Nasogastric or nasojejunal feeding in predicted severe acute pancreatitis: a meta-analysis.

INTRODUCTION: Enteral feeding can be given either through the nasogastric or the nasojejunal route. Studies have shown that nasojejunal tube placement is cumbersome and that nasogastric feeding is an effective means of providing enteral nutrition. However, the concern that nasogastric feeding increases the chance of aspiration pneumonitis and exacerbates acute pancreatitis by stimulating pancreatic secretion has prevented it being established as a standard of care. We aimed to evaluate the differences in safety and tolerance between nasogastric and nasojejunal feeding by assessing the impact of the two approaches on the incidence of mortality, tracheal aspiration, diarrhea, exacerbation of pain, and meeting the energy balance in patients with severe acute pancreatitis. METHOD: We searched the electronic databases of the Cochrane Central Register of Controlled Trials, PubMed, and EMBASE. We included prospective randomized controlled trials comparing nasogastric and nasojejunal feeding in patients with predicted severe acute pancreatitis. Two reviewers assessed the quality of each study and collected data independently. Disagreements were resolved by discussion among the two reviewers and any of the other authors of the paper. We performed a meta-analysis and reported summary estimates of outcomes as Risk Ratio (RR) with 95% confidence intervals (CIs). RESULTS: We included three randomized controlled trials involving a total of 157 patients. The demographics of the patients in the nasogastric and nasojejunal feeding groups were comparable. There were no significant differences in the incidence of mortality (RR=0.69, 95% CI: 0.37 to 1.29, P=0.25); tracheal aspiration (RR=0.46, 95% CI: 0.14 to 1.53, P=0.20); diarrhea (RR=1.43, 95% CI: 0.59 to 3.45, P=0.43); exacerbation of pain (RR=0.94, 95% CI: 0.32 to 2.70, P=0.90); and meeting energy balance (RR=1.00, 95% CI: 0.92 to 1.09, P=0.97) between the two groups. Nasogastric feeding was not inferior to nasojejunal feeding. CONCLUSIONS: Nasogastric feeding is safe and well tolerated compared with nasojejunal feeding. Study limitations included a small total sample size among others. More high-quality large-scale randomized controlled trials are needed to validate the use of nasogastric feeding instead of nasojejunal feeding.

[Study on mental workload of teachers in primary schools].

OBJECTIVE: To investigate the distribution characteristics and influencing factors of mental workload of teachers in primary schools. METHODS: National Aeronautics and Space Administration-Task Load Index (NASA-TLX) was used to assess the mental workload levels for 397 teachers of primary schools in a city. RESULTS: The mental workload (64.34+10.56) of female teachers was significantly higher than that (61.73+ 9.77) of male teachers (P<0.05). The mental workload (65.66+10.42) of "-35" years old group was the highest. When age of teachers was younger than 35 years old, there was a positive correlation between the mental workload and age (r=0.146, P<0.05). When age of teachers was older than 35 years old, there was a negative correlation between the mental workload and age (r=-0.190, P<0.05). The teachers with higher education level felt higher mental workload (unstandardized coefficients B=1.524, standardized coefficients /=0.111, P<0.05). There was a positive correlation between the mental workload and working hours per day (unstandardized coefficients B =4.659, standardized coefficients/3 =0.223, P<0.001). CONCLUSION: Mental workload of the teachers in primary schools is closely related to age, educational level and work hours per day. Work hours per day is an important risk factor for mental workload. Reducing work hours per day (8 hours) is an effective measure of alleviating the mental workload of teachers in primary schools.

[Coping resources of nurses' occupational stress].

OBJECTIVE: To study the effects of coping resources on nurses' strain. METHODS: Coping resources (recreation, self-care, social support, and rational coping) and strain (vocational strain, psychological strain, interpersonal strain, and physical strain) were measured on 387 nurses with personal resources questionnaire (PRQ) and personal strain questionnaire (PSQ). RESULTS: The higher the nurses' coping resources were, the lower their strain was (P<0.01). Nurses' coping resources had a negative correlation with their strain and had the closest relation with their psychological strain (P<0.01). Among coping resources, social support was closest related with nurses' strain. In the items of social support, those related to feeling support had more remission on strain. In the items of rational coping, those related to keeping good mind had more remission on strain, while doing more than one job at one time could raise nurses' strain (P<0.05). In the items of self-care, those related to good healthy habit, being immersed in contemplation and sufficient sleeping had the most effects on the remission of strain. In the items of recreation, those related to enough rest and self-determination had more effects on the remission of strain, while doing other things in most of leisure time had a positive correlation with strain (P<0.05). CONCLUSION: Enhancing coping resources, especially feeling support, keeping good mind, sufficient sleeping and rest, are the important measures for the remission of nurses' strain.

