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A study evaluating the effect of Educational Needs Assessment Tool (ENAT) focused patient education, on health outcomes in patients with Rheumatoid Arthritis: Protocol of an ongoing study

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Open Journal of Nursing 2013年第2期3卷 287-292页

作者： Bernadette Hardware Claire Hale Dawn Johnson Jackie Hill Tracey Young Adewale Adebajo Academic and Clinical Unit for Musculoskeletal Nursing Institute of Rheumatic and Musculoskeletal Medicine University of Leeds Leeds UK Academic and Clinical Unit for Musculoskeletal Nursing School of Healthcare University of Leeds Leeds UK Medical Statistics School of Health and Related Research University of Sheffield Sheffield UK R&D Department Barnsley Hospital NHS Foundation Trust Barnsley UK

Aims and objectives: To evaluate the effectiveness of a patient education tool (the ENAT) on self efficacy, patient knowledge, health outcomes and its usability in practice. Background: The effectiveness and value of patient education in rheumatoid arthritis have been questioned. The ENAT was developed to help the nurses to provide more focused, individualized and relevant education. The psychometric properties of the ENAT have been assessed. Design: This study is a single blind randomized controlled trial using both quantitative and qualitative methodology. The primary outcome is patient self efficacy. Secondary outcomes are physical function, psychological status, pain levels, social interaction and patient knowledge of disease. Methods: 130 RA patients will be randomized into an experimental (EG) or control group (CG). The EG patients will complete the ENAT prior to seeing a Clinical Nurse Specialist (CNS) at weeks 0, 16 and 32. The CNS will use the ENAT as a template to meet patients perceived educational needs in addition to the usual care. The CG will receive their usual care from the CNS without the aid of the ENAT. To determine the ENAT’s usability, semi-structured quailtative interviews will take place with the practitioners and a sample of patients once they have completed the quantitative arm of the study. Results: The study commenced in April 2011 and the results are expected to be available after April 2013. Conclusions: It is hypothesized that nurses’ use of the ENAT will lead to increased patient self efficacy, and improved patient knowledge and health outcomes among the patients who used it. Furthermore, it is hypothesized that the ENAT will be easy for staff and patients to use. Relevance to clinical practice: The ENAT was developed to assess the perceived educational needs of patients with rheumatoid arthritis and thus help the nurses to provide more focused, individualised and relevant education.

关键词： Educational Needs Assessment Tool Protocol Rheumatoid Arthritis Self Management Patient Education

心脏MR成像中4种心肌灌注定量估计方法的诊断效能比较:MR成像对冠心病的临床评估分项研究

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国际医学放射学杂志 2015年第4期 370-371页

作者： J.D.Biglands D.R.Magee S.P.Sourbron S.Plein J.P.Greenwood A.Radjenovic 刘春明 Department of Medical Physics and Engineering Leeds Teaching Hospitals NHS Trust

摘要目的采用 MR 心肌灌注成像研究中的数据比较4种药物动力学分析方法定量评估心肌灌注情况(诊断心肌缺血的能力)的诊断效能。材料与方法本研究经区域伦理委员

关键词：诊断效能 MR 心肌灌注临床评估冠心病冠状动脉病

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儿童便秘

英国医学杂志中文版 2022年第5期25卷 275-279页

作者： Olivia Bradshaw Robbie Foy Arnab K Seal Jonathan C Darling 崔雅茜(译) 黄娅茜(校) leeds Teaching Hospitals nhs trust LeedsUK leeds Institute of Health Sciences University of LeedsLeeds leeds Community Healthcare nhs trust Leeds University of leeds Leeds Division of Women′s and Children′s Health School of MedicineUniversity of LeedsLeeds 北京大学第一医院

一名2岁男孩排便费力且排便困难,这让他的父母很担心。他们用了2个星期的聚乙二醇治疗,但是因为苦恼用药会弄脏裤子,就很快停药了。

关键词：排便困难聚乙二醇儿童便秘停药苦恼

A Prospective Survey Comparing Patients’ Experience of a Nurse-Led Clinic and Consultant-Led Clinic for Surveillance of Patients with Dilatation of the Intrathoracic Aorta

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World Journal of Cardiovascular Surgery 2019年第2期9卷 24-34页

作者： Bhuvaneswari Krishnamoorthy Rashmi Birla William R. Critchley Paul D. Waterworth Department of Cardiothoracic Surgery Manchester Foundation NHS Trust Manchester UK Division of Cardiovascular Sciences Faculty of Biology Medicine and Health The University of Manchester Manchester UK Faculty of Health and Social Care Edge Hill University Ormskirk UK The Endothelial Cell Biology Unit School of Molecular and Cellular Biology University of Leeds Leeds UK

