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Sleep Quality among Medical Students at King Abdulaziz University: A Cross-sectional Study 阿卜杜勒阿齐兹国王大学医学院学生的睡眠质量:一项横断面研究
Pub Date : 2017-10-16 DOI: 10.4172/2161-0711.1000561
N. Ibrahim, Badawi Fa, Mansouri Ym, Ainousa Am, Jambi Sk, Fatani An, Andijani Ra
Poor sleep quality and Excessive Daytime Sleepiness (EDS) can affect the performance of medical students, their future work as practitioners, and the whole health care system. The study was done to determine the prevalence and predictors of poor sleep quality among medical students in King Abdulaziz University (KAU), Jeddah, Saudi Arabia. A cross-sectional study was done among 576 medical students who were selected through multi-stage stratified random sample. A standardized, confidential, self-administered data collection sheet was utilized. Pittsburg Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Hospital Anxiety and Depression Scale (HADS) were utilized. Descriptive, inferential statistics and multiple logistic regression analysis were done. Results revealed that prevalence of poor sleep quality and EDS among medical students were 70.4% and 37.3%, respectively. Poor sleep quality was associated with students’ gender, age, high-Grade Point Average (GPA), anxiety, depression, EDS and drinking caffeinated beverages. Students with poor sleep quality had low ability to attend educational sessions. After controlling confounding, the first predictor of poor sleep quality was having anxiety. Those with morbid anxiety were about 4 times more liable to have poor sleep quality compared to others (aOR=3.92; 95% CI: 2.46-6.24). The second predictor of poor sleeping was enrollment in the basic academic years. It is concluded that poor sleep quality was prevalent among medical students in KAU. Anxiety and enrollment in basic-years were the predictors. Screening programs for sleep disorders, anxiety, and depression among medical students are required. Sleep educational programs, stress management courses and lifestyles modifications are recommended.
睡眠质量差和日间嗜睡(EDS)会影响医学生的表现、他们未来的执业工作以及整个医疗保健系统。这项研究是为了确定沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医学生睡眠质量差的患病率和预测因素。对576名医科学生进行了横断面研究,这些学生是通过多阶段分层随机抽样选出的。使用了一份标准化、保密、自我管理的数据收集表。采用匹兹堡睡眠质量指数(PSQI)、埃普沃斯睡眠量表(ESS)和医院焦虑抑郁量表(HADS)。采用描述性、推断统计学和多元逻辑回归分析。结果显示,医学生睡眠质量差和EDS的患病率分别为70.4%和37.3%。睡眠质量差与学生的性别、年龄、平均绩点(GPA)高、焦虑、抑郁、EDS和饮用含咖啡因饮料有关。睡眠质量差的学生参加教育课程的能力较低。在控制了混杂因素后,睡眠质量差的第一个预测因素是焦虑。与其他人相比,患有病态焦虑症的人睡眠质量差的可能性大约是其他人的4倍(aOR=3.92;95%CI:2.46-6.24)。睡眠差的第二个预测因素是基础学年的入学人数。结果表明,KAU医学生睡眠质量差的现象普遍存在。焦虑和基础年的入学率是预测因素。医学生需要进行睡眠障碍、焦虑和抑郁的筛查项目。建议进行睡眠教育项目、压力管理课程和生活方式的改变。
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引用次数: 42
Maximum Strength Estimate of Quadriceps and Brachial Biceps Muscles in Patients with Chronic Heart Disease 慢性心脏病患者四头肌和肱二头肌的最大力量评估
Pub Date : 2017-10-11 DOI: 10.4172/2161-0711.1000560
S. Scarpa
Patients diagnosed with heart disease display diminished exercise tolerance, which can be attributed not only to a reduction in aerobic capacity but probably also to a strength deficit. The aim of this study was to estimate maximum dynamic strength of the quadriceps and the brachial biceps muscles in patients affected by chronic heart disease. Maximum strength was estimated by means of sub-maximal tests in 30 healthy sedentary volunteers and 140 male patients with chronic heart disease: 52 patients with coronary artery disease (CA D); 72 patients diagnosed with chronic heart failure (CHF); 16 patients who had undergone heart transplant (HT). Maximum strength estimate of the two muscles tested was significantly lower in patients diagnosed with heart disease compared to the control group. When patients were subdivided according to the type of disease, a clear trend among groups was displayed with maximum strength being higher in controls, followed by the CA D group, then the CHF group, and the HT group. In conclusion it seems possible to assert that maximum strength of both the muscle groups examined is significantly lower in patients diagnosed with cardiovascular disease than in control subjects. Moreover, chronic cardiovascular patients are characterized by a muscular impairment that parallels the history of the disease. This information should be kept in mind when planning a rehabilitation program.
