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.     

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.     

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.     

中医药院校工程制图课程教学改革与实践

工程制图是一门实践性很强的技术课。探讨在学时少的情况下,应改革工程制图课程教学方法,注重培养学生的空间构思能力,以及手工绘图、计算机绘图能力;并提出加强学生动手实践能力的几种途径。     

以学生为案例望面色教学实践体会

望面色是望诊的主要内容之一,为了加强学生望面色这一诊断方法的学习效果,在征得学生同意,自愿参加的前提下,在学生中找典型面色进行真实案例教学,调动了学生学习积极性,取得了良好教学效果,实现了教学相长。     

品管圈活动对降低临床实践带教差评率的影响

目的：探讨品管圈活动对于临床实践中带教差评数的影响,全面提高教学质量。方法：成立品管圈,运用PDCA循环方法,确定＂降低临床实践中带教差评率＂为主题,逐步开展品管圈活动步骤,进行效果分析。结果：通过7个月有序的品管圈活动,使临床实践中带教差评率由改善前的68.9%降为改善后的28.7%。结论：品管圈活动对于降低临床实践中带教差评率效果显著。     

HCV基因型在流行病和临床上的意义

近年来丙型肝炎病毒（Hepatitis C Virus,HCV）基因型愈来愈受到大家的关注,Simmonds分型法现在应用最为广泛,其分布不仅具有明显的“三间”流行病学特征,而且研究还发现HCV基因型存在多种生物学活性,与传播途径、临床类型、肝病严重程度、临床多样性、抗病毒疗效和疫苗的研发等密切相关。故本文就从HCV基因分型及在流行病和临床上的意义作一概述。     

Effectiveness and safety of Korean medicine treatment based on the clinical practice guidelines in patients with acute peripheral facial palsy: A protocol for a multicenter,prospective, observational study

Introduction:Peripheral facial palsy (PFP) results in weakness or paralysis of the affected side of the face. In Korea, there is a high demand for Korean medicine treatment for PFP. The clinical practice guidelines (CPGs) of Korean medicine for facial palsy were developed; however, there remains insufficient evidence to support the effectiveness and safety of Korean medicine treatment. Thus, this study aimed to evaluate the effectiveness and safety of Korean medicine treatment based on the CPGs in patients with acute PFP.Methods:This is a multicenter, prospective, observational study. The participants will be recruited from one Korean medicine hospital and eight Korean medicine clinics. The participants will receive Korean medicine treatments based on the CPGs, fill in survey questionnaires, and undergo electrophysiologic testing. The changes in House-Brackmann (H-B) grade, movement of the lip and eye, symptoms related to or accompanied by facial palsy, Facial Disability Index, EuroQol 5-dimension 5-level (EQ-5D-5L), and EuroQol Visual Analogue Scale (EQ-VAS), and the results of electromyography (EMG), electroneurography (ENoG), and Blink Reflex test will be analyzed. For the safety analysis, adverse events will be recorded, and for the feasibility analysis, the results of the Was It Worth It questionnaire will be assessed.Conclusion:We expect to draw real-world clinical data on the effectiveness and safety of Korean medicine treatment based on the CPGs in patients with acute PFP from this study. It would be the basis for complementing and improving the CPGs and provide the basis of clinical and policy decision-making.Trial registration:This study was approved by the Institutional Review Board of Kyung Hee University Korean Medicine Hospital (2021-06-005-001), and registered with the Korean Clinical Trial Registry (CRIS), Republic of Korea (KCT0006562).     

三级综合医院临床护理专家岗位设置及实践探索

文章总结了上海交通大学医学院附属仁济医院近10年来临床护理专家岗位设置及临床实践探索的相关经验.在设定入选标准、明确申报方案、制订管理及考核办法的基础上,医院护理部对临床护理专家进行统一选拔聘任,并以2年为1个考核周期,通过明确聘任等级、设立专项基金、明确岗位职责等一系列举措,各临床护理专家在临床实践、专科队伍建设、护...