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Psychosocial impact of partial or complete edentulism due to periodontal diseases among rural population of Tumkur district of Karnataka 卡纳塔克邦图姆库尔地区农村人口因牙周病而接受部分或全部补牙的社会心理影响
Pub Date : 2019-01-01 DOI: 10.15761/pmch.1000124
P. G., Subbaiah Sk, B. A, Joshipura V
Introduction: Periodontal diseases are one of the most prevalent oral diseases affecting more than 50% of Indian population. Untreated periodontitis is a major cause of tooth loss. In rural population of Tumkur (Karnataka), people live in closely knit large joint families. Partial edentulism at early age could affect marriages, performance at work, criticism from friends and family members and embarrassment at social gatherings. Objective: We started a cross-sectional study, for assessing the awareness about periodontal diseases and the psychosocial consequences of tooth loss due to periodontal diseases in rural population who visited Sri Siddhartha Dental College. Methodology: The study involved completion of a predesigned structured questionnaire formatted according psycho-social structure of Indian traditions and culture. It included multiple option questions to be filled up by patients. We screened 799 patients in 18-65 age groups. Results: The awareness about aggressive periodontitis was less, overall awareness was higher. 88% patients felt; they would have prevented the disease if there was access to economical dental care. 68% patients rated their oral health as bad, 59% did not want to marry partially edentulous person. 83% experienced criticism, 72% felt lower level of confidence and 77% felt quality of life being affected due to partial edentulism. Conclusion: Partial edentulism due to periodontal disease, especially in young patients, has high psychosocial impact on quality of life. Due to limited replacement options in these poor patients, prevention would give higher quality of life. *Correspondence to: Vaibhavi Joshipura, Intedent Healthcare Private Limited, India, Tel: 9880105198; E-mail: vaibhavi_joshipura@yahoo.co.in
牙周病是最普遍的口腔疾病之一,影响超过50%的印度人口。牙周炎未经治疗是牙齿脱落的主要原因。在图姆库尔(卡纳塔克邦)的农村人口中,人们生活在紧密结合的大家庭中。幼年部分长牙症可能会影响婚姻、工作表现、朋友和家人的批评以及社交场合的尴尬。目的:我们开始了一项横断面研究,以评估访问Sri Siddhartha牙科学院的农村人口对牙周病的认识和牙周病导致的牙齿脱落的社会心理后果。研究方法:该研究涉及根据印度传统和文化的心理社会结构完成预先设计的结构化问卷。它包括由患者填写的多个选项问题。我们筛选了799名18-65岁年龄组的患者。结果:患者对侵袭性牙周炎的认知度较低,但总体认知度较高。88%的患者感觉;如果能获得经济实惠的牙科护理,他们就能预防这种疾病了。68%的患者认为自己的口腔健康状况较差,59%的患者不愿与部分缺牙的人结婚。83%的人受到批评,72%的人感到信心下降,77%的人认为生活质量受到了部分假牙的影响。结论:牙周病引起的局部补牙,尤其是年轻患者,对生活质量有很高的社会心理影响。由于这些贫困患者的替代选择有限,预防可以提高生活质量。*通信:Vaibhavi Joshipura,印度intent Healthcare Private Limited,电话:9880105198;电子邮件:vaibhavi_joshipura@yahoo.co.in
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引用次数: 0
Contact phase of blood coagulation and thrombosis and hypertension: The conundrum has to be clarified 接触阶段的血液凝固和血栓形成与高血压:难题必须澄清
Pub Date : 2019-01-01 DOI: 10.15761/pmch.1000134
A. Girolami, S. Ferrari, E. Cosi
There is another peculiar observation with regard to PK deficiency: the large majority of thrombotic events concern the arterial system. As the matter of fact, the only venous thrombosis occurred in two sisters who, besides PK deficiency, showed also severe obesity [13]. On the contrary, these is no similar striking difference in FXII deficiency. It seems, in other words, that arterial thrombosis is probably associated with PK deficiency. This action seems mediated by the hypertension which has been frequently found in patients with PK deficiency [6].
