Motivational interviewing for maternal Immunizations: Intervention development

Background and ObjectiveVaccine uptake during pregnancy remains low. Our objectives were to describe 1) development and adaptation of a clinician communication training intervention for maternal immunizations and 2) obstetrics and gynecology (ob-gyn) clinician and staff perspectives on the intervention and fit for the prenatal care context.MethodsDesign of the Motivational Interviewing for Maternal Immunizations (MI4MI) intervention was based on similar communication training interventions for pediatric settings and included presumptive initiation of vaccine recommendations (“You’re due for two vaccines today”) combined with motivational interviewing (MI) for hesitant patients. Interviews and focus group discussions were conducted with ob-gyn clinicians and staff in five Colorado clinics including settings with obstetric physicians, certified nurse midwives (CNMs), and clinician-trainees. Participants were asked about adapting training to the ob-gyn setting and their implementation experiences. Feedback was incorporated through iterative changes to training components.ResultsInterview and focus group discussion results from participants before (n = 3), during (n = 11) and after (n = 25) implementation guided intervention development and adaptation. Three virtual, asynchronous training components were created: a video and two interactive modules. This virtual format was favored due to challenges attending group meetings; however, participants noted opportunities to practice skills through role-play were lacking. Training modules were adapted to include common challenging vaccine conversations and live-action videos. Participants liked interactive training components and use of adult learning strategies. Some participants initially resisted the presumptive approach but later found it useful after applying it in their practices. Overall, participants reported that MI4MI training fit well with the prenatal context and recommended more inclusion of non-clinician staff.ConclusionsMI4MI training was viewed as relevant and useful for ob-gyn clinicians and staff. Suggestions included making training more interactive, and including more complex scenarios and non-clinician staff.     

构建数字化、可视化教学平台实现妇产科学教学手段多元化

介绍了构建数字化、可视化教学平台,实现妇产科教学手段多元化的做法。内容包括多媒体课件开发制作,利用医学视听教材,建设妇产科图片数据库,建设妇产科标本库(馆),利用模型、模块进行模拟操作,加强实践技能培养和通过临床见习、实习将理论应用于实践等问题。     

2004年和2005年鲁东大学女教职工妇科查体结果分析

目的通过2004年和2005年本校女教职工妇科查体结果的分析，发现女教职工中未被识别的疾病与致病因子，从而达到防病、治病的目的。通过两年查体结果的分析比较，进一步说明高校女教职工定期进行妇科查体的必要性。方法收集、整理2004年和2005年两年的妇科查体结果，并对不同年龄组的患病率进行分析、比较，查找原因。结果两年的查体结果表明，2005年各年龄段妇科疾病的发病率明显较2004年低，经卡方比较，差异有显著性。结论对女教职工实施定期的妇科查体，对及旱发现妇科疾病、及时进行适当的治疗、保障女教职工的身体健康起了重要作用。     

“治未病”在中医妇科临床中的应用

结合文献与临床研究,总结何嘉琳教授在中医妇科临床工作中运用“治未病”理论的学术思想与临床用药经验。     

腹腔镜手术治疗小儿卵巢肿瘤26例

目的探讨腹腔镜手术治疗小儿卵巢肿瘤的效果及安全性。方法2000年1月~2005年3月,我们对26例小儿卵巢肿瘤行腹腔镜手术。气管插管全麻或静脉复合麻醉,行卵巢肿瘤剥除术或一侧附件切除术。对直径<5 cm的肿瘤,在肿瘤的外侧缘线形电凝囊肿包膜;直径>5 cm的肿瘤,在其中部或距基底部3 cm处环形电凝囊肿包膜,钝性分离肿瘤与囊壁,完整剥出肿瘤,残余囊壁创面彻底电凝止血,不缝合。卵巢冠囊肿切除。影响术野的大卵巢囊肿,先穿刺吸净囊液,帽状电凝卵巢囊肿包膜一周,再剥出肿瘤。结果所有患儿卵巢肿瘤手术都在腹腔镜下完成,肿瘤剥除术24例,一侧附件切除2例。手术时间(50±20)m in,术中出血量(30±10)m l,术后住院2~4 d,无手术并发症,无伤口感染。24例随访1年,未见复发。结论腹腔镜手术治疗小儿卵巢肿瘤是一种安全、有效的手术方法。     

我对子午流注阴阳盛衰转换的认识

阐述了时相与阴阳的关系，阴阳昼夜的盛衰转换与经脉循行、气血流注密切相关；对传统流注说和任督为主的阴阳循环说进行了分析，认为子午流注阴阳盛衰转换在妇科学中有重要意义，子午流注所指出的4个较重要的时期与月经周期中的4期(行经期、经后期、经间排卵期、经前期)相关。重视研究日相阴阳太极钟的变化，将能更加深入地认识月经周期中阴阳消长转化的规律变化，从而推动中医妇科学向前发展。     

Undergraduate medical education in obstetrics and gynaecology in the USA and Canada, 1985

Many factors have led to a movement from the emphasis of the 1960s and 1970s on departmental expansion towards an emphasis on cost-effective undergraduate medical education emphasizing the 'art' as well as the 'science' of medicine. In January 1985 a questionnaire was sent under the auspices of the Undergraduate Education Committee of the Association of Professors of Obstetrics and Gynecology to all chairmen of departments of obstetrics and gynecology in the USA and Canada seeking their opinions about these trends and information about the educational programmes in their departments. The information from this study indicates that the chairmen are aware of and responding to this new direction in medical education. A stabilization of teaching staff and clerkship sizes and the emphasis on clinical as well as cognitive evaluation, despite recognition of the cost of the former, shows active interventions towards these ends. An emphasis on education in 'basic' as compared to 'subspecialty' areas which is independent of the subspecialty of the academic chairman also supports this trend.     

第2产程剖宫产术对母婴的影响

本文对我院近 4年来第 2产程 (以下简称 2程 )剖宫产 6 1例进行回顾性分析。资料表明 :第 2产程剖宫产术易合并羊水污染及术时并发症 ,新生儿Apgar氏评分低 ,术后并发症高于对照组 (P <0 .0 5 ) ,提示第 2产程剖宫产术比一般头位急症剖宫产术对母婴不利 ,其并发症的发生与第 2产程的延长相关 (P <0 .0 1) ,故应把握时机尽量减少宫口开全后施行剖宫产。     

Hospital visiting in obstetrics and gynecology: a tool for the advancement of training.

OBJECTIVE: To assess the improvement of obstetric and gynecologic training brought about by peer influence in Europe. METHODS: In 1996, the European Board and College of Obstetrics and Gynecology (EBCOG) initiated a visiting process by international and local peers to improve training and decrease differences in health care standards. RESULTS: A large number of visits of obstetrics and gynecology departments have been conducted across Europe at teaching hospitals by the Hospital Visiting Committee. Compliance with the structured approach of the visiting policy and problems met during these visits are reported. CONCLUSION: The program focuses on the continuous improvement of the competencies of all persons trained in the obstetrics and gynecology departments of teaching hospitals throughout Europe. It also increases the understanding of diversity in training methods and can gradually lead to the convergence of training and health care standards in Europe.