Abstract: Complications of myopia have become an important public health issue with serious socio-economic burdens. Prevention and treatment are both important. The Taiwan Student Vision Care Program (TSVCP) promoted by Ministry of Education (MOE) has been carried out for 3 decades in Taiwan. The myopia prevalence has increased rapidly to a high level and therefore myopia prevention has continued to be the most important item in the program. Therefore, TSVCP aims to decrease the prevalence of myopia, in order to decrease the high myopia related blindness in the future. Recently, outdoor activity has been found to be an important protective factor for myopia and was implemented in TSVCP since 2010. Afterwards, the nationwide vision impairment rate (uncorrected vision 20/25 or less) of elementary school students declined unprecedentedly and continuously in recent years. Evidence-based protective and risk factors for myopia are now clearer. Widespread acknowledgement of myopic disease, preventing the onset of myopia, prompt diagnosis, and early treatment to control progression are all important.
Abstract: To describe the current aging population in China and globally, especially as it applies to age-related macular degeneration (AMD). To review the current standards of care for treating both wet (exudative) eAMD and dry (atrophic) aAMD. And to introduce a model for experimentation that is based on the Age-Related Eye Disease Study (AREDS) using eye bank tissue. A literature search that outlines current aging populations, standards of clinical treatment as defined by large, multicenter, randomized clinical trials that present level-I data with a low risk for bias. An experimental model system of AMD is presented that enables scientific analysis of AMD pathogenesis by applying grading criteria from the AREDS to human eye bank eyes. Analysis includes proteomic, cellular, and functional genomics. The standard of care for the treatment of eAMD is currently defined by the use of several anti-vascular endothelial growth (anti-VEGF) agents alone or in combination with photodynamic therapy. Monotherapy treatment intervals may be monthly, as needed, or by using a treat-and-extend (TAE) protocol. There are no proven therapies for aAMD. AMD that is phenotypically defined at AREDS level 3, should be managed with the use of anti-oxidant vitamins, lutein/zeaxanthin and zinc (AREDS-2 formulation). By understanding the multiple etiologies in the pathogenesis of AMD (i.e., oxidative stress, inflammation, and genetics), the use of human eye bank tissues graded according to the Minnesota Grading System (MGS) will enable future insights into the pathogenesis of AMD. Initial AMD management is with lifestyle modification such as avoiding smoking, eating a healthy diet and using appropriate vitamin supplements (AREDS-2). For eAMD, anti-VEGF therapies using either pro re nata (PRN) or TAE protocols are recommended, with photodynamic therapy in appropriate cases. New cellular information will direct future, potential therapies and these will originate from experimental models, such as the proposed eye bank model using the MGS, that leverages the prospective AREDS database.
Abstract: The teaching of professionalism, a key aspect of medical competence that regulates physician’s behavior towards patients, colleagues, society, and self, should be included in the curriculum of every training program. Studies suggest a variety of formats to teach and evaluate professionalism in residents, being role modeling, reflection, case discussions, and 360-degree assessments the most commonly used. However, little is published about the need to train faculty for teaching and evaluating professionalism, or how to improve institutional culture, so that principles that are indicated to teach in theory are also fulfilled in practice.
Abstract: Ophthalmology residency training programs need authentic methods of assessment to show that trainees have learned and can do what is expected upon graduation. Written and oral examinations are necessary to assess knowledge but other methods are needed to assess skill. Workplace-based assessments (WPBAs) should be utilized to observe resident skill in the clinic and during surgery. Several such assessment tools have been published and validated. These tools have the additional benefit of facilitating specific formative feedback and thus can be used for both teaching and assessing.
Background: To study the application of management tools such as Plan-Do-Check-Action (PDCA) cycle and fishbone diagram in optimizing surgical procedures to improve the satisfaction of doctor-nurse-patient.
Methods: The fundus surgery nursing team of our hospital began to implement the PDCA cycle management mode to optimize the surgical procedure from July 2017, set up a project activity improvement team, unified the surgical labeling processing plan, and made the fundus surgery procedure, and established the preoperative health education for surgical patients, and standardized the training content of post-rotating doctors and interns.
Results: The satisfaction degree to surgical procedure after implementation of doctors and nurses was higher than that before implementation.
Conclusions: Using PDCA cycle and fishbone diagram analysis tools to manage the surgical procedure optimization can better integrate doctor-nurse medical care, improve the efficiency and accuracy of the surgical procedure delivery and operation, and optimize the satisfaction of the three parties of doctor-nurse-patient.
Background: This study aims to investigate the current status and influencing factors of evidence-based practice (EBP) with knowledge, attitude and practice (KAP) of ophthalmic nursing staffs in south China.
Methods: Using a convenient sampling method, we selected 429 ophthalmic nursing staffs from 28 ophthalmology specialist hospitals or general hospitals in south China, and investigated their general information and implemented the evidence-based practice questionnaire (EBPQ).
Results: The scores of EBP and KAP of ophthalmic nursing staffs in south China from high to low were as follows: practical attitude (4.85±1.07 points), practical behavior (4.42±1.14 points), practical knowledge and skills (4.30±0.65 points). The single factor analysis results showed that the first graduation degree, technical title, scientific research achievements, whether or not participate in EBP training, the frequency of reading literature at ordinary time, and whether or not participate in EBP project were the influencing factors of EBP level; the multi-factor analysis results showed that EBP attitude, EBP knowledge and skills, whether or not participate in EBP training were independent influencing factors of EBP.
Conclusions: The ophthalmic nursing staffs in south China have a positive attitude towards EBP, however, their EBP knowledge, skills and behavioral capabilities need to be focused and improved. The ophthalmic nursing administrators should fully master the factors affecting the implementation of EBP, and take effective intervention measurement to improve the EBP abilities of ophthalmic nursing staffs, and promote the development of EBP in ophthalmology specialty.