关于钾代钾缺乏还有另一个特殊的观察结果:绝大多数血栓形成事件与动脉系统有关。事实上,仅有的静脉血栓形成发生在两姐妹身上,她们除了PK缺乏外,还表现出严重的肥胖。相反,在FXII缺乏中没有类似的显著差异。换句话说,动脉血栓形成可能与钾离子缺乏有关。这种作用似乎是由高血压介导的,而高血压在PK缺乏症患者中经常发现。
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引用次数: 0
Routine intraoperative cholangiography during laparoscopic cholecystectomy 腹腔镜胆囊切除术中常规术中胆道造影
Pub Date : 2019-01-01 DOI: 10.15761/pmch.1000137
L. Sebastiano, Massafra Roberto, M. Fabio
Objectives: The present study analyses the value of intraoperative cholangiography (IOC) performed in all patients during 22 years of surgical activity in three different Institutions and, as a result a continuous scientific concern on the matter, we developed a set of criteria that are analysed and discussed. Materials and methods: We studied the patients subjected to laparoscopic cholecystectomy in three hospitals between January 1995 and December 2017. A group of patients were analysed, IOC was performed in all cases. Results: we had a positive results of common bile duct stones (CBDS) unsuspected in more than 10%, a finding that changed surgical management of patient after IOC. This procedure required a median period of 10 minutes and there were no complications caused by IOC. Conclusions: Intraoperative cholangiography performed routinely represents an important tool in diagnosing unsuspected Common Bile Duct Stones (CBDS) during LC. This attitude has prevented further surgical treatment for all patients with asymptomatic biliary calculosis. *Correspondence to: Lacitignola Sebastiano, Contrada Sicarico 181/A, 70043 Monopoli , Italy, Tel: +39-330-840630; E-mail: lacitignola@libero.it Received: November 02, 2019; Accepted: November 24, 2019; Published: November 28, 2019 Introduction The asymptomatic stones of the common bile duct (CBD) represents, even today, a considerable challenge for the surgeon despite the progress made both in endoscopy and laparoscopy. Just over 10 years ago, 10% of patients with symptomatic calculosis and 15% of those with acute cholecystitis had stones in the common bile duct. With the laparoscopic procedure the patients had the advantage of a more immediate and faster approach to cholecystectomy with a consequent reduction of choledocholithiasis. Even when all procedures are feasible, there are some techniques preferred to others. If the patient had cholecystectomy it is unanimous opinion that the choledochal lithiasis must be treated endoscopically through endoscopic retrograde cholangiopancreatography (ERCP) with Endoscopic Sphincterotomy (ES) reserving surgery in case of failure (5-10%) [1]. If the gallbladder is “in situ” the treatment is controversial i.e. ERCP followed by laparoscopic cholecystectomy (LC). Another possibility is to perform the cholecystectomy and to remove the CBD stones through the laparoscopy or to abandon the stones with subsequent ERCP after LC. Many surgeons agree with these options in relation to their personal experience as well as the various protocols to be followed. Our personal tendency is to treat the CBDS in a single time using all the possible surgical strategies in our possession and this our attitude is also confirmed by the positive results obtained over the years. Materials and methods From January 1995 to December 2017 we were collected the data of 8918 patients undergoing LC for symptomatic lithiasis in three different Institutions. Routine Intraoperative Cholangiography (IO
