Pancreatic surgery units undertake several complex operations,albeit with consi-derable morbidity and mortality,as is the case for the management of complicated acute pancreatitis or chronic pancreatitis.The centralis...Pancreatic surgery units undertake several complex operations,albeit with consi-derable morbidity and mortality,as is the case for the management of complicated acute pancreatitis or chronic pancreatitis.The centralisation of pancreatic surgery services,with the development of designated large-volume centres,has contribu-ted to significantly improved outcomes.In this editorial,we discuss the complex associations between diabetes mellitus(DM)and pancreatic/periampullary disease in the context of pancreatic surgery and overall management of complex pancreatitis,highlighting the consequential needs and the indispensable role of specialist diabetes teams in support of tertiary pancreatic services.Type 3c pan-creatogenic DM,refers to DM developing in the setting of exocrine pancreatic disease,and its identification and management can be challenging,while the glycaemic control of such patients may affect their course of treatment and outcome.Adequate preoperative diabetes assessment is warranted to aid identification of patients who are likely to need commencement or escalation of glucose lowering therapy in the postoperative period.The incidence of new onset diabetes after pancreatic resection is widely variable in the literature,and depends on the type and extent of pancreatic resection,as is the case with pancreatic parenchymal loss in the context of severe pancreatitis.Early involvement of a specialist diabetes team is essential to ensure a holistic management.In the current era,large volume pancreatic surgery services commonly abide by the principles of enhanced recovery after surgery,with inclusion of provisions for optimisation of the perioperative glycaemic control,to improve outcomes.While various guidelines are available to aid perioperative management of DM,auditing and quality improvement platforms have highlighted deficiencies in the perioperative management of diabetic patients and areas of required improvement.The need for perioperative support of diabetic patients by specialist diabetes teams is uniformly underlined,a fact that becomes clearly more prominent at all different stages in the setting of pancreatic surgery and the management of complex pancreatitis.Therefore,pancreatic surgery and tertiary pancreatitis services must be designed with a provision for support from specialist diabetes teams.With the ongoing accumulation of evidence,it would be reasonable to consider the design of specific guidelines for the glycaemic management of these patients.展开更多
Buddhist monk Lin Daoren(790-850,from Xi'an,Shaanxi Province)was a specialist of traumatology and orthopedics of the Tang Dynasty.Secrets of Treating Wounds and Rejoining Fractures(Li Shang Xu Duan Fang)written by...Buddhist monk Lin Daoren(790-850,from Xi'an,Shaanxi Province)was a specialist of traumatology and orthopedics of the Tang Dynasty.Secrets of Treating Wounds and Rejoining Fractures(Li Shang Xu Duan Fang)written by him is the first extant monography on traumatology and orthopedics in China.According to the preface of the book,he had profound medical knowledge especially about the theory,diagnosis and treatment for wounds and fractures.展开更多
The objective of the article is identification of similarities in behavior and work attitude toward remote working in times of COVID-19 pandemic.Evaluation is concerned on employees of creative employees from differen...The objective of the article is identification of similarities in behavior and work attitude toward remote working in times of COVID-19 pandemic.Evaluation is concerned on employees of creative employees from different countries and business sectors.The author conducted research on Polish and American creative specialists,including software developers.Research conducted for this article in the first stage was qualitative,and in the second stage is based on quantitative methodology and secondary data from American research.The qualitative research conducted in Poland and was based on unstructured interviews with open-ended questions in the form of self-report concerning workflows during remote working.The first stage can be used as the starting point to next research of creative specialists from other countries.The quantitative research is based on secondary data from a study conducted among American employees of Microsoft Corporation.It was research made in the form of survey during COVID-19 pandemic(March-May 2020).The conclusions from each of the stages of research were used to create universal conclusions in the form of gathered key similarities and differences in behavior and wellbeing of creative specialist from different countries during remote working.The analysis included Industry 4.0 perspective-like market needs(e.g.building innovation which require a combination of creativity and technical skills)or condition of constant change.The research and analysis also reveals the potential for future research in the other countries and business sectors.展开更多
The clinical nursing specialist(CNS)is an expert who applies an expanded range of practical,theoretical,and research-based competencies to the care of patients within in a specialty clinical area within the larger dis...The clinical nursing specialist(CNS)is an expert who applies an expanded range of practical,theoretical,and research-based competencies to the care of patients within in a specialty clinical area within the larger discipline of nursing.A large number of studies consistently conclude that the CNS is a valuable healthcare resource that provides highquality clinical and evidence-based nursing practice and improves patient outcome.The CNS has been involved in healthcare practices for many years,with an increasingly diverse role.However,the training for the CNS in China is only in a preliminary developmental stage.The aim of this article is to review the history and development of the CNS role.Furthermore,the epidemiologic status of osteoporosis,as well as the feasibility and necessity of developing training programs in China for the osteoporosis CNS,will be discussed.展开更多
