Developing geriatric nursing micro-credentials for undergraduate nursing students based on training objectives: A modified Delphi study.

BACKGROUND: China's population has begun to age rapidly in the past several years and this trend is predicted to continue. In the face of this growing older population, the existing number of aged care personnel, especially medical care professionals, can hardly meet the demand for aged care services. AIM: To develop geriatric nursing micro-credentials (MCs) for undergraduate nursing students based on standardized training objectives and to specify the learning goals and course modules that correspond to each specific MC. DESIGN: Modified Delphi study. METHODS: An initial set of geriatric nursing MCs were developed based on the training objectives. Expert group discussion (n=13) reviewed the clarity and intelligibility of the statements' wording and supplemented the framework. A three-round Delphi survey (n=15) was then employed to obtain a consensus on the learning goals and course modules via an online questionnaire. Descriptive statistics were used to analyze the data. RESULTS: The final geriatric nursing MCs consisted of six courses, namely fundamentals of geriatric nursing (8 modules), geriatric sociology (6 modules), geriatric clinical nursing (3 modules), geriatric psychological nursing (8 modules), geriatric rehabilitation nursing (8 modules) and geriatric hospice care (10 modules). CONCLUSION: Nursing faculty can use the geriatric nursing MCs developed in this study to train current undergraduate nursing students to become backups for current, fully credentialed geriatric caregivers.

Developing a Capsule Clinic-A 24-Hour Institution for Improving Primary Health Care Accessibility: Evidence From China.

Telehealth is an effective combination of medical service and intelligent technology. It can improve the problem of remote access to medical care. However, an imbalance in the allocation of health resources still occurs. People spend more time and money to access higher-quality services, which results in inequitable access to primary health care (PHC). At the same time, patients' usage of telehealth services is limited by the equipment and their own knowledge, and the PHC service suffers from low usage efficiency and lack of service supply. Therefore, improving PHC accessibility is crucial to narrowing the global health care coverage gap and maintaining health equity. In recent years, China has explored several new approaches to improve PHC accessibility. One such approach is the capsule clinic, an emerging institution that represents an upgraded version of the internet hospital. In coordination with the United Nations, the Yinzhou district of Ningbo city in Zhejiang, China, has been testing this new model since 2020. As of October 2022, the number of applications in Ningbo was 15, and the number of users reached 12,219. Unlike internet hospitals, the entire process-from diagnosis to prescription services-can be completed at the capsule clinic. The 24-hour telehealth service could also solve transportation problems and save time for users. Big data analysis can accurately identify regional populations' PHC service needs and improve efficiency in health resource allocation. The user-friendly, low-cost, and easily accessible telehealth model is of great significance. Installation of capsule clinics would improve PHC accessibility and resolve the uneven distribution of health resources to promote health equity.

Hyperosmotic Infusion and Oxidized Surfaces Are Essential for Biofilm Formation of Staphylococcus capitis From the Neonatal Intensive Care Unit.

Staphylococcus capitis is an opportunistic pathogen often implicated in bloodstream infections in the neonatal intensive care unit (NICU). This is assisted by its ability to form biofilms on indwelling central venous catheters (CVC), which are highly resistant to antibiotics and the immune system. We sought to understand the fundamentals of biofilm formation by S. capitis in the NICU, using seventeen clinical isolates including the endemic NRCS-A clone and assessing nine commercial and two modified polystyrene surfaces. S. capitis clinical isolates from the NICU initiated biofilm formation only in response to hyperosmotic conditions, followed by a developmental progression driven by icaADBC expression to establish mature biofilms, with polysaccharide being their major extracellular polymer substance (EPS) matrix component. Physicochemical features of the biomaterial surface, and in particular the level of the element oxygen present on the surface, significantly influenced biofilm development of S. capitis. A lack of highly oxidized carbon species on the surface prevented the immobilization of S. capitis EPS and the formation of mature biofilms. This information provides guidance in regard to the preparation of hyperosmolar total parenteral nutrition and the engineering of CVC surfaces that can minimize the risk of catheter-related bloodstream infections caused by S. capitis in the NICU.

Relevant factors of estrogen changes of myopia in adolescent females.

BACKGROUND: Gender is one of the risk factors accounting for the high prevalence of adolescent myopia. Considerable research results have shown that myopia incidence of female is higher than that of male. This study aimed to analyze the correlation between ocular parameters and serum estrogen level and to investigate the vision changes along with estrogen change in menstrual cycle of adolescent females. METHODS: A total of 120 young females aged between 15 and 16 years, diagnosed with myopia were recruited. Spherical lens, cylindrical lens, axis, interpupillary distance (IPD), and vision in each tested eye of the same subject were measured by automatic optometry and comprehensive optometry, with repetition of all measurements in the menstrual cycle of the 2 nd or 3 rd days, 14 th days, and 28 th days, respectively. Serum estradiol (E 2 ) levels were assayed by chemiluminescence immunoassay at the same three times points of the menstrual cycle mentioned above. RESULTS: In young females with myopia, the spherical lens showed a statistically significant difference among all different time in menstrual cycle (all P < 0.0001). The cylindrical lens, axis, and IPD were changed significantly during the menstrual cycle (P < 0.05). The vision of the three different time points in menstrual cycle had a significant difference (χ2 = 6.35, P = 0.042). The vision during the 14 th and 28 th day was higher compared to that on the 2 nd or 3 rd days (P = 0.021). Serum E 2 levels were significantly different at different time points in menstrual cycle (P < 0.05). E 2 levels reached its maximum value on the 14 th day and the minimum value on the 2 nd or 3 rd day. CONCLUSIONS: In adolescent females, the spherical lens and other related ocular parameters vary sensitively with different levels of E 2 in menstrual cycle. Vision in late menstrual stage is significantly higher than that in premenstrual stage.

[Impact factor of timeliness lag for seeing a doctor about cataract patient in Wenzhou region of Zhejiang province].

OBJECTIVE: Investigation the impact factor of timeliness lag about cataract patient of operation. METHODS: Through Opportunistic Screening , from January 2007 to January 2012, we extracted people aged 50 or above and carried out the cataract screening in 10 towns of Wenzhou region of Zhejiang province. People extracted was checked by slit lamp microscope and ophthalmoscope directly, and the people who are suit for operation were brought to a first-rate of level three eye hospital and operated by MSICS . At the same time we have made questionnaire about five aspect including basic situation, economic status, basic life status, health and medical status and health needs for the operator and this questionnaire involves twenty-three relevant indexes about the timeliness, these factors of timeliness for patients seeing a doctor are judged. RESULTS: 36 681 people are checked for five years and 10 326 people(10 326 eyes) are suitable for surgery. Through analyzing sixteen relevant indexes about the timeliness , there are ten indexes which have Statistical Significance including in transportation, the distance for nearest medical aid post , care knowledge, population of family, income of family, respondents degree , the highest degree of family members type of work, structure of building, government subsidies. The first reason that the people can't be operated in time are economic difficulties, next are older and making children trouble for seven factors of no operation in time. The people for this three reason is more than 75% for not seeing a doctor in time. CONCLUSION: The key work of blindness prevention and treatment is the cataract surgery for our country.Eye doctors pay attention to new surgical technique , at the same time we should promote MSICS which is technique of low cost and have good effect of the operation.