模拟演练对创伤院前急救时效性的影响

目的 探讨模拟演练对急救半径≤6 km的创伤患者院前急救时效性的影响.方法 对急诊科医护人员创伤院前急救进行规范的模拟演练培训,采用回顾性对照研究的方法,随机抽取模拟演练前后创伤患者各170例,比较2组创伤患者院前急救措施实施情况、院前急救时间、急救半径、急救实际路程、急救反应时间的差异.结果 模拟演练前后院前急救时间、急救半径、急救实际路程比较,差异均无统计学意义（P＞0.05）;院前急救措施、急救反应时间比较,差异有统计学意义（P＜0.05）.结论 急救模拟演练对创伤院前急救有较强的指导意义,能提高救治时效性,增加有效救护措施的实施,缩短急救反应时间.     

Muscle work is increased in pre-swing during hemiparetic walking

Background

Muscle mechanical work is likely affected by gait abnormalities in hemiparetic walking during the paretic pre-swing phase (i.e., double support phase preceding paretic toe-off). Previous experimental studies suggest that muscle work may be decreased in the paretic leg, but paretic work may have been underestimated since experimental approaches based on net joint moments do not account for co-contraction of antagonist muscles. Also, whether the non-paretic leg does more work compared to control subjects at matched speeds and how work generation may differ between hemiparetic subjects walking with different self-selected speeds remains unknown.

Methods

Three-dimensional forward dynamics simulations of two representative hemiparetic subjects walking with different self-selected speeds (i.e., limited community = 0.45 m/s and community walkers = 0.9 m/s) and a speed and age-matched control subject were generated to quantify musculotendon (fiber and in-series tendon) work during paretic pre-swing.

Findings

Total paretic and non-paretic fiber work were increased in both the limited community and community hemiparetic walkers compared to the control. Increased fiber work in the limited community walker was primarily related to decreased fiber and tendon work by the paretic plantar flexors requiring compensatory work by other muscles. Increased fiber work in the community walker was primarily related to increased work by the hip abductors and adductors.

Interpretation

The hemiparetic walkers would expend more metabolic energy during pre-swing if the hemiparetic and control subjects were to perform work with the same mechanical efficiency. These results may partly explain the increased metabolic cost of hemiparetic walkers compared to nondisabled walkers at matched speeds.     

The effects of scenario-based communication training on nurses’ communication competence and self-efficacy and myocardial infarction knowledge

Objective

The aim of the study was to determine the effects of a simulated communication training course on nurses’ communication competence, self-efficacy, communication performance, myocardial infarction knowledge, and general satisfaction with their learning experience.

Methods

A randomized controlled trial was conducted with a pre-test and two post-tests. The experimental group underwent simulated communication training course and the control group received a case-based communication training course.

Results

The experimental group made more significant improvement in competence and self-efficacy in communication from pre-test to the second post-test than the control group. Although both groups’ satisfaction with their learning experience significantly increased from the first post-test to the second post-test, the experimental group was found to be more satisfied with their learning experience than the control group. No significant differences in communication performance and myocardial infarction knowledge between the two groups were identified.

Conclusion

Scenario-based communication training can be more fully incorporated into in-service education for nurses to boost their competence and self-efficacy in communication and enhance their communication performance in myocardial infarction patient care.

Practice implications

Introduction of real-life communication scenarios through multimedia in communication education could make learners more motivated to practice communication, hence leading to improved communication capacity.     

Impact of a standardized patient simulation on undergraduate nursing student knowledge and perceived competency of the care of a patient diagnosed with schizophrenia

Background

Undergraduate nursing students may not have the opportunity to assess and intervene with a patient diagnosed with schizophrenia during their clinical rotation. Provision of a standardized patient simulation experience affords students this opportunity in a safe setting without risk to the patient or student.

矿物粉尘与大肠埃希菌相互作用机制的研究

目的研究来自全国各地的4种天然及4种人工矿物粉尘与大肠埃希菌作用的机制。方法分析天然矿物粉尘物理组成及8种粉尘主要化学成分，观察矿物粉尘与大肠埃希菌作用16h后测定大肠埃希菌数量、培养基pH值、培养基14种主要元素及葡萄糖（GLU）、丙酮酸含量以及β半乳糖苷酶的活力变化。结果4种天然矿物粉尘物理组成基本一致，8种矿物粉尘所含化学成分不同；与细菌作用后元素溶出也不完全相同；含钙（ca）高的水泥粉尘以及来含镁（Mg）高的水镁石能使大肠埃希菌数量、丙酮酸含量和B半乳糖苷酶的活力增高并增加大肠埃希菌对GLU的利用。结论含Ca或Mg高的碱性矿物粉尘可能促进大肠埃希菌的生长代谢。     

情景模拟教学法在母婴护理实践教学中的应用

目的探讨情景模拟教学法在母婴护理实践教学中的应用与效果。方法在2007级护理专科生中随机选取2个班级（114名）为对照组,2个班级（114名）为试验组。试验组采用情景模拟教学法,并采用自行设计的问卷调查表进行学生能力自评,统计自评结果;对照组采用传统教学方法。比较2组学生期末考试成绩。结果试验组自评结果统计显示,90.0%的学生认为情景模拟教学法有利于理论与实践相结合;95.1%的学生认为加深了对理论知识的理解和记忆;89.3%的学生认为培养了临床思维能力;96.0%的学生认为提高了沟通能力;90.4%的学生认为增强了实践动手能力;87.0%的学生认为培养了团队协作精神。试验组实践和理论考试成绩均明显高于对照组（P〈0.001）,差异有统计学意义。结论情景模拟教学法提高了学生的综合能力和教师的教学水平。