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Background The impact of atmospheric fine particulate matter (PM2.5) and ozone (O3) on the mortality of circulatory system diseases cannot be ignored. However, whether the interaction between PM2.5 and O3 can affect population health is rarely reported and requires study. Objective To investigate the individual and interactive impacts of atmospheric PM2.5 and O3 on the mortality of circulatory system diseases in the population of Ningxia region. Methods The data of 119647 deaths due to circulatory system diseases, daily average concentrations of atmospheric pollutants, and meteorological data in Ningxia from 2013 to 2020 were retrieved. PM2.5 was divided into low, medium, and high concentrations according to the primary and secondary national limits (35 and 75 μg·m−3) of the Ambient air quality standards. Similarly, O3 was divided into low, medium, and high concentrations according to the national limits (100 and 160 μg·m−3). Using a generalized additive mixed model based on quasi Poisson distribution, the impacts of atmospheric PM2.5 and O3 as well as their interaction on the mortality of circulatory system diseases were analyzed using the population data of Ningxia region. Results During the target period, males and the ≥ 65 year group accounted for larger proportions of deaths due to circulatory system diseases (55.47% and 79.87% respectively). The daily average concentration of PM2.5 (40.25 μg·m−3) exceeded the national primary limit. In the single pollution model, the highest cumulative lag effects for mortality from circulatory system diseases were PM2.5 exposure over previous 1 d (lag01) and O3 exposure for previous 2 d (lag02), and their excess risk (ER) values were 1.03% (95%CI: 0.67%, 1.40%) and 1.02% (95%CI: 0.57%, 1.50%), respectively. The results of concentration stratification analysis showed that the most significant risks of death from circulatory system diseases [ER (95%CI): 1.12% (0.32%, 1.92%) and 0.95% (0.13%, 1.79%) respectively] were found at medium PM2.5 and O3 concentrations. The interaction analysis revealed that under, a synergistic effect on the risk of death from circulatory system diseases was identified (relative excess risk due to interaction=3.08%, attributable proportion of interaction=2.90%, synergy index=1.89) when considering the coexistence of PM2.5 and O3 above the primary limit. As the concentrations of PM2.5 and O3 increased, the synergistic effect increased the risk of death from circulatory system diseases in the general population, men, women, and the ≥ 65 years group. Conclusion Both atmospheric PM2.5 and O3 can increase the risk of death from circulatory system diseases, and the two pollutants have a synergistic effect on the risk of death from circulatory system diseases.
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Introducción: la enfermedad pulmonar obstructiva crónica es una limitación del flujo de aire por anomalías alveolares. En una exacerbación aguda, la ventilación mecánica no invasiva es la primera línea en el manejo, sin embargo, existen ciertos factores de riesgo que hacen más probable el uso de ventilación mecánica invasiva en estos pacientes, que no están apropiadamente descritos en la literatura científica y que pueden guiar hacia una elección de soporte ventilatorio apropiado. Objetivo: describir los factores que se asociaron con mayor necesidad de ventilación mecánica no invasiva en una cohorte de pacientes hospitalizados con exacerbación aguda de la enfermedad pulmonar obstructiva crónica. Métodos: estudio observacional analítico de corte transversal, con muestreo no probabilístico que incluye todos los pacientes que consultaron a urgencias y fueron hospitalizados por exacerbación aguda de la enfermedad pulmonar obstructiva crónica en un hospital de tercer nivel de Santander, Colombia, durante el período 2014-2020. Resultados: fueron incluidos 81 pacientes, 36 requirieron ventilación mecánica no invasiva y 12 ventilación mecánica invasiva; 25 % de los pacientes con ventilación mecánica no invasiva fallaron a la terapia inicial y demandaron el uso de ventilación mecánica invasiva. Las comorbilidades más frecuentes fueron hipertensión arterial (70,3 %) y cardiopatía (49,38 %); 70 % había tenido exposición al tabaquismo como fumador directo. Conclusiones: el uso de ventilación mecánica invasiva estuvo relacionado de forma estadísticamente significativa en pacientes con perfil de disnea severa, acidosis por parámetros gasométricos, escalamiento antibiótico, uso de corticoides intravenosos, requerimiento de unidad de cuidado intensivo, infecciones asociadas al cuidado de la salud y estancia hospitalaria prolongada.
