BACKGROUND & AIMS: Although nutrition is an important part of medical care, nutrition education is not provided in most training programs for physicians in the United States, resulting in limited nutrition knowledge among physicians and limited nutritional care of patients. A nutrition education program was provided by a physician nutrition specialist in a family practice residency program. For 6 mo, the nutrition specialist provided the family physicians with recommendations for nutritional care for their patients. The effects of the education program on residents' and faculty physicians' nutrition knowledge and nutritional patient care, patients' perceptions of the importance of nutrition, and physicians' dietary patterns were determined by pre- and post-intervention nutrition exams for physicians and patients, patient questionnaires about attitudes toward nutrition, chart reviews, and physicians' diet records. The nutrition education program resulted in an increase in physicians' nutrition knowledge scores (P < 0.01) and an increase in the frequency with which physicians discussed nutrition and recommended diets for their patients (P < 0.05). This suggests that nutrition education by a physician nutrition specialist within a family practice residency program can be effective in increasing nutritional care provided to patients.

背景与目标： 尽管营养是医疗保健的重要组成部分，但在美国大多数医师的培训计划中并未提供营养教育，这导致医师之间的营养知识有限，患者的营养保健也有限。营养保健教育计划是由医师营养专家在家庭执业驻留计划中提供的。营养专家在6个月内为家庭医生提供了有关为其患者提供营养护理​​的建议。通过干预前和干预后对医师和患者的营养检查来确定教育计划对住院医师和教职医师的营养知识和患者营养的影响，患者对营养重要性的看法以及医师的饮食方式的影响，有关营养态度的患者问卷调查表，图表评论以及医生的饮食记录。营养教育计划导致医师的营养知识得分增加（P <0.01），医师讨论营养和为患者推荐饮食的频率增加（P <0.05）。这表明在家庭执业住院医师计划中，由医生营养专家进行的营养教育可以有效地增加提供给患者的营养保健服务。

BACKGROUND & AIMS: The recognition of professional qualifications in all European Union (EU) member states for nurses is covered by both sectoral and general systems directives, yet in reality, few nurses take up their rights as European citizens to live and work in another EU country. One of the main reasons for this is a lack of linguistic skills. This article argues that the nursing profession should be taking a more active role in enabling nurses to move freely around Europe by encouraging language acquisition. It is argued that there are political, social, economic, professional and individual reasons why this should be so. The author gives a brief account of a pilot project which is currently under way to help improve (albeit in a small way) this situation. The project, which has been granted financial support of 100,000 ECU from the European Commission's new training programme, Leonardo da Vinci, will create a multimedia language pack in four languages aimed specifically at nurses.

背景与目标： 部门和通用系统指令均涵盖了所有欧盟（EU）成员国对护士的专业资格的认可，但实际上，很少有护士作为欧洲公民享有在另一个欧盟国家生活和工作的权利。造成这种情况的主要原因之一是缺乏语言能力。本文认为，护理行业应在鼓励护士掌握语言方面，使护士在欧洲自由行动方面发挥更积极的作用。有人认为，这样做的原因有政治，社会，经济，专业和个人原因。作者简要介绍了一个正在进行的试点项目，以帮助改善（尽管有小幅改善）这种情况。该项目已获得欧盟委员会新培训计划Leonardo da Vinci的100,000 ECU的财政支持，该项目将创建专门针对护士的四种语言的多媒体语言包。

