机器人辅助在前列腺癌外科治疗的研究进展

前列腺癌发病率和死亡率逐年升高,开放性根治性前列腺切除术仍是局部晚期前列腺癌的治疗金标准。近年来,腹腔镜和机器人辅助前列腺切除术等微创技术已广泛应用,与传统开放性手术比较,其在肿瘤切缘控制、尿控能力和性功能等方面取得巨大进步。另外机器人辅助前列腺切除术在改善患者功能学方面更具优势。本综述就根治性前列腺切除术的发展、不同手术入路的选择、围手术期并发症、肿瘤学、功能学及学习曲线等方面阐述机器人运用在前列腺癌根治术中的进展。     

Early career registered nurses: How they stay

BackgroundEarly career registered nurses (ECRNs) are those in the first five years of practice and are at increased risk of leaving the profession. There is limited research investigating the experiences and approaches of ECRNs who have chosen to stay, which can, in turn, shed light on strategies to assist future ECRNs.AimThis article reports on the findings of a study that explored the disorienting dilemmas of ECRNs and asked the question, how do ECRNs stay working in the profession of nursing.MethodsA qualitative methodology, employing a staged narrative approach was used to collect, develop and analyse the stories of 13 ECRNs. Transformative learning theory provided the theoretical framework for the study.FindingsThe disorienting dilemmas experienced upon commencing work as RNs, required ECRNs to question the premise for their disorientation. Through this questioning, they discovered a misalignment between what they imagined it would be like to work as an RN and what they experienced once registered and in the workforce. Supportive but ad hoc relationships facilitated participants’ abilities to transform their frames of reference and begin to develop effective and authentic ways of being in the world, leading to their decision to stay.ConclusionLearning for ECRNs must be a shared responsibility and the findings highlight the importance of relational and ontological learning for ECRNs. Workplaces must be safe, conducive to learning where uncivil and unprofessional behaviours are rejected.     

What do quantitative ratings and qualitative comments tell us about general surgery residents’ progress toward independent practice? Evidence from a 5-year longitudinal cohort

Background

This study examines the alignment of quantitative and qualitative assessment data in end-of-rotation evaluations using longitudinal cohorts of residents progressing throughout the five-year general surgery residency.

Stakeholders' viewpoints on work-integrated learning practices in radiography training in South Africa: Towards improvement of practice

Purpose

The aim of this investigation was to suggest practices to improve the delivery of work-integrated learning (WIL) in radiography training in South Africa (SA).

Comparison of PC and iPad administrations of the Cogstate Brief Battery in the Mayo Clinic Study of Aging: Assessing cross-modality equivalence of computerized neuropsychological tests

Objective: Computerized neuropsychological assessments are increasingly used in clinical practice, population studies of cognitive aging and clinical trial enrichment. Subtle, but significant, performance differences have been demonstrated across different modes of test administration and require further investigation.

Method: Participants included cognitively unimpaired adults aged 50 and older from the Mayo Clinic Study of Aging who completed the Cogstate Brief Battery and Cogstate’s Groton Maze Learning Test (GMLT) on an iPad or a personal computer (PC) in the clinic. Mode of administration differences and test–retest reliability coefficients were examined across 3 cohorts: a demographically matched test–retest cohort completing PC and iPad administrations the same day (N?=?168); a test naïve cohort comparing baseline PC (n?=?1820) and iPad (n?=605) performance; and a demographically matched longitudinal cohort completing 3 Cogstate visits over 15 months on either the PC (n?=63) or iPad (n?=63).

Results: Results showed a small but statistically significant and consistent finding for faster performance on PC relative to iPad for several Cogstate Brief Battery measures. Measures of accuracy generally did not differ or differences were very small. The GMLT showed faster performance and higher total errors on iPad. Most Cogstate variables showed no difference in the rate of change across PC and iPad administrations.

Conclusions: There are small, but significant, differences in performance when giving the same cognitive tests on a PC or an iPad. Future studies are needed to better understand if these small differences impact the clinical interpretation of results and research outcomes.