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1.
The concept of cause between exposure to agent X and the subsequent development of disease Y is reviewed briefly in terms of how it is used in experimental and clinical medicine, statistics and epidemiology, and in law. Some of the interrelationships of the definition of cause by these disciplines are considered.
Resumen El concepto de causalidad entre la exposición a un agente X y el desarrollo posterior de una enfermedad Y es examinado brevemente desde el punto de vista de su aplicación en la medicina experimental y clínica, en la estadística y en la epidemiología, así como desde el punto de vista jurídico. Este estudio examina ciertas relaciones existentes entre las definiciones de causa tomadas desde estas diferentes disciplinas.

Resumé Le concept de causalité entre une exposition à un agent X et le développment ultérieur d'une maladie Y est examiné brièvement dans l'optique de son application en médecine expérimentale et clinique, en statistique et en épidémiologie, ainsi que du point de vue juridique. Cette étude examine certaines relations qui existent entre les définitions de cause prises en considération dans ces différentes disciplines.
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Because health education is aimed at influencing behavior capable of affecting health and disease, patient education is an important constituent of health education. Patient education should demonstrably lead to increased self-assurance, reduced anxiety, better insight into one's ailments, more knowledge about the effects of medicines administered, greater self-acceptance after surgery, and improved social contacts among the chronically ill. It well deserves a place in primary health care. Patient education is not widely practiced in the Netherlands. Small-scale experiments are needed to establish effective modes of intervention.  相似文献   

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Context  Animations can depict dynamic changes over time and location, and illustrate phenomena and concepts that might otherwise be difficult to visualise. However, animations may not always be effective and educators who use animations must understand the principles that govern their use.
Objectives  This review aims to illustrate potential applications of animations in medical education, to identify evidence-based principles for their design and use, and to propose an agenda for future research.
Methods  We searched MEDLINE, PsychINFO and EMBASE for articles describing the use of computer animations in medical education. We reviewed and summarised all identified original research studies comparing animations with an alternative computer-based or non-computer-based format. We also selectively reviewed non-medical education research on the use of computer animations.
Results  Medical educators have used animations in a variety of computer-assisted learning applications, but few comparative studies have been published and the evidence is inconclusive. Research outside medical education shows conflicting results for studies comparing animations with static images. This may reflect differences in cognitive load induced by animation, or differences in the type of motion being illustrated. The benefits of animations may also vary according to learner characteristics such as prior knowledge and spatial ability. Features of animation that appear to facilitate learning include permitting learner control over the animation's pace, allowing learners to interact with animations and splitting the animation activity into small chunks (segmenting).
Conclusions  Existing medical education research does little to inform the use of animations. Research is needed to confirm and extend non-medicine research to ascertain when to use animations and how to use them effectively.  相似文献   

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Community pharmacy in the UK is often described as the most accessible of all primary healthcare providers, situated on the ‘high street’ and requiring no appointment. But what does the new public health movement mean for pharmacy, and where is pharmacy in terms of the new public health agenda? In this paper, the authors provide a critical assessment of pharmacy's response to this agenda through a review of key pharmacy relevant policy documents. In particular, in the context of pharmacy's re-professionalization agenda, they assess the contribution of pharmacy to public health from a micro- and macro-level framework. The aim is to provide a critical context in light of current proposals for the profession to develop a public health strategy.  相似文献   

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ABSTRACT

Attending to supervisees’ learning styles is a noted component of supervision best practices. However, the extant literature on learning styles is complex and controversial, leaving supervisors with little direction on whether or not—or how—to use them. In the following critical review, the literature on learning styles is reviewed and discussed, and recommendations for supervision practice and future research are provided.  相似文献   

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This review presents issues arising from an analysis of over 100 papers published in the field of patient satisfaction. The published output appearing in the medical and nursing literature which incorporated the term “patient satisfaction” rose to a peak of over 1000 papers annually in 1994, reflecting changes in service management especially in the U.K. and U.S.A. over the past decade. An introductory section discusses the setting and measurement of patient satisfaction within this wider context of changes in service delivery. Various models are examined that have attempted to define and interpret the idea of determining individual perceptions of the quality of health care delivered. Determinants of satisfaction are examined in relation to the literature on expectations, and demographic and psychosocial variables. These are distinguished from the multidimensional components of satisfaction as aspects of the delivery of care, identified by many authors. The review highlights the complexity and breadth of the literature in this field, the existence of which is often not acknowledged by researchers presenting the findings of studies.  相似文献   

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Freudian theory linking emotional development with somatic correlates has not been shown to explain certain phenomena from the laboratory and from clinical experience. Comparative studies, however, suffer from problems in methodology. Population samples may be biased by an absence of women more likely to be frigid, interview methods are emotionally superficial even though apparently comprehensive, and reliability and validity studies are generally not done. However, on the basis of these studies neurotic personality appears to be associated with sexual fears. Higher social class and younger age group are associated with less inhibition. Relationship to past personal experiences is more controversial, and there is less support for this hypothesis in comparative studies. Marital happiness appears to form a motivation for adaptation between partners. Successful treatment of frigidity has been accomplished by many forms of psychotherapy, including behavior therapy. In all types, nonconsummation has been very successfully treated, while treatment of orgasmic inadequacy has been disappointing. The absence of any comparative trials and the effects of self-selection of patients (especially in retraining schemes) make it impossible to compare the efficacies of treatment. Attention should be drawn to the similarity of nonconsummation to a phobic state and orgasmic inadequacy to a state of hysterical dissociation. This similarity would lead to an expectation, theoretically, of better results with behavior therapy and methods of desensitization and retraining.This study forms part of a thesis presented to the University of London for the degree of Master of Philosophy, April 1969.  相似文献   