BACKGROUND & AIMS: OBJECTIVE:The scholarly dissemination of innovative medical education practices helps broaden the reach of this type of work, allowing scholarship to have an impact beyond a single institution. There is little guidance in the literature for those seeking to publish program evaluation studies and innovation papers. This study aims to derive a set of evidence-based features of high-quality reports on innovations in emergency medicine (EM) education. METHODS:We conducted a scoping review and thematic analysis to determine quality markers for medical education innovation reports, with a focus on EM. A search of MEDLINE, EMBASE, ERIC, and Google Scholar was augmented by a hand search of relevant publication guidelines, guidelines for authors, and website submission portals from medical education and EM journals. Study investigators reviewed the selected articles, and a thematic analysis was conducted. RESULTS:Our search strategy identified 14 relevant articles from which 34 quality markers were extracted. These markers were grouped into seven important themes: goals and need for innovation, preparation, innovation development, innovation implementation, evaluation of innovation, evidence of reflective practice, and reporting and dissemination. In addition, multiple outlets for the publication of EM education innovations were identified and compiled. CONCLUSION:The publication and dissemination of innovations are critical for the EM education community and the training of health professionals. We anticipate that our list of innovation report quality markers will be used by EM education innovators to support the dissemination of novel educational practices.

背景与目标： 目的：学术上创新医学教育实践的传播有助于拓宽此类工作的范围，使奖学金的影响力超越单一机构。对于那些寻求发布程序评估研究和创新论文的人，文献中几乎没有指导。这项研究旨在得出一组有关急诊医学教育创新的高质量报告的基于证据的特征。
方法：我们进行了范围审查和主题分析，以确定医学教育创新报告的质量标志，重点是EM。通过手动搜索相关的出版指南，作者指南以及医学教育和EM期刊的网站提交门户，扩大了对MEDLINE，EMBASE，ERIC和Google Scholar的搜索。研究调查人员审查了选定的文章，并进行了主题分析。
结果：我们的搜索策略确定了14篇相关文章，从中提取了34篇质量标记。这些标记分为七个重要主题：创新的目标和需求，准备，创新发展，创新实施，创新评估，反思性实践的证据以及报告和传播。此外，还确定并汇编了多个出版新兴市场教育创新的渠道。
结论：创新的出版和传播对新兴市场教育界和卫生专业人员的培训至关重要。我们期望EM教育创新者将使用我们的创新报告质量标记列表来支持新颖教育实践的传播。

BACKGROUND & AIMS: PROBLEM:Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. METHODS:Since 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers. With the increased expectations of a well-orchestrated team and larger number of emergency nurses, our program created the Trauma Nurse Academy. This academy provides a core of experienced nurses with an advanced level of training while decreasing the variability of personnel in the trauma bay. Components of the academy include multidisciplinary didactic education, the Essentials of TeamSTEPPS, and interactive trauma bay learning, to include both equipment and drug use. Once completed, academy graduates participate in the orientation and training of General Surgery and Emergency Medicine residents' trauma bay experience and injury prevention activities. RESULTS:Internal and published data have demonstrated growing evidence linking trauma teamwork training to knowledge and self-confidence in clinical judgment to team performance, patient outcomes, and quality of care. IMPLICATIONS FOR PRACTICE:Although trauma resuscitations are stressful, high risk, dynamic, and a prime environment for error, new methods of teamwork training and collaboration among trauma team members have become essential.

背景与目标： 问题：护士是护理严重受伤的创伤患者的团队的关键成员。直到最近，护士和医师还分别了解领导和支持角色。随着多学科团队创伤治疗方法的问世，正式的团队培训和模拟已经出现。
方法：自2007年以来，我们的I级创伤系统已将TeamSTEPPS（提高绩效和患者安全的团队策略和工具；医疗研究与质量局，马里兰州罗克维尔）集成到我们的临床护理中，使用模拟对护士和医生进行联合培训在所有医疗保健提供者的参与下。随着团队的精心安排和急诊护士人数的增加，我们的计划创建了创伤护士学院。该学院为经验丰富的护士提供了高级培训，同时又减少了外伤部位人员的变异性。该学院的组成部分包括多学科的教学教育，TeamSTEPPS的基础知识以及交互式创伤学，包括设备和药物使用。完成后，学院的毕业生将参加普通外科和急诊科住院医师的创伤湾经验和伤害预防活动的指导和培训。
结果：内部和公开的数据表明，越来越多的证据将创伤团队合作训练与临床判断的知识和自信心与团队绩效，患者结果和护理质量联系起来。
实践的意义：尽管创伤复苏具有压力，高风险，动态且是错误的主要环境，但创伤团队成员之间进行团队合作培训和协作的新方法已变得至关重要。