Introduction: Chronic obstructive pulmonary disease is airflow limitation due to alveolar abnormalities. In an acute exa- cerbation, non-invasive mechanical ventilation is the first line of management, however, there are certain risk factors that make the use of invasive mechanical ventilation more likely in these patients, which are not adequately described in the scientific literature and that can guide towards a choice of appropriate ventilatory support. Objective: To describe the factors that were associated with an increased need for invasive mechanical ventilation in a cohort of hospitalized patients with an acute exacerbation of chronic obstructive pulmonary disease. Methods: Cross-sectional analytical observational study, with non-probabilistic sampling including all patients who consulted the emergency room and were hospitalized for acute exacerbation of chronic obstructive pulmonary disease in a tertiary care hospital in Santander-Colombia during the period 2014-2020. Results: 81 patients were included, 36 required non-invasive mechanical ventilation and 12 invasive me- chanical ventilation. 25 % of the patients with non-invasive mechanical ventilation failed the initial therapy and demanded the use of invasive mechanical ventilation. The most frequent comorbidities were arterial hypertension (70.3 %) and heart disease (49.38 %). 70 % had been exposed to smoking as direct smokers. Conclusions: The use of invasive mechanical ven- tilation was associated in a statistically significant way in patients with a profile of: severe dyspnea, acidosis by gasometric parameters, antibiotic escalation, use of intravenous corticosteroids, intensive care unit requirement, infections associa- ted with health care and prolonged hospital stay.
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Objective:To observe any effect of combining low-frequency transcranial magnetic stimulation (rTMS) with interactive virtual scenario training on the recovery of upper limb motor function after a stroke.Methods:Ninety stroke survivors were randomly divided into a pseudo-rTMS group, an rTMS group and a combination group, each of 30. In addition to basic medication, conventional rehabilitation and nursing care, the pseudo-rTMS, rTMS and combination groups received either sham rTMS treatment, 1Hz rTMS or virtual situational interaction along with 1Hz rTMS 5 days a week for 4 weeks. Before and after the 4 weeks their motor evoked potentials, cortical latency and central motor conduction time were measured, and surface electromyography was applied to the affected biceps brachii and triceps brachii. Meanwhile, the National Institutes of Health Stroke Scale, the Fugl-Meyer upper extremity assessment and the modified Barthel index were employed to assess the degree of neurological deficit, upper extremity motor function and ability in the activities of daily living (ADL).Results:After the 4-week intervention, a significant improvement was observed in all of the outcome measurements with all three groups. At that time the average scores of the rTMS group were significantly better than the pseudo-rTMS group′s averages but the average scores of the combination group were significantly better than those of either of the other two groups.Conclusion:Repeated application of low-frequency transcranial magnetic stimulation combined with virtual scenario interactive training can effectively improve the upper limb motor function and ADL performance of stroke survivors, and relieve the symptoms of neurological deficit. The combined therapy is worthy of application in clinical practice.
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Objective:To observe the application effect of mind mapping combined with interactive communication mode in clinical teaching of neurosurgery.Methods:A total of 40 students who practiced in the Department of Neurosurgery in the Affiliated Hospital of Guizhou Medical University from September 2019 to September 2020 were included in the control group, and traditional teaching was adopted; another 40 students who practiced from October 2020 to October 2021 were included in the observation group, and mind mapping combined with interactive communication mode was adopted for teaching. The two groups of students were taught for 2 weeks, and after the teaching, the teaching effect was compared between the two groups. SPSS 25.0 software was used to conduct t-test and Chi-square test. Results:After 2 weeks of teaching, the scores of theoretical knowledge (90.38±4.03) and practical operation skills (93.37±3.48) in the two groups were higher than those before teaching [(85.52±5.26) and (87.25±4.48)], with statistically significant differences ( t=4.63, 6.83, P<0.001). The case analysis score of the two groups was higher than that before teaching, and that of the observation group (86.03±6.07) was higher than that of the control group (79.13±5.57), with statistically significant differences ( t=5.30, P<0.001). The scores of interpersonal communication ability and cooperation ability of the two groups were higher than those before teaching. The scores of interpersonal communication ability (82.53±4.74), cooperation ability (169.73±7.55) of the observation group were higher than those of the control group [(77.93±4.45) and (158.42±8.01)], with statistically significant differences ( t=4.48, 6.49, P<0.001). Conclusion:Mind mapping combined with interactive communication mode can effectively improve the clinical basic knowledge and clinical practice ability of interns in the Department of Neurosurgery, and improve their communication and cooperation ability.
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Clinical laboratory instrumentation is a practical course. In order to change the limitations of the experimental site and the lack of large automatic testing instruments in the current teaching, this paper puts forward the idea of virtual simulation teaching of clinical laboratory instrument. Based on the training objective of medical laboratory application-oriented talents, the design and management of virtual simulation teaching of single instrument and comprehensive project training are formed. The teaching effect evaluation and quality control method are constructed, which significantly improves the students' autonomous learning ability and the comprehensive practical ability. It further promotes the connotation construction of medical laboratory experiment teaching with the help of Internet sharing advantages.