[The appraisal of reliability and validity of subjective workload assessment technique and NASA-task load index].

OBJECTIVE: To test the reliability and validity of two mental workload assessment scales, i.e. subjective workload assessment technique (SWAT) and NASA task load index (NASA-TLX). METHODS: One thousand two hundred and sixty-eight mental workers were sampled from various kinds of occupations, such as scientific research, education, administration and medicine, etc, with randomized cluster sampling. The re-test reliability, split-half reliability, Cronbach's alpha coefficient and correlation coefficients between item score and total score were adopted to test the reliability. The test of validity included structure validity. RESULTS: The re-test reliability coefficients of these two scales and their items were ranged from 0.516 to 0.753 (P < 0.01), indicating the two scales had good re-test reliability; the split-half reliability of SWAT was 0.645, and its Cronbach's alpha coefficient was more than 0.80, all the correlation coefficients between its items score and total score were more than 0.70; as for NASA-TLX, both the split-half reliability and Cronbach's alpha coefficient were more than 0.80, the correlation coefficients between its items score and total score were all more than 0.60 (P < 0.01) except the item of performance. Both scales had good inner consistency. The Pearson correlation coefficient between the two scales was 0.492 (P < 0.01), implying the results of the two scales had good consistency. Factor analysis showed that the two scales had good structure validity. CONCLUSION: Both SWAT and NASA-TLX have good reliability and validity and may be used as a valid tool to assess mental workload in China after being revised properly.

[Study on mental capacity among workers in chemical industry system].

OBJECTIVE: To study the mental capacity and its influential factors among workers in chemical industry system (CIS). METHODS: One hundred and one workers were selected from CIS by systematic sampling. Then their mental capacity was measured using 4 indices: short-time memory, decode, AYP and mental functional index (MFI). RESULTS: Normality test revealed that the data of CIS workers' mental capacity displayed a profile approximate to normal distribution. All the levels of the four indices measured in the CIS workers aged more than 40 years were lower than those in workers aged less than 40 years (P < 0.01). All the levels of indices gradually increased with the increase of educational level (P < 0.01). Among the workers doing different types of work, the mental workers had the highest level in all indices while physical workers had the lowest level, but only the difference in respect to MFI was significant (P < 0.05). Female CIS workers had higher level in all indices than male; the differences were significant except that in short-time memory (P < 0.01). Mental capacity was noted to have significantly negative correlation with age and significantly positive correlation with educational level (P < 0. 01). CONCLUSION: Increasing CIS workers' educational level is a very important approach to the improvement of their mental capacity and hence the upgrading of their work ability.

[Study on relationship between coping resources and strain in mental workers].

OBJECTIVE: To study the effects of mental workers' coping resources on their strain. METHODS: Strain (vocational strain, psychological strain, interpersonal strain, physical strain) and coping resources (recreation, self-care, social support, rational coping) were measured on 3379 mental workers with personal strain questionnaire (PSQ) and personal resources questionnaire (PRQ). RESULTS: There existed significantly negative correlations between PRQ and PSQ (P < 0.01). In PRQ, social support (SS) and rational coping (RC) had the closest relationships with PSQ. In the items of SS, those related to feeling support had more remission on strain. In the items of RC, those related to reasonable arrangement of time and anti-interference had more remission on strain. In the items of recreation (RE), those related to self-determination had more effects on the remission of strain, while indulging in watching TV could cause the strength of strain, and there was a positive correlation between watching TV and strain (P < 0.01). In the items of self-care (SC), sufficient sleeping had the most effects on the remission of strain in the all 40 items of PRQ, while not being immersed in contemplation had a positive correlation with strain (P < 0.01). CONCLUSION: Enhancing coping resources, especially sufficient sleeping, feeling support and reasonable arrangement of time, were the important measures for the remission of mental worker' strain.