Cognitive reserve in Parkinson's disease: A systematic review and meta-analysis

BackgroundThe concept of cognitive reserve is proposed to explain the mismatch between the degree of pathological changes and their clinical manifestations and has been used to help understand the variation in the rate of cognitive decline and the development of dementias. It is not clear whether this concept applies to cognitive performance, cognitive decline and dementia in Parkinson's disease (PD).MethodsA systematic review was conducted using the most commonly described proxies for cognitive reserve of education, occupation and leisure activities. Thirty four papers were found on education and cognition in PD but there were no studies of the other proxies of reserve. A random effects meta-analysis was used to assess the associations between education and cross-sectional cognitive assessments, longitudinal global cognitive decline and a long term dementia diagnosis.ResultsThere was a significant association between higher education and cross-sectional performance of MMSE, global cognition, mild cognitive impairment, attention, executive function, visuospatial function and memory. There was a small but significant association between higher education and a reduced rate of cognitive decline. There was no association with a final dementia diagnosis. There was not enough information to perform an analysis on the rate and timing of transition to dementia.ConclusionsHigher levels of education are associated with significantly better cognitive performance and a small but significant slowing in cognitive decline but are not associated with a reduction in long-term dementia in PD. More detailed, standardized, longitudinal studies are required to study conclusively the effects cognitive reserve in PD.     

结核病临床研究生科研能力的培养现状和教学体会

随着人们生存环境和生活方式的改变,人类的传染性疾病谱也发生了日新月异的变化。交通事业的飞速发展,人员流动的范围不断扩大,出行频度逐年增多,加快了传染性疾病的传播速度和蔓延范围。作为以收治结核病为主的传染病医院,本院不仅要履行常规的传染病的预防和诊治工作,而且要加强临床研究生科研能力的培养来应对传染性疾病谱的改变。但是,在当前医学的教育模式下,结核病临床研究生的科研能力的培养仍然存在着一些弊端和不足,因此,教育模式的转型,优秀教育方法的引进以及不断地完善自身的科研激励措施,依旧是本院教育改革的重要方面。     

Osteopathic student satisfaction and preparedness to practice: A comparative study

BackgroundOsteopathy is now taught across the world, but each school has different teaching and learning strategies that may influence the preparedness of students for practice in different ways.ObjectiveTo investigate levels of the satisfaction with the learning environment and the preparedness to practise from the perspective of osteopathic students. The study compares full-time schools in three different countries to analyse relationships between learning environment and preparedness.MethodA web-based questionnaire using a five-point Likert scale (strongly agree, agree, uncertain, disagree, strongly disagree) was sent by e-mail to all final year students of the British School of Osteopathy (BSO-UK), Accademia Italiana Osteopatia Tradizionale (AIOT-Italy) and Centre Européen d'Enseignement Supérieur de l'Ostéopathie (CEESO-France).ResultsThe response rate was 58% for the BSO (n = 51), 100% for the AIOT (n = 12) and 80% for the CEESO (n = 63). The AIOT students perceived a better learning environment than CEESO and BSO students, while CEESO students felt more prepared than AIOT and BSO students. Statistically significant associations were found between learning environment and preparedness.ConclusionSmall classes may be partly responsible for the perception of a better learning environment. This study also highlighted that the learning environment may be partly responsible for the perceived differences in preparedness.     

中外融通与产教融合模式打造养老服务领域教师教学创新团队实践

教师教学团队建设直接关系到教育教学发展质量,人口老龄化使健康养老成为国家战略,作者阐述了首批国家级教师教学创新团队建设现状和存在的问题,以长春医学高等专科学校为例,提出团队建设目标和以中外融通、产教融合模式打造养老服务专业教师团队的策略,为全国首批教师教学创新团队和其他教学团队建设提供参考和借鉴。     

《意外伤害健康教育手册》用于幼儿家长教育的效果

目的 探讨对幼儿家长进行预防意外伤害健康教育的方法的效果。方法采用行动研究法，根据前期调查发现的危险因素，用自行设计的《意外伤害健康教育手册》对8名1-3岁幼儿的家长进行有针对性的教育，并追踪家访强化教育2次，把谈话录音、现场观察记录作为数据，进行量性和质性分析。结果8名幼儿的家长接受健康教育后，对前期发现的77个危险因素中的58个因素在认识或行为上发生了变化。结论用《意外伤害健康教育手册》对幼儿家长进行健康教育，对提高家长对意外伤害危险因素的认识并采取安全行动有促进作用。     

牙周病患者对牙周病的认识及口腔保健行为调查

目的 :了解牙周病患者对牙周病的认识及口腔保健行为 ,为更好地开展牙周病的预防工作 ,有针对性地进行健康教育提供依据。方法 :采用问卷调查与访谈相结合的方法 ,对初诊组和复诊组的调查结果进行比较和分析 ,数据均进行统计学处理。结果 :对牙菌斑控制的认识 ,正确率复诊组高于初诊组 ,两组间存在差异。对牙周病早期表现的认识及处理情况 ,复诊组在及时就诊及正确认识牙龈出血原因的百分率高于初诊组 ,两组间差异有统计学意义。患者的口腔保健行为中 ,刷牙方法选择两组间存在差异 ,其他各项均没有差异。结论 :患者对牙周病认识水平较低 ,口腔保健行为不良 ,护士未在健康教育中充分发挥其作用。今后在加强牙周病知识健康教育的同时 ,更重要的是关注口腔保健行为的改变 ,充分发挥护士是健康的促进者这一角色功能     

