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Objective: To evaluate the implementation effect of serious illness medical insurance in Guang Xi Zhuang Autonomous Region of western China. Study design: Through the collection of 2017-2021 Guang Xi serious illness medical insurance specific policy making such as fund usage, serious illness compensation, medical expenses data, and data analysis of a serious illness medical insurance effect. Method: Literature research, Policy text analysis, quantitative data collection method, using Excel and SPSS 19.0 data descriptive statistical analysis and comparative analysis. Results: Serious illness medical insurance has had some effect, e.g., from 2017 to 2021, the utilization rate of serious illness medical insurance fund in Guang Xi was 109.49% and 103.87% respectively, the fund balance rate was -9.45% and -8.54% respectively, and the accumulated balance was -2.3871 million CNY and -70.7955 million CNY. Conclusion: The serious illness medical insurance has reduced the burden of large medical expenses of patients to a certain extent, but the fund is under too much pressure, and there is a payment deficit. The coverage and security of serious illness medical insurance need to be expanded and strengthened, and the cooperation mechanism with commercial insurance institutions should be gradually explored to improve the serious illness medical insurance.
Objetivo: evaluar el efecto de la implementación de seguros médicos para enfermedades graves en la Región Autónoma Guang Xi Zhuang, al oeste de China. Diseño del estudio: a través de la recopilación de pólizas de seguro médico específicas para enfermedades graves de la región de Guang Xi entre 2017-2021, como por ejemplo: uso de fondos, compensación por enfermedades graves, datos de gastos médicos y análisis de datos del efecto de seguros médicos para enfermedades graves. Método: investigación de literatura, análisis de textos de políticas públicas, metodología de recolección de datos cuantitativos utilizando Excel y SPSS 19.0, análisis estadístico descriptivo de datos y análisis comparativo. Resultados: el seguro médico para enfermedades graves ha demostrado tener efectos, tales como: entre 2017 y 2021, la tasa de utilización de fondos de seguros médicos para enfermedades graves en Guang Xi fue de 109,49 % y 103,87 % respectivamente, las tasas de saldo del fondo fue de -9,45 % y -8,54 % respectivamente y el saldo acumulado fue de -2,3871 millones de CNY y -70,7955 millones de CNY. Conclusión: El seguro médico para enfermedades graves ha reducido en cierta medida la carga de los grandes gastos médicos de los pacientes, pero al existir un déficit de pagos está bajo demasiada presión. Por ello, es necesario ampliar y fortalecer la cobertura y seguridad del seguro médico para enfermedades graves, y explorar gradualmente mecanismos de cooperación con instituciones de seguros comerciales.
Objetivo: Avaliar o efeito da implementação de seguro médico para doenças graves na Região Autônoma de Guang Xi Zhuang da China Ocidental. Desenho do Estudo: Através da coleta de políticas específicas de seguro médico para doenças graves de Guang Xi 2017-2021, uso de fundos, compensação por doenças graves, dados de despesas médicas e análise de dados de um efeito de seguro médico para doenças graves. Método: Pesquisa na literatura, análise do texto da política, método de coleta de dados quantitativos usando Excel e SPSS 19.0, análise estatística descritiva de dados e análise comparativa. Resultados: Seguro médico de doenças graves teve um certo efeito. Em 2017 e 2021, a taxa de utilização do fundo de seguro médico para doenças graves em Guang Xi foi 109,49% e 103,87% respectivamente, a taxa de saldo do fundo foi -9,45% e -8,54% respectivamente e o saldo acumulado foi -2,3871 milhões de yuans e -70,7955 milhões de yuans. Conclusão: O seguro médico para doenças graves reduziu o ônus de grandes despesas médicas dos pacientes até certo ponto mas o fundo está sob demasiada pressão e há um déficit de pagamentos. A cobertura e segurança do seguro médico de doenças graves necessitam ser expandidas e fortalecidas, e o mecanismo de cooperação com instituições de seguros comerciais deve ser gradualmente explorado para melhorar o seguro médico para doenças graves.
