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51.
52.
Pierre Gerbier Aurélien Binet Mathilde Etancelin Emmanuel Barteau Marie Auger Luciano Morales Philippe Bertrand Dominique Sirinelli Baptiste Morel 《Journal of pediatric surgery》2018,53(4):620-624
Purpose
The objective of this study was to evaluate the progress in performance of senior residents in diagnosing acute appendicitis.Material and methods
Results were collected and compared of ultrasound examinations performed for suspected acute appendicitis by three senior residents and two faculty members over a six-month period in a university hospital setting. A grid with the sonographic findings was completed separately by the residents and the faculty members immediately after each examination. The duration of each examination was reported. The final ultrasound diagnosis was compared to the surgical and pathological results and to the clinical follow-up.Results
The residents and faculty members performed 171 consecutive ultrasound examinations including 49 children with acute appendicitis and 122 with normal appendices. The accuracy of the diagnosis by the residents was 96%, and was similar to that of the faculty members (kappa = 0.90) over the six months. The duration of the resident ultrasound examinations was significantly shorter during the second three-month period (p = 0.01). No significant differences in diagnostic accuracy were demonstrated by the residents between the first and second three-month periods (p = 0.06).Conclusions
The residents performed well when using sonography to diagnose acute appendicitis in children, and were faster during the second three-month period.Level of evidence
I. 相似文献53.
54.
目的掌握徐州市居民罹患糖尿病的脆弱性情况,为进一步的干预提供科学依据。方法采用多阶段分层随机抽样方法,抽取徐州市15~69岁居民共4980人,进行统一的问卷调查,分析应对糖尿病的脆弱性。结果被调查人群中不知道肥胖易患糖尿病者共2427例(48:73%),不清楚糖尿病常见症状者2053例(41.22%),不知道父母患糖尿病子女易患糖尿病者共2746例(55.14%),不知道糖尿病会演变成其他疾病者2771例(55.64%),从未测血糖者共3424例(68.76%):1556例测过血糖中检出糖尿病116例,患病率为7.46%,其中未采取措施控制血糖者30例(25.86%);文化程度、家庭每月人均收入低者应对糖尿病脆弱性较高。结论徐州市居民罹患糖尿病脆弱性偏高,不同居民罹患糖尿病脆弱性不同,针对不同年龄、文化程度、收入等不同层次的人群加大多样化的健康教育和干预措施,降低居民罹患糖尿病的脆弱性。 相似文献
55.
Lapo Bencini Marco Bernini Francesco Martini Michele Rossi Cinzia Tommasi Egidio Miranda Luis Jos�� Sanchez Riccardo Naspetti Roberto Manetti Angelo Ferrara Silvia Nesi Bernardo Boffi Marco Farsi Renato Moretti 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2009,13(3):391-397
Background:
Laparoscopic appendectomy is widely performed by surgical residents, but its changing indications and outcomes have been poorly investigated. The aim of this study was to examine whether a difference exists in indications and outcomes between laparoscopic appendectomies performed by residents and those performed by experienced surgeons.Methods:
Between 1999 and 2007, 218 laparoscopic appendectomies were performed and recorded. Data were analyzed to compare operations performed by residents with those by experienced surgeons in terms of indications for surgery and severity of disease. Moreover, laparoscopic appendectomies were thoroughly compared regarding outcomes and complications.Results:
The residents had fewer conversions with laparoscopic appendectomy (8% vs 17%, P=0.04), and similar complication rates (12% vs 13%, P=0.16), compared with experienced surgeons. The median operating time was also comparable (67 minutes vs 60 minutes, P=0.23). However, patients operated on by residents had more emergencies (86% vs 70%, P=0.009), included more foreigners (27% vs 15%, P=0.03), and had intermediate to severe diseases, (81 vs 52%, P<0.001) than patients did operated on by experienced surgeons.Conclusions:
Surgical residents performed more emergency laparoscopic appendectomies on foreign patients suffering from intermediate to severe diseases compared with experienced surgeons, with comparable surgical outcomes and lower conversion rates. 相似文献56.
目的了解浦东新区社区居民在肿瘤早发现方面的知识和行为现状,为有针对性地开展社区居民的肿瘤健康教育提供科学依据。方法采用分层整群抽样,对2035名浦东新区的社区居民进行问卷调查。结果浦东新区社区居民在"认同吸烟有害健康"、"支持全民戒烟"、"了解乙肝表面抗原"、"了解表抗阳性复查时间"、"日饮水1L以上"、"便后注意观察大便性状"等6项差异有统计学意义,女性高于男性;认同"吸烟有害健康"、"了解乙肝表面抗原"、"了解表抗阳性复查时间"、"有生活压力"、"日饮水量1L以上"、"便后注意观察大便性状"、"饮食规律"和"支持全民戒烟"等8个方面差异有统计学意义,文化程度高者较文化程度低者的肿瘤知识及生活行为方式更为合理;女性随着文化程度的增高,乳腺自查率呈上升趋势(P<0.05)。结论社区居民对肿瘤早发现的认知及重视不足,通过向居民进行有针对性的肿瘤早期发现防治知识的健康教育,提高居民的认知水平,帮助他们建立健康的生活方式。 相似文献
57.