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OBJECTIVE@#To compare the curative effect between interactive scalp acupuncture and traditional scalp acupuncture on hemiplegic upper extremity motor dysfunction in the patients with ischemic stroke.@*METHODS@#Seventy cases of hemiplegic upper extremity motor dysfunction of ischemic stroke were randomly divided into an interactive scalp acupuncture group (35 cases, 1 case breaked off) and a traditional scalp acupuncture group (35 cases, 1 case dropped off). The patients of the two groups received the secondary prevention medication and routine rehabilitation therapy. Besides, in the interactive scalp acupuncture group, the upper extremity occupational therapy was operated during the needle retaining of scalp acupuncture; and in the traditional scalp acupuncture group, the upper extremity occupational therapy was delivered after the completion of scalp acupuncture. The same points were selected in the two groups such as Fuxiang head area, Fuxiang upper-limb-shoulder point, Fuxiang upper-limb-elbow point and Fuxiang upper-limb-wrist point. The needles were inserted perpendicularly by flying-needle technique and manipulated by triple technique of gentle twisting, heavy pressure and vibrating. The needles were retained for 30 min. Based on the degree of the upper extremity motor impairment, the regimen of the upper extremity occupational therapy was formulated individually and one treatment took 30 min. In the two groups, the therapies were delivered once daily, 5 times a week, lasting 4 weeks. Before and after treatment, the scores of Fugl-Meyer assessment of upper extremity (FMA-UE), Wolf motor function test (WMFT), the modified Barthel index (MBI) and the modified Ashworth scale (MAS) grade in the two groups were observed before and after treatment.@*RESULTS@#After treatment, the scores of FMA-UE, WMFT and MBI were higher than those before treatment (P<0.01), and MAS grade was improved (P<0.05) in the two groups. The scores of FMA-UE, WMFT and MBI in the interactive scalp acupuncture group were higher than those in the traditional scalp acupuncture group (P<0.01, P<0.05), and there was no statistical significance in the difference of MAS grade between the two groups (P>0.05).@*CONCLUSION@#The interactive scalp acupuncture can effectively improve the motor function of the hemiplegic upper extremities and the activities of daily living in the patients with ischemic stroke and its efficacy is better than traditional scalp acupuncture. But these two types of scalp acupuncture obtain the similar effect on spasticity.
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Humans , Stroke/therapy , Ischemic Stroke/complications , Stroke Rehabilitation , Activities of Daily Living , Hemiplegia/therapy , Scalp , Treatment Outcome , Acupuncture Therapy/methods , Upper ExtremityABSTRACT
Background and Objective The Projects of Global Growth of Medical Technologies, implemented by NCGM since 2015, have contributed to human resource development through on-site training in partner countries and training in Japan. However, since 2020, online training has become mainstream due to the travel restrictions by COVID-19 impact. As one of the projects, the NCGM and Bach Mai Hospital rehabilitation departments in Vietnam held an interactive online hands-on seminar in FY2022 for Vietnamese occupational therapists and others to provide technical guidance for making splint orthoses to rehabilitate patients with hand dysfunction. This paper aims to report on the preparation and implementation process of the seminar and its results.Preparation and Implementation of the Seminar NCGM (the instructor) and Bach Mai Hospital (the site of the hands-on training) prepared the seminar through regular online meetings, fostering ownership and collaborative planning on the Vietnamese side, and discussed the program development, necessary materials, participant selection, and obtaining authorization from the Vietnamese Ministry of Health. To ensure the quality of the technical instruction, the seminar was connected via Zoom to both NCGM and Bach Mai Hospital, where the live video of the splinting technique was conducted, along with explanations and Q&A sessions. The post-training evaluation was carried out through a questionnaire with self-assessment of the participants about the knowledge and skills they obtained. Outcome and Discussion As a result, 96% (27/28) of the participants answered that the seminar was “useful for clinical practice,” suggesting that the interactive online hands-on seminar regarding technical instruction in making splint orthosis was as good as or better than the face-to-face training. We found that the Vietnamese side took ownership from the preparatory stage by establishing a regular online meeting system; the quality of the training was assured by live video by both sides, which enabled detailed technical instruction; the training provider’s skills were improved by more detailed preparation; training was cost-effective compared to on-site training or training in Japan; and the materials used and the training videos can be used as teaching materials, which is expected local benefits and sustainability. These findings can be applied to face-to-face training to make the training more effective and extended as a useful method when similar activities are developed in other countries.
