基于健康信念理论对社区居民健康素养的干预研究

目的以健康信念理论为基础,通过线上和线下结合的健康教育方式规范社区居民健康的自我管理,提高居民的依从性和自我管理效能,达到有效干预居民的健康素养水平和防控慢病的目的。方法2018年4月—2018年10月组建干预小组,针对北京市西城区某社区149名居民进行横断面研究,以《中国公民健康素养66条》为基础对社区居民的健康素养进行基线调查,2018年11月-2019年4月基于健康信念理论对自愿参加类实验研究的149名社区居民进行线上和线下的健康宣教后,再次评估该社区居民的健康素养水平。结果该社区居民的健康素养水平由活动前的11.4%提升至活动后的21.5%,健康素养各方面的提升及不同性别、学历、经济状况方面健康素养的提升都存在差异,差异有统计学意义(P<0.05)。结论以健康信念理论为基础,对社区居民进行有效的线上和线下的健康宣教有助于提升居民的健康素养水平。     

社区医生对接种肺炎球菌疫苗的知信行及影响因素研究

  目的  了解2022年浙江省 ≥ 50岁居民流感和肺炎球菌疫苗接种情况及其影响因素,为有效提高该地区中老年人群流感和肺炎球菌疫苗的接种率提供参考依据。  方法  于2022年6月采用多阶段随机抽样方法在浙江省7个区/县35个社区/村抽取2200名 ≥ 50岁居民对其流感和肺炎球菌疫苗接种情况进行问卷调查,并采用多因素非条件logistic回归模型分析影响浙江省 ≥ 50岁居民流感和肺炎球菌疫苗接种情况的主要因素。  结果  浙江省最终纳入分析的2100名 ≥ 50岁居民中,接种流感疫苗和肺炎球菌疫苗者分别为776人和116人,流感疫苗和肺炎球菌疫苗接种率分别为36.95%和5.52%。多因素非条件logistic回归分析结果显示,高中及以上文化程度、知晓流感及其疫苗知识、享受流感疫苗免费接种政策和有医生推荐接种的居民更意愿接种流感疫苗;享受肺炎球菌疫苗免费接种政策和有医生推荐接种的居民更意愿接种肺炎球菌疫苗。浙江省 ≥ 50岁居民接种流感疫苗的主要原因为社区通知接种[590人次（76.03%）]、家人建议接种[400人次（51.55%）]和自己想要预防疾病[350人次（45.49%）],未接种的主要原因为对疫苗不了解[816人次（61.63%）]、担心有副作用[321人次（24.24%）]和感觉没有必要[296人次（22.36%）];接种肺炎球菌疫苗的主要原因为社区通知接种[85人次（73.28%）]、家人建议接种[67人次（57.76%）]和自己想要预防疾病[51人次（43.97%）],未接种的主要原因为对疫苗不了解[1270人次（64.01%）]、感觉没有必要[450人次（22.68%）]和担心有副作用[442人（22.28%）]。  结论   2022年浙江省 ≥ 50岁居民流感和肺炎球菌疫苗接种率均较低,是否享受疫苗免费接种政策和是否有医生推荐接种疫苗是该地区 ≥ 50岁居民流感和肺炎球菌疫苗接种情况的共同影响因素。     

Effects of social activation and physical mobilization on sleep in nursing home residents

Age-related changes in sleep physiology, frequent occurrence of health impairments, and a sedentary lifestyle make nursing home residents particularly vulnerable to sleep disturbances. Despite the high prevalence of sleep disturbances in nursing homes, there is a lack of research concerning the use of non-pharmacological approaches for improving residents' sleep. This study aimed to promote residents' sleep by improving their social activation and physical mobilization. An experimental group of residents attending an activation program four times a week during an eight-week study course was compared to a non-treated control group in a cluster-randomized intervention trial among 85 residents of 20 nursing homes. Sleep was assessed by the Insomnia Severity Index (ISI), nurses' ratings of residents' sleep disturbances and actigraphy-based sleep parameters. Although no changes in actigraphy-based sleep parameters were observed, the subjective sleep quality ratings of the intervention participants significantly improved compared to the control group members (p = 0.004). This study suggests that physical mobilization and social activation may improve residents' subjective sleep quality. Further efforts to improve residents' sleep by increasing their physical and social activity should consider existing obstacles to encourage participation and adherence to the program.     

