Cultural and linguistic appropriateness of a web-based breastfeeding educational resource for Saudi women: Consensus development conference approach

AimThe purpose of this study was to investigate the cultural and linguistic appropriateness of the content, images and layout of the web-based breastfeeding educational resource for Saudi women using a consensus development approach.BackgroundAlthough the World Health Organization highly recommends exclusive breastfeeding, there is a decline in breastfeeding rates in Saudi Arabia, especially during hospital stay. The combining of health professional support with e-technology tools has been proposed as a method to increase exclusive breastfeeding. However, the cultural and linguistic appropriateness of an e-technology-based approach has not been explored in Saudi women.MethodsAfter developing a content draft of the web-based breastfeeding educational resource specific to Saudi culture, an online consensus development conference was organised with ten participants including two university researchers and eight health care providers to investigate the cultural and linguistic appropriateness of the educational content. The participants from Saudi Arabia were Saudi mothers who had breastfeeding experiences and were key maternity health professionals employed at the Maternity and Children Hospital of Dammam, Saudi Arabia. The SQUIRE checklist was used in the reporting of this study.ResultsFeedback received prior to the meeting showed that 81% of the content was acceptable and minor changes were required. Changes were made to the content based on the suggestions and feedback received. The consensus group accepted all the changes and the content was finalised.ConclusionsThe online consensus development conference was found to be a very convenient way to decide on the cultural and linguistic appropriateness of the content of the web-based breastfeeding educational resource allowing the participation of experts from different countries; this was considered a critical step in ensuring the successful implementation of the intervention.     

突发性耳聋循证护理的文献研究与护理方法初探

目的本组通过循证护理的方法检索突发性耳聋护理方面的现代文献,初步分析突发性耳聋的临床护理,根据文献研究结果与临床专业知识、经验和患者的需求相结合,探索突发性耳聋患者的护理模式,使突发性耳聋的护理活动有证可循,从而提高对突发性耳聋患者的护理质量。方法以"突发性耳聋and护理"、"突聋and护理"为关键词,检索维普资源系统、中国期刊网、中国生物医学文献数据库从建库起至2011年07月关于突发性耳聋护理的相关文献,对文献进行Jadad评价和分析。结果检索出相关文献304篇,根据文献纳入标准和排除标准,仅有17篇文献被纳入进行本次研究,所纳入的17篇文献Jadad评分均<4,属于低质量文献。结论根据文献结果,应从心理护理、治疗护理、生活及出院护理等探索突发性耳聋的循证护理模式,后续研究应采用多中心、大规模、随机、双盲对照的前瞻性临床研究加以验证,以总结出疗效确切、特色明显的突发性耳聋临床护理模式。     

Value‐based medicine,a compass to guide healthcare decisions in the COVID‐19 aftermath

The ongoing COVID‐19 pandemics has claimed hundreds of thousands of lives among the elderly, the patients with chronic conditions and among underserved communities and people in social distress. In addition, the measures that succeeded in containing the epidemic created a profound economic crisis, which real dimension is still unclear. It is clear, however, that most healthcare systems were unprepared. Years of cost containments had eroded the ability of the healthcare sector to cope with the surge in cases. This editorial contends that rebuilding the healthcare systems will require forward thinking, a data‐driven approach and avoidance of reactive decision making. The editorial proposes the Value Based Medicine approach as a way to avoid the errors of the past and to align decision making in healthcare with patient health and quality of life (Value). This is an approach that is gaining traction in several systems. It needs a built‐in capability to collect and analyse outcome and costing data. Today the necessary informatic and computational capabilities are widely available.     