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Electronic tongue is one kind of bionic detection technologies, which can objectively reflect the taste of drugs based on electrochemical principle. In this paper, the development histories of electronic tongue both of potential type and voltammetry type were introduced, including their detection principles and key innovation technologies. In order to comprehensively improve the understanding of electronic tongue, its technological progresses, such as the study of dedicated sensors or biosensors for specific tastes, and the development of miniaturized or hybrid devices, were also discussed in detail. And the challenges and countermeasures in the application of electronic tongue were analyzed to provide some suggestions for its further technology promotion.
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Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and repetitive behaviors. With the rapid development of computer vision, visual behavior analysis aided diagnosis of ASD has got more and more attention. This paper reviews the research on visual behavior analysis aided diagnosis of ASD. First, the core symptoms and clinical diagnostic criteria of ASD are introduced briefly. Secondly, according to clinical diagnostic criteria, the interaction scenes are classified and introduced. Then, the existing relevant datasets are discussed. Finally, we analyze and compare the advantages and disadvantages of visual behavior analysis aided diagnosis methods for ASD in different interactive scenarios. The challenges in this research field are summarized and the prospects of related research are presented to promote the clinical application of visual behavior analysis in ASD diagnosis.
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Humans , Autism Spectrum Disorder/diagnosis , Vision, Ocular , BehaviorABSTRACT
@#Introduction: This study objectives were to evaluate the youth’s knowledge and awareness of reproductive health issues among the Hashemite University students and to measure the effectiveness of the interactive teaching approach in delivering the reproductive health knowledge course. Methods: Quantitative and qualitative research designs were used. The sample was 160 (two cohorts) undergraduate students who enrolled in the reproductive health course during two semesters at the Hashemite University. Quantitative data was collected from the students before and after receiving a reproductive health course. Qualitative data was collected through focus group discussions. Results: The study results showed an improvement in the reproductive health awareness level of students. There was a statistically significant increase in the total score of knowledge between the pretest (M = 19.97, SD = 3.89) and posttest (M = 21.65, SD = 4.03) for the first cohort at p =.00. There was a statistically significant increase in the total score of knowledge between pretest (M = 19.33, SD = 2.89) and posttest (M = 20.66, SD = 5.78) for the 2nd cohort at p =.00. Qualitative data revealed that the students were very interested in the reproductive health course and found it very useful for themselves, their families, friends, and society. Conclusion: The interactive learning approach was useful in teaching reproductive health course and increased university students’ awareness regarding reproductive health topics, which were important for students. It was recommended by students to teach reproductive health course to other students in all universities using interactive learning.
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Esta investigación se propuso explorar y analizar las características que presenta la interacción entre niños y adultos con un juego digital e interactivo que implica la solución de un problema, el armado de rompecabezas en una tablet. Se realizaron observaciones seminaturalísticas en los hogares y se indagó mediante un cuestionario la tenencia y hábitos de uso de tecnologías. Las interacciones se analizaron con un sistema de categorías construido inductivamente. Adultos y niños participaron de manera activa en la tarea. Los adultos ayudaron a los niños en su mayo-ría por medio de preguntas, guías e informaciones, acompañadas con frecuencia de acciones no verba-les como señalamientos y arrastre de las piezas. Las intervenciones infantiles fueron en su mayoría no verbales. A pesar de encontrar una fuerte presencia de tecnologías en los hogares, se diferenciaron dos grupos respecto a hábitos de uso: un grupo reportó un bajo uso y los niños no accedían a tablets, otro expresó mayor uso y los niños las utilizabancon frecuencia. Las intervenciones en el armado del rompecabezas se diferenciaron en función de la experiencia infantil con tecnologías. Los resultados se discuten a la luz de investigaciones previas sobre la interacción adulto-niño con herramientas analógicas y digitales.
This study aimed to explore and analyze the charac-teristics of the interaction between children and adults with a digital and interactive game that involves solv-ing a problem, that is, assembling puzzles on a tablet. Semi-naturalistic observations of the interactions in the homes were carried out, and the possession and the habits of the use of were investigated through a survey. The interactions were analyzed with an induc-tively constructed category system. Adults and chil-dren actively participated in the task. Adults helped the children mainly through questions, guidance, and information, accompanied frequently by nonverbal actions, such as pointing at and sliding the pieces. Most of the children's interventions were nonverbal. Despite finding a significant technology presence in the homes, two groups were differentiated regard-ing their habits of use. One group reported little use of technology and no access to tablets for children. Another one expressed that the children used tablets frequently. The interventions in the task differed ac-cording to the children's experience with technologies. The results were discussed considering previous research on adult-child interaction with analogical and digital tools.