被诊断为心脏病的患者表现出运动耐受性下降,这不仅归因于有氧能力下降,也可能归因于力量不足。本研究的目的是估计慢性心脏病患者的股四头肌和肱二头肌的最大动态强度。在30名健康久坐志愿者和140名男性慢性心脏病患者中,通过亚最大强度试验估计最大力量:52名冠状动脉疾病(CA D)患者;诊断为慢性心力衰竭(CHF)的72例;16例接受心脏移植的患者。与对照组相比,被诊断患有心脏病的患者的两块肌肉的最大强度估计值明显较低。将患者按疾病类型细分时,组间趋势明显,对照组强度最大,其次为CA - D组,其次为CHF组,最后为HT组。总之,似乎有可能断言,被诊断为心血管疾病的患者所检查的两个肌肉群的最大力量明显低于对照组。此外,慢性心血管患者的特点是肌肉损伤与疾病史相似。在制定康复计划时,这些信息应该牢记在心。
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引用次数: 1
Primary Care Provider Feedback of Training to Identify and Manage Pre-Diabetes 初级保健提供者对识别和管理糖尿病前期培训的反馈
Pub Date : 2017-09-29 DOI: 10.4172/2161-0711.1000557
N. Sohler, Yelena Zubatov, J. Sill, Julian Botta, B. Matti-Orozco, Edwin Young, J. Albu
Introduction: Disease-specific training to improve management of chronic diseases is essential in the context of the patient-centered medical home. Achieving provider and staff satisfaction with practices and training is critical for successful patient care. Models for assessing satisfaction in the context of diabetes management have been reported. Here we extend this work to diabetes prevention. Materials and methods: We administered a questionnaire to all provider and staff involved in a new pre-diabetes management program implemented in an inner city primary care network before, immediately after, and six months after a one-hour training session that was developed following American Diabetes Association guidelines. The questionnaire was adapted for pre-diabetes from the Provider Satisfaction Inventory, an instrument previously used to evaluate perceived ability to manage diabetes on four scales: chronic disease management, collaborative team practice, outcomes, and supportive environment. Results: Fifty-six attending physicians, 133 residents, and 28 office staff participated. Mean scores on two of the four scales (chronic disease management and supportive environment) improved significantly immediately after the training. Improvement was noted on the other scales, but the changes did not consistently reach statistical significance. Continued improvement in scores after six months was evident in most scales for the attending physicians and residents, but not for the office staff. Discussion: We successfully adapted a diabetes management satisfaction instrument to the evaluation of prediabetes management, and primary care providers and staff reported improved ability to manage pre-diabetes after our training. However, ongoing training after the initial session might be warranted for the office staff.
在以病人为中心的医疗之家的背景下,改善慢性病管理的疾病特异性培训是必不可少的。使提供者和工作人员满意的做法和培训是成功的病人护理的关键。评估糖尿病管理满意度的模型已被报道。在这里,我们将这项工作扩展到糖尿病预防。材料和方法:我们对参与一项新的糖尿病前期管理项目的所有提供者和工作人员进行了问卷调查,该项目在市中心的一个初级保健网络中实施,该项目是根据美国糖尿病协会的指导方针制定的,在此之前、之后和六个月后进行的一小时培训。该问卷适用于前驱糖尿病的提供者满意度量表,该量表以前用于评估管理糖尿病的感知能力,分为四个方面:慢性疾病管理、协作团队实践、结果和支持环境。结果:56名主治医师、133名住院医师和28名办公室工作人员参与。四个量表中的两个量表(慢性病管理和支持性环境)的平均得分在培训后立即显著提高。在其他量表上也有改善,但变化并不总是达到统计学意义。六个月后,在大多数量表中,主治医生和住院医生的得分持续提高,但办公室工作人员的得分没有明显提高。讨论:我们成功地将糖尿病管理满意度工具用于评估糖尿病前期管理,初级保健提供者和工作人员报告说,经过我们的培训,他们管理糖尿病前期的能力得到了提高。但是,可能需要在初次会议之后对办公室工作人员进行持续培训。
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引用次数: 0
Prevalence and Characteristics of Intimate Partner Violence (IPV) Among Pregnant Women Seeking Antenatal Care, Solomon Islands (2016) 所罗门群岛寻求产前护理的孕妇中亲密伴侣暴力(IPV)的患病率和特征(2016)
Pub Date : 2017-09-28 DOI: 10.4172/2161-0711.1000558
Benjamin Koete, Pushpa Nusair, M. Mohammadnezhad, Sabiha Khan
