医学教育学硕士研究生课程设置改革与实践

课程是教育最微观、最普通的问题,但它要解决的却是教育中最根本的问题——培养人.在医学教育学硕士研究生培养中,课程设置是关键环节之一,其设计的科学性、合理性直接关系到人才培养质量的高低.本文介绍了目前我国医学院校研究生课程设置的内容,分析了医学教育学硕士研究生课程设置中存在的问题,并结合锦州医科大学的相关实践,提出了医学...     

Vaccine provision: Delivering sustained & widespread use

The administration of a vaccine to a recipient is the final step in a development and production process that may have begun several decades earlier. Here we describe the scale and complexity of the processes that brings a candidate vaccine through clinical development to the recipient. These challenges include ensuring vaccine quality (between 100 and 500 different Quality Control tests are performed during production to continually assess safety, potency and purity); making decisions about optimal vaccine presentation (pre-filled syringes versus multi-dose vials) that affect capacity and supply; and the importance of maintaining the vaccine cold chain (most vaccines have stringent storage temperature requirements necessary to maintain activity and potency). The ultimate aim is to make sure that an immunogenic product matching the required specifications reaches the recipient.The process from concept to licensure takes 10–30 years. Vaccine licensure is based on a file submitted to regulatory agencies which contains the comprehensive compilation of chemistry, manufacturing information, assay procedures, preclinical and clinical trial results, and proposals for post-licensure effectiveness and safety data collection. Expedited development and licensure pathways may be sought in emergency settings: e.g., the 2009 H1N1 influenza pandemic, the 2014 West African Ebola outbreak and meningococcal serogroup B meningitis outbreaks in the United States and New Zealand.Vaccines vary in the complexity of their manufacturing process. Influenza vaccines are particularly challenging to produce and delays in manufacturing may occur, leading to vaccine shortages during the influenza season. Shortages can be difficult to resolve due to long manufacturing lead times and stringent, but variable, local regulations.New technologies are driving the development of new vaccines with simplified manufacturing requirements and with quality specifications that can be confirmed with fewer tests. These technologies could have far-reaching effects on supply, cost of goods, and on response timing to a medical need until product availability.     

中西医结合疼痛康复医学体系的认识与实践

本文阐述了疼痛康复医学体系的诊疗范围、病种及治疗特点,从国际、国内等多个方面探讨疼痛康复治疗理念和最新发展趋势。提出疼痛康复医学的发展必须得到重点关注。从中国国情需要出发,利用业已成熟的中医疼痛康复治疗技术结合西医慢性疼痛诊断治疗,提倡中西医结合"大康复"治疗理念。在实践中提出目前中国发展疼痛康复医学存在的问题,给出医疗模式及解决方案。     

Systematic review and meta-analyses of randomized controlled trials examining tinnitus management

Objectives/Hypothesis:

To evaluate the existing level of evidence for tinnitus management strategies identified in the UK Department of Health's Good Practice Guideline.

Study Design:

Systematic review of peer‐reviewed literature and meta‐analyses.

Methods:

Searches were conducted in PubMed, Cambridge Scientific Abstracts, Web of Science, and EMBASE (earliest to August 2010), supplemented by hand searches in October 2010. Only randomized controlled trials that used validated questionnaire measures of symptoms (i.e., measures of tinnitus distress, anxiety, depression) were included.

Results:

Twenty‐eight randomized controlled trials met our inclusion criteria, most of which provide moderate levels of evidence for the effects they reported. Levels of evidence were generally limited by the lack of blinding, lack of power calculations, and incomplete data reporting in these studies. Only studies examining cognitive behavioral therapy were numerous and similar enough to perform meta‐analysis, from which the efficacy of cognitive behavioral therapy (moderate effect size) appears to be reasonably established. Antidepressants were the only drug class to show any evidence of potential benefit.

Conclusions:

The efficacy of most interventions for tinnitus benefit remains to be demonstrated conclusively. In particular, high‐level assessment of the benefit derived from those interventions most commonly used in practice, namely hearing aids, maskers, and tinnitus retraining therapy needs to be performed.     

ICF框架下认知康复实训体系的构建及应用研究

认知康复是教育康复体系中的重要组成部分,实训活动作为实现认知康复实践教学目标的重要手段和形式,可帮助学生逐渐从理论过渡到临床实践,是提升教育康复人才专业素养和技能的关键过程。本文运用ICF理念与应用方法,根据认知康复总体目标与原则,构建ICF框架下认知康复实训体系的规范化流程与内容,主要包括填写患者基本信息、认知功能障碍筛查、认知功能评估、认知康复计划制订、实施认知康复与认知康复效果评价6部分,其对于完善认知康复教学体系、提升认知康复实训教学质量、培养合格的认知康复人才、促进教育康复行业发展新局面具有借鉴意义。     

The Good Pain Management （GPM） Ward Program in China and its impact on Chinese cancer patients： the SYSUCC experience

To improve cancer pain management, trle MeCllCal uncology uepartmem of sun yat-sen University Cancer Center （SYSUCC） launched the Good Pain Management （GPM） Ward Program, which has been recognized by the Chinese Ministry of Health and promoted throughout the nation. This retrospective casecontrol study was designed to evaluate the effectiveness of the program. Patients diagnosed with malignant solid tumors with bone metastasis were eligible. Patients who were admitted 6 months before the initiation of the GPM program were used as the control group, and patients admitted 6 months after the initiation of the program were used as the GPM group. The painreporting rate and pain management index （PMI） were calculated. The pain levels before and after pain management were compared. A total of 475 patients （244 in the control group and 231 in the GPM group） were analyzed. The painreporting rate of the GPM group was significantly higher than that of the control group （62.8% vs. 37.7%, P 〈 0.001）. The PMI of the GPM group was significantly higher than that of the control group （0.083 vs. -0.261, P 〈 0.001）. Therefore, the GPM Ward Program improved the pain management of cancer patients and provided experience for improving cancer pain management in the future.     

实践活动与动手能力对高等医学专科学校生存的意义

目的:加强学生实践技能的培养,提供高素质人才,增加毕业生职业能力和就业率以适应市场竞争的需要。方法:采用实做动手的方法。首先,教师分组比赛,通过评选、竞赛、决赛,最后发奖给学生,而后是让学生做竞赛。结果:合格率98.6%,学生进入临床实习,均受到医院医护人员的好评,调动了学生的积极性,也保证了毕业生的质量。结论:实践教学是提高实践技能的重要手段。实践技能培养应突出护理特色实习基地的建设在实践技能活动中也很重要     

The Bologna Agreement and its impact on the Master in Advanced Nursing Practice Program at Rotterdam University of Applied Science: incorporating mandatory internationalization in the curriculum

Aim:  The aim of this paper is to discuss the impact on nursing education in the Netherlands since the implementation of the Bologna Agreement.
Background:  In 1999, the Bologna Agreement was constructed to establish a comparable and transferable degree system in universities within the European Union for nine subject areas (chemistry, physics, mathematics, geology, history, business, education science, nursing and European studies). The target date for implementation of the undergraduate and graduate degrees is 2010.
Conclusion:  Since 2004, Rotterdam University of Applied Science has offered a Master in Advance Nursing Practice degree. This graduate study offers nursing students the opportunity to continue career and academic mobility within the nursing profession. This paper reports on the need for internationalization within nursing curriculum to meet the demands of the increasingly mobile nursing workforce.