目的:本研究分析术中胆道造影(IOC)在三家不同机构22年手术活动中对所有患者的价值,作为对该问题持续的科学关注的结果,我们制定了一套标准进行分析和讨论。材料与方法:选取1995年1月至2017年12月在三家医院行腹腔镜胆囊切除术的患者为研究对象。对一组患者进行分析,所有病例均行IOC。结果:我们在超过10%的患者中发现了未被怀疑的胆总管结石(CBDS)阳性结果,这一发现改变了IOC后患者的手术管理。该手术中位时间为10分钟,没有由IOC引起的并发症。结论:术中常规胆道造影是LC中诊断未怀疑的总胆管结石(CBDS)的重要工具。这种态度阻碍了所有无症状胆道结石患者的进一步手术治疗。*通信:Lacitignola Sebastiano, Contrada Sicarico 181/A, 70043 Monopoli, Italy,电话:+39-330-840630;邮箱:lacitignola@libero.it收稿日期:2019年11月02日;录用日期:2019年11月24日;尽管在内窥镜和腹腔镜检查方面取得了进展,但即使在今天,胆总管(CBD)的无症状结石对外科医生来说仍然是一个相当大的挑战。就在10多年前,10%的症状性结石患者和15%的急性胆囊炎患者在胆总管有结石。采用腹腔镜手术,患者的优点是更直接、更快地进行胆囊切除术,从而减少胆总管结石。即使所有的程序都是可行的,也有一些技术优于其他技术。如果患者行胆囊切除术,一致认为胆总管结石必须在内镜下通过内镜逆行胆管造影(ERCP)和内镜下括约肌切开术(ES)保留手术治疗,以防手术失败(5-10%)。如果胆囊“原位”,治疗方法是有争议的,即ERCP之后是腹腔镜胆囊切除术(LC)。另一种可能性是行胆囊切除术,通过腹腔镜切除CBD结石,或在LC后用ERCP放弃结石。许多外科医生根据他们的个人经验和需要遵循的各种方案同意这些选择。我们的个人倾向是使用我们所拥有的所有可能的手术策略在一次治疗CBDS,我们的态度也被多年来取得的积极结果所证实。材料与方法1995年1月至2017年12月,我们收集了三家不同机构8918例接受LC治疗的症状性结石患者的资料。术中常规胆道造影(IOC)成功8806例(98.8%)。在其余112例(1.2%)患者中,失败是由于技术困难。术前对CBDS的怀疑是基于患者的临床病史,考虑到血中胆红素(> 1.0 mg/dl)、碱性磷酸盐(>147 U/dl)、淀粉酶(>115 U/dl)或CBDS的超声记录或其直径大于7 mm,考虑可能出现黄疸或胰腺炎。如果这些元素都不存在,我们就考虑IOC例程。常见胆结石1631例(18.5%),术前诊断1458例(89.3%),围术期胆道造影发现173例(10.6%)。术前诊断为CBDS的1221例患者(86.7%)成功行ERCP合并ES。其余237例(16.2%)患者加上术中诊断为CBDS的患者接受手术治疗,见表1。所有患者均使用4-Fr导管进行手术胆道造影,并使用7-FR尺寸的纤维镜通过胆囊管或胆道切开术进行胆道镜检查,以确认胆管完全清除。随访6-12-24个月,未发现结石残留或复发。术后并发症报告2例拔除t管后胆囊瘤,均予保守治疗。未发现死亡率。
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引用次数: 1
Unmet needs in Italian cardiology: acute cardiovascular syndrome in the new multiethnic society 意大利心脏病学未满足的需求:新多民族社会中的急性心血管综合征
Pub Date : 2019-01-01 DOI: 10.15761/pmch.1000119
A. Sacco, N. Morici, Dario Brunelli, G. Viola, F. Oliva
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引用次数: 0
My retirement – An approach 我的退休——一种方法
Pub Date : 2019-01-01 DOI: 10.15761/pmch.1000131
Herbert Y Reynolds
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引用次数: 0
Nursing student engagement: Researching the journey and its potential impact on transitions to practice 护理学生参与:研究旅程及其对实践过渡的潜在影响
Pub Date : 2019-01-01 DOI: 10.15761/pmch.1000121
K. Hudson, Zhaomin He, R. Carrasco
Nursing student engagement fundamentally contributes toward quality student advancement and future quality nursing care. This research evaluates students’ perception of their nursing education and their commitment toward practice. The findings provide a background for the development of solid nursing practices with high scores of engagement, in both class and clinicals. The scores for stress management and coping were the lowest and further point to a greater learning need in this area. Currently doing very well with the learning content, they simultaneously are suffering with challenging emotional responses to this complex education. Stress management, coping, and resiliency sessions are now acutely highlighted as extremely important and necessary (for high quality nursing students’ long-term emotional and cognitive wellness). Students can be functioning at higher emotional levels longer with this supportive reinforcement. When this emotion protection is developed, and implemented, students will provide a stronger and more resilient future nursing workforce. *Correspondence to: Kathleen Hudson, University of Texas at Tyler, Longview University Center, USA, Tel: 903-240-7040, E-mail: KHudson@uttyler.edu
护理学生的参与从根本上有助于提高学生的素质和未来的护理质量。本研究评估学生对护理教育的认知及实践承诺。该研究结果为在课堂和临床中发展具有高参与度的坚实护理实践提供了背景。压力管理和应对方面的得分最低,进一步表明在这方面需要更多的学习。目前,他们在学习内容上做得很好,但同时,他们也在为这种复杂的教育带来的挑战性情绪反应而痛苦。压力管理、应对和恢复课程现在被强烈强调为极其重要和必要的(对于高质量护理学生的长期情感和认知健康)。有了这种支持性的强化,学生可以在更高的情感水平上工作更长时间。当这种情感保护得到发展和实施时,学生将提供一个更强大、更有弹性的未来护理队伍。*通讯:Kathleen Hudson,得克萨斯大学泰勒分校,朗维尤大学中心,美国,电话:903-2407040,E-mail: KHudson@uttyler.edu
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引用次数: 5
Nicotine degradation in smokers: will a new and potent enzymatic approach work where nicotine vaccines have failed? 吸烟者的尼古丁降解:在尼古丁疫苗失败的地方,一种新的有效的酶促方法会起作用吗?
