Objective To systematically review the influence of frailty on the prognosis of non-cardiovascular surgery heart failure (HF) patients and to provide references for its prevention and management. Methods CNKI, VIP, CBM, WanFang Data, PubMed, EMbase, Web of Science, and The Cochrane Library were searched to collect cohort studies on the prognosis of non-cardiovascular surgery HF patients with frailty from inception to November 1st, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Then, meta-analysis was performed using RevMan 5.3 software and Stata 14.0 software. Results A total of 20 studies involving 11 127 patients were included. The results of meta-analysis showed that frailty increased the risk of all-cause mortality (HR=1.72, 95%CI 1.61 to 1.84, P<0.000 01), hospitalization (HR=2.06, 95%CI 1.26 to 3.37, P=0.004), and combined endpoint (HR=1.59, 95%CI 1.37 to 1.84, P<0.000 01) in non-cardiovascular surgery HF patients. Conclusion Current evidence shows that frailty can increase the risk of all-cause mortality, hospitalization, and combined endpoints in non-cardiovascular surgery HF patients. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Standardized residents training is a necessary way to cultivate qualified clinical physicians, and the teaching ability of their mentors will be a key factor affecting the quality of standardized residents training. In view of the problems existing in the current teachers training of standardized residents training, West China Hospital of Sichuan University has innovatively built a “coordination of six priorities” teachers training system to conduct hierarchical training for different types of mentors, in order to improve the quality and achieve homogenization of training. This article mainly elaborates on the problems in the current residents teachers training, the “coordination of six priorities” teachers training system of West China Hospital of Sichuan University, and the effect of the teachers training.
Objective To learn about the attitudes and understanding of resident doctors with concerning Global Minimum Essential Requirements in Medical Education (GMER).Methods Two hundred and five resident doctors of West China Hospital of Sichuan University were investigated by using questionnaires. Results The majority of the resident doctors regarded 4 domains of GMER important, but they were lack of the recognition of the importance of “population health and health systems”, “communication skills”, and “management of information” domains. Conclusions Medical curriculum should be revised to strengthen the recognition of the importance of all the 7 domains in medical education, including the postgraduate medical education, so as to cultivate doctors’ suitability for their responsibility in healthcare.
Objective This study aimed to explore the characteristics and deficiencies of the current standardized training evaluation system for general practitioners (including professional master’s degrees), analyze the awareness and attitudes of teaching physicians toward entrustable professional activities (EPAs), and to explore feasible solutions for establishing an EPAs evaluation and assessment system for general practitioners in training. Methods This study used a questionnaire survey to investigate 158 clinical teaching professionals, analyzed the current status of the standardized training evaluation system for general practitioners, and explored the level of understanding and opinions of teaching physicians on EPAs. Results Currently, there were many assessments for trained general practitioner residents, but there were problems with excessive formalization, single assessment methods, and a focus on written assessments. The recognition rate of EPAs among preceptors before training was only 15.9%, which increased to 71.51% after training. The EPA system could improve understanding and facilitate rapid implementation in the short term (P<0.001). While recognizing the concept of EPAs, preceptors also suggested simplifying the EPA system. Conclusion To address the shortcomings of the current standardized training evaluation system for general practitioners, targeted work should be carried out to design EPAs for professional confidence behaviors. A concise and practical EPAs evaluation system should be established for general practitioners. In addition, teaching staff should be trained and educated on EPAs to improve their teaching competence and ensure the output of general medical education.
ObjectiveTo briefly describe the specific contents and analyze the implementation effects of the information-based training system on neurology residents.MethodsSince February 2020, an information-based training system was carried out in the standardized training center for residents in the Department of Neurology, Xuanwu Hospital of Capital Medical University. The effect of the information-based training system was measured by comparing the numbers of training lessions and examinations, participation rates of training lessions and examinations, and mock examination results after 4 months of training of the resident trainees in Grade 2017 under the information-based training mode (n=35) with those of the resident trainees in Grade 2016 under regular face-to-face training mode (n=35). Chi-square test was used for comparison between training groups.ResultsCompared with those in Grade 2016, the number of lessons in Grade 2017 increased by 87.0% (43 vs. 23), the participation rate of lessons in Grade 2017 was higher (100.0% vs. 87.0%, P<0.001), the number of examinations in Grade 2017 increased by 87.5% (15 vs. 8), the participation rates of examinations were both 100.0%, and the pass rate of the mock examination in Grade 2017 was higher (94.3% vs. 77.1%, P=0.040).ConclusionThe training method and effect of the standardized training model of the information-based training system for resident doctors are worthy of recognition, providing a reference for medical teaching, especially for the standardized training of resident physicians.