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Objective To understand the status quo of hierarchical diagnosis and treatment effect of medical alliance in Beijing and explore the influencing factors.Methods The convenience sampling method was used to select 26 vertical medical alliances,and the weighted TOPSIS method was used in combination with the index system established in the previous study to evaluate the effect of hierarchical diagnosis and treatment.The factors influencing the effect of hierarchical diagnosis and treatment in medical alliances were summarized through interviews with insiders,and the rank sum test was used to explore the factors influencing the effect of hierarchical diagnosis and treatment in medical alliances.Results The medical alliance B,A2 and A3 ranked high,and the implementation effect was relatively good in the four dimensions of"primary care first consultation,dual-way referral,acute and slow treatment,and vertical linkage";The C2,A8 and F2 medical alliances ranked low,and the implementation effect in the dimensions of"dual-way referral","acute and slow treatment"and"vertical linkage"was significantly lower than that of other medical alliances.The analysis results showed that the differences in the support intensity and core hospital level of different medical alliances were statistically significant(P<0.05),which affected the hierarchical diagnosis and treatment effect of medical alliances.Conclusion While strengthening the information construction and improving the initiative of grassroots and the signing rate of family doctors,it is necessary to improve the support of core hospitals to promote the sinking of resources.Core hospitals should optimize resource allocation according to local conditions and promote hierarchical diagnosis and treatment.
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Objective To understand cognition level and treatment intention of patients with endometriosis(EMs);To evaluate the effects of TCM chronic disease management on EMs patients.Methods The disease cognition level and treatment intention of 1 895 EMs patients from October 2020 to December 2021 in 19 provinces,autonomous regions and municipalities were analyzed through cross-sectional investigation.The cognitive effect of chronic disease management of TCM on 801 patients with EMs from 6 Grade A hospitals in Beijing was evaluated by self-control study.Results The cognition level of EMs patients for the disease was improved with the increase of educational background.Patients generally believed that EMs was a chronic disease,requiring regular review and long-term management.The proportion of patients with high school education or below,junior college education,bachelor degree or above who knew the possibility of malignant changes in EMs was less,only 32.3%,41.6%and 47.7%,respectively.The awareness rate of patients with high school education or below for recurrence after EMs conservative surgery was 46.9%,lower than that of those with junior college education(66.8%)and bachelor degree or above(72.7%).Among the patients with dietary contraindications,the proportion of patients with high school education or below,junior college education,bachelor degree or above who knew the contraindication of the forest frog oil was less,only 20.7%,30.3%and 32.9%,respectively.In the aspect of life adjustment,the awareness of patients was generally high.EMs patients mainly recognized the disease through face-to-face communication with gynecologists.Only 34.4%of patients with high school education or below learned about EMs through WeChat public accounts,APPs and other new media,which was lower than those with junior college education(48.6%)and bachelor degree or above(55.4%).EMs patients generally tend to be treated in comprehensive hospitals,with high acceptance of TCM treatment,mainly TCM decoction,and low acceptance of TCM appropriate technology.After 1 year of TCM chronic disease management,the disease awareness of EMs patients was significantly improved compared with before management,with statistical significance(P<0.05).Conclusion EMs patients with different educational backgrounds have different cognition of the disease,and each has different emphasis.Education and popularization should be carried out according to their knowledge blind spots.Chronic disease management of TCM can improve the disease cognition level of EMs patients.
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The incidence of occupational injury accidents in the metallurgy and mechanical manufacturing industries remains high, posing risks not only to the safety and health of workers but also causing heavy economic burdens to enterprises and families. The occupational injury accidents in metallurgy and mechanical manufacturing industries were caused by the following six items: human factors, machine factors, building factors, raw material factors, environmental factors, and management factors. The types and body parts of occupational injury accidents varied among different industries due to the nature of the occupation and working environment. Occupational injury accidents were both sudden and preventable. Currently, comprehensive intervention measures for occupational injury accidents at China and abroad included safety education, improving work environments, optimizing building layout and facilities, and enhancing safety management capabilities. Effective and feasible intervention measures for occupational injury accidents should be based on the characteristics and causes of occupational injury accidents in each industry, and should include corresponding interventions for workers, machines, buildings, raw materials, environment, and management.
