How does French initial osteopathic training value relational competency,patient education,and the competency-based approach? A cross-sectional survey

BackgroundDespite the promotion of international osteopathic recommendations and registration guidelines, relational competencies and patient education practices present a challenge in the clinical setting due to lack of training. In France, the latest national osteopathic standards for education and practice defined a relational competency that includes patient education. Little is known about its integration in curricula and how French osteopathic practitioners are subsequently trained for relational competency.ObjectiveTo determine teaching, learning, and assessment methods related to relational competency in French initial osteopathic training programs and identify the role of patient education in this relational competency.MethodsAn online questionnaire was designed and sent to all initial training institutes in France (n = 28). Eight institutes answered the survey.ResultsThe relational competencies appeared in various courses, enhanced by clinical learning. However, the courses were not specific to this competency and the volume of hours was relatively low. Patient education was seen as part of relational competency but was poorly implemented. This competency-based approach is still considered an emerging practice in these institutes.ConclusionsThere is a misalignment among intended learning outcomes, teaching, and assessment. Current educational practices are not sufficient to support relational competency, specifically regarding patient education. Further research is needed on how French standards are understood, how they are assimilated by educators, and how they are translated into educational practice. In addition, the adequacy of educators' training for effective implementation of the competency-based approach should be questioned.     

What's in a name? Justifying terminology for genomic findings beyond the initial test indication: A scoping review

Genome sequencing can generate findings beyond the initial test indication that may be relevant to a patient or research participant’s health. In the decade since the American College of Medical Genetics and Genomics published its recommendations for reporting these findings, consensus regarding terminology has remained elusive and a variety of terms are in use globally. We conducted a scoping review to explore terminology choice and the justifications underlying those choices. Documents were included if they contained a justification for their choice of term(s) related to findings beyond the initial genomic test indication. From 3571 unique documents, 52 were included, just over half of which pertained to the clinical context (n = 29, 56%). We identified four inter-related concepts used to defend or oppose terms: expectedness of the finding, effective communication, relatedness to the original test indication, and how genomic information was generated. A variety of justifications were used to oppose the term “incidental,” whereas “secondary” had broader support as a term to describe findings deliberately sought. Terminology choice would benefit from further work to include the views of patients. We contend that clear definitions will improve ethical debate and support communication about genomic findings beyond the initial test indication.     

糖尿病肾病中医分型肾脏叶间动脉彩色多普勒超声分析

借助彩色多普勒频谱图,对糖尿病肾病患者肾脏叶间动脉血流参数进行分析,探讨该病中医分型的客观指标。方法：选择糖尿病肾病３５例,将其分为气阴两虚及阴阳两虚组,于每位患者双肾叶间动脉测量：收缩期峰值血流速度（ＶＳ）、舒张期末血流速度（ＶＤ）、平均血流速度（ＭＳ）、搏动指数（ＰＩ）、阻力指数（ＲＩ）。结果：气阴两虚组ＰＩ、ＲＩ值明显高于正常组（Ｐ＜０．０１）,阴阳两虚组ＰＩ、ＲＩ明显高于气阴两虚组（Ｐ＜０．０５）;阴阳两虚组ＶＤ值高于气阴两虚组及正常组（Ｐ＜０．０１）;气阴两虚组与正常组比较无统计学差异。结论：糖尿病肾病气阴两虚及阴阳两虚组中ＰＩ及ＲＩ,可以作为糖尿病肾病中医分型的客观指标。     

Structural and steric requirements for β-phenethylamines as agonists of the noradrenergic cyclic AMP generating system in the rat limbic forebrain

Summary The present studies were undertaken to assess the structural and steric requirements for -phenethylamines as agonists of the noradrenergic cyclic AMP generating system in slices of the rat limbic forebrain. Significant agonist activity of -phenethylamines requires a -3,4-dihydroxyphenethylamine with a -hydroxyl group in the R configuration. Thus, dopamine did not stimulate the system at concentrations up to 10^–3 M. Moreover, -hydroxyphenethylamines without a 3,4-catechol group (octopamine, phenylephrine, p-hydroxynorephedrine, metaraminol and methoxamine)-though exerting -agonist activity in peripheral tissues-lack agonist activity in this particular cyclic AMP generating system. The effects of (R)-norepinephrine and (R)-isoproterenol at maximal concentrations were not additive. The results lend further support to the view that the cyclic AMP generating system in slices of the limbic forebrain is part of a norepinephrine receptor coupled adenylate cyclase system with a subpopulation of receptors that are in nature.     

Testicular focal atrophy – tubular blockade as partial degeneration of the tubule

This study investigated whether focal atrophy is a degenerative process of a whole tubule or tubular blockade as partial intratesticular degeneration. Serial section analyses of testicular tissue from 19 men with different andrologic diseases were examined. From every fifth section of any series, defined areas were viewed under a light microscope, and tubule sections were drawn. Three-dimensional reconstructions were made from these materials. Reconstructions of the seminiferous tubules showed tubular blockade as partial degeneration of the tubules. Transition from an intact portion to a blockade was accompanied by an increase in the thickness of the lamina propria. The blockade was a cell cord that contained Sertoli cells and, at most, spermatogonia, or it was a completely atrophied tubule, a so-called tubular scar. In a given tubule, defined areas of atrophy and areas of spermatogenic activity were both found. Occurrence of tubular blockade increased with age. Serial section analyses of testicular tissue showed tubular blockade as the partial degeneration of seminiferous tubules. In focal atrophy, a given tubule can have defined areas of atrophy and areas of spermatogenic activity. Received: 25 August 1999 / Accepted: 21 April 2000     

傣族保健茶用植物

近年来在云南西双版纳地区傣族民间医药调查研究和整理中．发现傣族从当地植物中选择了具有保健和药用功效的植物作为饮品，形成了独具民族特色和地方特色的保健茶，有开发保健饮料或药用茶价值，现介绍几种傣族常用茶用植物及其制法、用法和功效。     

石斛愈伤组织培养物的药用前景探讨

石解药材的自然资源严重枯竭。本研究从石斛重要药用有效成分多糖的角度出发,所作的愈伤组织培养物和它的原植物的比较,显示出石解愈伤组织培养物有可能代替原植物作药用,既解决石料药源紧缺,又带来保护环境生态和商业利益的理想途径。