BACKGROUND & AIMS: :This cross-sectional study surveyed a random sample of 129 nurse educators teaching in 61 U.S. schools of nursing. After the educators indicated their desire to participate, the survey instrument was e-mailed to them for completion; a 37.6% response rate was obtained. Demographically, the typical respondent was a healthy, 52-year-old, Caucasian female with a PhD in nursing. Outcomes reflected that respondents' mean anticipated age of retirement was 64.4; however, the optimal age of retirement desired by respondents was younger (62.4). The most influential factor affecting the timing of retirement was financial status. Workplace issues, personal and family health, and attitudes about retirement were other factors that affected participants' retirement decisions. The study findings indicate that nurse educators, as a group, do not plan to work beyond age 65.

背景与目标： ：这项横断面研究随机抽取了美国61所护理学校中129名教学教师的随机样本。在教育工作者表示希望参加之后，将调查工具通过电子邮件发送给他们，以供他们填写。获得了37.6％的响应率。人口统计学上，典型的受访者是健康的52岁白人女性，具有护理学博士学位。结果表明，受访者的平均预期退休年龄为64.4。然而，受访者期望的最佳退休年龄是年轻的（62.4）。影响退休时间的最有影响的因素是财务状况。工作场所问题，个人和家庭健康以及对退休的态度是影响参与者退休决定的其他因素。研究结果表明，护士教育者作为一个整体，不打算在65岁以上工作。

BACKGROUND & AIMS: :Ongoing blood loss and iron-deficiency anemia are common problems in patients on hemodialysis; therefore, nephrology clinicians are particularly concerned with their patients who are scheduled for surgery Surgery can cause significant blood and iron losses, thereby worsening their preexisting anemia. However, patients on hemodialysis can be effectively treated preoperatively by adjusting their continued doses of intravenous (i.v.) iron and recombinant human erythropoietin (EPO) therapy, based on expected blood and iron losses. This valuable strategy can help improve surgical and anemia outcomes as well as decrease EPO requirements and the need for transfusions. This article examines the use of IV iron and EPO therapy as preventive therapy for anemia in patients on hemodialysis prior to invasive surgical procedures, illustrated with an experience from a dialysis unit and patient case studies.

背景与目标： ：持续的失血和缺铁性贫血是血液透析患者的常见问题；因此，肾脏病临床医生特别关心计划进行手术的患者。手术可能会导致大量的血液和铁丢失，从而加剧他们先前的贫血。但是，可以根据预期的血液和铁损失，通过调整静脉注射铁和重组人促红细胞生成素（EPO）治疗的持续剂量，对接受血液透析的患者进行术前有效治疗。这种有价值的策略可以帮助改善手术和贫血结果，并降低EPO需求和输血需求。本文探讨了在侵入性外科手术之前，静脉铁剂和EPO疗法作为血液透析患者贫血的预防性疗法的应用，并结合透析部门和患者案例研究的经验进行了说明。

BACKGROUND & AIMS: PURPOSE:There has been little radiation oncologist (RO)-specific research in continuing medical education (CME) or quality improvement (QI) program efficacy. Our aim was to evaluate a CME/QI program for changes in RO behavior, performance, and adherence to department protocols/studies over the first 12 months of the program. METHODS AND MATERIALS:The CME/QI program combined chart audit with feedback (C-AWF), simulation review AWF (SR-AWF), reminder checklists, and targeted CME tutorials. Between April 2003 and March 2004, management of 75 patients was evaluated by chart audit with feedback (C-AWF) and 178 patients via simulation review audit (SR-AWF) using a validated instrument. Scores were presented, and case management was discussed with individualized educational feedback. RO behavior and performance was compared over the first year of the program. RESULTS:Comparing the first and second 6 months, there was a significant improvement in mean behavior (12.7-13.6 of 14, p = 0.0005) and RO performance (7.6-7.9 of 8, p = 0.018) scores. Protocol/study adherence significantly improved from 90.3% to 96.6% (p = 0.005). A total of 50 actions were generated, including the identification of learning needs to direct CME tutorials, the systematic change of suboptimal RO practice, and the alteration of deficient management of 3% of patients audited during the program. CONCLUSION:An integrated CME/QI program combining C-AWF, SR-AWF, QI reminders, and targeted CME tutorials effectively improved targeted RO behavior and performance over a 12-month period. There was a corresponding increase in departmental protocol and study adherence.