Objectives:To explore the current admittance situation of clinical teachers for masters of nursing specialist(MNS)postgraduates and to test the competence of clinical teachers in self-evaluation and other evaluations....Objectives:To explore the current admittance situation of clinical teachers for masters of nursing specialist(MNS)postgraduates and to test the competence of clinical teachers in self-evaluation and other evaluations.Methods:In this cross-sectional study,using a random number table,we chose 80 MNS postgraduates under clinical practice,their clinical teachers,and head nurses each from six hospitals in Hunan and Guangdong.The participants were tested on the basis of the Clinical Teachers'Competence Inventory of MNS Postgraduates.The competences of clinical teachers were evaluated by the three groups of participants.Results:The aggregated scores of teacher competence as evaluated by the MNS postgraduates(181.33±24.95)were lower than those assigned by both clinical teachers(190.75±24.30)and their head nurses(198.53±18.90),with significant differences in all dimensions except for clinical managing ability.The five highest rated items from all participants focused on the teachers'clinical nursing ability,and the five lowest rated items were mainly about their clinical research ability.Conclusion:The evaluation from MNS postgraduates is obviously lower than the self-evaluation of clinical teachers,and all participants are aware of the deficiency in research ability of the teachers.Thus,the admittance and examination of clinical teachers should be controlled strictly.Training should be carried out immediately to strengthen their comprehensive abilities,especially their research ability.展开更多
Introduction:Nurse specialists are being cultivated and trained in China to cope with the international development of nursing discipline.However,an empirical summary and reviews of literature have shown a lack of cor...Introduction:Nurse specialists are being cultivated and trained in China to cope with the international development of nursing discipline.However,an empirical summary and reviews of literature have shown a lack of core competence evaluation standards for emergency nurse specialists(ENSs)in China.ENS training has been conducted in several regions without any effective competence evaluation standards.This paper describes the development and psychometric testing of the Core Competence Evaluation Standards for Emergency Nurse Specialists(CCESENS)in the Chinese context.Methods:Several rigorous research methods were applied.The proposed evaluation process consisted of two phases with seven steps.First,the Core Competence Framework Model for Emergency Nurse Specialist(CCFMENS)was established,and 118 items were generated through a review of literature,theoretical analysis,and expert interviews.Drafts of the dimensions and items were evaluated by two-round Delphi methods.Analysis hierarchy process was used to determine the weight of each dimension.Second,field testing was performed among 138 senior emergency nurses.Internal consistency and correlation analysis were applied to test the reliability and validity of the model.Results:The CCESENS consisted of five first-level dimensions,16 second-level dimensions,and 55 items.Cronbach's a coefficient of overall standards was 0.972,and each dimension ranged from 0.508 to 0.972.Expert content validity index was 0.818,and the correlation coefficients of the five first-level dimensions with the overall standards CCESENS ranged from 0.701 to 0.886(P<0.05).Discussion:The CCESENS demonstrated sound internal consistency reliability,content validity,and construct validity.The proposed standard provides an objective standard and reference for assessing,training,and evaluating core competence of ENS.展开更多
Although liver transplantation(LT) is performed increasingly for patients with end-stage alcoholic liver disease(ALD), the topic remains controversial. Traditionally, the role of an addiction specialist focused on the...Although liver transplantation(LT) is performed increasingly for patients with end-stage alcoholic liver disease(ALD), the topic remains controversial. Traditionally, the role of an addiction specialist focused on the screening and identification of patients with a high risk on relapse in heavy alcohol use. These patients were in many cases subsequently excluded from a further LT procedure.Recently, awareness is growing that not only screening of patients but also offering treatment, helping patients regain and maintain abstinence is essential, opening up a broader role for the addiction specialist(team)within the whole of the transplant procedure. Within this context, high-risk assessment is proposed to be an indication of increasing addiction treatment intensity,instead of being an exclusion criterion. In this review we present an overview regarding the state of the art on alcohol relapse assessment and treatment in patients with alcohol use disorders, both with and without ALD.Screening, treatment and monitoring is suggested as central roles for the addiction specialist(team) integrated within transplant centers.展开更多
Objective: To establish an evaluation index system for the first-time certification of diabetes specialist nurses in line with the clinical nursing practice in China, and to provide a reference basis for government ad...Objective: To establish an evaluation index system for the first-time certification of diabetes specialist nurses in line with the clinical nursing practice in China, and to provide a reference basis for government administrations and hospitals to formulate unified standards. Methods: After the research team has determined the theme, it will consult the development of A) specialist nursing through the library, Internet and electronic literature database;B) the history of the development of specialist nurses in diabetes and other fields;C) the selection criteria of specialist nurses;D) the training of specialist nurses system, assessment method;E) Specialist nurse certification body, evaluation standards and certification standards and other related documents, literature, books and report materials. The author established the preliminary index system through literature review, specialist interview and group discussion and used Delphi method to organize three rounds of 30 experts’ consultations. Results: A first certification evaluation index system including 8 fundamental indicators, 5 first-level indicators, 19 second-level indicators and 99 third-level indicators was constructed for diabetes nurses. Conclusion: The results of three rounds of expert consultation and demonstration are reliable, and the constructed index system is suitable for comprehensive evaluation of diabetes specialist nurses, which provides a basis for the effective management of nursing resources.展开更多
Since domestic corporations firstly introduced into and implemented the Advanced Manufacturing Technology (AMT),how to scientifically evaluate the implementation effects of AMT has been an urgent problem.Through the r...Since domestic corporations firstly introduced into and implemented the Advanced Manufacturing Technology (AMT),how to scientifically evaluate the implementation effects of AMT has been an urgent problem.Through the review of for- eign relative studies,this paper constructs an indicator system used to evaluate the implementation effects of AMT.Operational performance,Organizational or managerial performance,Satisfactory performance,and Competitive performance are indicators of first level in the system,and 19 indicators of second level have been selected to estimate the implementation effects of AMT.In this study,a model based on Minkowski distance discriminance to select the specialists’ opinion was designed to evaluate the indica- tor system,and the measure’s validity and practicability was proved by a case study to a diesel engine factory.展开更多
