Barriers to lifestyle modification in patients with non-alcoholic fatty liver disease: a scoping review / Journal of Rural Medicine

Objective: Non-alcoholic fatty liver disease is common worldwide, and lifestyle modifications are key to its treatment. This study aimed to identify the barriers to lifestyle modifications in patients with non-alcoholic fatty liver disease and to organize the results using the Capability Opportunity Motivation-Behavior (COM-B) model.Materials and Methods: The framework of Arksey and O’ Malley was used in this scoping review. We searched PubMed, Scopus, and the Cochrane Library without language restrictions for reports published up to September 11, 2022, including peer-reviewed literature reporting barriers to lifestyle modifications in patients with non-alcoholic fatty liver disease. Patient-reported barriers were analyzed inductively and organized into the components (capability, opportunity, and motivation) of the COM-B model.Results: The literature search yielded 583 articles, of which seven qualitative studies, four quantitative studies, and one mixed-methods study met the inclusion criteria. Lack of time, lack of information on the diagnosis and management of non-alcoholic fatty liver disease, negative perceptions of the prescribed exercise and diet, physical symptoms interfering with the behavior, presence of comorbidities, and lack of family cooperation were frequently reported as barriers.Conclusion: The results of this study may contribute to the development of appropriate care and education strategies to promote behavioral changes in patients with non-alcoholic fatty liver disease.

Statistical process control of manufacturing tablets for antiretroviral therapy

Abstract In this study, the manufacturing process of lamivudine (3TC) and zidovudine (AZT) tablets (150+300 mg respectively) was evaluated using statistical process control (SPC) tools. These medicines are manufactured by the Fundação para o Remédio Popular "Chopin Tavares de Lima" (FURP) laboratory, and are distributed free of charge to patients infected with HIV by the Ministry of Health DST/AIDS national program. Data of 529 batches manufactured from 2012 to 2015 were collected. The critical quality attributes of weight variation, uniformity of dosage units, and dissolution were evaluated. Process stability was assessed using control charts, and the capability indices Cp, Cpk, Pp, and Ppk (process capability; process capability adjusted for non-centered distribution; potential or global capability of the process; and potential process capability adjusted for non-centered distribution, respectively) were evaluated. 3TC dissolution data from 2013 revealed a non-centered process and lack of consistency compared to the other years, showing Cpk and Ppk lower than 1.0 and the chance of failure of 2,483 in 1,000,000 tablets. Dissolution data from 2015 showed process improvement, revealed by Cpk and Ppk equal to 2.19 and 1.99, respectively. Overall, the control charts and capability indices showed the variability of the process and special causes. Additionally, it was possible to point out the opportunities for process changes, which are fundamental for understanding and supporting a continuous improvement environment.

Estratégia nacional de inovação: uma breve contribuição para sua efetividade sob a perspectiva de acumulação de capacidade tecnológica / Estrategia nacional de innovación: una breve contribución a su efectividad desde la perspectiva de la acumulación de capacidad tecnológica / National innovation strategy: A brief contribution to its effectiveness from the perspective of technological capability accumulation

Resumo A acumulação de um conjunto de habilidades e recursos intensivos em conhecimento para mudar tecnologias existentes ou para criar novas tecnologias, ou seja, a capacidade tecnológica, em nível de empresas e indústrias, é um dos insumos vitais para a transição de países para níveis progressivamente mais elevados de desenvolvimento industrial e de renda per capita. Esse tema tem integrado a agenda governamental e empresarial de vários países que realizaram essa transição de maneira exitosa. Porém, as diversas políticas públicas de inovação implementadas no Brasil durante as últimas décadas, assim como os diferentes estudos e debates sobre os resultados limitados gerados por essas políticas, têm dispensado um tratamento limitado à acumulação de capacidade tecnológica de empresas e indústrias como uma das fontes primárias do aumento da taxa de inovação e do crescimento sustentado da economia. Este artigo objetiva apresentar uma base analítica no intuito de contribuir para a efetividade de uma estratégia nacional de inovação centrada na acumulação de capacidade tecnológica em nível de empresas e indústrias. Essa base analítica pode contribuir para a aferição do retorno das políticas de incentivo à inovação em termos de acumulação de capacidade tecnológica para inovações significativas.

