目的系统评价新冠肺炎(COVID-19)疫情期间医务人员焦虑发生情况,为医务人员心理干预提供循证依据。方法检索中国知网、万方数据知识服务平台、维普咨讯中文期刊服务平台和PubMed等数据库,收集2020年1月1日至2021年11月30日国内外公开发...目的系统评价新冠肺炎(COVID-19)疫情期间医务人员焦虑发生情况,为医务人员心理干预提供循证依据。方法检索中国知网、万方数据知识服务平台、维普咨讯中文期刊服务平台和PubMed等数据库,收集2020年1月1日至2021年11月30日国内外公开发表的关于COVID-19疫情期间医务人员焦虑状况调查;依据美国卫生保健质量和研究机构关于横断面研究的质量标准评价文献质量;采用Open Meta Analyst 3.0软件对医务人员焦虑检出率进行Meta分析;采用漏斗图和Begg秩相关检验分析发表偏倚。结果检索文献598篇,纳入36篇,包括中文文献33篇和英文文献3篇。高、中等、低质量文献分别为5篇、29篇和2篇。调查均在2020年,共调查医务人员19872人,检出焦虑5261人,焦虑检出率为28.8%(95%CI:24.0%~33.6%)。33篇中文文献的亚组分析显示,我国西部、中部和东部地区医务人员焦虑检出率分别为31.9%(95%CI:17.6%~46.2%),29.6%(95%CI:17.8%~41.4%)和25.3%(95%CI:20.2%~30.3%);男性和女性医务人员焦虑检出率分别为4.9%(95%CI:3.3%~6.4%)和22.9%(95%CI:17.7%~28.0%);护士、医生及其他医务人员焦虑检出率分别为21.6%(95%CI:13.2%~29.9%),5.2%(95%CI:2.8%~7.5%)和4.8%(95%CI:2.2%~7.4%);轻度、中度和重度焦虑检出率分别为18.6%(95%CI:14.0%~23.2%),5.5%(95%CI:4.1%~6.8%)和1.9%(95%CI:1.3%~2.5%)。漏斗图和Begg秩相关检验显示无发表偏倚。逐一排除文献分析显示,Meta分析结果及异质性检验稳定。结论COVID-19疫情期间医务人员焦虑检出率为28.8%,以轻度焦虑为主;女性医务人员、护士的焦虑检出率相对较高,应予以重点关注并及时采取心理干预。展开更多
Correction of genetic errors, commonly known as gene editing, holds promise to treat diseases with unmet medical needs. However, gene therapy trials do encounter unwanted outcomes, because of an incomplete understandi...Correction of genetic errors, commonly known as gene editing, holds promise to treat diseases with unmet medical needs. However, gene therapy trials do encounter unwanted outcomes, because of an incomplete understanding of the disease states, and gene therapy processes, among others. This situation encourages a concept that healthcare professionals receiving laboratory research training will not only identify inadequacies in basic biomedical knowledge of gene therapies but also provide tangible refinements. To this end, we have undertaken the PharmD student training in gene editing in a basic research laboratory setting. As a model, MYC gene was chosen for knockout using CRISPR-Cas9 method in HT29 and OVCAR8 cells. Students were involved in the design of MYC-specific gRNAs, subcloning into Cas9-carrying plasmid, and selection of knockout clones from the transfected cells. Subsequently, genomic DNA isolation and sequencing, analysis of clonal DNA sequences using online bioinformatics tools, western blotting, cell proliferation and cell division cycle experiments, were performed to characterize the MYC knockout clones. Results presented in this communication suggest that healthcare professionals who received laboratory training gain a better understanding of the disease states and mechanisms, gene therapy protocols, limitations of gene therapies, ability to critically evaluate the literature and confidence in the oversight of gene therapies in the clinic.展开更多
Background: Burnout(encompassing emotional exhaustion, depersonalization and personal accomplishment) in healthcare professionals is a major issue worldwide. Emergency medicine physicians are particularly affected, po...Background: Burnout(encompassing emotional exhaustion, depersonalization and personal accomplishment) in healthcare professionals is a major issue worldwide. Emergency medicine physicians are particularly affected, potentially impacting on quality of care and attrition from the specialty.Objective: The aim of this study was to apply an attention-based training(ABT) program to reduce burnout among emergency multidisciplinary team(MDT) members from a large urban hospital.Design, setting, participants and interventions: Emergency MDT members were randomized to either a notreatment control or an intervention group. Intervention group participants engaged in a four session(4 h/session) ABT program over 7 weeks with a practice target of 20 min twice-daily. Practice adherence was measured using a smart phone application together with a wearable Charge 2 device.Main outcome measures: The primary outcome was a change in burnout, comprising emotional exhaustion, depersonalization and personal achievement. The secondary outcomes were changes in other psychological and biometric parameters.Results: The ABT program resulted in a significant reduction(P < 0.05; T1 [one week before intervention]vs T3 [follow-up at two months after intervention]) in burnout, specifically, emotional exhaustion, with an effect size(probability of superiority) of 59%. Similar reductions were observed for stress(P < 0.05) and anxiety(P < 0.05). Furthermore, ABT group participants demonstrated significant improvements in heart rate variability, resting heart rate, sleep as well as an increase in pro-inflammatory cytokine expression.Conclusion: This study describes a positive impact of ABT on emergency department staff burnout compared to a no-treatment control group.展开更多