广东省城市居民吸烟与被动吸烟现状及控烟态度调查 总被引:2,自引:1,他引:1
目的了解城市居民吸烟状况与被动吸烟状况,了解居民对吸烟与被动吸烟危害的认知与态度状况,为开展针对性的控烟工作提供依据。方法采用随机偶遇抽样方法,在广州市、江门市、增城市医院、商场、车站等候室、政府对外办公大楼4类公共场所抽取18岁及以上人群进行面对面问卷调查,问卷采用中国控烟办公室统一设计的《成人被动吸烟调查问卷》。结果共调查城市居民599人,其中吸烟者190人,吸烟率为31.7%;男性吸烟率为56.6%,女性为3.2%;30-岁组吸烟率为最高,为42.6%;不同文化程度调查对象吸烟率的差异无统计学意义(P〉0.05)。392名不吸烟者中,162人处于被动吸烟状况,被动吸烟率为41.3%,男性被动吸烟率为37.6%,女性为43.1%。调查对象中,家里、室内娱乐场所和室内工作场所全部禁烟的比例分别为32.2%、12.3%和40.9%。非吸烟者对吸烟危害知识的知晓率高于吸烟者,支持公共场所禁烟的比例也高于吸烟者。结论广东省城市居民吸烟和被动吸烟状况严重,居民对公共场所禁烟的支持程度较高,吸烟者对吸烟危害认识不足,应加强吸烟危害健康教育,推动各类公共场所禁烟立法。 相似文献
58.
目的 了解杭州市城乡居民手卫生现状,提出相应健康促进建议.方法 采用等容抽样方法,按照城市居民、农村居民、机关事业单位人员、城市学生、农村学生、企业职工六类人群,每类人群从杭州市下辖的13个区、县(市)中各抽取50人,共计3 337人;依据WHO推荐的正确洗手标准,开展问卷调查,调查内容包括:人口学特征、手卫生防病知识、什么情况下洗手、洗手方式、六步洗手法使用情况等.数据分析采用非条件logistic回归分析和x2检验.结果 杭州市城乡居民正确洗手率为35.84%;其中,城市居民为41.45%,农村居民为27.06%;城市社区居民最高(48.15%),农村学生最低(20.00%);居民对手卫生预防疾病的认识率为35.06%,其中,城市居民为36.25%,农村居民为33.21%;居民正确洗手影响因素为所在城区、城乡、性别、年龄、手卫生预防疾病知识了解度;居民认识手卫生可预防疾病的影响因素为所在城区、性别、年龄、文化程度.结论 杭州市居民正确洗手率较低,城乡差异显著,副城区居民手卫生知识、行为均有待提高,同时,学生群体手卫生状况急需改善. 相似文献
59.
Robert C. Smith Heather Laird-Fick Francesca C. Dwamena Laura Freilich Brian Mavis Katelyn Grayson-Sneed Dale D’Mello Mark Spoolstra David Solomon 《Patient education and counseling》2018,101(12)
Objective
We tested the hypothesis that trained medical faculty can train residents effectively in a mental health care model.Methods
After the authors trained medical faculty intensively for 15 months in primary care mental health, the newly trained faculty taught medical residents intensively. Residents were evaluated pre- and post-residency and compared to non-equivalent control residents in another city. Using ANOVA, the primary endpoint was residents’ use of a mental health care model with simulated patients. Secondary endpoints were residents’ skills using models for patient-centered interviewing and for informing and motivating patients.Results
For the mental health care model, there was a significant interaction between study site and time (F?=?33.51, p?<?.001, Eta2?=?.34); mean pre-test and post-test control group scores were 8.15 and 8.79, respectively, compared to 7.44 and 15.0 for the intervention group. Findings were similarly positive for models of patient-centered interviewing and informing and motivating.Conclusions
Training medical faculty to teach residents a mental health care model offers a new educational approach to the widespread problem of poor mental health care.Practice Implications
While the models tested here can provide guidance in conducting mental health care, further evaluation of the train-the-trainer program for preparing residents is needed. 相似文献60.
目的:探讨SF-36量表用于农村居民健康状况测定的可能性。方法:用中文版SF-36量表测定富阳2-7名14岁以上的农村居民,分析其信度,效度。结果:除了SF,RE维度,其余6维度内部一致性信度系数大于0.50,7维度内部一致性信度大于与其他维度的相关,因子分析产生3个主成分,累计方差贡献为64.6%,65岁以上者无应答,青年组与中年组各维度平均分数差异不显著,不同性别只在RP维度上判别显著,吸烟者与不吸烟者,饮酒者与不饮酒者的得分差异不显著,不同文化程度人群的得分差异不显著。结论:尚需更多证据支持SF-36量表适用于农村居民健康状况测定。 相似文献