Resumen La acumulación de un conjunto de habilidades y recursos intensivos en conocimiento para cambiar las tecnologías existentes o crear nuevas tecnologías, es decir, la capacidad tecnológica, en el ámbito empresarial e industrial, es uno de los insumos vitales para la transición de los países hacia niveles cada vez más altos de desarrollo industrial y de ingreso per cápita. Este tema ha integrado la agenda gubernamental y empresarial de varios países que hicieron exitosamente esta transición. Sin embargo, las diversas políticas públicas de innovación implementadas en Brasil durante las últimas décadas, así como los diferentes estudios y debates sobre los limitados resultados generados por estas políticas, han dado un tratamiento limitado a la acumulación de capacidad tecnológica por parte de empresas e industrias como una de las fuentes principales del aumento de la tasa de innovación y del crecimiento sostenido de la economía. Este artículo tiene como objetivo presentar una base analítica para contribuir a la efectividad de una estrategia nacional de innovación centrada en la acumulación de capacidad tecnológica en el ámbito empresarial e industrial. Esta base analítica puede contribuir a la evaluación del retorno de las políticas de incentivos a la innovación en términos de acumulación de capacidad tecnológica para innovaciones significativas.

Abstract Technological capability refers to knowledge-intensive skills and resources to change existing technologies or to create new ones. The accumulation of such capability by companies and industries has been part of governments' and businesses' agendas as it is vital for countries' industrial development and increase of per capita income. However, the various public innovation policies implemented in Brazil over the last few decades and the different studies and debates on their limited outcomes failed to address the accumulation of technological capabilities by companies and industries as one of the primary sources for the increase in the rate of innovation and the sustained growth of the economy. This article presents an analytical framework to contribute to the effectiveness of a national innovation strategy centred on the accumulation of technological capability at the level of companies and industries. This analytical framework can contribute to assessing the return on public innovation policies regarding the accumulation of technological capability to develop significant innovations.

Study on promotion of the scientific research capability for young imaging technologists by STAR training model in continuing education / 中华医学教育探索杂志

Combing with the professional characteristics of imaging technology, Radiological Department of West China Hospital, Sichuan University established the STAR training model for imaging technologists to cultivate the scientific research quality of young technicians, which includes sub-professional group training, tutor responsibility system, arrangement of research time, and reading-film session of technologists. Practice shows that this training model has made a series of achievements so far, such as that the number of publishing articles, funds application, authorized patents and oral presentation at international congress has been significantly increased. In addition, there is a high recognition of the STAR training model among young imaging technologists. Therefore, the STAR model can stimulate the scientific research passion of young technologists, and improve their scientific research capability.

Research on the Strategy of Improving the Efficiency of Multi-departmental Operation in the Ethics Review System of Traditional Chinese Medicine after CAP Certification / 中国医学伦理学

Capability Accreditation Program of Ethics Review for Chinese Medicine Research (CAP Accreditation) is the first medical ethics certification project in China. Institutions can further improve their ethics review work level after passing the CAP accreditation. However, the operational efficiency of each department in the ethics review system needs to be further improved when performing relevant functions in accordance with the certification requirements. Based on the experience and summary in the work of the ethical review system, this paper analyzed the main factors that affect the efficiency of the ethical review system and put forward improvement strategies from six aspects: organizational leadership, incentive policies, quality supervision, system construction, talent training, and promotion through evaluation, with a view to providing reference for improving the efficiency of ethical review, and promoting multi-department coordination and system integration.

Construction of an evaluation index system for the capability of comprehensive control of mountain - type zoonotic visceral leishmaniasis based on the One Health concept / 中国血吸虫病防治杂志

