家长对小学生近视的知信行分析

目的 了解保定市小学生家长关于小学生近视知信行的相关现状及影响因素,制定有效干预措施,为预防儿童青少年近视提供有力依据。方法 运用分层整群随机抽样的方法,抽取保定市某小学一年级至六年级766名学生家长进行问卷调查。结果 小学生家长用眼卫生相关知识总正确率为64.90%。家长年龄越大、文化程度越高以及自身近视的家长掌握小学生近视的相关知识越多。家长年龄越大,督导孩子健康用眼的行为越易发生(P=0.027,OR=0.169)。结论 应多渠道对学生家长进行健康教育,为控制和预防小学生近视的发生与发展构建以家庭为主的第一道防线。     

Intraoperative Practice Variability in Total Knee Arthroplasty

BackgroundConsiderable practice variability exists among orthopedic surgeons performing total knee arthroplasty (TKA). The purpose of this study is to understand what TKA surgical and perioperative techniques are standard among high-volume academic knee arthroplasty surgeons.MethodsA written survey with 59 questions regarding management preferences in TKA was distributed by the 2018 John N. Insall Traveling Fellows to all arthroplasty-trained attending physicians at 13 medical centers, with 45 responses recorded.ResultsSurveyed surgeons performed unicompartmental knee arthroplasty (88%) and bilateral TKA (87%). Most surveyed surgeons rarely or never performed outpatient primary TKA (71%). Conventional alignment guides and cemented implants were used by 80% of respondents. Most surgeons used posterior-stabilized implants (67%), followed by cruciate-retaining (20%), ultracongruent (20%), and medial congruent or medial pivot designs (17.8%). Surveyed surgeons frequently or always resurfaced the patella (73%), used a tourniquet for the entire case (73%), and used tranexamic acid for all TKAs (91%). The most common locations for intra-articular anesthetic injection were the arthrotomy (91%), the periosteum (84%), and the medial posterior capsule (82%). Saline (62%) and dilute iodine (47%) were the most common irrigation fluids. The arthrotomy was most commonly closed with running barbed suture (60%) followed by interrupted vicryl (40%). Skin closure was predominantly with running monocryl (60%) followed by staples (29%). Anticoagulation for TKA was primarily aspirin 81 mg BID (60%).ConclusionThere was considerable variability among surgeons polled although a strong preference for more conventional and less developmental techniques prevailed.     

Barriers to vaccination service delivery within general practice: opportunity to make a sustainable difference in Aboriginal child health?

Objective: To identify behavioural barriers of service provision within general practice that may be impacting the vaccination coverage rates of Aboriginal children in Perth, Western Australia (WA). Methods: A purposive developed survey was distributed to 316 general practices across Perth and three key informant interviews were conducted using a mixed‐methods approach. Results: Of the surveyed participants (n=101), 67.4% were unaware of the low vaccination coverage in Aboriginal children; 64.8% had not received cultural sensitivity training in their workplace and 46.8% reported having inadequate time to follow up overdue child vaccinations. Opportunistic vaccination was not routinely performed by 30.8% of participants. Key themes identified in the interviews were awareness, inclusion and cultural safety. Conclusion: Inadequate awareness of the current rates, in association with a lack of cultural safety training, follow‐up and opportunistic practice, may be preventing greater vaccination uptake in Aboriginal children in Perth. Cultural safety is a critical component of the acceptability and accessibility of services; lack of awareness may restrict the development of strategies designed to equitably address low coverage. Implications: The findings of this study provide an opportunity to raise awareness among clinicians in general practice and inform future strategies to equitably deliver targeted vaccination services to Aboriginal children.     

PBL教学法在核医学课间实习教学中的应用研究

目的 通过与LBL教学法对比,探讨PBL教学法在核医学科课间实习教学中的应用效果.方法 选取哈尔滨医科大学2016级临床医学专业本科二班学生72人,随机分为实验组和对照组,每组各36人,在课间实习教学中分别实施PBL教学法和LBL教学法.实习结束后,通过考试及问卷调查,进行教学法评价.结果 观察组在考试成绩、学习兴趣、学习热情、教学满意度、培养临床思维、增强知识点掌握等教学法评价指标均优于对照组,具有统计学意义(P<0.05).结论 与LBL教学法相比,PBL教学法应用于核医学科课间实习教学中更能激发学生学习兴趣、增强综合素质,从而提高教学效果.     

Local Landscapes of Breastfeeding: A comparison of breastfeeding amongst mothers in low- and high-income neighborhoods in Bristol,UK

This paper compares experiences of breastfeeding outside the home for women living in low-income and high-income neighborhoods of the same city. Our findings are based on an analysis of 22 interviews with breastfeeding mothers (11 in each of two study areas) undertaken in Bristol, UK in 2017. We extend existing scholarship by showing how experiences of breastfeeding vary not only at the regional level but between local areas of the same city, and outline how our findings can inform policy. We advance literature on maternal bodies by exploring how local “landscapes” of breastfeeding emerge as mothers encounter and negotiate different socio-material landscapes and locally-differentiated norms about “appropriate” maternal embodiment. We argue that these variegated interactions can lead to different orientations to space and forms of spatial practice on the part of breastfeeding mothers, as well as different kinds of maternal identities.