背景与目标： 目的：在继续医学教育（CME）或质量改善（QI）计划功效方面，几乎没有针对放射肿瘤学家（RO）的研究。我们的目的是评估一个CME / QI计划，以了解该计划的前12个月RO行为，绩效以及对部门规约/研究的遵守情况的变化。
方法和材料：CME / QI程序将图表审核与反馈（C-AWF），模拟审阅AWF（SR-AWF），提醒清单和目标CME教程相结合。在2003年4月至2004年3月之间，使用经过验证的工具，通过带有反馈的图表审计（C-AWF）评估了75名患者的管理，通过模拟审查审计（SR-AWF）评估了178名患者的管理。提出分数，并通过个性化的教育反馈讨论案例管理。在该计划的第一年，对RO的行为和性能进行了比较。
结果：与前六个月和第二个六个月相比，平均行为（14.12.7-13.6，p = 0.0005）和反渗透表现（7.6-7.9，8，p = 0.018）有显着改善。方案/研究依从性从90.3％显着提高到96.6％（p = 0.005）。总共产生了50项行动，包括确定直接进行CME指导的学习需求，对次优RO实践的系统性改变以及在该计划中审核的3％的患者管理不善的变更。
结论：结合了C-AWF，SR-AWF，QI提示和目标CME教程的集成的CME / QI程序可以在12个月内有效改善目标RO的行为和性能。部门规程和研究依从性相应增加。

BACKGROUND & AIMS: Importance:Individuals with attention-deficit/hyperactivity disorder (ADHD) are at greater risk for academic problems. Pharmacologic treatment is effective in reducing the core symptoms of ADHD, but it is unclear whether it helps to improve academic outcomes. Objective:To investigate the association between the use of ADHD medication and performance on higher education entrance tests in individuals with ADHD. Design, Setting, and Participants:This cohort study observed 61 640 individuals with a diagnosis of ADHD from January 1, 2006, to December 31, 2013. Records of their pharmacologic treatment were extracted from Swedish national registers along with data from the Swedish Scholastic Aptitude Test. Using a within-patient design, test scores when patients were taking medication for ADHD were compared with scores when they were not taking such medication. Data analysis was performed from November 24, 2015, to November 4, 2016. Exposures:Periods with and without ADHD medication use. Main Outcomes and Measures:Scores from the higher education entrance examination (score range, 1-200 points). Results:Among 930 individuals (493 males and 437 females; mean [SD] age, 22.2 [3.2] years) who had taken multiple entrance tests (n = 2524) and used ADHD medications intermittently, the test scores were a mean of 4.80 points higher (95% CI, 2.26-7.34; P < .001) during periods they were taking medication vs nonmedicated periods, after adjusting for age and practice effects. Similar associations between ADHD medication use and test scores were detected in sensitivity analyses. Conclusions and Relevance:Individuals with ADHD had higher scores on the higher education entrance tests during periods they were taking ADHD medication vs nonmedicated periods. These findings suggest that ADHD medications may help ameliorate educationally relevant outcomes in individuals with ADHD.

