Systematic review: Predictors of students’ success in baccalaureate nursing programs

Nursing schools strive to select a diverse student population who are likely to succeed by ensuring timely student progression through the program and effective use of educational sources. The purpose of this systematic literature review is to explore the preadmission variables and selection criteria that predict student success in 4-year baccalaureate nursing programs in the U.S. Sixteen articles met the eligibility criteria, and six measures were used to define student success: (a) early academic success, particularly during the first and second year; (b) attrition; (c) timely completion of the program; (d) graduation; (e) performance in nursing courses; and (f) academic performance in other science courses. Typically, the core set of cognitive predictors used in the admission process in nursing schools were pre-nursing GPA, pre-nursing collegiate science GPA, and scores on standardized aptitude exams. This review suggests that it is challenging to isolate one single variable as the best predictor of student success; however, using a combination of variables can offer a reliable prediction method. More researchers should consider using a theoretical basis to guide their inquiry on this topic. Additionally, researchers should examine admission variables that are most relevant across programs.     

贵州省"5+3"模式订单定向医学毕业生的离职意愿及影响因素研究

背景 我国基层全科医生的离职意愿较高，调查其离职意愿并分析影响因素，可以为减少基层卫生人才流失提供思路。目前，完成"5+3"模式（5年临床医学本科教育+3年住院医师规范化培训）培养的订单定向医学毕业生逐步履约进入基层工作，而针对该部分全科医生离职意向的研究相对较少。 目的 调查贵州省"5+3"模式订单定向医学毕业生回归基层工作后的离职意愿及影响因素，为完善吸引卫生人才留任、建设基层全科医生队伍相关政策提供依据。 方法 以贵州省截至2020年底已完成"5+3"模式培养并履约到基层医疗卫生机构工作的2015—2017级订单定向医学毕业生为研究对象。于2021-01-20至2021-02-10对其开展电子问卷调查，内容包括毕业生的一般情况、职业满意度、离职意愿、服务期满后职业方向。共回收问卷347份，其中有效问卷311份，问卷有效回收率为89.6%。采用单因素分析及多元逐步线性回归分析全科医生离职意愿的影响因素。 结果 贵州省"5+3"订单定向医学毕业生的整体离职意愿得分为（3.98±0.98）分，具有离职倾向者229例（73.6%）。不同性别、单位地理位置、每日工作量者的离职意愿得分比较，差异有统计学意义（P<0.05）。多元逐步线性回归分析显示，单位负责人对待下属的方式、在工作中获得的成就感、对当前收入满意程度、家人对工作的支持程度、当地激励政策执行程度是"5+3"订单定向医学毕业生离职意愿的影响因素（P<0.05）。服务期满后，计划留任原基层医疗卫生机构者12例（3.9%），计划去其他基层医疗卫生机构者21例（6.7%），计划离开基层去上级医院工作者196例（63.0%），计划攻读全日制硕士学位者60例（19.3%）。 结论 贵州省"5+3"模式订单定向医学毕业生的离职意愿较高，预计服务期满后基层全科人才流失较多，需从提高收入、重视全科医生心理需求、优化全科医生培养与使用、发展基层医疗卫生机构、加强全科宣传等方面着手改善。     

Glafenine-associated anaphylaxis as a cause of hospital admission in the Netherlands

Summary In 1981 generalized anaphylaxis was registered on 166 occasions in Dutch general and academic hospitals. Clinical details of 120 of those patients revealed that in 107 anaphylaxis was either probable (n=90) or possible (n=17), whereas in 13 cases some other reaction than anaphylaxis had occurred. The series of confirmed cases contained 46 men and 61 women, with mean ages of 47 y and 48 y, respectively.There was a complete recovery in 102 patients and two patients died. Hypotension was present in 79 cases (74%), dyspnoea in 34 cases (32%) and a skin reaction, mainly urticaria, erythema or angioedema, was mentioned in 62 cases (58%). Most cases of anaphylaxis were drug-induced (76%), the main causes being the analgesic glafenine and contrast media. Glafenine was mentioned as the cause in 36% of all admissions for drug-induced anaphylaxis. Only 3.7% of cases had been reported to the voluntary reporting scheme of the Netherlands Centre for Monitoring of Adverse Reactions to Drugs.On the basis of reimbursement data, the risk of developing severe anaphylaxis to glafenine was estimated at 11.7–19.3-fold relative to indomethacin, and 13.4–20.2-fold relative to oral penicillins.     

