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.     

Health dynamics shape life-cycle incomes

This paper empirically investigates the long-run effects of major health improvements on income growth in the United States. To isolate exogenous changes in health, the econometric model uses quasi-experimental variation in cardiovascular disease mortality across states over time. Based on data for the white population, the results show that there is a causal link between health and income per person, and they provide novel evidence that health dynamics shape life-cycle incomes. Life-cycle income profiles slope more strongly at the beginning and at the end of work life in 2000 than in 1960, indicating that age becomes a more prominent determinant of income dynamics over this period. The channels for this transformation include better health, higher educational attainment, and changing labor supply.     

COVID-19 vaccination in pregnant women in Sweden and Norway

Vaccines against SARS-CoV-2 are highly effective in preventing severe disease and mortality. Although pregnant women are at increased risk of severe COVID-19, vaccination uptake among pregnant women varies. We used the Swedish and Norwegian population-based health registries to identify pregnant women and to investigate background characteristics associated with not being vaccinated. In this study of 164 560 women giving birth between May 2021 and May 2022, 78% in Sweden and 87% in Norway have been vaccinated with at least one dose at delivery. Not being vaccinated while being pregnant was associated with age below 30 years, low education and income level, birth region other than Scandinavia, smoking during pregnancy, not living with a partner, and gestational diabetes. These results can assist health authorities develop targeted vaccination information to diminish vaccination inequality and prevent severe disease in vulnerable groups.     

在校大学生艾滋病认知状况的调查研究

目的：了解高校大学生对艾滋病的认知状况,以便为制定有针对性的健康教育和综合防治措施提供科学依据。方法：采用现场不记名方式于2000年11月对西安五所高校大学生进行了问卷调查,用EpiInfo5.0统计软件进行统计分析。结果：70．5％的被调查者清楚艾滋病的全称。49．1％的人能正确回答艾滋病的三种主要传播途径,25．6％的人还认为蚊虫叮咬可传播艾滋病,对此知识的掌握年龄大者,已婚者,受教育程度高的和医学生掌握程度优于年龄小的,未婚者,教育程度低的和非医学生。结论：高校大学生对艾滋病有关知识了解甚少,他们又处在感染的高危人群,这种低知识水平的现状,与我国面临的艾滋病流行趋势极不适应,提示令后艾滋病知识的健康教育应在大学生尤其应在低年级学生中加强。     

医学大学生对医德认知的调查研究

采用抽样研究方法,对４３８名不同专业、不同层次的大学生进行了医德认知调查,以了解大学生对医德基本知识掌握的情况,结果表明,大学生对开设医学伦理学课必要性认识均率为６２．９％,课外经常阅读医德书籍均率为２２．７５％,对中外基德发展史各朝代典型的人物及代表作了解的均率为３１．１％,文中对调查结果进行了分析。     

Prevalence and control of arterial hypertension in the south-east of Spain: A radical but still insufficient improvement

Stroke mortality rates in Spain are one of the highest in all of Europe. At the same time, the Murcia region (south-east Spain) shows, for both genders, the highest age-adjusted stroke mortality rates in all of Spain. The earliest available hypertension figure estimations for this area go back to 1981, when a high prevalence combined with an almost nonexistent control was detected. One decade later, updated prevalence estimations of hypertension are presented jointly with their degree of control and their association with other risk factors based on the results of a prevalence survey in a random population sample (n = 3,091). Arterial blood pressure was measured following the MONICA protocol, maintaining a tight quality control on between and within-observer variability. As hypertensive was considered as any person with systolic blood pressure (SBP) 140 mmHg or with diastolic blood pressure (DBP) 90 mmHg or with antihypertensive pharmacological treatment. Detected prevalence rises to 32.3% (CI 95%: 29.1%–35.5%) among males and to 23.7% (CI 95%: 21.4%– 26%) among females, maintaining its level regarding figures observed back in 1981. However, its control has been increased, especially among hypertensive women [from less than 5% in 1981 to 35% (95% CI: 32%–37.8%) at present]. Hypertension is strongly associated to hipercholesterolemia, overweight, obesity and diabetes (p < 0.01). On the contrary, it shows an opposite association with current smoking, higher educational level and leisure time physical activity (p < 0.01). The highest educational level was associated with better hypertension treatment and control. In summary, while hypertension prevalence is stabilized in our population, its control has improved in a measurable but still insufficient way. These results are in accordance with a decreasing trend in stroke mortality registered in the Murcia Region along the last decade.     

保定医学堂的初创

保定医学堂是在我国医学教育中较早的一所中西医结合院校,该校的建立为中西医结合的发展起到了积极的作用。本文介绍了该学堂建立时的历史背景,教学计划及学生管理等方面的规章制度,这对当前的教育、教学改革无疑有所裨益。     

World Wide Web and Internet: applications for radiologists

Global exchange of information is one of the major sources of scientific progress in medicine. For management of the rapidly growing body of medical information, computers and their applications have become an indispensable scientific tool. Approximately 36 million computer users are part of a worldwide network called the Internet or “information highway” and have created a new infrastructure to promote rapid and efficient access to medical, and thus also to radiological, information. With the establishment of the World Wide Web (WWW) by a consortium of computer users who used a standardized, nonproprietary syntax termed HyperText Markup Language (HTML) for composing documents, it has become possible to provide interactive multimedia presentations to a wide audience. The extensive use of images in radiology makes education, worldwide consultation (review) and scientific presentation via the Internet a major beneficiary of this technical development. This is possible, since both information (text) as well as medical images can be transported via the Internet. Presently, the Internet offers an extensive database for radiologists. Since many radiologists and physicians have to be considered “Internet novices” and, hence, cannot yet avail themselves of the broad spectrum of the Internet, the aim of this article is to present a general introduction to the WWW/Internet and its applications for radiologists. All Internet sites mentioned in this article can be found at the following Internet address: http://www.univie.ac.at/radio/radio.html (Department of Radiology, University of Vienna) Received: 2 February 1998; Revision received: 11 June 1998; Accepted: 27 July 1998     

The impact of student-generated learning issues on individual study time and academic achievement

OBJECTIVES: The aim of this study was twofold. The first question concerns the way students make use of the learning issues they generate (as strict guidelines or as global guidelines) and whether this changes across years of training. The second question concerned the relationship between the way students make use of learning issues and the time spent on individual study and achievement on two tests of knowledge. DESIGN: A questionnaire was developed, containing seven items that measured to what extent students study strictly according to the student-generated learning issues and six items that measured to what extent students study beyond the student-generated learning issues. The questionnaire also contained one question in which students had to estimate the mean time spent on individual study. Achievement was measured by two forms of tests of knowledge, a block test assessing course content and a progress test assessing long-term functional knowledge. SETTING: Medical School of Maastricht University, the Netherlands. SUBJECTS: Medical students (response=69%) from the problem-based curriculum at the Maastricht University. RESULTS: During their first year students study strictly according to the content of the learning issues, whereas in later years students studied more according to their own learning needs and interests. In addition, students who tended to study beyond the generated learning issues spent more time on individual study and achieved better on both tests. CONCLUSIONS: Students in a problem-based curriculum seem to become better self-directed learners during the years of training.