Experiences of nurses involved in natural disaster relief: A meta-synthesis of qualitative literature.

AIM: To explore nurses' experiences in natural disaster response. BACKGROUND: Nurses are key to disaster response. There is a growing body of qualitative research exploring this emerging nursing issue. However, there is a need to synthesise and summarise this body of knowledge to identify the overarching elements of how nurses experience working in disaster situations to reflect on their experiences so that we may help shape future clinical practice, research and education. DESIGN: Qualitative meta-synthesis. METHOD: Following PROSPERO guidelines (Moher et al., 2015), an exhaustive and systematic literature search and quality appraisal was undertaken in December 2019 to reveal nurses' experiences during natural disaster response. Sandelowski and Barroso's systematic retrieval, analysis and interpretation of findings method was used to produce a meta-summary of findings from 10 papers evaluating experiences across 9 disasters. A meta-aggregation was used to synthesise the findings from the studies and was methodically quality assessed with PRISMA and CASP. RESULTS: Our findings aggregated data from 42 sub-themes, into the following four themes to capture nurses' experiences after responding to disasters. These included agile response; leadership and innovative problem solving; building resilience; positive communication and need for psychological/emotional support. DISCUSSION: This meta-synthesis provides evidence to illustrate nurses' resilience and leadership capabilities as means to manage and perceive their disaster relief response. Factors such as emotional intelligence, capacity to react to changing situations, to manage scant resources in extreme situations were highlighted in nurses practising in highly stressful environments. Managers can use these examples to support ways to improve disaster management policies, but also, to engage in support for their staff. RELEVANCE TO CLINICAL PRACTICE: The role of nursing staff in disaster rescue is receiving significant attention. Understanding nurses' experiences during disaster rescue can help future leaders to improve capacity to respond and nursing preparedness through education, training and management, but also for continuing emotional support after the event.

Diagnostic efficiency and result of prostate biopsy for patients with t-PSA between 4.0 and 10 ng/ml / 军事医学

Objective To investigate the diagnostic efficiency and result of prostate biopsy for patients with t -PSA between 4.0 and 10 ng/ml.Methods This analysis was based on 20 qualified research papers from such lectronic databases as PubMed, MEDLINE, EMBASE and Cochrane from January 2010 until September 2017.Data extracted was analyzed using classic Meta-analysis with R software .The random or fixed effect model analysis was used to estimate the rate.Heterogeneity was analyzed using I 2 statistic.Results Totally 5481 patients were included in the 20 research papers. The positive rate of prostate biopsy was 20.6％, with t-PSA between 4.0 and 10 ng/ml, which was higher than the rate in the data from CUA Guide(2014).The difference was statistically significant .Conclusion Patients should be subjected to prostate biopsy if their t-PSA ranges 4.0 from 10 ng/ml regardless of the rate of f/t-PSA.The Gleason grade is relatively low when PSA is in the gray area , and the risk is also low.

The recent clinical efficacy study of photoselective vaporization of prostate (120 W) for treatment of large gland benign prostatic hyperplasia / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the recent clinical safety and efficacy of photoselective vaporization of prostate (120 W) for the treatment of large gland benign prostatic hyperplasia.</p><p><b>METHODS</b>The clinical data of 112 cases who accepted photoselective vaporization of prostate (120 W) for the treatment of severe benign prostatic hyperplasia (the weight of prostate > 75 g) from July 2010 to January 2012 was statistical analyzed. Relief symptoms and complications were observed around surgery, and the recent clinical efficacy was analyzed.</p><p><b>RESULTS</b>All the operations were smooth. There were not transurethral resection syndrome. No cases need transfusion intraoperative and postoperative. The operation average time was (52.6 ± 12.1) minutes, and the average amount of bleeding was (27.4 ± 18.5) ml. The postoperative bladder irrigating time was (19.4 ± 7.3) hours, the mean postoperative indwelling catheter time was (3.2 ± 0.6) days, and the mean postoperative hospital stay was (4.8 ± 1.3) days. Postoperative international prostate symptom score (t = 52.24 - 59.10), quality of life (t = 48.42 - 53.63), maximum flow rate (t = -31.01 - -24.23) and residual urine volume (t = 9.85 - 12.53) compared with preoperative are significantly improved (P < 0.01).</p><p><b>CONCLUSIONS</b>With the safe operation of photoselective vaporization of prostate (120 W) for the treatment of large gland benign prostatic hyperplasia, it is less bleeding, recent efficacy is significant, and it is especially appropriate to elderly patients at high risk of large gland.</p>

Effect of probiotics on respiratory tract pathogen colonization in neonates undergoing mechanical ventilation / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the effect of mouth-fed probiotics on pathogenic bacteria colonization of the oropharynx and lower respiratory tract in neonates undergoing mechanical ventilation.</p><p><b>METHODS</b>Randomized control method was employed to divide the neonates undergoing mechanical ventilation into probiotics (n=82) and control groups (n=83). The control group received routine treatment. The probiotics group was administered with oral probiotics in addition to routine treatment. The number of pathogenic bacteria colonized on the oropharynx and lower respiratory tract, and the number of the bacterial strain of ventilator-associated pneumonia (VAP) in the two groups were examined. The timing of the bacteria colonization and VAP occurrence were also examined.</p><p><b>RESULTS</b>The probiotics group presented a lower bacterial strain colonization rate of the oropharynx pathogenic bacteria than the control group (35% vs 51%; P<0.05). The colonization time of pathogenic bacteria of the oropharynx and lower respiratory tract, and the time of VAP occurrence lagged behind in the probiotics group compared with that the control group (P<0.05). No adverse reaction caused by probiotics was found.</p><p><b>CONCLUSIONS</b>Probiotics administration is effective in decreasing pathogenic bacteria colonization on the oropharynx, in postponing the pathogenic bacteria colonization on the oropharynx and lower respiratory tract and in delaying the occurrence of VAP in neonates undergoing mechanical ventilation.</p>

Comparative study of pneumatic lithotripsy and holmium laser lithotripsy for ureteral stones / 中南大学学报(医学版)

OBJECTIVE@#To compare the efficacy and safety of endoscopic laser lithotripsy (LL) and endoscopic pneumatic lithotripsy (PL) for ureteral stones.@*METHODS@#We retrospectively analyzed the clinical data of 415 patients with ureteral calculi treated with endoscopic laser lithotripsy (n = 214 ) and pnumatic lithotripsy (n = 201 ).@*RESULTS@#The overall successful fragmentation rate of all ureteral stones in a single session of the LL group was higher than that of the PL group (95% vs. 69%, P < 0.01). The average stonefree time of the LL group was shorter than that of the PL group (18 days vs. 31 days, P < 0.01). No complications such as perforation during the operation were observed in the LL group whereas 3 perforations occurred in the PL group.@*CONCLUSION@#LL has its advantage over PL in its better clinical effect for the stone fragmentation and low complication rate and is an effective and safe treatment for ureteral stones.