued about the importance of carrying-out partnerships with various stakeholders in order to achieve sustainability of the interventions. The Ecohealth approach implies dialogue between community and researchers; participation of different disciplines; active participation of the various stakeholders; creation and maintenance of strategic alliances in pursuit of sustainability and scaling up of interventions into public policy.
文摘 In this issue of the Journal of Geriatric Cardiology;Jing et al. showed off their near perfect results of percutaneous coronary interventions (PCI) through transfemoral approach (TFA) and transradial approach (TRA) in the elderly Chinese patients. All patients were older.than 60years of age, with an average of 67.……
文摘The objective of this work is to analyze the reasons why community health interventions in Africa do not consider multisectoral approaches. To achieve it, we perform a mini-review of health development policies and plans available online in seven countries from four regions of Sub-Saharan Africa. Thus, two main reasons have been highlighted. First, national strategic plans and policies for health development, in their formulation, neither sufficiently emphasize multisectoral approaches, nor sufficiently make these approaches operational in strategies and activities. Second, the mindset of health professionals due to their initial training orientation based on the biomedical approach, stands that disease is only a result of a physiological imbalance in the body;therefore, to restore health, such an imbalance only needs sophisticated procedures and interventions to be overcome. Such an orientation completely ignores the social, cultural and economic context in which the individual lives, which has an irretrievable influence on the health imbalance. However, health, influenced by the conditions in which people are conceived, born, grow, live, work and aged, cannot be effectively improved in a sustainable way without taking into account all these conditions. Whence the importance of approaches based on every sector of human activity that influences the living conditions.
文摘Objectives To evaluate the effectiveness and feasibility of transradial approach for primary, emergency percutaneous coronary intervention （PCI） in patients with acute myocardial infarction （AMI）. Methods One hundred and ninety five patients with AMI undergone primary PCI were randomized into two groups using different catheter insertion pathways ： 105 cases by transfemoral approach and 90 cases by transradial approach. We compared data of different operating approaches in terms of success rate of access, cannulation time, the time from local anesthesia to the first balloon inflation, the total procedure time, success rate of PCI, access site complications, total duration of hospitalization, and the clinical outcomes at six-month follow-up. Results The success rate of artery puncture, cannulation time, and the time from local anesthesia to the first balloon inflation in the transradial and transfemoral groups were 98.9 % vs 100 % （P 〉0. 05）, 3.15 ± 1.56 minutes vs 2. 86 ± 0.97 minutes （P 〉0. 05）, and 18.56 ± 4. 37 minutes vs 17.75± 3.21 minutes （P 〉 0. 05 ）, respectively. Although the total procedure time was significantly shorter in the transfemoral group （27.89 ± 3.95 minutes） than in the transradial group （29.75 ±4. 38 minutes） （P 〈0. 05）, the overall PCI success rate was similar between the two groups （96.2 % vs 96. 7 % ）. Use of the transradial approach was associated with fewer access site complications （ 2. 2 % vs 11.4 %, P 〈 0. 05 ） and a shorter length of hospital stay （ 10. 6 days vs 13.8 days, P 〈 0. 05 ）. At six-month follow-up, the cumulative cardiac event-free survival rate was 86. 1% and 86. 4% （P 〉 0. 05 ）, respectively, in the transradial and transfemoral groups. Conclusions Transradial approach achieved similar effectiveness as transfemoral approach in emergency PCI. However, the use of the transradial approach decreased access complications and hospital stay. Primary PCI via transradial approach is safe, effective, and feasible in patients with AMI.
文摘Objective:To analyze the effect of solution-focused approach on advanced schistosomiasis(AS).Methods:10 cases of patients with AS that were treated with a solution-focused approach were included in our study.The indicators before and after the intervention were measured(knowledge mastery,prevention and treatment compliance,personal behavior,self-care ability,management satisfaction,complication rate).Results:After analyzing pre-and post-intervention indicators,statistical significance was found(P<0.05).The intervention received a satisfaction rate of 80.00%,with a complication rate of 10.00%.Conclusion:Using a solution-focused approach for ankylosing spondylitis(AS)patients can enhance their understanding and attitude toward disease prevention and treatment,improve their behaviors and self-care ability,resulting in high satisfaction and reduced complications.
文摘This paper describes the current status of percutaneous coronary intervention (PCI) for totally occluded coronary arteries. Chronic total occlusion is associated with 10%-20% of all PCI procedures. Results show that opening an occluded vessel, especially one supplying a considerable area of myocardium, may be beneficial for a patient's angina relief and heart function. We describe the devices used currently in re-canalization such as new wires, microcatheters (including Tonus and Cosair) and intravascular ultrasound guidance. Different techniques to improve the success rate and reduce complications are discussed in detail.
