Utilidad y seguridad de los ingresos directos a una unidad hospitalaria de agudos de un servicio de geriatría valorados por atención geriátrica en residencias

Background and objectiveMore than half of institutionalized older people need a emergency department visit annually, with high resources consumption and higher risk of adverse events, due to high complexity. Direct admission to Acute Geriatric Unit (AGU), after geriatric consultant and nursing home medical team assessment, could be a safety and effective alternative to emergency department (ED) admission.MethodsRetrospective observational study of AGU patients admitted by Nursing Home Geriatric Team between January, 1st and December, 31st, 2021. Planned admissions and SARS-CoV-2 positive patients were excluded. Medical (sociodemographic, clinical, functional and cognitive) records and outcomes data (inpatient mortality, hospital and ED lenght of stay, transfer to ED and delirium within 48 h after admission, hospital discharge location) were collected.ResultsTwo hundred and six patients directly admitted, 101 through ED (N 307). 62.5% with Barthel index <40, 65% with dementia, 56.4% with Charlson index ≥3. Inpatient mortality was 14.6% in direct admission, 20.8% in ED referral group, p = 0.14. Hospital lenght of stay was 9.61 ± 6.01 days in direct admission, 11.22 ± 5.36 days in ED group, p = 0.02. 27.7% of patients with delirium in direct admission and 36.6% in ED group; only one patient was transferred to ED, within 48 h after admission.ConclusionsDirect admission is a safety and effective alternative to ED referral in institutionalized older people after geriatric assessment, due to no increased mortality, shorter length of stay and hospital cost reduction.     

Improved therapeutic efficiency of photothermal treatment and nursing care in prostate cancer by DOX loaded PEG coated Cu@Se nano-hybrid vesicle

Cancer is one of the major life threatening diseases, with higher mortality rate and morbidity. It is always a challenge for effective drug delivery and release of drug in specific tumor sites. Therefore to identify the synergistic effect of chemotherapeutic drug and photo thermal agent on tumor area, Doxorubicin (DOX) acts as anticancer agent but it has low aqueous solubility so its clinical application is limited. The present study developed doxorubicin (DOX) were designed to be with the poly ethylene glycol (PEG) functionalized copper and selenium (Cu-Se) nanoparticles (PEG@Cu-Se+DOX) and it is efficiently synthesized and enhance its aqueous formulation and improve the prostate cancer (DU145 and LNCaP) activity. The characteristics like mono dispersity, size stability and constant spectral of as-synthesized nanoparticles are comparably excellent than DOX alone. Also the enhanced cellular uptake and in vitro cytoxicicty suggests these nanoparticles selectively killing prostate cancer. In this present study explained that PEG@Cu-Se+DOX as a safe and hopeful strategy for chemotherapeutics of photothermal therapy and deserve for further clinical evaluations.     

全国大学生生命科学竞赛数据分析与展望

全国大学生生命科学竞赛至今已举办三届,赛事组织好、规模大、参与度高,对促进生命科学教育与研究具有重要作用。文中简述全国大学生生命科学竞赛的模式与现状,并基于前三届竞赛数据分地区分年度统计分析报名数据和竞赛成绩,同时结合生命科学领域的新变化新认识进行展望,以更好地推动赛事发展。     

Is the edTPA the Right Choice for Evaluating Teacher Readiness?

The purpose of this article is to describe and analyze the edTPA, a performance assessment created by the Stanford Center for Assessment, Learning, and Equity (SCALE) and administered by Pearson, Inc., to assess the professional readiness of student teachers. We challenge claims made in support of using this assessment, specifically within the context of arts teacher preparation programs, and we address areas of immediate critical concern to make alternative recommendations.     