Animation-assisted CPRII program as a reminder tool in achieving effective one-person-CPR performance

Objective

The objective of this study is to compare the skill retention of two groups of lay persons, six months after their last CPR training. The intervention group was provided with animation-assisted CPRII (AA-CPRII) instruction on their cellular phones, and the control group had nothing but what they learned from their previous training.

Methods

This study was a single blind randomized controlled trial. The participants’ last CPR trainings were held at least six months ago. We revised our CPR animation for on-site CPR instruction content emphasizing importance of chest compression. Participants were randomized into two groups, the AA-CPRII group (n = 42) and the control group (n = 38). Both groups performed three cycles of CPR and their performances were video recorded. These video clips were assessed by three evaluators using a checklist. The psychomotor skills were evaluated using the Resusci^®Anne SkillReporter™.

Results

Using the 30-point scoring checklist, the AA-CPRII group had a significantly better score compared to the control group (p < 0.001). Psychomotor skills evaluated with the AA-CPRII group demonstrated better performance in hand positioning (p = 0.025), compression depth (p = 0.035) and compression rate (p < 0.001) than the control group.

Conclusion

The AA-CPRII group resulted in better checklist scores, including chest compression rate, depth and hand positioning. Animation-assisted CPR could be used as a reminder tool in achieving effective one-person-CPR performance. By installing the CPR instruction on cellular phones and having taught them CPR with it during the training enabled participants to perform better CPR.     

高等护理专业法律教育课程的调查研究

目的通过对实习护生、临床带教老师和护理专业教师的问卷调查,旨在了解目前浙江省高等护理专业法律教育的现状、以及护生和护理专业教师对法律知识的掌握情况。方法采用自行设计的3份不同的问卷,分别随机对485名本、专科(含高职)实习护生、192名临床带教老师及75名护理专业教师进行问卷调查。结果目前高等护理法律教育课时数偏少,学期安排不尽合理;护生和护理专业教师法律基础知识薄弱等。结论高等护理专业应加强师生的法律教育,培养师资,改进教学方法,以提高学生的法律意识。     

Research priorities for nursing and midwifery in Southern Ireland

AIM: To identify research priorities for nursing and midwifery in the Southern Health Board area in Ireland for the immediate and long term. METHOD: Ten focus groups were conducted over a 2-month period with 70 nurses and midwives working in clinical, managerial and educational roles participating. Based on focus group findings and a literature review a multi-item Likert type questionnaire was constructed and administered to 520 nurses and midwives (response rate 95%n=494). RESULTS: Research priorities were identified as: (1) impact of staff shortages on retention of RNs/RM's (80%); (2) quality of life of chronically ill patients (76%); (3) stress and bullying in the workplace (76%); (4) assessment and management of pain (75%); (5) skill mix and staff burnout (73%); (6) cardio-pulmonary resuscitation decision making (72%); (7) coordination of care between hospital and primary care settings (69%); (8) medication errors (67%); and (9) promoting healthy lifestyles (64%). Respondents also indicated that these priorities warranted immediate attention. Implications for practice include the need for: (1) emphasis on quality pain control; (2) recognition and exploration of the ethical issues relating to resuscitation; and (3) management of the context within which clinical care is given.     

Overview of methods for flexible endoscopic training and description of a simple explant model

The question of how to train surgeons in flexible endoscopy has been debated over the years as these skills have become an essential part of residency and practice. As many as two-thirds of surgeons perform flexible endoscopy, and for many, endoscopy represents up to 50% of their practice. Training in flexible endoscopy has evolved over many decades from an apprenticeship-type model to a more formal training program. Surgical residencies vary widely in their approach, with some having dedicated endoscopy rotations and others using an integrated approach. Innate to a good training program are faculty dedicated to teaching, an established curriculum, and adequate exposure of residents to proper training tools, whether as patient-based learning or supplemented by simulators. Hands-on models for teaching surgical endoscopy include mechanical, animal, and computer-based platforms. Herein, we describe our experience with a low-cost approach using porcine stomach explants that offers a breadth of endoscopic training including scope navigation, band ligation, endoscopic mucosal resection, hemostasis management, esophageal stenting, foreign body extraction, and ERCP. Simulation-based learning must be validated from a construct and internal validity perspective to be considered useful. Correlation between simulator learning and improvement in clinically relevant skills must then be shown using a validated scale, such as the Global Assessment of Gastrointestinal Endoscopy Skills. Competency in flexible endoscopy, which is currently measured by case volume, may be replaced by objective programs, such as Fundamentals of Endoscopic Surgery, that combine didactic teaching, cognitive assessment, and hands-on technical skills evaluation to determine a minimum level of proficiency.