AIM:To obtain information on the prevailing practice patterns of glaucoma specialists in India.METHODS:Glaucoma specialists attending the Annual Conference of the Glaucoma Society of India(GSI) were surveyed.This surv...AIM:To obtain information on the prevailing practice patterns of glaucoma specialists in India.METHODS:Glaucoma specialists attending the Annual Conference of the Glaucoma Society of India(GSI) were surveyed.This survey,conducted in 2013,was based on an interactive audience response system.RESULTS:The information was obtained from 146 glaucoma specialists.Approximately half(n=83;57%) had ≥10 y of experience in managing glaucoma and were in institutional practice(n=74,51%).Goldmann applanation tonometry was preferred by 103(72%) specialists whilst n=25(17.4%) used non-contact tonometer.Indentation gonioscopy was favoured by two-thirds(n=90,66%) whereas stereoscopic optic disc examination and visual fields using Humphrey perimeter was performed by a majority of the specialists surveyed(n=115,86% and n=114;83% respectively).Nearly three quarter specialists(n=96;72%) preferred optical coherence tomography for imaging.The primary choice for treatment of angle closure disease and primary open angle glaucoma was laser(iridotomy,n=117;93%) and medical management(prostaglandin analogue,n=104;78%),respectively.Approximately only a third of the specialists surveyed(n=37;28%) were performing both trabeculectomy and implantation of a glaucoma drainage device and about half(n=64;47%) were not operating on congenital glaucoma at all.CONCLUSION:This survey has found conformance with preferred practice patterns in several areas of diagnosisand management of glaucoma,but there was diversity in a few areas.The information is a significant step towards improvement of glaucoma care in India,including planning for future strategies.展开更多
Objective: By constructing a training system of quality evaluation standards for emergency nurse specialist(ENS), we can ensure smooth operations and quality training for ENS.Methods: First, the frame structure of ind...Objective: By constructing a training system of quality evaluation standards for emergency nurse specialist(ENS), we can ensure smooth operations and quality training for ENS.Methods: First, the frame structure of indicators was designed on the basis of system theory and the balanced scorecard method. Meanwhile, corresponding quantitative standard indicators were compiled through literature analysis and a review of training characteristics. Next, screening indicators were collected through consultation with experts and statistical calculations. The indicators weight coefficient was calculated using the analytic hierarchy process(AHP). Finally, indicators were validated in two groups of nurses in two different training courses.Results:(1) We created a three-level indicator system: level-Ⅰ dimensions have 4 indicators, while level-Ⅱ dimensions and level-Ⅲ dimensions have 13 and 34 indicators, respectively;(2) The coefficient of expert's judgment is 0.840, familiarity is 0.914 and authority is 0.877, and the three rounds of coordination coefficient are 0.456, 0.553 and 0.715, respectively;(3) There are at least 56 indicators in alternative quantitative standards; and(4) The alpha reliability value of the indicator system in the two training course had no significant difference(P > 0.05). The same result was observed when examining two groups of nurses in one training course(P > 0.05).Conclusions: This study established a training system of quality evaluation standards for emergency nurse specialists that is objective, reliable, easy to operate and representative according to scientific selection and verification. This system can therefore provide a basis for quality evaluation and targeted improvement for ENS training in addition to promoting health.展开更多
Background: There is a high variability in the reasons for cancellation of elective urological surgery cases. Case cancellation rate is expected to be high in the Public Health System with perceived inefficiencies com...Background: There is a high variability in the reasons for cancellation of elective urological surgery cases. Case cancellation rate is expected to be high in the Public Health System with perceived inefficiencies compared to private facilities in the same developing economy. Aims and Objectives: This comparative analysis was to determine the case cancellation rate and the reasons for cancellation of elective urological surgeries in a public tertiary hospital and a private specialist hospital in Accra. This is intended to form a basis for interventions aimed at reducing the case cancellation rate. Methods: This was a retrospective analysis of prospectively collected data on Day of Surgery cancelled elective urological cases from September 2014 to October 2015 at the urology unit of the Korle-Bu Teaching Hospital (KBTH), a public Tertiary Hospital and the Trust Specialist Hospital (TSH), a privately managed hospital in Accra. The reasons for case cancellation were categorized into structural factors, patient factors and process factors. Results: There was no significant difference between the case cancellation rate for elective urological cases at KBTH and the TSH which were 20.8% and 17.1% respectively (p = 0.317). For KBTH, the reasons for cancellation of elective urological cases were due to structural factors in 11/117 (9.4%), patient factors in 15/117 (12.8%) and process factors in 91/117 (77.8%) which was due mainly to surgery running late. At the TSH, the reasons were due to structural factors in 1/29 (3.4%), patient factors in 27/29 (93.1%) mainly due to patient not turning up and process factors in 1/29 (3.4%). Conclusion: The case cancellation rate of elective urological surgeries in both the Public Tertiary Hospital and the Private Specialist Hospital were high with no significant difference between the two. However, in the Public Tertiary Hospital, process factors predominated as the cause of these cancellations while patient factors were the predominant cause in the privately managed facility. Exposure of theater managers in public facilities to management practices in privately run facilities should be encouraged to help improve the efficiency of the public facilities.展开更多