Esta pesquisa teve como objetivo explorar e analisar as características da interação entre crianças e adultos com um jogo digital e interativo que envolve a resolução de um problema, a montagem de quebra-cabeças em um tablet. Observações seminaturalísticas foram feitas nas residências e a posse e hábitos de uso de tecnologia foram indagados por meio de um questio-nário. As interações foram analisadas com um sistema de categorias construído indutivamente. Adultos e crianças participaram ativamente da tarefa. Os adul-tos ajudavam seus filhos principalmente por meio de perguntas, orientações e informações, muitas vezes acompanhadas de ações não verbais, como apontar e arrastar as peças. As intervenções das crianças foram em sua maioria não verbais. Apesar de constatar uma forte presença de tecnologias nas residências, dois grupos se diferenciaram quanto aos hábitos de uso. Um grupo relatou baixo uso e as crianças não acessavam tablets, outro grupo expressou maior uso e as crianças os utilizavam com frequência. As intervenções na montagem do quebra-cabeça foram diferenciadas de acordo com a experiência da criança com as tecnologias. Os resultados são discutidos à luz de pesquisas anteriores sobre a interação adulto-criança com ferramentas analógicas e digitais.
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Humans , Play and Playthings , Solutions , Technology , HabitsABSTRACT
Introducción: los beneficios de la ventilación asistida ajustada neuronalmente (NAVA) en los recién nacidos prematuros son inciertos. El objetivo de este estudio fue explorar si la NAVA no invasiva (NIV) era más beneficiosa para los recién nacidos prematuros que la presión positiva continua nasal (NCPAP). Diseño del estudio: metanálisis de tres ensayos clínicos: dos ensayos controlados aleatorizados y un estudio de grupos cruzados. Se comparó la NAVA-NIV con la NCPAP y se informó sobre el fracaso del tratamiento, la mortalidad y los eventos adversos como resultados principales. Resultados: tres estudios con 173 pacientes (89 recibieron NAVA-NIV) cumplieron los criterios de inclusión en este metanálisis. No se observaron diferencias en el fracaso del tratamiento entre la NAVA-NIV y la NCPAP (razón de riesgos [RR] = 1,09; intervalo de confianza [IC] del 95 % = 0,65-1,84; diferencia de riesgos = 0,02; IC95% = -0,10-0,14; I2 = 33 %; P = 0,23). De manera similar, no hubo diferencias en la mortalidad (RR = 1,52; IC95% = 0,51-4,52; no aplica heterogeneidad). En comparación con la NCPAP, la NAVA-NIV redujo significativamente el uso de cafeína (RR = 0,85; IC 95% = 0,74-0,98; I2 = 71 %; P = 0,03). Conclusiones: en comparación con la NCPAP, no hay evidencia suficiente para sacar una conclusión sobre los beneficios o daños de la NAVA-NIV en los recién nacidos prematuros. Los hallazgos de esta revisión deben confirmarse en ensayos clínicos con una metodología rigurosa y potencia adecuada
Introduction: The benefits of neurally adjusted ventilatory assist (NAVA) in preterm infants are unclear. This study aimed to explore if noninvasive NAVA is more beneficial for preterm infants than nasal continuous positive airway pressure (NCPAP). Study design: Meta-analysis was performed in three clinical trials comprising two randomized controlled trials and one crossover study. We compared NIV-NAVA and NCPAP and reported treatment failure, mortality, and adverse events as the primary outcomes. Results: Three studies including 173 patients (89 of whom underwent NIV-NAVA) were eligible for this meta-analysis. This review found no difference in treatment failure between NIV-NAVA and NCPAP (RR 1.09, 95% CI 0.65 to 1.84; RD 0.02, 95% CI -0.10-0.14; I2=33%, P=0.23). Similarly, there was no difference in mortality (RR 1.52, 95% CI 0.51-4.52, heterogeneity not applicable). Compared with NCPAP, NIV-NAVA significantly reduced the use of caffeine (RR 0.85, 95% CI 0.74-0.98, I2=71%, P=0.03). Conclusions: Compared with NCPAP, there is insufficient evidence to conclude on the benefits or harm of NIV-NAVA therapy for preterm infants. The findings of this review should be confirmed using methodologically rigorous and adequately powered clinical trials.
