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The associations between resilience and socio-demographic factors in parents who care for their children with congenital heart disease

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International Journal of Nursing Sciences 2022年第3期9卷 321-327,I0002页

作者： Amy E.delaney Mei Rosemary Fu Melissa L.McTernan Audrey c.Marshall Jessica Lindberg Ravi R.Thiagarajan Zhuzhu Zhou Jeibei Luo Sharon Glazer Boston college William F.Connell School of NursingChestnut HillMAUSA Rutgers University School of NursingeCamdenCamdenNJUSA Boston college Academic Research ServicesChestnut HillMAUSA University of Toronto The Hospital for Sick ChildrenTorontoONCanada The Ethan M.Lindberg Foundation CaledoniaILUSA Harvard Medical School Department of CardiologyBoston Children's HospitalBostonMAUSA Xiamen University School of Economics&the chow center XiamenChina Boston college Boston College Thomas P.O'Neill Jr.LibraryChestnut HillMAUSA The University of Baltimore Yale Gordon College of Arts&Sciences BaltimoreMDUSA

Objective To examine the resilience of parents of children with congenital heart disease and to investigate socio-demographic factors that may influence parents’*** This is a web-based survey study using a cross-sectional design.A purposive sampling method was utilized to recruit 515 parents who care for children with congenital heart *** was assessed using the Dispositional Resilience Scale-Ⅱ.Based on expert-interviews,a questionnaire was designed to collect socio-demographic *** statistics,factor analysis,and linear regressions were used to analyze *** A total of 413 parents completed the survey *** mean resilience score was 3.75(SD=0.61;range=1.89–4.89)with higher scores indicating higher *** linear regression models demonstrated that parents who had lower education levels and lower gross household income had lower resilience(pconclusions parents reported resilience that reflected their ability to cope with stressful events and mitigate stressors associated with having and caring for children with congenital heart *** education levels and lower gross household income are associated with lower *** increase parents’resilience,nursing practice and nurse-led interventions should target screening and providing support for parents at-risk for lower *** lower education level and financial hardship are factors that are difficult to modify through personal efforts,charitable foundations,federal and state governments should consider programs that would provide financial and health literacy support for parents at-risk for lower resilience.

关键词： child congenital heart defects Financial stress Households parents Resilience

pre-Operative Anaemia predicts poor Outcomes in patients Undergoing Infra-Inguinal Bypass Surgery

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World Journal of cardiovascular Diseases 2014年第12期4卷 594-600页

作者： K. Sierakowski Y. T. Wong c. delaney p. Hakendorf K. Missen J. I. Spark Department of Vascular Surgery Flinders University Bedford Park South Australia Australia clinical Epidemiology Unit Flinders Medical Centre Bedford Park South Australia Australia Flinders centre for Epidemiology and Biostatistics Flinders University Bedford Park South Australia Australia

Objectives: critical limb ischaemia (cLI) requiring infra-inguinal bypass is a common presentation to the vascular surgery service. A significant number of cLI patients also present with anaemia as a comorbidity, the impact of which is unknown. We reviewed the impact of anaemia on mortality and amputation in patients who underwent infra-inguinal bypass surgery. Methods: Demographic data from all patients who underwent infra-inguinal bypass surgery for cLI at the Flinders Medical centre & Repatriation General Hospital, South Australia between January 2005 and January 2010 were recorded. Haemoglobin (Hb) level, serum creatinine (Scr) level, mortality and amputation events were also recorded for retrospective analysis. Results: 190 patients (141M, 49F) who underwent infra-inguinal bypass surgery over a 5 year period were analyzed. 100 (53%) of these patients had mild anaemia (mean Hb 113 g/L, mean for females 103 g/L, mean for males 116 g/L). Those who presented with anaemia were more likely to have diabetes and renal dysfunction as comorbidities. Anaemia had a significant negative impact on mortality with 30% deaths in those who were anaemic compared to 15.6% deaths in those without anaemia odds ratio (OR) 1.76, 95% cI: 0.90 - 3.48, p p was similar when looking at amputation as an outcome;with the number of amputations in those who were anaemic preoperatively 14% vs 6.7% in those who were not anaemic, OR 2.56, 95% cI: 1.00 - 6.54, p = 0.05. The negative impact of anaemia on mortality 43.5% vs 18.8% was also noted in patients who did not have diabetes or impaired renal function as a comorbidity p conclusions: Anaemia is a common comorbidity in patients presenting with cLI and it predicts poor outcomes after infra-inguinal bypass. The role of transfusion is debatable, but it is clear that this group of patients requires careful management during the perioperative period to ensure they are medically optimized.

