以问题为基础的教学法对护理专业实习生应急能力的影响

目的 评价以问题为基础的教学法（problem-based learning,PBL）对提高护理专业实习生应急能力的效果.方法 将64名护理专业实习生随机分为两组,每组32名.对照组采用传统教学法,试验组采用PBL教学法.比较两组实习生理论、操作及临床应急能力的考核成绩,并由试验组实习生对PBL教学法的效果进行评价.结果 试验组实习生理论、操作及临床应急能力考核成绩好于对照组（P＜0.01）,对PBL教学法的效果评价积极,认为能提高急危重症抢救时的应对能力,93.75％的学生希望继续使用这种模式.结论 应用PBL教学法能激发实习生的求知积极性,培养他们综合分析和处理问题的能力,进而提高应急能力.     

精神科患者噎食发生原因及预防和应急处理

目的分析精神科患者噎食的发生原因,提出预防和应急处理策略。方法对精神科12例患者发生的13例次噎食事件进行回顾性分析。结果精神科患者发生噎食的主要风险因素是抗精神病药物不良反应,其次是暴饮暴食等精神症状;引起噎食的常见食物是馒头,噎食发生时段主要是午餐时。结论精神病患者发生噎食致窒息者较多,必须针对其风险因素进行动态风险评估,落实针对性干预措施,做好应急处理,以降低住院精神病患者噎食的发生率和死亡率。     

干休所院前急救相关因素分析

目的探讨军队干休所院前急救(FA)的影响因素,为科学干预、降低发生风险提供依据。方法整群抽样军队干休所1435例离退休干部为对象,连续观察3年,采用Logistic回归和chi-square危险度分层分析的方法,分别分析自身特征、自然条件、医疗条件与FA呼救率的相关性。结果高龄、健康状况不良、男性、丧偶、职务级别低是FA的危险因素(OR>1);夏季和冬季FA风险高于春、秋季(RR>1),冬季最高(RR=2.05),寒冷、炎热极端天气条件下FA风险进一步增高;交通不便、距保障医院道路距离远也是FA危险因素(RR>1);健康管理水平越高,FA呼救率越低(RR<1),增强干休所医疗人员力量有助于降低FA风险(RR<1)。结论针对FA影响因素,采取措施,积极干预,强化健康管理,是降低干休所FA风险的有效途径。     

70例心脏骤停患者急救的回顾与临床分析

目的：探讨心脏骤停患者的急救措施和临床分析。方法回顾性分析2008年10月～2013年10月70例心脏骤停患者的资料。患者入院后立即对其实施抢救，抢救主要包括心肺复苏术、辅助给氧、电除颤等，同时严格监控患者的各项生理指标。根据患者心脏骤停时间将其分为3组分别为A组1～5 min，B组6～10 min，C组＆gt;10 min。结果 A、B、C 组抢救成功50、6、2例患者，抢救成功率分别为96.15%、75.00%、20.00%，A组抢救成功率明显高于B、C组，差异有统计学意义（P〈0.05）。结论及时有效的早期复苏术和抢救处理对于患者的复苏至关重要，可以明显提高患者的生存概率。     

News and Product Update

The education of biomedical engineers in Canada is discussed, with reference to the Canadian health care system and related industry. Information on specific educational programmes, with enrolment data, is presented. The paper concludes with brief comments on the certification of clinical engineers in Canada.     

2例重度烧伤患者使用翻身床治疗时呼吸骤停的抢救

报告了2例重度烧伤患者在使用翻身床治疗过程中出现呼吸骤停的抢救体会。全面评估患者的病情,通过加强病情观察,保持患者呼吸道通畅,重视落实多种预防措施,运用正确的判断力和娴熟的复苏技巧,保证患者的安全。     