Aims: This article seeks to address some of the factors, particularly cultural barriers, contributing to inequity in healthcare service provisions for indigenous Australians. Furthermore, this article presents ways fo...Aims: This article seeks to address some of the factors, particularly cultural barriers, contributing to inequity in healthcare service provisions for indigenous Australians. Furthermore, this article presents ways for healthcare professionals to take action on culture-related health equity issues. Finally, this article addresses what nurses can do to support more operational interventions and enhance the quality of services for indigenous Australians and Torres Strait Islanders.Background: Recently, scholarly literature in Australia has focused on the issue of ensuring equitable access to healthcare for aboriginal Australians and Torres Strait Islanders, who are regarded as economically, socially, politically and culturally disadvantaged(Larkins et al, 2016; Lowell, 2013).^(1,2)However, in spite of significant efforts on the part of the Australian government, scholars, policy makers and communities to provide fair and equitable healthcare, this challenging and longstanding issue remains unresolved and needs to be addressed immediately(Australian Institute of Health and Welfare, 2015; Australian Bureau of Statistics(ABS), 2011).^(3,4)Data sources: Using the Population, Intervention and Outcome framework, several databases(PUBMED,MEDLINE, and SCOPUS) and government web-based literature resources were searched to identify original research articles published from 2000 to 2016.Discussion: Health inequity exists among aboriginal Australians and Torres Strait Islanders, and the cultural barriers are vital factors in addressing aboriginals' health inequity. Healthcare professionals could be part of an effective solution for diminishing racial/ethnic disparities in healthcare. Different types of nurses could play different roles in addressing aboriginal cultural barriers among aboriginal Australians and Torres Strait Islanders.Nurses are uniquely positioned to initiate and sustain contact with aboriginal Australians and Torres Strait Islanders in healthcare workplaces,as they can intervene at the points of greatest need展开更多
Influenza burden: Influenza imposes a major burden on people and public health systems, causing millions of severe cases and up to one million deaths annually. Much of this burden is borne by those aged 65 or over, ch...Influenza burden: Influenza imposes a major burden on people and public health systems, causing millions of severe cases and up to one million deaths annually. Much of this burden is borne by those aged 65 or over, children under 2 years of age and people with non-communicable chronic diseases, such as heart and lung conditions and diabetes. In the elderly, influenza can have longer-term effects beyond acute infection, with some facing increased disability and care requirements. Prevention: Taking into account the growing elderly population worldwide and their susceptibility to non-communicable conditions as well as rising healthcare costs, public health policies are increasingly focusing on disease prevention strategies and promotion of healthy ageing initiatives. Influenza vaccination has an important role to play in these approaches. Immunization of high-risk groups is recommended by public health organizations, both internationally and locally within many countries. However, although vaccines are considered the most effective method for preventing influenza, many high-risk people remain unvaccinated. Improving vaccination rates: In recent years, research has focused on increasing vaccine coverage. The results demonstrate the key role healthcare professionals play in encouraging immunization, alongside factors such as communication, education and financial support for vaccination. Paradoxically, although vaccination recommendations often include healthcare professionals and studies demonstrate the potential protection offered to workers and patients, many remain unvaccinated. As a result, a growing number of organizations, particularly in North America, are implementing policies requiring vaccination of healthcare pro fessionals as a patient safety measure. In summary: Influenza vaccination has a key role to play in helping to protect the health of the growing elderly population, reduce the burden associated with non-communicable diseases and decrease the annual toll on public health. Improving vaccination lev展开更多