ObjectiveTo improve activities of daily living (referring to Barthel Index) in the older inpatients.MethodsIn January 2016, a quality control circle (QCC) was established. According to 10 steps in activity of QCC, we figured out the causes of low Barthel Index score in older inpatients by using Plato method and Fishbone Diagram which were common methods of QCC. In addition, we designed and implemented a rectification program to improve Barthel Index score.ResultsAfter intervention of QCC, the average Barthel Index score of the older inpatients increased from 72.40±6.42 to 89.30±5.87 with a statistical difference (P<0.01); the satisfaction percent of hospitalized patients increased from 94.5% to 98.7% with a statistical difference (P<0.01). The percentage of registered nurses whose theoretical test score were over 90 increased from 57% to 88% (P<0.01) and the satisfaction percent of nurses increased from 90.5% to 95.6% (P<0.01). Moreover, the member’s ability of learning, discovery, analysis and problem solving, communication, application of QCC skills were improved.ConclusionThe application of QCC activities will increase older inpatients’ Barthel Index score, improve the satisfaction of patients and nursing staff, and enhance the members’ ability of solving problems by using QCC skills.
Objective To analyze the risk factors of hospitalized children with acute asthma exacerbation in Chongqing region. Methods A total of 193 cases were randomly selected from the hospitalized children with acute asthma exacerbation in Chongqing Children’s hospital and Jiangjin District People’s Hospital from January 2009 to December 2009. A self-designed questionnaire was used to collect data. A control group of children were randomly selected from the out-patients who received regular maintain therapy without asthma attacks for more than 3 months. Results The first independent risk factor of asthma hospitalization was respiratory infection ( 85. 5%, 165 /193) . Irregular use of control medications was the second important factor for the acute exacerbation. There were 75% ( 138 /193) patients didn’t take controlmedications regularly, includes 102 undiagnosed and 36 pre-diagnosed cases which was more common than that in regular maintain therapy group ( 21/110, 19. 1% ) . A variety of allergen-induced acute exacerbation of asthma was also common, which accountted for 9. 3 % ( 18/193) . There were more boys than girls ( M/F:124 /69) and no significant difference in the family history of allergic diseases ( P gt; 0. 05) . Conclusion Respiratory infection, under-diagnosis of asthma, and irregular use of the control medications are risk factors of acute exacerbation in children with asthma in Chongqing region. Meanwhile allergen exposure warrantsmore attention.
Objective To analyze the correlation between frailty syndrome and lower limb motor function in hospitalized elderly patients. Methods Convenience sampling method was used to select inpatients aged 65 and above from the Center of Gerontology and Geriatrics of West China Hospital, Sichuan University between December 2022 and May 2023. The FRAIL Scale, Short Physical Performance Battery (SPPB), and Timed Up and Go Test (TUGT) were used to evaluate the degree of frailty and lower limb motor function, and to explore the correlation between frailty and lower limb motor function. Results A total of 501 elderly patients were included, including 325 males (64.9%) and 176 females (35.1%); 256 cases of frailty (51.1%), 161 cases of pre-frailty (32.1%), and 84 cases of non-frailty (16.8%). The incidence of frailty in hospitalized elderly male patients was higher than that in female patients (P<0.05); The incidence of frailty in patients aged 80-99 was higher than that in patients aged 65-79 (P<0.05). The Spearman correlation analysis results showed that all dimensions of SPPB were negatively correlated with frailty (P<0.001), while TUGT was positively correlated with frailty (r=0.776, P<0.001). The results of multiple linear regression analysis showed that the worse the motor function of the lower limbs, the higher the debilitation score. Conclusions Frailty syndrome in hospitalized elderly patients is closely related to lower limb motor function. Lower limb motor function assessment can be used to predict the onset of frailty in clinical practice, and interventions to improve lower limb motor function can be used to improve the frailty of elderly patients.
