Interactive Atlas of the Canine Brain, Heart and Kidney Created from Plastinated Samples

SUMMARY: Currently, training in the field of anatomy requires the implementation of learning and knowledge technologies (TAC). Therefore, the objective of this work was to use digital images taken of plastinated canine brains, hearts, and kidneys to create an interactive atlas that facilitates the teaching-learning of the anatomy of these organs. The research was carried out in 3 phases. In the first, canine brains, hearts and kidneys were obtained using the cold-temperature silicone plastination. In the second stage, photographs were taken, the images were edited with Adobe Photoshop and converted to SVG format using Adobe Illustrator. During the last phase, the 2D atlas was created using MongoDB and Node.js for the backend and Vue.js as the framework for the frontend. In addition, it was used three.js to render the 3D models. As a result, the 'Interactive Canine Atlas', ATINCA, was created. The atlas comprises 27 interactive images and 27 in atlas mode view (28 of the brain, 20 of the heart, and 6 of the kidney). Furthermore, the atlas features 3D models of the three organs. The developed atlas constitutes the first digital tool created in Ecuador based on local institutional needs, including a 3D format. Consequently, ATINCA will be integrated into the curricula as a digital material that will facilitate significant autonomous and collaborative learning of canine anatomical knowledge.

Actualmente, la formación en el campo de la anatomía requiere la implementación de tecnologías del aprendizaje y el conocimiento (TAC). Por ello, el objetivo del trabajo fue utilizar imágenes digitales tomadas de cerebros, corazones y riñones caninos plastinados para crear un atlas interactivo que facilite la enseñanza-aprendizaje de la anatomía de estos órganos. La investigación se llevó a cabo en tres fases. En la primera se obtuvieron cerebros, corazones y riñones caninos mediante la técnica de plastinación con silicona al frío. En la segunda etapa se tomaron fotografías, las imágenes se editaron con Adobe Photoshop y se convirtieron a formato SVG con Adobe Illustrator. Durante la última fase, se creó el atlas 2D usando MongoDB y Node.js para el backend y Vue.js como framework para el frontend. Además, se utilizó three.js para renderizar los modelos 3D. Como resultado se creó el Atlas Interactivo del Canino, ATINCA. El atlas cuenta con 27 imágenes interactivas y 27 en vista modo atlas (28 del cerebro, 20 del corazón y 6 del riñón). Además, el atlas presenta modelos 3D de los tres órganos. El atlas desarrollado constituye la primera herramienta digital creada en el Ecuador con base en necesidades institucionales locales y donde se incluye el formato 3D. Con lo cual, ATINCA podrá incorporarse en las mallas curriculares como material digital que facilitará el aprendizaje autónomo y colaborativo significativo de conocimientos anatómicos de los órganos caninos.

Preliminary construction of a measurement tool for atrial fibrillation patient's experience of catheter ablation / 复旦学报（医学版）

Objective To construct a measurement tool for atrial fibrillation(AF)patients'experience of catheter ablation,in order to provide quantifiable basis for improving the patients'perioperative experience.Methods From Jun 2022 to Apr 2023,literature analysis,qualitative research,Delphi expert consultation,and analytic hierarchy process were used to determine the content and weight of various indicators of the measurement tool.Results The enthusiasm of experts in 3 rounds was 100%.The authority coefficient of experts was 0.946,0.961 and 0.976.The Kendal harmony coefficients of the 2 and 3 rounds of expert consultation was 0.130 and 0.370(P＜0.001).The final measurement tool included 46 items and 5 dimensions,including operational and technical quality experience,comfort management experience,information and communication experience,emotional support experience,service process and response experience.Conclusion The preliminary construction of measurement tool for AF patients'experience of catheter ablation,which were based on the features of specialty,could not only evaluate the patients'experience accurately,but also provide a basis for targeted improvement of medical and nursing service quality.