Introduction: Violence against women by partners during pregnancy is a major public health concern. As there is no studies done in the Solomon Islands to date on the prevalence of Intimate partner violence (IPV) specifically in the pregnant population, this study is aimed to understand the prevalence and characteristics of Intimate Partner Violence (IPV) among pregnant women seeking antenatal care, Solomon Islands (2016). Methodology: This cross-sectional descriptive study was conducted at the National Referral Hospital (NRH) in Solomon Islands. Data was collected in 2016 using a valid questionnaire. A purposive sampling was used. An interviewer administered structured questionnaire was used in health facilities after participants approval. Participants were given an open invitation and those who volunteered to take part in the study were provided with a participant information sheet. Written informed consent was obtained before administration of the questionnaire. Data were analysed using SPSS and the results were shown in table and graph. Results: 242 women met the study criteria. Participants’ age ranged from 16 to 44 years with a mean of 28 years. 55% have had one or more pregnancy and 222 (92%) had their antenatal booking in the second or third trimester. Out of the total participants, 136 (56%) reported experiencing IPV in pregnancy. The prevalence of emotional, sexual and physical IPV was 45%, 33% and 17% respectively. The results also showed that 92% of women who reported experiencing violence in the current pregnancy didn’t received any form of counseling. Conclusion: Demographic characteristics of participants and also high prevalence of IPV as shown in this study highlight this issue as an urgent health priority for the policy makers and health decision makers. Using the results of this study to develop an interventional study can be suggested.
引言:伴侣在怀孕期间对妇女的暴力行为是一个主要的公共卫生问题。由于到目前为止,所罗门群岛还没有关于亲密伴侣暴力(IPV)在孕妇中的流行率的研究,本研究旨在了解所罗门群岛(2016)寻求产前护理的孕妇中亲密伴侣暴力的流行率和特征。方法:这项横断面描述性研究在所罗门群岛的国家转诊医院(NRH)进行。数据是在2016年使用有效问卷收集的。采用了有目的的抽样。在参与者批准后,在卫生机构使用访谈者管理的结构化问卷。参与者收到了公开邀请,自愿参加研究的参与者收到了参与者信息表。在进行问卷调查之前获得书面知情同意书。使用SPSS对数据进行分析,结果如表和图所示。结果:242名女性符合研究标准。参与者的年龄从16岁到44岁不等,平均28岁。55%的人有过一次或多次怀孕,222人(92%)在妊娠中期或晚期进行了产前预约。在所有参与者中,136人(56%)报告在怀孕期间经历IPV。情感IPV、性IPV和身体IPV的患病率分别为45%、33%和17%。结果还显示,92%的报告在当前怀孕期间经历过暴力的女性没有接受任何形式的咨询。结论:如本研究所示,参与者的人口统计学特征以及IPV的高患病率突出表明,这一问题是政策制定者和卫生决策者的当务之急。可以建议利用这项研究的结果来进行介入性研究。
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引用次数: 4
Thalamic Bilateral Lesions Due to Occlusion of the Artery of Percheron 柏契隆动脉闭塞所致双侧丘脑病变
Pub Date : 2017-09-20 DOI: 10.4172/2161-0711.1000I101
R. García, C. Pascual, L. Forcelledo, D. Escudero
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引用次数: 0
Electronic Health Record Implementation: A Quality Assurance Assessment from a Free Clinic Perspective 电子健康记录的实施:从免费诊所的角度进行质量保证评估
Pub Date : 2017-09-20 DOI: 10.4172/2161-0711.1000556
A. Asmussen, Paiva Cj, E. Hepner, A. Garibay, McCarroll Ml
Introduction: The Health Information Technology for Economic and Clinical Health Act (HITECH Act) in 2009, clinics across the United States have new incentive to ensure that the use of the electronic health record (EHR) works to improve patient access to care and health outcomes. Methods: As a quality improvement project for implementing a new EHR, four diagnoses were focused on from 1/1/2017 to 7/1/2017 to improve documentation compliance and follow-up diagnostic tests: diabetes (DM), hypertension (HTN), congestive heart failure (CHF) and chronic kidney disease (CKD). Results: A total of n=502 patient charts were reviewed. The compliance percentage in capturing/documenting the metrics were 100% for age, gender; 49% race/ethnicity; 16% education and employer information; 25% primary care providers; 59% weight and 70%-93% key outcomes based on each diagnosis on the first visit documented in the EHR. Conclusions: The EHR provided a consistent platform to establish quality metrics in a free clinic not previously acquired. By establishing these benchmarks, a free clinic can adapt and modify meaningful use expectations even though they are not required.
