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51.
Students' perceptions of relationships between some educational variables in the out-patient setting
Dolmans DH Wolfhagen HA Essed GG Scherpbier AJ Van Der Vleuten CP 《Medical education》2002,36(8):735-741
BACKGROUND: Medical education uses the cognitive apprenticeship model of student learning extensively. Students rotate among different hospitals and out- patient clinics where they are exposed to a range of professionally relevant contexts. Here they learn to think and act in different domains under the supervision of experts. Previous research has shown that these learning situations involve little teaching. Students see a narrow range of patient problems and feedback is limited. The aim of this study is to investigate relationships among some educational variables in the out-patient clinic. METHOD: This paper provides a theoretical model that specifies the factors influencing the effectiveness of student rotations at out-patient clinics. The model makes distinctions between input variables, such as organizational quality, number of students contemporaneously involved and available space, and process variables, such as patient mix and supervision, and the output variable of the effectiveness of rotations in out-patient clinics. RESULTS: The model was tested against empirical data from evaluative surveys and showed a reasonable fit. The model offers suggestions for improving the learning environment of clinical rotations. DISCUSSION: The strength of this study lies in its process evaluation perspective which investigates interactions between intervening variables rather than the influence of particular variables in isolation from other variables. 相似文献
52.
IH Vandvik 《Acta paediatrica (Oslo, Norway : 1992)》1994,83(8):884-887
In Norway, the first paediatric department was founded in Oslo 100 years ago. The first child psychiatric department was opened in 1950. To assess qualitative and quantitative aspects of child psychiatric liaison work, questionnaires were sent to the heads of 25 paediatric departments and 53 child psychiatric units. Scarce child psychiatric resources were spent in paediatrics. The average score for satisfaction with collaboration was moderate (5.5 on a 10-cm visual analogue scale) and agreement between the parties was modest. Improvement will involve development of a common language and a shared model for understanding the psychosocial aspects of acute and chronic childhood illnesses. In-service training for paediatricians in child psychiatry and vice versa may help. Both parties indicated a need for more training in consultation/liaison and in multi-professional assessments and therapeutic interventions with children with physical illnesses. 相似文献
53.
Chorionic gonadotropin inhibits rat mammary carcinogenesis through activation of programmed cell death 总被引:3,自引:2,他引:3
Human chorionic gonadotropin (hCG) inhibits the progression of 7,12-
dimethylbenz[a]anthracene (DMBA) induced mammary carcinomas. In order to
determine whether this phenomenon was mediated by induction of programmed
cell death or apoptosis, 45-day-old virgin Sprague-Dawley rats received 8
mg DMBA/100 g body weight; 20 days later they were injected daily with 100
IU hCG for 40 days (DMBA + hCG group). Age- matched untreated, hCG- and
DMBA + saline treated rats were used as controls. Tissues were collected at
the time of DMBA administration and at 5, 10, 20 and 40 days of hCG
injection. RNA from mammary glands, adenocarcinomas and ovaries was probed
for transforming growth factors (TGF) alpha and beta, and the apoptotic
genes TRPM2, ICE, bcl2, bcl-XL, bcl-XS, p53 and c-myc. The mammary glands
of hCG-treated animals with or without DMBA exhibited elevated expression
of TRPM2, ICE, bcl-XS, c- myc and p53; and elevation in the apoptotic
index. Mammary adenocarcinomas developed in those animals treated with hCG
showed an elevation in the expression of p53, c-myc and ICE genes in
comparison with the levels detected in the adenocarcinomas developed by the
animals treated with DMBA alone. No significant alterations in the
expression of any of the genes tested was observed in ovarian RNAs. These
results led us to conclude that hCG induces programmed cell death in the
mammary gland initiated in the carcinogenic process, that this process is
p53 dependent, and is modulated by c-myc expression. Our data also indicate
the possibility that a cell death program dependent on the bcl2 family
exists, because of the potential involvement of p53, bcl-XS and Bax in
apoptosis. This additional mechanism of tumor inhibition makes hCG
treatment a useful approach for the prevention and therapy of breast
cancer.
相似文献
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Fraaij PL van der Vries E Beersma MF Riezebos-Brilman A Niesters HG van der Eijk AA de Jong MD Reis Miranda D Horrevorts AM Ridwan BU Wolfhagen MJ Houmes RJ van Dissel JT Fouchier RA Kroes AC Koopmans MP Osterhaus AD Boucher CA 《The Journal of infectious diseases》2011,204(5):777-782
A retrospective nationwide study on the use of intravenous (IV) zanamivir in patients receiving intensive care who were pretreated with oseltamivir in the Netherlands was performed. In 6 of 13 patients with a sustained reduction of the viral load, the median time to start IV zanamivir was 9 days (range, 4-11 days) compared with 14 days (range, 6-21 days) in 7 patients without viral load reduction (P = .052). Viral load response did not influence mortality. We conclude that IV zanamivir as late add-on therapy has limited effectiveness. The effect of an immediate start with IV zanamivir monotherapy or in combination with other drugs need to be evaluated. 相似文献
56.
M. J. Bruins M. J. Egbers T. M. Israel S. H. A. Diepeveen M. J. H. M. Wolfhagen 《European journal of clinical microbiology & infectious diseases》2017,36(4):619-623
Early appropriate antimicrobial treatment of patients with sepsis has a large impact on clinical outcome. To enable prompt and efficient processing of blood cultures, the inoculated vials should be placed into an automated continuously monitoring blood culture system immediately after sampling. We placed an extra BACTEC FX instrument at the emergency department of our hospital and validated the twice-daily re-entering of ongoing vials from this instrument into the BACTEC FX at the laboratory. We subsequently assessed the benefits of shortening the transport time between sampling and monitored incubation of blood culture vials by comparing the turnaround times of positive blood cultures from emergency department patients with a historical control group. Re-entering ongoing vials within 2 h raised no technical problems with the BACTEC FX and did not increase the risk of false-negative culture results. The decreased transport time resulted in significantly earlier available Gram stain results for a large proportion of patients in the intervention group and a significant shortening of the median total turnaround time to less than 48 h. The median length of hospital stay shortened by 1 day. Immediate entering of blood culture vials into a point of care placed BACTEC FX instrument and subsequent efficient processing enables earlier decision-making regarding antimicrobial treatment, preventing the development of antimicrobial resistance and reducing healthcare costs. 相似文献
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