Objective To construct an evaluation index system for the capability of comprehensive control of mountain-type zoonotic visceral leishmaniasis based on the One Health concept, so as to provide insights into the control and elimination of mountain-type zoonotic visceral leishmaniasis using the One Health approach. Methods A preliminary evaluation index system was constructed based on literature review, panel discussions and field surveys. Thirty-three experts were selected from 7 provincial disease control and prevention centers in Beijing Municipality, Hebei Province, Shanxi Province, Henan Province, Sichuan Province, Shaanxi Province and Gansu Province where mountain-type zoonotic visceral leishmaniasis was endemic, and two rounds of expert consultations were conducted to screen the indicators. The positive coefficient, degree of concentration, degree of coordination, and authority of the experts were calculated, and the normalized weights of each index were calculated with the analytic hierarchy process. Results The response rates of questionnaires during two rounds of expert consultation were both 100.00% (33/33), and the authority coefficients of the experts were 0.86 and 0.88, respectively. The coefficients of coordination among experts on the rationality, importance, and operability of the indicators were 0.392, 0.437, 0.258, and 0.364, 0.335, 0.263, respectively (all P values < 0.05). Following screening, the final evaluation index system included 3 primary indicators, 17 secondary indicators, and 50 tertiary indicators. The normalized weights of primary indicators “external environment”, “internal support” and “comprehensive control” were 16.98%, 38.73% and 44.29%, respectively. Among the secondary indicators of the primary indicator “external environment”, the highest weight was seen for natural environment (66.67%), and among the secondary indicators of the primary indicator “internal support”, the lowest weight was seen for the scientific research for visceral leishmaniasis control (8.26%), while other indicators had weights of 12.42% to 13.38%. Among the secondary indicators of the primary indicator “comprehensive control”, the weight was 16.67% for each indicator. Conclusions An evaluation index system has been constructed for the capability of comprehensive control of mountain-type zoonotic visceral leishmaniasis based on the One Health concept. In addition to assessment of the effect of conventional mountain-type zoonotic visceral leishmaniasis control measures, this index system integrates the importance of top-level design, organizational management, and implementation of control measures, and includes indicators related to multi-sectoral cooperation.

Data-driven engineering framework with AI algorithm of Ginkgo Folium tablets manufacturing

Smart manufacturing still remains critical challenges for pharmaceutical manufacturing. Here, an original data-driven engineering framework was proposed to tackle the challenges. Firstly, from sporadic indicators to five kinds of systematic quality characteristics, nearly 2,000,000 real-world data points were successively characterized from Ginkgo Folium tablet manufacturing. Then, from simplex to the multivariate system, the digital process capability diagnosis strategy was proposed by multivariate Cpk integrated Bootstrap-t. The Cpk of Ginkgo Folium extracts, granules, and tablets were discovered, which was 0.59, 0.42, and 0.78, respectively, indicating a relatively weak process capability, especially in granulating. Furthermore, the quality traceability was discovered from unit to end-to-end analysis, which decreased from 2.17 to 1.73. This further proved that attention should be paid to granulating to improve the quality characteristic. In conclusion, this paper provided a data-driven engineering strategy empowering industrial innovation to face the challenge of smart pharmaceutical manufacturing.

A preliminary study on the system construction for evaluating the professional capability of provincial radiological health institutions / 中华放射医学与防护杂志

Objective:To construct a system for evaluating the professional capability of provincial radiological health institutions.Methods:Based on the Donabedian model and the main professional responsibilities of provincial radiological health institutions, the logical framework and indicator database of the capability evaluation system were initially constructed, the Delphi expert consultation method and analytic hierarchy process were further used to determine each indicator and its weight. The self-assessment test was carried out throughout the provincial radiological health institutions by using the system established in this study.Results:The evaluation system included 3 primary-class indicators, 11 second-class indicators, 30 third-class indicators and 76 fourth-class indicators. Taking 100 points as the full score, the self-assessment scores of the 29 provincial institutions ranged from 28.7 to 97.7 with an average of 78.7, and the scores conform to the normal distribution.Conclusions:The system established in this study are scientific, comprehensive and operable, which can be used as an effective tool to evaluate the professional capability of provincial radiological health institutions.

Application of scaffolding education in the nursing teaching of infectious diseases in the post-epidemic era / 中华医学教育探索杂志

Objective:To explore the effect of applying scaffolding teaching to infectious disease teaching.Methods:The study selected 259 undergraduate nursing students of Batch 2017 as the research objects, and they were randomly divided into an experimental group (126 students) and a control group (133 students) according to the odd and even numbers of their student numbers. The experimental group carried out scaffolding teaching, and the control group adopted traditional teaching. After the teaching, the two groups of students were assessed on the theory of infectious diseases and scenario simulation excercises. The teaching satisfaction of the two groups was assessed through questionnaire surveys. SPSS was used for t test and chi-square test. Results:The experimental group's theoretical assessment and scenario simulation excercises scores were both higher than those of the control group, and the difference was statistically significant ( P<0.05). The results of the questionnaire survey showed that the experimental group students were more satisfied with the scaffolding teaching model [80.2% (101/126)], which was higher than that of the control group [54.1% (72/133)], with statistically significant differences ( P<0.001). Conclusion:Scaffolding teaching is helpful to improve teaching quality and satisfaction in infectious disease teaching, and it is worthy of further promotion and application in educational practice.