Effects of multiple shared decision-making mode on the mode of delivery for pregnancies with scarred uterus / 实用医学杂志

Objective To explore the effects of the multiple shared decision-making mode using a decision aid manual in conjunction with online labor and delivery decision support on the delivery mode for pregnant women with a scarred uterus.Methods A total of 94 women with scarred uterus who received prenatal care at a tertiary hospital from September 2019 to October 2022 were enrolled and assigned to experimental and control groups using the random number table method.The control group received standard prenatal education,and the experimental group received multiple shared decision-making interventions in addition to standard prenatal education.The degree of conflict in decision-making for delivery,preference for delivery mode,postpartum decision regret,and the final delivery mode between the two groups were compared,respectively.Results Following the multiple shared deci-sion intervention,decision conflict scores in the experimental group were significantly reduced(P<0.001).In the survey on delivery mode preferences,there was a reduction in the number of individuals in the experimental group expressing"uncertainty",and an increase in those choosing vaginal delivery.Ultimately,in the experimental group,30 women(68.2%)underwent cesarean sections,and 14(31.8%)had vaginal deliveries.The level of post-decision regret in the experimental group was lower than that in the control group(P<0.001).Conclusions Multiple shared decision-making for women pregnant with a scarred uterus could reduce the level of decision-making conflict,increase the willingness for vaginal delivery,and assist them in making rational and scientifically informed decisions regarding childbirth.

Machine learning to analyze risk factors for postoperative failure of proximal humeral fractures with medial column instability / 中国组织工程研究

BACKGROUND:Internal fixation and open reduction with locking plate is the main treatment for proximal humeral fractures with medial column instability.However,reduction failure is one of the main postoperative complications,and accurate risk factor assessment is beneficial for screening high-risk patients and clinical decision selection. OBJECTIVE:To construct four types of prediction models by different machine learning algorithms,compare the optimal model to analyze and sort the risk variables according to their weight scores on the impact of outcome,and explore their significance in guiding clinical diagnosis and treatment. METHODS:262 patients with proximal humeral fractures with medial column instability,aged(60.6±10.2)years,admitted to Foshan Hospital of Traditional Chinese Medicine between June 2012 and June 2022 were included.All patients underwent open reduction with locking plate surgery.According to the occurrence of reduction failure at 5-month follow-up,the patients were divided into a reduction failure group(n=64)and a reduction maintenance group(n=198).Clinical data of patients were collected,and model variables and their classification were determined.The data set was randomly divided into a training set and a test set according to a 7:3 ratio,and the optimal hyperparameters were obtained in the training set according to a 5-fold cross-over test.Four machine learning prediction models of logistic regression,random forest,support vector machine,and XGBoost were constructed,and the performance of different algorithms was observed in the test set using AUC,correctness,sensitivity,specificity,and F1 scores,so as to comprehensively evaluate the prediction performance of the models.The best-performing model was evaluated using SHAP to assess important risk variables and to evaluate its clinical guidance implications. RESULTS AND CONCLUSION:(1)There were significant differences between the two groups in deltoid tuberosity index,fracture type,fracture end with varus deformity before operation,fragment length of inferior metaphyseal of humerus,postoperative reduction,cortical support of medial column of proximal humerus,and insertion of calcar screw(P<0.05).(2)The best-combined performance of the four machine models was XGBoost.The AUC,accuracy,and F1 scores were 0.885,0.885,and 0.743,respectively;followed by random forest and support vector machine,with both models performing at approximately equal levels.Logistic regression had the worst combined performance.The SHAP interpretation tool was used in the optimal model and results showed that deltoid tuberosity index,medial humeral column cortical support,fracture type,fracture reduction quality,and the status of the calcar screw were important influencing fators for postoperative fracture reduction failure.(3)The accuracy of using machine learning to analyze clinical problems is superior to that of traditional logistic regression analysis methods.When dealing with high-dimensional data,the machine learning approach can solve multivariate interaction and covariance problems well.The SHAP interpretation tool can not only clarify the importance of individual variables but also obtain detailed information on the impact of dummy variables in each variable on the outcome.

