从医院现代化管理看检验医学未来发展

本文从医院现代化管理的角度对检验医学的发展予以展望。阐述了要符合现代化医院管理的要求,临床检验部门应该对现有的组织构架予以重塑与整和,完善临床实验室认可和质量管理体系,加强与临床医学的沟通,以及将循证医学的理论运用其中将有助检验医学在未来的发展和提高。     

再论温病方治疗杂病--兼论温病方症与辨温病方症的临床意义

温病方治疗杂病研究进展缓慢的主要原因有两点:一是忽视了温病方症及辨温病方症论治体系的研究;二是没有重视温病学中杂病辨治理论的研究.未来温病学应努力从以下四方面作为切入点进行研究:①加强温病方症的研究;②深化辨温病方症论治体系的研究;③注重温病学中杂病辨治内容的研究;④温病学教学应以学习温病原著特别是方症相关的原文为中心.     

Sexual Health Competencies for Undergraduate Medical Education in North America

IntroductionThe number of hours spent teaching sexual health content and skills in medical education continues to decrease despite the increase in sexual health issues faced by patients across the lifespan. In 2012 and 2014, experts across sexuality disciplines convened for the Summits on Medical School Education and Sexual Health to strategize and recommend approaches to improve sexual health education in medical education systems and practice settings. One of the summit recommendations was to develop sexual health competencies that could be implemented in undergraduate medical education curricula.AimTo discuss the process of developing sexual health competencies for undergraduate medical education in North America and present the resulting competencies.MethodsFrom 2014 to 2016, a summit multidisciplinary subcommittee met through face-to-face, phone conference, and email meetings to review prior competency-based guidelines and then draft and vet general sexual health competencies for integration into undergraduate medical school curricula. The process built off the Association of American Medical Colleges' competency development process for training medical students to care for lesbian, gay, bisexual, transgender, and gender non-conforming patients and individuals born with differences of sex development.Main Outcome MeasuresThis report presents the final 20 sexual health competencies and 34 qualifiers aligned with the 8 overall domains of competence.ResultsDevelopment of a comprehensive set of sexual health competencies is a necessary first step in standardizing learning expectations for medical students upon completion of undergraduate training.ConclusionsIt is hoped that these competencies will guide the development of sexual health curricula and assessment tools that can be shared across medical schools to ensure that all medical school graduates will be adequately trained and comfortable addressing the different sexual health concerns presented by patients across the lifespan. Bayer CR, Eckstrand KL, Knudson G, et al. Sexual Health Competencies for Undergraduate Medical Education in North America. J Sex Med 2017;14:535–540.     

Perceived impacts of COVID-19 on wellbeing among US working-age adults with ADL difficulty

BackgroundThe COVID-19 pandemic has disproportionately impacted people with disabilities. Working-age adults with ADL difficulty may face unique challenges and heightened health risks because of the pandemic. It is critical to better understand the impacts of COVID-19 on social, financial, physical, and mental wellbeing among people with disabilities to inform more inclusive pandemic response policies.ObjectiveThis study compares perceived COVID-19 physical and mental health, social, and financial impacts for US working-age adults with and without ADL difficulty.MethodsWe analyzed data from a national survey of US working-age adults (aged 18–64) conducted in February and March 2021 (N = 3697). We used logistic regression to compare perceived COVID-19-related impacts on physical and mental health, healthcare access, social relationships, and financial wellbeing among those with and without ADL difficulty.ResultsAdults with ADL difficulty were more likely to report negative COVID-19 impacts for many but not all outcomes. Net of covariates, adults with ADL difficulty had significantly greater odds of reporting COVID-19 infection (OR = 2.1) and hospitalization (OR = 6.7), negative physical health impacts (OR = 2.0), and negative impacts on family relationships (OR = 1.6). However, they had significantly lower odds of losing a friend or family member to COVID-19 (OR = 0.7). There were no significant differences in perceived impacts on mental health, ability to see a doctor, relationships with friends, or financial wellbeing.ConclusionsWorking-age adults with ADL difficulty experienced disproportionate health and social harm due to the COVID-19 pandemic. To address these disparities, public health response efforts and social policies supporting pandemic recovery must include disability perspectives.     