Extending a Model of Shift‐Work Tolerance

The present study contributes to theory and practice through the development of a model of shift‐work tolerance with the potential to indicate interventions that reduce nurses' intention toward turnover and increase job satisfaction in hospital‐based settings. Survey data from 1257 nurses were used to conduct structural equation modeling that examine the direct and indirect effects of supervisor and colleague support, team identity, team climate, and control over working environment on time‐based work/life conflict, psychological well‐being, physical symptoms, job satisfaction, and turnover intention. The analysis of the proposed model revealed a good fit The chi‐square difference test was non‐significant (χ²(26)=338.56), the fit indices were high (CFI=.923, NFI=.918, and NNFI=.868), the distribution of residuals was symmetric and approached zero, the average standardized residual was low (AASR=.04), and the standardized RMR was. 072. In terms of the predictor variable, the final model explained 48% of the variance in turnover intention. The data revealed considerable evidence of both direct effects on adjustment and complex indirect links between levels of adjustment and work‐related social support, team identity, team climate, and control. Nurses with high supervisor and coworker support experienced more positive team climates, identified more strongly with their team, and increased their perceptions of control over their work environment. This in turn lowered their appraisals of their time‐based work/life conflict, which consequently increased their psychological well‐being and job satisfaction and reduced their physical health symptoms and turnover intention. The type of shift schedule worked by the nurses influenced levels of turnover intention, control over work environment, time‐based work/life conflict, and physical symptoms.     

Factors Affecting Work Ability in Day and Shift‐Working Nurses

Satisfactory work ability is sustained and promoted by good physical and mental health and by favorable working conditions. This study examined whether favorable and rewarding work‐related factors increased the work ability among European nurses. The study sample was drawn from the Nurses' Early Exit Study and consisted of 7,516 nursing staff from seven European countries working in state‐owned and private hospitals. In all, 10.8% were day, 4.2% were permanent night, 20.9% were shift without night shift, and 64.1% were shift workers with night shifts. Participants were administered a composite questionnaire at baseline (Time 0) and 1 yr later (Time 1). The Work Ability Index (WAI) at Time 1 was used as the outcome measure, while work schedule, sleep, rewards (esteem and career), satisfaction with pay, work involvement and motivation, and satisfaction with working hours at Time 0 were included as potential determinants of work ability. Univariate and multivariate analyses were conducted after adjusting for a number of confounders (i.e., country, age, sex, type of employment, family status, and other job opportunities in the same area). Work schedule was not related to Time 1 changes in WAI. Higher sleep quality and quantity and more favorable psychosocial factors significantly increased work ability levels. Higher sleep quality and quantity did not mediate the effect of work schedule on work ability. No relevant interaction effects on work ability were observed between work schedule and the other factors considered at Time 0. As a whole, sleep and satisfaction with working time were gradually reduced from day work to permanent night work. However, scores on work involvement, motivation, and satisfaction with pay and rewards were the highest in permanent night workers and the lowest in rotating shift workers that included night shifts.     

案例教学法在护理本科专业组织学与胚胎学教学中的实施与体会

组织学与胚胎学为护理本科专业学生必修课.在教学过程中采取＂学生为主体、教师为主导＂的案例教学法,激发学生的主观能动性,注重学生创新能力培养.在案例教学过程中,也发现一些问题：学生素质不一、学习目标不明确以及教师教育理念滞后等.因此,在护理本科专业组织学与胚胎学实施案例教学过程中,引导学生确立学习目标,积极思考,注重团队合作,全面调动学生学习的积极性和主动性.教师在更新教学观念的同时,提倡奉献精神,注重自身素质的培养和提高.     

在320排螺旋CT双下肢动脉成像中的护理配合效应

目的：探讨320排螺旋CT血管成像（CTA）在行双下肢动脉血管成像过程中,护理配合对的图像质量的影响。方法：将138例患者分为护理组（82例）及对照组（56例）,分别进行320排螺旋CT双下肢血管造影检查,经高压团注造影剂欧乃派克,进行三维重组,获取容积再观（VR）、曲面重组（CPR）和最大密度投影（MIP）图像。对照组的患者只进行口头的训练,没有其他的护理干预措施;实验组进行一系列的护理干预以提高患者的配合,减低在成像过程中的非生理性运动。用工作站进行图像后处理,显示双下肢动脉图像,对其图像质量和影响因素进行分析,并在检查过程中的护理干预加以总结。结果：对照组有2例患者穿刺部位不合理而影响图像质量,对双下肢的病变显示具有一定的影响,3例患者注射压力过高引起外渗,流速在2.5-3.5 ml/s,影响了图像的清晰度,其余均获得满意效果。结论：良好的护理配合有利于320排CT双下肢成像的顺利进行,精心的护理操作是取得检查成功的动脉成像保证。