Analysis of Anti-tumor Innovative Drug Policy Text Based on Policy Tools in China / 医药导报

Objective By analyzing the anti-tumor innovative drug policies text in China,this study aimed to explore the focus and shortcomings of policies related to anti-tumor innovative drugs,and provide the reference for future policy formula-tion and optimization in the field of anti-tumor innovative drug.Methods By accessing the official websites of relevant minis-tries and subordinate institutions such as the Central Committee of the Communist Party of China,the State Council of the People's Republic of China,the National Health Commission of the People's Republic of China,and National Medical Products Administra-tion,and using the keywords"cancer","tumor","anti-tumor drug",and"innovative drug",etc,the national level policies related to the anti-tumor innovative drugs from January 1,2005,to December 31,2022,were collected.Based on a two-dimensional analy-sis framework of policy tools and stakeholders,the collected policy texts were classified,encoded,and statistically analyzed.Results A total of 30 policy texts were involved,and a total of 90 policy codes were generated.There were 24,43,and 23 codes for demand-based policy tools,environmental policy tools,and supply-based policy tools,accounting for 26.67%,47.78%,and 25.56%,respectively.Based on policy tools and stakeholders,a total of 183 codes were generated,with government departments,pharmaceutical enterprises,medical institutions,and patients having 70,36,54,and 23 codes respectively,accounting for 38.25%,19.67%,29.51%,and 12.57%.Conclusions China had the highest proportion of environmental policy tools in the application of innovative anti-tumor drug policies,while supply-oriented and demand-oriented policy tools were underutilized,resulting in an overall imbalance in application;The distribution pattern of stakeholders was not coordinated,with government departments and medical institutions having higher attention than pharmaceutical enterprises and patients..It was necessary to reasonably promote the collaborative application of anti-tumor innovative drug policy tools,scientifically plan the layout of anti-tumor innovative drug policy sub-tools,and balance the interests of all stakeholders to ensure the efficient implementation of the policies.

The introduction of Theoretical Comparison and Selection Tools and its application in the field of nursing care / 中华护理杂志

Scientific and rigorous selection of theories,models or frameworks is the premise of high-quality nursing research.This work introduces the development process,basic information,application in nursing of T-CaST(Theory Comparison and Selection Tool,T-CaST),and shows the specific application process of this tool through examples,to provide evaluation methods for nursing scholars to choose appropriate guiding theories in the research process,and has guiding significance for developing high-quality nursing research under the guidance of theories,models or frameworks.

Correlation of serum 25-(OH)D3, albumin, ferritin with STAMP score and their predictive value for clinical outcome of preschool children with malnutrition / 中国儿童保健杂志

【Objective】 To investigate the correlation of serum 25-hydroxyvitamin D3 [25-(OH)D3], albumin (ALB) and ferritin (SF) with Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) score in preschool children with malnutrition, and to analyze the predictive value of these factors on clinical outcomes, so as to provide reference for improving clinical outcomes. 【Methods】 Totally 90 preschoolers with malnutrition in Fuzhou Children′s Hospital from August 2021 to August 2022 were selected as the observation group, and 60 healthy preschool children during the same period were selected as the control group. Nutritional guidance was provided to the preschoolers for a consecutive 3-month period, followed by monitoring and recording the incidence of malnutrition and iron deficiency anemia within 3 months after treatment. 【Results】 The levels of serum 25-(OH)D3, ALB and SF were lower in the observation group compared to the control group, while the STAMP score was higher in the observation group (t=9.700, 6.047, 4.771, 26.976, P<0.05). The levels of serum 25-(OH)D3, ALB and SF in preschool children with malnutrition showed a negative correlation with the STAMP score (r=-0.813, -0.792, -0.829, P < 0.05). After 3 months of treatment, the levels of serum 25-(OH)D3, ALB and SF, as well as the difference between pre- and post-treatment levels, were lower in children with adverse clinical outcomes compared to those with good clinical outcomes (t=3.622, 2.189, 2.163, 8.704, 4.354, 5.296, P< 0.05). When the difference in serum 25-(OH)D3, ALB and SF before and after treatment was small, preschool children with malnutrition had a higher risk of adverse clinical outcomes [25-(OH)D3:OR=7.250, 95%CI: 3.008 - 17.476; ALB: OR=9.167, 95%CI: 2.954 - 28.444; SF: OR=5.730, 95%CI: 2.364 - 13.890]. The combined predictive value of serum 25-(OH)D3, ALB and SF before and after treatment had an AUC value of 0.927, higher than that of any single index. The decision curve analysis (DCA) showed that the combined prediction scheme of these factors had a clinical net benefit in predicting the clinical outcome of preschool children with malnutrition. 【Conclusions】 Low serum levels of 25-(OH)D3, ALB and SF are indicative of a higher risk of adverse clinical outcomes. Utilizing the combined prediction of these factors before and after treatment shows high accuracy in predicting clinical outcomes.

