Protein tyrosine phosphatase conjugated with a novel transdermal delivery peptide,astrotactin 1–derived peptide recombinant protein tyrosine phosphatase (AP-rPTP), alleviates both atopic dermatitis–like and psoriasis-like dermatitis

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Avances del Modelo Educativo para Desarrollar Actividades Profesionales Confiables (MEDAPROC)☆

The Educational Model to Develop Entrustable Professional Activities (MEDAPROC) arises as a response to the implementation of competency-based education. It is a multidisciplinary project based on interpretative epistemology, the constructivist paradigm, the transformations of the national health system, and the context of the current practice of medicine. Its purpose is to encourage the acquisition of essential knowledge, skills, and attitudes by the medical student. It integrates the international trend of the entrustable professional activities and converts them into entrustable professional activities (APROC). MEDAPROC proposes that the development of the APROC be promoted in an inverse manner, from the profile of the graduate to the beginning of the undergraduate studies. Therefore, it is involved in several phases of the learning and teaching process (planning, didactics, assessment, and feedback) through projects to implement didactic strategies and assessment resources, with the support of teacher training, educational research, and technology. Its aim is to improve medical and health sciences education, with the firm purpose of making a positive change in the health care quality from the educational environment.     

老年人生活能力评定及康复

老年人康复是提高老年人生活能力和质量的重要手段，日常生活能力评定是老年病康复过程中的必须环节。本文重点介绍适合老年人的基本日常生活活动（BADL）和工具性日常生活活动（IADL）评定方法和选用原则、老年人康复机构的选择、康复流程的制定、康复的注意问题和老年人运动方法等。     

Components of a proper hospital discharge for elders

SIGNIFICANCE: Effective discharge planning is a vital link in continuity of care for elders. Previous studies identify problems with planning for elders' discharge from the hospital and problems elders encounter managing care post-discharge. However, little attention has been given to identifying effective discharge planning processes. Explicating the components of effective discharge planning is critical to replicate the process in other health care settings and predict post-discharge outcomes. PURPOSE: The purpose of this study was to identify the components of effective discharge planning for elders and factors that impede planning. METHODS: Ethical approvals were obtained from the University and National Health Service (NHS) Trust. Qualitative methods were used and data were collected from two wards in a 78-bed geriatric rehabilitation hospital that was part of a National Health Service Trust serving Southwest London. Data included semi-structured interviews and documents related to discharge planning, care delivery, and community resources. A total of 24 semi-structured interviews were conducted with health care professionals who were part of the hospital's multidisciplinary team, those affiliated with the Community Trust that provided aftercare, elders, and family carers. RESULTS: Participants consistently used the term "proper discharge" when referring to effective discharge planning. The multidisciplinary team comprised a vital context for a proper discharge. The findings indicated that three circles of communication were central in a four stage discharge process. Different circles of communication were key at different stages. CONCLUSIONS: The findings provide insights for educating nurses about effective planning practices and examining the global significance of impediments to a proper hospital discharge.     

胆石的回声强度和化学成分关系的研究

目的：评价回声强度可否预测胆石的化学性质和结构特点。方法：６２例胆石症患者进行Ｂ超检查，测量胆石的回声强度（ＥＬ）。以红外光谱仪定量分析所有胆石的四种主要化学成分。结果：ＥＬ《１００（７例），１０１～１４０（２２例），１４１～１８０（２５例），》１８０（８例）。四组间胆固醇，胆红素及胆红素钙的含量无显著差异（Ｐ＞００５，但》１８０组中碳酸钙的含量显著高于其它三组。ＥＬ与碳酸钙的含量呈显著正相关（Ｐ＜００１，ｒ＝０７９），而与其它三种无相关。结论：ＥＬ可用于预测胆石的碳酸钙含量及钙化情况，但不能用于预测其它三种化学成分     

Prediction of the intensity and diversity of day-to-day activities among people with schizophrenia using parameters obtained during acute hospitalization

Purpose: Participation in day-to-day activities of people with schizophrenia is restricted, causing concern to them, their families, service providers and the communities at large. Participation is a significant component of health and recovery; however, factors predicting participation are still not well established. This study examines whether the parameters obtained during acute hospitalization can predict the intensity and diversity of participation in day-to-day activities six months after discharge.

Method: In-patients with chronic schizophrenia (N?=?104) were enrolled into the study and assessed for cognitive functioning, functional capacity in instrumental activities of daily living (IADL), and symptoms. Six months after discharge, the intensity and diversity of participation in day-to-day activities were evaluated (N?=?70).

Results: Multiple correlations were found between parameters obtained during hospitalization and participation diversity, but not participation intensity. The model that is better suited to the prediction of participation diversity contains cognitive ability of construction, negative symptoms and number of previous hospitalizations. The total explained variance is 37.8% (F_3,66?=_?14.99, p?Conclusions: This study provides evidence for ecological validity of the in-patient evaluation process for the prediction of participation diversity in day-to-day activities six months after discharge. Participation diversity is best predicted through a set of factors reflecting personal and environmental indicators.

• Implications for rehabilitation

• Results of in-patient evaluations can predict the diversity of participation in day-to-day activities six months after discharge.

• Higher prediction of participation diversity is obtained using a holistic evaluation model that includes assessments for cognitive abilities, negative symptoms severity and number of hospitalizations.

     

Zinc chloride smoke inhalation: a rare cause of severe acute respiratory distress syndrome

Zinc chloride smoke inhalation is a rare cause of slowly progressive and often fatal acute respiratory distress syndrome (ARDS). The conventional treatment includes intravenous N-acetylcysteine, L-3, 4-dehydroproline, methylene blue, and respiratory support according to the lung protective strategy. This report presents the cases of three patients with serious zinc chloride inhalation and ARDS, the last of whom survived after prolonged intensive care, videothoracoscopic excision of emphysema bullae, and recurrent chemical pleurodesis. Received: 3 March 1999 Final revision received: 6 July 1999 Accepted: 27 October 1999