课程思政视域下医学生思政素养现状及影响因素研究

目的　为推进医学院校课程思政教育改革工作，充分掌握医学生思政素养现状及其影响因素，发现思政素养及课程思政建设存在的问题，为课程思政教育改革提供参考依据，特开展本研究。方法　采用问卷调查法针对某医学院校2 145 名本科生思政素养现状及影响因素进行调研。思政素养共涉及国家方针政策、家国情怀和社会责任、职业兴趣与职业发展、专业伦理和道德法制、人文精神和科学精神5 个方面。结果　医学生思政素养总体得分为4.20±0.77，学生在思政素养的5 个方面得分具有统计学意义（P ＜ 0.05）；家国情怀和社会责任得分最高，职业兴趣与职业发展得分最低；对医学生总体思政素养得分进行单因素分析显示，所在年级、专业类型、是否为学生干部、高考医学志愿是否为本人选择以及就读专业是否为意向志愿方面差异均具有统计学意义(P ＜ 0.05)。结论　医学生思政素养的总体水平待提升，职业兴趣与职业发展教育是未来课程思政教育的重点内容。课程思政教育十分必要，要充分把握医学教育发展规律，考虑学生专业学习的阶梯式成长特征，科学系统、循序渐进设计思政教育路径。     

日间手术模式对医疗费用控制的作用机制研究

目的:研究日间手术模式在控制医疗费用方面的机制特点。方法:将2018年度出院的854例单病种患者,分为日间组(818例)和非日间组(36例),比较两组在肿块大小、年龄、住址、住院日、住院费用结构、实际费用消耗等方面的差异。结果:在年龄、住院日、住院费用方面,日间组明显低于非日间组。加上门诊相关费用后,日间组和非日间组在实际费用消耗方面差异不显著。结论:日间手术开展依赖于微创技术的发展。日间手术模式能够降低与住院日密切相关的床位费、护理费、药费等费用,但由于高值耗材的使用,同时也抬升了卫生材料费用。日间手术能够有效降低患者隐形社会成本支出。推行日间手术需要兼顾医师的工作积极性。推广日间手术与医保费用管控并不矛盾。     

Preceptors’ perceptions of supporting nursing students in prison health services: A qualitative study

BackgroundOur university commenced clinical placements for third-year nursing students in Prison Health Services (PHS) in 2014. Registered nurse preceptors employed in these services facilitated students’ experiential workplace learning, assessed their competence and assisted them to meet course objectives in this challenging environment. To date, no studies have examined preceptors’ experiences of supporting students in the prison health setting.AimThe study aim was to investigate preceptors’ perceptions of supporting nursing students undertaking clinical placements in PHS, in order to inform development of resources and processes.MethodsQualitative data were collected via a focus group and interviews with preceptors (n = 6) working in metropolitan PHS. Data underwent thematic analysis.FindingsParticipants valued the opportunity to support student learning, finding students contributed to the workplace by bringing in new ideas, and conducting beneficial projects. However, preceptors requested better rostering and workload management by their employer. They also wished for more detailed information from the university regarding student orientation and preparation to support student learning. They felt that the employer-provided preceptorship training did not fulfil their needs.DiscussionPreceptors in PHS settings shared many of the support needs of those in other settings, although some challenges were more specific to the setting.ConclusionThis paper makes recommendations on how preceptors in PHS can be better supported to fulfil the role.     

The impact of program-driven wellness initiatives on burnout and depression among surgical trainees

BackgroundThe prevalence of burnout and depression are high among surgical trainees. This study examined the impact of program-driven initiatives to improve surgical trainee wellness.MethodsA survey was administered to residents and fellows at all surgical training programs across an urban academic health system. The survey measured burnout, depressive symptoms, and perceptions of program-driven wellness initiatives.ResultsThe response rate was 44% among 369 residents. Of these, 63.2% screened positively for burnout, and 36.7% for depression. Residents who were burned out were more likely to work >80 h per week, have greater clerical duties, and miss educational activities more frequently. Conversely, having opportunities for wellness activities, dedicated faculty and housestaff wellness champions, and assistance with clerical burden were all associated with lower rates of burnout and depression.ConclusionThe presence of wellness support was associated with better outcomes, suggesting the value of initiatives to manage workload and support the well-being of surgical resident physicians.     

