ABSTRACT
One hundred and fifty diabetic patients,who received management by community family doctors and hospital consortium (1+1+1) team for at least 1 year,were enrolled from January 2017 to May 2017.After that they continued to receive the management for 1 more year by the team which were trained with TeamSTEPPS (team strategies and tools to enhance performance and patient safety).The management effect before and after TeamSTEPPS training was compared.After the TeamSTEPPS training,the team management ability was improved,so that the compliance of diabetic patients with medical advice,regular examination of blood glucose,regular follow-up assessment,health education,regular exercise and diet control were all better than before,and the differences were statistically significant (all P＜0.01).Fasting blood glucose,postprandial 2 h-blood glucose,glycosylated hemoglobin and LDL-C levels were all lower than before,and the achieved rate of the above indicators were also increased (P＜0.05).It is suggested that application of TeamSTEPPS in team training can effectively enhance the management ability for chronic disease of family doctors and improve compliance and clinical indicators of patients with diabetes under management.
ABSTRACT
Objective To evaluate the application of TeamSTEPPS in training of community osteoporosis management team .Methods The TeamSTEPPS was applied for training of osteoporosis management team, and 1 513 residents aged ≥45 year were screened for osteoporosis in Kangjian community from January 2014 to March 2017.The identified patients with osteopenia and osteoporosis were intervened for one year.Cognitive level of the risk factors and symptoms associated with osteoporosis were assessed by questionnaires before and after the intervention .The bone density was examined at baseline and 6 months, 12 months after intervention.The effect of intervention was evaluated .Results A total of 467 patients (30.87%) with osteopenia and 476 patients (31.46%) with osteoporosis were detected .The cognitive levels of osteoporosis risk factors , including low calcium, vitamin D deficiency, lack of exercise, low weight, women menopause, matrilineal family history, smoking, excessive alcohol drinking and coffee drinking, were higher than those before intervention ( χ2＝62.909,78.742,59.974,50.478,29.512, 34.699,6.500,15.779,6.089,all P＜0.05).The awareness rates of symptoms , including lower back pain or body bone pain, shorter height and hunchback , low energy or nonviolent fracture , were also increased (χ2＝59.942,76.220,16.856,all P＜0.01).After intervention, the bone mineral density levels were increased compared to those before intervention (F＝530.28, P＜0.01 for osteopenia group; F＝339.51, P＜0.01 for osteoporosis group ); meanwhile, the differences were also significant between 6 months, 12 months after intervention and before intervention , between 12 months and 6 months after intervention (t＝-0.452,-0.968,-0.516,all P＜0.01 for osteopenia group; t＝-0.530,-1.045,-0.518, all P＜0.01 for osteoporosis group ).Conclusion The community osteoporosis management team trained by TeamSTEPPS can effectively improve the management levels of osteoporosis among residents in the community.
ABSTRACT
TeamSTEPPS (team strategies and tools to enhance performance and patient safety) defines four core capabilities in teamwork which can be trained: leadership,situation monitoring,mutual support and communication.TeamSTEPPS is a successful medical team training project and its effectiveness has been proved.The application of TeamSTEPPS can provide a new teaching model for general practice training.
ABSTRACT
TeamSTEPPS(Team Strategies & Tools to Enhance Performance & Patient Safety)is an evidence-based set of teamwork tools,aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals.It integrates teamwork skills with clinical practice to improve team performance in healthcare services and improve the quality of care effectively.The article introduces the TeamSTEPPS course and its clinical application.
ABSTRACT
To test the hypothesis that the first degree relatives of Chinese women with polycystic ovarian syndrome (PCOS) have higher risk of cardiovascular disease than those without PCOS.The metabolic phenotype and risks of cardiovascular disease were evaluated in 110 family members of 35 women with PCOS and 85 unrelated healthy control subjects without family history of diabetes and PCOS ( four age- and weight-matched subgroups ).The prevalence of impaired glucose tolerance was 51.4％ in mothers and 57.5％ in fathers with their daughters suffering from PCOS.The first degree relatives of PCOS women had significantly higher serum fasting insulin level,homeostasis model assessment for insulin resistance,insulin area under the curve,and lower insulin sensitivity index in all subgroups than the control subjects( P＜0.05 ).The control subjects had significantly elevated high molecular weight-adiponectin levels and decreased high sensitive-C reactive protein levels compared to the first degree relatives of PCOS women in all subgroups.Parents and brothers,but not sisters,of women with PCOS had significantly higher total cholesterol and low density lipoprotein-cholesterol ( P＜ 0.05 ),as well as triglyceride levels ( P＜ 0.05 ),compared with control subjects.The first degree relatives of PCOS women had features of insulin resistance and increased risk of cardiovascular disease.
ABSTRACT
Forty women with polycystic ovary syndrome( PCOS) were enrolled. Basal plasma and urine cortisol, pituitary hormones, homeostasis model assessment for insulin resistance, and plasma cortisol in 0. 25 mg dexamethasone inhibition test were determined. In over-weight or obese PCOS patients, cortisol levels before and after inhibition test were increased (P<0. 05 or P<0. 01 ). The results suggest that the feed-back regulation of glucocorticoids to hypothalamas-pituitary is impaired and the change in hypothalamic-pituitary-adrenal axis is associated with insulin resistance.
ABSTRACT
PPARγ2 gene C1431T polymorphism was assayed by PCR-RFLP in 200 polycystic ovary syndrome( PCOS)patients and 150 normal subjects. Serum adiponectin and leptin levels were determined by ELISA method. Polymorphism of the site might be associated with serum leptin and adiponectin concentrations and thiazolidinedione treatment in women with PCOS ( P<0.05 or P<0.01).