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61.
62.
Arjenne H.M. Gussenhoven Amika S. Singh S. Theo Goverts Marten van Til Johannes R. Anema Sophia E. Kramer 《International journal of audiology》2015,54(8):507-517
Objective: A multidisciplinary vocational rehabilitation programme, the Vocational Enablement Protocol (VEP) was developed to address the specific needs of employees with hearing difficulties. In the current study we evaluated the process of implementing the VEP in audiologic care among employees with hearing impairment. Design: In conjunction with a randomized controlled trial, we collected and analysed data on seven process parameters: recruitment, reach, fidelity, dose delivered, dose received and implemented, satisfaction, and perceived benefit. Study sample: Sixty-six employees with hearing impairment participated in the VEP. The multidisciplinary team providing the VEP comprised six professionals. Results: The professionals performed the VEP according to the protocol. Of the recommendations delivered by the professionals, 31% were perceived as implemented by the employees. Compliance rate was highest for hearing-aid uptake (51%). Both employees and professionals were highly satisfied with the VEP. Participants rated good perceived benefit from it. Conclusions: Our results indicate that the VEP could be a useful treatment for employees with hearing difficulties from a process evaluation perspective. Implementation research in the audiological setting should be encouraged in order to further provide insight into parameters facilitating or hindering successful implementation of an intervention and to improve its quality and efficacy. 相似文献
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目的调查呼吸专科护士慢性呼吸疾病管理现状,为提高慢性呼吸疾病的管理水平提供参考。方法依据《中国成人慢性呼吸疾病患者护理管理指南》设计调查问卷,对重庆、四川、贵州、陕西、河北、湖北、海南7省市的205名呼吸专科护士进行问卷调查。结果呼吸专科护士慢性呼吸疾病管理总分为(140.72±23.90)分。慢性呼吸疾病管理得分最低的3个条目有评估工具应用、个性化管理计划的实施、慢阻肺随访的次数及指导哮喘患者使用峰流速仪;呼吸专科护士所在单位慢性呼吸疾病管理平台建设均低于50%。结论呼吸专科护士慢性呼吸疾病管理处于中等偏下水平,评估是慢性呼吸疾病管理的薄弱点。需加强呼吸专科护士专业能力培养,规范慢性呼吸疾病全程管理,强化医院平台建设等,提高慢性呼吸疾病的管理水平。 相似文献
65.
目的应用6σ理论对肿瘤标志物项目的分析性能进行评价,并初步确定各项目的质量目标。
方法收集本实验室2018年1至12月室内质控数据和国家卫生健康委临床检验中心室间质量评价结果,以生物学变异导出的质量规范和国家室间质量评价标准作为允许总误差(TEa)计算6项肿瘤标志物的σ水平,并依据质量目标选择流程图和肿瘤标志物分析性能验证图评价肿瘤标志物的分析性能,进而为肿瘤标志物选择合适的质量目标。
结果应用不同层级的生物学变异导出的质量规范和国家室间质量评价标准,肿瘤标志物项目的σ水平存在显著差异;依据质量目标选择流程图:选择生物学变异导出的"适当的"质量规范作为CA125项目的质量目标,选择生物学变异导出的"最低的"质量规范作为t-PSA、CEA、AFP、CA199和CA153项目的质量目标。
结论6σ能够客观评价肿瘤标志物的分析性能,并为实验室质量目标的选择提供重要的参考价值。 相似文献
66.
Fiene Marie Kuijper Uma V. Mahajan Seul Ku Daniel A.N. Barbosa Sheila M. Alessi Sherman C. Stein Kyle M. Kampman Brandon S. Bentzley Casey H. Halpern 《Neuromodulation》2022,25(2):253-262
ObjectivesCocaine is the second most frequently used illicit drug worldwide (after cannabis), and cocaine use disorder (CUD)-related deaths increased globally by 80% from 1990 to 2013. There is yet to be a regulatory-approved treatment. Emerging preclinical evidence indicates that deep brain stimulation (DBS) of the nucleus accumbens may be a therapeutic option. Prior to expanding the costly investigation of DBS for treatment of CUD, it is important to ensure societal cost-effectiveness.AimsWe conducted a threshold and cost-effectiveness analysis to determine the success rate at which DBS would be equivalent to contingency management (CM), recently identified as the most efficacious therapy for treatments of CUDs.Materials and MethodsQuality of life, efficacy, and safety parameters for CM were obtained from previous literature. Costs were calculated from a societal perspective. Our model predicted the utility benefit based on quality-adjusted life-years (QALYs) and incremental-cost-effectiveness ratio resulting from two treatments on a one-, two-, and five-year timeline.ResultsOn a one-year timeline, DBS would need to impart a success rate (ie, cocaine free) of 70% for it to yield the same utility benefit (0.492 QALYs per year) as CM. At no success rate would DBS be more cost-effective (incremental-cost-effectiveness ratio <$50,000) than CM during the first year. Nevertheless, as DBS costs are front loaded, DBS would need to achieve success rates of 74% and 51% for its cost-effectiveness to exceed that of CM over a two- and five-year period, respectively.ConclusionsWe find DBS would not be cost-effective in the short term (one year) but may be cost-effective in longer timelines. Since DBS holds promise to potentially be a cost-effective treatment for CUDs, future randomized controlled trials should be performed to assess its efficacy. 相似文献
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68.