文摘AIM： Pancreatic pseudocysts （PPC） as a complication of pancreatitis are approached only in the case of abdominal pain, infection, bleeding, and compression onto the gastrointestinal tract or biliary tree. METHODS： From 02/01/2002 to 05/31/2004, all con- secutive patients with symptomatic PPC who underwent an interventional endoscopic approach were evaluated in this pilot case-series study： Group （Gr.） Ⅰ-Primary percutaneous （external）, ultrasound-guided drainage. Gr. Ⅱ- Primary EUS-guided cystogastrostomy. Gr. Ⅲ-EUS-guided cystogastrostomy including intracystic necrosectomy. RESULTS： （=＂follow up＂： n = 27）： Gr. Ⅰ （n = 9; 33.3%）： No complaints （n = 3）; change of an external into an internal drainage （n = 4）; complications： （a） bleeding （n = 1） followed by 3 d at ICU, discharge after 40 d; （b） septic shock （n = 1） followed by ICU and several laparotomies for programmed lavage and necrosectomy, death after 74 d. Gr. Ⅱ （n = 13; 48.1%）： No complaints （n = 11）; external drainage （n = 2）; complications/problems out of the 13 cases： 2nd separate pseudocyst （n = 1） with external drainage （since no communication with primary internal drainage）; infection of the residual cyst （n = 1） ＋ following external drainage; spontaneous PPC perforation （n = 1） ＋ following closure of the opening of the cystogastrostomy using clips and subsequently ICU for 2 d. Gr. Ⅲ （n = 5; 18.5%）： No complaints in all patients, in average two endoscopic procedures required （range, 2-6）. CONCLUSION： Interventional endoscopic management of pancreatic pseudocysts is a reasonable alternative treatment option with low invasiveness compared to surgery and an acceptable outcome with regard to the complication rate （11.1%） and mortality （3.7%）, as shown by these initial study results.
文摘A number of prominent solution-focused brief therapists have expressed the view that, to its detriment, this school of therapy tends to downplay emotion. Accordingly, we contend that, given that emotion is a primal binding force, the bonding component of the crucially important therapeutic alliance risks being compromised in the current practice of this approach. We further argue that the prioritization of the depiction of actions that accompany the emotion expressed by the client over the actual participation in this emotion by the therapist tends to superficialize therapeutic communication. This is especially likely to happen when the therapist lapses into a formulaic, action-soliciting interrogatory mode in response to the emotion expressed by the client. In addition, we claim that the incorporation of emotion- and body-based approaches into the solution-focused canon could remedy the affective lacuna referred to above. We note, however, that such a modification would most likely face stiff resistance from some of the gatekeepers of solution-faced therapy, in particular those who subscribe to the “surface-only” descriptive approach advocated by the philosopher Ludwig Wittgenstein. And yet, the effectiveness of depth-oriented therapies, such as sensorimotor psychotherapy and somatic experiencing, is supported by neurophysiological considerations. Finally, we suggest that these therapies, and even creativogenic elements of psychoanalysis, can actually synergize solution-focused brief therapy through the generation of affect-laden images, sensations and thoughts that lend themselves to the realization of outcomes desired by the client, which is the raison d’etre of solution-focused brief therapy. This paper pleads for the incorporation of the above-noted depth approaches into solution-focused brief therapy with a view to augmenting its effectiveness through a stronger therapeutic bond owing to an increased emotional engagement on the part of the therapist.
文摘Objective: To analyze the impact of motivational nursing under the solution-focused approach on health behaviors in surgical care for bladder cancer patients. Methods: A sample of 72 bladder cancer patients who underwent surgical treatment from September 2024 to September 2025 was randomly divided into groups using a random number table. Group A received motivational nursing under the solution-focused approach, while Group B received conventional nursing. Health behavior scores and complication indicators were compared between the two groups. Results: Group A had higher scores on the Health-Promoting Lifestyle Profile II (HPLP-Ⅱ) than Group B, with p < 0.05. The postoperative complication rate in Group A was lower than that in Group B, with p < 0.05. Conclusion: For bladder cancer patients undergoing surgery, receiving motivational nursing under the solution-focused approach can improve health behaviors, alleviate negative emotions, and is highly feasible and effective.
文摘Colorectal anastomotic leakage(CAL) remains a major complication after colorectal surgery. Despite all efforts during the last decades, the incidence of CAL has not decreased. In this review, we summarize the available strategies regarding prevention, prediction and intervention of CAL and categorize them into three categories: communication, infection and healing disturbances. These three major factors actively interact during the onset of CAL. We aim to provide an integrated approach to CAL based on its etiology. The intraoperative air leak test, intraoperative endoscopy, radiological examinations and stoma construction mainly aim to detect and to prevent communication between the intra- and extra-luminal content. Other strategies including postoperative drainage, antibiotics, and infectious-parameter evaluation are intended to detect and prevent anastomotic or peritoneal infection. Most currently available interventions for CAL focus on the control of communication and infection, while strategies targeting the healing disturbances such as lifestyle changes, oxygen therapy and evaluation of metabolic biomarkers still lack wide clinical application. This simplified categorization may contribute to an integrated understanding of CAL. We strongly believe that this integrated approach should be taken into consideration during clinical practice. An integrated approach to CAL could contribute to a better understanding of the etiology of CAL and eventually better patient outcome.
