The ESSO core curriculum committee update on surgical oncology

IntroductionSurgical oncology is a defined specialty within the European Board of Surgery within the European Union of Medical Specialists (UEMS). Variation in training and specialization still occurs across Europe. There is a need to align the core knowledge needed to fulfil the criteria across subspecialities in surgical oncology.Material and methodsThe core curriculum, established in 2013, was developed with contributions from expert advisors from within the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy and Oncology (ESTRO) and European Society of Medical Oncology (ESMO) and related subspeciality experts.ResultsThe current version reiterates and updates the core curriculum structure needed for current and future candidates who plans to train for and eventually sit the European fellowship exam for the European Board of Surgery in Surgical Oncology. The content included is not intended to be exhaustive but, rather to give the candidate an idea of expectations and areas for in depth study, in addition to the practical requirements. The five elements included are: Basic principles of oncology; Disease site specific oncology; Generic clinical skills; Training recommendations, and, lastly; Eligibility for the EBSQ exam in Surgical Oncology.ConclusionsAs evidence-based care for cancer patients evolves through research into basic science, translational research and clinical trials, the core curriculum will evolve, mature and adapt to deliver continual improvements in cancer outcomes for patients.     

西医学历背景护士中医护理基础知识及技能培训内容的构建

目的构建西医学历教育背景的在职护士中医护理基础知识与技能的培训内容。方法通过文献回顾、文献计量学分析、德尔菲专家函询法确定培训内容及权重。结果培训内容包括"中医护理概述""中医护理基本理论""中医护理基本内容""中医护理基本技术"4个一级条目及30个二级条目和105个三级条目。结论构建的西医学历教育背景在职护士中医护理基础知识与技能培训内容的专家积极系数、权威程度较高,意见集中,结果可靠。临床护士中医护理基础知识与技能培训内容的构建能够为各机构中医护理培训提供依据。     

Relative distribution of quadriceps head anatomical cross-sectional areas and volumes—Sensitivity to pain and to training intervention

IntroductionQuadriceps heads are important in biomechanical stabilization and in the pathogenesis osteoarthritis of the knee. This is the first study to explore the relative distribution of quadriceps head anatomical cross-sectional areas (ACSA) and volumes, and their response to pain and to training intervention.MethodsThe relative proportions of quadriceps heads were determined in 48 Osteoarthritis Initiative participants with unilateral pain (65% women; age 45–78 years). Quadriceps head volumes were also measured in 35 untrained women (45–55 years) before and after 12-week training intervention. Cross-sectional areas of the vastus medialis (VM), inter-medius (VIM), and lateralis (VL), and of the rectus femoris (RF) were determined from axial T1-weighted MR images.ResultsThe proportion of the VM on the total quadriceps ACSA increased from proximal to distal. The difference in quadriceps ACSA of painful (vs. pain-free) limbs was −5.4% for the VM (p < 0.001), −6.8% for the VL (p < 0.01), −2.8% for the VIM (p = 0.06), and +3.4% for the RF (p = 0.67) but the VM/VL ratio was not significantly altered. The muscle volume increase during training intervention was +4.2% (p < 0.05) for VM, +1.3% for VL, +2.0% for VIM (p < 0.05) and +1.6% for RF.ConclusionThe proportion of quadriceps head relative to total muscle ACSA and volume depends on the anatomical level studied. The results suggest that there may be a differential response of the quadriceps heads to pain-induced atrophy and to training-related hypertrophy. Studies in larger samples are needed to ascertain whether the observed differences in response to pain and training are statistically and clinically significant.     

État des lieux de l’enseignement des techniques microchirurgicales en France et à l’étranger

The objective of this work was to determine the state of current training programs for microsurgery in France and abroad. Our survey of microsurgery training programs determined the registration volume, program contents, and number of students in France, and looked at registration volume and teaching time for programs abroad. Data were obtained from the Internet, university administration, those responsible for university diploma programs, and students. There were 18 university diploma programs in microsurgery in France. The average list price was €1,129 for an average of 19 hours of theoretical training and 100 hours of practice. Evaluation methods varied, but all required at least vascular anastomosis in rats. In 2011–2012, 148 students were enrolled and 126 graduated (85% passing rate). Abroad, 16 basic courses were listed in the USA, Europe and Asia. Nine advanced courses were offered. The average price was $1,346 for 36 hours of practice in the basic courses and $1,955 for over 50 hours of training in advanced courses. None of these courses gave out a diploma. Our results show that in France, university diploma programs in microsurgery are heterogeneous and the French College should consider updating them. Globally, a study is underway by the International Microsurgical Simulation Society.     

儿童踝关节背屈在步行中后期完成足廓清动作的作用分析

目的：探讨儿童踝关节背屈在步行中后期完成足廓清动作的重要性分析。方法将100例存在异常步态患儿随机分成两组，一组作为治疗组给予加强摆动相中后期踝关节背屈活动的康复训练，另一组作为对照组只给予常规康复训练。结果特别加强踝关节背屈训练组步行时足廓清动作显著改善，异常步态明显纠正。结论踝关节背屈对步行中后期完成足廓清动作进而纠正异常步行姿势有重要作用。     

The long-term benefits of a multi-component exercise intervention to balance and mobility in healthy older adults

We examined the long-term effects of a multi-component exercise program on balance, mobility and exercise behavior. The benefits of a community-based resistance and flexibility exercise intervention in a group of healthy older (60-75 years) individuals were recorded 12 months after completion of the randomized control intervention. Differences between those participants who continued to exercise and those who discontinued were investigated. Significant improvements from baseline in sit to stand (p < 0.001), timed up and go (p = 0.001), and sway (p < 0.001) remained at follow up in the exercise intervention group, with a control group unchanged. Participants who continued exercising had significantly greater improvements in strength immediately after the intervention, compared to those who discontinued (p = 0.004). Those who continued regular resistance training performed better in the step test at 12-month follow up (p = 0.009) and believed that the program was of more benefit to their physical activity (p < 0.001) than those who discontinued exercising. Benefits to balance and mobility persist 1 year after participation in a multi-component exercise program, due in part to some continuing participation in resistance training. Motivation to continue resistance training may be related real and perceived benefits attained from the intervention as well as the environmental context of the intervention.