背景与目标： 重要性：患有注意力缺陷/多动症（ADHD）的人更容易出现学术问题。药物治疗可有效减轻多动症的核心症状，但尚不清楚它是否有助于改善学业成果。
目的：探讨多动症患者使用多动症药物与高等教育入学考试成绩之间的关系。
设计，背景和参与者：该队列研究从2006年1月1日到2013年12月31日观察了61640名患有ADHD的患者。他们的药物治疗记录与瑞典的学历能力数据一起被提取。测试。使用患者内设计，将患者服用ADHD药物时的测试得分与未服用ADHD药物时的得分进行比较。数据分析时间为2015年11月24日至2016年11月4日。
暴露：有或没有使用ADHD药物的时期。
主要成果和措施：高等教育入学考试分数（分数范围：1-200分）。
结果：在930名个体（平均SD年龄，22.2 [3.2]岁）中，参加了多次入院测试（n = 2524）并且间歇性地使用了ADHD药物，测试得分平均为4.80分在调整年龄和实践影响后，他们在服药期间与非服药期间相比更高（95％CI，2.26-7.34； P <.001）。在敏感性分析中，ADHD药物使用与测试评分之间存在相似的关联。
结论与相关性：ADHD患者在接受ADHD药物治疗期间与非药物治疗期间在高等教育入学考试中得分较高。这些发现表明，多动症药物可能有助于改善多动症患者的教育相关成果。

BACKGROUND & AIMS: BACKGROUND:A growing body of literature shows that many universities and colleges are making educational portfolios part of their faculty assessment and student's learning plan for both undergraduate and graduate programs. We provide an outline for the development of a medical educator's portfolio, including an electronic version. DESCRIPTION:Guidelines for the development of an educational portfolio focusing on medical education are provided, including design, format, and content. An electronic version of the portfolio, which combines flexibility and ease of revision, is also described, including formats for publication and distribution. Student reflections on the e-portfolio are presented, and potential applications of the e-portfolio in medical education are described. CONCLUSION:We believe that portfolio development is a valuable application that provides rich documentation of participants' educational history, accomplishments, and intellectual property as related to their professional learning and growth.

背景与目标： 背景：越来越多的文献表明，许多大学和学院正在将教育档案袋作为其本科和研究生课程教师评估和学生学习计划的一部分。我们为医学教育者的档案袋的发展提供了一个大纲，包括电子版本。
描述：提供了针对医学教育的教育档案袋的开发指南，包括设计，格式和内容。还介绍了组合的灵活性和易于修改的电子版本，包括发布和分发的格式。介绍了学生对电子档案夹的思考，并描述了电子档案夹在医学教育中的潜在应用。
结论：我们认为，档案袋开发是一种有价值的应用程序，它为参与者的教育历史，成就和与他们的专业学习和成长有关的知识产权提供了丰富的文档。

BACKGROUND & AIMS: :This paper examines factors that have lead to increasing internationalisation in nursing workforce and nursing education and contends that education and support for nurse managers and nurse academics is required in order to better prepare them for the challenges they will face. There are many benefits to be gained from internationalisation of nursing, the most significant being greater cross-cultural understanding and improved practices in workplaces across countries. However, the way in which nursing and nurses contribute to the international agenda is crucial to maintaining standards of education and nursing care in Australia and in countries with whom Australians collaborate. Internationalisation poses numerous challenges that need to be carefully thought through. This paper seeks to unravel and scrutinize some of the issues central to internationalisation in nursing, particularly in the Australian context.

背景与目标： ：本文探讨了导致护理人员队伍和护理教育国际化的因素，并认为需要对护士管理者和护士学者进行教育和支持，以便更好地为他们准备应对挑战。护理国际化将带来许多好处，其中最重要的是在各国之间提高对跨文化的了解和改进工作场所的实践。但是，护理和护士为国际议程做出贡献的方式对于维持澳大利亚以及与澳大利亚人合作的国家的教育和护理标准至关重要。国际化提出了许多挑战，需要仔细考虑。本文旨在探讨和审查护理国际化中的一些重要问题，特别是在澳大利亚的情况下。

