Background:The Global Leadership Initiative on Malnutrition(GLIM)has been used in China since 2019.This study aimed to test the use of the GLIM criteria in Chinese cancer patients and to compare the diagnostic perform...Background:The Global Leadership Initiative on Malnutrition(GLIM)has been used in China since 2019.This study aimed to test the use of the GLIM criteria in Chinese cancer patients and to compare the diagnostic performance of the GLIM criteria with the Patient-Generated Subjective Global Assessment(PG-SGA)and modified PG-SGA(mPG-SGA). Methods:A total of 2,000 cancer patients were consecutively screened using the Nutritional Risk Screening 2002 instrument on ad-mission.Patients at nutritional risk(Nutritional Risk Screening 2002 score≥3)were enrolled to obtain the complete GLIM,PG-SGA,and mPG-SGA criteria.To evaluate the convergent validity,Spearman correlation analysis was used to compare the test-retest reliability of the GLIM criteria and its results with the scores of various nutritional tools and objective parameters.Kruskal-Wallis tests and χ2 tests were used to test the discriminant validity among groups with different nutritional status.We calculated the sensitivity,specificity,positive predictive value,and negative predictive value for the various tools. Results:There were 562 patients found to be at nutritional risk,accounting for 28.1%of all patients.One hundred seventy-four patients(8.7%)were diagnosed as moderately malnourished,and 333 patients(16.6%)were severely malnourished based on the PG-SGA.When assessed using the GLIM criteria,185 patients(9.3%)were diagnosed as moderately malnourished and 311 patients(15.5%)were severely malnourished.The content validity of the GLIM criteria was 95%,evaluated by 60 medical staff members.The test-retest reliability was good.For the diagnosis of malnutrition versus the PG-SGA,the sensitivity of the GLIM was"good"(90.5%;95%confidence interval[95%CI]=88.0%-93.1%),with a positive predictive value of 92.5%(95%CI=90.2%-94.9%),but the spec-ificity and negative predictive value were"poor."Similar results were obtained when the mPG-SGA was used as the criterion. Conclusions:Overall,this cross-sectional study suggests that the GLIM criteria comprise a valid and reliable tool to assess the nutri-tional status of Chinese cancer patients.展开更多
营养不良在老年人群中的发生率呈逐年上升的趋势,可导致老年人的身体功能下降、易发生感染、延迟康复等,严重影响其生活质量及疾病预后。因此,营养不良的早期识别和诊断对普外科老年患者有着重要的意义。目前针对老年人群营养不良的诊...营养不良在老年人群中的发生率呈逐年上升的趋势,可导致老年人的身体功能下降、易发生感染、延迟康复等,严重影响其生活质量及疾病预后。因此,营养不良的早期识别和诊断对普外科老年患者有着重要的意义。目前针对老年人群营养不良的诊断主要包括全球营养领导层倡议营养不良诊断标准(Global Leadership Initiative on Malnutrition,GLIM)、主观全面评定(Subjective Global Assessment,SGA)等。GLIM进入临床应用较晚,能否全面反映外科老年人群的营养状态仍有争议。本文主要探讨GLIM在普外科老年人群中诊断营养不良的应用现状,旨在为老年人营养不良的诊断提供参考。展开更多
Is there a "leadership crisis" in the world today? Thirty years ago, James MacGregor Burns, the Pulitzer Prize winner for the book of Leadership (1978), coined this phrase - leadership crisis. This topic has...Is there a "leadership crisis" in the world today? Thirty years ago, James MacGregor Burns, the Pulitzer Prize winner for the book of Leadership (1978), coined this phrase - leadership crisis. This topic has been quite old, but during specific times, it always has its new content. Leadership crisis roughly means the inefficient leadership that might bring the ineffectiveness. Having entered the times of globalization, the sentiment-oriented Chinese leadership unexceptionally has exposed its disadvantages and deficiencies compared with the mature and complete modern management.展开更多
This descriptive phenomenological study was to explore how communication and leadership influenced retention of registered nurses. The theoretical foundation of this descriptive phenomenological study is communication...This descriptive phenomenological study was to explore how communication and leadership influenced retention of registered nurses. The theoretical foundation of this descriptive phenomenological study is communication and leadership grounded in Burns theory of transformational leadership. The purpose of this study was to expand on and fill a gap in the research of how the lived experiences of nine registered nurses add to the influence communication and leadership has on retention, and to answer the following research questions. What are the lived experiences of registered nurses in the Western United States as they relate to retention when those registered nurses perceive a lack of communication? And, what are the lived experiences of registered nurses in the Western United States as they relate to retention when those registered nurses perceive a lack of leadership? The researcher interviewed nine participants working in hospitals in the Western United States. Thematic and descriptive data analysis resulted in five primary themes, transparency, cohesive workplace, passion, collaboration, and leadership. The study used transformational leadership as the primary leadership philosophy. The results of the study showed that leadership and communication can have a positive, or a negative influence on retention of registered.展开更多