文摘目的评价健康行动过程取向(health action process approach,HAPA)理论联合正念减压干预康复手段对直肠癌放化疗患者的康复效果,为临床康复方案提供循证依据。方法检索中国知网(China national knowledge infrastructure,CNKI)、维普中文科技期刊数据库、WanFang、中国生物医学文献数据库(Chinese biomedical literature database,CBM)、PubMed、Embase、Cochrane Library共7个大数据库及中国临床试验注册中心、美国临床试验注册中心,纳入采用HAPA理论联合正念减压干预治疗直肠癌放化疗患者的随机对照试验,检索时限为建库至2024年7月,对符合纳入标准的文献进行Meta分析。结果本研究共纳入28篇文献,其中相比于西药常规护理,采用HAPA理论联合正念减压干预对Meta分析结果的贡献最大,贡献度为25.0%。在临床总有效率方面的Meta分析结果比较,HAPA理论联合正念减压干预优于单纯HAPA理论干预(95%CI为1.45~2.49)、单纯正念减压(95%CI为1.65~2.99)及西药常规护理(95%CI为3.65~6.36)。针对连续性结局指标,以标准化均数差(standardized mean difference,SMD)为效应量分析:相比于西药常规护理,HAPA理论联合正念减压干预在生活质量、癌因性疲劳、焦虑抑郁以及睡眠障碍改善率的连续性指标中的效应量最优(SMD=-1.82、-1.65、-1.73、-1.69、-1.58,均P<0.05)。不同干预措施的临床总有效率的累积排序曲线下面积(surface under the cumulative ranking curve,SUCRA)排序为:HAPA理论联合正念减压干预(91.30%)>单纯HAPA理论干预(65.70%)>单纯正念减压(52.40%)>西药常规护理(30.60%)。结论HAPA理论联合正念减压的干预方案对直肠癌放化疗患者的康复效果均优于单一干预措施及西药常规护理,可作为临床优选康复方案。
文摘Objectives: To evaluate the feasibility, efficiency, and safety of the transradial approach(TRA) for cerebral angiography versus the transfemoral approach(TFA) in patients.Methods: In this trial, 2314 patients underwent cerebral angiography, with 1085 patients undergoing the procedure via radial access and 1229 via transfemoral access. The arterial puncture time, operation success rate,oppression time on puncture points, local vascular complication incidence(including bleeding, hematoma, and pseudoaneurysm), deep venous thrombosis of lower limbs(DVT), and bradycardia/hypotension were observed and compared between the two groups.Results: Of the patients who underwent cerebral angiography via radial access, the procedure was successful in1070 patients;compared with 1219 patients with transfemoral access, there was no significant difference(P > 0.05) in the success rate or the arterial puncture time. Radial access patients were less likely to present with oppression time on puncture points, local vascular complications, DVT, and bradycardia/hypotension compared with femoral access patients.Conclusions: For patients undergoing cerebral angiography, radial and femoral approaches are both safe and effective. However, the lower rate of local vascular complications may be a reason to use the radial approach.
基金Supported by The Ministry of Health,Czech RepublicConceptual Development of Research Organization,FNBr,No.65269705。
文摘In the evolving landscape of cardiac rehabilitation(CR),adopting digital technologies,including synchronous/real-time digital interventions and smart applications,has emerged as a transformative approach.These technologies offer realtime health data access,continuous vital sign monitoring,and personalized educational enhanced patient self-management and engagement.Despite their potential benefits,challenges and limitations exist,necessitating careful consideration.Synchronous/real-time digital CR involves remote,two-way audiovisual communication,addressing issues of accessibility and promoting home-based interventions.Smart applications extend beyond traditional healthcare,providing real-time health data and fostering patient empowerment.Wearable devices and mobile apps enable continuous monitoring,tracking of rehabilitation outcomes,and facilitate lifestyle modifications crucial for cardiac health maintenance.As digital CR progresses,ensuring patient access,equitable implementation,and addressing the digital divide becomes paramount.Artificial intelligence holds promise in the early detection of cardiac events and tailoring patient-specific CR programs.However,challenges such as digital literacy,data privacy,and security must be addressed to ensure inclusive implementation.Moreover,the shift toward digital CR raises concerns about cost,safety,and potential depersonalization of therapeutic relationships.A transformative shift towards technologically enabled CR necessitates further research,focusing not only on technological advancements but also on customization to meet diverse patient needs.Overcoming challenges related to cost,safety,data security,and potential depersonalization is crucial for the widespread adoption of digital CR.Future studies should explore integrating moral values into digital therapeutic relationships and ensure that digital CR is accessible,equitable,and seamlessly integrated into routine cardiac care.Theoretical frameworks that accommodate the dynamic quality of real-time monitoring and feedback feature of digital CR interventions should be considered to guide intervention development.