Correlation analysis of electronic screen use and myopia among primary and secondary school students in six provinces and cities of China / 中国学校卫生

Objective@#To study the correlation between electronic screen use and myopia among primary and secondary school students in six provinces and cities in China, in order to provide a scientific basis for comprehensive prevention and control of myopia.@*Methods@#From November 2020 to June 2022, a total of 16 557 primary and secondary school students from six provinces and cities in China (Beijing City, Liaoning Province, Zhejiang Province, Henan Province, Shaanxi Province, Chongqing City) were selected by stratified cluster random sampling and probability smampling methods, and a questionnaire prepared by Beijing Center for Disease Control and Prevention was used to investigate their electronic screen use. According to Screening Criteria for Myopia in Children and Adolescents, 0.5% mass concentration of compound topicamide eye drops was used to paralyze the ciliary muscle and undergo slit lamp optometry. Chisquare test was used to compare the differences between groups, and binary Logistic regression was used to analyze the association between electronic screen use and myopia.@*Results@#About 58.3% of primary and secondary school students used electronic screens for more than two hours a day on average, and 63.4% of primary and secondary school students used continuously electronic products for more than 15 minutes at a time for nonstudy purposes. After adjusting for confounding factors, parents unrestricted use of electronic screen time and electronic screen time ≥2 h/d were positively correlated with myopia (OR=1.27, 1.13, P<0.05). Gender stratified analysis showed that boys who used electronic screen time ≥2 h/d had a higher risk of myopia (OR=1.15, P<0.05). The results of grade stratification analysis showed that parents unrestricted electronic screen use time and electronic screen time ≥2 h/d were positively correlated with myopia in the lower grade of primary school students (OR=1.34, 1.18, P<0.05). Among the higher grade of primary school students, continuous use of electronic screens for nonstudy purposes for more than 15 minutes at one time was positively correlated with myopia (OR=1.18, P<0.05). There was a multiplicative interaction between total screen time and one continuous screen time (OR=1.04, P<0.05).@*Conclusions@#Primary and secondary students in six provinces and cities in China reports excessive electronic screen usage which is associated with myopia. Schools and parents should jointly limit the use of electronic screen among primary and secondary students to reduce the occurrence of myopia.

Research progress on food literacy assessment tools for children and adolescents / 中国学校卫生

Abstract@#As dietary issues of children and adolescents become increasingly complex, the assessment of food literacy (FL) is increasingly importance. FL involves a comprehensive cognition and practical ability concerning food among children, playing a key role in fostering healthy eating habits and improving health levels. The article explores the definition and connotations of FL, and introduces eight FL assessment tools in terms of theoretical foundations, dimensions, assessment methods, and their reliability and validity. Moreover, it provides a comparative analysis of these tools by examining their dimensional design, evaluation indicators, strengths, and weaknesses, as well as their applicable subjects and scenarios, aiming to offer references for implementing relevant policies and developing more comprehensive and effective FL assessment tools.

Impact of social media on adolescent suicide and countermeasures / 中国学校卫生

Abstract@#In recent years, much attention has been paid on possible impact of social media on adolescents suicidal and selfinjurious behaviors, and their relationship and mechanism of action which would be clarified are crucial for suicide prevention work of adolescents. The review mainly summarizes the conceptualization of social media and suicide/selfinjurious behaviors, as well as the directions and mechanisms of their associations. It points out further steps to prevent suicide for those internet aborigines among adolescents, aiming to provide a theoretical basis and practical direction for future suicide prevention work.