Background: Increasing workload in consultant-led clinics often means patients to wait a long time for clinic appointments. To address this, there is an increasing trend in developing nurse-led clinics across many specialities in the National Health Service. This study aims to assess whether the implementation of a nurse-led clinic in thoracic aortic surgery will optimise the utilisation of health care services and improve overall patient satisfaction. Methods: 80 follow-up patients were asked to complete a questionnaire following their appointment in an aortic clinic, which was led either by a consultant (n = 40) or an aortic specialist nurse (n = 40). All patients seen by a nurse in the clinic were assessed by a consultant surgeon prior to the clinic for suitability. No new patients were seen by a nurse. Any patient with an aortic dimension of 5 cm or greater was seen by the consultant. If there were any complicated clinical features, the patient was seen in the consultant-led clinic. Patients were asked questions about their time spent with the respective health care professionals across 12 categories (punctuality, preparedness, understanding of concerns, clarity of speech, listening, respect, explaining, letting you talk, putting you at ease, emotional support, advice and advice for next follow-up). Patients rated each category using an ordinal scale from 0 - 10. Results: Patient scores were greater in nurse-led clinics compared to consultant-led clinics across a number of categories although only punctuality reached significance (mean 9.2 vs. 6.8, p 0.05). Conclusion: Patients were highly satisfied with the nurse-led clinic across all categories, with greater satisfaction for punctuality. These findings suggest that a nurse-led clinic can be implemented for the management of carefully selected thoracic aortic surgery patient without reduction in patient satisfaction.

关键词： Nurse-Led Clinic Consultant-Led Clinic Thoracic Aortic Surgery Surveillance Patient Satisfaction

直接面视下短程抗结核化疗影响病人依从性的因素

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国际结核病与肺部疾病杂志 2002年第2期 65-70页

作者： S.J.O'Boyle J.J.Power M.Y.Ibrahim J.P.Watson 邹级谦 University of leeds School of Medicine Leeds UK Unit of Infectious Diseases Public Health Department Sabah Borneo Malaysia Department of Respiratory Medicine Leeds Teaching Hospitals NHS Trust Leeds General Infirmary Leeds UK

背景:马来西亚,沙巴,Kota Kinabalu及其周边社区。目的:了解影响抗结核化疗病人依从性的诸因素,以及他们的结核病知识水平及和DOTS管理的改进意见。设计:对2000年8月至9月期间到诊所DOTS治疗的合作及不合作病人进行家庭访视。结果:... 详细信息

背景:马来西亚,沙巴,Kota Kinabalu及其周边社区。目的:了解影响抗结核化疗病人依从性的诸因素,以及他们的结核病知识水平及和DOTS管理的改进意见。设计:对2000年8月至9月期间到诊所DOTS治疗的合作及不合作病人进行家庭访视。结果:共访问了63例合作病人和23例不合作病人。对于不合作者,他们去治疗中心的花费(P<0.005)及旅途时间(P<0.005)均比合作者明显要多。交通费常常是不去治疗的主要原因。不合作病人中完成中等教育的多(P<0.05),并且有工作的也多(P<0.01)。更多的不合作者中其家庭成员曾患过本病(P<0.01)。有关结核病知识的得分,两组间无差别;但是,不合作病人大多认为,当症状消失后便可停止治疗(P<0.01)。很多病人(73％)认为,通过提供更多的结核病知识可改善DOTS管理体系。结论:赴治疗中心的交通费、占用的时间及家庭成员曾患过结核病等因素对沙巴,Kota Kinabalu地区病人的DOTS依从性产生影响。病人愿意获得更多关于结核病的知识。

关键词：结核病 DOTS 东南亚依从性

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腹部钝器伤：必须改进创伤患者的诊疗服务

英国医学杂志中文版 2008年第5期11卷 318-319页

作者：高健(译) leeds Teaching Hospitals nhs trust St James’s University Hospital Leeds LS9 7TF.

Jansen等作者在综述中（见第4期第222页）提到的诊疗方法反复重申一些陈旧的规则，也许仅仅能对创伤死亡率高于其他发达国家的英国有所帮助。作者们没有讨论为什么需要和如何提高创伤患者的诊疗服务。在英国，多发性创伤的发病率相对较... 详细信息

Jansen等作者在综述中（见第4期第222页）提到的诊疗方法反复重申一些陈旧的规则，也许仅仅能对创伤死亡率高于其他发达国家的英国有所帮助。作者们没有讨论为什么需要和如何提高创伤患者的诊疗服务。在英国，多发性创伤的发病率相对较低，缺乏与之匹配的创伤患者接诊服务规定，英国国家医疗卫生服务体系（nhs）对此项目的反应虽有热情，但缺乏有序化。