Background: Most countries have a shortage of Primary Care (PC) physicians. Japan has mitigated this problem by specialists making a mid-career change to PC when they go into private practice. This study examines the ...Background: Most countries have a shortage of Primary Care (PC) physicians. Japan has mitigated this problem by specialists making a mid-career change to PC when they go into private practice. This study examines the circumstances under which specialists shift to PC. Methods: Since the division between specialists and PC physicians is blurred in Japan, we focus on Physicians Providing Home Visits (PPHV). The list of PPHV was obtained from the local medical associations in two neighboring medical planning areas in Japan. The methods used were a questionnaire and in-depth interviews. Results: Of the 46 listed as PPHV, 38 responded to the questionnaires. Physicians mainly acquired their knowledge and skills in primary care from post-graduate clinical training and on the job training after becoming PPHV. The specialists who had moved to PC were equally knowledgeable regarding PC as those had taken the PC accreditation exam. The in-depth interviews revealed that the higher income earned in clinics and being able to retain their identity as a specialist were also important factors. Conclusions: The factors that contributed to physicians making a mid-career change from specialists to PC were their experiences after being certified, the higher income in clinics and the ability to retain their professional identity as specialists. These enabling factors might also be applicable for increasing the ratio of PC physicians at the global level although further studies are required.展开更多
There is a significant unmet need for palliative care globally: of the 58 million people dying annually, it was estimated that at least 60% will have the prolonged advanced illness and dying and would benefit from pal...There is a significant unmet need for palliative care globally: of the 58 million people dying annually, it was estimated that at least 60% will have the prolonged advanced illness and dying and would benefit from palliative care. Zambia has a total population of 15,066,266 people. About 1,150,400 people are living with HIV and 18,900 people were reported to have died of HIV in 2014 alone. The most recent palliative care situational analysis in Zambia highlighted that palliative care remained “an essential absent factor” and revealed that there were gaps in the type of care given in various home based care (HBC) programs. Therefore, this study aimed at exploring the experiences of trained palliative care specialists in implementing palliative care in Lusaka, Zambia. This study was an exploratory qualitative research. The population comprised of the trained palliative care specialists in either degree or diploma in palliative care, working in Lusaka. Purposive sampling was used and the sample totaled 6 (n-6). The data collection was done using a semi-structured interview guide, through face-to-face in-depth interviews. The interviews lasted for an average of 20 minutes. Prompts and probes were used to increase detailed analysis explorations. Eleven themes broadly classified as facilitators or challenges emerged from the study. Among the facilitators: training influence;higher level support;effective team work and delivery models;and personal development and motivation to serve. challenges included: lack of PC knowledge;lack of essential medication for PC;work burden;lack of financial resources;lack of acceptance of PC;lack of PC guidelines;and legal restrictions on the use of opioids. The study provided evidence of the challenges and facilitators that influence palliative care that specialists experience while implementing PC. It is therefore, recommended that more research, education, effective teamwork is promoted as the study revealed that participants needed support for effective implementation of palliative care.展开更多
Wu Tang(style name Wu Peihang and courtesy name Wu Jutong,1758e1836)was from Huiyin,Jiangsu Province.Popularly known as Wu Jutong,he was a celebrated specialist of warmpathogen disease of the Qing Dynasty and the auth...Wu Tang(style name Wu Peihang and courtesy name Wu Jutong,1758e1836)was from Huiyin,Jiangsu Province.Popularly known as Wu Jutong,he was a celebrated specialist of warmpathogen disease of the Qing Dynasty and the author of The Detailed Analysis of Warm-Pathogen Disease(Wen Bing Tiao Bian),Wu Jutong's Case Records(Wu Ju Tong Yi An)and Rectify Errors in Medical Practice(Yi Yi Bing Shu).展开更多
Living with a congenital heart condition can require a daunting and uncertain patient journey during which the support of a specialist nursing service is vital. A descriptive, cross-sectional evaluation completed over...Living with a congenital heart condition can require a daunting and uncertain patient journey during which the support of a specialist nursing service is vital. A descriptive, cross-sectional evaluation completed over two years, utilised a postal questionnaire to investigate patient’s satisfaction with aspects of service. Qualitative responses to open questions on satisfaction with emotional support (n = 103) and contributions to well-being (n = 90) were analysed using a framework approach which identified eight themes. Professional knowledge and expertise, service accessibility, caring attributes, enabling patients to cope with anxiety, depression and meeting changing needs contributed positively to both patient well-being and emotional support. Family support was influential on emotional support alone, whilst mediating medical liaison exerted an impact on well-being by enhancing feelings of security. In conclusion, the specialist nursing service contributed positively to well-being and emotional support of patients and thereby to selective aspects of continuity of care.展开更多
Background: Although inflammatory bowel disease (IBD) patients have been increasing and new thera-peutic options for IBD have been developed, there are relatively few clinicians who specialize in IBD. Patients treated...Background: Although inflammatory bowel disease (IBD) patients have been increasing and new thera-peutic options for IBD have been developed, there are relatively few clinicians who specialize in IBD. Patients treated by a non-specialist of IBD may not receive appropriate treatment. This study aimed to compare disease and medication status between IBD patients treated by a specialist and those treated by a non-specialist. Methods: Medical charts of ambulating IBD patients in two hospitals were examined. All patients in one hospital were treated by one of the IBD specialists, while in the other hospital, patients were treated by one of the gastroenterologists who was a non-specialist of IBD. Results: The numbers of IBD patients were 255 (hospital with specialists) and 74 (hospital without specialists), respectively. Disease activity of the patients was not well-controlled in the hospital without specialists compared to in the hospi- tal with specialists (ulcerative colitis (UC): p = 0.0006 and Crohn’s disease: p = 0.012, respectively). The proportion of UC patients who received an insufficient dose of mesalazine (Pentasa < 3 g/day or Asacol < 3.6 g/day) was higher in the hospital without specialists (47% vs. 15%, p < 0.0001). In the hospital without specialists, more patients received long-term corticosteroids (UC: 23% vs. 5%, p < 0.0001), while fewer patients received immunomodulators (UC: 8% vs. 46%, p < 0.0001). Conclusions: IBD patients of the hospital without specialists were not well-controlled and were not prescribed appropriately with thera-peutic drugs. Fostering and placement of the specialist of IBD is an urgent problem.展开更多
