Changes in practice of breast cancer radiotherapy 1998–2002: An Australasian survey

In order to assess the impact on radiation oncology practice of the publication of evidence-based guidelines for technical aspects of therapeutic radiation for breast cancer, the Radiation Oncology Expert Advisory Group of the National Breast Cancer Centre conducted two postal surveys of radiation oncologists practising in Australia and New Zealand. Results from a survey conducted in 1998, prior to distribution of the guidelines, have been published previously. This article reports on results from a survey undertaken in 2002 and contains data from 102 respondents who manage women with breast cancer. The results show several important changes in practice since 1998, including increased use of CT scanning in breast cancer treatment planning and increased use of immobilization devices for patient treatment. There is also evidence of increased attention to technical aspects of treatment planning that reduce the potential risk of treatment toxicity. The influence of the guidelines, the wider availability of modern equipment and results from landmark clinical trials on change in radiation therapy practice is discussed.     

经方临床运用的几个问题

经方为群方之冠 ,是方剂的鼻祖。临床运用经方要掌握几个关键问题 :1.辨识病机 ,不拘病名 ;2 .突出主症 ,参合佐症 ;3.确定病位 ,落实脏腑 ;4 .伤寒治法 ,有常有变 ;5 .深究方规 ,抓住主方 ;6 .化裁经方 ,扩大运用。要真正探讨经方的奥秘 ,还应当深入读好《伤寒论》,在学中用 ,在用中学。     

二、三级综合性医院组建联合体的实践和探讨

随着卫生体制改革的深入,医院重组的类型和运作模式各不相同,以二、三级综合性医院所有权和经营权分离的托管模式组建医院联合体,这一运行机制对全面提升二级医院的管理、医疗技术水平,扩大医疗市场,起到了积极、有效的作用.这一运作形式将是我国医院管理者,特别是公立制医院管理者不断探索的方向之一.     

澳大利亚护理硕士专业学位人才培养现状及启示

通过比较我国与澳大利亚护理硕士专业学位研究生人才培养项目在办学规模、师资情况、教育模式、课程设置、临床实践与评估、毕业要求方面的现状,提出了立足我国实际的教学改革建议,为完善具有中国特色的护理硕士专业学位研究生教育培养体系,培养健康中国建设所需要的高级护理人才提供参考。     

南华大学临床技能学课程金课实践

高等学校本科教育质量评价的重点在于课程质量。金课是教育部提出的具有高阶性、创新性和挑战度特点的高质量课程标准,是国家教育部对于建设一流本科教育的要求。文章介绍了南华大学衡阳医学院临床技能学课程在教学实践中,以金课的标准和要求贯彻课程教学,广泛调动了学生的积极性和主动性,取得了更好的教学效果,是提高课程质量的有效方法,应该大力倡导并尽可能推广到其他医学课程中去。     

Assessment of knowledge,attitude, and practice of glaucoma among different cadres of optometrists

Purpose:To assess the level of knowledge, attitude, and clinical practice of glaucoma among optometry students and optometry practitioners with different years of clinical experience and academic background.Methods:A survey with 20 questions on knowledge, attitude, and practice (KAP) of glaucoma was prepared and self-administered to optometry students and optometry practitioners practicing in an eye hospital/clinic/optical with varied years of clinical experience and education qualification.Results:Among the 558 participants, 57% were optometry practitioners and 43% were students. The knowledge scores among optometry practitioners increased significantly with an increase in the years of clinical experience (P < 0.001). Participants with master’s degrees scored higher than participants with bachelor’s degrees (P = 0.12). There was no statistically significant difference in knowledge scores based on the type of clinical practice - hospital, private practice, or optical (P = 0.39). Practicing optometrists who performed slit-lamp examination, gonioscopy, IOP measurements, and disc evaluation for the detection of glaucoma had significantly higher knowledge scores than those who did not perform these tests in their practice (P < 0.05). A positive attitude toward glaucoma learning through workshops and hands-on training was reported by optometrists and students.Conclusion:Knowledge about glaucoma was good among optometrists and optometry students and was better among those who handled the diagnostics. All the optometrists had a positive attitude toward enhancing their practice through proper training.     

灾害护理知信行量表的编制及信效度检验

目的:编制灾害护理知信行量表,并对其进行信效度检验。方法:根据知信行理论模型编制灾害护理知信行量表。随机抽取500名护生实施问卷调查并进行因子分析及信效度评估,3周后,随机抽取200名护生检验重测信度。结果:灾害护理知信行量表包括知识、态度及行为3个维度,共30个条目,总量表及各维度Cronbach′sα系数分别为0.96,0.92,0.95,0.96;分半信度为0.82,总量表及各维度重测信度分别为0.90,0.82,0.83,0.85。量表总内容效度指数为0.93,各条目内容效度指数为0.85～1.00。结论:灾害护理知信行量表具有良好的信效度,可作为评估护生灾害护理知信行水平的工具,可作为灾害护理教育的形成性评价指标。     

实习前护理专科学生睡眠质量及其影响因素

目的:研究实习前护理专科学生(护生)的睡眠质量及影响因素. 方法:采用匹兹堡睡眠质量指数量表(PSQI)和自行设计的调查问卷对193名实习前护生进行调查. 结果:实习前护生睡眠差者占19.7%;PSQI总分为(5.990±2.834)分;影响因素有人际关系复杂、担心实习单位分配不好、学习压力大、家庭经济状况、考试因素、担心饮食和生活习惯明显改变和感到前途渺茫等. 结论:影响实习前护生睡眠质量的因素是多方面的,应采取多种措施改善睡眠,保证身心健康.     

安宁疗护家庭会议临床实践的系统综述

目的 系统总结安宁疗护家庭会议临床实践的经验,为召开家庭会议和改进会议质量提供参考.方法 运用计算机检索Web of Science、PubMed、The Cochrane Library、OVID、VIP、Sinomed、CNKI和万方数据库,检索从建库至2019年10月1日中英文文献,归纳安宁疗护家庭会议的准备过程...     

河南省非订单定向全科住院医师规范化培训结业学员的就业状况及影响因素研究

背景 全科医生数量和质量是人力资源管理的两个重要维度,其中,医生数量的新增、保持和流失,是全科人力动态规划、管理和评价的重要考量,也是全科住院医师规范化培训(简称全科住培)的绩效指标。探讨全科住培学员的就业状况及影响因素,可以为今后住培政策和激励机制的制定提供参考,但目前针对非订单定向全科住培学员的相关研究较为缺乏。目的 了解河南省非订单定向全科住培学员的就业状况,分析学员结业后未从事全科医学相关工作的原因,从而为完善培训管理和人力资源激励机制提供参考。方法 于2021年8月,采用分层随机整群抽样法,在河南省选取2014—2017年入培且已结业的非订单定向全科住培学员326例进行问卷调查。问卷由课题组自行设计,主要内容为学员的基本信息、全科住培情况、目前工作情况及结业后从事与未从事全科医学相关工作的原因。问卷通过“问卷星”平台发放,由学员自行填写。结果 共发放问卷326份,回收有效问卷271份(83.1%)。结业后,从事全科医学相关工作者77例(28.4%),从事非全科医学相关工作者194例(71.6%)。多因素Logistic回归分析结果显示,年龄、文化程度、生源类型、全科住培基地所...