Effect of cognitive retraining treatment in mild to moderate depressive disorders

Abstract Background Cognitive retraining or remediation approaches dispense high levels of stimulation and new learning tasks, leading to an increased neural connections, which facilitate rapid recovery in patients with neurological as well as psychiatric conditions. Objectives The current study aimed to investigate the effect of cognitive retraining (CR) in depressive disorders. We assigned 40 patients with mild to moderate depression to two sample groups, with 20 participants each: CR alone and CR with medicine. A 6-week CR module was delivered, and participants' scores on measures such as the Beck Depression Inventory-II, Metacognition Questionnaire 30, World Health Organization Quality of Life-Brief, and Global Assessment of Functioning were compared. Results Analysis using Stata/IC version 16 included descriptive statistics, paired and independent t-tests, analysis of covariance, and propensity score matching. Cohen's d was computed to determine the effect size. Within-group analysis revealed statistically significant differences in pre-post scores of the outcome measures (p < .05) and large effect size (d = 3.41; d = 3.60) in both groups. The difference in scores of outcome measures between the groups was not significant (p > .05) even when covariates were controlled, or nearest neighbor match analysis was carried out. CR is effective in alleviating symptoms and dysfunctional metacognitive beliefs in addition to enhancing functioning and quality of life. Conclusions CR-based interventions may be essential mental health services owing to growing research in psychotherapy via virtual modes such as tele- and video-conferencing. These interventions can substantiate both prevention and remedy.

Strengthen the training and application of electromyography and clinical neurophysiological examination in the diagnosis, treatment and research of neuromuscular diseases / 中华神经科杂志

Electromyography and neurophysiological examination are not only a clinical examination technique, but also play a more and more important role in the interpretation and solution of clinical problems of neuromuscular diseases by emphasizing the correlation between clinical and neurophysiology. In order to accurately locate the lesion site, further provide pathophysiological information, and assess the severity and course of the disease, it is necessary to develop a personalized examination program according to the symptoms and signs of patients, and it is also necessary to conduct systematic standardized training for clinicians and electrophysiological practitioners.

Fellowship training of family medicine in the United States and its implications for China / 中华全科医师杂志

The study utilized a cross-sectional design. Data was retrieved from the American Academy of Family Physicians fellowship training directory, including program names, areas of focus, program length, and program descriptions. The collected data was categorized and analyzed based on areas of focus and training duration. The program descriptions were also analyzed qualitatively using Nvivo12 software. A total of 532 programs were included in the study:295 programs (55.5%) were ACGME-certified, while 237 programs (44.5%) were not. The majority of programs, 468 (87.9%), were clinically oriented, while 64 programs (12.1%) were non-clinical. Among ACGME-certified programs, the largest number of programs were in sports medicine (121 programs), followed by geriatrics (52 programs). Among non-certified programs, the largest number of programs was in obstetrics (66 programs), accounting for 27.8% of all non-certified programs. Qualitative research found that fellowship programs were diverse, reflecting the societal demands of healthcare service. Moreover, a significant emphasis was placed on empowering teaching and research abilities.The family medicine fellowship programs in the United States cover a wide range of disciplines and meet both the professional interests of doctors and the needs of patients. As China continues to implement its tiered medical system, it can learn from the experience of the United States and develop general practice subspecialty training programs, thereby improving the service capacity of general practitioners and improve the quality of healthcare.

Atención del paciente quemado en «tiempos de COVID-19¼ / Care of the Burn Patient in «COVID-19 times¼ / Cuidados ao paciente queimado em «tempos de COVID-19¼

Resumen: En diciembre de 2019 inicia un brote de un nuevo coronavirus en la ciudad de Wuhan, capital de la provincia de Hubei, China, denominado por la Organización Mundial de la Salud (OMS) como SARS-CoV-2, causante de una nueva enfermedad COVID-19 declarada pandemia el 11 de marzo de 2020. Esto conlleva un reto para todos los sistemas sanitarios, incluyendo las unidades de quemados (UQ) alrededor del mundo, que se ven obligadas a modificar su estructura, logística de trabajo y funcionamiento con la finalidad de garantizar la atención y el cuidado de pacientes quemados, y a su vez participar en la contención de la pandemia. Los elementos más importantes a tomar en cuenta son la reconversión hospitalaria, que no excluye a las UQ, la atención primaria y la atención hospitalaria de los pacientes quemados, y el uso de la telemedicina como herramienta para optimizar la atención de estos enfermos. Es importante generar nuevos conocimientos a partir de las experiencias vividas y prepararnos para futuras situaciones similares.