Pub Date : 2019-01-01 DOI: 10.15761/pmch.1000120
C. V. Schayck, Bo Van Engelen, T. Thisted, M. Kalnik
Smoking and tobacco use continue to be the largest preventable causes of death. Although there are current pharmaceutical and behavioural therapies, the one-year sustained quit rate of these therapies is only 20-25% at best. Recently, an alternative biotherapeutic strategy has been proposed: enzymatic degradation of nicotine in the bloodstream preventing accumulation in the brain. The bacterial enzyme NicA2 oxidizes nicotine into pseudo-oxynicotine, a non-addictive compound already found in smokers. Proof-of-concept animal studies have shown that NicA2 can rapidly reduce the levels of nicotine accumulating in the brain after intravenous nicotine dosing, and NicA2 has shown to have efficacy in a continuous nicotine access self-administration rat model. Enzymatic elimination of nicotine upon smoke inhalation to combat tobacco addiction is an innovative therapeutic concept. However, it is in line with recent clinical studies demonstrating that reduction in nicotine content in cigarettes (to 2.5% of normal levels) lead to significant reduction in the number of cigarettes smoked and higher smoking cessation rates compared to a control group smoking normal nicotine level cigarettes. Enzymatic degradation of nicotine appears to be more potent than nicotine-specific antibodies or vaccines for reducing nicotine distribution to brain, and if this proves to be the case in humans, it could also be more effective for enhancing smoking cessation rates and succeed where nicotine vaccines have failed thus far. The work reviewed in this article constitutes promising initial steps towards an urgently needed new effective treatment strategy in smoking cessation therapy. *Correspondence to: van Schayk Onno, Maastricht University, Faculty of Health Medicine & Lifesciences, Maastricht, Netherlands, E-mail: onno.vanschayck@ maastrichtuniversity.nl Received: November 22, 2018; Accepted: December 14, 2018; Published: December 19, 2018 Introduction Smoking and tobacco use