Experiences of Chinese immigrant women following "Zuo Yue Zi" in British Columbia.

AIMS AND OBJECTIVES: To describe Chinese women's experiences with "zuo yue zi" in British Columbia, Canada. BACKGROUND: Women born in China and Taiwan are increasingly immigrating to westernised countries. Many women choose to follow traditional Chinese postpartum practices, also called "zuo yue zi." Few studies have examined women's use of traditional practices in western countries. DESIGN: The study used a qualitative descriptive design. METHODS: We recruited 13 mothers who were: aged 19 or older, immigrants from mainland China, Hong Kong or Taiwan in the last 5 years, and caring for infants born in the previous 6 weeks. Semistructured interviews were conducted in Mandarin, translated into English, transcribed and analysed using inductive content analysis. RESULTS: The core theme was Chinese women's novel encounters with "zuo yue zi." The women's expectations of "zuo yue zi" were acquired through birth experiences or interactions with family and friends. The participants struggled with implementing traditional practices because social support and formal institutional structures were lacking. They modified their expectations about "zuo yue zi." Factors affecting their practices were catalysts and deterrents. Catalysts included help from Chinese family members, friends and informed healthcare providers. Deterrents included unregulated paid helpers, uninformed care providers, financial constraints and structural limitations in their new environments. CONCLUSIONS: Chinese immigrant women struggled to modify and implement traditional practices in their adopted country when they encountered financial constraints, unregulated paid helpers and varying support from health care providers. RELEVANCE TO CLINICAL PRACTICE: Some postpartum women following "zuo yue zi" believed that the practice would prevent chronic illness and strengthen their intrafamily relationships. Immigrant mothers require nursing support to follow traditional postpartum practices. Nurses can advocate on patients' behalf to increase care providers' knowledge about "zuo yue zi" and public awareness for necessary regulated institutional structures.

The relationship between ocular trauma and substance abuse in emergency department patients.

INTRODUCTION: Eye injury is the second most common cause of visual impairment and a leading cause of monocular blindness in the United States. There are approximately 6 million ED visits related to drug use annually, including misuse or abuse of pharmaceuticals and illicit drug use. The purpose of this study was to assess the relationship between ocular trauma and substance abuse among emergency department patients and to assess that relationship with demographic factors, including age and gender. METHODS: This study was a retrospective, observational study conducted at Miami Valley Hospital, an urban hospital ED, in Dayton, Ohio. Eligible participants included consecutive ocular trauma patients identified by the Trauma Registry from January 2014 through January 2016. Data were collected from the ED medical record including demographic information, mechanism of injury, visual acuity, slit lamp exam findings, ED procedures, inpatient procedures, toxicology results, ED diagnosis, ED disposition, and eye exam. RESULTS: Among 229 patients, the mean age was 44 (range 14-93). 73% of patients were male. Most patients were White (74%), followed by African American (21%), Hispanic (2%), and other (3%). Most patients arrived by ambulance (62%), followed by helicopter (30%), and walk-ins (18%). Most patients were admitted to the hospital (79%). Mechanisms of injury included motor vehicle accidents (31%) and cases of assault (28%). Most ocular trauma involved the external eye (44%), the anterior chamber (28%), the orbit (25%) and the globe (22%). The incidence of substance abuse in this patient population was high. Of the patients tested for alcohol (N=143), 49% tested positive. Among 98 patients who received a urine toxicologic screen, 63% tested positive for at least one illicit substance, including opiates (39%), cocaine (12%), benzodiazepines (25%), and/or THC (27%). There was no significant association between substance abuse and ED disposition. CONCLUSION: Mechanisms of eye injury included primarily motor vehicle accidents and assault. Most ocular trauma involved the external eye, the anterior chamber, the orbit, and the globe. The incidence of alcohol and illicit substance abuse is high among ED patients with ocular trauma.

Association between Risk Communication Format and Perceived Risk of Adverse Events after COVID-19 Vaccination among US Adults.

The format used to communicate probability-verbal versus numerical descriptors-can impact risk perceptions and behaviors. This issue is salient for the Coronavirus disease 2019 (COVID-19), where concerns about vaccine-related risks may reduce uptake and verbal descriptors have been widely used by public health, news organizations and on social media, to convey risk. Because the effect of risk-communication format on perceived COVID-19 vaccine-related risks remains unknown, we conducted an online randomized survey among 939 US adults. Participants were given risk information, using verbal or numerical descriptors and were asked to report their perceived risk of experiencing headache, fever, fatigue or myocarditis from COVID-19 vaccine. Associations between risk communication format and perceived risk were assessed using multivariable regression. Compared to numerical estimates, verbal descriptors were associated with higher perceived risk of headache (ß = 5.0 percentage points, 95% CI = 2.0-8.1), fever (ß = 27 percentage points, 95% CI = 23-30), fatigue (ß = 4.9 percentage points, 95% = CI 1.8-8.0) and myocarditis (ß = 4.6 percentage points, 95% CI = 2.1-7.2), as well as greater variability in risk perceptions. Social media influence was associated with differences in risk perceptions for myocarditis, but not side effects. Verbal descriptors may lead to greater, more inaccurate and variable vaccine-related risk perceptions compared to numerical descriptors.

Abdominal pain as the initial and sole clinical presenting feature of systemic lupus erythematosus.

Classically, a diagnosis of systemic lupus erythematosus (SLE) is dependent on renal, rheumatological, cutaneous and neurological target organ damage with supporting serological markers. A previously healthy 26-year-old Japanese woman whose only manifestation of otherwise occult SLE was severe abdominal pain is reported. A computed tomographic scan of the abdomen revealed thickened loops of small bowel, endoscopic findings were nonspecific and jejunal biopsy revealed a nonspecific enteritis. Laboratory studies revealed lymphopenia, hypocomplementemia, a positive antinuclear antibody, a weakly positive anti-Smith and a strongly positive anti-double stranded DNA. There was a prompt symptomatic recovery with immunosuppressive therapy. The authors' experiences, and a review of the literature suggest that a diagnosis of SLE should be considered in young Asian women who present with significant but clinically enigmatic gastrointestinal illness.