关键词： Anaemia Infra-Inguinal Bypass Renal Impairment Amputation Mortality

根除幽门螺杆菌——谁会受益? 主要是内镜证实的消化性溃疡或功能性消化不良患者

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英国医学杂志中文版 2006年第2期9卷 69-70页

作者： Brendan c delaney 李柯 University of Birmingham EdgbastonBirmingham B15 2TT

消化不良（dyspepsia）最新的定义是指明显的上腹部疼痛至少持续4周，伴或不伴有烧心。胃-食道反流性疾病（gastro—oesophageal reflux disease，GORD）则是指以烧心为突出症状。当内镜检查排除消化性溃疡后，这两个定义是实用及合理... 详细信息

消化不良（dyspepsia）最新的定义是指明显的上腹部疼痛至少持续4周，伴或不伴有烧心。胃-食道反流性疾病（gastro—oesophageal reflux disease，GORD）则是指以烧心为突出症状。当内镜检查排除消化性溃疡后，这两个定义是实用及合理的，但对于尚未进行内镜检查的患者，这两个定义就不能充分说明问题。因此，2004年英国国立临床卫生优选研究所（National Institute for Health and clinical Excellence，

关键词：功能性消化不良患者消化性溃疡内镜检查幽门螺杆菌上腹部疼痛反流性疾病

腹腔镜结肠切除术中转为开腹切除术是否不利于患者的疾病转归

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世界核心医学期刊文摘（胃肠病学分册） 2005年第3期1卷 23-24页

作者： casillas S. delaney c.p. Senagore A.J. 陈云茹 Department of colorectal Surgery Cleveland Clinic Foundation 9500 Euclid Avenue Cleveland OH 44195 United States Dr.

pURpOSE: conversion during laparoscopic colectomy varies in frequency according to the surgeon’s experience and case selection. However, there remains concern that conversion is associated with increased morbidity and higher hospital costs. METHODS: From January 1999 to August 2002, 430 laparoscopic colectomies were performed by two surgeons, with 51 (12 percent) cases converted to open surgery. converted cases were matched for operation and age to 51 open cases performed mostly by other colorectal surgeons from our department. Data collected included gender, American Society of Anesthesiology score, operative indication, resection type, operative stage at conversion, in hospital complications, direct hospital costs, unexpected readmission within 30 days, and mortality. RESULTS: There were no significant differences between the groups for age (converted, 55 ±19; open, 62 ±16), male:female ratio (converted, 17:34; open, 23:28), or American Society of Anesthesiology score distribution. Indications for surgery were neoplasia (converted, 16; open, 31); diverticular disease (converted, 21; open, 13); crohn’s disease (converted, 12; open, 5); and other disease (converted, 2; open, 2). Operative times were similar (converted, 150 ±56 minutes; open, 132 ±48 minutes). conversions occurred before defining the major vascular pedicle/ureter (50 percent), in relation to intracorporeal vascular ligation (15 percent), or during bowel transection or presacral dissection (35 percent). Specific indications for conversion were technical (41 percent), followed by adhesions (33 percent), phlegmon or abscess (23 percent), bleeding (6 percent), and failure to identify the ureter (6 percent). Median hospital stay was five days for both groups. In hospital complications (converted 11.6 percent; open 8 percent), 30 day readmission rate (converted 13 percent vs. open 8 percent), and direct costs were similar between groups. There were no mortalities. cONcLUSION: conversion of a laparo scopic