Drug related hospital admissions

Summary As part of a high-intensity monitoring study of drug events as the cause of admission to departments of internal medicine, the effect of an educational intervention programme was studied. Two departments were included, one specialising in geriatrics and one that received patients by non-selected referral. The series consisted of 607 consecutive admissions studied before and 703 after the intervention. The drug events considered were adverse drug reactions and dose-related therapeutic failures, mainly due to non-compliance.A modest, statistically non-significant decrease in drug related hospital admissions (DRH) was seen, from 14% before to 13% after the intervention period. However, DRHs classified as definitely avoidable showed the significant decrease of 83%.There was no apparent relationship between the topics selected for the intervention programme and changes in the pattern of DRHs. No relationship between alterations in sales data and hospital admissions caused by a given drug could be demonstrated. A blinded external evaluation of case abstracts did not disclose any significant shift in the investigators' assessments.The intervention may have had an non-specific effect on avoidable DRHs.     

90例慢性牙周炎临床分析

目的评价不同治疗方法对慢性牙周炎的临床效果。方法对90例慢性牙周炎患者,随机分成三组:龈上洁治术 抗生素组(A组),单纯龈上洁治术组(B组)和单纯抗生素组(C组)。分别给予不同的治疗,在治疗后1周、2周和4周记录牙周袋探诊深度(PPD)、探诊附着水平(PAL)、菌斑指数(PLI)、龈沟出血指数(SBI)。结果治疗1周和2周后各指标显著减轻(P<0.05),2周比1周减轻更明显(P<0.05),4周与2周比较无明显差异(P>0.05),A组各指标减轻比B组显著(P<0.05);B组比C组疗效显著(P<0.05)。结论A组作用优于B组(P<0.05),B组优于C组(P<0.05)。     

Semantic category and initial letter word fluency in left-brain-damaged patients

Fluency deficits have been found in different neuropsychological populations, and dissociation of letter initial and category fluency has been demonstrated in right-brain-damaged and Alzheimer patients. Studies on normal controls also indicate that letter initial and category fluency are supported by different brain regions. We studied letter initial and category fluency in 79 left-brain-damaged patients, 18 non-aphasic and 61 aphasic. Our results indicate that brain-damaged patients are significantly impaired in both fluency tasks compared to normal controls, and a difference between letter initial and category fluency emerges from our data. Firstly, only letter initial fluency is more impaired in aphasic than in non-aphasic patients; secondly, many aphasics have normal category fluency and pathological letter initial fluency but the reverse is seldom true and thirdly, only category fluency scores correlate with confrontation-naming scores. It is suggested that strategies to recover words based on a semantic or a phonological prompt are different. A semantic strategy is coherent with the organizational structure of the semantic system and corresponds to the normal way in which we recover words whereas a phonological strategy is quite unusual and it is not used for actual communication.     

The value of serial determination of MEGX and hyaluronic acid early after orthotopic liver transplantation

Abstract. Post-transplant assessment of early graft function has become an essential part of monitoring, especially when deciding on retransplantation. If primary non-function is indicated, retransplantation is inevitable; early graft dysfunction may be related to subsequent complications. In a prospective study in 84 patients after orthotopic liver transplantation (OLT) we measured aspartate aminotransferase (AST), alanine aminotransferase (ALT), glutamate dehydrogenase (GLDH), bilirubin (BIL), prothrombin time, MEGX formation, hyaluronic acid (HA) and soluble interleukin-2 receptor (sIL-2R) concentrations during the first 2 postoperative weeks; graft outcome was followed over 4 months. The aim of this study was to determine whether graft survival could be predicted by such variables early after OLT. Compared with patients with stable graft function (n= 25), patients with post-transplant icteric cholestasis (n= 30) exhibited no difference in graft survival, despite a decrease in MEGX formation to a nadir median of 12 μgL^-1 on day 10. Patients with rejection (n= 8) and septicaemia (n= 6) showed a marked decrease in MEGX values and an increase in HA and sIL-2R concentrations between postoperative days 3 and 7. Patients with primary non-function (PNF; n= 5) were characterized by strongly reduced MEGX formation (median 4 μgL) and increased HA values (median 2300 μgL^-1) on day 3 after OLT. A total of 24/84 grafts were lost within 120 days. In a survival analysis using the Cox proportional hazards regression, HA and MEGX values on day 1 were the only independent variables entering the model that showed an adequate prognostic sensitivity. At cut-off points of 22 μgL^-1 (MEGX) and 730 μgL^-1 (HA) the combined use of these parameters in a parallel approach yielded a sensitivity of 58% with a corresponding specificity of 95% for 120-day graft survival. These findings suggest that the inclusion of MEGX and HA in postoperative monitoring of OLT patients may be helpful in the early prediction of graft survival.