A pilot study of cadre training to promote responsible self-medication in Indonesia: Which is better specific or general modules?

In 2015, the Indonesian Government initiated ‘Smart Use of Medications Movement’ (‘GeMa CerMat’) which included cadre training to promote responsible self-medication. Evaluation of a pilot training conducted across Indonesia suggested the need to improve those training modules. This study aimed to assess cadre’ knowledge gained following training with newly developed general or specific training modules. Five types of modules were developed and used to train cadres at five Community Health Centres (CHCs) in Surabaya, Indonesia: 1) Sidosermo CHC (general-drugs module), 2) Tenggilis CHC (common cold drugs module), 3) Gunung Anyar CHC (analgesic drugs module), 4) Kalirungkut CHC (anti-diarrhoeal drugs module), and 5) Jagir CHC (indigestion drugs module). Cadres’ knowledge improvements were evaluated using pre-/post-test scores and the difference scores depending on the module being tested. Multifactorial ANOVA explored the effects of the type of module on difference scores. A total of 279 cadres across five CHCs were involved in the training, giving response rates from 65% to 93%. There was an increase in the post-test scores after the training with all modules. However, significant differences were reported only for the specific-drugs module groups (all p < .001). Furthermore, the general module group had the lowest difference score (1.12; 95% CI [−0.45, 2.92]) while the common cold module group had the highest gain (5.02; 95% CI [1.95, 5.17]). Multifactorial ANOVA revealed that there was a significant main effect of the type of modules on difference scores [F (4, 263) = 8.37, p <.001]. In conclusion, this preliminary study indicated that the development of modules for specific minor illnesses could be beneficial in facilitating effective community-based training to promote responsible self-medication in Indonesia. The priority for therapeutic areas chosen for the module should be based on the local needs. Further research is required to confirm the findings in broader community members.     

Assessing attitudes towards online psychoeducational interventions: Psychometric properties of a Brief Attitudes Scale

Participant attitudes are an explanatory factor for attrition in online health-related interventions. However, its assessment prior to interventions start is uncommon, partly because proper measures are missing. This study presents the psychometric properties of a new scale measuring attitudes towards online psychoeducational interventions (OPIs). Structural validity, reliability and screening performance of the Online Psychoeducational Intervention – Brief Attitudes Scale (OPI-BAS) were studied in a sample of 157 dementia caregivers. Scale cut-off scores were derived to categorise the participants into ‘OPIs sympathisers’ or ‘non-sympathisers’. Groups were compared across sociodemographic and internet use variables. A parsimonious five-item version of OPI-BAS demonstrated good structural validity, with one factor explaining 63.3% of variance. Internal consistency of the scale was high (α = 0.85). OPI-BAS showed good screening performance in identifying individuals with either a preference to use conventional face-to-face or online psychoeducational interventions (area under the curve = 0.84). An optimal cut-off score of 20 was suggested by the receiver operating characteristic graph, providing good sensitivity (74%) and specificity (84%). No significant differences were found between groups on sociodemographic and internet use variables. Attitudes towards OPIs were overall positive, but face-to-face interventions were preferred. This study offers preliminary support to the psychometric quality of OPI-BAS. This short scale has practical applications for research and intervention.     

三甲医院高层次卫技人才队伍建设发展现状及对策研究

通过对某三甲医院高层次卫技人才的规模、构成、引培和流失进行统计分析,了解医院高层次卫技人才队伍建设现状和流动变化规律,为制定和完善医院高层次卫技人才队伍建设策略提供证据参考。结果显示,该院高层次卫技人才规模、构成均得到有效改善,高层次卫技人才流失情况在可控范围内,但也面临着高层次卫技人才总量相对不足、流失人才中辞职占比较大等问题。未来要继续推动"人才强院"战略,创新人才引培考核机制,完善人才培养体系和计划,建立科学的测评体系以及健全绩效评价机制和薪酬分配制度。     

基于ISD模型的福建省医养护理员培训体系设计探索

目的:本研究针对福建省当前医养护理员的现状,基于医养结合背景下养老服务的需求,设计一个较为科学、系统、规范的医养护理员培训体系,为福建省养老护理人才的培养提供借鉴,从而提高福建省医养护理员的整体素质。方法:通过文献研究法,结合养老护理员国家职业技能标准以及医疗护理员培训与规范服务和管理标准,并基于实地调查法和深入访谈法,对医养护理员现状进行调查,拟定医养护理员的培训体系框架。结果:教学系统设计(ISD)作为一种常用的培训体系设计模型,针对目前福建省医养护理员及其培训的实际情况,提出了基于ISD模型的养老护理员培训体系。结论:基于ISD培训体系设计模型,从分析、设计、开发、实施、评价五个环节,构建了医养护理员培训体系,并详细介绍每个环节可操作的实施策略。     

Regional alterations of brain biogenic amines and GABA/glutamate levels in rats following chronic lead exposure during neonatal development

Wistar rat pups were administered either a high dose of lead acetate (400 g lead/g body weight/day) or a low dose (100 g lead/g body weight/day) by gastric intubation, from 2 days through 60 days of age. The rats on both these doses exhibited statistically significant decreases in body and brain weights throughout the lead treatment period. A group of rats on high dose was also rehabilitated by discontinuing the lead from 60 days of age. In these rats, at 160 days of age, the body weight but not the brain weight recovered to normal levels. During the lead intake, the rats on high dose revealed significant elevations in the levels of noradrenaline (NA) in the hippocampus (HI), cerebellum (CE), hypothalamus (HY), brainstem (BS), and accumbens-striatum (SA). The elevated levels in all the above regions except in the HY persisted even after rehabilitation. The dopamine (DA) levels changed significantly in opposite directions in HY (elevation) and BS (reduction) during the lead treatment, and the HY recovered after rehabilitation. Under lead, the serotonin (5HT) levels were elevated significantly in the HI, BS and MC (motor cortex), while after rehabilitation the abnormality persisted only in the MC. Low dose lead treatment was also effective on the same areas of brain. In the low dose group, estimation of the levels of GABA and glutamate were also done, and a significant decrease of GABA in CE and glutamate in MC was observed. The differences observed in the neurotoxic effects (none or significant) of lead in the different regions for each of the transmitters (NA, DA, 5HT) supports the interesting conclusion that the vulnerability of the axon terminals of any given type is dependent on some regional factors, although the projections of the different regions originate from an apparently similar category of neurons in the brain stem.     

新兵基础训练军训伤预防的主导措施

目的　评价新兵基础训练期间军训伤的预防措施 .方法　以驻陕某部新兵 2个连为研究对象 ,随机决定一连为重点措施分队 ,重点措施为对 5 km跑予以一定限制 :开训后第一个月不安排 5 km跑 ,跑步距离逐渐增加 ,从第二个月起每周 5 km跑 3次以下 ,间日进行 ;二连为综合措施分队 ,综合措施包括 :1同重点措施 ;2培训班排骨干 ;3心理测试与心理疏导 ;4上卫生课 (3次 ) .结果　综合措施分队军训伤的累积发生率为 2 8.6 % ,明显高于重点措施分队 11.6 % ,P<0 .0 1,两组在正课军事训练科目和时数安排上相同 ,心理测试无明显差别 .综合措施分队与重点措施分队在落实限跑措施方面实际 5 km跑累计数 (145 km对 10 5 km)和每周 5 km跑超过 4次的周数 (4 wk对 1wk)均有较大差别 .结论　 5 km跑是致伤的主要因素 .预防军训伤的主导措施应是科学训练 ,加强训练组织与管理 ,其他措施只能做为辅助