引言:2009年的《经济和临床健康健康信息技术法案》(HITECH Act),美国各地的诊所都有新的激励措施,以确保电子健康记录(EHR)的使用能够改善患者获得护理和健康结果的机会。方法:作为实施新EHR的质量改进项目,从2017年1月1日至2017年7月1日,重点关注四种诊断,以提高文件依从性和后续诊断测试:糖尿病(DM)、高血压(HTN)、充血性心力衰竭(CHF)和慢性肾脏病(CKD)。结果:共回顾了n=502份病历。在获取/记录指标方面,年龄、性别的符合率为100%;49%为种族/民族;16%的教育和雇主信息;25%的初级保健提供者;基于EHR中记录的第一次就诊的每次诊断,59%的权重和70%-93%的关键结果。结论:EHR提供了一个一致的平台,可以在以前没有获得的免费诊所中建立质量指标。通过建立这些基准,免费诊所可以调整和修改有意义的使用期望,即使它们不是必需的。
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引用次数: 0
A Contraceptive Review and Update 避孕回顾与更新
Pub Date : 2017-09-15 DOI: 10.4172/2161-0711.1000554
M. Marnach
There are many effective, well-tolerated, safe and readily reversible contraceptives. Clinicians should remain informed regarding contraceptive methods, including emergency contraception. The following is a concise summary of the important aspects of various contraceptives, including current recommendations for options that may be tailored to the unique needs of individual women.
有许多有效、耐受性好、安全且易于逆转的避孕药具。临床医生应随时了解避孕方法,包括紧急避孕。以下简要概述了各种避孕药具的重要方面,包括目前针对可能适合妇女个人独特需求的备选方案的建议。
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引用次数: 0
Consider: The Ramification of Female Age on Reproductive Health 考虑:女性年龄对生殖健康的影响
Pub Date : 2017-09-15 DOI: 10.4172/2161-0711.1000555
Eva Monson, E. Louden, L. Gavrilova-Jordan
Female-factor infertility is an emotional, physical, social and financial stress on couples as they try to conceive children. One cause of female infertility, and one seen more commonly, is age-related decreased fertility. Clinicians within and outside the specialty of Obstetrics and Gynecology can provide a vested discussion with patients who are delaying childbearing for social or ethical reasons to consider fertility preservation. The medical profession is obligated to consider their patients’ health status, age and treatments in counseling for future reproductive health and satisfaction. With the advent of ART many advances are available such as social freezing of oocytes, fertility preservation in patients undergoing treatments that can alter oocyte quality, Intrauterine Insemination (IUI) and the extreme end of management with Invitro fertilization (IVF). Unfortunately, those patients who present with diminished ovarian reserve or premature ovarian failure may not be ideal candidates for these services, but we can offer hope. The focus of the evaluation is to determine the goal of each patient, whether having a biological child, experiencing pregnancy, or the nurturing capacity of parenting. Through Reproductive Endocrinology and Infertility specialists, hope is provided for patients who may have neglected or overlooked the aging effects on oocyte quantity and, even more importantly, quality. Nevertheless, the future is optimistic and the goal is to provide women with the best care which starts through educating on reproductive health.
女性因素不孕是夫妇试图怀孕时的情感、身体、社会和经济压力。女性不孕的一个原因,也是一个更常见的原因,是与年龄相关的生育能力下降。妇产科专业内外的临床医生可以与出于社会或伦理原因推迟生育的患者进行既得讨论,以考虑保留生育能力。医学界有义务在为未来的生殖健康和满意度提供咨询时考虑患者的健康状况、年龄和治疗。随着抗逆转录病毒疗法的出现,许多进步已经出现,如卵母细胞的社会冷冻、接受可能改变卵母细胞质量的治疗的患者的生育能力保存、宫内受精(IUI)和体外受精(IVF)的极端管理。不幸的是,那些卵巢储备减少或卵巢早衰的患者可能不是这些服务的理想人选,但我们可以提供希望。评估的重点是确定每个患者的目标,无论是生孩子、经历怀孕还是养育子女的能力。通过生殖内分泌学和不孕不育专家,为那些可能忽视或忽视了衰老对卵母细胞数量的影响,更重要的是,对质量的影响的患者带来了希望。尽管如此,未来是乐观的,目标是从生殖健康教育开始,为妇女提供最佳护理。
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引用次数: 0
Poilo Eradication from Pakistan: Our Fears and Favors at Field Site 巴基斯坦根除小儿麻痹症:我们在现场的恐惧和支持
Pub Date : 2017-09-11 DOI: 10.4172/2161-0711.1000553
Naurin Abdul Karim, Arjum, sohalia, N. Muhammad
Poilo is among the three last countries Afghanistan, Nigeria and Pakistan. Where the virus is still the endemic, more or less the same number are reported which seems to be astonished and annoyed situations for the health care system and at government level. This could be only night mare for Pakistan to be polio free country where to hold a strong religious belief, and cultural misconception and myths creating the hurdles and failures in the polio campaigns. On the other hand, strong development of policies, awareness programs, telecommunication services, radio talks, media advertisement and IPC interpersonal communication campaigns made significant acceptance among the community.