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Objective To study the population distribution characteristics and follow-up results of a health examination institution in Xinjiang.Methods 65 045 subjects who took physical examination in the Health Management Center of Xinjiang Medical University in 2022,and 4 665 subjects with important abnormal results were selected.The follow-up rules of important abnormal results class B were formulated,telephone notification and follow-up in January and June,and follow-up were recorded by follow-up information system.Results Of the 4665 cases,447 cases(9.58% )had important abnormal results of class A and 4 218 cases(90.42% )had important abnormal results of class B;there were 2 815 males(60.34% )and 1 850 females(39.66% ),indicating cases were higher in males than in females(P<0.05);there was a correlation between age and impor-tant abnormal results(P<0.05).The number of abnormal results in important sections of 41-50 years old(1 114 cases)and 51-60 years old(1 211 cases)accounted for a high proportion.4 457 cases(95.54% )were effectively notified,4 397 cases(98.65% )were effectively followed up after notification,and 60 cases(1.35% )lost follow-up.After telephone follow-up,2118 cases(48.17% )were treated and 2 279 cases(51.83% )were not treated.1 562(58.57% )ofmales who did not see a doctor,compared with 717(41.45% )of females,and there was statistical significance between sex and whether they saw a doc-tor or not(P<0.05).There were 1 194 cases(56.40% )of non-tumor diseases,97 cases(4.5% )of malignant diseases and 827 cases(39.1% )of undefined diseases.Conclusion Significant abnormal results are higher in men than women,and the in-cidence of significant abnormalities increases with age.The notification and follow-up success rate in the implementation of the follow-up pathway should also be improved.The subjects did not fully understand and paid enough attention to the important abnormal outcome indicators(60.44% )or see a doctor in time according to the follow-up recommendations.Health education needs to be strengthened to improve their health awareness and urge them to get timely treatment,which was of great significance to improve the"early screening,early evaluation and early intervention"of the disease.
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Objective To compare the application value of filter membrane method and smear method on the evaluation of disinfection effect of flexible endoscope.Methods 242 flexible endoscopes after cleaning and disinfection from January 2022 to November 2022 were collected as the study subjects,and the disinfection effect of all endoscopes was tested by filter membrane method and smear method.The qualified rate,pathogen detection rate,colony detection and use cost of the two detection methods were compared.Results Among the 242 flexible endoscopes,the total qualified rate of filter membrane method was lower than that of smear method while the total detection rate of pathogenic bacteria and the number of bacterial colony were significantly higher than those of smear method(P<0.05).In the two evaluation methods,the colony count detected by gastroscopy was mainly≤100 cfu/n,and the colony count detected by enteroscopy was mainly≥100 cfu/n(P>0.05).The economic cost and time cost of filter membrane method were higher than those of smear method(P<0.05),and filter membrane method increased the annual depreciation cost of the suction filtration system of 976 yuan.Conclusion Compared with smear method,filter membrane method is more effective in evaluating the disinfection of flexible endoscope,but its economic cost and time cost are also higher.However,in order to build a green environment-friendly hospital,it is necessary to increase the investment of endoscopy center,thus it is recommended to apply filter membrane method.
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Objective To evaluate the short-term effect of self-management group project for chronic disease patients in Suzhou. Methods Eight to ten streets / towns were randomly selected from 10 cities and districts under the jurisdiction of Suzhou. Each street / town set up a chronic disease self-management group and carried out group activities. The awareness rate of chronic disease related knowledge, health management behavior and health status of the group members after and before the activities were compared to evaluate the short-term effect of the self-management group project. Results A total of 89 chronic disease self-management groups were set up in Suzhou in 2020. Among them, there were 47 hypertension groups and 42 diabetes groups. A total of 1176 people were surveyed at baseline, and 1161 people participated in the evaluation survey after the group activities. By setting up self-management groups, the awareness rates of chronic disease-related knowledge (BMI range, variety of food intake per day per week, moderate-intensity activity time per week, daily salt intake, harm of excessive salt intake, diagnostic criteria for hypertension, sodium content in low sodium salt, fasting blood glucose criteria, low-density lipoprotein control targets) in hypertension and diabetes patients after the intervention were improved compared with those before the intervention, and the differences were statistically significant (P“self-monitoring blood pressure” increased from 52.80% before the intervention to 66.32%, while the proportion of "having a blood glucose monitoring system at home" increased from 52.80% before the intervention to 66.32%, and the proportion of “self-monitoring blood glucose” increased from 25.67% before the intervention to 38.67%. The percentage of "drinking alcohol in the past 30 days" dropped from 12.14% before the intervention to 8.35%. All these differences were statistically significant. There was no difference in the number of "smoking in the past 30 days" compared with before the activity (P≥0.05). The number of days with poor health resulting from injuries in the past 30 days also decreased but the difference was not statistically significant (P≥0.05). In terms of the severity of depression, the number of people with moderate and severe depression decreased after the intervention, and the number of people who turned into mild depression increased, and the difference was statistically significant (P<0.05). Conclusion The self-management group project for chronic disease patients in Suzhou has achieved good results and is suitable for continued promotion and application in this region.
