我国空运后送专业护士培训课程体系的构建研究

目的结合我国飞行护士能力标准指标体系、飞行护士培训知识需求调查和飞行护士核心知识体系,探讨我国空运后送专业护士的培训对象、培养目标、课程模块及学时设置、具体课程内容和考核要点,以尝试构建我国空运后送专业护士的培训课程体系。方法通过国内外文献回顾和专家访谈法制定出专家咨询问卷,运用德尔菲法对15名专家进行两轮函询,并对数据进行分析处理。结果在两轮问卷中,93.3%的专家认同空运后送专业护士培训对象的要求,专家对具体培养目标、课程模块和考核要点的权威系数分别在87.0%以上、79.0%以上和85.0%以上,所有肯德尔协调系数均有统计学意义(P0.01)。结论构建的空运后送专业护士培训课程体系具有较高的科学性,对未来空运后送专业护士的培训与考核提供了重要理论依据。     

军队医院灾难救援机动护士能力体系的构建

目的 构建军队医院灾难救援机动护士能力体系,以更好地适应军队医院灾难救援任务需求。方法 查阅国内外文献,初步形成军队医院机动护士灾难救援能力体系的草案,采用德尔菲法,对来自全国军队医院、院校、研究所的20名专家进行两轮专家咨询,最终确立军队医院机动护士灾难救援能力体系。结果 两轮专家函询问卷的有效回收率均为100%,权威系数分别为0.89、0.88,专家咨询协调系数经χ²检验后均有统计学意义(P<0.01),专家咨询后各指标的变异系数为0.025～0.181。构建的军队医院机动护士灾难救援能力体系包括4个一级指标、24个二级指标。结论 军队医院机动护士灾难救援能力体系构建方法科学,专家积极性和权威性高,各指标专家咨询意见趋于一致,可用于军队医院机动护士灾难救援能力的评估和培养。     

创伤专科护士岗位职责核心指标体系的初步构建

目的构建符合我国创伤救治体系架构特征的创伤专科护士岗位职责核心指标体系, 为创伤中心设置创伤专科护士岗位提供参考。方法通过文献研究法和小组讨论法构建创伤专科护士岗位职责核心指标体系初稿。应用Delphi专家咨询法对来自全国7个省(市)的15位专家进行两轮咨询, 确定指标体系终稿。计算两轮咨询专家的积极系数、权威系数(Cr)、肯德尔协调系数(Kendall′sW)、各级指标的重要性赋值均数及变异系数(CV)。结果两轮咨询专家的积极系数均为100%, Cr为0.953。第2轮咨询的Kendall′sW为0.188(χ2=155.29, P<0.001), 所有指标的重要性赋值均数范围为4.27～5.00分, CV均<0.25分。最终构建的创伤专科护士岗位职责核心指标体系包含7项Ⅰ级指标和49项Ⅱ级指标。结论创伤专科护士岗位职责核心指标体系科学合理、内容全面, 可以为我国创伤专科护士岗位设置提供参考依据。     

门诊医疗质控重点指标的构建与实践

目的 构建门诊医疗质控重点指标体系，以提高门诊医疗质量和患者满意度。方法 通过文献研究和专家访谈，形成咨询问卷，运用德尔菲法对17名专家进行两轮专家咨询，确立构建门诊医师医疗质控重点指标。提取医院HIS系统相关数据和移动终端满意度调查结果。结果 两轮专家函询的回收率均为100%,专家权威系数大于0.7,筛选后门诊医师质控重点指标体系包括3个一级指标、12个二级指标，指标问卷调查的克朗巴赫系数为0.728。从指标体系实践结果来看，预约挂号率增高了29.09%,基本药物占比增加了2.75%,门诊病历打印率增加了28.28%,出诊考勤合格率和患者满意度均有明显提升。结论 构建的医疗质控重点指标定位准确、导向性强，数据可量化，可用于门诊医疗质控，提升患者满意度。     

介入专科护士理论知识体系的构建

目的通过构建介入专科护士理论知识体系,为介入专科护士培养和理论课程设置提供参考。方法应用德尔菲法对16名专家进2轮函询,确立理论知识大纲要点。结果 2轮专家函询的积极性均为100%,专家咨询的权威系数为0.89,判断系数0.89,熟悉程度0.89,均>0.7。最终确定的理论知识体系包括5项一级指标,21项二级指标。结论介入专科护士理论知识体系专家意见集中,可信度高,能为介入专科护士理论课程培训的设置提供参考依据。     

我国空运后送护理安全管理评价指标体系的构建研究

目的 初步构建我国空运后送护理安全管理评价指标体系,旨在降低空运后送伤病员护理安全隐患,有效减少不良事件的发生.方法 通过文献回顾法、专家议题小组法初步拟定专家咨询问卷;采用德尔菲法对不同专业的15位专家进行两轮专家咨询;使用Excel 2010、SPSS 23.0软件和yaahp层次分析软件对数据进行汇总分析,筛选指标并确定指标权重.结果 两轮咨询专家积极系数均为100％,专家权威系数均在0.912以上,肯德尔和谐系数差异均有统计学意义(P<0.05).最终确定包含5项一级指标、16项二级指标、85项三级指标的我国空运后送护理安全管理评价指标体系.结论 初步构建的我国空运后送护理安全管理评价指标体系具有较高的科学性和实用性,专家意见较为集中,经进一步验证后可作为空运后送护理安全评价工具.     

