Exploring the implementation of evidence-based optimisation strategies: A qualitative study of the experience of diagnostic radiographers

IntroductionRadiographers are responsible for ensuring safe and effective use of ionising radiation. Through evidence-based practice (EBP), valuable optimisation strategies can be implemented to fulfil these responsibilities. This study aimed to explore radiographers' attitudes, perceptions, and experience of using evidence-based optimisation strategies.MethodsA Grounded Theory approach using in-depth interviews. UK-based radiographers were recruited. Discussions focused on (1) the role of evidence-based optimisation strategies in daily practice, (2) assistance in implementing evidence-based optimisation strategies, and (3) the role of EBP and optimisation strategies in the future. Interviews were transcribed verbatim and analysed using open and axial coding.ResultsParticipants (n = 13) stated that EBP is not frequently used to implement optimisation strategies. Participants relied on the knowledge taught in education settings and their professional skills to optimise in daily practice, alongside departmental protocols. Barriers identified as affecting the implementation of optimisation strategies related to reluctance to change, a lack of support from superiors, and a lack of resources to engage with EBP. Some participants expected the use of optimisation strategies to become unnecessary due to technology advancements.ConclusionThe results indicate that effective operationalisation of EBP is not part of daily practice among radiographers to implement valuable optimisation strategies in daily practice.Implications for practiceThe potential barriers to implementing evidence-based optimisation strategies highlighted in this study suggest that improving access to resources and empowerment of individual radiographers is required to enable radiographers to implement optimisation strategies.     

河南省非订单定向全科住院医师规范化培训结业学员的就业状况及影响因素研究

背景 全科医生数量和质量是人力资源管理的两个重要维度，其中，医生数量的新增、保持和流失，是全科人力动态规划、管理和评价的重要考量，也是全科住院医师规范化培训（简称全科住培）的绩效指标。探讨全科住培学员的就业状况及影响因素，可以为今后住培政策和激励机制的制定提供参考，但目前针对非订单定向全科住培学员的相关研究较为缺乏。 目的 了解河南省非订单定向全科住培学员的就业状况，分析学员结业后未从事全科医学相关工作的原因，从而为完善培训管理和人力资源激励机制提供参考。 方法 于2021年8月，采用分层随机整群抽样法，在河南省选取2014—2017年入培且已结业的非订单定向全科住培学员326例进行问卷调查。问卷由课题组自行设计，主要内容为学员的基本信息、全科住培情况、目前工作情况及结业后从事与未从事全科医学相关工作的原因。问卷通过"问卷星"平台发放，由学员自行填写。 结果 共发放问卷326份，回收有效问卷271份（83.1%）。结业后，从事全科医学相关工作者77例（28.4%），从事非全科医学相关工作者194例（71.6%）。多因素Logistic回归分析结果显示，年龄、文化程度、生源类型、全科住培基地所在区域是学员结业后是否从事全科医学相关工作的影响因素（P<0.05）。与结业后未从事全科医学相关工作的学员相比，结业后从事全科医学相关工作学员注册为全科医学专业的比例更高〔70.1%（54/77）比32.0%（62/194），P<0.05〕，在乡镇卫生院/社区卫生服务中心执业的比例更高〔49.4%（38/77）比6.2%（12/194），P<0.05）〕。194例未从事全科医学相关工作的学员中，从事内科学工作者78例（40.2%），从事急诊及危重症医学工作者33例（17.0%），从事外科学工作者17例（8.8%）。不选择从事全科医学相关工作的前3位原因分别为：单位安排〔34.5%（67/194）〕，所在单位没有全科医学科〔29.9%（58/194）〕，薪酬低〔26.8%（52/194）〕。 结论 非订单定向全科住培学员选择从事全科医学相关工作的比例较低，年龄、文化程度、生源类型及基地所在区域是影响因素。建议加大全科医学理念宣传，加快综合医院全科医学科建设，提高全科医生薪酬待遇，以此增加全科医生的职业吸引力。     

Antifungal susceptibility testing practices in mycology laboratories in France, 2018

A survey of mycology laboratories for antifungal susceptibility testing (AFST) was undertaken in France in 2018, to better understand the difference in practices between the participating centers and to identify the difficulties they may encounter as well as eventual gaps with published standards and guidelines. The survey captured information from 45 mycology laboratories in France on how they perform AFST (number of strains tested, preferred method, technical and quality aspects, interpretation of the MIC values, reading and interpretation difficulties). Results indicated that 86% of respondents used Etest as AFST method, with a combination of one to seven antifungal agents tested. Most of the participating laboratories used similar technical parameters to perform their AFST method and a large majority used, as recommended, internal and external quality assessments. Almost all the participating mycology laboratories (98%) reported difficulties to interpret the MIC values, especially when no clinical breakpoints are available. The survey highlighted that the current AFST practices in France need homogenization, particularly for MIC reading and interpretation.     

家长对小学生近视的知信行分析

目的 了解保定市小学生家长关于小学生近视知信行的相关现状及影响因素,制定有效干预措施,为预防儿童青少年近视提供有力依据。方法 运用分层整群随机抽样的方法,抽取保定市某小学一年级至六年级766名学生家长进行问卷调查。结果 小学生家长用眼卫生相关知识总正确率为64.90%。家长年龄越大、文化程度越高以及自身近视的家长掌握小学生近视的相关知识越多。家长年龄越大,督导孩子健康用眼的行为越易发生(P=0.027,OR=0.169)。结论 应多渠道对学生家长进行健康教育,为控制和预防小学生近视的发生与发展构建以家庭为主的第一道防线。