الملخص
Objective:To explore the impact of health self-focused attention on knowledge, attitude and practice of health management in patients with essential hypertension.Methods:This was a cross-sectional study. A total of 190 patients with essential hypertension were randomly selected from Shanghai Dapuqiao Community Health Service Center to participate in a questionnaire survey from October to December, 2021. The contents of the questionnaire included the general information of the patients, the degree of influence of hypertension on individuals, and the patients′ knowledge and personal cognition of hypertension, self-management behaviors, health self-focused attention, and blood pressure control. SPSS 25.0 and AMOS 24.0 were used to develop a structural equation model for analysis.Results:The recovery rate of questionnaires was 100.0% (190/190). Of the 190 patients, there were 82 males and 108 females with a mean age of (71.2±8.5) years. According to blood pressure, 190 hypertensive patients were divided into blood pressure controlled group ( n=119) and blood pressure non-controlled group ( n=71). There were significant differences in the total scores of hypertension self-management behavior and health self-focused attention between the two groups ( P<0.05). Correlation analysis showed that the degree of influence of hypertension on individuals was negatively correlated with the disease knowledge and personal cognition, and the performance of hypertension self-management behavior ( r=-0.39 and -0.28, P<0.01), while the disease knowledge and personal cognition were positively correlated with the performance of hypertension self-management behavior and health self-focused attention ( r=0.29 and 0.27, P<0.01). Hypertension self-management behavior was positively correlated with health self-focused attention and blood pressure control ( r=0.28 and 0.48, P<0.01), and health self-focused attention was positively correlated with blood pressure control ( r=0.21, P<0.01). The equation model analysis showed that health self-focused attention had a driving effect on patients′ disease knowledge and cognition and self-management behavior. Health self-focused attention significantly affected patients′ mastery of disease knowledge and formation of correct cognition (path coefficient=0.28). In addition, hypertension patients′ disease knowledge storage and internal recognition of prevention and treatment strategies determined their self-management behavior (path coefficient=0.20). On the other hand, the impact of hypertension on patients life, work and economic burden played a negative role in their acceptance of disease management knowledge, formation of correct concepts, and adoption of self-management behaviors with adjustment coefficients of -0.48 and -0.22, respectively. Conclusion:Health self-focused attention may play an initial role in the process of changing the knowledge, attitude and behavior of hypertension patients.
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ObjectiveTo explore the correlation between blood stasis constitution （BSC） and diseases based on constitution literature involving “constitution-diseases correlation”. MethodsA comprehensive search was conducted on six Chinese and English electronic databases including CNKI， Wanfang， VIP， SinoMed， PubMed and Embase to find all clinical researches on the correlation between constitution and diseases using the Classification and Identification of Chinese Medicine Constitution standard from April 1st， 2009 to December 31st， 2022， and the participants of the research were BSC related. By analyzing the characteristics of the literature， such as authors， publication institutes， participants， and results， the disease with the highest proportion of BSC distribution or BSC as their risk factors or protective factors were summarized to explore the correlation between BSC and diseases. ResultsTotally 135 clinical studies on diseases highly related to BSC were included， with a total sample size of 71 172 cases.There were 27 keywords in the articles appeared more than 3 times， including the elderly， lumbar disc herniation， coronary heart disease， cardiovascular disease， and endometriosis. In the author's clustering， included studis were mainly from Shenzhen Hospital of Beijing University of Chinese Medicine， Second Affiliated Hospital of Guangzhou University of Chinese Medicine， and Wenzhou Central Hospital. In terms of blood stasis related diseases， 81 studies showed that BSC was the most common type of constitution in the study population， involving 48 disease or morbid states. The diseases and median proportions of BSC with reported literature ≥3 included coronary heart disease （28.8%）， endometriosis （31.3%）， neurocognitive impairment （26.4%）， lumbar disc herniation （26.0%）， ischemic stroke （25.0%）， adenomyosis （34.7%）， and endometrial polyps （25.0%）. Fifty-eight studies found that BSC was a risk factor for disease occurrence，and these diseases reported more than 3 times included hypertension （median OR = 2.956）， type 2 diabetes （median OR = 3.436），osteoporosis （median OR = 5.171）， sudden deafness （median OR = 3.827） and endometriosis （median OR = 5.412）. One study indicated BSC as the protective factor of lateral growth tumor of large intestine （median OR = 0.161）. ConclusionBSC is closely related to circulatory system diseases， urogenital system diseases， and musculoskeletal system diseases.