Using an anatomic model to teach female stress incontinence to gynecologic residents‑in‑training: A prospective cohort study / Philippine Journal of Obstetrics and Gynecology

Background@#Stress urinary incontinence (SUI) is a complex condition with a multifactorial etiology that makes its concepts challenging to teach. This study aimed to assess the efficacy of simulation-based training (SBT) with an anatomic teaching model in improving the understanding of SUI among gynecologic residents-in-training. @*Objective@#The primary objective of this study was to evaluate the efficacy of SUI simulation-based teaching in enhancing the learning experience for gynecologic residents-in-training. The secondary objective was to gather feedback from participants with the intent to further enhance existing teaching methodologies.@*Materials and Methods@#This was a descriptive prospective study within a single institution, involving gynecologic residents-in-training. Participants were given an anatomic teaching tool to construct, followed by an SUI lecture. Pre- and posttest Multiple Choice Questions were administered to assess the efficacy of the teaching tool in improving the participants’ understanding of SUI. Frequency and percentages were used to describe the categorical variables, whereas continuous variables were described using mean and standard deviation. Paired t-test was used to compare the pre- and posttest scores. ANOVA was used to compare the pre- and posttest scores of participants by year level. A P < 0.05 is statistically significant. A separate Likert-scale questionnaire, to evaluate changes in participant’s self-assessment on learning, response to teaching content and resources, and overall feedback of the SBT was used.@*Results@#There were 50 gynecologic residents-in-training that were included in the study. The mean posttest score is significantly higher (6.4 vs. 3.48) than the pretest score, with a mean difference of 3.48. The mean posttest score is significantly different between the year levels with a P < 0.05, with senior residents-in-training performing best. Although participants with only gynecologic conferences as SUI reference performed best, the mean pre- and posttest scores were not statistically different with respect to SUI education exposure. With the use of an anatomic SUI model, the number of correct answers for questions pertaining to anatomy, physiology, and pathophysiology was consistently higher in the posttest scores as compared to the pretest scores but did not reach statistical significance. The majority of participants strongly agree to recommend the course to a colleague.@*Conclusion@#This study supports the use of simple, low-fidelity physical teaching tools in improving the understanding of SUI in gynecologic residents-in-training. Considering the ease of production, improved test scores, and participants’ enthusiasm, the incorporation of the anatomic teaching tool for its use in SUI education should be encouraged.

Developing a prenatal health literacy tool for Filipino women

@#Pregnancy is a critical period in every woman's life. The health of both the mother and her unborn child is at stake, with poor access to needed prenatal care services. Obtaining prenatal care is affected by the pregnancy literacy of the expectant mother. However, the assessment tool for health literacy among Filipino pregnant women is limited. This paper aimed to examine existing maternal health literacy instruments. Hopefully, an adopted tool can be found for assessing prenatal health literacy. After examining existing maternal health literacy tools, 18 questions were suggested that can be further modified before they are used for Filipino pregnant women to assess their prenatal health literacy.

Validity and reliability of a localized nursing assessment guide for symptoms of anxiety and depression among admitted adult cardiac Filipino patients

@#One of the most commonly used tools by clinicians to identify cases of anxiety and depression in medically ill patients is the Hospital Anxiety and Depression Scale, or the HADS Filipino version. However, there were some “gray areas” with its use, particularly for those who are in the non-psychiatric setting. Some translated items may pertain to something else which could influence patients' responses. Furthermore, local studies showed differences in the conception, understanding, and expression of depression unique to Filipino culture and could be potentially missed during the assessment. This paper determined the validity and reliability of the Anxiety and Depression Symptom Assessment Guide or ADSAto a sample of 91 adult cardiac Filipino patients in the in-patient setting.@*@#In addition to the 29-item ADSAtool that was generated from HADS, the review of literature and other sources was also reviewed by experts from two rounds of Delphi Survey. It was written in a yes-or-no format and available in both English and Filipino versions. The tool was tested for internal consistency, intra-class and inter-item reliability. Another test used was criterion-based validity utilizing HADS to identify cases of anxiety and depression. The results showed that ADSAis highly reliable with Cronbach's alpha of 0.97, poor-to-moderate intra-class correlation (0.670 for anxiety, 0.440 for depression), and consistent/acceptable interitem correlation (0.528 for anxiety, 0.382). Both HADS and ADSAwere positively correlated with correlation coefficients of 0.667 and 0.391 (p-value<0.5) for anxiety and depression respectively. Using a cut-off score of 5, ADSA has moderate sensitivity and specificity of 72.5% and 78.4% for anxiety, and 66.7% and 64.3% for depression. Further research is needed to strengthen ADSA's validity by increasing the sample size and the multi-center sites.

