Adult ; Animals ; Endometrium ; parasitology ; physiopathology ; Enterobiasis ; complications ; drug therapy ; Enterobius ; drug effects ; pathogenicity ; Female ; Humans ; Menstruation Disturbances ; drug therapy ; parasitology ; Treatment Outcome

INTRODUCTIONThis study aimed to develop a realistic and lifelike uterine model for the training of hysteroscopy skills.

MATERIALS AND METHODSA lifelike "uterine" model was constructed using female pig bladder. The pig bladder was enclosed within a malleable mould, with both ureters blocked by pins. Both rigid and flexible hysteroscopes were used in this study.

RESULTSBasic diagnostic hysteroscopy can be performed in the usual fashion using this lifelike model. The cost of each learning station is minimal. Pig bladder accurately simulates the human uterus with its realistic tactile feel, and conditions in the surgical environment, including obscuration of vision by debris, uterine "folds", realistic "ostia", incomplete shearing of tissue, "uterine" perforation, etc.

CONCLUSIONThis low-cost novel model provides realistic tissue resistance and yields an almost anatomically accurate hysteroscopic training tool, thereby allowing trainees to effectively acquire both diagnostic and therapeutic hysteroscopic skills.

Animals ; Education, Medical, Graduate ; methods ; Female ; Gynecology ; education ; Hysteroscopes ; Hysteroscopy ; education ; instrumentation ; Models, Anatomic ; Obstetrics ; education ; Singapore ; Swine ; Urinary Bladder ; Uterus

ObjectiveTo develop a systematic case management model based on the International Classification of Functioning, Disability and Health (ICF) Vocational Rehabilitation Core Set (VR-CS) and explore its application pathways and efficacy in vocational rehabilitation. The 13 core categories of VR-CS are applied in vocational rehabilitation case management practices, utilizing comprehensive functional assessments to design and implement structured and individualized case management plans. This, in turn, seeks to enhance individuals' vocational independence, social participation and overall quality of life. MethodsThis study adopted a combined approach of theoretical research and empirical case analysis. Based on the 13 core categories of VR-CS, a comprehensive vocational assessment was conducted across three dimensions: body function and structure, activities and participation, and environmental factors. The study theoretically analyzed how to develop and implement holistic and individualized vocational rehabilitation plans, along with dynamic monitoring processes. Three types of typical vocational rehabilitation cases were examined, including individuals with major depressive disorder, high-functioning autism and mild cognitive impairment, to illustrate the evidence and effectiveness of VR-CS-based case management. ResultsThe VR-CS-based case management method, grounded in the ICF bio-psycho-social model, constructed an integrated and individualized case management system. This system combined the assessment and analysis of vocational rehabilitation needs, goal setting and planning, multidisciplinary team intervention, individualized interventions, process monitoring and dynamic adjustments, return-to-work activities, and long-term follow-up services.The case management model developed through VR-CS demonstrated significant and systematic efficacy in promoting vocational independence and social participation. This study provided a detailed analysis of the primary methods and steps involved in designing and implementing case management and elaborates on the practical applications of this model from the three representative cases. At the body function and structure level, case management included the evaluation of energy and drive functions (b130), high-level cognitive training (b164), and the enhancement of exercise tolerance (b455). Case management focused on accurately setting short- and long-term goals around functional limitations and needs. Dynamic monitoring during interventions ensured timely adjustments to intervention measures. This process improved physical endurance and cognitive function, enhanced sustained work capacity in complex vocational environments. At the activities and participation level, the focus was on skill acquisition (d155), stress management and psychological adjustment (d240), and the cultivation of complex interpersonal communication abilities (d720). Individuals engaged in regular professional skills training, role-playing and simulated work scenarios to progressively enhance vocational adaptability and social interaction skills. Through this process, individuals acquired practical skills, gradually boosting self-efficacy and vocational confidence, thereby facilitating the reshaping of their social roles. At the environmental and personal factors level, case management pathways involved active participation from immediate family (e310), positive shifts in societal attitudes (e460), and the effective utilization of health and employment policy resources (e580, e590). By integrating social and community resources comprehensively, the program created a more inclusive and supportive rehabilitation environment. By designing and implementing systematic case management programs, individuals showed significant improvements in psychological well-being, vocational adaptability and social interaction skills. The majority of cases achieved stable employment or continued participation in social activities following the intervention. ConclusionVR-CS provides a systematic, multidimensional and person-centered case management framework. This framework applies the bio-psycho-social model, analyzing individuals' primary functional impairments and vocational rehabilitation needs from the perspectives of body functions, psychological states and environmental factors. On this basis, a comprehensive, targeted and holistic case management plan is developed and implemented. The VR-CS-based case management approach not only enhances vocational capabilities but also improves overall quality of life and social adaptability.