《The surgeon》2020,18(3):165-177
IntroductionThe liver is the most frequently damaged organ in blunt abdominal trauma. It is widely accepted that hemodynamically stable patients with low-grade liver trauma should be treated with non-operative management, however there is controversy surrounding its safety and efficacy in high-grade trauma. The purpose of this review is to investigate the role of non-operative management in patients with high-grade liver trauma.MethodsPubMed and reference lists of PubMed articles were searched to find studies that examined the efficacy of non-operative management in high-grade liver injury patients, and compare it to operative management. Non-operative management was considered successful if rescue surgery was avoided. Outcomes considered were success, mortality, and complication rates.ResultsThe electronic search revealed 2662 records, 8 of which met the inclusion criteria. All 8 studies contained results suggesting that non-operative management was safe and effective in hemodynamically stable patients with high-grade liver trauma. By combining the outcomes of the different studies, non-operative management had a high success rate of 92.4% (194/210) in high-grade liver trauma patients, which was near the overall 95.0% non-operative management success rate. Non-operative management also had mortality and complication rates of 4.6% (9/194) and 9.7% (7/72) in high-grade injury patients, respectively, compared to operative management's 17.6% (26/148) and 45.5% (5/11).ConclusionNon-operative management of liver trauma is safe and effective in hemodynamically stable patients with high-grade liver injury. It is associated with significantly lower mortality compared with operative management. More studies are required to evaluate complications of non-operative management in high-grade liver injury. 相似文献
69.
目的:研究阳春砂小花假合蕊柱的形成过程。方法:将阳春砂小花自0. 5 cm长度至开花后一天划分为8个生长时期,对小花鲜样解剖并制作石蜡切片,测定花药腔的高度,花粉囊裂口夹角,花粉囊缝隙宽度,花柱直径,花丝与唇瓣的夹角(α),花丝与花药的夹角(β)。结果:花粉囊夹角在开花前无明显变化,开花时从32°缩小为17°。两对花粉囊间的缝隙宽度在第5时期增大至约0. 29 mm,同时期的花柱直径约0. 32 mm,两者比例达92%。相比开花前一天,开花时α角从83°减小为42°,β角从186°减小为147°。花丝的远轴侧比近轴侧多1至5层细胞,花柱的近轴侧比远轴侧多1至6层细胞。结论:远、近轴侧细胞结构的不对称性是花丝、花柱运动的基础。在第5时期,花粉囊间的缝隙增大至几乎与花柱等径,花柱运动嵌入花粉囊间。开花时花粉囊夹角缩小,将花粉囊间隙出口封闭,花柱留在花粉囊间,同时角α,β剧烈减小,雄蕊将雌蕊夹在其中向唇瓣弯曲,最终形成半包于唇瓣内的假合蕊柱结构。 相似文献
70.
目的探究持续质量改进在体检科护理质量管理中的应用效果。方法该次将该院在2018年7-12月的体检者200名作为研究的对象,视为对照阶段,采取常规护理管理方法;将该院2019年1-6月的体检者200名作为观察阶段对象,在护理管理工作中采取持续质量改进管理模式,进一步对比两个阶段患者对于体检科工作质量的评分。结果在体检工作质量、服务态度、体检满意度这3个模块,观察阶段评分对照阶段比较均明显更高,差异有统计学意义(P<0.05)。结论持续质量改进应用于体检科护理质量管理中,可有效提升体检服务品质,值得推广应用。 相似文献