阿富汗、尼日利亚和巴基斯坦是最后三个国家之一。在病毒仍然是地方病的地方,报告的人数或多或少是相同的,这似乎使卫生保健系统和政府层面感到震惊和烦恼。这可能是巴基斯坦成为无脊髓灰质炎国家的噩梦,在那里,人们持有强烈的宗教信仰,文化误解和神话在脊髓灰质炎运动中造成障碍和失败。另一方面,大力发展政策、宣传计划、电信服务、广播演讲、媒体广告和IPC人际交流活动,使社区对IPC的接受程度显著提高。
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引用次数: 0
Assessing Competences in Medical Students with a Newly Designed 360- Degree Examination of a Simulated First Day of Residency: A Feasibility Study 用新设计的模拟住院第一天360度考试评估医学生能力的可行性研究
Pub Date : 2017-08-31 DOI: 10.4172/2161-0711.1000550
S. Harendza, P. Berberat, M. Kadmon
Abstract Background: Many medical schools worldwide are in the process of curricular change towards competencebased undergraduate medical education to ease the transition to residency. Aspects of patient management, interprofessional interaction and the concept of entrustable professional activities are in the focus of medical educators. Such curricular changes require an assessment with valid and reliable measurements of competences feasible for large numbers of medical students. Methods: Seventy medical students from three German medical schools (Hamburg, Oldenburg, and Munich) participated in our newly designed 360-degree examination based on selected competences relevant for first year residents. A consulting hour with five simulated patients is followed by a patient management phase of 2.5 hours with interprofessional disturbances, followed by a 30-minutes handover of the patients to a resident. Different competences are assessed by the supervisors, simulated patients, nurses, residents, and by the participants themselves. All participants and research assistants evaluated the assessment regarding aspects of organization and content. Results: All participants, assessors, and research assistants were satisfied with the process, technical equipment, and organization of the assessment. All assessors and research assistants stated that their respective training prepared them well for their role in the assessment. The participating students felt satisfied with the content of the assessment. They considered the patient cases to be very realistic. While there was no difference between students in their final year and students below semester 11 with respect to feeling confident during history taking and handover, final year students felt significantly more confident (p=0.02) during the patient management phase. Conclusion: It is feasible to implement a competence-based 360-degree assessment for a large group of students. Further analysis of the data will provide evidence whether students from medical schools with different undergraduate curricula perform differently with respect to competences relevant for first year residents.
摘要背景:世界各地的许多医学院都在向以能力为基础的本科医学教育转变课程,以缓解向住院医师的过渡。患者管理、跨专业互动和可持续专业活动的概念是医学教育工作者关注的焦点。这种课程改革需要对大量医学生的能力进行有效和可靠的评估。方法:来自三所德国医学院(汉堡、奥尔登堡和慕尼黑)的70名医学生参加了我们新设计的360度考试,该考试基于一年级居民的相关能力。对五名模拟患者进行咨询一小时后,进入2.5小时的跨专业干扰患者管理阶段,然后将患者移交给住院医师30分钟。不同的能力由主管、模拟患者、护士、住院医生和参与者自己进行评估。所有参与者和研究助理都对组织和内容方面的评估进行了评估。结果:所有参与者、评估员和研究助理都对评估的过程、技术设备和组织感到满意。所有评估员和研究助理都表示,他们各自的培训为他们在评估中的角色做好了充分准备。参与评估的学生对评估内容感到满意。他们认为这些病例非常现实。虽然大四学生和第11学期以下的学生在历史记录和交接过程中的自信感没有差异,但大四学生在患者管理阶段的自信感明显增强(p=0.02)。结论:对一大群学生实施基于能力的360度评估是可行的。对数据的进一步分析将提供证据,证明不同本科课程的医学院学生在与一年级住院医师相关的能力方面表现是否不同。
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引用次数: 16
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Journal of community medicine & health education
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