ObjectiveTo reconstruct the vocational rehabilitation service process based on the framework and tools of the International Classification of Functioning, Disability and Health (ICF), to establish a systematic and standardized vocational rehabilitation service system to achieve the integrated development of vocational rehabilitation and other rehabilitation services, and to improve the overall rehabilitation effect and quality of life of people with disabilities. By establishing a systematic and standardized vocational rehabilitation service system, it provides function-oriented, holistic rehabilitation services for the whole person. MethodsThis study adopted the ICF framework and tools to conduct a systematic analysis of the vocational rehabilitation process. Based on this, according to the functional characteristics and systematic application of ICF-based tools, a vocational rehabilitation process was constructed, including functional assessment and rehabilitation goal setting, rehabilitation plan formulation, implementation of multidisciplinary intervention, outcome evaluation and quality of life assessment, and long-term follow-up and support. ResultsBased on the ICF framework and the application of ICF tools, according to the characteristics and nature of work of vocational rehabilitation institutions for persons with disabilities, a five-step vocational rehabilitation process was constructed. The main activity content of each process was defined in detail, and the ICF tools used and the methods of application were determined. The reengineering of the vocational rehabilitation process significantly improved the efficiency and quality of multidisciplinary comprehensive rehabilitation. The ICF framework and tools were the conceptual framework and platform for communication and collaboration among multidisciplinary teams. According to different vocational rehabilitation processes, the normative application of ICF-based tools ensured the development and implementation of scientific and effective rehabilitation intervention programs. The use of ICF-based tools also integrated vocational rehabilitation with other rehabilitation services, and achieved synergy among different rehabilitation services and different rehabilitation institutions. ConclusionThis study reengineered the vocational rehabilitation process based on the ICF framework, and constructed an ICF-based vocational rehabilitation process including the following five key processes, namely functional assessment and rehabilitation goal setting, formulating personalized and holistic rehabilitation plan, multidisciplinary team implementing comprehensive intervention strategies, evaluations of outcome and quality of life, and long-term follow-up and support services. Using the ICF framework and tools, the vocational rehabilitation service process of rehabilitation institutions has been reengineered, and an integrated rehabilitation service system has been constructed to provide a function-oriented comprehensive rehabilitation model, so that people with disabilities could receive whole-person rehabilitation services throughout their life cycle. Establishing a common language and tools based on ICF can effectively improve communication and collaboration among professionals, and also provide standardized tools for cross-institutional service integration, which is conducive to achieve smooth collaboration and information sharing among different rehabilitation institutions, ensuring the smooth transition of people with disabilities between different rehabilitation stages and institutions, and ensuring the coherence and integrity of the rehabilitation process.

BACKGROUNDProactive infection control management is crucial in preventing the introduction of multiple drug resistant organisms in the healthcare setting. In Hong Kong, where vancomycin-resistant enterococci (VRE) endemicity is not yet established, contact tracing and screening, together with other infection control measures are essential in limiting intra- and inter-hospital transmission. The objective of this study was to illustrate the control measures used to eradicate a VRE outbreak in a hospital network in Hong Kong.

METHODSWe described an outbreak of VRE in a healthcare region in Hong Kong, involving a University affiliated hospital and a convalescent hospital of 1600 and 550 beds respectively. Computer-assisted analysis was utilized to facilitate contact tracing, followed by VRE screening using chromogenic agar. Multi-locus sequence typing (MLST) was performed to assess the clonality of the VRE strains isolated. A case-control study was conducted to identify the risk factors for nosocomial acquisition of VRE.

RESULTSBetween November 26 and December 17, 2011, 11 patients (1 exogenous case and 10 secondary cases) in two hospitals with VRE colonization were detected during our outbreak investigation and screening for 361 contact patients, resulting in a clinical attack rate of 2.8% (10/361). There were 8 males and 3 females with a median age of 78 years (range, 40 - 87 years). MLST confirmed sequence type ST414 in all isolates. Case-control analysis demonstrated that VRE positive cases had a significantly longer cumulative length of stay (P < 0.001), a higher proportion with chronic cerebral and cardiopulmonary conditions (P = 0.001), underlying malignancies (P < 0.001), and presence of urinary catheter (P < 0.001), wound or ulcer (P < 0.001), and a greater proportion of these patients were receiving β-lactam/β-lactamase inhibitors (P = 0.009), carbapenem group (P < 0.001), fluoroquinolones (P = 0.003), or vancomycin (P = 0.001) when compared with the controls.

CONCLUSIONExtensive contact tracing and screening with a "search-and-confine" strategy was a successful tool for outbreak control in our healthcare region.

Aged ; Aged, 80 and over ; Enterococcus faecium ; growth & development ; pathogenicity ; Female ; Gram-Positive Bacterial Infections ; epidemiology ; prevention & control ; Hong Kong ; epidemiology ; Humans ; Male ; Middle Aged ; Vancomycin Resistance