名义群组技术在中医院校英语专业循证医学文献（英）阅读课程评价中的应用

本文采用名义群组技术,对某中医院校新开课英语专业循证医学文献（英）阅读课程进行教学评价,了解教学效果和学生需求,为提高教学质量提供参考。结果表明学生在充分肯定课程内容、方法、重要性的基础上,普遍认为课程难度较大,课业负担过重。提示该门课程需要重新调整教学内容和方法。     

Identifying scientific artefacts in biomedical literature: The Evidence Based Medicine use case

Evidence Based Medicine (EBM) provides a framework that makes use of the current best evidence in the domain to support clinicians in the decision making process. In most cases, the underlying foundational knowledge is captured in scientific publications that detail specific clinical studies or randomised controlled trials. Over the course of the last two decades, research has been performed on modelling key aspects described within publications (e.g., aims, methods, results), to enable the successful realisation of the goals of EBM. A significant outcome of this research has been the PICO (Population/Problem–Intervention–Comparison–Outcome) structure, and its refined version PIBOSO (Population–Intervention–Background–Outcome–Study Design–Other), both of which provide a formalisation of these scientific artefacts. Subsequently, using these schemes, diverse automatic extraction techniques have been proposed to streamline the knowledge discovery and exploration process in EBM. In this paper, we present a Machine Learning approach that aims to classify sentences according to the PIBOSO scheme. We use a discriminative set of features that do not rely on any external resources to achieve results comparable to the state of the art. A corpus of 1000 structured and unstructured abstracts – i.e., the NICTA-PIBOSO corpus – is used for training and testing. Our best CRF classifier achieves a micro-average F-score of 90.74% and 87.21%, respectively, over structured and unstructured abstracts, which represents an increase of 25.48 percentage points and 26.6 percentage points in F-score when compared to the best existing approaches.     

Psychometric testing of the Chinese evidence-based practice scales

wang s.-c., lee l.l., wang w.-h., sung h.-c., chang h.-k., hsu m.-y., chang s.-c. & tai c.-h. (2012)?Psychometric testing of the Chinese evidence-based practice scales. Journal of Advanced Nursing68(11), 2570-2577. ABSTRACT: Aim. This article is a report of the psychometric testing of the Chinese version of Evidence-Based Practice Implementation and Beliefs, and Barriers to, and Facilitators of Research Utilization scales. Background. Investigations into the effect of evidence-based practice on clinical care could be facilitated by instruments for measuring the levels of evidence-based practice implementation; the strength of beliefs in evidence-based practice; the barriers to, and the facilitators of research utilization. An English version of the scales measuring the above constructs has been tested whereas the Chinese one has not. Design. Instrument development. Methods. Psychometric analyses of the four evidence-based scales were conducted on a sample of 361 nurses from a medical centre in Taiwan. Both the internal consistency and squared multiple correlation coefficients were used to examine reliability. The validity testing for the four scales was estimated by examining their construct and concurrent validity. Data were collected between December 2008-January 2009. Findings. Internal consistencies exist for the Chinese Evidence-Based Practice Implementation, Beliefs, and Barriers to, and Facilitator of Research Utilization scales (≥0·85); some were greater than 0·9, which may indicate redundancy in items. Construct validity of the four scales was supported by hypotheses testing. Concurrent validity of the four scales was supported by known-group analysis, in which experienced nursing researchers had higher scores compared with clinical nurses. Conclusion. These scales may have value in discrimination between implementation of EBP and perception of barriers to, and facilitators of research utilization among nurses with different education levels, research experiences or working years in clinical setting.