Effects of Interactive Dynamic Scalp Acupuncture on Motor Function and Gait of Lower Limbs after Stroke: A Multicenter, Randomized, Controlled Clinical Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the effects of interactive dynamic scalp acupuncture (IDSA), simple combination therapy (SCT), and traditional scalp acupuncture (TSA) on motor function and gait of the lower limbs in post-stroke hemiplegia patients.@*METHODS@#A total of 231 patients with post-stroke hemiplegia was randomly divided into IDSA (78 cases), SCT (78 cases), and TSA (75 cases) groups by a random number table. Scalp acupuncture (SA) and lower-limb robot training (LLRT) were both performed in the IDSA and SCT groups. The patients in the TSA group underwent SA and did not receive LLRT. The treatment was administered once daily and 6 times weekly for 8 continuous weeks, each session lasted for 30 min. The primary outcome measures included Fugl-Meyer assessment of the lower extremity (FMA-LE), berg balance scale (BBS), modified barthel index (MBI), and 6-min walking test (6MWT). The secondary outcome measures included stride frequency (SF), stride length (SL), stride width (SW), affected side foot angle (ASFA), passive range of motion (PROM) of the affected hip (PROM-H), knee (PROM-K) and ankle (PROM-A) joints. The patients were evaluated before treatment, at 1- and 2-month treatment, and 1-, and 2-month follow-up visits, respectively. Adverse events during 2-month treatment were observed.@*RESULTS@#Nineteen patients withdrew from the trial, with 8 in the IDSA and 5 in the SCT groups, 6 in the TSA group. The FMA-LE, BBS, 6MWT and MBI scores in the IDSA group were significantly increased after 8-week treatment and 2 follow-up visits compared with the SCT and TSA groups (P<0.05 or P<0.01). Compared with pre-treatment, the grade distribution of BBS and MBI scores in the 3 groups were significantly improved at 1, 2-month treatment and 2 follow-up visits (P<0.05 or P<0.01). The SF, PROM-H, PROM-K and PROM-A in the IDSA group was significantly increased compared with the SCT and TSA groups after 8-week of treatment (P<0.05 or P<0.01). Compared with the SCT group, ASFA of the IDSA group was significantly reduced after 8-week of treatment (P<0.05). SF, SL, PROM-K and PROM-A were significantly increased at the 2nd follow-up visit whereas the ASFA was significantly reduced in the IDSA group compared with the SCT groups at 1st follow-up visit (P<0.05 or P<0.01). The SF was significantly increased in the SCT group compared with the TSA group after 8-week treatment (P<0.05). Compared with the TSA group, PROM-K, PROM-A were significantly increased at the 2nd follow-up visit (P<0.05).@*CONCLUSIONS@#The effects of IDSA on lower-limb motor function and walking ability of post-stroke patients were superior to SCT and TSA. The SCT was comparable to TSA treatment, and appeared to be superior in improving the motion range of the lower extremities. (Registration No. ChiCTR1900027206).

Construction of the evaluation index system on TCM service capability of county-level hospitals of traditional Chinese medicine / 中华医院管理杂志

Objective:To build the evaluation index system of traditiond Chinese medicine(TCM) service capacity in county-level TCM hospitals, for references to improve the TCM service capability in China.Methods:Based on the " structure-process-result" evaluation model, a preliminary screening index system for the evaluation of TCM service capacity in county-level TCM hospitals was established by analyzing relevant literature and policies; Two rounds of Delphi expert consultation were made to screen the evaluation indexes; The combination weighting method based on both expert scoring method and entropy weight method was used to determine the index weight.Results:The evaluation index system of TCM service capacity of county-level TCM hospitals was finally incorporated into 3 first-level indicators, 9 second-level indicators and 33 third-level indicators. The top five third-level indicators in terms of comprehensive weight were the person time of TCM preventive care in the year(12.02%), the person time of manual reduction diagnosis and treatment(9.03%), the person time of acupuncture and moxibustion(6.55%), the proportion of income from inpatient TCM services in medical income(5.87%) and the person time of massage(5.34%).Conclusions:From the perspective of the whole process of TCM service, the evaluation index system of TCM service capacity of county-level TCM hospitals reflectd the health service capacity of county-level TCM hospitals, highlighted the characteristics of TCM.