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《Vaccine》2016,34(38):4484-4500
BackgroundVaccination is one of the most significant and successful public health measures of recent times. Whilst the use of complementary medicine (CM) continues to grow, it has been suggested that CM practitioners hold anti-vaccination views. The objective of this critical review is to examine the evidence base in relation to CM practitioner attitudes to childhood vaccination alongside attitudes to vaccination among parents who visit CM practitioners and/or use CM products.MethodsA database search was conducted in MEDLINE, PubMed, CINAHL, EMBASE and AMED for research articles published between January 2000 and September 2015 that evaluated either CM practitioner or CM user attitudes and intention towards childhood vaccination.ResultsA total of 23 articles were found that detailed the attitudes of CM practitioners to vaccination. A further 16 papers examined the association between the use of CM products and visits to CM practitioners, and immunisation. The interface between CM and vaccination is complex, multi-factorial and often highly individualised. The articles suggest that there is no default position on immunisation by CM practitioners or parents who use CM themselves, or for their children. Although CM use does seem positively associated with lower vaccination uptake, this may be confounded by other factors associated with CM use (such as higher income, higher education or distrust of the medical system), and may not necessarily indicate independent or predictive relationships.ConclusionsAlthough anti-vaccination sentiment is significant amongst some CM practitioners, this review uncovers a more nuanced picture, and one that may be more agreeable to public health values than formerly assumed.  相似文献   

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Peer-led health education in school is widely used. Advocates suggest it is an effective method based on the belief that information, particularly sensitive information, is more easily shared between people of a similar age. Critics suggest that this is a method not based on sound theory or evidence of effectiveness. This review evaluates school-based health education programmes which have set out to compare the effects of peers or adults delivering the same material. The identified studies indicated that peer leaders were at least as, or more, effective than adults. Although this suggests that peer-led programmes can be effective, methodological difficulties and analytical problems indicate that this is not an easy area to investigate, and research so far has not provided a definitive answer.  相似文献   

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Objectives This article reviews and critically evaluates historical and contemporary research on simulation‐based medical education (SBME). It also presents and discusses 12 features and best practices of SBME that teachers should know in order to use medical simulation technology to maximum educational benefit. Methods This qualitative synthesis of SBME research and scholarship was carried out in two stages. Firstly, we summarised the results of three SBME research reviews covering the years 1969–2003. Secondly, we performed a selective, critical review of SBME research and scholarship published during 2003–2009. Results The historical and contemporary research synthesis is reported to inform the medical education community about 12 features and best practices of SBME: (i) feedback; (ii) deliberate practice; (iii) curriculum integration; (iv) outcome measurement; (v) simulation fidelity; (vi) skill acquisition and maintenance; (vii) mastery learning; (viii) transfer to practice; (ix) team training; (x) high‐stakes testing; (xi) instructor training, and (xii) educational and professional context. Each of these is discussed in the light of available evidence. The scientific quality of contemporary SBME research is much improved compared with the historical record. Conclusions Development of and research into SBME have grown and matured over the past 40 years on substantive and methodological grounds. We believe the impact and educational utility of SBME are likely to increase in the future. More thematic programmes of research are needed. Simulation‐based medical education is a complex service intervention that needs to be planned and practised with attention to organisational contexts. Medical Education 2010: 44 : 50–63  相似文献   

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Because health education is aimed at influencing behavior capable of affecting health and disease, patient education is a important constituent of health education. Patient education should demonstrably lead to increased self-assurance, reduced anxiety, better insight into one's ailments, more knowledge about the effects of medicines administered, greater self-acceptance after surgery, and improved social contacts among the chronically ill. It well deserves a place in primary health care. Patient education is not widely practiced in the Netherlands. Small-scale experiments are needed to establish effective modes of intervention.  相似文献   

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A critical review of the extant literature on anorexia nervosa in males is presented, with the aim of comparing symptomatology in male versus female cases.  相似文献   

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This paper is a critical examination of and reflection about,the notion of action and its implications for modern healtheducation and its campaigns. Based on observations of Danishhealth campaigns, the paper aims to contribute to discussionsabout educational thinking and planning for health. In healtheducation it is important to examine whether contemporary healthcampaigns help or hinder progress towards the official goalfor Health Education in Danish schools, which is to developpupils' capability to act, to promote their own and others'health. In the Danish arena there is, however, much con fusion aboutthe concept of action. The lack of a viable, or generally accepteddefinition is mirrored both in health education in schools,and in nation-wide campaigns. The ward ‘action’isoften used in different ways, as a word meaning activity, abehaviour, habits or reasoned action. It is therefore a necessarypart of educational planning to consider the notion of actionand what it implies for the implementation of goals for healtheducation and health education campaigns.  相似文献   

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