China Accreditation Test for Translators and Interpreters(CATTI)is the most authoritative accreditation for translation and interpretation qualification in China.It is an important task to improve English majors’tran...China Accreditation Test for Translators and Interpreters(CATTI)is the most authoritative accreditation for translation and interpretation qualification in China.It is an important task to improve English majors’translating and interpreting ability in specialist cultivation.By applying CATTI level 3 to translation course teaching for English majors,this paper aims to explore CATTI participation in teaching practice from the perspective of teaching contents,teaching forms,and teaching methods so as to realize close integration between CATTI and cultivation of English majors in translation for training more qualified translators and interpreters.展开更多
文摘Pancreatic surgery units undertake several complex operations,albeit with consi-derable morbidity and mortality,as is the case for the management of complicated acute pancreatitis or chronic pancreatitis.The centralisation of pancreatic surgery services,with the development of designated large-volume centres,has contribu-ted to significantly improved outcomes.In this editorial,we discuss the complex associations between diabetes mellitus(DM)and pancreatic/periampullary disease in the context of pancreatic surgery and overall management of complex pancreatitis,highlighting the consequential needs and the indispensable role of specialist diabetes teams in support of tertiary pancreatic services.Type 3c pan-creatogenic DM,refers to DM developing in the setting of exocrine pancreatic disease,and its identification and management can be challenging,while the glycaemic control of such patients may affect their course of treatment and outcome.Adequate preoperative diabetes assessment is warranted to aid identification of patients who are likely to need commencement or escalation of glucose lowering therapy in the postoperative period.The incidence of new onset diabetes after pancreatic resection is widely variable in the literature,and depends on the type and extent of pancreatic resection,as is the case with pancreatic parenchymal loss in the context of severe pancreatitis.Early involvement of a specialist diabetes team is essential to ensure a holistic management.In the current era,large volume pancreatic surgery services commonly abide by the principles of enhanced recovery after surgery,with inclusion of provisions for optimisation of the perioperative glycaemic control,to improve outcomes.While various guidelines are available to aid perioperative management of DM,auditing and quality improvement platforms have highlighted deficiencies in the perioperative management of diabetic patients and areas of required improvement.The need for perioperative support of diabetic patients by specialist diabetes teams is uniformly underlined,a fact that becomes clearly more prominent at all different stages in the setting of pancreatic surgery and the management of complex pancreatitis.Therefore,pancreatic surgery and tertiary pancreatitis services must be designed with a provision for support from specialist diabetes teams.With the ongoing accumulation of evidence,it would be reasonable to consider the design of specific guidelines for the glycaemic management of these patients.
文摘Buddhist monk Lin Daoren(790-850,from Xi'an,Shaanxi Province)was a specialist of traumatology and orthopedics of the Tang Dynasty.Secrets of Treating Wounds and Rejoining Fractures(Li Shang Xu Duan Fang)written by him is the first extant monography on traumatology and orthopedics in China.According to the preface of the book,he had profound medical knowledge especially about the theory,diagnosis and treatment for wounds and fractures.
文摘The objective of the article is identification of similarities in behavior and work attitude toward remote working in times of COVID-19 pandemic.Evaluation is concerned on employees of creative employees from different countries and business sectors.The author conducted research on Polish and American creative specialists,including software developers.Research conducted for this article in the first stage was qualitative,and in the second stage is based on quantitative methodology and secondary data from American research.The qualitative research conducted in Poland and was based on unstructured interviews with open-ended questions in the form of self-report concerning workflows during remote working.The first stage can be used as the starting point to next research of creative specialists from other countries.The quantitative research is based on secondary data from a study conducted among American employees of Microsoft Corporation.It was research made in the form of survey during COVID-19 pandemic(March-May 2020).The conclusions from each of the stages of research were used to create universal conclusions in the form of gathered key similarities and differences in behavior and wellbeing of creative specialist from different countries during remote working.The analysis included Industry 4.0 perspective-like market needs(e.g.building innovation which require a combination of creativity and technical skills)or condition of constant change.The research and analysis also reveals the potential for future research in the other countries and business sectors.
基金The work was supported by the Comprehensive investment strategic emerging industries related construction projects in“twelfth five-year”for Tianjin(Tianjin Education Committee[2011]no.61).
文摘The clinical nursing specialist(CNS)is an expert who applies an expanded range of practical,theoretical,and research-based competencies to the care of patients within in a specialty clinical area within the larger discipline of nursing.A large number of studies consistently conclude that the CNS is a valuable healthcare resource that provides highquality clinical and evidence-based nursing practice and improves patient outcome.The CNS has been involved in healthcare practices for many years,with an increasingly diverse role.However,the training for the CNS in China is only in a preliminary developmental stage.The aim of this article is to review the history and development of the CNS role.Furthermore,the epidemiologic status of osteoporosis,as well as the feasibility and necessity of developing training programs in China for the osteoporosis CNS,will be discussed.
