Retrospective Analysis of Emotional Burden and the Need for Support of Patients and Their Informal Caregivers after Palliative Radiation Treatment for Brain Metastases

Cancer burdens not only the patients themselves but also their personal environment. A few studies have already focused on the mental health and personal needs of caregivers of patients. The purpose of this retrospective analysis was to further assess the emotional burden and unmet needs for support of caregivers in a population of brain metastasis patients. In the time period 2013–2020, we identified 42 informal caregivers of their respective patients after palliative radiation treatment for brain metastases. The caregivers completed two standardized questionnaires about different treatment aspects, their emotional burden, and unmet needs for support. Involvement of psycho-oncology and palliative care was examined in a chart review. The majority of the caregivers (71.4%, n = 30) suffered from high emotional burden during cancer treatment of their relatives and showed unmet needs for emotional and psychosocial support, mostly referring to information needs and the involvement in the patient’s treatment decisions. Other unmet needs referred to handling personal needs and fears of dealing with the sick cancer patient in terms of practical care tasks and appropriate communication. Palliative care was involved in 30 cases and psycho-oncology in 12 cases. There is a high need for emotional and psychosocial support in informal caregivers of cancer patients. There might still be room for an improvement of psychosocial and psycho-oncological support. Care planning should cater to the emotional burden and unmet needs of informal caregivers as well. Further prospective studies in larger samples should be performed in order to confirm this analysis.     

晚期早产与学龄前期儿童发育性运动协调障碍的相关研究

目的探讨晚期早产儿与学龄前期发生发育性运动协调障碍(developmental coordination disorder,DCD)的关系,为能进行有效干预提供依据。方法 2012年6-12月于江苏省苏南、苏中、苏北随机整群抽取5个城市25所幼儿园中6 811名3~6岁学龄前儿童,对儿童一般健康状况和出生史进行问卷调查,运用儿童运动成套评估工具第2版(Movement Assessment Battery for Children-Second Edition,MABC-2)对递交有效问卷的6 155名儿童进行运动协调能力测试,研究不良出生史对儿童运动协调能力发展的损伤。结果 6 147名儿童完成所有测试,晚期早产儿DCD及手灵巧度低下发生率与足月儿相比差异无统计学意义,但动静态平衡能力显著低于足月儿(P=0.014),目标抓握能力低于足月儿(P=0.051)。结论晚期早产可损伤儿童学龄前期动静态平衡和目标抓握能力,其原因可能与脑发育过程中不同部位损伤有关。     

医院中层干部管理素质培育探讨

医院中层干部是医院各项事业发展的骨干力量。中层干部的管理素质如何,对医院改革与发展关系极大。中层干部具备良好的管理素质,是做好科室管理工作的先决条件。因此,加强对医院中层干部管理素质的培养是一项十分紧迫和重要的任务,医院决策者应从医院事业兴旺发达的战略高度来增强对中层干部管理素质培养的紧迫性和迫切性的认识,抓紧推进这项工作。     

紧急避孕方法的社会支持水平及相关因素研究

目的:探讨紧急避孕方法的社会支持水平及相关因素。方法:选择2006年1月以来到嘉峪关市计划生育服务站要求采取紧急避孕的360例育龄女性,进行心理状态与社会支持水平分析。结果:已婚妇女采取紧急避孕的社会支持高于未婚人群;与主观支持显著相关的是婚姻状况、职业和年龄,客观支持与青春期性教育和避孕方法的知晓程度显著相关,与对婚前性行为危害的认知水平密切相关。结论:紧急避孕方法的社会支持与诸多因素相关。对未婚女性健康教育、关怀帮助显著偏低,对婚前性教育的配套系统的社会支持尚未真正建立和运行,从而影响到整体的社会支持水平。     

某驾校教练超重与肥胖人群体重管理效果分析

目的针对某驾校教练中存在超重与肥胖问题开展控制体重的健康教育,提高驾校教练的自我保健意识。方法对昌平区某驾校116名教练进行体格检查和生化检验,对筛查出的79名超重与肥胖教练开展控制体重管理。结果经过3年的综合管理,79名超重与肥胖人群干预前后腰围为（93．5±8．4）cm和（92．0±9．5）cm、血糖为（5．6±1．5）mmol／L和（5．4±1．6）mmol／L,收缩压为（130．8±12．4）mmHg（1mmHg=0.133kPa）和（127．8±11．6）mmHg、舒张压为（87．0±9．7）mmHg和（85．6±9．3）mmHg、高密度脂蛋白为（1．1±0．4）mmol／L和（1．2±0．3）mmol／L,经t检验,差异均有统计学意义（P〈0．05）;21项肥胖及相关知识知晓率在干预前后差异均有统计学意义（P〈0．05）。3年管理人群慢性病及相关异常检测指标无变化（P〉0．05）。结论中年人超重肥胖问题应开展干预工作,体重控制需要个人与卫生行政管理部门共同努力,体重管理工作具有长期性和渐进性。     

论以需求为导向的军队医院卫勤训练转型

医院着眼＂保健康、保打赢、保战斗力＂的职能使命,强化＂训为用、练为战＂意识,主动转型,探索建立以需求为导向、以应对多种安全威胁的卫勤保障能力与平时医疗救治能力同步提升的训练模式,从根本上提高综合训练效益,加快转变战斗力生成模式步伐。     

中医诊断学实训课教学改革探索与实践

中医诊断学是中医基础理论与临床各科之间的桥梁课程,是中医、针推、养生、康复等专业的主干课程。要求学生掌握扎实的中医基本理论,训练学生四诊、辨证的中医思维方式及基本操作技能。以学生为中心,加强学生动手能力,从实训课改革入手。此文分析了实训教学现状,以实训教学目标为中心,探索实训课教学内容、手段、方法、考核的改革。     

PBL教学法在内科临床实训教学中的应用

临床实训教学是内科临床教学的重要组成部分,是培养医学专业学生具备实践能力的主要步骤。以问题为导向(Problem-based learning,PBL)教学法已经成为主流新型教学方法之一,被广泛应用于各个阶段的学科教学中,同时,也成为医学专业的重要教学法。通过与传统医学专业教学法的对比,分析了PBL教学法在实训教学中的优势,与内科临床实训课程教学的特征。为了更好地实现内科临床实训教学以学生为中心的教学改革目标,培养并提高学生解决实际问题的能力,提出了将PBL教学法应用在内科临床实训教学中的实施策略,讨论了其能够从发现问题、分析问题、解决问题和教学评价反馈4个维度提升教学效果的机制,以期为内科临床实训教学的优化提供参考。     

Obesity and the Orthopedic Trauma Patient: A Review of the Risks and Challenges in Medical and Surgical Management

Abstract

The medical and surgical care of obese trauma patients presents a variety of unique and important challenges. Over the past 30 years, this population has increased dramatically in number, and the optimization of their care demands the attention of the medical community. The problems of caring for an obese trauma patient begin before the actual traumatic event occurs due to their substantially higher incidence of serious comorbidities, such as diabetes mellitus, hypertension, and cardiopulmonary issues. In the setting of trauma, important considerations for the obese patient include careful and expeditious preoperative medical optimization; appropriate deep vein thrombosis prophylaxis; planning for and preventing operative and postoperative challenges (eg, pulmonary and wound complications); and ensuring adequate hospital equipment and staffing resources in the acute and rehabilitative phases of care. This article outlines the scope of the obesity epidemic, reviews the medical consequences of obesity, and highlights surgical considerations specific to the care of orthopedic injuries in the obese trauma patient.