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Senile dementia is a disease that gradually develops with age. At present, the etiology, pathogenesis and treatment of senile dementia cannot be completely determined clinically. Therefore, it is extremely necessary to prevent and treat senile dementia from prevention and disease management. For the non-ill people, this article analyzed the susceptible groups of senile dementia from the perspective of TCM constitution, combined with the current prevention plan of Alzheimer's disease, from the aspects of examination, nutritional supplementation, adjustment of work and rest, exercise, etc., early physical fitness prevention targeting populations at different stages was conducted; the early onset of senile dementia is not obvious, and the early prevention of senile dementia can be carried out from various aspects in combination with constitution identification and inspection of senile dementia; for the exact sick population, disease management guidance can be added on the basis of the above aspects to provide definite and feasible recommendations for disease prevention and management of the elderly.
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ObjectiveTo explore the association between total iron， iron supplements， dietary total iron， heme iron intake and the risk of gestational diabetes mellitus（GDM）. MethodsA total of 668 pregnant women who gave birth in one hospital in Shanghai during January 2020 to July 2021 were included in a retrospective cohort study. Baseline characteristics and data of iron supplements in second trimester were collected through a questionnaire. A simplified dietary frequency questionnaire was used to quantify the food intake in second trimester. Total iron， iron supplements， dietary total iron， and heme iron intake was classified into groups by quintile and median. The association between iron intake from different sources and risk of GDM was determined using logistic regression analysis. ResultsAfter correction for age， family history of diabetes， overweight / obesity before pregnancy， hemoglobin（Hb）in first trimester， energy， carbohydrate energy， protein， and free sugar， it showed no association between total iron intake and risk of GDM （P>0.05）， while elevated risk of GDM among women with high iron supplements intake （OR=1.65； 95%CI： 1.14‒2.39）， and decreased risk of GDM among those with high dietary total iron intake （OR=0.53； 95%CI： 0.35‒0.81）. However， no association was found between heme iron intake and risk of GDM （P>0.05）. ConclusionHigh dietary total iron intake may be a protective factor， while high iron supplements may be a risk factor for GDM. It suggests that pregnant women should carefully choose high-dose iron-containing supplements in the absence of iron deficiency， as dietary iron intake should be the priority.
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【Objective:】 Using classic moral dilemma cases, this paper investigates the choice tendency of medical students when facing the moral dilemma, and analyzes their cognitive status and characteristics when facing the "moral dilemma", in order to provide effective enlightenment for optimizing the teaching cases of medical ethics. 【 Method:】 771 medical students in Shanghai Jiao Tong University School of Medicine were investigated by electronic questionnaire and SPSS 20.0 for statistical description and statistical analysis. 【Result:】 In the emergency room doctors and transition scenes, medical students tend to the principle of maximum happiness, and in the ring track scene and pedestrian overpass scene, they tend to the principle of deontology; In the loop track scene and pedestrian overpass scene, boys are more inclined to deontological principles than girls, and undergraduates are more inclined to deontological principles than postgraduates, and the difference is statistically significant (P<0.05). 【Conclusion:】 Although medical students have different moral tendencies in different scenes, they generally do not agree with the practice of sacrificing one person to save five people. Especially when more rigorous sacrifice conditions cause greater moral pressure, the vast majority of medical students will tend to the latter between utilitarianism and deontological principles.
الملخص
Objective · To investigate the smoking hypertensive elderly, find out the status of smoking in this population, and explore effective system intervention. Methods · The smoking hypertensive elderly in Waigang Town of Shanghai who received free antihypertensive drugs were recruited to investigate and descriptively analyze the smoking status of them with questionnaires. Results · There were 77.6% of the smoking hypertensive elderly who began to smoke in the age of 13 to 25, and nearly 70% smoking for more than 40 years. There were 59.5% of these people smoking 11 to 29 cigarettes daily in recent 3 years, and 41.6% spending 200-299 yuan on smoking monthly. Conclusion · Currently almost 70% of the smoking hypertensive elderly, who receives free antihypertensive drugs, have been smoking for more than 40 years, and the average number of cigarettes smoked daily is big. It is clear that the health education attached to the policy of providing free antihypertensive drugs has not changed the behavior. Therefore, medical personnel still needs to contact the illness and smoking hazards to help the elderly reduce smoking. Besides, it proves that tobacco control should be implemented in the young population to control epidemic at the early stage.