Research competence and training needs of young general practitioners / 中华全科医师杂志

Objective:To investigate the research competence and training needs of young general practitioners (GPs) in Guangdong province.Methods:A questionnaire survey on research competence and training needs was conducted in December 2020 among GPs from one selected economically developed area and one selected less developed area in Guangdong Province.Results:A total of 172 young GPs were included in the study. The survey showed that 75.6% (130/172) and 76.2% (131/172) respondents thought that participation in scientific research and research literacy were important, but only 11.9% (21/172) had participated in research project, among whom 81.0% (17/21) undertook data collection. The basic score of evidence-based medicine was 24.00(21.00, 28.00), and 55.2% respondents (95/172) were able search literature when they encountered problems and 43.7% (77/172) used domestic databases. The self-assessment score of scientific research ability was 14.00(12.00, 17.00), the score of research training needs was 41.00(31.00, 49.50), and the scores of "scientific research topic selection, scientific research design, statistical analysis, organization and implementation, and paper writing" were generally high. There was significant difference in the total scores of the two scales of evidence-based medicine basis and scientific research ability self-assessment among respondents with different educational background ( P<0.05). The basic score of evidence-based medicine of orientation-trained GPs was higher than that of non-orientation-tranined GPs; the average score of research training needs in female respondents was higher than that in males ( P<0.05). Conclusions:The study suggests that young general practitioners have inadequate experience in research participation and organization, and low self-ratings of research competence, but generally high personal efficacy in research. It is recommended that appropriate training content and well-organized intervention should be developed for young GPs.

Protocolo de admisión del paciente diabetico. Un enfoque desde los factores básicos condicionantes y la agencia de autocuidado / Diabetic patient admission protocol. An approach from the basic conditioning factors and the self-care agency

El Consejo Internacional de Enfermeras (CIE) define a la Enfermería como los cuidados, autónomos y en colaboración, que se prestan a las personas de todas las edades, familias, grupos y comunidades, enfermos o sanos, en todos los contextos. Incluye la promoción de la salud, la prevención de la enfermedad y los cuidados de los enfermos, discapacitados y personas moribundas. A su vez Berbiglia y Banfield citan a Orem, ésta plantea que la práctica de la Enfermería en relación con los individuos se institucionaliza alrededor del proceso de una persona, la/el enfermera/o, que proporciona ayuda directa a otra persona, cuando ésta persona es total o parcialmente incapaz de ayudarse a sí misma en el cumplimiento de los cuidados diarios relacionados con la salud, a causa de la situación de salud existente. La misma autora define al estado de salud que indica la necesidad de asistencia enfermera como "la incapacidad de las personas de proporcionarse por sí mismas y continuamente el autocuidado (AC) de calidad y cantidad necesarios según las situaciones de la salud personal". Expresa también que los factores básicos condicionantes son "los factores internos o externos a los individuos que afectan sus habilidades para involucrarse en el autocuidado o afectan el tipo y cantidad de autocuidado requeridos". El objetivo, Sistematizar y acordar las intervenciones y cuidados de enfermería en la admisión del paciente con diabetes, con un enfoque desde los factores básicos condicionantes del autocuidado y la capacidad de la agencia de Autocuidado, que ingresan al servicio de urgencias de adultos, de un Hospital público, 2020. En este sentido el profesional de Enfermería cumple un rol fundamental dentro del equipo de salud para identificar el déficit de autocuidado y promover, gestionar e impulsar diversas estrategias para la promoción de la salud, la prevención de la enfermedad y su tratamiento[AU]