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Objective:To explore the application effects of multiple teaching methods based on the outcome-based education (OBE) on the teaching of physiology.Methods:The application of multiple teaching methods based on the OBE was used in physiology teaching for 356 students majoring in anesthesiology, stomatology, medical imaging, and psychiatry of five-year undergraduate from 2020 in Shenyang Medical College. Analysis and assessments were done by course examinations and questionnaires. SPSS 16.0 was used for t-test. Results:According to the course examinations, students got higher scores in the medical licensing examination than in the western medicine integrated examination [(88.19±16.35) points vs. (66.69±21.45) points, P < 0.001], and students had higher scores in the final exam (A2 questions) than in the final exam (A1 questions) [(70.63±17.67) points vs. (63.16±14.80) points, P < 0.001]. At the same time, the results of questionnaires showed that students had a positive attitude towards multiple teaching methods. Conclusion:The multiple teaching methods based on the OBE applied in the teaching of physiology can enhance the comprehensive learning ability and future position competence of students, and improve the teaching quality.
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Objective:To construct a virtual simulation training platform for peripheral inserted central catheter (PICC) catheterization and discuss its application in clinical training.Methods:A total of 118 nurses who attended the PICC professional and technical advanced training courses in a province in 2020 and 2021 were enrolled in this study. In 2020, the training was conducted in the form of theoretical teaching combined with practical training ( n=51), and in 2021, virtual simulation platform was introduced as a supplement on the basis of the original training ( n=67). SPSS 23.0 was used for independent-samples t-test to compare the theoretical and operational assessment results of the two years and evaluate the application effect of the platform. Through the satisfaction survey and learning log, the nurses' experience of using the platform was understood. Results:The theoretical performance and the operational performance of nurses who participated in the training in 2021 were (96.56±3.17) and (94.06±2.16) respectively, and the operational performance was better than that of nurses who participated in the training in 2020 ( t=-11.37, P<0.001), and the difference in theoretical performance was not statistically significant ( t=0.17, P=0.853). In 2021, 63 nurses (94.0%) who used the virtual simulation platform believed that the platform could assist to improve the training effect; 61 nurses (91.0%) expected the application of virtual simulation technology in the teaching and training of other knowledges. Conclusion:As a new teaching form, virtual simulation technology can significantly improve the training effect and satisfaction, and provide reference for the development of relevant teaching and training.
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Objective:To evaluate the effectiveness of prevention and control of coal-burning-borne endemic fluorosis in Sichuan Province, and to provide basis for further development of targeted prevention and control measures.Methods:According to the requirements of the Implementation Plan for the Elimination and Evaluation of Coal-burning-borne Endemic Fluorosis in Sichuan Province, from 2018 to 2021, the assessment of the elimination of coal-burning-borne endemic fluorosis was carried out in all the endemic fluorosis villages of 23 counties (cities, districts) in Sichuan Province. In each village, 30 households were selected to be investigated the use of improved stoves, the drying of corn and pepper for human consumption, and the prevalence of dental fluorosis among all children aged 8 - 12 years old in the village.Results:A total of 222 242 households were surveyed in 1 640 villages, 196 towns, 23 counties (cities, districts) in Sichuan Province. Among them, the rate of qualified improved stoves was 99.99% (222 238/222 242), the correct use rate of qualified improved stoves was 99.90% (212 026/222 238), and the correct drying rate of corn and pepper for human consumption was 99.96% (212 630/212 721). A total of 135 125 children aged 8 to 12 years old were examined, and 5 927 cases of dental fluorosis were detected. The prevalence of dental fluorosis in children was 4.39%. The grading of dental fluorosis was mainly very mild and mild, which were 2.71% (3 656/135 125) and 1.32% (1 783/135 125), respectively. In the county-level self-assessment of 1 640 villages, 1 621 villages had reached the elimination standard, with the elimination rate of 98.84%. Taking counties as a unit, the elimination rate of diseased villages ranged from 96.69% to 100.00%, and 23 diseased counties (cities, districts) had reached the elimination standard. In the provincial-level review results of 174 villages with endemic fluorosis, 174 diseased villages had reached the elimination standard, with the consistency rate of 98.85% (172/174) with the county-level self-assessment results. Among them, except for Gulin County, the consistency rate of self-assessment results was 7/9, the consistency rate of other counties (cities, districts) was 100.00%.Conclusions:The prevention and control of coal-burning-borne endemic fluorosis in Sichuan Province has achieved remarkable results, and all the diseased counties (cities, districts) have reached the elimination standard. In the future, we should continue to take active prevention and control measures to ensure that the elimination status is maintained.