الملخص
Objective · To investigate the intention of quitting smoking and influencing factors among husbands in gestational households in Shanghai and provide a scientific basis for establishing smoking cessation strategies. Methods · Pregnant women and their spouses who received antenatal examination in 5 hospitals in Shanghai were asked to finish two versions of questionnaires respectively. Basic demographic information, smoking history, history of smoking cessation and intention of quitting smoking were investigated. The database was set up by EpiData 3.1, and data were analyzed by SPSS 22.0, such as descriptive analysis, χ2 test (univariate), and Logistic regression analysis (multivariate). Results · A total of 282 questionnaires were sent to smoking husbands and 266 effective questionnaires got back with the effective rate of 94.3%. Among them 34.2% smoking husbands had intention of quitting smoking, 18.4% were trying to quit, and 22.9% had tried to quit before. Single-factor analysis showed that influencing factors for intention of quitting smoking among smoking husbands in gestational households included the daily cigarette consumption, overall opinion for smoking, the knowledge about the harm of passive smoking to pregnant women and fetuses, having smoking cessation experience or not, how many people smoking among five intimate friends except family members (P<0.05). Multivariate Logistic regression analysis showed that intention of quitting smoking had relationship with the daily cigarette consumption (OR = 0.456, 95% CI: 0.245 ~ 0.852), overall opinion for smoking(OR=2.443, 95% CI: 1.008 ~ 5.921), having smoking cessation experience or not (OR =0.316, 95% CI: 0.162 ~ 0.616). Conclusion · Intention of quitting smoking is relatively strong in gestational households. It is recommended to strengthen the education of tobacco control for smoking husband in gestational households, and encourage smokers who had smoking cessation experience before to quit smoking again.
الملخص
Objective · To investigate the prevalence of passive smoking among pregnant women in Shanghai and to analyze its influencing factors and to provide the basis and suggestion for making related intervention measures to reduce the harm of secondhand smoke on the health of pregnant women. Methods · From July to October 2014, pregnant women and their spouses were recruited for a questionnaire investigation at the antenatal care clinics of 3 maternity hospitals and 3 community hospitals in Shanghai. The questionnaire included demographic information, family basic situation and cognitive status of passive smoking. Results · The passive smoking rate before pregnancy in the 2831 pregnant women, who were involved in the investigation, was 17.1%. The passive rate during pregnancy was 7.8%. The difference between these two rates was statistically significant (P<0.05). 71.0% of the pregnant women have passive smoking for 15~59 min each day. Relative to home and work place, the passive smoking rate of pregnant women in public place was the highest (P<0.05). The passive smoking rate of pregnant women was significantly associated with the educational level of smoking spouses and the attitude of pregnant women when they faced the smokers. Conclusion · The passive smoking rate of pregnant women is influenced by the educational level of their spouses and the pregnant women's feedback to the smokers face to face. Public places are the most important exposure places to secondhand smoke for pregnant women. In order to reduce the harm from passive smoking to pregnant women and their fetuses, the related measures of smoking control at home education and smoking ban in public place should be made.