文摘目的系统评价新冠肺炎(COVID-19)疫情期间医务人员焦虑发生情况,为医务人员心理干预提供循证依据。方法检索中国知网、万方数据知识服务平台、维普咨讯中文期刊服务平台和PubMed等数据库,收集2020年1月1日至2021年11月30日国内外公开发表的关于COVID-19疫情期间医务人员焦虑状况调查;依据美国卫生保健质量和研究机构关于横断面研究的质量标准评价文献质量;采用Open Meta Analyst 3.0软件对医务人员焦虑检出率进行Meta分析;采用漏斗图和Begg秩相关检验分析发表偏倚。结果检索文献598篇,纳入36篇,包括中文文献33篇和英文文献3篇。高、中等、低质量文献分别为5篇、29篇和2篇。调查均在2020年,共调查医务人员19872人,检出焦虑5261人,焦虑检出率为28.8%(95%CI:24.0%~33.6%)。33篇中文文献的亚组分析显示,我国西部、中部和东部地区医务人员焦虑检出率分别为31.9%(95%CI:17.6%~46.2%),29.6%(95%CI:17.8%~41.4%)和25.3%(95%CI:20.2%~30.3%);男性和女性医务人员焦虑检出率分别为4.9%(95%CI:3.3%~6.4%)和22.9%(95%CI:17.7%~28.0%);护士、医生及其他医务人员焦虑检出率分别为21.6%(95%CI:13.2%~29.9%),5.2%(95%CI:2.8%~7.5%)和4.8%(95%CI:2.2%~7.4%);轻度、中度和重度焦虑检出率分别为18.6%(95%CI:14.0%~23.2%),5.5%(95%CI:4.1%~6.8%)和1.9%(95%CI:1.3%~2.5%)。漏斗图和Begg秩相关检验显示无发表偏倚。逐一排除文献分析显示,Meta分析结果及异质性检验稳定。结论COVID-19疫情期间医务人员焦虑检出率为28.8%,以轻度焦虑为主;女性医务人员、护士的焦虑检出率相对较高,应予以重点关注并及时采取心理干预。
文摘Correction of genetic errors, commonly known as gene editing, holds promise to treat diseases with unmet medical needs. However, gene therapy trials do encounter unwanted outcomes, because of an incomplete understanding of the disease states, and gene therapy processes, among others. This situation encourages a concept that healthcare professionals receiving laboratory research training will not only identify inadequacies in basic biomedical knowledge of gene therapies but also provide tangible refinements. To this end, we have undertaken the PharmD student training in gene editing in a basic research laboratory setting. As a model, MYC gene was chosen for knockout using CRISPR-Cas9 method in HT29 and OVCAR8 cells. Students were involved in the design of MYC-specific gRNAs, subcloning into Cas9-carrying plasmid, and selection of knockout clones from the transfected cells. Subsequently, genomic DNA isolation and sequencing, analysis of clonal DNA sequences using online bioinformatics tools, western blotting, cell proliferation and cell division cycle experiments, were performed to characterize the MYC knockout clones. Results presented in this communication suggest that healthcare professionals who received laboratory training gain a better understanding of the disease states and mechanisms, gene therapy protocols, limitations of gene therapies, ability to critically evaluate the literature and confidence in the oversight of gene therapies in the clinic.
基金the Health Research Board of Ireland/Wellcome Clinical Research Facility at St.James’ Hospital (Dublin) for their professional support
文摘Background: Burnout(encompassing emotional exhaustion, depersonalization and personal accomplishment) in healthcare professionals is a major issue worldwide. Emergency medicine physicians are particularly affected, potentially impacting on quality of care and attrition from the specialty.Objective: The aim of this study was to apply an attention-based training(ABT) program to reduce burnout among emergency multidisciplinary team(MDT) members from a large urban hospital.Design, setting, participants and interventions: Emergency MDT members were randomized to either a notreatment control or an intervention group. Intervention group participants engaged in a four session(4 h/session) ABT program over 7 weeks with a practice target of 20 min twice-daily. Practice adherence was measured using a smart phone application together with a wearable Charge 2 device.Main outcome measures: The primary outcome was a change in burnout, comprising emotional exhaustion, depersonalization and personal achievement. The secondary outcomes were changes in other psychological and biometric parameters.Results: The ABT program resulted in a significant reduction(P < 0.05; T1 [one week before intervention]vs T3 [follow-up at two months after intervention]) in burnout, specifically, emotional exhaustion, with an effect size(probability of superiority) of 59%. Similar reductions were observed for stress(P < 0.05) and anxiety(P < 0.05). Furthermore, ABT group participants demonstrated significant improvements in heart rate variability, resting heart rate, sleep as well as an increase in pro-inflammatory cytokine expression.Conclusion: This study describes a positive impact of ABT on emergency department staff burnout compared to a no-treatment control group.