Abstract: In December 2019, an outbreak of a new coronavirus begins in the city of Wuhan, capital of the province of Hubei, China, called by the World Health Organization (WHO) as SARS-CoV-2, causing a new disease, COVID-19 and declaring a pandemic on March 11, 2020. This entails a challenge for all health systems, including Burn Units (BU) around the world, which are forced to modify their work and operating structure and logistics, in order to guarantee the care of burned patients, and participate in the containment of the pandemic. The most important elements to take into account are hospital reconversion, which does not exclude BUs, primary care and hospital care for burned patients, and the use of telemedicine as a tool to optimize the care of these patients. It is important to generate new knowledge from lived experiences and prepare for future similar situations.

Resumo: Em dezembro de 2019, iniciou-se um surto de um novo coronavírus na cidade de Wuhan, capital da província de Hubei, na China, nomeado pela Organização Mundial da Saúde (OMS) como SARS-CoV-2, causando uma nova doença, COVID-19 e declarou uma pandemia em 11 de março de 2020. Isso representa um desafio para todos os sistemas de saúde, incluindo as Unidades de Queimados (UQ) de todo o mundo, que são obrigados a modificar sua estrutura e logística de trabalho e funcionamento, a fim de garantir o atendimento e atenção aos pacientes queimados, e por sua vez participar na contenção da pandemia. Os elementos mais importantes a serem levados em consideração são a reconversão hospitalar, que não exclui UQ, atenção primária e atenção hospitalar para pacientes queimados, e o uso da telemedicina como ferramenta para otimizar o atendimento a esses pacientes. É importante gerar novos conhecimentos a partir de experiências vividas e preparar-se para futuras situações semelhantes.

Analysis of self-assessment on the position competency of residents with completion of residency training in a certain hospital in Beijing / 国际外科学杂志

Objective:To analyze the results of self-assessment on the position competency of residents in a certain hospital, and to provide reference for improving the quality of training.Methods:From June 2021 to October 2021, a whole-group questionnaire survey was conducted among 224 residents who participated in the standardized training in Beijing Friendship Hospital, Capital Medical University. The questionnaire consists of general information questionnaire, position competency questionnaire. The position competency questionnaire contains eight dimensions. Measurement data were expressed as mean ± standard deviation ( ± s), t-test was used for comparison between two groups, and one-way analysis of variance was used for comparison between multiple groups. Results:The position competency score of residents was (3.94±1.07) points, among which the scores of interpersonal communication ability was the highest (4.42±0.68) points. The scores of scientific research ability [(3.26±1.30) points] was the lowest among the eight dimensions. There were statistically significant differences among residents of different genders in post competency, disease prevention and health promotion and interpersonal communication ability ( P<0.05). There were statistically significant differences in the scores of medical knowledge and lifelong learning ability and scientific research ability among residents with different identity ( P<0.05). There was statistical significance in the score of scientific research ability among residents with different educational backgrounds ( P<0.05). There were statistically significant differences in the scores of position competency, disease prevention and health promotion, interpersonal communication ability, medical knowledge and lifelong learning ability among residents of different majors ( P<0.05). Conclusions:The position competency of residents should be further improved. To guarantee the quality of training, it was suggested to establish a competence-oriented training mechanism, strengthen the construction of teachers′ training teams, enrich and innovate training contents and methods.

