根据护士的年龄段特点分层进行教育培训的实践

多年来医院对护士的训练大多停留在制订计划-布置任务-组织考核等几个环节上,全程实行管、卡、压,方法比较陈旧,做法多是满堂灌,内容基本是常用科目。教育训练的方法不新颖,缺乏吸引力,效果不佳。针对其薄弱点,对教育训练的方法进行了改革。根据护士的年龄、资历、思想、心理、社会环境、工作氛围等不同因素的影响,将护士的工作经历大致分为4个阶段,以每个阶段的特点确定教育培训的内容,取得好的效果。     

21台生物安全柜性能测试及分析评价

目的 了解生物安全柜的安全使用现况.方法 对21台Ⅱ级生物安全柜进行使用情况调查和物理指标检测.结果 生物安全柜洁净度和前窗操作口流入气流流速合格率仅为57.14％;高效过滤器完整性、下降气流流速、下降气流流向、前窗操作口边缘气流、观察窗气流、噪声、振动幅值、紫外线灯辐照强度等项目合格率分别为75％、80.95％、80.95％、85.71％、95.24％、76.19％、76.19％、71.43％.结论 生物安全柜性能检测合格率较低,存在生物安全隐患,要加强维护和检测.     

The Effect of a 2-Year Intervention Consisting of Diet,Physical Exercise,Cognitive Training,and Monitoring of Vascular Risk on Chronic Morbidity—the FINGER Randomized Controlled Trial

Objective

To verify whether a multidomain intervention lowers the risk of developing new chronic diseases in older adults.

临床医学博士专业学位与专科医师规范化培训衔接

毕业后医学教育包括研究生教育和住院/专科医师规范化培训,临床医学专业学位博士和专科医师规范化培训作为两种重要的毕业后医学教育,对医学人才的培养起着承上启下的作用.从临床医师培养规律、临床能力培养目标、制度保障以及试点经验等方面,阐述临床医学博士专业学位与专科医师规范化培训衔接的可行性,探讨可能出现的问题,并提出相应的建议,为完善我国毕业后医学教育提供依据.     

Resistance Exercise Training Improves Metabolic and Inflammatory Control in Adipose and Muscle Tissues in Mice Fed a High-Fat Diet

This study investigates whether ladder climbing (LC), as a model of resistance exercise, can reverse whole-body and skeletal muscle deleterious metabolic and inflammatory effects of high-fat (HF) diet-induced obesity in mice. To accomplish this, Swiss mice were fed for 17 weeks either standard chow (SC) or an HF diet and then randomly assigned to remain sedentary or to undergo 8 weeks of LC training with progressive increases in resistance weight. Prior to beginning the exercise intervention, HF-fed animals displayed a 47% increase in body weight (BW) and impaired ability to clear blood glucose during an insulin tolerance test (ITT) when compared to SC animals. However, 8 weeks of LC significantly reduced BW, adipocyte size, as well as glycemia under fasting and during the ITT in HF-fed rats. LC also increased the phosphorylation of Akt_Ser473 and AMPK_Thr172 and reduced tumor necrosis factor-alpha (TNF-α) and interleukin 1 beta (IL1-β) contents in the quadriceps muscles of HF-fed mice. Additionally, LC reduced the gene expression of inflammatory markers and attenuated HF-diet-induced NADPH oxidase subunit gp91phox in skeletal muscles. LC training was effective in reducing adiposity and the content of inflammatory mediators in skeletal muscle and improved whole-body glycemic control in mice fed an HF diet.     

Out-Of-Pocket Expenditure Associated with Physical Inactivity,Excessive Weight,and Obesity in China: Quantile Regression Approach

IntroductionPrevious studies exploring associations of physical inactivity, obesity, and out-of-pocket expenditure (OOPE) mainly used traditional linear regression, and little is known about the effect of both physical inactivity and obesity on OOPE across the percentile distribution. This study aims to assess the effects of physical inactivity and obesity on OOPE in China using a quantile regression approach.MethodsStudy participants included 10,687 respondents aged 45 years and older from the recent wave of the China Health and Retirement Longitudinal Study in 2015. Linear regression and quantile regression models were used to examine the association of physical activity, body weight with annual OOPE.ResultsOverall, the proportion of overweight and obesity was 33.2% and 5.8%, respectively. The proportion of individuals performing high-level, moderate-level, and low-level physical activity was 55.2%, 12.7%, and 32.1%, respectively. The effects of low-level physical activity on annual OOPE were small at the bottom quantiles but more pronounced at higher quantiles. Respondents with low-level activity had an increased annual OOPE of 26.9 USD, 150.3 USD, and 1,534.4 USD, at the 10th, 50th, and 90th percentiles, respectively, compared with those with high-level activity. The effects of overweight and obesity on OOPE were also small at the bottom quantiles but more pronounced at higher quantiles.ConclusionInterventions that improve the lifestyles and unhealthy behaviors among people with obesity and physical inactivity are likely to yield substantial financial gains for the individual and health systems in China.     

