互联网时代移动教学在神经外科教学中的应用探讨

在“互联网+教育”时代,借助移动通讯设备和网络的学习模式成为了新的教学趋势。该文对移动学习的特点和移动教学的方式,以及当前的移动教学新模式在神经外科教学中的应用进行了回顾和探讨,重点讨论了MOOC课程、翻转课堂以及微信平台教学对神经外科教学理念和教学模式带来的变化及其应用前景。同时也分析了当前移动设备应用于教学的不足之处及对大学生学习可能产生的负面影响,并对相应的解决方案进行了探讨。正确对待移动设备在教学中的作用,积极探索并发展适应时代潮流、多模式、高效的教学方法,对神经外科教学乃至其他医学类课程的教学具有重要意义。     

Pentobarbital overdose: A case of contract killing

Suicides by pentobarbital overdose have increased since about 2012, which appear to be influenced by technical information on active euthanasia that has spread over the Internet. We encountered a pentobarbital poisoning case of a patient with amyotrophic lateral sclerosis. A caregiver found the patient unconscious immediately after two visitors left the room. The patient was immediately transferred to the emergency hospital but eventually declared dead. A fatal concentration of pentobarbital was detected in peripheral blood samples collected in the emergency hospital and during autopsy (53.8 μg/mL and 29.4 μg/mL, respectively). Because the ratios of pentobarbital concentrations between the gastric contents and peripheral blood were 35 and 29 in the hospital and autopsy samples, respectively, it is likely that pentobarbital was administered via the gastrostomy tube. The patient had contacted the visitors through social media. Although the patient had requested the doctor perform active euthanasia and expressed a desire to end their life on social media, nobody had noticed the plan to commit suicide.     

Monoamine Oxidase Inhibitor Poisoning Resulting from Internet Misinformation on Illicit Substances

The Internet may represent a new mechanism by which adolescents initiate the use of illicit substances. The existence of multiple partisan websites providing misinformation regarding the safety of these substances may lead to an increase in unsafe behavior among this age group. Adverse outcomes related to Internet‐based drug information are rarely identified. We report a case of an adolescent whose use of the Internet to obtain drug information led to severe poisoning from the combination of a monoamine oxidase inhibitor, harmaline, and a hallucinogenic tryptamine, 5‐methoxydimethyltryptamine (5‐MeO‐DMT).     

互联网环境下医学院校高效班级规范管理制度探讨

通过对江苏省1132名医学院校大学生网络利用现状调查问卷的研究分析,论述当下网络环境下医学院校大学生网络利用现状,分析互联网的迅速发展给高效班级管理带来的发展机遇和面临的挑战。提出能够更好地利用互联网进行班级管理的措施:树立正确的上网观念、加强网络监管;积极引导学生正确利用互联网上的优质资源;利用网络平台,加强班级交流。     

实体社区互联网医院建设的探索与实践

“互联网+”是互联网创新成果与经济社会各领域深度融合的产物，“互联网诊疗”和“互联网+健康”是点和面的关系，互联网医院的属性是医疗机构。慢性病患者的复诊“续药”是互联网医院的重要功能，从医疗机构的功能定位来说，互联网医院的建设适合在基层医疗卫生机构发展。除了方便慢性病患者的复诊续药，“互联网医院”作为信息技术、互联网平台及传统医疗业务的深度融合，将是大健康领域的新生态和医疗服务领域新业态。本文从顶层设计、技术架构、业务模型、线下药品的配送和电子票据等方面，介绍国内首家实体社区互联网医院的建设实践经验，总结取得的成效和存在的问题，旨在为推动互联网诊疗与互联网医院发展提供参考。     

一种医用体温感受识别式腕带的设计思路及临床应用

医用腕带,又叫医疗识别带,是腕带的一种,主要用于医疗领域。医用腕带是医院对患者进行识别的有效工具,可提供患者的医疗信息,是国家卫生健康委员会最新要求的版面内容项目,其内容包括姓名、性别、床号、住院号及其他医疗特别要求的信息。现有的医用腕带具有使用简单、佩戴牢固、舒适、样式新颖美观的特点,被各大医院广泛使用,但其仅具有患者医疗信息识别功能,且佩戴后无法轻易取下导致患者外出时腕带上的信息直接被透露,对患者造成一定的心理负担,甚至导致抗拒佩戴腕带心理的出现。体温测量是基础护理工作。鉴于此,该研究提出了一种医用体温感受识别式腕带,腕带上的信息由直接透露改为点亮显示屏后可见,保护患者隐私,并利用物联网技术,通过SIM卡通信模块向护士站终端实时发送患者的体温测量值,实现对体温测量、记录、汇总等临床基础护理工作的优化,同时具有自动记录、报警等各种附加增值功能。     

Evaluating the effects of an Internet education programme on newborn care in Taiwan

Aim. The objectives of this study were to evaluate an Internet education programme provided to primigravida in the third trimester of pregnancy with the aim of enhancing mothers’ knowledge about newborn care and increasing their maternal confidence. Background. Shorter hospital stays have had an impact on the traditional role of mother–baby nurses in providing education about parenting to their parturient women. Internet education is an efficient way to provide nursing instruction. Design. A randomised controlled trial was used. A total of 118 women receiving prenatal care in a hospital clinic who met study criteria and who consented were assigned randomly to intervention and control groups. The study was conducted at a hospital in Taiwan. Methods. The target population was women at 32–34 weeks gestation, using the Internet on a regular basis. The primigravida were randomly assigned to either the control group (n = 57) or the experimental group (n = 61). Two primary outcome measures were newborn‐care knowledge and maternal confidence. Results. The changes in newborn‐care knowledge were 7·21 for the experimental group, compared with 1·95 for the control group; the difference between the least‐squares means computed by ancova was 5·73 and statistically significant (p < 0·001). The changes in maternal confidence were 8·46 for the experimental group and 3·05 for the control group; the difference between the least‐squares means computed by ancova was 5·94 and statistically significant (p < 0·001). Conclusion. Results suggest that Internet education about newborn care may contribute to greater care knowledge and maternal confidence. Relevance to clinical practice. Internet newborn‐care education programmes can achieve success in promoting newborn care and provide health professionals with evidence‐based intervention.     

Methodological Challenges in Online Trials

Health care and health care services are increasingly being delivered over the Internet. There is a strong argument that interventions delivered online should also be evaluated online to maximize the trial’s external validity. Conducting a trial online can help reduce research costs and improve some aspects of internal validity. To date, there are relatively few trials of health interventions that have been conducted entirely online. In this paper we describe the major methodological issues that arise in trials (recruitment, randomization, fidelity of the intervention, retention, and data quality), consider how the online context affects these issues, and use our experience of one online trial evaluating an intervention to help hazardous drinkers drink less (DownYourDrink) to illustrate potential solutions. Further work is needed to develop online trial methodology.     

Death following ingestion of MDMA (ecstasy) and moclobemide

Four deaths following the ingestion of moclobemide and MDMA ('ecstasy') are described. The probable cause of death in each case was serotonin syndrome as a result of an interaction between the two drugs. As none of the victims had been prescribed moclobemide it seems that each had taken the drug to enhance the effects of MDMA, with fatal consequences. Warnings are needed against misinformed attempts to potentiate the pharmacological effects of illicit drugs.     

新媒体环境下医学图书馆服务水平的提升

介绍新媒体的内涵和特征,阐述新媒体在信息传播中的表现形式丰富、获取信息便捷等优势,论述新媒体环境下医学资源的采集与揭示,提出完善新媒体服务形式、理念的途径和方法。