continue to be the largest preventable causes of death [1]. In 2015, approximately 6.4 million deaths were attributed to smoking worldwide. Although most smokers are aware of the health risks, smoking cessation is usually difficult to maintain. Current pharmacological therapies for smoking cessation combined with counselling have significant clinical effects compared to counselling alone [2]. However, only 20-25% of smokers remain abstinent for at least 1 year after treatment [3]. This fact means that new, more efficacious drugs need to be developed. Multiple meta-analyses have been conducted to investigate the pharmaceutical interventions for smoking cessation, and guidelines have been published by many organizations [2,4]. The first-line pharmacological therapy for smoking cessation are nicotine replacement products (patches, gums, inhalers, nasal sprays, tablets, and oral sprays). It evokes its effects by stimulating the nicotinic receptors in the ventral tegmental area of the brain releasing dopamine
吸烟和使用烟草仍然是可预防的最大死亡原因。虽然目前有药物和行为疗法,但这些疗法一年的持续戒烟率最多只有20-25%。最近,一种替代的生物治疗策略被提出:酶降解血液中的尼古丁,防止尼古丁在大脑中积累。细菌酶NicA2将尼古丁氧化为伪氧尼古丁,这是一种在吸烟者体内发现的不会上瘾的化合物。概念验证动物研究表明,NicA2可以迅速降低静脉给药后尼古丁在大脑中积累的水平,并且NicA2在连续尼古丁获取自我给药大鼠模型中显示出有效性。酶消除尼古丁吸入对抗烟草成瘾是一个创新的治疗概念。然而,最近的临床研究表明,与吸烟尼古丁水平正常的对照组相比,香烟中尼古丁含量的减少(降至正常水平的2.5%)导致吸烟数量的显著减少和更高的戒烟率。在减少尼古丁在大脑中的分布方面,酶对尼古丁的降解似乎比尼古丁特异性抗体或疫苗更有效,如果这在人类中被证明是如此,它也可能更有效地提高戒烟率,并在尼古丁疫苗迄今为止失败的地方取得成功。本文综述的工作构成了戒烟治疗中迫切需要的新的有效治疗策略的有希望的初步步骤。*通信:van Schayk Onno,马斯特里赫特大学卫生医学与生命科学学院,荷兰,马斯特里赫特,E-mail: Onno。vanschayck@ maastricht大学。收稿日期:2018年11月22日;录用日期:2018年12月14日;吸烟和烟草使用仍然是最大的可预防的死亡原因。2015年,全世界约有640万人死于吸烟。虽然大多数吸烟者都意识到吸烟的健康风险,但戒烟通常很难坚持。目前的戒烟药物治疗结合咨询与单独咨询相比有显著的临床效果[10]。然而,只有20-25%的吸烟者在治疗后至少1年内保持戒烟。这一事实意味着需要开发新的、更有效的药物。已经进行了多项荟萃分析来调查戒烟的药物干预措施,许多组织也发表了指南[2,4]。戒烟的一线药物治疗是尼古丁替代产品(贴片、齿龈、吸入器、鼻喷雾剂、片剂和口服喷雾剂)。它通过刺激大脑腹侧被盖区的烟碱受体,在伏隔核释放多巴胺来发挥其作用。NRT可以减少想要戒烟的吸烟者的戒断症状。伐尼克兰作为nACh受体的部分激动剂也释放多巴胺[6]。此外,安非他酮,一种三环抗抑郁药,可用于戒烟治疗。它抑制多巴胺、去甲肾上腺素和血清素在中枢神经系统的再摄取,是一种非竞争性尼古丁受体拮抗剂。抑制多巴胺和去甲肾上腺素的水平被认为是安非他酮具有戒烟作用的重要原因。瓦伦尼克兰和安非他酮通常是处方,使用2-3个月后,与安慰剂相比,戒烟率增加了一倍。此外,应给予辅导,以帮助戒烟。由全科医生提供的简单建议可使戒烟率增加2-3%。