Welcome back survey: exploring concerns impacting HIV care engagement and retention

The current study describes the development of a short pre-clinic survey that helped multidiscipline providers to elicit patient perspective on barriers to HIV primary care. The survey was piloted with 318 patients returning to care after being lost to care for at least 12 months. Reasons for breaks in care were dependent on age, gender, and race. Concerns about confidentiality in care were more commonly reported by African-American, Latino, and younger patients, while concerns relating to acceptance of diagnosis and side effects were greater for women, African-American, and Latino participants. Further, Intimate Partner Violence (IPV) and transportation were greater concerns for women and younger patients in the sample.     

基于“微课”的翻转课堂在超声住院医师规范化培训中的初步应用

随着住院医师规范化培训体系日趋完善,培训质量日益受到关注与重视。传统超声医学教学模式已不能满足规范化培训的最新需求,更新教学理念、改革教学模式成为必然。"微课"因其快速、方便、可重复性的特点,在现代教学活动中发挥了积极作用,我科尝试在"微课"中引入翻转课堂,让学员充当教员角色,主动参与"微课"的构思、设计、制作及讲解,着重培养其自主学习、交流沟通及团队合作等综合能力,以提高培训质量。     

Deep learning for intelligent diagnosis in thyroid scintigraphy

ObjectiveTo construct deep learning (DL) models to improve the accuracy and efficiency of thyroid disease diagnosis by thyroid scintigraphy.MethodsWe constructed DL models with AlexNet, VGGNet, and ResNet. The models were trained separately with transfer learning. We measured each model’s performance with six indicators: recall, precision, negative predictive value (NPV), specificity, accuracy, and F1-score. We also compared the diagnostic performances of first- and third-year nuclear medicine (NM) residents with assistance from the best-performing DL-based model. The Kappa coefficient and average classification time of each model were compared with those of two NM residents.ResultsThe recall, precision, NPV, specificity, accuracy, and F1-score of the three models ranged from 73.33% to 97.00%. The Kappa coefficient of all three models was >0.710. All models performed better than the first-year NM resident but not as well as the third-year NM resident in terms of diagnostic ability. However, the ResNet model provided “diagnostic assistance” to the NM residents. The models provided results at speeds 400 to 600 times faster than the NM residents.ConclusionDL-based models perform well in diagnostic assessment by thyroid scintigraphy. These models may serve as tools for NM residents in the diagnosis of Graves’ disease and subacute thyroiditis.     

Perceptions of psychiatry residents and non-residents on training needs and care related to patients with intellectual disability and mental health problems: A study from Singapore

Background: People with intellectual disability (ID) have higher risk of mental morbidity and specialised training may be required in their management. We explored the training needs and knowledge as well as perceptions of care of such patients among residents and non-residents working in psychiatry.

Method: The study was conducted as an anonymous survey. Questionnaires were sent to all residents and non-residents at a large psychiatric hospital in Singapore.

Results: Forty-eight out of the 76 questionnaires sent out were returned. All participants responded that postgraduate training was required in the area of ID and mental health and according to the majority, available training was inadequate. Over 90% believed that people with ID were vulnerable to exploitation and they should be under a specialist team.

Conclusion: Efforts should be made to include specialist training in psychiatry of ID in the Singapore psychiatry curriculum to enhance the knowledge and expertise of psychiatrists in this field.     

城市居民婚姻压力、社会支持与离婚意向的关系

目的:探讨城市居民婚姻压力、社会支持与离婚意向之间的关系以及社会支持在婚姻压力与离婚意向之间的调节作用。方法:采用城市居民婚姻压力问卷、社会支持量表和离婚意向问卷对422名城市居民进行施测。结果:1婚姻压力与客观支持、支持利用度存在显著正相关(r=0.195,0.118;P均0.05);2离婚意向与客观支持、主观支持和支持利用度之间均存在显著负相关(r=-0.216,-0.310,-0.182;P均0.05);3客观支持、支持利用度对婚姻压力和离婚意向关系的调节作用显著(β=0.143,-0.127;P均0.05)。结论:社会支持是影响城市居民离婚意向的重要因素,并能有效调节婚姻压力与离婚意向的关系。     

Distinctive Mutation Spectrum of the HBB Gene in an Urban Eastern Indian Population

Hemoglobinopathies such as β-thalassemia (β-thal) and sickle cell anemia (or Hb S [β6(A3)Glu→Val]) impose a major health burden in the Indian population. To determine the frequencies of the HBB gene mutations in eastern Indian populations and to compare with the available data, a comprehensive molecular analysis of the HBB gene was done in the normal Odisha State population. Using polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP), amplification refractory mutation system (ARMS) and DNA sequencing techniques, β-thal and sickle cell anemia mutations were characterized in 267 healthy individuals. Entire HBB gene sequencing showed 63 different mutations including 11 new ones. The predominant mutation HBB: c.9T?>?C was observed at a high frequency (19.57%) in the normal population. In the urban population of Odisha State, India, carrier frequency of hemoglobinopathies was found to be 18.48%, and for β-thal, the carrier rate was 14.13%, which is very high indeed. In the absence of a complete cure by any expensive treatment and drug administration, this information would be helpful for planning a population screening program and establishing prenatal diagnosis of β-thal in order to reduce the burden of such a genetic disease.     

慕课在产科住院医师规范化培训中的应用

目的产科住院医师工作繁忙,很难进行大规模的规范化培训,因此需要形式灵活、不受时间和场地限制的先进的培训方法。慕课是通过互联网平台进行的由国家教育部门重点推荐的教育模式,文章将慕课应用于产科住院医师培训工作,探讨其教学效果。方法选择在科室进行住院医师规范化培训的医师,随机分为实验组(100人)和对照组(100人),对照组采用常规小讲座、临床实践方法进行住院医师规范化培训,实验组采用慕课教学模式,3个月后,比较两组住院医考试成绩和住院医主观评价结果。结果实验组住院医理论考试成绩和和技能考试成绩均显著优于对照组,差异有统计学意义(P<0.05);实验组住院医对慕课主观评价较高。结论慕课将传统被动的授课模式改为积极主动的学习模式,利用碎片化时间学习,并重视个性化教学,在产科住院医师规范化培训过程中起到了很好的效果。     

Social support,rural/urban residence,and depressive symptoms among Chinese adults

This study aims to examine the extent to which people are socially integrated and the association between social support and depressive symptoms among Chinese adults, with regard to the moderating effect of the rural or urban residence. The author used data from the China health and longitudinal study (CHARLS), a nationally representative longitudinal survey of the population of adults aged over 45 in China. A total of 16,372 participants were included in this study, and the mean age of the sample was 59.7. Three variables were used to measure participants' social support: family size, proximity of support, and social involvement. The Chinese version of 10-item center for epidemiologic studies depression scale was used as a measurement tool for depressive symptoms. The findings demonstrate that small family size, living with a spouse, frequency of contact with children, and a number of social activities have significant effects on depressive symptoms. For all aspects of social support, the influence on depressive symptoms is not significantly different between urban and rural areas. Family support, especially the support of a spouse is crucial to prevent depression. This study also identifies the vital effect of social activity and encourages the government to improve public services, especially in rural areas.