The aging development in Shanghai shows speed, high degree of aging, the number of elderly people living alone increased and other trends, the contradiction between degree of aging and care become more prominent. Howe...The aging development in Shanghai shows speed, high degree of aging, the number of elderly people living alone increased and other trends, the contradiction between degree of aging and care become more prominent. However, the prevalence of current pension model has a pension without medical care, health care and pension separate and other issues, so the development of ＂medical support combined with pension＂ long-term care insurance system is imperative. Based on the study to explore parts of the country which operate basic pension model of＂medical pension combination＂, we analyze the necessity and feasibility of the implementation of Shanghai ＂medical support combined with pension ＂ long-term care insurance system, by summing up experiences and lessons, put forward some of the recommendations for the development in Shanghai ＂medical support combined with pension＂ type of long-term care system.展开更多
The objective is to explore the foundation of the elderly long-term care insurance system in China, which is to face the problem resulted from aging of the population. Adopting the contrastive analysis to introduce br...The objective is to explore the foundation of the elderly long-term care insurance system in China, which is to face the problem resulted from aging of the population. Adopting the contrastive analysis to introduce briefly the long-term care insurance system in German, Japan and America for our learning. Therefore, China＇s long-term care insurance system could not totally indiscriminately imitate the mandatory long-term care insurance system in German and Japan, it also could not copy the business model of nursing insurance system in America. The conclusion is that long-term care insurance system in China should use the experience of developed countries based on the basic national conditions, doing some relative works, such as establishing policies and regulations, strengthening personnel training, and improving the market specification.展开更多
AIMTo determine the long-term effects of selective laser trabeculoplasty (SLT) on intraocular pressure (IOP) and the number of medications used up to 5y following treatment in glaucoma patients receiving maximally tol...AIMTo determine the long-term effects of selective laser trabeculoplasty (SLT) on intraocular pressure (IOP) and the number of medications used up to 5y following treatment in glaucoma patients receiving maximally tolerated medical therapy (MTMT).METHODSThe Wills Eye Hospital Glaucoma Research Center retrospectively reviewed the charts of glaucoma patients who underwent SLT after receiving MTMT. Eyes that did not achieve their target pressure within 3mo following SLT were excluded from the study. Changes in mean IOP and number of glaucoma medications used were analyzed at 1, 3, and 5y following SLT.RESULTSSeventy-five eyes of 67 patients were included in the study. Fifteen eyes that received SLT failed to achieve their target pressure within 3mo and were excluded from the study. The average follow-up time was 37.4mo (±14.4). Mean IOP was significantly reduced 1y after treatment (P=0.005). It was also reduced 3, 5y after treatment without reaching statistical significance (P=0.20 and P=0.072, respectively). There was a significant decrease in mean number of medications used 1, 3, 5y after treatment (P<0.001, P<0.001, and P=0.039, respectively). In the span of 5y, 2 eyes (2.7%) underwent repeat SLT, 7 eyes (9.3%) underwent glaucoma surgery and an additional 3 eyes (4.0%) underwent both.CONCLUSIONSLT significantly reduced the number of glaucoma medications used 5y following treatment in glaucoma patients receiving MTMT. SLT may delay operating-room surgery.展开更多
Beneficial effects of providing engaging activities to long-term care residents have been well documented. However, it is important to determine the effects of activities when providing throughout the day, especially ...Beneficial effects of providing engaging activities to long-term care residents have been well documented. However, it is important to determine the effects of activities when providing throughout the day, especially as they related to outcomes salient to administrators. We describe the creation and pilot testing of a sustained, coordinated activities program, Memory in Rhythm®(MIR), which incorporated Montessori-Based Dementia Programming™, in a skilled nursing facility (SNF). Effects of implementing MIR then were examined in memory care units in 16 aged care centers—9 SNFs and 7 assisted living residences in Ohio. For these centers, all data were collected over a period of one year before and one year after implementation of MIR. Results indicate that implementation of MIR was associated with reductions in medication use, increased census, decreased employee turnover, decreased wandering and agitation, and increased sleeping at night, eating and capacity for activities of daily living. In the SNFs, increases in RUGS case mix and use of Medicare Part B (rehabilitation services) were noted, while in assisted living implementation also was related to increased amount of time residents who were able to age in place. Implications of these findings are discussed.展开更多
目的随着信息技术的发展,“新医科”以培养更全面的医学专业人才为目的,为推动国内医学教育模式而逐步调整,本研究主要在繁多的模式中探索其主要的发展趋势。方法对中文数据库,中国知网(China National Knowledge Infrastructure,CNKI)...目的随着信息技术的发展,“新医科”以培养更全面的医学专业人才为目的,为推动国内医学教育模式而逐步调整,本研究主要在繁多的模式中探索其主要的发展趋势。方法对中文数据库,中国知网(China National Knowledge Infrastructure,CNKI)及中文科学引文索引(Chinese Social Sciences Citation Index,CSSCI)中,于1998年1月—2022年12月发表的“医学教育/教学模式”相关的期刊论文,运用CiteSpace软件进行计量分析。本研究面向上海交通大学医学院医学技术学院的412名本科生及研究生,采用随机整群抽样法抽取93名,研究数据通过问卷调查收集,问卷调查的实施时间为2023年11月10—14日。结果最终纳入8023篇文献,可视化分析发现目前文献研究的热点是线上教学。时间线图显示,近10年来,“慕课”及“翻转课堂”等依托网络教学资源的教学模式被持续聚焦,而传统线下教学仍被提及。为证实不同学历级别的学生对多种医学教育模式的选择意向,发放93份调查问卷,回收率100%。问卷结果显示,在线上模式的学习效果及对线下模式的可替代性等观点上,62.2%(58/93)的学生选择二者并行,不同学历间比较,差异无统计学意义(P>0.05);进一步分析发现,60.22%(56/93)的学生更倾向于线上结合线下的混合式教学模式。结论在医学教育模式变革过程中,线上教学是前沿热点。但因为医学的实践属性,线上与线下并行的混合式教学模式仍是发展趋势。二者合理的占比分配探索仍是未来的研究方向。展开更多
文摘The aging development in Shanghai shows speed, high degree of aging, the number of elderly people living alone increased and other trends, the contradiction between degree of aging and care become more prominent. However, the prevalence of current pension model has a pension without medical care, health care and pension separate and other issues, so the development of ＂medical support combined with pension＂ long-term care insurance system is imperative. Based on the study to explore parts of the country which operate basic pension model of＂medical pension combination＂, we analyze the necessity and feasibility of the implementation of Shanghai ＂medical support combined with pension ＂ long-term care insurance system, by summing up experiences and lessons, put forward some of the recommendations for the development in Shanghai ＂medical support combined with pension＂ type of long-term care system.