戒烟就是打破一种复杂的习惯和成瘾,要达到合理的戒烟率,就必须提供心理支持并结合药物治疗。然而,即使采用最佳药物治疗,也只有20-25%的吸烟者在治疗后至少1年内保持戒烟。这意味着需要开发新的治疗方法。作为基于小分子的治疗方法的一种替代方法,在过去的三十年中,人们对戒烟的免疫治疗方法和尼古丁疫苗进行了研究。研究人员表明,有可能将精神活性药物(如可卡因、海洛因或尼古丁)与载体蛋白连接或结合,从而使这些小分子具有抗原性。这项工作导致了一种假设,即有可能开发出可以预防或治疗这些药物成瘾的疫苗。提出的作用机制是疫苗引发的抗体在外围靶向并捕获药物,减少到达大脑的浓度并减少其强化作用。 吸烟和使用烟草仍然是可预防的最大死亡原因。虽然目前有药物和行为疗法,但这些疗法一年的持续戒烟率最多只有20-25%。最近,一种替代的生物治疗策略被提出:酶降解血液中的尼古丁,防止尼古丁在大脑中积累。细菌酶NicA2将尼古丁氧化为伪氧尼古丁,这是一种在吸烟者体内发现的不会上瘾的化合物。概念验证动物研究表明,NicA2可以迅速降低静脉给药后尼古丁在大脑中积累的水平,并且NicA2在连续尼古丁获取自我给药大鼠模型中显示出有效性。酶消除尼古丁吸入对抗烟草成瘾是一个创新的治疗概念。然而,最近的临床研究表明,与吸烟尼古丁水平正常的对照组相比,香烟中尼古丁含量的减少(降至正常水平的2.5%)导致吸烟数量的显著减少和更高的戒烟率。在减少尼古丁在大脑中的分布方面,酶对尼古丁的降解似乎比尼古丁特异性抗体或疫苗更有效,如果这在人类中被证明是如此,它也可能更有效地提高戒烟率,并在尼古丁疫苗迄今为止失败的地方取得成功。本文综述的工作构成了戒烟治疗中迫切需要的新的有效治疗策略的有希望的初步步骤。*通信:van Schayk Onno,马斯特里赫特大学卫生医学与生命科学学院,荷兰,马斯特里赫特,E-mail: Onno。vanschayck@ maastricht大学。收稿日期:2018年11月22日;录用日期:2018年12月14日;吸烟和烟草使用仍然是最大的可预防的死亡原因。2015年,全世界约有640万人死于吸烟。虽然大多数吸烟者都意识到吸烟的健康风险,但戒烟通常很难坚持。目前的戒烟药物治疗结合咨询与单独咨询相比有显著的临床效果[10]。然而,只有20-25%的吸烟者在治疗后至少1年内保持戒烟。这一事实意味着需要开发新的、更有效的药物。已经进行了多项荟萃分析来调查戒烟的药物干预措施,许多组织也发表了指南[2,4]。戒烟的一线药物治疗是尼古丁替代产品(贴片、齿龈、吸入器、鼻喷雾剂、片剂和口服喷雾剂)。它通过刺激大脑腹侧被盖区的烟碱受体,在伏隔核释放多巴胺来发挥其作用。NRT可以减少想要戒烟的吸烟者的戒断症状。伐尼克兰作为nACh受体的部分激动剂也释放多巴胺[6]。此外,安非他酮,一种三环抗抑郁药,可用于戒烟治疗。它抑制多巴胺、去甲肾上腺素和血清素在中枢神经系统的再摄取,是一种非竞争性尼古丁受体拮抗剂。抑制多巴胺和去甲肾上腺素的水平被认为是安非他酮具有戒烟作用的重要原因。瓦伦尼克兰和安非他酮通常是处方,使用2-3个月后,与安慰剂相比,戒烟率增加了一倍。此外,应给予辅导,以帮助戒烟。由全科医生提供的简单建议可使戒烟率增加2-3%。戒烟就是打破一种复杂的习惯和成瘾,要达到合理的戒烟率,就必须提供心理支持并结合药物治疗。然而,即使采用最佳药物治疗,也只有20-25%的吸烟者在治疗后至少1年内保持戒烟。这意味着需要开发新的治疗方法。作为基于小分子的治疗方法的一种替代方法,在过去的三十年中,人们对戒烟的免疫治疗方法和尼古丁疫苗进行了研究。研究人员表明,有可能将精神活性药物(如可卡因、海洛因或尼古丁)与载体蛋白连接或结合,从而使这些小分子具有抗原性。这项工作导致了一种假设,即有可能开发出可以预防或治疗这些药物成瘾的疫苗。提出的作用机制是疫苗引发的抗体在外围靶向并捕获药物,减少到达大脑的浓度并减少其强化作用。 尼古丁结合疫苗在临床前显示出早期的希望,但未能证明广泛的临床应用van Schayck OCP(2018)吸烟者的尼古丁降解:在尼古丁疫苗失败的地方,一种新的有效的酶促方法会起作用吗?卷1(4):2-4预防医学和公共卫生,2018 doi: 10.15761/PMCH。大型临床随机对照试验的有效性[10,11]。虽然在达到最高抗尼古丁抗体滴度的个体中观察到更高的疗效[10-12],表明抗体介导的戒烟策略可能起作用,但抗体水平通常太低且变化太大,无法产生临床相关的结果bbb。从本质上讲,挑战在于缺乏足够的能力来改变尼古丁的药代动力学,以消除其对广大吸烟者的强化
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引用次数: 0
After VITAL study: Is Vitamin D supplementation necessary? VITAL研究后:补充维生素D是必要的吗?