A New Look at Neurodevelopmental and Neuropsychological Outcome in Children with Congenital Heart Disease

New surgical techniques and advances in intensive care and medical treatment have significantly decreased mortality rates for children and adolescents with complex congenital heart disease (CHD). Survivors are at risk for neurodevelopmental and neuropsychological morbidity caused by both genetic and environmental risk factors, which causes a distinctive pattern of developmental and neuropsychology impairment characterized by mild cognitive impairment, executive functions impaired social interaction, and impairments in core communication skills, including pragmatic language, as well as attention, impulsive behavior, and impaired executive functions among children affected with congenital heart disease. In view of this, the present study reviews the neurodevelopmental and neuropsychological impairment with an objective of insisting the importance in developing and implementing a neuropsychological intervention program for children with congenital heart defect to retrain neuropsychological and neuro-developmental functions. With increased survival rates, the focus of clinical research in the pediatric cardiac population has paralleled the population shift and transitioned from short term surgical survival to the assessment of long- term morbidity

Executive dysfunction in idiopathic epilepsy: the journey so far

Epilepsy is one of the most common neurological disorders known to man with a high global prevalence. This disease process affects the overall quality of life. In recent times the concept of executive dysfunction in patients with epilepsy has emerged. This phenomenon has widespread therapeutic implications. This review hence aims to summarize our current understanding of the topic, highlighting the results of benchmark studies and outlining the aspects that require further research. The keywords epilepsy, executive dysfunction and cognitive retraining were used in the search engines of Pubmed and Google scholar and articles identified were extensively reviewed. The consensus of this review is that executive dysfunction is a phenomenon that occurs in patients with epilepsy irrespective of epilepsy type, however the magnitude varies with contributory factors which include poor seizure control. Furthermore, patients with cognitive dysfunction have a further decline over the course of the disease process, however longitudinal studies in regard to the same are lacking and there is a need for additional research in this regard.

Effect Of Motor Control Retraining Of Scapular Stabilizers Versus Mulligan Mobilisation With Movement In Shoulder Impingement Syndrome

Background: Shoulder Impingement is one of the most common causes of shoulder pain in adults. Scapular muscle imbalances results in impaired scapular orientation with altered scapular kinematics and altered glenohumeral rhythm. Purpose of study: To study the effect of motor control retraining of scapular stabilizers versus mulligan mobilisation with movement in shoulder impingement patients. Methodology: 60 patients with positive Hawkins, kinetic medial rotation and/or Neer impingement test were taken for the study as subjects. They were then divided into two groups of 30 each- Group A and Group B. Both the groups were assessed and reassessed for(i) pain status using VAS (Visual Analogue Scale) both at rest and on internal rotation, (ii)Shoulder Flexion, Extension, Shoulder Abduction, Adduction, Internal and External Rotation Range Of Motion (ROM), (iii)Functional Scale SPADI( Shoulder Pain and Disability Index) pre and post the intervention. Group A received motor control retraining of scapular stabilizers whereas group B received Mulligan’s mobilization with movement for 6 weeks (3 times in a week). Both the groups received conventional physiotherapy. Data analysis was done using Wilcoxon sign ranked test for intragroup comparison and Manwhitney test for intergroup comparison. Results: The results showed statistically significant improvement in shoulder pain, ROM and shoulder function in motor control retraining as compared to mulligan mobilisation with movement. Conclusion: Motor control retraining of scapular stabilizers is more effective treatment technique as compared to mulligan mobilisation with movement in shoulder impingement.

Effects of Gait Retraining on Impact Forces, Lower Limb Biomechanics and Leg Stiffness / 医用生物力学

Objective By establishing the intervention mode of 12-week gait retraining (GR) (with the specific aim of changing the habitual running gait), to determine the changes of vertical ground reaction force (vGRF), kinematics and dynamics of hip, knee, ankle joints, as well as stiffness of lower limbs in running before and after GR, and to explore the influence of running posture transformation on impact force and lower limb biomechanics. Methods Vicon motion capture system and Kistler 3D force measurement platform were used to collect the GRF and marker track of 30 runners (15 in experimental group and 15 in control group) before and after GR with the minimalist shoes at a speed of 12 km/h±5%. Results A total of 17 subjects (9 in experimental group and 8 in control group) completed the GR. After GR, the maximum loading rate of both groups decreased significantly, and the maximum loading rate of experimental group was lower than that of control group. The foot strike angle in experimental group decreased significantly after GR, and the plantarflexion angle and hip joint angular extension velocity increased in both groups. The force moment of ankle joint increased in experimental group, and the stiffness of lower limbs was significantly improved in both groups. Conclusions A 12-week GR exercise intervention model was successfully established, with 78% conversion rate (from rearfoot strike to forefoot strike). GR can effectively avoid the peak of impact force, reduce the maximum loading rate, increase the lower limb stiffness, and thus reduce or even avoid the risk of running injury caused by impact force and may provide a possibility for the improvement of running economy.