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Humans , Infant, Newborn , Interactive Ventilatory Support/adverse effects , Infant, Premature , Treatment Failure , Cross-Over Studies , Continuous Positive Airway Pressure/adverse effectsABSTRACT
Objetivo: Descrever a experiência de um estágio acadêmico vivenciado por universitários da área da saúde em um município do Baixo Solimões. Síntese dos dados:Trata-se do relato descritivo de um estágio acadêmico extramuro realizado em Manacapuru, Amazonas, ocorrido no período de outubro de 2019 a fevereiro de 2020. A realização da atividade teve a participação de acadêmicos de Medicina, Enfermagem e Odontologia e contou com a aplicação de práticas em saúde direcionadas à atuação individual e coletiva. Tendo como público-alvo os pacientes atendidos por uma Unidade Básica de Saúde (UBS), os universitários auxiliaram na realização de atendimentos eletivos em suas respectivas áreas de atuação e conduziram atividades de educação em saúde como rodas de conversa, gincanas educativas, palestras interativas e educação continuada à equipe da UBS. Conclusão: As práticas e ações em saúde realizadas no período do estágio extramuro proporcionaram uma integração interdisciplinar satisfatória entre os acadêmicos, possibilitando aos mesmos uma vivência apropriada na atenção básica do Sistema Único de Saúde (SUS).
Objective: To describe the experience of an academic internship completed by university students in the health field in a municipality in Baixo Solimões. Data synthesis: This is a descriptive report of an extramural academic internship carried out in Manacapuru, Amazonas, from October 2019 to February 2020. The activity was carried out with the participation of medical, nursing and dentistry students and included the application of health practices aimed at individual and collective action. Having as a target audience the patients assisted by a Primary Health Care (PHC) center, the university students helped in carrying out elective care in their respective fields and conducted health education activities such as conversation circles, educational scavenger hunts, interactive lectures and continuing education for the PHC center team. Conclusion: The health practices and actions carried out during the extramural internship enabled a satisfactory interdisciplinary integration among the students and allowed them to have an appropriate experience in primary care in the Unified Health System (Sistema Único de Saúde SUS).
Objetivo: Describir la experiencia de una pasantía académica vivida por universitarios del área de la salud en un municipio del Baixo Solimões. Síntesis de los datos: Se refiere al informe descriptivo de una pasantía académica extramuros realizado en Manacapuru, Amazonas, ocurrido entre octubre de 2019 y febrero de 2020. La realización de la actividad tuvo la participación de académicos de medicina, enfermería y odontología y contó con la aplicación de prácticas en salud direccionadas a la actuación individual y colectiva. Teniendo como público meta los pacientes atendidos por una Unidad Básica de Salud (UBS), los universitarios ayudaron en la realización de atendimientos electivos en sus respectivas áreas de actuación y condujeron actividades de educación y en salud como charlas, juegos educativos, conferencias interactivas y educación continuada para el equipo de la UBS. Conclusión: Las prácticas y acciones en salud realizadas en el período de la pasantía extramuros proporcionaron una integración interdisciplinar satisfactoria entre los académicos, posibilitando a los mismos una experiencia apropiada en la atención básica del Sistema Único de Salud (SUS).
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Modern medical quality management is characterized by professionalism, continuity and comprehensiveness. It is necessary to strengthen the communication and cooperation among health administrative authorities, medical institutions and professionals. Since 2011, based on the guidance of the interactive governance theory and the governance interface as a platform, Zhejiang Province had explored and established a relatively independent third-party quality evaluation service organization, which aimed to correct such setbacks as the imbalance and inadequacy of medical quality management. Through the interaction of organization interface, management interface, service interface, information interface and method interface, the province had initially achieved the multi-level diagonal governance in medical quality management, and transformed the traditional management relationship into an interactive relationship. This practice had achieved desirable results in improving the quality control work network, updating management methods, and improving medical quality and safety, serving as reference in upgrading the medical quality and safety management of medical institutions in China.
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Explainable artificial intelligence (AI) promotes the development of medicine and raises different ethical challenges. This new challenge is manifested in two aspects, including pre-interpretation and post-interpretation. The technical root of the ethical issues leading to the medical application of explainable AI is the negative effects of explainable technology, the social root is the lack of relevant moral principles and legislation, and the root of subjectivity lies in the diversity of interests of various stakeholders. Therefore, the solutions to the problem are to strengthen technological innovation, explainable AI medical application ethics education, training of medical staff and interdisciplinary cooperation, improve relevant moral principles, laws and regulations, and realize personalized interactive interpretation.