O Conselho Internacional de Enfermeiras (ICN) define Enfermagem como cuidado autônomo e colaborativo, prestado a pessoas de todas as idades, famílias, grupos e comunidades, doentes ou saudáveis, em todos os contextos. Inclui a promoção da saúde, a prevenção de doenças e o atendimento de doentes, deficientes e moribundos. Berbiglia e Banfield, por sua vez, citam Orem, que afirma que a prática de enfermagem em relação aos indivíduos é institucionalizada em torno do processo de uma pessoa, a enfermeira, que fornece ajuda direta a outra pessoa, quando essa pessoa é total ou parcialmente incapaz de ajudar a si mesma na realização dos cuidados diários relacionados à saúde, devido à situação de saúde existente. O mesmo autor define o estado de saúde que indica a necessidade de assistência de enfermagem como "a incapacidade das pessoas de proverem a si mesmas e continuamente o autocuidado (CA) de qualidade e quantidade necessárias de acordo com as situações de saúde pessoal". Também expressa que os fatores condicionantes básicos são "fatores internos ou externos aos indivíduos que afetam suas habilidades para se envolver em autocuidado ou afetam o tipo e a quantidade de autocuidado necessária". O objetivo sistematizar e acordar intervenções e cuidados de enfermagem na admissão do paciente com diabetes, com foco nos fatores condicionantes básicos do autocuidado e na capacidade da agência de Autocuidado, que entra no pronto-socorro de adultos, de um hospital público, 2020. Nesse sentido, o profissional de enfermagem desempenha papel fundamental dentro da equipe de saúde para identificar o déficit de autocuidado e promover, gerenciar e promover diversas estratégias de promoção da saúde, prevenção e tratamento de doenças[AU]

The International Nurses Council (INC ­ 2015) defines Nursery as the independent and accompanied care given to people of all ages, ethnicity, gender, rather family, group and communities, ill or heathy in all sort of contexts. Including Heath`s promotion, sickness prevention and different cares of patients, disable and dying people. In turn, Berbiglia and Banfield cite Orem, which states that the practice Nursing practice as the relationship individuals, which is institutionalized around the process of one person the Nurse, the one who helps directly to the other person, when this one is not fully or partially capable on their own means to help themselves to take charge of their daily health care, caused by the actual health situation remaining. The same author defines the state of health that indicates the Nurses assistance as "The non-capacity of people to assure by themselves the continued self-care, nor in quality and quantity necessary according to the situation of personal health". On the other hand, the author, also states that the basic conditioning factors are "internal or external factors handled by individuals who affect their abilities to engage in self-care or affect the type and amount of self-care required ". The objective is to systematize and agree on interventions and nursing care in the admission of the patient with diabetes, with an approach from the basic conditioning factors of self-care and the capacity of the Self-care agency, who enter the emergency department of adults, of a public hospital, 2020 In this sense, the nursing professional plays a fundamental role within the health team to identify the deficit of self-care and promote, manage and promote various strategies for health promotion, disease prevention and treatment[AU]

Effect of self-management capability cluster intervention on clinical compliance and treatment outcome in patients with end-stage renal disease undergoing hemodialysis / 中华行为医学与脑科学杂志

Objective:To explore the effect of self-management capability cluster intervention on clinical compliance and treatment outcome in patients with end-stage renal disease undergoing hemodialysis.Methods:A total of 88 patients undergoing hemodialysis in dialysis center from June to December 2019 were randomly divided into intervention group (44 cases) and control group (40 cases) according to odd-even number method. Patients in both groups were treated with hemodialysis and basic treatment, and patients in intervention group were treated with self-management capability cluster intervention. The self-management ability, dialysis compliance and related complications were compared between the two groups before and after intervention. The data were statistically analyzed by SPSS 26.0 software. Independent sample t-test was used for intergroup comparison, and paired t-test was used for intragroup comparison. Results:There was no significant difference in self-management ability at baseline between intervention group and control group ( P>0.05). After 6 months, the total score of self-management ability ((68.61±10.16), (55.12±9.29)) and emotional processing ((13.42±2.89), (11.04±2.46)), executive self-care ((21.67±4.87), (16.71±3.59)), problem solving ((16.61±3.22), (12.03±4.61)), partnership ((14.26±3.64), (10.88±3.29)) were higher than those in the control group, and the differences were statistically significant ( t=7.112, 3.764, 4.739, 5.515, 5.834, all P<0.05). The total score of self-management behavior and the scores of four dimensions in the intervention group were significantly higher than those in the control group ( t=13.413, 5.432, 8.114, 1.910, 4.127, all P<0.05). There were significant differences between the intervention group and the control group in jumping behavior (9.09%, 22.50%) , shortening behavior (11.36%, 30.00%) , hyperkalemia (15.91%, 55.00%), heart failure (11.36%, 37.50%) and arteriovenous fistula occlusion (4.55%, 10.00%) ( χ2=4.095, 5.206, 17.571, 8.843, 5.127, all P<0.05). There were significant differences between the intervention group and the control group in urea clearance index, anemia improvement, blood phosphorus, parathyroid hormone level ( t=3.830, 4.558, -3.720, 6.481, all P<0.05). Conclusion:Self-management capability cluster intervention can improve the clinical compliance and treatment outcome in patients with end-stage renal disease undergoing hemodialysis.