营养风险或营养不良在急诊患者中普遍存在,可导致病死风险上升并造成疾病负担加重。但迄今为止,在急诊领域中,对营养风险的关注度明显低于其他专科。2016年多个国际性营养组织提出了全球领导人营养不良倡议(Global Leadership Initiativ...营养风险或营养不良在急诊患者中普遍存在,可导致病死风险上升并造成疾病负担加重。但迄今为止,在急诊领域中,对营养风险的关注度明显低于其他专科。2016年多个国际性营养组织提出了全球领导人营养不良倡议(Global Leadership Initiative on Malnutrition,GLIM)。GLIM自提出以来,发展迅速,已成为进行营养诊断的主要方法学工具。与此同时,疾病诊断相关分组(diagnosis related groups,DRGs)在中国已经快速普及,并成为新一轮医改的重要内容。在DRGs背景下,营养不良的诊断和干预对患者具有重要的临床和经济学意义。本文将基于GLIM标准结合DRGs的时代背景,从急诊患者的营养风险筛查、营养不良诊断、临床经济学效益以及急诊患者营养评估的未来发展方向等多方面的应用与研究进展进行评述,以期为广大急诊医务人员更好的理解急诊患者的营养评估提供借鉴。展开更多
文摘Background:The Global Leadership Initiative on Malnutrition(GLIM)has been used in China since 2019.This study aimed to test the use of the GLIM criteria in Chinese cancer patients and to compare the diagnostic performance of the GLIM criteria with the Patient-Generated Subjective Global Assessment(PG-SGA)and modified PG-SGA(mPG-SGA). Methods:A total of 2,000 cancer patients were consecutively screened using the Nutritional Risk Screening 2002 instrument on ad-mission.Patients at nutritional risk(Nutritional Risk Screening 2002 score≥3)were enrolled to obtain the complete GLIM,PG-SGA,and mPG-SGA criteria.To evaluate the convergent validity,Spearman correlation analysis was used to compare the test-retest reliability of the GLIM criteria and its results with the scores of various nutritional tools and objective parameters.Kruskal-Wallis tests and χ2 tests were used to test the discriminant validity among groups with different nutritional status.We calculated the sensitivity,specificity,positive predictive value,and negative predictive value for the various tools. Results:There were 562 patients found to be at nutritional risk,accounting for 28.1%of all patients.One hundred seventy-four patients(8.7%)were diagnosed as moderately malnourished,and 333 patients(16.6%)were severely malnourished based on the PG-SGA.When assessed using the GLIM criteria,185 patients(9.3%)were diagnosed as moderately malnourished and 311 patients(15.5%)were severely malnourished.The content validity of the GLIM criteria was 95%,evaluated by 60 medical staff members.The test-retest reliability was good.For the diagnosis of malnutrition versus the PG-SGA,the sensitivity of the GLIM was"good"(90.5%;95%confidence interval[95%CI]=88.0%-93.1%),with a positive predictive value of 92.5%(95%CI=90.2%-94.9%),but the spec-ificity and negative predictive value were"poor."Similar results were obtained when the mPG-SGA was used as the criterion. Conclusions:Overall,this cross-sectional study suggests that the GLIM criteria comprise a valid and reliable tool to assess the nutri-tional status of Chinese cancer patients.
文摘营养不良在老年人群中的发生率呈逐年上升的趋势,可导致老年人的身体功能下降、易发生感染、延迟康复等,严重影响其生活质量及疾病预后。因此,营养不良的早期识别和诊断对普外科老年患者有着重要的意义。目前针对老年人群营养不良的诊断主要包括全球营养领导层倡议营养不良诊断标准(Global Leadership Initiative on Malnutrition,GLIM)、主观全面评定(Subjective Global Assessment,SGA)等。GLIM进入临床应用较晚,能否全面反映外科老年人群的营养状态仍有争议。本文主要探讨GLIM在普外科老年人群中诊断营养不良的应用现状,旨在为老年人营养不良的诊断提供参考。
文摘Is there a "leadership crisis" in the world today? Thirty years ago, James MacGregor Burns, the Pulitzer Prize winner for the book of Leadership (1978), coined this phrase - leadership crisis. This topic has been quite old, but during specific times, it always has its new content. Leadership crisis roughly means the inefficient leadership that might bring the ineffectiveness. Having entered the times of globalization, the sentiment-oriented Chinese leadership unexceptionally has exposed its disadvantages and deficiencies compared with the mature and complete modern management.
文摘This descriptive phenomenological study was to explore how communication and leadership influenced retention of registered nurses. The theoretical foundation of this descriptive phenomenological study is communication and leadership grounded in Burns theory of transformational leadership. The purpose of this study was to expand on and fill a gap in the research of how the lived experiences of nine registered nurses add to the influence communication and leadership has on retention, and to answer the following research questions. What are the lived experiences of registered nurses in the Western United States as they relate to retention when those registered nurses perceive a lack of communication? And, what are the lived experiences of registered nurses in the Western United States as they relate to retention when those registered nurses perceive a lack of leadership? The researcher interviewed nine participants working in hospitals in the Western United States. Thematic and descriptive data analysis resulted in five primary themes, transparency, cohesive workplace, passion, collaboration, and leadership. The study used transformational leadership as the primary leadership philosophy. The results of the study showed that leadership and communication can have a positive, or a negative influence on retention of registered.
文摘营养风险或营养不良在急诊患者中普遍存在,可导致病死风险上升并造成疾病负担加重。但迄今为止,在急诊领域中,对营养风险的关注度明显低于其他专科。2016年多个国际性营养组织提出了全球领导人营养不良倡议(Global Leadership Initiative on Malnutrition,GLIM)。GLIM自提出以来,发展迅速,已成为进行营养诊断的主要方法学工具。与此同时,疾病诊断相关分组(diagnosis related groups,DRGs)在中国已经快速普及,并成为新一轮医改的重要内容。在DRGs背景下,营养不良的诊断和干预对患者具有重要的临床和经济学意义。本文将基于GLIM标准结合DRGs的时代背景,从急诊患者的营养风险筛查、营养不良诊断、临床经济学效益以及急诊患者营养评估的未来发展方向等多方面的应用与研究进展进行评述,以期为广大急诊医务人员更好的理解急诊患者的营养评估提供借鉴。