Effect of group attribution training combined with clozapine on negative symptoms and quality of life in refractory schizophrenia patients / 中华行为医学与脑科学杂志

Objective To investigate the effect of attributional retraining group therapy ( ARGT) combined with closabine on the negative symptoms and quality of life in refractory schizophrenia patients. Methods The refractory schizophrenia patients were divided into ARGT combined with clozapine therapy group(study group,n=56) and clozapine alone group(control group,n=54). The positive and negative syn-drome scale( PANSS) was used to assess the symptoms of all patients at baseline and 8 weeks later. The quality of life(QOL) of the patients was assessed by GQOLI-74 at baseline and 8 weeks after treatment. The side effects were evaluated by treatment emergent symptom scale(TESS) before and after treatment. SPSS18. 0 was used for statistical analysis. Results At baseline,there was no significant difference in PANSS score between the two groups. After 8 weeks,the total score of PANSS (79. 41±11. 64) and the score of negative symptoms (28. 68 ±2. 74) in the study group were lower that those of control group(83. 06±11. 58,30. 61± 2. 12),and the differences were statistically significant(t=7. 68,7. 10,both P<0. 05). The scores of positive symptoms,cognitive symptoms,emotional symptoms and aggression symptoms in the study group had no sta- tistical differences compared with the control group (all P>0. 05). There were no significant differences in the scores of material life,mental health,physical health and social function between the two groups at base-line (P>0. 05). After 8 weeks,the total score of GQOLI- 74 (206. 37±14. 37),material life score (48. 69± 6. 35),body health score ( 52. 83± 7. 32),mental health score ( 51. 66 ± 4. 63) and social function score (53. 62± 6. 17) of the study group were higher than those of control group((182. 00± 12. 56),( 44. 62± 6. 11),(48. 52±5. 52),(45. 26±4. 66),(46. 18±5. 32))(t=4. 67,5. 26,3. 26,4. 92,3. 25,all P<0. 05). There was no significant difference in TESS score between the two groups(P<0. 05). Conclusion ARGT combined with clozapine can improve the negative symptoms and the quality of life of patients with refractory schizophrenia.

Why did You Choose not to be a Generalist? A Qualitative Study About Career Decision-Making Among Physicians who were Interested in General Practice but Chose to be a Specialist / 日本プライマリ・ケア連合学会誌

Background: There is an increasing demand for general practitioners capable of examining patients from a broad perspective. Although the training of such doctors is urgently needed, the accreditation system was only recently put into place.Purpose: Our aim was to identify factors that influence career decision-making among doctors who were interested in general practice but chose to be specialists, in addition to finding methods to improve general practitioner training in the future.Method: From April 2017 to April 2018, we conducted semi-structured interviews with five subjects to understand the process leading up to the selection of their current careers. The verbatim records were analyzed using the modified grounded theory approach.Results: The reasons given for choosing specialist careers included "attraction as a field of study", "being relied upon by other doctors", and "the sense of security from having a specialty". Cited barriers to entering general practice included "uncertainty about the future" and "criticism from specialists".Conclusion: Improving the training curriculum for general practitioners will require improvement of the quality of community-based medical education and the general practice board certification system, in addition to the implementation of general practice retraining for specialists.

Standardized training system for oral and maxillofacial radiology specialist in the United States / 中华口腔医学杂志

Oral and maxillofacial radiology (OMR) in the United States is one of the nine dental specialties recognized by the American Dental Association (ADA). It has a nearly 100-year history of development and has also established a complete set of specialist training system. Staffing, base facilities, financial status, timing of training courses, contents, plans, and goals to be achieved are all clearly defined. All training centers need to undergo regular assessments every seven years with the ADA's Commission on Dental Accreditation (CODA). After graduation, the specialist graduates can be engaged in the clinical teaching and scientific research of radiological diagnosis in universities or general hospitals. They also have the option to open their own business by setting up imaging diagnostic centers or being specialized in tele-radiology to provide imaging diagnosis or consultation report to clinicians in other disciplines, or even assisting in the development of treatment planning for dental implants and orthodontic procedures. Of course, stomatology and OMR education systems are different in China and the United States due to different national conditions. Although the experience in the United States cannot be completely copied, many concepts, standards and goals of OMR specialty training there have been practiced and improved for a long period of time and are worth learning by the Chinese OMR counterparts or relevant agencies.

