BACKGROUND & AIMS: AIM:To explore nursing students' experiences of patient safety and peer reporting using hypothetical medication administration scenarios. BACKGROUND:Pre-registration nurse training is tasked with the preparation of students able to provide safe, high quality nursing care. How students' contextualise teaching related to patient safety, risk recognition and management in the clinical setting is less clear. METHOD:A total of 321 third year students enrolled in the final semester of an adult branch pre-registration nursing programme in 2011 in a UK university were surveyed. Using free texts, the questionnaire contained hypothetical medication administration scenarios where patient safety could potentially be at risk. Students' qualitative responses were analysed using thematic analysis. FINDINGS:The response rate was 58% (n = 186). Four themes were identified from the scenarios: (1) Protecting patient safety (2) Willingness to compromise; (3) Avoiding responsibility; (4) Consequences from my actions. CONCLUSION:The findings underscore the importance of contextual teaching about risk management, practical techniques for error management and leadership for optimal patient safety in nursing curricula. IMPLICATIONS FOR NURSING MANAGEMENT:Nurse managers are role models for nursing students in the clinical setting. Nursing management must lead, by example, the patient safety agenda in the clinical setting.

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BACKGROUND & AIMS: PURPOSE:To examine the trends of substance use and correlated variables in high-school students in Southern Thailand. METHODS:Surveys of high-school years 7, 9 and 11 and vocational school year 2 students in four provinces in Southern Thailand were conducted in 2002-2004 to examine lifetime substance use, use within 1 year and 30 days before the interview, using a self-completed questionnaire. RESULTS:The prevalence of lifetime use of any illicit substance was 5-7% overall (about 7%, 9% and 13% in boys and 2%, 1% and 3% in girls in 2002, 2003 and 2004, respectively). Krathom, a local addictive plant, and cannabis were the most commonly used illicit substances on a lifetime basis with prevalences of 2.3%, 2.8%, 4.9% (p<0.01) and 2.6%, 2.3%, 3.4% (p>0.05) in the surveyed years. The rates of alcohol consumption in the past 30 days were 19.3%, 17.3% and 15.2% (p>0.05) while smoking rates were 14.6%, 8.8% and 10.8% (p<0.05). The significant correlates of current illicit substance use were surveyed year, male, vocational school, school level, and school performance. CONCLUSION:The problem of substance abuse is increasing among Thai adolescents. School-based interventions seem desirable, especially in boys, vocational and public school students.

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BACKGROUND & AIMS: :In this review, we aim at establishing a relationship between the fundamentals of the microfluidics technologies used in the Pharmacy field, and the achievements accomplished by those technologies. We describe the main methods for manufacturing micrometer drops, bubbles, and capsules, as well as the corresponding underlying physical mechanisms. In this regard, the review is intended to show non-specialist readers the dynamical processes which determine the success of microfluidics techniques. Flow focusing (FF) is a droplet-based method widely used to produce different types of fluid entities on a continuous basis by applying an extensional co-flow. We take this technique as an example to illustrate how microfluidics technologies for drug delivery are progressing from a deep understanding of the physics of fluids involved. Specifically, we describe the limitations of FF, and review novel methods which enhance its stability and robustness. In the last part of this paper, we review some of the accomplishments of microfluidics when it comes to drug manufacturing and delivery. Special attention is paid to the production of the microencapsulated form because this fluidic structure gathers the main functionalities sought for in Pharmacy. We also show how FF has been adapted to satisfy an ample variety of pharmaceutical requirements to date.

背景与目标： : 在这篇评论中，我们旨在建立药学领域中使用的微流体技术的基础与这些技术所取得的成就之间的关系。我们描述了制造千分尺液滴，气泡和胶囊的主要方法，以及相应的潜在物理机制。在这方面，该评论旨在向非专业读者展示决定微流体技术成功的动力学过程。流动聚焦 (FF) 是一种基于液滴的方法，广泛用于通过应用扩展共流在连续基础上产生不同类型的流体实体。我们以这项技术为例，说明用于药物输送的微流体技术如何从对所涉及流体的物理原理的深刻理解中发展。具体来说，我们描述了FF的局限性，并回顾了增强其稳定性和鲁棒性的新颖方法。在本文的最后一部分中，我们回顾了微流体在药物制造和输送方面的一些成就。特别注意微囊形式的生产，因为这种流体结构收集了药学中寻求的主要功能。我们还展示了FF是如何适应到目前为止满足大量药物需求的。

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.