Usefulness of the STarT Back Screening Tool to Predict the Effect of Acupuncture Treatment: Evaluation of Its Risk Classification Focusing on the Changes in the Lumbar Pain Visual Analog Scale / 日本温泉気候物理医学会雑誌

  Background: The STarT (Subgrouping for Targeted Treatment) Back Screening Tool (SBST) is an established clinical evaluation tool that easily assesses the risk of chronic or refractory low back pain. This study aimed to examine the usefulness of acupuncture in patients with low back pain.  Methods: A total of 71 outpatients with low back pain who underwent acupuncture and moxibustion at the Center for Integrative Medicine, Tsukuba University of Technology, between 2019 and 2022 were included in this study, regardless of the specific medical condition causing the pain. Survey items included the SBST and lumbar pain intensity visual analog scale (VAS). Demographic factors and contents of acupuncture treatment were collected from the medical charts. The VAS score 4 weeks after the start of treatment was used as an index of clinical outcome and was analyzed using repeated measures analysis of variance (ANOVA) and hierarchical multiple regression analysis.   Results: Classification using the SBST at the first visit resulted in 36, 30, and 15 patients in the low-, medium-, and high-risk groups, respectively. Repeated-measures ANOVA showed statistically significant differences in the mean VAS values with respect to differences in time point (P < 0.01), group (P < 0.01), and interaction (P < 0.05). The VAS values after 4 weeks in the high-risk group were significantly higher than those in the other two groups (both P < 0.01). In the hierarchical multiple regression analysis, with VAS as the dependent variable, the relationship between SBST classification and VAS maintained a significant positive relationship in all models, including adjustments for interaction terms and patients’ background items. A simple slope analysis indicated that this relationship was more evident in patients with lower limb symptoms than in those without symptoms.  Conclusion: The SBST could be a simple and useful tool for predicting the clinical outcomes of acupuncture.

Research on content and psychometric properties of evaluations of functioning and adaptive behaviors in children with intellectual and developmental disabilities in educational settings using ICF / 中国康复理论与实践

Objective To explore the content and the psychometric properties of assessment tools used for evaluating functioning and adaptive behavior in school-age children with intellectual and developmental disabilities within educational settings. Methods The most used assessment tools included Vineland Adaptive Behavior Scales(VABS),Supports Intensity Scale for Children(SIS-C),Strengths and Difficulties Questionnaire(SDQ)and Repetitive Behavior Scale-Revised(RBS-R),for assessing functioning and adaptive behavior children with intellectual and developmental disabili-ties.Employing the framework and methods of the International Classification of Functioning,Disability,and Health(ICF),this research encoded and categorized the assessment dimensions and items of the four tools,and explored their psychometric properties. Results VABS's assessment content was solely focused on activities and participation,including speaking(d330),con-versation(d350),toileting(d530),eating(d550),drinking(d560),basic interpersonal interactions(d710),com-plex interpersonal interactions(d720),changing and maintaining body positions(d410-d429),carrying,moving and handing objects(d430-d449),and walking and moving(d450-d469).SIS-C assessed activities and participa-tion,and environmental factors,including washing oneself(d510),caring for body parts(d520),community life(d910),using transportation(d470),school education(d820),basic learning(d130-d159),looking after one's health(d570),basic interpersonal interactions(d710),and products and technology for education(e130).SDQ fo-cused on body functions,and activities and participation,including emotional functions(b152),global psychoso-cial functions(b122),attention functions(b140),and basic interpersonal interactions(d710).RBS-R focused on body functions,and activities and participation,including involuntary movement reaction functions(b755),invol-untary movement functions(b765),looking after one's health(d570),energy and drive functions(b130),under-taking a single task(d210),carrying out daily routine(d230),attention functions(b140),and handling stress and other psychological demands(d240).VABS was characterized by good specificity and excellent sensitivity.SIS-C demonstrated very good internal consistency,reliability and validity.SDQ was good in internal consistency,with excellent credibility and validity.RBS-R showed good internal consistency,reliability and validity. Conclusion SDQ and RBS-R cover both body functions,and activities and participation,SIS-C covers activity and par-ticipation,and environmental factors,while VABS solely assesses activities and participation.In terms of body functions,the assessment items primarily focus on mental functions(b130-b189)and movement functions(b750-b799).For activities and participation,the tools assess content across eight domains of functioning.Regarding en-vironmental factors,the assessment content mainly includes products and technology for education(e130),as well as design,construction and building products and technology of buildings for public use(e150).VABS,SIS-C,SDQ,and RBS-R are all norm-referenced measures,with moderate to excellent internal consistency,and good to excellent reliability and validity.