Fisioterapia no paciente com asma: intervenção baseada em evidências / Physiotherapy in asthma patients: evidence-based intervention

As intervenções fisioterapêuticas destacam-se como tratamento não farmacológico e são coadjuvantes no tratamento da asma. O tratamento fisioterapêutico só deve ser iniciado quando o indivíduo estiver com a medicação ajustada para sua condição e em acompanhamento médico regular. Como a asma é uma doença crônica com episódios recorrentes de sibilância, tosse e dispneia, ocorre aumento do trabalho respiratório e da percepção do esforço, podendo levar a alterações da mecânica respiratória, função muscular respiratória e do descondicionamento físico. Os objetivos da fisioterapia são: reduzir o desconforto respiratório e a dispneia, melhorar a mecânica respiratória, melhorar a força muscular respiratória nos casos de fraqueza desta musculatura, melhorar o condicionamento cardiorrespiratório, promover higiene brônquica, quando necessária, e melhorar a qualidade de vida. Estudos prévios investigaram os efeitos dos exercícios respiratórios, do treinamento muscular respiratório (TMR), da reabilitação pulmonar (RP) e das técnicas de higiene brônquica em pacientes asmáticos. Não há evidências de que os exercícios respiratórios melhorem a função pulmonar, embora reduzam os sintomas e a medicação de resgate e melhorem a qualidade de vida. O TMR diminui a dispneia, aumenta a força muscular inspiratória e melhora a capacidade de exercício. O treinamento físico, que é o principal componente da RP, leva à melhora dos sintomas respiratórios, da capacidade funcional e qualidade de vida. Por fim, não há evidências científicas que suportem a realização de técnicas manuais de higiene brônquica. No entanto, o oscilador oral de alta frequência pode ser uma estratégia para eliminar secreção de adultos e crianças na vigência de infecção pulmonar.

Respiratory physiotherapy stands out as a nonpharmacological approach and is an adjuvant intervention in the treatment of asthma. Physiotherapy should only be initiated when the medication is adjusted to the patient's condition and when the patient is under regular medical follow-up. Asthma is a chronic disease with recurrent episodes of wheezing, cough, and dyspnea, resulting in increased respiratory workload and perceived exertion and potentially leading to changes in respiratory mechanics, respiratory muscle function, and physical deconditioning. The objectives of respiratory physiotherapy are: to reduce respiratory distress and dyspnea, to improve respiratory mechanics and respiratory muscle strength (in cases of muscle weakness), to improve cardiopulmonary conditioning, to promote bronchial hygiene when necessary, and to improve quality of life. Previous studies have investigated the effects of breathing exercises, respiratory muscle training (RMT), pulmonary rehabilitation (PR), and bronchial hygiene techniques in patients with asthma. There is no evidence that breathing exercises can improve lung function, even though they reduce symptoms and the use of rescue medication and improve quality of life. RMT reduces dyspnea, increases inspiratory muscle strength, and improves exercise capacity. Physical training, the main component of PR, leads to improvement of respiratory symptoms, functional capacity, and quality of life. Finally, there is no scientific evidence supporting the use of manual bronchial hygiene techniques. Nevertheless, the use of oral high-frequency oscillators could be a strategy for mucus clearance in adults and children with pulmonary infection.