文摘The objective is to explore the foundation of the elderly long-term care insurance system in China, which is to face the problem resulted from aging of the population. Adopting the contrastive analysis to introduce briefly the long-term care insurance system in German, Japan and America for our learning. Therefore, China＇s long-term care insurance system could not totally indiscriminately imitate the mandatory long-term care insurance system in German and Japan, it also could not copy the business model of nursing insurance system in America. The conclusion is that long-term care insurance system in China should use the experience of developed countries based on the basic national conditions, doing some relative works, such as establishing policies and regulations, strengthening personnel training, and improving the market specification.
文摘AIMTo determine the long-term effects of selective laser trabeculoplasty (SLT) on intraocular pressure (IOP) and the number of medications used up to 5y following treatment in glaucoma patients receiving maximally tolerated medical therapy (MTMT).METHODSThe Wills Eye Hospital Glaucoma Research Center retrospectively reviewed the charts of glaucoma patients who underwent SLT after receiving MTMT. Eyes that did not achieve their target pressure within 3mo following SLT were excluded from the study. Changes in mean IOP and number of glaucoma medications used were analyzed at 1, 3, and 5y following SLT.RESULTSSeventy-five eyes of 67 patients were included in the study. Fifteen eyes that received SLT failed to achieve their target pressure within 3mo and were excluded from the study. The average follow-up time was 37.4mo (±14.4). Mean IOP was significantly reduced 1y after treatment (P=0.005). It was also reduced 3, 5y after treatment without reaching statistical significance (P=0.20 and P=0.072, respectively). There was a significant decrease in mean number of medications used 1, 3, 5y after treatment (P<0.001, P<0.001, and P=0.039, respectively). In the span of 5y, 2 eyes (2.7%) underwent repeat SLT, 7 eyes (9.3%) underwent glaucoma surgery and an additional 3 eyes (4.0%) underwent both.CONCLUSIONSLT significantly reduced the number of glaucoma medications used 5y following treatment in glaucoma patients receiving MTMT. SLT may delay operating-room surgery.
文摘Beneficial effects of providing engaging activities to long-term care residents have been well documented. However, it is important to determine the effects of activities when providing throughout the day, especially as they related to outcomes salient to administrators. We describe the creation and pilot testing of a sustained, coordinated activities program, Memory in Rhythm®(MIR), which incorporated Montessori-Based Dementia Programming™, in a skilled nursing facility (SNF). Effects of implementing MIR then were examined in memory care units in 16 aged care centers—9 SNFs and 7 assisted living residences in Ohio. For these centers, all data were collected over a period of one year before and one year after implementation of MIR. Results indicate that implementation of MIR was associated with reductions in medication use, increased census, decreased employee turnover, decreased wandering and agitation, and increased sleeping at night, eating and capacity for activities of daily living. In the SNFs, increases in RUGS case mix and use of Medicare Part B (rehabilitation services) were noted, while in assisted living implementation also was related to increased amount of time residents who were able to age in place. Implications of these findings are discussed.
文摘目的随着信息技术的发展,“新医科”以培养更全面的医学专业人才为目的,为推动国内医学教育模式而逐步调整,本研究主要在繁多的模式中探索其主要的发展趋势。方法对中文数据库,中国知网(China National Knowledge Infrastructure,CNKI)及中文科学引文索引(Chinese Social Sciences Citation Index,CSSCI)中,于1998年1月—2022年12月发表的“医学教育/教学模式”相关的期刊论文,运用CiteSpace软件进行计量分析。本研究面向上海交通大学医学院医学技术学院的412名本科生及研究生,采用随机整群抽样法抽取93名,研究数据通过问卷调查收集,问卷调查的实施时间为2023年11月10—14日。结果最终纳入8023篇文献,可视化分析发现目前文献研究的热点是线上教学。时间线图显示,近10年来,“慕课”及“翻转课堂”等依托网络教学资源的教学模式被持续聚焦,而传统线下教学仍被提及。为证实不同学历级别的学生对多种医学教育模式的选择意向,发放93份调查问卷,回收率100%。问卷结果显示,在线上模式的学习效果及对线下模式的可替代性等观点上,62.2%(58/93)的学生选择二者并行,不同学历间比较,差异无统计学意义(P>0.05);进一步分析发现,60.22%(56/93)的学生更倾向于线上结合线下的混合式教学模式。结论在医学教育模式变革过程中,线上教学是前沿热点。但因为医学的实践属性,线上与线下并行的混合式教学模式仍是发展趋势。二者合理的占比分配探索仍是未来的研究方向。
