Trends in general surgery workforce data

BACKGROUND: During the past 25 years, there has been much debate about general surgical workforce supply and demand. In the late 1970s and early 1980s, concern was raised by the Study on Surgical Services for the United States and the Graduate Medical Education National Advisory Council that there would be a gross oversupply of total physicians and surgeons by the years 1990 and 2000. DATA SOURCES: In a 1990 report sponsored by the Council on Graduate Medical Education, reevaluation of the workforce data showed no surplus at that time and instead predicted a deficit of surgeons by 2010. Studies by other investigators in the mid-1990s supported these conclusions. Furthermore, a new workforce model published in 2002 predicted a significant overall deficit of physicians by 2020. The discrepancies in the projected and the actual data have been explained by a variety of factors including an aging population with increased surgical needs, an increasing number of outpatient surgical procedures, subspecialization within the field of general surgery, and decreasing interest in the field by United States medical students. CONCLUSIONS: Although it is difficult to compare data among studies, and there are many confounding factors in the data, review of the workforce data does support a future deficit of surgeons, a prediction that warrants further investigation.     

学科化信息服务的实践与探讨

学科化信息服务,是适应新的信息环境、以学科用户的信息需求为中心的新的服务模式.本文通过中国中医科学院广安门医院学科化信息服务的实践与探讨,提出了开展该服务对于促进学科的信息资源建设、提升信息服务层次、提高医院核心竞争力的积极意义.     

中文科技期刊集群化办刊模式的探索与实践——以中国激光杂志社为例

【目的】 探索和研究中文科技期刊集群化办刊模式,为中文科技期刊做大做强提供参考。【方法】 以中国激光杂志社3种中文科技期刊的集群化发展为例,从机制体制改革、资源重组、细化分工、专业化发展的角度,详细介绍期刊集群化和差异化发展中的办刊理念、办刊策略和发展历程。【结果】 期刊集群化运作、专业化分工可有效提升办刊质量和工作效率。同时,集群化办刊模式可以实现统筹管理、资源共享、优势互补,可显著提升期刊集群的品牌影响力,为中文科技期刊提供知识服务、服务学科发展奠定基础。【结论】 中文科技期刊集群化办刊模式可有效提升期刊的质量和影响力,转变“小、散、弱”现状,使各刊相互促进、融合发展。     

高校辅导员专业化建设与职业能力要求

提升高校辅导员职业素质和能力是辅导员队伍专业化建设的有效途径和直接体现。本文在分析专业化建设的内涵及现实不足之后,重点论述了提升职业能力对于专业化建设的意义,并解读了职业素质与能力的构建要素。     

借助微信平台联合使用标准化病人的教学方法在胰腺外科专科化培训中的效果探析

目的 探讨借助微信结合使用标准化病人(standardized patient, SP )在胰腺外科专科化培训中的效果。方法 选择长海医院外科住院医师规范化培训医师48名（全部为研究生学历）为教学对象。按照随机抽样原则将48名医师分为两组，实验组24名医师采用微信联合SP教学，对照组24名医师采用传统教学方式。两组均由专科资深的副主任医师进行临床带教。对照组采用传统临床带教方式，采用课堂授课，辅以视频资料巩固教学效果，再让学员参与实践临床工作；而对照组则采用微信结合SP教学，利用微信推送学习计划，学习内容、临床问题及组织组内讨论，辅以SP模拟临床实际进行实践教学。结束后，采用理论考试、问卷调查和专家答辩的方式评价两种教学模式的教学效果。采用SPSS19软件进行统计学处理。问卷调查结果采用描述性分析，采用卡方检验；理论考试成绩和专家答辩成绩以均数±标准差表示，采用t检验。结果 两组医师的理论考试成绩差异无统计学意义（85.5±7.6 vs. 81.4±14.9；P=0.238）。在问卷调查方面两组在理论知识的理解和记忆、提高学习主动性和积极性、提高临床思维判断、理论结合实践应用、提高临床操作技能水平和提高医患沟通能力等方面的差异，有统计学意义（P≤0.001），专家答辩考核中两组在在理论能力、分析能力方面差异无统计学意义（P>0.05），而在综合应用能力及沟通能力方面实验组医师的成绩均明显优于对照组医师（P≤0.001）。 结论 微信平台联合标准化病人教学模式在胰腺外科专科培训中切实可行，较传统教学模式可更有效提高教学效果。     