A preliminary study on measurement of capability of spreading Traditional Chinese Medicine of young and middle-aged physicians in Traditional Chinese Medicine hospitals / 国际中医中药杂志

The cross-cultural sensitivity scale (ISS) and the self-made cross-cultural communication Traditional Chinese Medicine (TCM) professional ability test were used to investigate the ability of 151 young and middle-aged doctors (under 45 years old) in Xiyuan Hospital of Chinese Academy of Chinese Medicine. SPSS 21.0 was used to describe the statistics of the questionnaire data. ANOVA was used to analyze the factors that affected the capability, and Pearson to analyze the relevance of the internal structure of this capability. The final score of the test was 3.73±0.54 points (5 points in total). The capability of spreading TCM of young and middle-aged doctors had a significant positive correlation with their individual professional background, English language proficiency, and oversea experience ( P<0.05). The result showed that the correlation among 5 dimensions of cross-cultural sensitivity was significant, and there was a significant correlation between cross-cultural sensitivity and professional competence to spread TCM ( r>0.5, P<0.01). The young and middle-aged doctors in this hospital had an overall high score in this survey, and it was necessary to improve interaction enjoyment and strengthen professional English training. When selecting relevant talents, it should be noted that those with educational background of TCM and integrated TCM and western medicine were more suitable as workers to spread TCM. Educational background, English ability, and relevant experience showed a significant impact on capability to spread TCM. It was recommended to carry out quantitative testing of the capability to spread TCM of young and middle-aged doctors widely. When selecting talents for cross-cultural spreading of TCM, attention should be paid on factors that related to the capability.

Resilience of community health emergency staff / 预防医学

Objective@#To learn the level of resilience among community health emergency staff in Zhejiang Province and its influencing factors under the epidemic situation of coronavirus disease 2019. @*Methods@#Using stratified cluster sampling method, the community health emergency workers from six counties in Zhejiang Province were recruited in this study. A self-designed questionnaire, a scale for core emergency response capability of medical workers and 10 Items Connor-Davidson Resilience Scale ( CD-RISC-10 ) were employed. The multivariate linear regression model was used to analyze the influencing factors for resilience. @*Results@#A total of 749 people were surveyed, with 699 valid questionnaires ( effective rate 93.32% ). Among the 699 community health emergency staffs, the total scores of resistance and core emergency response capability were 34.97±7.95 and 118.38±27.60. The multivariate linear regression analysis showed that core emergency response capability ( β＇=0.410 ), education background (diploma: β＇=0.158; bachelor: β＇=0.196), position ( top: β＇=0.083 ) and self-rated physical fitness ( not qualified: β＇=-0.152; less qualified: β＇=-0.235; generally qualified: β＇=-0.219; more qualified: β＇=-0.107 ) were the influencing factors for resilience of community health emergency staff. @*Conclusion@#The resilience of community health emergency staff in Zhejiang Province is at a medium level, and is associated with education background, physical fitnes and position.

Result analysis of the 2019 national assessment of individual dose monitoring capability in Chongming District, Shanghai / 上海预防医学

Objective In 2019, Laboratory of Shanghai Chongming Center for Disease Control and Prevention participated in national assessment of individual dose monitoring capability. By analyzing the results, this report summarizes the experience and shortcomings that will help improve the individual dose monitoring capability of the laboratory. Methods According to the requirements of the national assessment scheme for individual dose monitoring capacity in 2019, the assessment process and results were sorted out and analyzed one by one. Results The single group performance deviations(Pi values)between the measured values and references of the five groups were -0.04, -0.07, -0.05, -0.04 and -0.06, respectively. The overall bias(B value)of all groups was 0.003. According to the judgment standards, both the single group performance and overall performance were all qualified. Conclusion The individual dose monitoring system of the laboratory meets the requirements of the relevant national standards. The individual dose monitoring capability can be further improved by strengthening the quality control of the relevant procedures of the assessment.