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Objective:To explore the effect of multimedia interactive teaching mode on the standardized residency training in department of geriatrics.Methods:This study selected 80 geriatric residents taking the standardized training in the Department of Geriatrics, First Hospital of Jilin University from October 2019 to October 2020, and they were randomly divided into experimental group and control group. The control group adopted the traditional teaching mode to train the residents, while the experimental group adopted the multimedia interactive teaching mode to train the residents. After training for 3 months, the theoretical knowledge and clinical skills examination results after the training, comprehensive ability before and after the training, and the satisfaction with the training mode after the training were compared between the two groups. SPSS 26.0 was performed for t test. Results:There were significant differences between the two groups in the scores of theoretical knowledge[(92.06±4.75) vs. (87.54±4.23)] and clinical skills [(89.63±4.28) vs. (80.09±4.13)]( P<0.05), and the scores of theoretical knowledge and clinical skills in the experimental group were significantly higher than those in the control group ( P<0.05). There was no significant difference in the scores of thinking ability, clinical practice ability, scientific research ability, innovation ability and doctor-patient communication ability between the two groups before the training ( P>0.05). However, after the training, the above abilities were all improved ( P<0.05), and the scores of the experimental group were significantly higher than those of the control group ( P<0.05). The satisfaction of the experimental group was higher than that of the control group in improving cognitive speed, improving understanding, enhancing memory, improving problem analysis, stimulating learning interest, improving classroom participation, knowledge expansion, cultivating critical thinking, improving overall clinical thinking, and improving clinical work proficiency ( P<0.05). Conclusion:The application of multimedia interactive teaching mode in standardized residency training of geriatrics can improve the theoretical knowledge and clinical skills examination results of residents, enhance their comprehensive ability, and improve their satisfaction with the training mode.
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Objective:To explore the application effect of case-based learning (CBL) based on UMU interactive mobile learning in the teaching of standardized training of respiratory medicine.Methods:A total of 80 trainees who had standardized training in Department of Respiratory Medicine of Daping Hospital from June 2019 to June 2020 were enrolled as the research objects. They were randomly divided into observation group ( n=42) and control group ( n=38). The control group was given traditional teaching mode, while observation group was given CBL based on UMU interactive mobile learning. The assessment results, control situations of core competence and teaching satisfaction after training were compared between the two groups. SPSS 20.0 was conducted for chi-square test and t test. Results:The scores of professional theoretical knowledge, case analysis ability and clinical operation skills in observation group were higher than those in control group ( P<0.05). The total control rate of core competence in observation group was significantly higher than that in control group (95.24% vs. 78.95%) ( P<0.05), and the teaching satisfaction rate of observation group was significantly higher than that of control group (100% vs. 84.21%) ( P<0.05). Conclusion:Application of CBL based on UMU interactive mobile learning in the teaching of standardized training of respiratory medicine is not only conducive to improving the teaching quality, but also conducive to cultivating core competence, clinical thinking ability and problem-solving ability of the training students, with higher teaching satisfaction.
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Objective:To analyze the online learning behaviors and learning results of students under different teaching modes with different learning motivations, and to provide a reference for optimizing the development of online teaching.Methods:Samples of students taking the physiology small private online course (SPOC) in 2019 and 2020, and students taking the massive open online courses (MOOC) in the same year were selected in the study to discuss the differences in learning behaviors of students under different teaching modes and learning effects on students with different learning motivations. The online learning behaviors of students were analyzed based on their learning engagement, interactive behavior and learning motivation. SPSS 25.0 was used to analyze the data with statistical methods such as function calculation, frequency statistics, regression analysis, rank sum test, correlation test and chi-square test.Results:The learning participation level ( z=14.36, P<0.001), and the human-machine and interpersonal learning interaction level ( z=-11.70, -16.18, both P<0.001) of SPOC learners in 2020 were higher than those in 2019. The overall interactive level was moderately correlated with performances of students ( r=0.42, 0.52, both P<0.001), and the correlation between interpersonal behavior and grades was much more stronger ( r=0.60, 0.55, both P<0.001). The performance composition of SPOC and MOOC learners in 2019 was completely different ( χ2=857.45, P<0.001). The learning effect of externally motivated students was significantly better than that of internally motivated students ( z=-28.42, P<0.001). Conclusion:The teaching mode adopted by the school can affect the learning effect by influencing the students' online learning engagement and interactive behavior. Besides, students' own learning motivation also plays a key role in their academic performance.