国家儿童医学中心青年儿科医师培养机制研究

目的 探讨对国家儿童医学中心(以下简称为本中心)青年儿科医师培养机制研究现状.方法 选择2020年本中心430位在职青年儿科医师(年龄≤45岁)为调查对象.采用本研究自行设计的《国家儿童医学中心青年儿科医师培养机制调查问卷》,主要包括①纳入调查对象基本情况;②本中心为纳入调查对象提供科研条件情况;③本中心对纳入调查对象...     

The frequency of assessment tools in arthroscopic training: a systematic review

BackgroundMultiple assessment tools are used in arthroscopic training and play an important role in feedback. However, it is not fully recognized as to the standard way to apply these tools. Our study aimed to investigate the use of assessment tools in arthroscopic training and determine whether there is an optimal way to apply various assessment tools in arthroscopic training.MethodsA search was performed using PubMed, Embase and Cochrane Library electronic databases for articles published in English from January 2000 to July 2021. Eligible for inclusion were primary research articles related to using assessment tools for the evaluation of arthroscopic skills and training environments. Studies that focussed only on therapeutic cases, did not report outcome measures of technical skills, or did not mention arthroscopic skills training were excluded.ResultsA total of 28 studies were included for review. Multiple assessment tools were used in arthroscopic training. The most common objective metric was completion time, reported in 21 studies. Technical parameters based on simulator or external equipment, such as instrument path length, hand movement, visual parameters and injury, were also widely used. Subjective assessment tools included checklists and global rating scales (GRS). Among these, the most commonly used GRS was the Arthroscopic Surgical Skill Evaluation Tool (ASSET). Most of the studies combined objective metrics and subjective assessment scales in the evaluation of arthroscopic skill trainingConclusionsOverall, both subjective and objective assessment tools can be used as feedback for basic arthroscopic skill training, but there are still differences in the frequency of application in different contexts. Despite this, combined use of subjective and objective assessment tools can be applied to more situations and skills and can be the optimal way for assessment.Level of EvidenceLevel III, systematic review of level I to III studies.

Key messages

• Both subjective and objective assessment tools can be used as feedback for basic arthroscopic skill training.
• Combined use of subjective and objective assessment tools can be applied to more situations and skills and can be the optimal way for assessment.

     

东莞市各级医院263名护理人员沟通能力现状调查

目的 了解东莞市各级医院护理人员自我沟通理念和技能水平,提出应对措施.方法 采用问卷调查的方法,对东莞市三级甲等医院160名护理人员和二级或以下医院110名护理人员进行沟通理念和沟通技能调查,收回有效问卷263份,对263名护理人员的数据资料进行分析.结果 被调查的263名护理人员中,在与亲密朋友共享信息和分享情感方面的沟通方面能力较强,在处理不明确或不确定的问题时沟通能力较差.护理人员的各项沟通能力中,倾听能力》语言表达能力》自我克制力》处理人际关系中的冲突和摩擦能力.三级甲等医院的护理人员沟通能力明显高于二级或以下医院的护理人员(P＜0.05);高职称、高学历护理人员的沟通能力明显高于低职称、低学历的护理人员(P＜0.01);30岁以上的护理人员沟通能力明显高于其他低年龄组护理人员(P＜0.01);护龄10年以上护理人员的沟通能力明显高于其他低护龄组护理人员(P＜0.01).结论 东莞市各级医院临床护理人员的沟通能力需要进一步培训和提高,尤其要做好低年资护理人员沟通技巧的培训.     

Instituting a Curriculum for Cardio-Obstetrics Subspecialty Fellowship Training

Maternal mortality is rising in the United States, and cardiovascular disease is the leading cause. Adverse pregnancy outcomes such as preeclampsia and gestational diabetes heighten the risk of cardiovascular complications during pregnancy and the peripartum period and are associated with long-term cardiovascular risks. The field of cardio-obstetrics is a subspecialty within adult cardiology that focuses on the management of women with or at high risk for heart disease who are considering pregnancy or have become pregnant. There is growing recognition of the need for more specialists with dedicated expertise in cardio-obstetrics to improve the cardiovascular care of this high-risk patient population. Current recommendations for cardiovascular fellowship training programs accredited by the Accreditation Council for Graduate Medical Education involve establishing core competency in the knowledge of managing heart disease in pregnancy. However, little granular detail is available of what such training should entail, which can lead to knowledge gaps. Additionally, dedicated advanced subspecialty training in this area is not commonly offered. Multidisciplinary collaborative teams have been shown to improve outcomes in cardiac patients during pregnancy, and cardiovascular fellows-in-training interested in cardio-obstetrics should have the opportunity to participate in and contribute to a pregnancy heart team. In this document, we describe a proposed specialized cardio-obstetrics training pathway that could serve to adequately prepare trainees to competently and comprehensively care for women with cardiovascular disease before, during, and after pregnancy.