我国近代“西医东渐”研究的发展与热点分析

目的：分析我国期刊在“西医东渐”领域的重要研究方向及其研究热点与趋势。方法：应用文献计量学分析中国知网和万方数据收录的“西医东渐”文献,建立关键词共现矩阵，揭示领域研究热点。结果：截至检索时间，我国共发表“西医东渐”文献765篇，经历了缓慢进展、快速发展两个阶段，研究范围涉及医学史、宗教学、社会学等学科，形成了独特的研究视角以及稳定的核心作者群。结论：我国在“西医东渐”方的面研究经历了缓慢进展和快速发展两个阶段，医学史学术期刊是刊载“西医东渐”研究成果的主要刊物；引入西医后，我国的中医事业发展受到了一定影响和冲击。     

预见习在精神病学教学中的作用研究

目的探讨预见习在精神病教学中的作用。方法选取120名本科学生,随机分为预见习组(n=60)和对照组(n=60)。预见习组在学习精神病学理论课程前一学期开始实施带教老师带领学生预见习、见习、实习全程教学,对比两组学生实践操作、理论知识成绩和学生满意度。结果干预后,导师制预见习组实践操作和理论知识成绩显著高于对照组(P<0.05)。导师制预见习组学生满意度显著高于对照组(P<0.05)。结论预见习教学有助于学生全面发展,提高精神病学教学水平。     

Medical populism and the COVID-19 pandemic

ABSTRACT

This paper uses the vocabulary of ‘medical populism’ to identify and analyse the political constructions of (and responses to) the COVID-19 pandemic in Brazil, the Philippines, and the United States from January to mid-July 2020, particularly by the countries’ heads of state: Jair Bolsonaro, Rodrigo Duterte, and Donald Trump. In all three countries, the leaders’ responses to the outbreak can be characterised by the following features: simplifying the pandemic by downplaying its impacts or touting easy solutions or treatments, spectacularizing their responses to crisis, forging divisions between the ‘people’ and dangerous ‘others’, and making medical knowledge claims to support the above. Taken together, the case studies illuminate the role of individual political actors in defining public health crises, suggesting that medical populism is not an exceptional, but a familiar response to them. This paper concludes by offering recommendations for global health in anticipating and responding to pandemics and infectious disease outbreaks.     

Formaldehyde exposure and its effects during pregnancy: Recommendations for laboratory attendance based on available data

Formalin is commonly used in fixation of cadaveric specimens. Exposure to formaldehyde, a component of formalin and a known carcinogen, during gross anatomy laboratory dissection is a continuing concern for pregnant students and instructors. Since there is little literature on this specific topic, the current review was compiled in the hope of offering recommendations to pregnant students and instructors who are engaged in human anatomical dissection where formalin is used. Relevant articles were obtained through searches of PubMed and Google Scholar for the terms “formaldehyde,” “pregnant,” “formalin,” and “exposure.” A literature search was conducted for chemical information and articles about exposure as issued by government regulatory agencies and chemical companies that produce formaldehyde. This led to the compilation of 29 articles each of which included references to previous, relevant, human research. The reviewed literature contains data strongly suggesting that pregnancy can be affected by formaldehyde exposure. Therefore, on the basis our analysis, female students who might be pregnant should avoid formaldehyde exposure, including that in a gross anatomy laboratory. Instructors should find other means of ensuring anatomical competence for these students. Clin. Anat. 28:972–979, 2015. © 2015 Wiley Periodicals, Inc.     

Mineralized Collagen: Rationale,Current Status,and Clinical Applications

This paper presents a review of the rationale for the in vitro mineralization process, preparation methods, and clinical applications of mineralized collagen. The rationale for natural mineralized collagen and the related mineralization process has been investigated for decades. Based on the understanding of natural mineralized collagen and its formation process, many attempts have been made to prepare biomimetic materials that resemble natural mineralized collagen in both composition and structure. To date, a number of bone substitute materials have been developed based on the principles of mineralized collagen, and some of them have been commercialized and approved by regulatory agencies. The clinical outcomes of mineralized collagen are of significance to advance the evaluation and improvement of related medical device products. Some representative clinical cases have been reported, and there are more clinical applications and long-term follow-ups that currently being performed by many research groups.