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BACKGROUND & AIMS: BACKGROUND:Prelicensure nursing education has generally emphasized acute care; however, as primary care changes in the United States, academia must transform. The national call for transforming primary care requires innovation in the education of prelicensure nursing students. PROBLEM:To ensure future RNs can function in the primary care setting and assume enhanced roles within the interprofessional team, prelicensure nursing students need to be exposed to primary care. A key barrier to providing this essential education is the lack of partnerships with primary care facilities. APPROACH:The purpose of this project was to collaborate with rural practice partners to provide a primary care clinical experience for prelicensure nursing students. OUTCOMES:Collaboration between academic-practice partners to develop a clinical experience for prelicensure nursing students allowed exposure to the role of RNs in rural primary care. CONCLUSIONS:By sharing the process for planning the clinical experience, other interested academic institutions may replicate similar opportunities.

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BACKGROUND & AIMS: :Blended online and digital learning includes a variety of activities that combine engaging classroom-based education with online learning. The aim of this study is to evaluate undergraduate students' perceptions of a blended online and digital curriculum for anatomy and physiology in the nursing degree program. A quantitative methodology was used with a sample of 100 undergraduate nursing students from a single Australian University. Descriptive statistics are and presented in this article. Of the 100 participants, 90% were enrolled in the standard mode compared to 10% in a flexible mode of delivery. Results indicated that 29% of participants preferred laboratory classes as having the most impact. Participants (46%) also agreed that recorded lectures were useful, with 36% indicating that the online platform was easy to navigate going as far as wanting more online quizzes (49%). More than half of the participants (54%) acknowledged that anatomy and physiology was important for their future careers. The blended online and digital learner preferences in delivering anatomy and physiology-related courses should be adjusted in order for learning to be effective for undergraduate students in the future.

背景与目标： : 混合在线和数字学习包括各种活动，这些活动将基于课堂的引人入胜的教育与在线学习相结合。这项研究的目的是评估本科生对护理学位课程中解剖和生理学的在线和数字混合课程的看法。使用定量方法对来自一所澳大利亚大学的100名护理本科生进行了抽样。本文介绍了描述性统计。在100名参与者中，90% 名以标准模式登记，而10% 名以灵活的分娩方式登记。结果表明，29% 的参与者更喜欢实验班，因为实验班的影响最大。参与者 (46%) 还同意录制的讲座很有用，36% 表明在线平台很容易导航，甚至想要更多的在线测验 (49%)。超过一半的参与者 (54%) 承认解剖学和生理学对他们未来的职业很重要。在提供解剖学和生理学相关课程时，应调整在线和数字学习者的混合偏好，以便将来对本科生有效学习。

BACKGROUND & AIMS: :This paper studies whether geographic barriers can influence nonadherence to prescription drugs and its effect on patients' health. We used a multivariate probit model estimated by maximum simulated likelihood that considers individual unobserved heterogeneity, which may characterize the relationship between adherence, medical care utilization, and health outcome. We used administrative data from Liguria, Italy, the region with the highest rate of individuals over the age of 65 in Europe. Our sample included older individuals affected by cardiovascular diseases, which remain one of the leading causes of death in most OECD countries. Our results showed that geographic barriers to pharmacies negatively influence patients' adherence. According to our results, patients' nonadherence to pharmacological therapy is responsible for an increased probability of patients' mortality and the overuse of other medical services, namely, hospitalizations and emergency department visits. Nonadherence may thus represent a potential source of waste for the health care system.

背景与目标： : 本文研究了地理障碍是否会影响对处方药的不依从性及其对患者健康的影响。我们使用了由最大模拟似然估计的多元概率模型，该模型考虑了个体未观察到的异质性，这可能表征了依从性，医疗保健利用率和健康结果之间的关系。我们使用了意大利利古里亚 (Liguria) 的行政数据，该地区是欧洲65岁以上人口比例最高的地区。我们的样本包括受心血管疾病影响的老年人，在大多数经合组织国家，心血管疾病仍然是主要的死亡原因之一。我们的结果表明，药房的地理障碍会对患者的依从性产生负面影响。根据我们的结果，患者不坚持药物治疗是导致患者死亡和过度使用其他医疗服务 (即住院和急诊就诊) 的可能性增加的原因。因此，不遵守可能是医疗保健系统浪费的潜在来源。