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@#Abstract: Objective To explore the efficacy and safety of photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA) combined with antifungal drugs combined and comprehensive nursing intervention in the treatment of refractory kerion. Methods From January 2019 to December 2022,6 cases of refractory kerion who were treated at the Fifth People's Hospital of Hainan Province with photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA) combined with antifungal drugs. A solution with 20% concentration of ALA solution was uniformly dropped on the cotton sheet, shielded from light for 3 h, and irradiated with (633±10) nm LED red light for 20-30 min. The treatment was performed once a week, with one treatment course consisting of three sessions. Prior to treatment, debridement and fire needles pre-treatment were performed. Provide timely and targeted psychological care during treatment to alleviate psychological negative disorders and health education. Follow-up examinations were conducted 6 months after the treatment to evaluate clinical efficacy, safety and patient satisfaction. Results Six children received standard ALA-PDT combined with antifungal drugs, supplemented by comprehensive nursing intervention. The cure rate of children reached 100%, and no disease relapse or atrophic scar was found. The satisfaction rate of patients and their families was 100%. Conclusions PDT combined with antifungal drugs has obvious clinical efficacy in the treatment of kerion, especially when combined with comprehensive nursing intervention. This approach can help to relieve patients' anxiety, improve treatment outcomes, enhances patient compliance, and further improve patients' satisfaction.
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Objective:To analyze the clinical characteristics and evaluate the effect and safety of anti-vascular endothelial growth factor (VEGF) therapy in retinopathy of prematurity (ROP) in Sichuan province.Methods:A retrospective study. From January 2013 to January 2022, 156 patients (306 eyes) with ROP who received intravitreal anti-VEGF therapy for the first time in the Department of Ophthalmology, West China Hospital of Sichuan University were selected. According to the type of anti-VEGF drugs, the children were divided into intravitreal injection of ranibizumab (IVR) group and intravitreal injection of conbercept (IVC) group; IVC group was divided into hospital group and referral group according to the different paths of patients. After treatment, the patients were followed up until the disease degenerated (vascular degeneration or complete retinal vascularization) or were hospitalized again for at least 6 months. If the disease recurred or progressed, the patients were re-admitted to the hospital and received anti-VEGF drug treatment, laser treatment or surgical treatment according to the severity of the disease. Clinical data of these children was collected, including general clinical characteristics: gender, gestational age at birth (GA), birth weight (BW), history of oxygen inhalation; pathological condition: ROP stage, zone, whether there were plus lesions; treatment: treatment time, postmenstrual gestational age at the time of the first anti-VEGF drug treatment; prognosis: re-treat or not, time of re-treatment, mode of re-treatment; adverse events: corneal edema, lens opacity, endophthalmitis, retinal injury, and treatment-related systemic adverse reactions. The measurement data between groups were compared by t test, and the count data were compared by χ2 test or rank sum test. Results:Of the 306 eyes of 156 children with ROP, 74 were male (47.44%, 74/156) and 82 were female (52.56%, 82/156). Each included child had a history of oxygen inhalation at birth. The GA was (28.43±2.19) (23.86-36.57) weeks, BW was (1 129±335) (510-2 600) g, and the postmenstrual gestational age was (39.80±3.04) (31.71-49.71) weeks at the time of the first anti-VEGF drug treatment. All patients were diagnosed as type 1 ROP, including 26 eyes (8.50%, 26/306) of aggressive ROP (A-ROP), 39 eyes (12.74%, 39/306) of zone Ⅰ lesions, and 241 eyes (78.76%, 241/306) of zone Ⅱ lesions. The children were treated with intravitreal injection of anti-VEGF drugs within 72 hours after diagnosis. Among them, 134 eyes (43.79%, 134/306) of 68 patients were treated with IVR, and 172 eyes (56.21%, 172/306) of 88 patients were treated with IVC. In IVC group, 67 eyes of 34 patients (38.95%, 67/172) were in the hospital group and 105 eyes of 54 patients (61.05%, 105/172) were in the referral group. 279 eyes (91.18%, 279/306) were improved after one treatment, 15 eyes (4.90%, 15/306) were improved after two treatments, and 12 eyes (3.92%, 12/306) were improved after three treatments. The one-time cure rate of IVR group was lower than that of IVC group, but the difference was not statistically significant ( χ2=1.665, P=0.197). In different ROP categories, IVC showed better therapeutic effect in A-ROP, and its one-time cure rate was higher than that in IVR group, with statistically significant difference ( χ2=7.797, P<0.05). In the hospital group of IVC group, the GA, BW and the postmenstrual gestational age at first time of anti-VEGF drug treatment were lower than those in the referral group, and the difference was statistically significant ( t=-2.485, -2.940, -3.796; P<0.05). The one-time cure rate of the hospital group and the referral group were 94.94%, 92.38%, respectively. The one-time cure rate of the hospital group was slightly higher than that of the referral group, but the difference was not statistically significant ( χ2=0.171, P=0.679). In this study, there were no ocular and systemic adverse reactions related to drug or intravitreal injection in children after treatment. Conclusions:Compared with the characteristics of ROP in developed countries, the GA, BW and postmenstrual gestational age of the children in Sichuan province are higher. Both IVR and IVC can treat ROP safely and effectively. There is no significant difference between the two drugs in the overall one-time cure effect of ROP, but IVC performed better in the treatment of A-ROP in this study.