PCMC教学模式结合案例分析法在低年资护士培训中的应用

目的 ：探讨问题导向临床医学教学模式（PCMC）结合案例分析法在低年资护士培训中的应用效果。方法 ：选择在我院感染科轮转的低年资护士96名,分为对照组和观察组,观察组48人,对照组48人。观察组采用PCMC教学模式与案例分析法结合培训,对照组采用传统方法培训,比较两组护士出科考核成绩、护士对培训方法的评价、病人对护士的评价。结果：观察组出科考核成绩、护士对教学方法的评价以及病人对护士的评价均优于对照组（P〈0.01）。结论 ：PCMC教学模式与案例分析法结合可有效提高低年资护士的综合能力,提高培训质量和病人对护士的满意度。     

LONG-TERM OBSERVATION FOR OSSEOINTEGRATION OF CALCIUM PHOSPHATE SOL-GEL COATING ON Ti-6Al-4V IMPLANTS

Objective To observe the long-term impact of calcium phosphate (CaP) sol-gel coating on bone growth around porous-surfaced implant. Methods The porous-surfaced Ti-6Al-4V implants were prepared with the addition of a thin film of CaP sol-gel coating, and implanted into the tibiae of 8 rabbits, each with two implants. Implanted sites were allowed to heal for 2, 8, 12, and 24 weeks, after which specimens were obtained for scanning electron microscope analysis using the freeze-fracture technique. Results The sol-gel coated implants recovered by freeze-fracture technique showed extensive bone growth from the endosteum along the implant surface. The bone was in direct contact with the CaP layer. The cement line-like layer was clearly demonstrated to be an intervening electron dense afibrillar layer between the CaP coat and the overlying newly deposited bone. The stability and osseointegration of the porous-surfaced implants seemed not to be affected by the osteoclastic resorption of CaP layer occurred during 24 weeks of healing. Conclusion Based on the findings in the long-term observation, the addition of a thin layer of CaP promotes an extensive osseointegrated interface between the porous-surfaced Ti-6Al-4V implants and the newly deposited bone.     

Implementation of evidence‐based practice by nurses working in community settings and their strategies to mentor student nurses to develop evidence‐based practice: A qualitative study

The aim of the study was to explore how community nurses apply the best available evidence to their practice, and how they mentor student nurses to conceptualize and implement evidence‐based practice in community settings. In the UK, the expansion of health‐care provision in the community has supported the development of highly skilled community nurses. However, there is limited literature regarding the strategies used by community nurses to implement evidence‐based practice and mentor student nurses to conceptualize evidence‐based practice in community placements. An exploratory qualitative approach applying inductive reasoning to focus group data was used. As a result, nurses working for a community NHS Foundation Trust in South England with a mentor qualification were invited to participate in one of the seven focus groups, 33 nurses participated. Data were analyzed with thematic analysis. The themes discussed in this paper are: ‘our practice is evidence‐based’ as guidelines and policies provided structure, but occasionally stifled autonomous clinical decision‐making, and ‘time’ as a barrier and facilitator to mentoring student nurses in community settings. In conclusion, nurses need to develop the ability to incorporate patients' needs and wishes within evidence‐based care. Time was a facilitator for some community mentors, but protected time is required to complete the necessary practice documentation of student nurses.     

Eliciting youth and adult recommendations through citizens’ juries to improve school based adolescent immunisation programs

Objectives

Completion of adolescent immunisation schedules in Australia is sub-optimal despite a well-established school based delivery program. The aim of this study was to seek adolescent and adult views on how existing adolescent school based immunisation policy and program delivery could be improved to increase adolescent immunisation uptake.

Method

Two citizens’ juries held separately, one with adolescent participants and one with adult participants deliberated on recommendations for public policy. Jury members were selected using a stratified sampling technique and recruited from a standing panel of community research participants through a market research company in South Australia. Juries were conducted in Metropolitan South Australia over two days and used university facilities with all meals and refreshments provided.

Results

Fifteen adults and 16 adolescents participated in the adult and youth juries respectively. Similar recommendations were made by both juries including increased ensuring the accuracy of information provided to adolescents and parents; employing a variety of formats for information delivery; and greater consideration of students’ physical and emotional comfort in order to improve the experience for adolescents. While the youth jury recommended that it should be compulsory for adolescents to receive vaccines through the school based immunisation program, the adult jury recommended an ‘opt-out’ system of consent. Both juries also recommended the use of incentives to improve immunisation uptake and immunisation course completion.

Conclusions

Eliciting adolescent views and including the perspectives of adolescents in discussions and development of strategies to improve engagement in the school based immunisation program provided valuable insight from the group most impacted by these policies and practices. Specifically, incorporation of adolescent and community views using citizens’ juries may lead to greater overall support from the community as their values and needs are more accurately reflected.