文摘Aims: This article seeks to address some of the factors, particularly cultural barriers, contributing to inequity in healthcare service provisions for indigenous Australians. Furthermore, this article presents ways for healthcare professionals to take action on culture-related health equity issues. Finally, this article addresses what nurses can do to support more operational interventions and enhance the quality of services for indigenous Australians and Torres Strait Islanders.Background: Recently, scholarly literature in Australia has focused on the issue of ensuring equitable access to healthcare for aboriginal Australians and Torres Strait Islanders, who are regarded as economically, socially, politically and culturally disadvantaged(Larkins et al, 2016; Lowell, 2013).^(1,2)However, in spite of significant efforts on the part of the Australian government, scholars, policy makers and communities to provide fair and equitable healthcare, this challenging and longstanding issue remains unresolved and needs to be addressed immediately(Australian Institute of Health and Welfare, 2015; Australian Bureau of Statistics(ABS), 2011).^(3,4)Data sources: Using the Population, Intervention and Outcome framework, several databases(PUBMED,MEDLINE, and SCOPUS) and government web-based literature resources were searched to identify original research articles published from 2000 to 2016.Discussion: Health inequity exists among aboriginal Australians and Torres Strait Islanders, and the cultural barriers are vital factors in addressing aboriginals' health inequity. Healthcare professionals could be part of an effective solution for diminishing racial/ethnic disparities in healthcare. Different types of nurses could play different roles in addressing aboriginal cultural barriers among aboriginal Australians and Torres Strait Islanders.Nurses are uniquely positioned to initiate and sustain contact with aboriginal Australians and Torres Strait Islanders in healthcare workplaces,as they can intervene at the points of greatest need
文摘Influenza burden: Influenza imposes a major burden on people and public health systems, causing millions of severe cases and up to one million deaths annually. Much of this burden is borne by those aged 65 or over, children under 2 years of age and people with non-communicable chronic diseases, such as heart and lung conditions and diabetes. In the elderly, influenza can have longer-term effects beyond acute infection, with some facing increased disability and care requirements. Prevention: Taking into account the growing elderly population worldwide and their susceptibility to non-communicable conditions as well as rising healthcare costs, public health policies are increasingly focusing on disease prevention strategies and promotion of healthy ageing initiatives. Influenza vaccination has an important role to play in these approaches. Immunization of high-risk groups is recommended by public health organizations, both internationally and locally within many countries. However, although vaccines are considered the most effective method for preventing influenza, many high-risk people remain unvaccinated. Improving vaccination rates: In recent years, research has focused on increasing vaccine coverage. The results demonstrate the key role healthcare professionals play in encouraging immunization, alongside factors such as communication, education and financial support for vaccination. Paradoxically, although vaccination recommendations often include healthcare professionals and studies demonstrate the potential protection offered to workers and patients, many remain unvaccinated. As a result, a growing number of organizations, particularly in North America, are implementing policies requiring vaccination of healthcare pro fessionals as a patient safety measure. In summary: Influenza vaccination has a key role to play in helping to protect the health of the growing elderly population, reduce the burden associated with non-communicable diseases and decrease the annual toll on public health. Improving vaccination lev
文摘目的探讨援外医疗救助"爱心行"项目中,针对柬埔寨医务人员不同培养形式初步结果。方法 2017年12月-2019年3月,横断面调查方法。近5年卫生人力资源培养相关文献查询,参加"爱心行"项目中国柬埔寨政府多部门,中国援外医疗队员,柬埔寨西部大学教授,参加培养柬埔寨卫生管理及医疗卫生人员等为访谈对象。半结构式访谈收集培养时间、内容类型及过程,分析比较长短期不同培训形式优缺点及初步结果。结果 7种形式共培养柬埔寨医生167人,来自柬埔寨4个省及金边市。其中硕士1名;长期进修(3月及以上)2名,会议及培训40名,与柬大学联合短期培训24名学员,来华现场培训实习5名,中国援外医疗队现场带教33人,中国流动医疗车现场带教培训70名。培训内容包括项目管理组织,筛查技能,心脏B超检查,Intensive Care Unit(ICU),心导管,经皮介入治疗结构性心脏病及车载心电图机,X线,生化分析仪使用等。结论援外项目应长短期培养相结合,多种培养形式有利于兼顾项目实施现场需求及长期项目影响。