Application of capability sixpack in quality analysis of hospital preparation magnesium sulfate oral solution / 药学实践杂志

Objective To analyze the quality of the hospital preparation magnesium sulfate oral solution by using capability sixpack. Methods By using the capability sixpack of Minitab, the content of magnesium sulfate in the magnesium sulfate oral solution was used as an indicator to determine whether the magnesium sulfate composition reached a controlled state during the production process and whether the production process of magnesium sulfate oral solution was stable. Results The content of magnesium sulfate and the production process of magnesium sulfate oral solution was under control, but there were potential disadvantages. Based on the concept of risk management philosophy, The failure model and effect analysis (FMEA) were applied to the prospective management of potential risks. Conclusion The application of the capability sixpack in the quality analysis of the hospital preparation of magnesium sulfate oral solution is helpful for us to discover the potential risks under the controlled state of the production process, which is beneficial to the improvement of the preparation production process and the assurance of the quality of the preparation.

Research on the organizational capability and maturity status of private hospitals in China / 中华医院管理杂志

Objective:To evaluate the current organizational capacity and maturity of private hospitals in China, in references improving their organizational capacity and promoting their sustainable development.Methods:The purposive sampling method was used from May to November 2019, and private hospitals of continuous operation for 5 years or above were selected for a questionnaire survey. Self-evaluation was made on the organization capacity of these hospitals in such 12 aspects as positioning, normalization, decision making, execution, supervision, marketing, coerciveness, risk exposure, innovation, learning capacity and leadership. Based on existing models, five levels of maturity models from low to high were established, namely that of business in difficulty, that of basic stable operation, that of stable development, that of expanding business, and that of independent branding.Factor analysis was used for structural efficiency analysis, the questionnaires were subject to a descriptive analysis, and a maturity scoring was obtained based on self-evaluation of organizational capacity.Results:A total of 45 non-public hospitals were investigated in this study, and 450 valid questionnaires were recovered. The factor analysis classified the organizational capacity into basic capacity, core capacity and development capacity. The organizational capability of the hospitals scored in average 4.14 points; the development capacity scoring(3.87 points) was lower than basic capacity(4.16 points) and core capacity(4.06 points). 80% of the private hospitals were in the basic stable stage or stable development stage.Conclusions:Private hospitals feature in general lower maturity, good basic capacity and core capacity, while they tend to have weak development capacity, not to mention innovation and construction of learning organizations.

Investigation and analysis on the capability of municipal radiological health technical institutions in China / 中国职业医学

OBJECTIVE: To understand the current status of the capability in building primary radiological health technical institutions in China.METHODS: A total of 38 prefecture level radiological health technical institutions from 27 provinces, autonomous regions and municipalities in China were selected as the research subjects using the judgment sampling method, and their qualification, department settings from 2014 to 2018, related conditions of professional and technical personnel, 22 items of radiation health technical work development, 14 kinds of radiation health related laboratory settings and six types of instruments and equipment were investigated and analyzed. RESULTS: A total of 37 radiological health technical institutions provided feedback data. Among them, 30 were Centers for Disease Control and Prevention, and seven were institutions for Occupational Disease Control and Prevention. Among the 37 institutions, 31(83.7%) had radiological health-related qualifications and 12(32.4%) institutions had set up independent radiological health departments. There were 294 professional and technical personnel in radiological health field, with an average of eight persons for each institution. The ratio of male to female was 1.7 ∶1.0. The proportion of professionals younger than 50 years was 82.0%, and 83.0% professionals had an educational background with bachelor′s degree or above. Only 11.9% of the professionals had radiation health education background, and 81.3% had medical and health related educational background. There were 74.8% of the professionals who had intermediate title or above, and 60.2% had less than 10 years of service. From 2014 to 2018, the annual total inflow of personnel showed a decreasing trend(P<0.01), while the total outflow showed an increasing trend(P<0.01). Among the 37 institutions, each institution undertook an average of nine radiological health technical tasks. The individual dose-monitoring laboratory had the largest number of laboratories related to radiological health and the largest sample handling capacity. On average, each institution was equipped with only 0.5 instruments and equipment for each type of radiological health technical work. CONCLUSION: The distribution of age, educational background and professional title of the staffs in the municipal radiological health technical institutions in China is reasonable, but the laboratory construction and equipment allocation still need to be strengthened.