空降兵地面跳伞训练相关肌肉的德尔菲法调查分析

目的 利用德尔菲专家咨询法,筛选空降兵地面伞训涉及程度高的关键肌肉,指导特定肌肉进行精细化训练。方法按照德尔菲专家咨询法要求,选择10名具备相关经验的运动医学及相关专业专家,对空降兵地面伞训所涉及的50项肌肉指标进行判断打分,共进行三轮。采用界值法对每一轮咨询结果得分较低的指标进行删减,并将前一轮统计结果与下一轮问卷整合,最终当专家意见趋于一致时,问卷中的指标即为咨询目标条目（即空降兵地面伞训涉及的重要肌肉）。结果 专家积极程度系数为1,权威系数为0.838,三轮咨询协调系数分别为0.281、0.163、0.417(P<0.01)。经过三轮专家咨询,问询表中肌肉指标由50项精简至31项。结论 利用德尔菲专家咨询法筛选出空降兵伞训过程中关键肌肉指标31项,对指导训练有重要意义。应进一步通过实际训练,对本研究中筛选出的重点肌肉进行验证,并修正和完善结果,更加科学有效地指导空降兵地面跳伞训练,降低训练伤发生率,提高部队战斗力。     

手术室护理操作难度系数评价指标体系的构建研究

目的 构建手术室护理操作难度系数评价指标体系,为评估手术室护理操作难度系数提供参考依据。方法 2020年1月-2022年12月期间,选取近10余家三甲医院手术室临床护理人员、护理管理人员共30名专家作为函询对象,运用文献检索、理论研究、半结构式访谈及层次分析法等方式初步构建手术室护理操作难度系数评价指标体系初稿,撰写专家咨询问卷,再运用德尔菲法(Delphi)对初稿中指标实施两轮专家函询咨询,形成具有科学性、客观性的手术室护理操作难度系数评价指标体系。结果 两轮专家函询问卷有效回收率分别为97.22%、91.42%,意见提出率分别为28.57%、15.62%,表明专家对本课题具有较高积极性;两轮专家函询Cr分别为0.86、0.89,说明专家参与制定指标体系权威性高,结果具有可信性;两轮专家函询总体指标W分别为0.347、0.404,Cv分别为0.203、0.155,差异有统计学意义(P<0.05),表明专家协调度良好;临床普遍认为Cronbach′s α系数在0.7以上表明可接受,本课题2两轮专家函询问卷Cronbach′s α系数分别为0.939、0.963,均符合上述标准,表...     

机动卫勤分队特诊模块岗位胜任力评价指标体系构建

 目的 构建科学、系统、实用的机动卫勤分队特诊模块岗位胜任力评价指标体系,为训练和考评提供参考。方法 结合胜任力特征理论,通过文献分析法和小组访谈法初步拟定机动卫勤分队特诊模块岗位胜任力指标体系框架,采用德尔菲专家咨询法对21名专家进行2轮咨询,确定各级指标及权重分值,构建机动卫勤分队特诊模块岗位胜任力评价指标体系。结果 两轮咨询的有效回收率分别为95.2%、100%,两轮咨询的专家的权威程度为0.87、0.90,一、二级指标的重要性赋值均大于4.0,变异系数0.0382~0.1280,咨询专家积极性、权威程度及可信度高。构建的机动卫勤分队特诊模块岗位胜任力评价指标体系涵盖一级指标6项,二级指标49项。结论 本研究构建的机动卫勤分队特诊模块岗位胜任力评价指标体系具有较好的科学性、系统性和实用性。     

基于改进德尔菲法与层次分析法构建寒区冷习服评价指标体系

目的 针对寒区特殊环境的作业需求,采用德尔菲法和层次分析法构建一个可以对冷习服能力进行评价的指标体系。方法 按照德尔菲法原理,对在冷习服领域具有权威的21位专家进行3轮函询,根据指标筛选标准及专家反馈意见,确定评估指标体系并应用层次分析法计算权重。结果 3轮专家函询的积极系数分别为100.0%、95.2%、100.0%,专家权威系数在0.75～1.00之间,肯德尔和谐系数分别为0.198、0.201、0.113(P均<0.01)。第3轮各指标变异系数均<0.25,专家意见趋于一致,研究结果可靠性高。最终建立了由4个一级指标和18个二级指标构成的冷习服评价指标体系。结论 本研究充实了寒区冷习服评价指标体系的各种可行性权重指标,为评价寒区冷习服能力提供了科学的理论工具,但信度、效度及应用效果仍需进一步评估。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.