BACKGROUND & AIMS: :In 1998 the Society for Academic Emergency Medicine's (SAEM's) Board of Directors asked the SAEM Public Health and Education Task Force to develop recommendations for prevention, screening, and counseling activities to be conducted in emergency departments (EDs). The Task Force's work was divided into two phases: 1) a discussion of the rationale for preventive services in the ED, along with generation of a preliminary list of prevention activities that could be studied for ED implementation; and 2) a formal evidence-based review of topics chosen from the preliminary list, along with recommendations for ED implementation and further study. This paper represents Phase I of the project. Phase II, the formal evidence-based review and recommendations, is published separately in this issue.

背景与目标： ：1998年，美国学术急诊医学协会（SAEM）董事会要求SAEM公共卫生和教育工作组制定有关在急诊科（ED）开展的预防，筛查和咨询活动的建议。专责小组的工作分为两个阶段：1）讨论急诊中预防服务的理由，并生成可以进行急诊研究的预防活动初步清单； 2）对从初步清单中选择的主题进行基于证据的正式审查，以及有关ED实施和进一步研究的建议。本文代表了该项目的第一阶段。第二阶段，即正式的基于证据的审查和建议，在本期中单独出版。

BACKGROUND & AIMS: OBJECTIVE:Nurse educators need an enhanced understanding of factors contributing to nursing student success to decrease attrition and increase retention. Improved understanding of factors related to successful nurse preparation could improve educational processes and facilitate student success, thereby addressing the worldwide nursing shortage as well as increasing the competence and expertise of new graduates. Student-faculty trust and related characteristics have been identified as factors associated with student success (Applebaum, 1995). Research investigating trust in communications and education has been conducted with students in other disciplines but not with nursing students. This research investigated the complex relationships between students' trust in faculty, the students' mood states, and students' educational performance and outcomes. METHOD:The study utilized a quantitative, cross-sectional, descriptive, and correlational design. Student volunteers were recruited from a baccalaureate nursing education program located in the southwest United States. Participants completed three instruments: the Health Sciences Reasoning Test (HSRT), Profile of Mood States (POMS), and Interpersonal Trust Scale (ITS). The resulting scores were compared and contrasted along with selected demographic variables. RESULTS:The study identified a significant relationship between total mood disturbance and interpersonal trust. The trends in the POMS subscales of Anger and Confusion are of particular interest, as the two factors strongly influenced shifts in Total Mood Disturbance. As students progressed through the nursing program, experiences of Anger and Confusion increased with each progressive semester and were accompanied by corresponding decreases in trust. CONCLUSIONS:The results complement established findings relating mood and cognitive function. Alterations in the student's level of trust potentially could share relationships with cognition and critical thinking, although perhaps not in a direct and linear fashion.

背景与目标： 目的：护士教育者需要对有助于护理学生成功的因素有更深入的了解，以减少损耗和增加保留率。更好地理解与成功的护士准备相关的因素，可以改善教育过程并促进学生的成功，从而解决全球范围内的护理短缺问题，并提高新毕业生的能力和专业知识。学生与教师之间的信任和相关特征已被确定为与学生成功相关的因素（Applebaum，1995）。已经与其他学科的学生进行了调查研究，以研究对交流和教育的信任，但没有与护生一起进行。这项研究调查了学生对教师的信任，学生的情绪状态以及学生的教育表现和成果之间的复杂关系。
方法：本研究采用定量，横断面，描述性和相关性设计。学生志愿者是从位于美国西南部的学士学位护理教育计划招募的。参与者完成了三项工具：健康科学推理测验（HSRT），情绪状态简介（POMS）和人际信任量表（ITS）。将所得分数与选定的人口统计学变量进行比较和对比。
结果：该研究确定了总情绪障碍与人际信任之间的显着关系。愤怒和混乱的POMS子量表的趋势特别受关注，因为这两个因素强烈影响了总情绪干扰的变化。随着学生逐步完成护理计划，每学期的学期中，愤怒和困惑的经历就会增加，随之而来的是信任的减少。
结论：该结果补充了有关情绪和认知功能的既定发现。学生信任度的改变可能会与认知和批判性思维共享关系，尽管可能不是直接和线性的方式。