Evaluation of the Decision Aid for Genital Surgery in Transmen

BackgroundMultiple options of genital gender-affirming surgery are available to transmen. The transman should be able to weigh these options based on the outcomes, risks, and consequences that are most important to him. For this reason, a decision aid for genital surgery in transmen (DA-GST) was developed. It aims to support the transman in making thoughtful choices among treatment options and facilitate shared decision-making between the healthcare professionals and the transindividual.AimThe aim of this study was to evaluate the newly developed DA-GST.MethodsThis was a cross-sectional study using mixed methods. Transmen considering to undergo genital surgery were eligible to partake in the study. The questionnaires used in this study were developed by adapting the validated Dutch translation of the “Decisional Conflict Scale,” the “Measures of Informed Choice,” and the “Ottawa Preparation for Decision-Making Scale.” Qualitative interviews were conducted querying their subjective experience with the DA-GST. The data from the questionnaires were statistically analyzed, and the data from the interviews were thematically analyzed.OutcomesThe main outcome measures were decisional conflict and decisional confidence measured via self-report items and qualitative data regarding the use of the DA-GST via interviews.ResultsIn total, 51 transmen participated in the questionnaires study, 99 questionnaires were analyzed, and 15 interviews were conducted. Although confident in their decision, most transmen felt responsible to collect the necessary information themselves. The ability to go through the decision aid independently aided the decision-making process by providing information and highlighting their subjective priorities. Suggested additions are pictures of postoperational outcomes and personal statements from experienced transmen.Clinical TranslationThe DA-GST could be implemented as an integral part of transgender health care. Clinicians could take the individual personal values into account and use it to accurately tailor their consult. This would ultimately improve the doctor-patient relationship and decrease decisional regret by enhancing effective shared decision-making.Strengths & LimitationsThis mixed-method design study confirmed the use of the DA-GST while taking a broad range of decisional factors into account. Limitations include the absence of a baseline analysis and the limited power for the comparison of treatment groups.ConclusionsThis study suggests that the DA-GST helped transmen feel more prepared for their personal consult with the surgeon, reduced decisional conflict, and increased their decisional confidence.Mokken SE, Özer M, van de Grift TC, et al. Evaluation of the Decision Aid for Genital Surgery in Transmen. J Sex Med 2020;17:2067–2076.     

“一带一路”医疗援外项目卫生人员不同培养方式结果分析

目的探讨援外医疗救助爱心行项目中,针对柬埔寨医务人员不同培养形式初步结果。方法 2017年12月-2019年3月,横断面调查方法。近5年卫生人力资源培养相关文献查询,参加爱心行项目中国柬埔寨政府多部门,中国援外医疗队员,柬埔寨西部大学教授,参加培养柬埔寨卫生管理及医疗卫生人员等为访谈对象。半结构式访谈收集培养时间、内容类型及过程,分析比较长短期不同培训形式优缺点及初步结果。结果 7种形式共培养柬埔寨医生167人,来自柬埔寨4个省及金边市。其中硕士1名;长期进修(3月及以上)2名,会议及培训40名,与柬大学联合短期培训24名学员,来华现场培训实习5名,中国援外医疗队现场带教33人,中国流动医疗车现场带教培训70名。培训内容包括项目管理组织,筛查技能,心脏B超检查,Intensive Care Unit(ICU),心导管,经皮介入治疗结构性心脏病及车载心电图机,X线,生化分析仪使用等。结论援外项目应长短期培养相结合,多种培养形式有利于兼顾项目实施现场需求及长期项目影响。     

Development of a Decision Aid for Genital Gender-Affirming Surgery in Transmen

Background

As genital gender-affirming surgery (GAS) is a demanding and life-changing intervention, transmen should be able to make choices about the surgical treatment based on outcomes that are most important to them, while taking into consideration the concomitant risks involved.

急救人员对院外心肺复苏效果的影响

目的通过对无锡市院外急救心肺复苏效果急救人员影响因素的分析,探讨提高院外急救心搏骤停患者心肺复苏成功率的方法。方法对2006年1月1日-2010年12月31日期间无锡市急救中心接诊心搏骤停患者并进行心肺复苏的急救医生进行分析,对不同学历、职称、工作年资、急救技能、现场组织抢救能力医生的心肺复苏病例进行比较。结果本科以上（含本科）组与本科以下学历组心肺复苏成功率差异无统计学意义;中级职称以上组与中级职称以下组心肺复苏成功率差异无统计学意义;高年资急救医生组与低年资急救医生组心肺复苏成功率差异有统计学意义;熟练掌握心肺复苏技能急救医生组与一般掌握心肺复苏技能急救医生组心肺复苏成功率差异有统计学意义;现场组织抢救能力较强急救医生组与现场组织抢救能力一般急救医生组心肺复苏成功率差异有统计学意义。结论急救医生的学历、职称对心肺复苏效果无影响;高年资急救医生心肺复苏成功率高于低年资急救医生;熟练掌握心肺复苏技能急救医生心肺复苏成功率高于一般掌握心肺复苏技能急救医生;现场组织抢救能力较强的急救医生心肺复苏成功率高于现场组织抢救能力一般急救医生。