Moving forward in occupational health physical therapy: the journey toward specialization in the United States

Abstract

Background: The Occupational Health Special Interest Group of the Orthopaedic Section of the American Physical Therapy Association has championed the role of physical therapy in the area of occupational health in the United States.

Objective: This article is a brief review of the role physical therapists play in occupational health, competencies for professional development in this practice area, and efforts to achieve physical therapy specialization in the United States through petition to the American Board of Physical Therapy Specialties.

Major Findings: Physical therapists have an important role to play in the health, wellness, and sustained function of the working population based on the numbers and types of injuries sustained in the workplace, and chronic problems common to working age adults. Physical therapists can help prevent injury and promote return to work through interventions including ergonomics, job modifications and transitional duty programs, functional testing, case management and communication, and care coordination with workers and other stakeholders. Practice analysis competencies are discussed as the foundation of professional development in the field of occupational health. This article also overviews petitioning materials for specialization.

Conclusion: Physical therapist specialization in occupational health may benefit workers and employers through injury reduction and improved or sustained abilities of the workforce following injury. Specialization will help to promote consistency within the field of physical therapy for external stakeholder recognition of skills, while also promoting knowledge transfer and diffusion of best practice. The specialization petition has not been approved; however the process is ongoing.     

我院临床药师“专科化结合会诊”工作模式初探

目的：探讨适合我院的临床药师工作模式。方法：分析2010年5月-2012年4月我院临床药师参与临床药物治疗工作的成绩与不足。结果：按照“专科化结合会诊”的工作模式,我院临床药师深入重症监护病房（ICU）等科室开展专科定点工作,在全院会诊方面,我院临床药师年会诊量近200人次。结论：在目前,临床药师数量少、临床需求大的情况下,“专科化结合会诊”的工作模式可充分发挥临床药师的作用,不但可以使临床药师深入临床,同时也可以使临床药师的作用发挥到各个科室。     

Healthy aging attenuates task-related specialization in the human medial temporal lobe

Recent research on aging has established important links between the neurobiology of normal aging and age-related decline in episodic memory, yet the exact nature of this relationship is still unknown. Functional neuroimaging of regions such as the medial temporal lobe (MTL) have produced conflicting findings. Using functional magnetic resonance imaging (fMRI), we have recently shown that young healthy individuals show a stronger activation of the MTL during encoding of objects as compared with encoding of positions. Using the same encoding task, the present study addressed the question whether this greater MTL activation during encoding of objects varies with age. Fifty-four healthy individuals aged between 18 and 81 years underwent functional magnetic resonance imaging while they encoded and subsequently made new-old judgments on objects and positions. Region of interest (ROI) analysis of task related changes in the blood oxygen level-dependent (BOLD) signal was performed in native space after correction for gender effects and individual differences in cerebral blood flow. The hippocampus, amygdala, and parahippocampal, perirhinal, entorhinal, and temporopolar cortices of right and left hemisphere were defined as ROIs. Aging had an adverse effect on memory performance that was similar for memorizing objects or positions. In left and right MTL, relatively greater activation for object stimuli was attenuated in older individuals. Age-related attenuation in content specificity was most prominent in the recognition stage. During recognition, the larger response to objects gradually decreased with age in all ROIs apart from left temporopolar and entorhinal cortex. An age-related attenuation was also present during encoding, but only in right parahippocampus and amygdala. Our results suggest that memory-related processing in the MTL becomes gradually less sensitive to content during normal aging.