关键词：创伤患者诊疗服务钝器伤医疗卫生服务体系腹部多发性创伤诊疗方法发达国家

Treatment of Helicobacter pylori in surgical practice:A randomised trial of triple versus quadruple therapy in a rural district general hospital

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World Journal of Gastroenterology 2008年第24期14卷 3855-3860页

作者： Siok Siong Ching Sivakumaran Sabanathan Lloyd R Jenkinson Clinical Research Fellow in General Surgery Leeds General Infirmary Department of Surgery Ysbyty Gwynedd

AIM: To compare a lansoprazole-based triple versus quadruple therapy for Helicobacter pylori (H pylori) eradication with emphasis on side effect prof ile,patient compliance and eradication rate at a rural district general hospital in Wales,United Kingdom. METHODS: One hundred one patients with H pylori infection were included in the study. Patients were randomised to receive triple therapy comprising of lansoprazole 30 mg,amoxycillin 1 g,clarithromycin 500 mg,all b.d. (LAC),or quadruple therapy comprising of lansoprazole 30 mg b.d.,metronidazole 500 mg t.d.s.,bismuth subcitrate 240 mg b.d.,and tetracycline chloride 500 mg q.d.s. (LMBT). Cure was defi ned as a negative 13C urea breath test 2 mo after treatment. RESULTS: Seven patients were withdrawn after randomisation. Fifty patients were assigned to LAC group and 44 to LMBT group. The intention-to-treat cure rates were 92% and 91%,whereas the per-protocol cure rates were 92% and 97%,respectively. Side effects were common,with 56% experiencingmoderate to severe symptoms in the LAC group and 59% in the LMBT group. Symptoms of vomiting,diarrhoea and black stools were significantly more common in the LMBT group. Patient compliance was 100% for triple therapy and 86% for quadruple therapy (P < 0.01). One-third of patients in both groups were still taking acid-reducing medications at six-month follow-up. CONCLUSION: One-week triple and quadruple therapies have similar intention-to-treat eradication rates. Certain side effects are more common with quadruple therapy,which can compromise patient compliance. Patient education or modifi cations to the regimen are alternative options to improve compliance of the quadruple regimen.

关键词： Helicobacter pylori Triple therapy Quadruple therapy Side effects Treatment compliance Eradication rate

The 7th lung cancer TNM classification and staging system:Review of the changes and implications

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World Journal of Radiology 2012年第4期4卷 128-134页

作者： Saeed Mirsadraee Dilip Oswal Yalda Alizadeh Andrea Caulo Edwin JR van Beek Clinical Research Imaging Centre University of EdinburghEdinburgh EH16 4TJUnited Kingdom Department of Radiology Mid Yorkshire NHS TrustWakefield WF1 4DGUnited Kingdom Department of Pathology Leeds Teaching HospitalsLeeds LS9 7TFUnited Kingdom

Lung cancer is the most common cause of death from cancer in males,accounting for more than 1.4 million deaths in *** is a growing concern in China,Asia and Africa as *** staging of the disease is an important part of the management as it provides estimation of patient’s prognosis and identifies treatment *** also helps to build a database for future staging projects.A major revision of lung cancer staging has been announced with effect from January *** new classification is based on a larger surgical and non-surgical cohort of patients,and thus more accurate in terms of outcome prediction compared to the previous *** are several original papers regarding this new classification which give comprehensive description of the methodology,the changes in the staging and the statistical *** overview is a simplified description of the changes in the new classification and their potential impact on patients’ treatment and prognosis.

关键词： Lung neoplasms Neoplasm staging Lung cancer staging

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类风湿关节炎的治疗

英国医学杂志中文版 2006年第2期9卷 100-104页

作者： Paul Emery 张卓莉（译） Academic Unit of Musculoskeletal Disease Leeds Teaching Hospitals NHS Trust Chapel Allerton Hospital Leeds LS7 4SA 不详

应尽早控制类风湿关节炎患者的炎症传统的改善病情抗风湿药以及新的生物制剂可以更有效地治疗类风湿关节炎改善病情抗风湿药对类风湿关节炎患者的症状和体征控制有效,但是生物制剂对阻止骨质破坏的进展有更强的作用初步数据显示:如果在... 详细信息

应尽早控制类风湿关节炎患者的炎症传统的改善病情抗风湿药以及新的生物制剂可以更有效地治疗类风湿关节炎改善病情抗风湿药对类风湿关节炎患者的症状和体征控制有效,但是生物制剂对阻止骨质破坏的进展有更强的作用初步数据显示:如果在类风湿关节炎起病时即开始生物制剂治疗,而且治疗持续足够的时间。

关键词：类风湿关节炎治疗关节炎患者生物制剂抗风湿药骨质破坏数据显示基层医疗控制病情

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