基金Postgraduates Research Innovation Project in Hunan Province(CX2016B484)
文摘Objectives:To explore the current admittance situation of clinical teachers for masters of nursing specialist(MNS)postgraduates and to test the competence of clinical teachers in self-evaluation and other evaluations.Methods:In this cross-sectional study,using a random number table,we chose 80 MNS postgraduates under clinical practice,their clinical teachers,and head nurses each from six hospitals in Hunan and Guangdong.The participants were tested on the basis of the Clinical Teachers'Competence Inventory of MNS Postgraduates.The competences of clinical teachers were evaluated by the three groups of participants.Results:The aggregated scores of teacher competence as evaluated by the MNS postgraduates(181.33±24.95)were lower than those assigned by both clinical teachers(190.75±24.30)and their head nurses(198.53±18.90),with significant differences in all dimensions except for clinical managing ability.The five highest rated items from all participants focused on the teachers'clinical nursing ability,and the five lowest rated items were mainly about their clinical research ability.Conclusion:The evaluation from MNS postgraduates is obviously lower than the self-evaluation of clinical teachers,and all participants are aware of the deficiency in research ability of the teachers.Thus,the admittance and examination of clinical teachers should be controlled strictly.Training should be carried out immediately to strengthen their comprehensive abilities,especially their research ability.
基金the support from the Shanghai Nursing Association and the Second Military Medical University.
文摘Introduction:Nurse specialists are being cultivated and trained in China to cope with the international development of nursing discipline.However,an empirical summary and reviews of literature have shown a lack of core competence evaluation standards for emergency nurse specialists(ENSs)in China.ENS training has been conducted in several regions without any effective competence evaluation standards.This paper describes the development and psychometric testing of the Core Competence Evaluation Standards for Emergency Nurse Specialists(CCESENS)in the Chinese context.Methods:Several rigorous research methods were applied.The proposed evaluation process consisted of two phases with seven steps.First,the Core Competence Framework Model for Emergency Nurse Specialist(CCFMENS)was established,and 118 items were generated through a review of literature,theoretical analysis,and expert interviews.Drafts of the dimensions and items were evaluated by two-round Delphi methods.Analysis hierarchy process was used to determine the weight of each dimension.Second,field testing was performed among 138 senior emergency nurses.Internal consistency and correlation analysis were applied to test the reliability and validity of the model.Results:The CCESENS consisted of five first-level dimensions,16 second-level dimensions,and 55 items.Cronbach's a coefficient of overall standards was 0.972,and each dimension ranged from 0.508 to 0.972.Expert content validity index was 0.818,and the correlation coefficients of the five first-level dimensions with the overall standards CCESENS ranged from 0.701 to 0.886(P<0.05).Discussion:The CCESENS demonstrated sound internal consistency reliability,content validity,and construct validity.The proposed standard provides an objective standard and reference for assessing,training,and evaluating core competence of ENS.
文摘Although liver transplantation(LT) is performed increasingly for patients with end-stage alcoholic liver disease(ALD), the topic remains controversial. Traditionally, the role of an addiction specialist focused on the screening and identification of patients with a high risk on relapse in heavy alcohol use. These patients were in many cases subsequently excluded from a further LT procedure.Recently, awareness is growing that not only screening of patients but also offering treatment, helping patients regain and maintain abstinence is essential, opening up a broader role for the addiction specialist(team)within the whole of the transplant procedure. Within this context, high-risk assessment is proposed to be an indication of increasing addiction treatment intensity,instead of being an exclusion criterion. In this review we present an overview regarding the state of the art on alcohol relapse assessment and treatment in patients with alcohol use disorders, both with and without ALD.Screening, treatment and monitoring is suggested as central roles for the addiction specialist(team) integrated within transplant centers.
文摘Objective: To establish an evaluation index system for the first-time certification of diabetes specialist nurses in line with the clinical nursing practice in China, and to provide a reference basis for government administrations and hospitals to formulate unified standards. Methods: After the research team has determined the theme, it will consult the development of A) specialist nursing through the library, Internet and electronic literature database;B) the history of the development of specialist nurses in diabetes and other fields;C) the selection criteria of specialist nurses;D) the training of specialist nurses system, assessment method;E) Specialist nurse certification body, evaluation standards and certification standards and other related documents, literature, books and report materials. The author established the preliminary index system through literature review, specialist interview and group discussion and used Delphi method to organize three rounds of 30 experts’ consultations. Results: A first certification evaluation index system including 8 fundamental indicators, 5 first-level indicators, 19 second-level indicators and 99 third-level indicators was constructed for diabetes nurses. Conclusion: The results of three rounds of expert consultation and demonstration are reliable, and the constructed index system is suitable for comprehensive evaluation of diabetes specialist nurses, which provides a basis for the effective management of nursing resources.
文摘Since domestic corporations firstly introduced into and implemented the Advanced Manufacturing Technology (AMT),how to scientifically evaluate the implementation effects of AMT has been an urgent problem.Through the review of for- eign relative studies,this paper constructs an indicator system used to evaluate the implementation effects of AMT.Operational performance,Organizational or managerial performance,Satisfactory performance,and Competitive performance are indicators of first level in the system,and 19 indicators of second level have been selected to estimate the implementation effects of AMT.In this study,a model based on Minkowski distance discriminance to select the specialists’ opinion was designed to evaluate the indica- tor system,and the measure’s validity and practicability was proved by a case study to a diesel engine factory.