关键词：开腹切除术疾病转归结直肠外科开腹手术外科手术指征医师工作手术时间手术特点主要血管憩室病

pOSSUM、p-pOSSUM和cr-pOSSUM:在美国医疗保健系统进行的有关结肠癌切除术预后的研究

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世界核心医学期刊文摘（胃肠病学分册） 2005年第2期1卷 9-10页

作者： Senagore A.J. Warmuth A.J. delaney c.p. 郝筱倩 Department of colorectal Surgery Cleveland Clinic Foundation 9500 Euclid Avenue Clevelan d OH 44195United StatesDr.

pURpOSE: The physiologic and Operative Severity Score for the enUmeration of M ortality and morbidity (pOSSUM), portsmouth revision (p)-pOSSUM, and colorectal (cr)-pOSSUM scoring systems were developed as audit tools for comparing outcomes in surgical and colorectal patients on the basis of operati ve risk assessment. The aim of this study was to evaluate the applicability of t hese systems to a cohort of colon cancer patients undergoing surgery in the Unit ed States. METHODS: pOSSUM factors from 890 consecutive patients undergoing majo r surgical procedures for colon cancer in nine United States hospitals over a tw o-year period from January 2000 through December 2001 were prospectively collec ted. The observed over the expected hospital mortality was compared by means of the pOSSUM, p-pOSSUM, and cr-pOSSUM scoring systems. The effect of missing dat a on the utility of this process for outcome assessment was assessed with three methods for data imputation. RESULTS: The number of resections per institution r anged from 13 to 437. The observed mortality rate ranged from 0.8 percent to 15. 4 percent among the institutions, with an overall operative mortality of 2.3 per cent. The pOSSUM, p-pOSSUM, and cr-pOSSUM predicted mortality was 10.7 percent , 11.2 percent, and 4.9 percent, respectively. The pOSSUM and p-pOSSUM models o verpredicted mortality in all institutions (p cr-pOSSUM de monstrated an observed over expected hospital mortality ratio of >1 in three ins titutions. The calculations were unaffected by the various methods of inserting missing data. cONcLUSION: An apparent overprediction of mortality for colon canc er resection was evident with all three pOSSUM variants. This implies that a cal ibration process is required for use of these variants in the United States heal th care system. Missing data may be treated as normal values without influencing outcome. The cr-pOSSUM appeared to be the most promising audit tool for colore ctal cancer

关键词： p-pOSSUM 结肠癌切除术 cr-pOSSUM 美国医疗保健系统结肠癌患者结直肠癌手术总体死亡率住院死亡率外科患者

一种新型的外周性Mu阿片受体拮抗剂,爱维莫潘用于大型腹部术后肠梗阻治疗的Ⅲ期临床试验

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世界核心医学期刊文摘（胃肠病学分册） 2005年第11期1卷 6-7页

作者： delaney c.p. Weese J.L. Hyman N.H. 陈云茹 Department of colorectal Surgery/A30 Cleveland Clinic Foundation 9500 Euclid Avenue Cleveland OH 44195 United StatesDr.

pURpOSE: postoperative ileus presents significant clinical challenges that potentially prolong hospital stay, contribute to readmission, and increase morbidity. There is no approved treatment for postoperative ileus. Alvimopan is a novel, peripherally acting, mu opioid receptor antagonist currently in development for the management of postoperative ileus. METHODS: patients undergoing partial colectomy or simple or radical hysterectomy were randomized to receive alvimopan 6 mg (n = 152), alvimopan 12 mg (n = 146), or placebo (n = 153) orally 2 hours before surgery and twice daily thereafter until discharge or for up to seven days. The primary efficacy end point, time to return of gastrointestinal function, was a composite measure of passage of flatus or stool and tolerating solid food. Secondary end points included time to the hospital discharge order written. Adverse events were monitored throughout the study. RESULTS: Mean time to gastrointestinal recovery was significantly reduced in patients treated with alvimopan 6 mg vs. placebo (hazard ratio = 1.45; p = 0.003), with a smaller reduction seen with alvimopan 12 mg (hazard ratio = 1.28; p = 0.059). Mean time to the hospital discharge order written was significantly accelerated in patients treated with alvimopan 6 mg (hazard ratio = 1.50; p common treatment-emergent adverse events across all treatment groups were nausea, vomiting, and hypotension; the incidence of nausea and vomiting was reduced by 53 percent in the alvimopan 12-mg group. cONcLUSIONS: In patients undergoing major abdominal surgery, alvimopan accelerated gastrointestinal recovery and time to the hospital discharge order written compared with placebo and was well tolerated.

