SRTR Center-Specific Reporting Tools: Posttransplant Outcomes

Measuring and monitoring performance—be it waiting list and posttransplant outcomes by a transplant center, or organ donation success by an organ procurement organization and its partnering hospitals—is an important component of ensuring good care for people with end-stage organ failure. Many parties have an interest in examining these outcomes, from patients and their families to payers such as insurance companies or the Centers for Medicare and Medicaid Services; from primary caregivers providing patient counseling to government agencies charged with protecting patients.
The Scientific Registry of Transplant Recipients produces regular, public reports on the performance of transplant centers and organ procurement organizations. This article explains the statistical tools used to prepare these reports, with a focus on graft survival and patient survival rates of transplant centers—especially the methods used to fairly and usefully compare outcomes of centers that serve different populations. The article concludes with a practical application of these statistics—their use in screening transplant center performance to identify centers that may need remedial action by the OPTN/UNOS Membership and Professional Standards Committee.     

开展卫勤指挥员任职培训的教学实践和体会

近几年来,第二军医大学卫生勤务学系承担了大量卫勤指挥员的任职培训任务.通过几年的理论研究和实践摸索,在教学的组织、管理、实施、保障等方面积累了一些经验,获得了一些具体的体会.我们认为要做好卫勤指挥员的任职培训教学必须明确培训目标,科学制定教学方案,精心安排教学内容,做好施训教员的培训,并在教学中注重合理运用教学方法,特别是要做好下部队调研,切实提高教学实效.     

Continuing professional development for radiographers

Purpose: The purposes of this survey were to identify the current participation in Continuing Professional Development (CPD) of radiographers in the South and West Regional Health Authority (SWRHA), and to invite them to comment on issues related to CPD activities.Methods: A questionnaire was sent to 1686 diagnostic and therapy radiographers in the SWRHA. This was designed to gain a profile of those radiographers currently practising and their participation in, and comments on, CPD activities.Results: A response rate of 51% was achieved, although only 634 questionnaires were used for the final analysis. The population of radiographers who responded were predominantly diagnostic, in the age range 26–45 years, female and employed on a full-time basis. Most respondents did not hold any post-registration qualifications, and only 149 respondents were involved in formal studies. Most respondents were involved in statutory CPD activities such as resuscitation and manual lifting, and fewer, although a majority, were involved in activities associated with changing roles and developing new competencies. Other CPD activities which respondents considered as benefiting their professional role were wide ranging. Most of the issues raised concerning CPD related to provision, support and funding.Conclusions: The challenge for the future is to develop a coherent, progressive and affordable scheme of CPD to meet the needs of individual radiographers, the health services, the patient and the profession.     

Midwives' practices and beliefs about discharging clients from their practice

Discharging a client from a practice is a choice clinicians may need to make when conflicts arise that cannot be resolved. The legal and ethical considerations before discharging a client are presented. This preliminary survey of 111 certified nurse-midwives was conducted to determine their practices and beliefs about discharging clients. Most (83.7%) participants had discharged five or fewer clients from their practice throughout their careers, including 36.9% who had never discharged a client from their practice. In contrast, 77.5% of participants said that midwives should definitely discharge clients from their practice under some circumstances. Antepartum care was the most frequent period during which clients were discharged, and 59% of those discharged were for noncompliance with the therapeutic regimen, obnoxious or abusive behavior as subjectively identified by the midwife and her colleagues, or failure to keep appointments. When asked why they might not discharge a client from their practice, 60% identified empathy or sympathy for the client as the reason. When asked why they did not discharge clients in the past, 23 (21%) respondents selected "colleagues disagreed" as the reason.     

The Development and Teaching of the Ethical Principles and Guidelines for Family Scientists*

This article describes the development of the Ethical Principles and Guidelines for Family Scientists that the National Council on Family Relations Board of Directors unanimously approved. Furthermore, it discusses the importance of ethics education for family professionals and provides suggestions for educators. Finally, the ethical principles and guidelines are delineated. We argue that the development of a scholarship on ethics education is important for current and future family scientists.     