文摘AIM:To obtain information on the prevailing practice patterns of glaucoma specialists in India.METHODS:Glaucoma specialists attending the Annual Conference of the Glaucoma Society of India(GSI) were surveyed.This survey,conducted in 2013,was based on an interactive audience response system.RESULTS:The information was obtained from 146 glaucoma specialists.Approximately half(n=83;57%) had ≥10 y of experience in managing glaucoma and were in institutional practice(n=74,51%).Goldmann applanation tonometry was preferred by 103(72%) specialists whilst n=25(17.4%) used non-contact tonometer.Indentation gonioscopy was favoured by two-thirds(n=90,66%) whereas stereoscopic optic disc examination and visual fields using Humphrey perimeter was performed by a majority of the specialists surveyed(n=115,86% and n=114;83% respectively).Nearly three quarter specialists(n=96;72%) preferred optical coherence tomography for imaging.The primary choice for treatment of angle closure disease and primary open angle glaucoma was laser(iridotomy,n=117;93%) and medical management(prostaglandin analogue,n=104;78%),respectively.Approximately only a third of the specialists surveyed(n=37;28%) were performing both trabeculectomy and implantation of a glaucoma drainage device and about half(n=64;47%) were not operating on congenital glaucoma at all.CONCLUSION:This survey has found conformance with preferred practice patterns in several areas of diagnosisand management of glaucoma,but there was diversity in a few areas.The information is a significant step towards improvement of glaucoma care in India,including planning for future strategies.
基金supported by the nursing special items of Health and Family Planning Commission Research Fund in Hubei province(No.HL2012-15)
文摘Objective: By constructing a training system of quality evaluation standards for emergency nurse specialist(ENS), we can ensure smooth operations and quality training for ENS.Methods: First, the frame structure of indicators was designed on the basis of system theory and the balanced scorecard method. Meanwhile, corresponding quantitative standard indicators were compiled through literature analysis and a review of training characteristics. Next, screening indicators were collected through consultation with experts and statistical calculations. The indicators weight coefficient was calculated using the analytic hierarchy process(AHP). Finally, indicators were validated in two groups of nurses in two different training courses.Results:(1) We created a three-level indicator system: level-Ⅰ dimensions have 4 indicators, while level-Ⅱ dimensions and level-Ⅲ dimensions have 13 and 34 indicators, respectively;(2) The coefficient of expert's judgment is 0.840, familiarity is 0.914 and authority is 0.877, and the three rounds of coordination coefficient are 0.456, 0.553 and 0.715, respectively;(3) There are at least 56 indicators in alternative quantitative standards; and(4) The alpha reliability value of the indicator system in the two training course had no significant difference(P > 0.05). The same result was observed when examining two groups of nurses in one training course(P > 0.05).Conclusions: This study established a training system of quality evaluation standards for emergency nurse specialists that is objective, reliable, easy to operate and representative according to scientific selection and verification. This system can therefore provide a basis for quality evaluation and targeted improvement for ENS training in addition to promoting health.
文摘Background: There is a high variability in the reasons for cancellation of elective urological surgery cases. Case cancellation rate is expected to be high in the Public Health System with perceived inefficiencies compared to private facilities in the same developing economy. Aims and Objectives: This comparative analysis was to determine the case cancellation rate and the reasons for cancellation of elective urological surgeries in a public tertiary hospital and a private specialist hospital in Accra. This is intended to form a basis for interventions aimed at reducing the case cancellation rate. Methods: This was a retrospective analysis of prospectively collected data on Day of Surgery cancelled elective urological cases from September 2014 to October 2015 at the urology unit of the Korle-Bu Teaching Hospital (KBTH), a public Tertiary Hospital and the Trust Specialist Hospital (TSH), a privately managed hospital in Accra. The reasons for case cancellation were categorized into structural factors, patient factors and process factors. Results: There was no significant difference between the case cancellation rate for elective urological cases at KBTH and the TSH which were 20.8% and 17.1% respectively (p = 0.317). For KBTH, the reasons for cancellation of elective urological cases were due to structural factors in 11/117 (9.4%), patient factors in 15/117 (12.8%) and process factors in 91/117 (77.8%) which was due mainly to surgery running late. At the TSH, the reasons were due to structural factors in 1/29 (3.4%), patient factors in 27/29 (93.1%) mainly due to patient not turning up and process factors in 1/29 (3.4%). Conclusion: The case cancellation rate of elective urological surgeries in both the Public Tertiary Hospital and the Private Specialist Hospital were high with no significant difference between the two. However, in the Public Tertiary Hospital, process factors predominated as the cause of these cancellations while patient factors were the predominant cause in the privately managed facility. Exposure of theater managers in public facilities to management practices in privately run facilities should be encouraged to help improve the efficiency of the public facilities.