关键词：术后肠梗阻 Mu 阿片受体拮抗剂外周性 Ⅲ期临床试验结肠切除术肠道功能安慰剂子宫根治术固体食物

Effects of protein Toxins and Innocuous Dietary proteins on Indicators of Barrier Integrity,cytotoxicity,and Inflammatory cytokine production in Human Intestinal Epithelial cell Monolayers

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Effects of Protein Toxins and Innocuous Dietary Proteins on ...

超声触发微泡破裂增强肝细胞肝癌对经动脉放射栓塞治疗反应的随机临床试验

中国毒理学会第七次全国毒理学大会暨第八届湖北科技论坛

作者： Hurley Bp pirzai W Eaton AD Harper M Roper J Zimmermann c Ladics GS Layton RJ delaney B Mucosal Immunology & Biology Research center Massachusetts General Hospital Department of pediatrics Harvard Medical School

Human derived cells modeling the gastrointestinal barrier were assessed as an in vitro tool for identifying potential for adverse effects following exposure to protein toxins or innocuous dietary *** of cytotoxicity(LDH release,MTT conversion),monolayer barrier integrity([H]-inulin flux,horse radish peroxidase flux,trans-epithelial electrical resistance[TEER]),and production of inflammatory cytokines(IL-8,IL-6) were assessed using human intestinal epithelial cell lines(T84,caco-2,and HcT-8) grown on permeable Transwell filters following addition of purified *** proteins included streptolysin O(from Streptococcus pyogenes),clostridium difficile Toxins A and B,heat-labile toxin from enterotoxigenic Escherichia coli,listeriolysin O(from Listeria monocytogenes),melittin(bee venom),and mastoparan(wasp venom).The allergenic food proteins bovine milk β-lactoglobulin and peanut Ara h 2 and the anti-nutritive food protein wheat germ agglutinin were also *** not expected to cause adverse effects in the intestine included bovine and porcine serum albumin,bovine fibronectin,and ribulose bisphosphate carboxylase/oxygenase(RuBisco) from *** results demonstrated that multiple toxic proteins exerted effects on cytotoxicity and monolayer integrity whereas proteins considered innocuous did *** evaluation of this model is warranted as it may prove useful in hazard analysis for proteins with unknown toxicity profiles.

关键词： Biotechnology In vitro cellular toxicology

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国际医学放射学杂志 2021年第2期44卷 237-238页

作者： J.R.Eisenbrey F.Forsberg c.E.Wessner L.J.delaney K.Bradigan S.Gummadi 朱海涛

摘要充满气体的微泡(MB)超声对比剂可在外部超声波作用下原位破裂。在临床前模型中,超声触发的MB破裂即UTMD,已被证实可以通过对血管内皮细胞的局部损伤增

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非溃疡性消化不良的Hp根除治疗(摘要)

循证医学 2003年第2期3卷 120-121页

作者： Moayyedi p Soo S Deeks J delaney B Harris A Innes M Oakes R Wilson S Roalfe A Bennett c Forman D 郭云蔚

1 背景幽门螺杆菌(helicobacter pylori,Hp)是消化性溃疡的主要病因,而Hp在非溃疡性消化不良的作用机制尚未完全明确。2 目的评估Hp根除治疗对非溃疡性消化不良患者消化不良症状和生活质量分数的影响。

关键词：非溃疡性消化不良 Hp根除治疗幽门螺杆菌感染安慰剂