目的了解开展安宁缓和医疗(hospice and palliative care,HPC)对生命末期老年病人医疗状况的影响。方法连续查阅2014~2021年我院老年医学科死亡病人的病历,记录一般情况、心肺复苏意愿、生命支持手段的应用及临终前抢救措施。根据开展HP...目的了解开展安宁缓和医疗(hospice and palliative care,HPC)对生命末期老年病人医疗状况的影响。方法连续查阅2014~2021年我院老年医学科死亡病人的病历,记录一般情况、心肺复苏意愿、生命支持手段的应用及临终前抢救措施。根据开展HPC教育及临床工作的时间(以2018年1月为界点),将病例分为2014~2017年、2018~2021年2组进行纵向研究;并对2018~2021年开展HPC期间的病人进行亚组分析。结果共纳入254例死亡病人:2014~2017年死亡131例,2018~2021年死亡123例。2组年龄、性别、入院时躯体功能状况、1年内住院次数、住院时间、死亡原因构成差异均无统计学意义(P>0.05)。2组口服药物数量、多重用药比例、呼吸机使用率、使用白蛋白情况差异有统计学意义(P<0.05)。2组选择临终前不行心肺复苏及心外按压的比例差异无统计学意义(P>0.05),电除颤、简易呼吸器、血管活性药物、呼吸兴奋剂使用率差异有统计学意义(P<0.05)。2020~2021年与2018~2019年相比,生命末期老年病人多重用药率(37.3%比51.4%,P<0.05)、临终前血管活性药物使用率(49.0%比77.8%,P<0.05)、呼吸兴奋剂使用率(15.7%比50.0%,P<0.05)进一步下降。结论对于老年生命末期病人,开展HPC能够减少部分生命支持手段的使用,降低临终前无效医疗的应用。展开更多
针对学生实践教学能力培养不足问题,立足新工科,以培养高阶工程人才为目标,以能力培养为主线,对实验、工程实训、企业实习等实践教学环节进行贯通研究。探索了贯通式培养中的有效衔接机制、逆向反馈机制和保障机制,构建了基于实验室资源...针对学生实践教学能力培养不足问题,立足新工科,以培养高阶工程人才为目标,以能力培养为主线,对实验、工程实训、企业实习等实践教学环节进行贯通研究。探索了贯通式培养中的有效衔接机制、逆向反馈机制和保障机制,构建了基于实验室资源的LAB-CDIO工程教育新模式,进行实践教学贯通式培养中基于专业认证能力要求和企业需求反馈的“精准供给”工程训练项目及其体系设计,形成了“实验、工程实训、企业实习”三位一体化贯通培养系统。人才培养实践应用表明,实践教学贯通式培养体系能够确保实验、工程训练、企业实习三环节有效衔接,使实践教学管理水平与质量不断提高,有效促进了学生实践创新与工程应用能力的培养。Aiming at the problem of insufficient training of students’ practical ability, on the basis of the emerging engineering education, this paper takes cultivating high-level engineering talents as the goal and takes ability training as the main line, carrying out a study of through-training in practice teaching including experiment, engineering training and enterprise practice. The effective cohesion mechanism, reverse feedback mechanism and safeguard mechanism are researched. A new model of LAB-CDIO engineering education based on laboratory resources is constructed, and carried out “precision supply” engineering training projects and system design based on professional accreditation requirements and feedback from enterprise needs. At last, a tripartite integrated training system of “experiment, engineering training and enterprise practice” is formed. The practical application of talent training shows that the system of through-training in practice teaching can ensure the effective connection of experiment, engineering training and enterprise practice, the level and quality of practical teaching have been continuously improved, and the practical innovation and engineering application ability of students have been also effectively promoted.展开更多
文摘目的了解开展安宁缓和医疗(hospice and palliative care,HPC)对生命末期老年病人医疗状况的影响。方法连续查阅2014~2021年我院老年医学科死亡病人的病历,记录一般情况、心肺复苏意愿、生命支持手段的应用及临终前抢救措施。根据开展HPC教育及临床工作的时间(以2018年1月为界点),将病例分为2014~2017年、2018~2021年2组进行纵向研究;并对2018~2021年开展HPC期间的病人进行亚组分析。结果共纳入254例死亡病人:2014~2017年死亡131例,2018~2021年死亡123例。2组年龄、性别、入院时躯体功能状况、1年内住院次数、住院时间、死亡原因构成差异均无统计学意义(P>0.05)。2组口服药物数量、多重用药比例、呼吸机使用率、使用白蛋白情况差异有统计学意义(P<0.05)。2组选择临终前不行心肺复苏及心外按压的比例差异无统计学意义(P>0.05),电除颤、简易呼吸器、血管活性药物、呼吸兴奋剂使用率差异有统计学意义(P<0.05)。2020~2021年与2018~2019年相比,生命末期老年病人多重用药率(37.3%比51.4%,P<0.05)、临终前血管活性药物使用率(49.0%比77.8%,P<0.05)、呼吸兴奋剂使用率(15.7%比50.0%,P<0.05)进一步下降。结论对于老年生命末期病人,开展HPC能够减少部分生命支持手段的使用,降低临终前无效医疗的应用。
文摘针对学生实践教学能力培养不足问题,立足新工科,以培养高阶工程人才为目标,以能力培养为主线,对实验、工程实训、企业实习等实践教学环节进行贯通研究。探索了贯通式培养中的有效衔接机制、逆向反馈机制和保障机制,构建了基于实验室资源的LAB-CDIO工程教育新模式,进行实践教学贯通式培养中基于专业认证能力要求和企业需求反馈的“精准供给”工程训练项目及其体系设计,形成了“实验、工程实训、企业实习”三位一体化贯通培养系统。人才培养实践应用表明,实践教学贯通式培养体系能够确保实验、工程训练、企业实习三环节有效衔接,使实践教学管理水平与质量不断提高,有效促进了学生实践创新与工程应用能力的培养。Aiming at the problem of insufficient training of students’ practical ability, on the basis of the emerging engineering education, this paper takes cultivating high-level engineering talents as the goal and takes ability training as the main line, carrying out a study of through-training in practice teaching including experiment, engineering training and enterprise practice. The effective cohesion mechanism, reverse feedback mechanism and safeguard mechanism are researched. A new model of LAB-CDIO engineering education based on laboratory resources is constructed, and carried out “precision supply” engineering training projects and system design based on professional accreditation requirements and feedback from enterprise needs. At last, a tripartite integrated training system of “experiment, engineering training and enterprise practice” is formed. The practical application of talent training shows that the system of through-training in practice teaching can ensure the effective connection of experiment, engineering training and enterprise practice, the level and quality of practical teaching have been continuously improved, and the practical innovation and engineering application ability of students have been also effectively promoted.