PBL-CBL整合教学在内分泌科轮转临床医学专业学位研究生培养中的应用

目的 探讨以问题为基础的学习（problem-based learning,PBL）-以案例为基础的学习（case-based learning,CBL） 整合教学在内分泌科轮转临床医学专业学位研究生培养的效果。方法 将80名在内分泌科轮转的临床医学专业学位研究生随机分为试验组（采用PBL-CBL整合教学）和对照组（采用传统教学）,每组40人,轮转期为3个月。记录两组学生入科和出科时专业考试成绩,并通过问卷调查分析自信心、学习主动性和人际交往能力。采用SPSS 20.0进行t检验、卡方检验。结果 两组学生基线情况一致,经过3个月的转轮期后,与入科前相比,试验组学生的出科考试成绩、自信心、学习主动性和人际交往能力明显提升,差异均有统计学意义（P<0.001）。结论 PBL-CBL整合教学效果优于传统教学,有助于提高临床医学专业学位研究生在内分泌轮转的学习能力和成绩,值得推广。     

新时代加强高校师德师风建设的四重向度

师德师风是评价教师队伍素质的第一标准。党的十八大以来,习近平总书记对高校师德师风建设作出一系列重要指示,亲自部署谋划师德师风建设。当前,高校师德师风建设的整体态势是积极良好的,但仍面临协同管理机制有待进一步完善、教师育人意识有待进一步提高、师德培训成效有待进一步深化、评价考核体系有待进一步健全等问题。站在新的历史方位上,高校需着眼于新形势新情况,从构建师德师风建设运行体系、健全师德师风建设引领体系、健全师德师风建设考核体系、打造师德师风建设关怀体系等向度,进一步深化新时代师德师风建设,全面提升高校教师师德水平。     

Community participation in primary health care (PHC) programmes: lessons from tuberculosis treatment delivery in South Africa

Background

Currently, there is renewed interest in the role community participation can play in Primary Health Care (PHC) programmes such as the delivery of effective anti-TB treatment to patients in high-burden settings.

Objectives

To explore the feasibility of community participation in a high-burden Tuberculosis Control Programme and to establish how supervision of treatment by lay volunteers compares with other methods of tuberculosis treatment delivery in the Northern Cape province of South Africa.

Methods

Prospective study involving 769 patients with confirmed pulmonary TB who were followed-up over a one-year period. Questionnaire interviews were also carried out with 135 lay volunteers participating in the TB programme.

Results

One-third of the TB patients in the study received their treatment from lay volunteers in the community. Treatment outcomes for new patients supervised from the community were found to be equivalent to those who received treatment through other modes of treatment delivery (RR=1.04[0.94–1.16], p=0.435). For the re-treatment patients, community-based treatment was found to be superior (RR=5.89[2.30–15.09], p<0.001), to self-administered therapy.

Conclusions

Health care planners should consider community participation as a viable way of ensuring accessibility and effectiveness in PHC programmes. There is need for more research into ways of achieving sustainability in resource-limited but high disease burden settings.     

大学生寻求专业性心理帮助态度的预测因素研究

目的:探讨大学生寻求专业性心理帮助态度的预测因素。方法:选取700名不同年级、不同专业的大学生作样本,进行问卷调查。结果:以寻求专业性心理帮助态度为因变量,进行性别(2)×专业(2)的方差分析。结果发现,性别的主效应显著,F(1,615)=3.294,P=0.050。专业的主效应显著,F(1,615)=20.896,P=0.001。性别和专业的交互效应没达到显著性水平,F(1,615)=1.890,P=0.170。以寻求专业性心理帮助态度为因变量,回归分析结果得出R=0.636,R2=0.405,F=29.641,P=0.001,说明建立的回归方程是有意义的。结论:①对寻求专业性心理帮助态度有显著预测作用的变量按预测作用大小排序依次是:是否求助过、依赖的自我结构、自我隐藏度、专业、内控性和性别。②女生的寻求专业性心理帮助的态度比男生积极。③文体艺术类学生的寻求专业性心理帮助的态度比非文体艺术类学生积极。④自我结构是相互依赖的人寻求专业性心理帮助的态度积极。⑤自我隐藏度高的人寻求专业性心理帮助的态度消极。⑥内控者寻求专业性心理帮助的态度消极。