文摘Background: Most countries have a shortage of Primary Care (PC) physicians. Japan has mitigated this problem by specialists making a mid-career change to PC when they go into private practice. This study examines the circumstances under which specialists shift to PC. Methods: Since the division between specialists and PC physicians is blurred in Japan, we focus on Physicians Providing Home Visits (PPHV). The list of PPHV was obtained from the local medical associations in two neighboring medical planning areas in Japan. The methods used were a questionnaire and in-depth interviews. Results: Of the 46 listed as PPHV, 38 responded to the questionnaires. Physicians mainly acquired their knowledge and skills in primary care from post-graduate clinical training and on the job training after becoming PPHV. The specialists who had moved to PC were equally knowledgeable regarding PC as those had taken the PC accreditation exam. The in-depth interviews revealed that the higher income earned in clinics and being able to retain their identity as a specialist were also important factors. Conclusions: The factors that contributed to physicians making a mid-career change from specialists to PC were their experiences after being certified, the higher income in clinics and the ability to retain their professional identity as specialists. These enabling factors might also be applicable for increasing the ratio of PC physicians at the global level although further studies are required.
文摘There is a significant unmet need for palliative care globally: of the 58 million people dying annually, it was estimated that at least 60% will have the prolonged advanced illness and dying and would benefit from palliative care. Zambia has a total population of 15,066,266 people. About 1,150,400 people are living with HIV and 18,900 people were reported to have died of HIV in 2014 alone. The most recent palliative care situational analysis in Zambia highlighted that palliative care remained “an essential absent factor” and revealed that there were gaps in the type of care given in various home based care (HBC) programs. Therefore, this study aimed at exploring the experiences of trained palliative care specialists in implementing palliative care in Lusaka, Zambia. This study was an exploratory qualitative research. The population comprised of the trained palliative care specialists in either degree or diploma in palliative care, working in Lusaka. Purposive sampling was used and the sample totaled 6 (n-6). The data collection was done using a semi-structured interview guide, through face-to-face in-depth interviews. The interviews lasted for an average of 20 minutes. Prompts and probes were used to increase detailed analysis explorations. Eleven themes broadly classified as facilitators or challenges emerged from the study. Among the facilitators: training influence;higher level support;effective team work and delivery models;and personal development and motivation to serve. challenges included: lack of PC knowledge;lack of essential medication for PC;work burden;lack of financial resources;lack of acceptance of PC;lack of PC guidelines;and legal restrictions on the use of opioids. The study provided evidence of the challenges and facilitators that influence palliative care that specialists experience while implementing PC. It is therefore, recommended that more research, education, effective teamwork is promoted as the study revealed that participants needed support for effective implementation of palliative care.
文摘Wu Tang(style name Wu Peihang and courtesy name Wu Jutong,1758e1836)was from Huiyin,Jiangsu Province.Popularly known as Wu Jutong,he was a celebrated specialist of warmpathogen disease of the Qing Dynasty and the author of The Detailed Analysis of Warm-Pathogen Disease(Wen Bing Tiao Bian),Wu Jutong's Case Records(Wu Ju Tong Yi An)and Rectify Errors in Medical Practice(Yi Yi Bing Shu).
文摘Living with a congenital heart condition can require a daunting and uncertain patient journey during which the support of a specialist nursing service is vital. A descriptive, cross-sectional evaluation completed over two years, utilised a postal questionnaire to investigate patient’s satisfaction with aspects of service. Qualitative responses to open questions on satisfaction with emotional support (n = 103) and contributions to well-being (n = 90) were analysed using a framework approach which identified eight themes. Professional knowledge and expertise, service accessibility, caring attributes, enabling patients to cope with anxiety, depression and meeting changing needs contributed positively to both patient well-being and emotional support. Family support was influential on emotional support alone, whilst mediating medical liaison exerted an impact on well-being by enhancing feelings of security. In conclusion, the specialist nursing service contributed positively to well-being and emotional support of patients and thereby to selective aspects of continuity of care.
文摘Background: Although inflammatory bowel disease (IBD) patients have been increasing and new thera-peutic options for IBD have been developed, there are relatively few clinicians who specialize in IBD. Patients treated by a non-specialist of IBD may not receive appropriate treatment. This study aimed to compare disease and medication status between IBD patients treated by a specialist and those treated by a non-specialist. Methods: Medical charts of ambulating IBD patients in two hospitals were examined. All patients in one hospital were treated by one of the IBD specialists, while in the other hospital, patients were treated by one of the gastroenterologists who was a non-specialist of IBD. Results: The numbers of IBD patients were 255 (hospital with specialists) and 74 (hospital without specialists), respectively. Disease activity of the patients was not well-controlled in the hospital without specialists compared to in the hospi- tal with specialists (ulcerative colitis (UC): p = 0.0006 and Crohn’s disease: p = 0.012, respectively). The proportion of UC patients who received an insufficient dose of mesalazine (Pentasa < 3 g/day or Asacol < 3.6 g/day) was higher in the hospital without specialists (47% vs. 15%, p < 0.0001). In the hospital without specialists, more patients received long-term corticosteroids (UC: 23% vs. 5%, p < 0.0001), while fewer patients received immunomodulators (UC: 8% vs. 46%, p < 0.0001). Conclusions: IBD patients of the hospital without specialists were not well-controlled and were not prescribed appropriately with thera-peutic drugs. Fostering and placement of the specialist of IBD is an urgent problem.
文摘China Accreditation Test for Translators and Interpreters(CATTI)is the most authoritative accreditation for translation and interpretation qualification in China.It is an important task to improve English majors’translating and interpreting ability in specialist cultivation.By applying CATTI level 3 to translation course teaching for English majors,this paper aims to explore CATTI participation in teaching practice from the perspective of teaching contents,teaching forms,and teaching methods so as to realize close integration between CATTI and cultivation of English majors in translation for training more qualified translators and interpreters.
