高等医学院校人事考评系统研究

年度人事考评是实现人力资源有效控制的重要环节。考评的结果受多种因素的影响，如何针对存在的问题，完善各评估环节，通过评估最大限度调动员工的积极性，是深化人事考评亟需研究和解决的一个新课题，本文对此进行了分析。     

Statistics over features for internal carotid arterial disorders detection

The objective of the present study is to extract the representative features of the internal carotid arterial (ICA) Doppler ultrasound signals and to present the accurate classification model. This paper presented the usage of statistics over the set of the extracted features (Lyapunov exponents and the power levels of the power spectral density estimates obtained by the eigenvector methods) in order to reduce the dimensionality of the extracted feature vectors. Since classification is more accurate when the pattern is simplified through representation by important features, feature extraction and selection play an important role in classifying systems such as neural networks. Mixture of experts (ME) and modified mixture of experts (MME) architectures were formulated and used as basis for detection of arterial disorders. Three types of ICA Doppler signals (Doppler signals recorded from healthy subjects, subjects having stenosis, and subjects having occlusion) were classified. The classification results confirmed that the proposed ME and MME has potential in detecting the arterial disorders.     

再议法医在医疗纠纷技术鉴定中的定位、问题及建议

目前医疗纠纷鉴定机构主要为医学会和司法鉴定机构,其鉴定的主体分别为医疗专家和法医,当前学术界对两类鉴定主体参与医疗纠纷司法鉴定有两种不同主张,有些主张由医学会进行医疗纠纷鉴定,有些主张由法医进行医疗纠纷鉴定,文章认为法医进行医疗纠纷鉴定有他的合理性,他在医疗纠纷的定位应为“‘专职的司法鉴定人、独立的诉讼参与人”。但是,法医作为鉴定人也存在一些问题和不足,文章针对现存的问题进行了分析,提出了相关的建议。     

公立医院专家坐诊社区卫生服务中心现状及问题对策

目的完善上级专家社区坐诊制度内涵,促进坐诊工作开展,建立坐诊开展长效机制。方法调查表内容以最近一周（7天）对口支援公立医院医生在社区坐诊多少人日等为主要内容。结果实际到社区坐诊专家少;未能对社区卫生人才队伍服务能力提高起到作用;未形成常见病、多发病下沉到社区卫生服务机构的意识;尚未形成坐诊制度化。结论坐诊工作机制需进一步完善,才能发挥其更大作用。     

Solution‐driven approaches to generic substitution challenges – a survey among international experts

The main objective of this study was to explore the perception and understanding of economic, legal, and social barriers that may restrain generic uptake among recognized international experts in health care, and to identify and verify recommendations on how to streamline generic substitution (GS) at no expense of therapeutic safety. A questionnaire survey was devised, and experts with world‐renowned expertise in the field of generic medicinal products were selected. Almost 3/4 of respondents claimed that all drugs that satisfy bioequivalence criteria represent similar efficacy and adverse effects, and 1/4 of respondents believed that some differences could be reported. The majority of experts supported (i) the right of patients to refuse GS, (ii) the right of physicians to veto GS, and (iii) the introduction of a statutory obligation to provide patients with access to the cheapest generics available on the market. The main obstacles to more general uptake of generics were as follows: (i) perception of generics as lower quality products, (ii) absence of a transparent policy governing GS, and (iii) disincentives to pharmacists and physicians. Among the most popular recommendations were as follows: (i) introduction of various measures to aid physicians in generic prescribing, (ii) setting clear guidelines specifying when GS is not advisable, (iii) supporting competition on the generic market. The views of experts and the resulting recommendations were strongly affected by their opinion on the bioequivalence of generics. From this analysis, we have selected several principal recommendations which could help shape successful healthcare policies regarding GS.     

‘…it shows that there's no limits’: the psychological impact of co‐production for experts by experience working in youth mental health

Co‐production is commonly conceptualised as a more equal sharing of power and decision‐making between a dichotomy of service user and service provider, each bringing valuable and different assets to the process. Experts by experience lie in the overlap between this conceptually created duality, providing the services they now do by virtue of having once used services themselves. Previous related studies suggest that their involvement in co‐production could impact positively on their social capital, self‐esteem, self‐efficacy and life skills. However, no studies have been explicitly psychological or phenomenological in nature, and the theoretical basis for such outcomes remains under‐developed. This phenomenological study explored the psychological impact of co‐production for young people who were paid experts by experience for a young person's mental health charity in a large and diverse urban area in the UK, looking at the what of psychological impact, as well as the theoretical why and how. Semi‐structured interviews were conducted with a convenience sample of five males, with a mean age of 25 years. Interpretative phenomenological analysis yielded three master themes: the co‐production approach, I'm a professional and identities in transition. Participants valued a collegiate organisational approach that prioritised empowerment, agency and equality between experts by experience and ‘experts by qualification’, leading to a positive impact on their self‐efficacy and self‐esteem. Co‐production impacted fundamentally on their identity structure, enabling them to explore a new identity as a ‘professional’. The results are framed within identity process theory and point to the potential benefits of this model to co‐production.     

Expert Opinions on the Concept of Blood Stasis in China: An Interview Study

Objective

To study various experts’ opinions on the defifinition and diagnosis of blood stasis in China.

Methods

We e-mailed the selected experts to explain the purpose of the study and to invite them to participate and asked them to name a time for the investigator to call them. Eight experts and fifive organizations were interviewed in the research community investigating blood stasis in China.

Results

Six main categories emerged from the interviews: (1) blood stasis concepts; (2) blood stasis-related biomarkers; (3) methods of diagnosing blood stasis; (4) drugs for promoting blood circulation and dissipating stasis; (5) blood stasis-related diseases; and (6) blood stasis-related societies. The consensus among the interviewed experts was that the defifinition of blood stasis is rather complicated and that there is no gold standard marker for detecting blood stasis.

Conclusions

This paper acquired experts’ opinions on the defifinition and diagnosis of blood stasis in order to establish a modern concept of blood stasis. This paper also developed a diagnostic tool and diagnostic indices for blood stasis and identifified biological indices and pathologic mechanisms related to blood stasis, which might be of great reference value in future blood stasis standardization research.

     

基于技能培养的中医诊断学形成性评价研究

通过形成性评价的方法对望诊技能教学环节进行分阶段的评价,改变终结性考试单一的考试评价模式,实现考试与教学的真正对接,并通过计算机看图考试评价系统的研制,进行理论实践相结合、方式灵活的形成性评价来评价学生的综合学习能力。此做法突出能力考核,有利于激发实践技能的培养以及建立考试后的信息反馈机制。     

糖尿病肾病中医治疗经验撷要

通过分析相关文献,就现代各医家对糖尿病肾病痛名,病位、病因、病机、治疗方法等内容进行总结,旨在加强医疗卫生人员对糖尿病肾病的认识,指导临床治疗.