BACKGROUND & AIMS: OBJECTIVE:To describe pharmacy-supported transition-of-care (TOC) interventions and determine their effect on 30-day all-cause readmissions. DATA SOURCES:MEDLINE/PubMed, EMBASE, International Pharmaceutical Abstracts, ABI Inform Complete, PsychINFO, Web of Science, Academic Search Complete, CINHAL, Cochrane library, OIASTER, ProQuest Dissertations & Theses, ClinicalTrials.gov , and relevant websites were searched from January 1, 1995, to December 31, 2015. STUDY SELECTION AND DATA EXTRACTION:PICOS+E criteria were utilized. Eligible studies reported pharmacy-supported TOC interventions compared with usual care in adult patients discharged to home within the United States. Studies were required to evaluate postdischarge outcomes (eg, rate of readmissions, hospital utilization). Randomized controlled trials, cohort studies, or controlled before-and-after studies were included. Two reviewers independently extracted data and evaluated study quality. DATA SYNTHESIS:A total of 56 articles were included in the systematic review (n = 61 858), of which 32 reported 30-day all-cause readmissions and were included in the meta-analysis. A taxonomy was developed to categorize targeted patients, intervention types, and pharmacy personnel as sole intervener. The meta-analysis demonstrated about a 32% reduction in the odds of readmission (odds ratio [OR] = 0.68; 95% CI = 0.61 to 0.75) observed for pharmacy-supported TOC interventions compared with usual care. Heterogeneity was identified ( I2 = 55%; P < 0.001). A stratified meta-analysis showed that interventions with patient-centered follow-up reduced 30-day readmissions relative to studies without follow-up (OR = 0.70; CI = 0.63 to 0.78). CONCLUSIONS:Pharmacy-supported TOC programs were associated with a significant reduction in the odds of 30-day readmissions.

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BACKGROUND & AIMS: THE AIM OF THE STUDY:The aim of this study is to examine the effect of critical thinking education on nursing students' problem-solving skills. MATERIALS AND METHOD:This study was conducted with 93 nursing students, 49 in the control group and 44 in the education group. The California Critical Thinking Disposition Inventory and the Problem-solving Inventory were administered to them before and after 12 weeks of critical thinking education. RESULTS:The education group's mean critical thinking score was 253.61 on the pretest and 268.72 on the posttest. This increase was statistically significant (p < .001). The posttest mean score of the control group fell to 258.18 on the posttest after a pretest mean score of 260.79, and this difference was statistically significant (p < .001). According to the posttest results, the problem-solving skills of education group increased significantly (p < .001), while the control group's score fell significantly (p < .001). CONCLUSION:This study determined that critical thinking education improves problem-solving skills.

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BACKGROUND & AIMS: CONTEXT:Diagnostic efficiency is important in daily clinical practice as doctors have to face problems within a limited time frame. To foster the clinical reasoning of students is a major challenge in medical education research. Little is known about students' diagnostic efficiency. On the basis of current theories, scaffolds for case representation (statement of the case as far as it is summarised in the mind) could be a promising approach to make the diagnostic reasoning of intermediate medical students more efficient. METHODS:Clinical case processing of 88 medical students in their fourth and fifth years was analysed in a randomised, controlled laboratory study. Cases dealing with dyspnoea were provided in an electronic learning environment (CASUS). Students could freely choose the time, amount and sequence of clinical information. During the learning phase the intervention group was asked to write down case representation summaries while working on the cases. In the assessment phase diagnostic efficiency was operationalised as the number of correct diagnoses divided by the time spent on diagnosing. RESULTS:Diagnostic efficiency was significantly improved by the representation scaffolding (M = 0.12 [SD = 0.07], M = 0.09 [SD = 0.06] correct cases/time, p = 0.045), whereas accuracy remained unchanged (M = 2.28 [SD = 1.10], M = 2.09 [SD = 1.08], p = 0.52). Both groups screened the same amount of clinical information, but the scaffolding group did this faster (M = 20.8 minutes [SD = 7.15], M = 24.6 minutes [SD = 7.42], p = 0.01; Cohen's d = 0.5). CONCLUSION:Diagnostic efficiency is an important outcome variable in clinical reasoning research as it corresponds to workplace challenges. Scaffolding for case representations significantly improved the diagnostic efficiency of fourth and fifth-year medical students, most likely because of a more targeted screening of the available information.