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ObjectiveTo evaluate the changes of the usage of oil, salt, sugar and nutritional knowledge and behavior intervention among diners before and after the establishment of healthy canteens and restaurants in Shanghai. MethodsA comprehensive intervention was conducted through the establishment of healthy canteens and restaurants, encompassing interventions such as oil, salt, and sugar management, improvement of nutritional environment, staffing and training activities, and nutrition labeling guidance. A pre-post self-controlled study design was used to compare changes in oil, salt and sugar usage, as well as diners’ knowledge and behaviors related to nutrition and nutrition labeling, before and after the intervention. ResultsAfter intervention, the total usage of oil, salt, and sugar per meal in the canteens and restaurants decreased by 18.33%, 14.83%, and 13.66%, respectively,and all had statistically significance differences(P<0.001). The awareness rate of "cooking oil intake", "salt intake", and "added sugar intake" among diners increased from 24.07% to 38.04%, 58.52% to 71.28%, and 26.85% to 45.01%, respectively. The awareness rate of "daily food types" and "weekly food types" increased from 43.07% to 56.53% and 49.52% to 64.32%, with significant differences (P<0.001). The rate of understanding the content of nutrition labels increased from 66.91% to 76.90%, the awareness rate of nutrition labels increased from 53.59% to 69.06%, the rate of active reading of nutrition labels among diners increased from 73.38% to 81.23%, and the rate of selecting and purchasing food based on the information of nutrition labels increased from 69.27% to 77.79%, all of which were statistically significant (P<0.001). ConclusionThe comprehensive interventions carried out through the creation of healthy canteens and restaurants have significantly impact on usage of oil, salt, and sugar, as well as on the nutritional knowledge and behaviors of diners.
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Complex intervention of traditional Chinese medicine has the characteristics of individuality,dynamic and time space view.That how to implement process standardization,how to explain the mechanism of action of different interventions in complex treatment and how to establish the theoretical basis of the complex intervention become the key point of TCM complex intervention study.Intervention Component Analysis(ICA)is a qualitative Analysis technique to identify key characteristics of different interventions affecting outcome changes.It is suitable for situations where existing theories cannot explain the impact of Intervention schemes on outcome,or intervention information description is incomplete in methodological evaluation.ICA could not solve complex intervention in clinical trials of traditional Chinese medicine report fully and analyzes in-depth problems such as insufficient understanding,background factors,to assist the key feature of complex intervention affect curative effect of traditional Chinese medicine and its theoretical basis.In this paper,the application of ICA in the treatment of knee osteoarthritis by Tuina was explored,the evidence of the effectiveness of Tuina in the treatment of KOA was comprehensively compared,the characteristics of Tuina in the treatment of KOA were identified,and the mechanism of Tuina in the treatment of KOA was elucidated,and the key elements of Tuina in the treatment of KOA were clarified.Among them,the targeted areas,the purpose of treatment and the application of corresponding manipulations were the key factors affecting the efficacy.The strength of manipulations during treatment,the changes of the patient's condition and the risk factors after treatment were the key factors to maintain the efficacy and ensure the safety.However,the application of acupuncture points and complex traditional Chinese medicine prescriptions in ICA has not been carried out.Therefore,researchers need to further improve the ICA to suit the best conditions for the research and analysis of TCM interventions.Criticism and corrections from academic colleagues are welcome.
