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1.
目的:应用99mTc-DTPA肾动脉显像评价Stanford不同分型主动脉夹层患者术后左、右侧肾功能及总体肾功能受损程度,帮助临床制定进一步的治疗方案,改善患者预后。方法:回顾性分析2018年3月8日至2019年7月19日,在本院核医学科行99mTc-DTPA肾动态显像的主动脉夹层术后患者48例,评价患者双肾血流灌注、总肾小球滤过率(GFR)和分肾的GFR,比较Stanford主动脉夹层A型(简称A型)患者和主动脉夹层B型(简称B型)患者之间总肾功能及分肾功能,血肌酐、血尿素氮及血尿酸水平的差异。结果:B型患者术后总GFR低于A型患者(67.5 vs.80.6 m L/min,P<0.05),其中以左肾功能受损为著(30.9 vs.40.3 m L/min,P<0.05),差异有统计学意义。结论:肾动态显像对主动脉夹层术后患者早期评价肾功能有重要价值。主动脉夹层B型患者GFR较A型减低,且左侧肾GFR减低更明显,临床可以早期采取干预措施,改善主动脉夹层患者预后。 相似文献
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Julia H. Vermylen Gordon J. Wood Elaine R. Cohen Jeffrey H. Barsuk William C. McGaghie Diane B. Wayne 《Journal of pain and symptom management》2019,57(3):682-687
Introduction
Physician communication impacts patient outcomes. However, communication skills, especially around difficult conversations, remain suboptimal, and there is no clear way to determine the validity of entrustment decisions. The aims of this study were to 1) describe the development of a simulation-based mastery learning (SBML) curriculum for breaking bad news (BBN) conversation skills and 2) set a defensible minimum passing standard (MPS) to ensure uniform skill acquisition among learners.Innovation
An SBML BBN curriculum was developed for fourth-year medical students. An assessment tool was created to evaluate the acquisition of skills involved in a BBN conversation. Pilot testing was completed to confirm improvement in skill acquisition and set the MPS.Outcomes
A BBN assessment tool containing a 15-item checklist and six scaled items was developed. Students' checklist performance improved significantly at post-test compared to baseline (mean 65.33%, SD = 12.09% vs mean 88.67%, SD = 9.45%, P < 0.001). Students were also significantly more likely to have at least a score of 4 (on a five-point scale) for the six scaled questions at post-test. The MPS was set at 80%, requiring a score of 12 items on the checklist and at least 4 of 5 for each scaled item. Using the MPS, 30% of students would require additional training after post-testing.Comments
We developed a SBML curriculum with a comprehensive assessment of BBN skills and a defensible competency standard. Future efforts will expand the mastery model to larger cohorts and assess the impact of rigorous education on patient care outcomes. 相似文献4.
目的将简明膳食自评工具(SDSAT)应用在食管癌术后患者中,评价其信度和效度。 方法本研究通过3个研究分别测量SDSAT的评定者间信度、重测信度和预测效度。研究A选择食管癌术前患者60例,由2位研究者分别进行SDSAT的测量,评价评定者间信度。研究B最终纳入食管癌术后1个月患者30例进行SDSAT的测量,间隔2周复测1次,比较2次结果,评价重测信度。研究C最终共纳入171例食管癌患者通过测量术前、术后1个月和术后3个月3个时间点测量,评价SDSAT对前白蛋白含量的预测程度。 结果评定者间信度是0.854(P<0.01)。 重测信度是0.782(P<0.01)。通过广义预测方程发现SDSAT对患者的前白蛋白含量预测效果好(P<0.01)。结论SDSAT信效度好,适合应用于评价食管癌术后患者的饮食状况。 相似文献
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Animal behaviour can be viewed as a stream of elements, which, once accurately described, can be counted and timed. Data acquisition techniques and tools are reviewed, and some strategies for collection and analysis of data using PC computers are suggested. Automated instruments are not satisfactory for the study of complex behaviour and as such systemic observation remains irreplaceable. IBM PC-type computers, with a wide range of analytical software (e.g., spreadsheets, statistical packages, technical graphics), are practical for data acquisition. Several systems which can satisfy different applications are reviewed. Some systems can communicate with a videorecorder, a facility which remarkably increases the accuracy of measurement; this is essential for meaningful analyses of the internal structure of behavioural streams (sequences, time patterns) or communication processes. The power of new tools enables behavioural measurement with the necessary complexity to allow a whole new set of questions to be addressed. However, it also increases demands for meaningful content and analysis of data. 相似文献