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BACKGROUND & AIMS: BACKGROUND:The purpose of this study was to assess graduate and undergraduate international respiratory therapy students' perceptions of the impact of their international educational experience on their life experience and development. METHODS:Data were collected through a validated descriptive survey. Four main dimensions of development were assessed: professional respiratory therapist (RT) role, global understanding, personal development, and intellectual development. RESULTS:The sample size was 62. Just over half of the subjects held a graduate degree in respiratory therapy, and 47% held an undergraduate degree in respiratory therapy. Female participants accounted for 13% of participants. The dimensions of development that were the most affected for RT undergraduate students were professional RT role and global understanding, whereas personal development was the most impacted area of development for graduate RT students. The time spent abroad for education had a positive correlation with the students' perceptions of development of their professional RT role (rs = 0.43, P = .001), personal development (rs = 0.26, P = .047), and overall survey development score (rs = 0.28, P = .036). Former graduates had a significantly higher perception of development of their professional practice (P = .035) and cultural interaction (P = .03) than did current students. CONCLUSIONS:International education has a large overall positive impact on students' life experience and development. The study findings support the value of promoting international education in RT programs due to its role in advancing students' development and the internationalization of RT education.

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BACKGROUND & AIMS: OBJECTIVE:This study investigates sleep patterns of fourth- and fifth-grade students using actigraphy. METHODS:The study included 257 students enrolled in a Southwestern US school district who participated in a novel sleep science curriculum during the Spring 2016-17 and Fall 2017-18 semesters and met the study inclusion criteria. As part of this curriculum, participants underwent 5-7 days of continuous wrist actigraphy and completed an online sleep diary. RESULTS:Approximately two-thirds of the 9-11-year-old fourth- and fifth-grade students slept less than the minimum 9 h per night recommended by both the American Academy of Sleep Medicine/Sleep Research Society and the National Sleep Foundation. The sleep midpoint time on weekends was about 1 h later than on weekdays. There was a significant effect of age on sleep duration. Compared to 9-year old students, a larger proportion of 10-year old students had a sleep duration less than 8.5 h. Boys had shorter sleep duration than girls, and a larger percentage of boys obtained less than 9 h of sleep compared to girls. CONCLUSIONS:Insufficient sleep is a highly prevalent condition among 9-11-year-old fourth- and fifth-grade elementary students. Importantly, there is a difference between sleep patterns on weekdays and weekends which may portend greater problems with sleep in adolescence and young adulthood.

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BACKGROUND & AIMS: :Teaching biochemistry well is not an easy job for teachers and so is learning biochemistry well for students. Just as many students often complain, they virtually always fail in either physiology or biochemistry. I have been teaching biochemistry at Nanjing University for over 25 years and am very successful in my biochemistry-teaching career. The way and style that I teach biochemistry is highly praised by both my students and my fellow teachers. As an instructor, the most important thing is, I think, you have to do your best to arouse or ignite students' interest in biochemistry learning. But how? In this article, I will introduce many first-hand practical tips on how to arouse the students 'interest in studying biochemistry from giving the first lecture to last lecture, from how to combine advanced teaching methods with traditional teaching methods to how to combine classic biochemistry with latest biochemical developments, from the main classroom teaching to organization of extracurricular activities as the second classroom, and so on. These tips are proven very useful and then can be followed by other professors who are teaching biochemistry. Hopefully, they can help many professors improve their skills for teaching biochemistry.

背景与目标： : 对老师来说，良好的生物化学教学不是一件容易的事，对学生来说，学习生物化学也不是一件容易的事。正如许多学生经常抱怨的那样，他们实际上总是在生理学或生物化学方面失败。我在南京大学教授生物化学超过25年，在我的生物化学教学生涯中非常成功。我教授生物化学的方式和风格受到我的学生和老师的高度评价。作为一名教师，最重要的是，我认为，你必须尽最大努力唤起或点燃学生对生物化学学习的兴趣。但是怎么做呢？在本文中，我将介绍许多第一手的实用技巧，从第一堂课到最后一堂课，如何激发学生学习生物化学的兴趣，从如何将先进的教学方法与传统的教学方法相结合，到如何将经典的生物化学与最新的生物化学发展相结合，从主要的课堂教学到组织课外活动作为第二课堂等等。这些技巧被证明非常有用，然后可以被其他教授生物化学的教授所遵循。希望他们能帮助许多教授提高他们的生物化学教学技能。