BACKGROUND & AIMS: :Parents and school staff play important roles in promoting children's oral health. Our study goals were to investigate whether an intervention targeting parents and school staff can improve the oral-health behavior and oral-health status of schoolchildren. Three-hundred and ninety-two schoolchildren in six schools in Tehran participated in a group randomized trial from September 2010 to March 2011. Schools were randomly allocated into three groups: comprehensive, student, and control. Intervention in the comprehensive group consisted of strategies to encourage children, their parents, and school staff to increase the frequency of toothbrushing and flossing. In the student group, the intervention targeted only children. The control group received no intervention. The primary outcome was change in oral-health behaviors (brushing and flossing), while the secondary outcomes were changes in oral hygiene and Community Periodontal indices and in Health Belief Model components. Multilevel modeling was employed for data analyses. Students who were in the comprehensive intervention group brushed and flossed significantly more frequently compared with those in the student intervention group. Although students' gingival health improved significantly in the comprehensive intervention group, such significant improvement was not seen in the student group. In conclusion, promising results are seen when the oral-health education targets both school and home settings.

背景与目标： ：父母和学校职员在促进儿童口腔健康中发挥重要作用。我们的研究目标是调查针对父母和学校员工的干预措施是否可以改善小学生的口腔健康行为和口腔健康状况。从2010年9月至2011年3月，德黑兰六所学校的392名学童参加了一项小组随机试验。学校被随机分为三组：综合，学生和对照。对综合人群的干预包括鼓励儿童，他们的父母和学校工作人员增加刷牙和使用牙线的策略。在学生群体中，干预仅针对儿童。对照组未接受干预。主要结果是口腔健康行为的变化（刷牙和使用牙线），而次要结果是口腔卫生和社区牙周指数以及健康信念模型组成部分的变化。采用多级建模进行数据分析。与学生干预组相比，综合干预组的学生刷牙和使用牙线的频率明显更高。尽管在综合干预组中学生的牙龈健康显着改善，但在学生组中却没有看到这种显着改善。总之，当口腔健康教育针对学校和家庭环境时，可以看到令人鼓舞的结果。

BACKGROUND & AIMS: Background:Since 1985, nurse-run asthma clinics have been developing and are now widespread in the United Kingdom, having been greatly stimulated by the New Contract for General Practice (1990). To date, there have been few definitive studies evaluating such clinics. This study, in two adjacent general practices in semi-rural Somerset, evaluates the effect of nurse-run clinics on patients' symptoms, pulmonary function, and healthcare utilisation over a four-month period. Methods:One hundred and twenty-nine subjects, aged 2-79 years, were recruited from the two practices over a one-year period (1991-1992). All patients identified in either practice who had used preventive therapy in the preceding 12 months were eligible and were included if they had a positive exercise or reversibility (20%) test and had not previously received formal asthma education. A pre- and post-experimental study design was used. Subjects' symptoms, pulmonary function, and health care in the preceding eight weeks were assessed at intake and at 16 weeks; the nurse education being delivered at intake, one and four weeks. Results:Both mean number of days off work/school and mean number of nights on which waking occurred fell (p < 0.001). Peak expiratory flow rates and forced expiratory volumes improved during the study period (p < 0.001 and p < 0.01 respectively). Use of antibiotics, oral steroids, and rescue bronchodilator use all improved significantly (p < 0.001). Physician attendances were also reduced. Conclusions:A nurse-run asthma clinic in general practice is an effective way to improve symptoms, pulmonary function, and health care utilisation for asthmatic patients.