How to manage complaints in blood centers: a management mode based on healthcare complaint analysis tool / 中国输血杂志

【Objective】 To investigate and analyze the current situation of blood donors’ complaints in Changsha Blood Center, find out the reasons and characteristics of the complaints, aimed at improving the satisfaction of blood donors and the quality of blood donation service. 【Methods】 The healthcare complaint analysis tool (HCAT) was used to encode and statistically analyze the complaints against our center from 2020 to 2022, and then a three-level framework for complaint management classification was constructed. 【Results】 Blood donors had relatively more appeals to the management of primary classification, accounting for 61.77%(126/204). For secondary classification, complaints mainly focused on the working system and process, accounting for 24.02%(49/204), and the problems related to policies and regulations such as free blood use and voluntary blood donation incentive mechanism, accounting for 22.55%(46/204), and the problems related to environment and facilities such as the adjustment of blood donation centers and blood donation time was not announced timely and not updated synchronously on the Baidu map, accounting for 15.2%(31/204). 【Conclusion】 In response to the demands of blood donors, blood centers should optimize the working process and improve the service model of " Internet + voluntary blood donation" and the service awareness of the staff. Further more, the complaint process should be gradually improved to solve the demands of blood donors in time.

Research progress of nurses'humanistic caring / 中国医学伦理学

Nursing is a discipline that integrates natural science,social science,and humanities.The nursing profession has been closely related to humanistic care since its inception.The particularity of nursing requires that nurses not only need to master solid nursing technology but also need to have good humanistic care ability.Improving nurses'humanistic care ability is an important way to further improve the quality of nursing in the new era.This paper summarized the concept,assessment tools,and influencing factors of nurses'humanistic care,preliminarily discussed the countermeasures to improve nurses'humanistic care ability,and put forward the development expectations of nurses'humanistic care,so as to provide a reference for nursing education,nursing management,and nursing practice.

A Systematic Review of the Effectiveness Evaluation Tools for Multidisciplinary Diagnosis and Treatment of Tumors / 中国医院管理

Objective To understand the effectiveness evaluation research of tumor MDT,and analyze the development status and differences of evaluation tools at home and abroad,to provide reference for the subsequent summary evaluation and continuous improvement of tumor MDT,and the strengthening of MDT supervision.Methods Four literature databases at home and abroad were searched to obtain relevant literatures,and literature screening and systematic review were conducted.Results A total of 87 literatures were included,including 26 literatures in Chinese and 61 literatures in English;the most published years were 2020;the main countries of the first authors were the UK.Foreign evaluation tools focus on the key elements of structure and process,while evaluation systems in China focus on the index content at the result level.Conclusion In China,the scientific and comprehensive selection of tumor MDT evaluation indicators needs to be improved,the analysis of influencing factors on the structure and process of MDT needs to be strengthened,and the extrapolation of the existing evaluation systems need to be verified.It is suggested to strengthen the evidence support of evaluation index selection,attach importance to the evaluation of process links,promote the in-depth study of the influencing factors of tumor MDT,and further encourage the empirical application of the existing evaluation system.