Effects of sertraline combined with attribution retraining in post-stroke depression and recovery of nerve function / 中国神经精神疾病杂志

Objective To explore the effects of sertraline combined with attribution retraining in post-stroke depression and recovery of neurological function.Methods A total of seventy-eight patients with post-stroke depression were randomly divided into research group and control group.The research group was treated by sertraline combined with attribution retraining and the control group was treated by sertraline only for 8 weeks.Depressive symptoms were assessed using the Hamilton Depression Rating Scale (HAMD) and recovery of neurological functions using the National Institute of Health Stroke Scale (NIHSS) at baseline and at the end of the 24,44,64 and 84 week.Results Repeated measure ANOVA for the total scores of HAMD showed that the main effect of time,the main effect of group and the interactive effect of time and group were significant (P＜0.05).Total scores of HAMD in the research group were significantly lower than those in the control group at the end of the 2nd,44,64 and 84 week [(18.25±4.27) vs.(20.81±4.63),(15.94±3.47)vs.(18.12±4.51),(12.85±3.12) vs.(16.54±3.70),(10.42±3.66) vs.(13.09±3.59),P＜0.05].HAMD Total scores in two groups were showed significantly decreased on each time point after treatment (P＜0.01).Effective rates (using reduction rate of HAMD total scores as evaluation) were more significant in the research group than those in the control group at the end of the 8th week (77.5％ vs.52.6％,P＜0.05).The repeated measure ANOVA showed that the main effect of time in NIHSS total scores was significant (P＜0.01).The main effect of group and the interactive effect of time and group in NIHSS total scores were not significant (P＞0.05).Total scores of NIHSS in two groups significantly decreased on each time point after treatment (P＜0.01).Conclusions Sertraline combined with attribution retraining can significantly relieve post-stroke depression and attribution training does not have obvious effects on the recovery of neurological function.

Exploration and Practice of Improving Community Pharmaceutical Care / 中国药房

OBJECTIVE:To improve community pharmaceutical care so as to promote the rational drug use of community resi-dent and improve the quality of life. METHODS:By analyzing the situation of community pharmaceutical care,the pharmaceutical care of community pharmacists was improved by changing pharmaceutical care mode,actively developing the propaganda of ratio-nal drug use,strengthening retraining of clinical pharmacists. RESULTS:With the help of Hongkou district quality control group, many hospitals of the district signed thepharmaceutical linkage assistance agreement. Through the efforts of Hongkou district quality control group and many hospitals,community pharmaceutical care was improved and the propaganda of rational drug use has achieved certain results. CONCLUSIONS:Through exploration and practice,the pharmaceutical care levels of community phar-macists have been improved and the rational drug use of community residents has been promoted.

The Effect of Different Counselors on Treatment Outcome of Tinnitus Retraining Therapy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tinnitus retraining therapy (TRT) is one of the most effective treatment modalities of tinnitus based on the neurophysiological model proposed by Jastreboff and Hazell. This study was performed to evaluate the effect of counselor factor on treatment outcomes of TRT. SUBJECTS AND METHOD: The total of 78 patients who had TRT from three different counselors in a tinnitus clinic of tertiary referral center from Jan 2015 to Dec 2015 were included in this study. Their medical records were retrospectively reviewed to evaluate the therapeutic response to TRT. RESULTS: Among 78 patients who were followed-up for more than 6 months, 47, 20, and 11 patients were treated by counselors A, B, C (all ENT specialists), respectively. Counselor A had 15-year-experience of TRT counseling, whereas counselor B and C were well trained but beginners of TRT counseling. Initial clinical characteristics including Tinnitus Handicap Inventory (THI) and tinnitus Visual Analogue Scale (VAS) scores of the patients among three groups were not significantly different. Treatment responses evaluated via THI and most of the tinnitus VAS scores after at least 6 months after TRT were significantly improved in all three groups (p<0.05) with no significant difference between the senior (A) and junior (B, C) group. CONCLUSION: TRT seems to be an effective treatment modality of tinnitus even in this short term follow-up study. Treatment outcomes of TRT may not depend on the counselors once they are well trained and follow the same protocol.