Pub Date : 2019-01-01 DOI: 10.15761/pmch.1000128
R. Sakamoto
Received: September 01, 2019; Accepted: September 16, 2019; Published: September 20, 2019 Informing the public about Vitamin D, its benefits, particularly its protective effects against non-skeletal chronic illnesses such as that of cardiovascular and cancer effects remains challenging and confusing [1]. The recent Vitamin D and Omega-3 fatty acid (VITAL) study results, a Randomized Clinical Trial (RCT) [2] has further thrown the public in mistrusting vitamin D supplementation. I hear patients and practitioners alike stating: “vitamin D does not work” perhaps because they equate the negative findings of the VITAL study to mean that vitamin D (cholecalciferol) supplementation is not effective at all. Such misunderstanding could lead to stepping backwards from what the scientific society has long proven the science behind Vitamin D’s effects. Hence, the purpose of this commentary is to discuss weaknesses in the VITAL’s study that could assist healthcare practitioners’ hence, the population they serve on vitamin D supplementation.
收稿日期:2019年9月01日;录用日期:2019年9月16日;向公众宣传维生素D及其益处,特别是其对心血管和癌症等非骨骼慢性疾病的保护作用,仍然具有挑战性和令人困惑。最近的维生素D和Omega-3脂肪酸(VITAL)研究结果,一项随机临床试验(RCT) b[2]进一步使公众不信任维生素D补充剂。我听到病人和医生都说:“维生素D不起作用”,也许是因为他们把VITAL研究的负面结果等同于补充维生素D(胆钙化醇)根本没有效果。这种误解可能会导致科学社会长期以来证明维生素D作用背后的科学的倒退。因此,这篇评论的目的是讨论VITAL研究的弱点,这可以帮助医疗从业者,因此,他们所服务的人群补充维生素D。
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引用次数: 0
Developing a Public Health Pipeline: Key Components of a Public Health Leadership Program. 发展公共卫生管道:公共卫生领导计划的关键组成部分。
Pub Date : 2018-06-01 Epub Date: 2018-06-07 DOI: 10.15761/PMCH.1000110
Alina L Flores, Kristina Risley, Kenneth Quintana

Thirty percent of federal public health employees were retirement eligible in September 2017. Further, at the state public health level, as indicated in the recent Public Health Workforce Interests and Needs Survey (PH WINS), an estimated 25% of employees are planning to retire before 2020 with an additional 18% intending to leave their organizations within one year. Due to these workforce changes, there is an urgent need for public health organizations to examine how they are ensuring a talent pool from which leaders can emerge. As a large federal public health agency, the Centers for Disease Control and Prevention (CDC) faces the challenge of providing leadership development to staff. Factors were examined that agency leaders identified as key components of a leadership development program to transition scientific public health staff into supervisory leadership roles. While many factors contribute to leadership development, participants more often identified training, provision of opportunities, mentors, and identification of high potential employees as key components of a leadership develop program. With the need to develop organizational leaders to be ready when vacancies become available, findings from this study can inform the development and implementation of public health leadership development programs.

2017年9月,30%的联邦公共卫生雇员符合退休条件。此外,在州公共卫生一级,最近的公共卫生工作人员兴趣和需求调查(phwins)表明,估计有25%的员工计划在2020年之前退休,另有18%的员工打算在一年内离开他们的组织。由于这些员工队伍的变化,公共卫生组织迫切需要检查他们如何确保人才库能够产生领导者。作为一个大型的联邦公共卫生机构,疾病控制与预防中心(CDC)面临着为员工提供领导力发展的挑战。审查了机构领导人确定为领导能力发展计划的关键组成部分的因素,以将科学公共卫生人员转变为监督领导角色。虽然有许多因素有助于领导力发展,但参与者通常认为培训、提供机会、导师和识别高潜力员工是领导力发展计划的关键组成部分。由于需要培养组织领导者,以便在空缺出现时做好准备,本研究的结果可以为公共卫生领导力发展计划的制定和实施提供信息。
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引用次数: 1
期刊
Preventive medicine and community health
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