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Objective · To compare the prevalence of tobacco advertisement before and after implementation of the new edition of Advertising Law of the People's Republic of China and evaluate the effects of implementation of the new Advertising Law. Methods · Tobacco sales places, public places, and streets in Shanghai were randomly selected to observe tobacco advertisement and complete the survey. The survey was carried out in 10 districts of Shanghai in June 2015 with 10 tobacco sales places selected in each district, and in 4 districts of Shanghai in June 2016 with 25 tobacco sales places selected in each district. Sales places included convenient stores, tobacco stores, supermarkets, and kiosks. In addition, public transport waiting points, public transport vehicles, hospitals, shopping centers, restaurants, bars, and Internet cafes were selected into survey in 2016. Results · In 2016, the proportion of tobacco sales places having tobacco advertisement was lower than that in 2015, but the proportion of tobacco promotion behaviors was higher. In 2016, 128 public places and streets were investigated and only 1 had outdoor tobacco advertisement. Conclusion · The new edition of Advertising Law has significant effect on controlling tobacco advertisement, but tobacco sales places still have tobacco advertisement with various disguised promotion forms. Tobacco sales places have diversified business styles and minors often enter these places. It is recommended that a clear definition of disguised forms of tobacco advertisement should be made, tobacco advertisement at tobacco sales places needs to be supervised, the release of tobacco advertisement should be strictly reviewed, and existing tobacco advertisement should be severely punished, so as to prevent minors from exposing to tobacco advertisement and information luring smoking.
الملخص
Objective · To conduct a survey on the current status of professionalism and personal protection in Central Sterile Supply Department (CSSD) practitioners in Shanghai, analyze the existing problems and provide suggestions, in order to improve work quality and management level of CCSD. Methods · Cluster sampling was used to extract 23 different level hospitals with CSSDs among 4 districts in Shanghai including Jing'an, Jinshan,Qingpu and Jiading. A total of 147 participants consisted of 104 employees and 43 heads of CSSDs. Field investigation and questionnaire survey were applied into CSSD practitioners for investigating their essential information, professionalism and personal protection status. Results · Practitioners in different hospitals showed different professional knowledge, especially practitioners in private hospital performed worse than those in secondary and tertiary-level hospitals in this survey of professionalism. Daily protection measures were defective due to lacking of consciousness of personal protection.Conclusion · There was problem of personal professionalism and protection consciousness in CSSD practitioners. It is important to optimize the allocation of CSSD human resource, reinforce skill training and improve quality management.
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As a new service form,community medical service provides primary health care for residents and it is operated with reasonable medical expenses.The function and service range of community medical service have reached consensus in medical industry,but the key issues of how to gain the market by competitive products and reasonable price have not been solved.This article analyzes the position of community medical service in healthcare system to clarify its unique attributes.The article further discusses the contents and pricing characteristics of community medical service,and the main influencing factors.The article introduces the issues dealing with community medical service product development,including the procedure of development,key points at different stages of development and the related research methods for the development of new service products.
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Objective To explore the competency of community health administrators in a survey of such administrators at large in Shanghai. Methods McClelland's Competency Dictionary was used to set two benchmark positions, while the behavioral event interviewing and questionnaires were made to survey 19 community health service centers in Shanghai. Results The competency model benchmarking on the head of a medical branch consists of 6 character clusters, 11 characteristic items, 27 evaluation dimensions and 27 typical behavior descriptions. The model benchmarking on the community team leader consists of 5 character clusters, 8 characteristic items, 21 evaluation dimensions and 21 typical behavior descriptions. Conclusion Findings of the survey provide objective criteria for competence appraisal of community health administrators, and serve as reference for formulating their development plans as well.
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This paper summarized the theory and characteristics of Kanban management,analyzed characteristics of the biomedical industry,research and development.The Kanban management put forward some ideas for the managemerit of biomedical research and development,also the task decomposition,team communication and the compression cycle were proposed respectively in it.The industry case would corroborate the Kanban management for the management of the biomedical research and development to be able to use as a reference to management innovation.
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OBJECTIVE:To explore the innovation pattern of biopharmaceutical industry in China.METHODS:Three major problems encountered by the research and development (R&D) of new drug,the core of Chinese biopharmaceutical industry,including the weak construction of operation base for R&D of new drug,insufficient fund,difficulty in the transformation of achievements were analyzed.An innovation pattern of biopharmaceutical industry was founded based on the "Contract Research Organization(CRO)".RESULTS:An innovation industry pattern consisting of multiple-concurrent CRO R&D mode,venture capital and patent/new drug certificate tie-in financing form and new drug certificate oriented R&D process management has been put forward,which was integrated into an "advanced CRO"(CRO+) mode.CONCLUSION:The CRO+ mode is an open and integrative service system which can help shorten the R&D cycle,lower the cost and risk of R&D and promote the development of biopharmaceutical industry in China.