Investigation of the present situation and demand of nurses training in the different level hospitals of a suburb / 中国基层医药

[Abstract ] Objective To investigate the present situation and demand of nurses training in the different level hospitals of a suburb,so as to provide reference to the building of nursing team.Methods Stratified random sampling was taken in 764 nurses in 20 different level hospitals of a suburb of Beijing.Results In recent 3 years, 31.9% of nurses went out to short -term training and 15.58% of nurses went out to further study for a longer time. The continuous education scores came mainly from own hospital(88.22%),suburb training center(77.75%)and networks(42.54%).About training needs,over half of nurses chose training inside themselves areas,58.38% of nurses chose special short duration training,53.66% of nurses chose further study,48.04% of nurses chose WeChat network platform.About the training content,the first need of training for nursing administrators was nursing safety management (4.65 ±0.54)points,the first need of training for clinical nurses was emergency techniques training (4.41 ±0.69)points.89.14% of nurses would like to have two -way feedback.Conclusion The present situation of nurses training should be improved.Integrating resources and flexible and multiple training methods should be adopted to satisfy nurses training demand.

The course of development, present situation and policy trends of neonatal resuscitation program / 中国实用护理杂志

The neonatal resuscitation program consisted of three stages:pilot promotion, provinces promotion and grass-roots promotion in China. Neonatal resuscitation was easy to learn, training forms were various, the duration was different. There were regional differences in the pass rate of examination and standard recovery rate. The neonatal resuscitation training rate, the system execution rate and the equipment rate in primary hospitals was lower than secondary hospitals and tertiary hospitals. The primary hospitals would be the key link of the neonatal resuscitation program. We suggested to build neonatal resuscitation training and treatment system.

Tinnitus Retraining Therapy / 한양의대학술지

According to the Jastreboff's neurophysiological model of tinnitus, if negative associations are attached to the tinnitus signal, tinnitus is perceived to be a threat or a danger and it activates the autonomic nervous and limbic systems. Consequently patient's awareness of tinnitus is heightened and so patient perceives it to be louder and more persistent. Jastreboff and Hazell started tinnitus retraining therapy (TRT) based on the neurophysiological model of tinnitus. The purpose of TRT is blocking tinnitus from activating the sympathetic nervous and limbic systems (habituation of reaction) and from reaching the cerebral cortex (habituation of perception). TRT is composed of two components directive counseling that tries to reclassify tinnitus into the meaningless stimuli and sound therapy that decreases the relative strength of the tinnitus signal. Physicians try to put patient's tinnitus into the territory of meaningless stimuli through retraining the brain (habituation of reaction). Because the brain habituates all unimportant stimuli, if habituation of reaction is fully achieved, habituation of perception will follow automatically. In most clinical results, clinical success rates of TRT approach or exceed 80% improvement. Early improvement can be achieved during the first few months, followed by additional progressive improvement. It should be recommended that the patient continue treatment at least 18 months.

Simulation-based learning combined with debriefing in neonatal resuscitation training / 中华围产医学杂志

ObjectiveTo explore and analyze the effect of simulation-based learning combined with debriefing in neonatal resuscitation training.MethodsA total of 114 clinical medical staffs attended the neonatal resuscitation training course hold by Department of Neonatology, Quzhou Maternal and Child Health Hospital from November 2014 to May 2015, and were randomly assigned to observation (n=60) and control group (n=84) by coin tossing. Staffs in the observation group adopted to training skills with simulation-based learning combined with debriefing,while those in the control group were educated with traditional method. The examinations on theoretical knowledge were taken before and after the training. Operational exam and self-confident questionnaire for all staffs on each procedure taught in the course were taken at last. Scores of the exams and self-confident questionnaire were compared between the two groups witht-test and Mann-WhitneyU test.ResultsThe mean score of theoretical test rose up significantly after the training in both observation and control group (25.19±2.62 vs 20.17±3.71,t=7.725,P<0.01; 25.44±2.64 vs 18.90±4.27,t=11.170,P<0.01), but no difference was found in this score after the training between the two groups (t=0.492,P=0.624). The practical operation examination score in the observation group was higher than that in the control (34.05±1.34 vs 31.32±4.10,t=4.183,P<0.01). All questionnaires sent to the staffs were retrieved (100%), and the total values after the training in the observation group were higher than in the control (mean rank: 92.81 vs 57.99; rank sum:5 569 vs 4 872,Z=-4.96,P<0.01).ConclusionsSimulation-based learning combined with debriefing is a much more effective teaching methods for neonatal resuscitation training, which might quickly improve the resuscitation skills of clinical staffs.