The beginning doctor: a problem-based course for first year medical and dental students*

A problem-based course designated as ‘Beginning Doctor’ was given to 136 first year medical and dental students. The students were divided into small groups and under guidance of a tutor studied largely unfamiliar clinical problems presented to them as written résumés. They determined what further information they required, obtained the information on their own and described it to the others in plenary sessions. The tutors acted as facilitators of student learning rather than as sources of information. Contrary to the widely held assumption that students in these parts of the world are passive learners, incapable of taking direct responsibility for their own learning, the staff was pleasantly surprised to see the enthusiasm and the competence with which the students tackled the problems and easily adopted the self-learning mode.     

An initial evaluation of learning units to facilitate problem solving and self-directed study (portable patient problem pack)

This paper describes the initial evaluation of the portable patient problem pack, a learning unit designed to facilitate the development of problem-solving skills and stimulate self study.
A cross-over design using two neurological patient problems, each presented in two formats (simulated patient and P4), was used with a sample of twenty-nine volunteer nursing and medical students.
The results indicate that the P4 appears to be feasible and effective in stimulating problem solving and self-directed study. The suggested concurrent validity, low cost of production, and implementation make it a potentially potent tool for evaluation.     

Gender and ethnic differences in the co-occurrence of adolescent risk behaviors

Design

Results

Conclusion

We consider gender and ethnic differences in the co-occurrence of adolescent behaviors related to health and well-being.

Using a nationally representative sample of adolescents in the National Longitudinal Survey of Youth (1997–2000), we examine behavior among students as well as school drop-outs. We use latent class models (LCMs) to identify subpopulations of adolescents with similar patterns of co-occurring behaviors. The generalizability of the findings for African American adolescents in the 1970s is considered using a sample of inner-city youth from the Pathways to Adulthood Survey.

For all ethnic groups, we find a subpopulation with ‘problem behavior’ characteristics (in which early sexual initiation, alcohol use, smoking, marijuana use, and truancy are all highly prevalent). This cluster is most common among European American adolescents and among young men. A subpopulation characterized by behaviors often leading to poor social outcomes (e.g. truancy, early sexual initiation and fighting) is most common for African American adolescents, especially young African American men.

Our findings suggest that multi-factorial interventions which address the interrelationships between all of the behaviors are relevant regardless of gender or ethnicity. However, the ethnic and gender differences in the likelihood of specific patterns of interrelationships highlight the importance of considering the ethnic and gender composition of a population when developing future research and interventions.     

Pregnant smokers who quit,pregnant smokers who don't: does history of problem behavior make a difference?

More than half of women who smoke in the USA continue to do so while pregnant. While socioeconomic and demographic factors that distinguish pregnancy quitters from persistent smokers have been identified, less is known about behavioral factors that are associated with persistent smoking. Because smoking during pregnancy is not only an individual, but also a maternal behavior, it may have different behavioral correlates than women's smoking has in general. We propose a conceptual framework in which smoking during pregnancy is viewed as a maternal problem behavior. We explore this conceptualization by examining whether persistent smoking during pregnancy is associated with a pattern of psychosocial risk- and health-compromising behaviors in multiple domains, with pilot data from a small clinic-based sample. Data are presented for 96 predominantly Caucasian, working-class pregnant women recruited from prenatal clinics in the USA. Smoking during pregnancy was measured repeatedly by self-report and biochemical assay. Participants were non-smokers (37%), pregnancy quitters (17%), and persistent smokers (46%). These groups were compared in terms of their history of problem behavior in three domains: interpersonal difficulties, problems in adaptive functioning and problematic health behaviors. With few exceptions, smokers were more likely to have problematic relationships, poorer adaptive functioning and to engage in problematic health behaviors, than both pregnancy quitters and non-smokers. This pattern of problem behavior may interfere with the effectiveness of standard public health prenatal cessation interventions for a sub-group of women. Examining pregnancy smoking as part of a broader matrix of problem behavior may help to identify pregnant women most at risk for persistent smoking and inform the development of targeted interventions.     

乡镇卫生院医院感染管理中存在问题及对策

目的 加强乡镇卫生院、民营医院医院感染管理工作，以降低医院感染发生率。方法 对域区内二级以下的乡镇卫生院、民营医院开展医院感染管理调查。结果 医院感染管理工作中存在问题突出且严重，主要是领导不重视，组织不健全，制度不完善，医务人员缺乏医院感染管理相关知识，医院感染管理、监测、控制滞后，消毒灭菌不规范等不安全医疗隐患较多。结论 乡镇卫生院、民营医院是医院感染管理工作中的一个薄弱环节，各县医院感染管理分中心需加强管理。     

CT球管的故障分析处理

球管是CT中最昂贵的消耗性核心部件。本文简析了球管的一般常见故障,以及对非致命故障的排除方法。     

临床医学教学中存在的问题与对策

随着现代医学的发展,临床医学教学也面临着新的问题和挑战,包括教学内容与社会需求脱节;教学方法和手段落后;教学资源匮乏;医学生临床技能训练不足等。针对这些问题,我院进行了多方面的教学改革,以提高临床医学的教学质量。     

Why Problem Gamblers Quit Gambling: A Comparison of Methods and Samples

Reasons for quitting gambling were reported by two samples of problem gamblers, long-term quitters and recent quitters, using two methodologies. The participants first described their reasons for quitting in an open-ended fashion and then with a 15-item checklist. There was a fair degree of similarity between the responses of the two samples. Both groups most frequently reported that their resolution was a conscious decision, although recent quitters were more likely to report that the decision evolved over a long period of time vs. being an immediate decision. About a third of both groups described their decision as related to a specific event and involving a crisis. In both methods, negative emotions and financial concerns were most often reported. The checklist method yielded about three times as many reasons as the open-ended method. There were no gender differences in reasons although participants with a treatment history reported more reasons than those who had not sought treatment.