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Objective:To explore the application research of continuity nursing based on the interactive reaching standard theory after heart transplantation.Methods:The clinical data of 104 patients after heart transplantation in Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital) from June 2012 to June 2020 were collected for retrospective study. According to the file order, they were divided into the control group and the experimental group with 52 cases in each group. The control group took regular nursing care, and the experimental group took continuation nursing based on the interactive standard theory on the basis of the control group. The intervention continued for 24 weeks. The compliance behavior, psychological state and other indexes were compared between two groups.Results:The scove of Positive and Negative Affect Scale: after 12 weeks and 24 weeks of nursing, the experimental group′s positive emotion scores (27.71 ± 4.42, 35.11 ± 4.19) were higher than those of the control group (24.45 ± 4.03, 28.87 ± 4.36). The negative emotional scores (24.52 ± 3.71, 16.66 ± 2.28) were lower than those of the control group (28.84 ± 4.14, 23.31 ± 3.46), the differences were statistically significant ( t=5.60, 11.57, P<0.05). After 12-week and 24-week nursing, the experimental group′s health knowledge level score (44.12 ± 4.43, 53.64 ± 4.55) , self-care skills score(35.35 ± 4.01, 44.78 ± 4.22) , self-responsibility score (21.15 ± 2.38, 26.11 ± 1.44) , and self-concept score (18.56 ± 6.25, 23.58 ± 2.58) were higher than the control group (37.78 ± 4.52 and 45.56 ± 5.13, 31.11 ± 3.64 and 36.65 ± 3.91, 18.82 ± 2.46 and 22.35 ± 1.29, 15.96 ± 4.10 and 18.12 ± 3.10), the differences were statistically significant ( t values were 2.51-14.03, P<0.05). Conclusions:Continuing care led by the interactive standard theory can improve the health literacy of patients after heart transplantation, relieve negative emotions, promote post-traumatic growth, enhance self-management capabilities, establish compliance behaviors, and improve heart function.
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Objective:To explore the application of interactive communication mode combined with problem-based learning in clinical teaching of undergraduate nursing students so as to provide basis for nursing teaching reform.Methods:A total of 62 undergraduate nursing students in Beijing Jishuitan Hospital were selected. Among them, 32 cases from September to November 2018 received traditional teaching (the control group), and 30 cases from September to November 2019 were given interactive communication mode combined with problem-based learning (the observation group). The assessment results, comprehensive ability, clinical communication ability, scientific research ability, and feedback results of teaching quality were compared between the two groups.Results:After intervention, the total score of assessment in the observation group was (90.62 ± 4.75) points, higher than that in the control group (83.84 ± 5.01) points, there was significant difference ( t=5.46, P<0.05). After intervention, the scores of observation ability, operation ability and teamwork ability in the observation group were (3.51 ± 0.59), (3.75 ± 0.50), (4.30 ± 0.77) points, higher than those in the control group (3.18 ± 0.44), (3.22 ± 0.46), (3.53 ± 0.81) points, there were significant differences ( t=2.51,4.35, 3.83, all P<0.05). After intervention, the scores of clinical communication and keen listening, determining patients′ problems, participating together, sending effective information, establishing harmonious doctor-patient relationship, and verifying perception ability in the observation group were (83.61 ± 10.18), (81.66 ± 8.92), (84.01 ± 9.17), (83.25 ± 9.73), (80.90 ± 9.99), (84.15 ± 8.08) points, higher than those in the control group (73.91 ± 9.73), (74.95 ± 8.05), (76.02 ± 8.22), (73.16 ± 8.02), (74.61 ± 8.54), (76.08 ± 8.25) points, there were significant differences ( t values were 2.67-4.47, all P<0.05). After intervention, the scores of literature reading ability, data processing ability and paper writing ability in the observation group were (14.29 ± 1.54), (13.02 ± 1.29), (14.91 ± 1.50) points, higher than those in the control group (13.08 ± 1.43), (11.44 ± 1.24), (12.36 ± 1.28) points, there were significant differences ( t=3.21, 4.92, 7.22, all P<0.05). The feedback scores of students about improving nursing humanistic quality, professional self-identity, learning interest, communication ability, clinical thinking ability and innovation ability in the observation group were (4.26 ± 0.75), (4.43 ± 0.81), (4.25 ± 0.77), (4.18 ± 0.66), (4.44 ± 0.90), (4.38 ± 0.94) points, higher than those in the control group (3.51 ± 0.64), (3.79 ± 0.70), (3.48 ± 0.84), (3.40 ± 0.76), (3.83 ± 0.89), (3.60 ± 0.89) points, there were significant differences ( t values were 2.68-4.30, all P<0.05). Conclusions:The interactive communication mode combined with problem-based learning can effectively improve assessment results of undergraduate nursing students, and promote the improvement of their comprehensive quality, which is conducive to the improvement of clinical communication ability and scientific research ability in nursing students.