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Objective:To investigate the oral health knowledge awareness, attitude and behavior of children in endemic fluorosis areas of Guizhou Province, and evaluate the effectiveness of health education, so as to provide a scientific basis for improving oral health.Methods:In September 2020, 6 counties (cities and districts) were selected as survey sites from the historical fluorosis medium and severe areas in Guizhou Province. One township/village primary school was selected from each survey site to carry out health education activities for one school year. A questionnaire survey was conducted among students from grades 1 to 6 to analyze the changes in children's oral health knowledge, attitude, and behavior before and after health education and their influencing factors.Results:Before and after health education, the awareness rate of children's oral health knowledge increased from 79.22% (7 744/9 775) to 94.38% (9 169/9 715), the recognition rate of children's importance of oral health increased from 89.26% (3 490/3 910) to 95.88% (3 726/3 886), and the formation rate of children's oral health behavior increased from 62.59% (6 118/9 775) to 80.38% (7 809/9 715), with an increase of 15.16, 6.62 and 17.79 percentage points, respectively, the differences were statistically significant (χ 2 = 975.62, 15.17, 756.29, P < 0.001). The analysis of influencing factors showed that whether to stay, gender, and ethnic characteristics could significantly affect the overall score ( t = - 3.94, - 3.86, - 3.62, P < 0.001). Conclusion:The implementation of oral health education in endemic fluorosis areas in Guizhou Province has significantly improved the health knowledge, attitude and behavior of oral health among children in endemic fluorosis areas.
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Based on the experimental teaching reform of health information management courses in Capital Medical University, this paper has explored the paths of experimental teaching suitable for the health management profession and provided suggestions for the teaching reform. The research was carried out in three stages. In the first stage, the needs of experimental teaching of health information management course were investigated. In the second stage, the experimental teaching practice was carried out based on the hospital information system platform. In the third stage, the experimental teaching effect was evaluated. The results showed that medical undergraduates have a great demand for the experimental teaching of the course. The experimental teaching method can greatly improve the interest of students in learning. The experimental teaching effect is good, and it is helpful to improve the students' practical ability and logical analysis ability. Furthermore, it is necessary and feasible to introduce experimental teaching into the specialty of health management, and better teaching effects will be achieved by closely combining the teaching reform practice with hardware and software configuration, personnel quality training and management.
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Objective:To explore the application of new teaching techniques and establish a new model for experimental teaching of Medical Statistics for undergraduate students of clinical medicine. Methods:We enrolled 2 classes of students from Xi'an Medical University as research objects, and they were randomized into study group ( n=62) and control group ( n=54). The study group received "traditional demonstration+ blended" learning, while the control group only received traditional teaching. On the premise of balanced comparability, the effects of the two teaching patterns were evaluated from such three aspects as satisfaction questionnaire, teacher's self-evaluation and achievement. SPSS 22.0 was performed for chi-square test, t test and rank sum test. Results:At the end of the semester, the value cognition of statistics in both groups was higher than before class, and the study group [93.5% (58/62)] was higher than that in the control group [68.5% (37/54)] ( χ2=12.20, P<0.001). The overall satisfaction ( Z=-7.05, P<0.001) and the satisfaction with teaching methods ( Z=-3.95, P<0.001) of the study group were significantly higher than those of the control group, with no statistical difference in satisfaction with teaching contents between the two groups ( Z=-0.27, P=0.784). More students in the study group thought that the experimental class deepened their understanding of statistical theory ( χ2=26.87, P<0.001). In the last four experimental classes, the post-test scores of both groups were higher than those of the pre-test, but the pre-test scores and post-test scores of the study group were higher than those of the control group. The performance of software operation in study group was higher than that in control group ( t=8.27 P<0.001). There was no statistical difference in the final test scores between the two groups ( t=0.29, P=0.773). Conclusion:The "traditional demonstration+ blended" learning is more in line with the students' learning pattern, and can better improve students' cognition and satisfaction of the statistics, especially can better cultivate students' team cooperation, expression and the SPSS analysis ability.
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Objective:To explore the application effects of mixed courses based on E-disciplinary platform on the teaching of nutrition and food hygiene.Methods:The study included in 31 preventive medicine students from group 1 to 3 Batch 2015 in Binzhou Medical University, who were divided into control group adopting (lecture-based learning, LBL) teaching model. While another 30 students from group 4-6 were divided into the experimental group adopting mixed teaching based on E-disciplinary platform. Analysis and assessments were done by course examinations and questionnaires. SPSS 20.0 was used for t test, rank sum test and chi-square test. Results:According to the course examinations, students in the experimental group got higher scores than those in the control group in terms of usual, examination and overall test scores [(46.17±8.84) points vs. (42.35±8.28) points; (37.31±6.58) points vs. (33.61±6.38) points; (81.97±9.18) points vs. (74.32±8.32) points, ( t=4.69, t=3.16, t=5.16, P< 0.01)]. Furthermore, the experimental group were better than the control group in the number distribution of excellent performance in usual, examination and overall test ( Z=2.71, Z=2.13, Z=4.57, P<0.05). The questionnaires demonstrated that the overall satisfaction rate of the experimental group (77.8%) was higher than that of the control group (47.8%) ( χ2=34.98, P<0.001). Conclusion:Student learning effect and the teaching quality can be improved by applying mixed teaching based on E-disciplinary platform.
