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We investigated the situation of leptosperosis infection among patients with fever in Hainan Province in China.Blood samples of patient from Hainan Province in the year of 2015 were detected for Leptospira by microscope agglutination test (MAT),enzyme-linked immunity test (ELISA) and polymerase chain reaction (PCR),respectively.Results showed that 179 blood samples of patients with fever were found,and microscope agglutination test detected 40 positive samples,with a infection rate of 22.35％.The infection rate was 21.65％(21/97) for male and 23.17％(19/82) for female.Seven groups of bac teria were found including Leptospira serogroup icterohemorrhagie,ballom group,autumralis group,pomona group,grippotyphosa group,Sejroe group and Batavia group.Thirty-eight samples were tested positive by ELISA,with a positive rate of 21.23 ％,in which six samples were IgM positive (detection rate =3.35 ％) and 32 samples were IgG positive (detection rate=17.88 ％).Serological detected with MAT and ELISA methods results were consistent and that were tested negative by PCR.Results of our study supported the presence of Leptospira infection infection among the patients with fever of unknown origin (FUO) in Hainan Province.The main types are Leptospira serogroup icterohemorrhagie.
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Objective To evaluate the effectiveness of clinical pathways for pediatric asthma.Methods The literatures on the application of clinical pathways for pediatric asthma were collected in the databases such as PubMed,Cochrane Library,Ovid,ScienceDirect,EBSCOhost,CNKI,Wanfang and CBM while a manual search was added.The search was performed from 1980 to 2014.Two reviewers independently screened references,extracted data and assessed the risk of bias.Data was pooled and analyzed by using Revman 5.2 version.Results Eleven studies involving 2 207 participants from nearly 1 048 relevant studies met the inclusion criteria.1 174 participants were in the clinical pathway group while the other 1 033 participants were in the control group.Meta-analysis result showed that patients with asthma in a clinical pathway had a shorter length of stay,less medical cost,reduced rate of emergency room visits,and improved health education.However,clinical pathway did not appear to reduce readmission.Conclusions Clinical pathway can significandy reduce the length of hospital stay,cost,rate of emergency room visits and improve health education.
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Objective To develop an evidence-based community extended care model for patients with asthma.Methods Mixed research methods were applied to integrate best evidences:80 literatures were included in systemic review; 394 medical records were analyzed; 112 nurses admitted a test and a questionnaire to assess their competence on asthma care; clinical observation to both hospital and community centers were conducted; 6 multidisciplinary experts were consulted; and 100 patients admitted a questionnaire on patient needs and 17 of them were further interviewed.Results The nursing care model with the feature of hospital and community health service center collaborating to provide extended care for patients with asthma was established.Conclusions The development of a nursing care model for practice should be based on the current best evidence generating from the best research evidence,professional judgment on clinical practice requirement and patients' needs.
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The authors have applied the Omaha system in six different researches conducted in Hong Kong and mainland China in the last ten years. These researches have been conducted using different client groups,specialty nurses,and in the hospital,clinic and community settings. The Omaha system was found to be instrumental in serving as a conceptual framework for study,designing the intervention protocol,identifying clients' health problems,defining nursing interventions and evaluating research outcomes. The Omaha system is a valuable tool for research and practice and is worth exploring further for its application in mainland China,particularly in the areas of community nursing and transitional care.