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Rebecca P. Ang Robert M. Klassen Wan Har Chong Vivien S. Huan Isabella Y.F. Wong Lay See Yeo Lindsey L. Krawchuk 《Journal of adolescence》2009,32(5):1225-1237
We provide further evidence for the two-factor structure of the 9-item Academic Expectations Stress Inventory (AESI) using confirmatory factor analysis on a sample of 289 Canadian adolescents and 310 Singaporean adolescents. Examination of measurement invariance tests the assumption that the model underlying a set of scores is directly comparable across groups. This study also examined the cross-cultural validity of the AESI using multigroup confirmatory factor analysis across both the Canadian and Singaporean adolescent samples. The results suggested cross-cultural invariance of form, factor loadings, and factor variances and covariances of the AESI across both samples. Evidence of AESI's convergent and discriminant validity was also reported. Findings from t-tests revealed that Singaporean adolescents reported a significantly higher level of academic stress arising from self expectations, other expectations, and overall academic stress, compared to Canadian adolescents. Also, a larger cross-cultural effect was associated with academic stress arising from other expectations compared with academic stress arising from self expectations. 相似文献
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This paper presents a method for calculating stage line diagrams, a novel type of reference diagram useful for tracking developmental processes over time. Potential fields of applications include: dentistry (tooth eruption), oncology (tumor grading, cancer staging), virology (HIV infection and disease staging), psychology (stages of cognitive development), human development (pubertal stages) and chronic diseases (stages of dementia). Transition probabilities between successive stages are modeled as smoothly varying functions of age. Age‐conditional references are calculated from the modeled probabilities by the mid‐P value. It is possible to eliminate the influence of age by calculating standard deviation scores (SDS). The method is applied to the empirical data to produce reference charts on secondary sexual maturation. The mean of the empirical SDS in the reference population is close to zero, whereas the variance depends on age. The stage line diagram provides quick insight into both status (in SDS) and tempo (in SDS/year) of development of an individual child. Other measures (e.g. height SDS, body mass index SDS) from the same child can be added to the chart. Diagrams for sexual maturation are available as a web application at http://vps.stefvanbuuren.nl/puberty . The stage line diagram expresses status and tempo of discrete changes on a continuous scale. Wider application of these measures scores opens up new analytic possibilities. Copyright © 2009 John Wiley & Sons, Ltd. 相似文献
9.
3种氟喹诺酮类药物抗生素后效应的研究 总被引:40,自引:2,他引:38
应用AVANTAGF分析仪的光密度法测定了环丙沙星(CPLX)、氧氟沙星(OFLX)和氟罗沙星(FLRX)的抗生素后效应(PAE).结果表明氟喹诺酮类抗菌药物对革兰氏阳性球菌和革兰氏阴性杆菌均产生明显的PAE.并随抗菌药物浓度的增大、对受试菌的PAE逐渐延长.呈现了明显的浓度依赖性;3种抗菌药物对铜绿假单胞菌的PAE都较长.MIC均较小.显示了良好的杀菌效果:氯罗沙星对除金葡球菌之外的受试菌的PAE均比其它2药较长.PAE的存在提示在临床设计给药方案时.可适当延长给药间期.减少给药次数与剂量.仍能维持抗菌效果。 相似文献
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目的通过应用痛觉测试笔测试痛觉平面,探讨其临床应用的实用性。方法选择100名志愿者观察痛觉测试笔产生刺痛感的定性描述,另500例行硬膜外阻滞的患者用针刺法和测试笔同时间同检查部位测试。结果100名志愿者认为痛觉测试笔对皮肤只引起如针刺样疼痛,每次测试产生刺痛程度一致,不产生肌肉抽搐、不放散。500例行硬膜外阻滞患者针刺法和测试笔测得的麻醉平面一致,测试笔无划痕反应。结论测试笔可替代锐器针刺法检测麻醉平面,可减少针刺法引起的皮肤损伤。 相似文献