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Objective:To evaluate the effect of health education of a three-year special action for prevention and control of drinking water-borne endemic fluorosis (referred to as drinking water-borne fluorosis) in Shandong Province, and to provide basis for formulating health education measures in the next step.Methods:Nineteen of the disease affected counties (cities and districts) were selected as project counties (cities and districts) in key areas for prevention and control of drinking water-borne fluorosis in Shandong Province in 2018, and 50 disease affected counties (cities and districts) were selected in 2019, and the project counties (cities and districts) were expanded to all of the 105 disease affected counties (cities and districts) in Shandong Province in 2020. Three disease affected townships (towns) were selected in each county (city and district), and health education activities on drinking water-borne fluorosis were carried out in Grade 4 to Grade 6 of the central primary schools and the three villages under its jurisdiction. Students and housewives were selected to conduct questionnaire surveys on prevention and control knowledge of drinking water-borne fluorosis before and after health education. The incidence of dental fluorosis among children aged 8 - 12 years was investigated annually in 6 villages (with children aged 8 - 12 years > 50) , where health education activity was implemented and the incidence of dental fluorosis among children was > 30%, water fluoride content was > 1.5 mg/L and water improvement time was < 5 years.Results:After health education, the awareness rates of drinking water-borne fluorosis in fifth grade pupils [92.46% (4 571/4 944) vs 65.80% (3 334/5 067) in 2018; 94.84% (12 897/13 599) vs 73.55% (9 993/13 587) in 2019; 95.59% (30 407/ 31 809) vs 77.52% (24 463/31 557) in 2020] and housewives [94.12% (2 400/2 550) vs 76.04% (1 939/2 550) in 2018; 94.99% (6 412/6 750) vs 72.00% (4 860/6 750) in 2019; 95.53% (16 183/16 941) vs 78.43% (12 971/16 539) in 2020] were significantly improved (χ 2 = 1 070.47, 2 315.27, 4 456.40, 328.25, 1 294.80, 2 174.63, P < 0.05). After health education in 2020, there were significant differences in the correct answer rates of epidemic causes, hazards and preventive measures of drinking water-borne fluorosis in the questionnaire of fifth grade pupils and housewives (χ 2 = 390.78, 164.94, P < 0.05). The awareness rates of drinking water-borne fluorosis in fifth grade pupils and housewives in the eastern region (Qingdao City, Yantai City and Weifang City) were significantly higher than those in the western region (Dezhou City, Liaocheng City and Heze City) before health education (χ 2 = 547.43, 210.12, P < 0.05), and after health education, the awareness rates increased to more than 90%. The detection rate of dental fluorosis in children decreased year by year (χ 2trend = 27.95, P < 0.05). Conclusions:Through implementation of a three-year special action for prevention and control of drinking water-borne fluorosis in Shandong Province, the awareness rate of fluorosis among target populations has been significantly improved. However, it is still necessary for government departments to further increase investment in health education and carry out health education activities in a deep-going way.
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@#Objective To evaluate the implementation effect of work improvement in health services technical tool ( ) - HealthWISE developed by the International Labor Organization and the World Health Organization in a grade A tertiary Methods - hospital. A total of 14 healthcare workers who had participated in the HealthWISE teacher training in a grade A - tertiary hospital since 2016 were selected as the research subjects using a typical sampling method. Semi structured interviews , Results , were conducted and the interview data were collected and analyzed. Among the 14 subjects five participated in the training for more than three times. The research subjects believed that they had gained great insights through the training. The , training had led to positive changes in both individual and team levels. In particular the hospital had established an , , occupational health protection system which had been significantly improved in organizational construction training and , - , education capacity building and so on. During the prevention and control of the COVID 19 pandemic the hospital strengthened HealthWISE application to ensure the occupational safety and health of healthcare workers. All research subjects provided opinions and suggestions on the improvement of the national comprehensive occupational health protection system for healthcare Conclusion , workers in the future. The application of HealthWISE in this hospital has achieved remarkable results which helps to promote the establishment of a comprehensive occupational health protection system for healthcare workers on a large scale.