Comparative analysis of primary health care attributes between children under and over 3 years of age using the primary care assessment tool

Abstract Introduction: Child health actions in Brazil have their primary focus on early childhood. A new epidemiological profile is emerging for children after the first one thousand days: an increase in non-communicable chronic diseases. This research aimed to analyze the attributes of Primary Health Care comparatively among different age groups, using three years of age as the cutoff point. Methods: The study design was cross-sectional and conducted in three Primary Health Care Units and three Ambulatory Medical Assistance facilities in the Western Region of Sao Paulo. The PCA Tool Brazil was used as the assessment instrument. Results: A total of 311 interviews were conducted with caregivers of children aged 0 to 12 years; 153 children were under three years old, and 158 were three years or older. The attributes that showed statistically significant differences between age groups (< 3 years and > 3 years) were affiliation (4.9 × 3.8), longitudinality (5.7 × 5.2), information system (7.4 × 6.3), and services provided (5.4 × 4.5). Through linear regression analysis, it was observed that there was a trend for better overall and essential scores in the evaluations of the group of children under three years old who attended Primary Health Care Units. Conclusion: The comparative analysis of Primary Health Care attributes among pediatric age groups revealed a trend towards higher scores, according to caregivers' perceptions, for children under three years old. This study suggests the need for the implementation of programs that can better address the healthcare needs of children beyond early childhood.

Detección de eventos adversos en pacientes internados en clínica médica utilizando la herramienta Global Trigger Tool / Detection of adverse events in patients interned in medical clinic using the Global Trigger Tool

Resumen Introducción : El Global Trigger Tool (GTT) es una herramienta que identifica con precisión los eventos adversos, estos representan un problema relevante y prevenible en los hospitales. Métodos : Estudio de corte transversal basado en la revisión retrospectiva de historias clínicas aleatorizadas utilizando el GTT. Resultados : Se detectaron 161 eventos adversos (EA): 51 por cada 100 admisiones, 66 por cada 1000 días pa ciente y 30% de admisiones con EA. Los disparadores más frecuentes fueron del módulo cuidados, 25% com plicaciones asociadas al uso de procedimientos, 10% úlceras por presión y 9% infecciones asociadas a la atención. La presencia de EA tuvo asociación estadís ticamente significativa con estancia mayor a 5 días, y asociación moderada con edad y número de disparado res. En cuanto al daño, 78% de los pacientes presentaron eventos leves y 4% eventos fatales. En el análisis con cur vas ROC, los disparadores con mayor área bajo la curva fueron: complicación de procedimientos (0.70), úlceras por presión (0.61) y código de respuesta rápida (0.60). Discusión : Los eventos por 100 admisiones fueron superiores a la bibliografía pero no hubo diferencias en eventos por cada 1000 días paciente. Los casos fatales se produjeron por enfermedades infecciosas respiratorias en pacientes con comorbilidades, necesidad de sonda nasogástrica y deterioro cognitivo. Se destaca la escasa aplicación de la herramienta en hospitales públicos, y la implementación de análisis de disparadores con cur vas ROC. Conocer la frecuencia y el tipo de evento más frecuente permitirá implementar medidas que mejoren la seguridad de los pacientes.

Abstract Introduction : The Global Trigger Tool (GTT) is a tool that accurately identifies adverse events that represent a significant problem in hospitals. Methods : Cross-sectional study based on retrospec tive review of randomized medical records using the GTT tool. Results : A total of 161 adverse events (AEs) were detected: 51 events per 100 admissions, 66 per 1000 patient-days, and 30% of admissions with AEs. The most frequent triggers were from the care module, with 25% complications associated with the use of procedures, 10% pressure ulcers, and 9% care-associated infections. The presence of AEs had a statistically significant asso ciation with a stay of more than 5 days, and a moderate association with age and number of triggers. Regarding the damage, 78% of the patients presented mild events and 4% fatal events. The ROC curves analysis showed that the triggers with the greatest area under the curve were: procedural complication (0.70), pressure ulcers (0.61) and rapid response code (0.60). Discussion : The number of events per 100 admis sions was higher than that reported in the literature, but there were no differences in events per 1000 patient-days. Fatal cases were caused by respiratory infectious diseases in patients with comorbidities, nasogastric tube needs and cognitive decline. The study highlights the scarce use of the tool in public hospitals and the implementation of trigger analysis with ROC curves. Knowing the frequency and the most frequent type of event will allow the implementation of measures that improve patient safety.