感染科住院医师规范化培训的实践与探索

住院医师规范化培训是医学生毕业后教育的重要组成部分,是培养合格的、具有综合素养的青年医师的重要手段。西安交通大学第二附属医院感染科在住院医师规范化培训的实践与探索中,逐步建立了符合专业特点的规培管理体系,包括规培管理梯队、规培实施细则、三阶段评价反馈体系、教学相长双向培训模式、三维评价体系等,旨在以岗位胜任力为导向,从理论知识、临床技能、医学人文素养、科研能力、人际沟通能力,多维度高质量的进行住院医师规范化培训工作。     

Pro Re Nata Drug Use in Nursing Home Residents: A Systematic Review

Objectives

In addition to routinely administered long-term medication, complex drug regimens of nursing home residents often include as needed or pro re nata (PRN) medication. However, there has been no systematic evaluation of the frequency and concomitants of PRN medication in nursing homes. The main objective of this systematic review was to provide a current assessment of PRN drug use in nursing homes.

Effect of Life Review on Quality of Life For Older Adults Living in Nursing Homes

Aim: To examine the effects of life review on daily activities, social participation, outlook on life, and perceptions of living in a nursing home measured by life satisfaction and quality of life in older adults. Method: The study design was a two-phase quasi-experimental pre-post-tests including development and testing of a life review protocol. Nine residents, age ≥65, participated in a life review group once weekly for 6 weeks. Outcomes were analyzed using the Life Satisfaction Index-Z (LSI-Z) and pre-post surveys. Results: LSI-Z scores improved post-intervention and survey outcomes indicated participation in activities of daily living (ADLs), socialization, outlook on life, and living in a nursing home perceptions improved for all participants. Conclusion: The study demonstrates the effectiveness of a life review protocol to improve ADLs, social participation, and enhancing perceptions of outlook on life and living in a nursing home enhancing QOL and life satisfaction for older adult nursing home residents.     

Deep learning for intelligent diagnosis in thyroid scintigraphy

ObjectiveTo construct deep learning (DL) models to improve the accuracy and efficiency of thyroid disease diagnosis by thyroid scintigraphy.MethodsWe constructed DL models with AlexNet, VGGNet, and ResNet. The models were trained separately with transfer learning. We measured each model’s performance with six indicators: recall, precision, negative predictive value (NPV), specificity, accuracy, and F1-score. We also compared the diagnostic performances of first- and third-year nuclear medicine (NM) residents with assistance from the best-performing DL-based model. The Kappa coefficient and average classification time of each model were compared with those of two NM residents.ResultsThe recall, precision, NPV, specificity, accuracy, and F1-score of the three models ranged from 73.33% to 97.00%. The Kappa coefficient of all three models was >0.710. All models performed better than the first-year NM resident but not as well as the third-year NM resident in terms of diagnostic ability. However, the ResNet model provided “diagnostic assistance” to the NM residents. The models provided results at speeds 400 to 600 times faster than the NM residents.ConclusionDL-based models perform well in diagnostic assessment by thyroid scintigraphy. These models may serve as tools for NM residents in the diagnosis of Graves’ disease and subacute thyroiditis.     

Perceptions of psychiatry residents and non-residents on training needs and care related to patients with intellectual disability and mental health problems: A study from Singapore

Background: People with intellectual disability (ID) have higher risk of mental morbidity and specialised training may be required in their management. We explored the training needs and knowledge as well as perceptions of care of such patients among residents and non-residents working in psychiatry.

Method: The study was conducted as an anonymous survey. Questionnaires were sent to all residents and non-residents at a large psychiatric hospital in Singapore.

Results: Forty-eight out of the 76 questionnaires sent out were returned. All participants responded that postgraduate training was required in the area of ID and mental health and according to the majority, available training was inadequate. Over 90% believed that people with ID were vulnerable to exploitation and they should be under a specialist team.

Conclusion: Efforts should be made to include specialist training in psychiatry of ID in the Singapore psychiatry curriculum to enhance the knowledge and expertise of psychiatrists in this field.     

自制社区居民健康档案封面标签的应用

目的：探讨社区卫生服务中心应用自制封面标签对社区居民健康档案进行标识管理。方法：采用购买的彩色蜡光可粘贴型标签纸按一定的规格裁剪成型后，分别按照卫生服务中心的规定进行粘贴标识。结果：自2008年应用自制封面标签对社区居民健康档案进行分类标识管理以来，提高了社区居民健康档案的管理质量，也提高了医护人员的工作效率。结论：自制社区居民健康档案封面标签不仅费用低、易于制作，应用效果也好。