背景与目标： 背景：自1985年以来，由护士执照的哮喘诊所一直在发展，并在英国得到广泛应用，这受到《新通用合同》（1990年）的大力推动。迄今为止，很少有明确的研究评估此类诊所。这项研究是在半农村萨默塞特郡的两个相邻常规实践中，评估了四个月内护士经营的诊所对患者症状，肺功能和医疗保健利用率的影响。
方法：在一年的时间里（1991-1992），从这两种实践中招募了129名2-79岁的受试者。两种做法中确定的在过去12个月中均使用过预防性治疗的所有患者均符合资格，并且如果他们的运动或可逆性测试阳性（20％）并且先前未接受过正规的哮喘教育，则将其包括在内。实验之前和之后的研究设计被使用。在进食时和第16周评估受试者在前八周的症状，肺功能和医疗保健；入学时分一，四个星期进行护士教育。
结果：平均下班天数/上学时间和平均醒来晚数均下降（p <0.001）。在研究期间，峰值呼气流速和强制呼气量有所改善（分别为p <0.001和p <0.01）。抗生素，口服类固醇和急救支气管扩张剂的使用均显着改善（p <0.001）。医师出勤率也有所降低。
结论：一般由护士经营的哮喘诊所是改善哮喘患者症状，肺功能和医疗保健利用率的有效方法。

BACKGROUND & AIMS: BACKGROUND:Evidence suggests that behavioral, social, and environmental factors may modify the effects of life stress on health and performance of new nurses as they transition to hospitals. OBJECTIVES:The aim of this study was to describe the methods of a project designed to investigate the role of social, behavioral, and environmental factors in modifying the adverse effects of stress on new nurses and to discuss demographic, health, and life stress characteristics of the cohort at baseline. METHODS:A prospective cohort design was used to conduct a comprehensive assessment of health endpoints, life stress, behaviors, personal traits, social factors, indicators of engagement and performance, and environmental exposures in nursing students. Adjusted odds ratios and analyses of covariance were used to examine associations between these factors at baseline. RESULTS:Health indicators in the cohort were comparable or better than in the broader United States population, and lifetime stress exposure was lower than among students from other majors. Exposure to more lifetime stressors was associated with greater risk for various health conditions, including hypertension, diabetes, and depression. Conversely, better social, environmental, behavioral, and personal profiles were associated with protective effects for the same health conditions. DISCUSSION:These data comprehensively summarize the lives of predominately Hispanic nursing students and highlight risk and resilience factors associated with their health and well-being. The findings are timely, as the nursing field diversifies in preparation to care for a diverse and aging population. Comprehensively assessing stress-health relationships among student nurses ought to inform the policies, practices, and curricula of nursing schools to better prepare nurses to thrive in the often-strenuous healthcare environment.

背景与目标： 背景：证据表明，行为，社会和环境因素可能会改变生活压力对新护士过渡到医院时的健康和绩效的影响。
目的：本研究的目的是描述一个项目的方法，该项目旨在研究社会，行为和环境因素在减轻压力对新护士的不良影响中的作用，并讨论人口统计学，健康状况和生活压力特征。基线时的同类群组。
方法：采用前瞻性队列设计，对护理专业学生的健康终点，生活压力，行为，个人特质，社会因素，参与度和绩效指标以及环境暴露进行了综合评估。调整后的优势比和协方差分析用于检查基线时这些因素之间的关联。
结果：该队列中的健康指标与美国更广泛的人群相当或更好，并且终身压力暴露低于其他专业的学生。暴露于更多终生应激源与各种健康状况（包括高血压，糖尿病和抑郁症）的更大风险相关。相反，在相同的健康状况下，更好的社交，环境，行为和个人形象与保护作用相关。
讨论：这些数据全面总结了主要是西班牙裔护生的生活，并突出了与他们的健康和福祉相关的风险和适应力因素。由于护理领域的多样化，为照顾多样化和老龄化的人群做准备，因此发现是及时的。全面评估学生护士之间的压力与健康的关系，应告知护理学校的政策，做法和课程，以更好地为护士做好准备，使其在经常艰苦的医疗环境中壮成长。