Talking about smoking in primary care medical practice-Results of experimental studies from the US, UK and Germany

Objective

To analyse effects of patient and physician characteristics on questions and advice about smoking in primary care practice and to examine country differences.

Methods

We conducted a factorial experiment, employing filmed scenarios in which actors played the role of patients with symptoms of coronary heart disease (CHD) or type 2 diabetes. Versions were filmed with patient–actors of different gender, age, race, and socioeconomic status. The videotapes were presented to primary care physicians in the US, UK and Germany. Physicians were asked whether they would ask questions about smoking or give cessation advice.

Results

Female and older CHD patients are less likely to be asked or get advice about smoking in all three countries. Effects of physician attributes are weak and inconsistent. Compared to physicians in the US and the UK, German doctors are least likely to ask questions or give advice.

Conclusions

Although all physicians viewed the same cases their questioning and advice giving differed according to patient attributes and country. Due to the experimental design external validity of the study may be limited.

Practice implications

Findings have implications for medical education and professional training of physicians as well as for the organization and financing of health care.     

高校双语教学的问题与对策

总结了高校开展双语教学存在的主要问题,一是专业课教师的英语口语水平不能满足教学的需要,二是学生的外语基础薄弱,三是教材建设滞后;对解决高校双语教学问题提出了做好教学基本建设和合理地组织教学等对策性措施.     

唐时诸王冰析疑

依据《四库提要辨证》中提供的线索对唐时诸王冰作进一步探讨。余嘉锡书中所言韦抗举荐之王冰与宇文融举荐者可能是一人 ,二者与《素问》的注者在时间上均相重合。而且 ,《列女传》中记载的王琳之子王冰与韦抗、宇文融举荐之王冰、及《素问》注者在时间上也相重合 ,也存在着是一人的可能。而《郎官石柱题名》之王冰则不可考。对于称王者 ,或如诸家所言 ,乃附会杜甫诗而改之 ,其为《素问》注者似不可能     

王应遴与《答朝鲜医问》

日本内阁文库所藏的《答朝鲜医问》一书,如实地记载了明万历年间,中国官员王应遴对朝鲜医官尹知微所持疑问的书面回答。原书成书于明天启甲子年（１６２４）,日本曾于享保五年（１７２０）再次单行,书中所回答的２４条问题,主要围绕临床中常见疾病的治疗,亦涉及经络,医学理论等方面。对该书的考察,不仅可以解决医史研究中有关尹,王医学交流的种种疑问,而且还能了解当时朝鲜的医学发展水平及医疗实际状况。     

课堂教学中的几点体会

教师要从树立良好自我形象、正确对待学生课堂提问、与时俱进、备好课等诸多方面进行卓有成效的工作,才能有效掌控学生的注意力,把学生的思想集中到讲课上来,达到提高课堂教学质量的目的。     

Assessment of the convergent validity of the Questions About Behavioral Function scale with analogue functional analysis and the Motivation Assessment Scale

The present study examined the convergent validity of the Questions About Behavioral Function (QABF) scale, a behavioural checklist for assessing variables maintaining aberrant behaviour, with analogue functional analyses and the Motivation Assessment Scale (MAS). The two checklists were more highly correlated with each other than either checklist with results from the analogue sessions, and the QABF was more highly correlated with analogue sessions than the MAS. Using analogue sessions, the experimenters failed to ascertain behavioural function for a number of subjects because the behaviour problems in question were low frequency/high intensity and failed to appear during the course of the analysis, pointing out a limitation of this technology. These findings, taken together with recent research outlining the psychometric properties of the QABF, seem to support the use of the QABF in a hierarchical model of functional analysis. The implications of the findings are discussed.     

《伤寒质难》以人为本思想浅探

<伤寒质难>是民国时期沪上著名中医学家祝味菊先生学术思想的代表作,该书立足于人体本身,治人为主,倡导本体疗法及自然疗能,治病疗疚时以人为本,因而疗效卓越.     

The kindergarten today: six critical questions

The kindergarten, rapidly absorbed into the public school systems of the United States at the turn of the last century, is again the focus of controversy. This article examines the fundamental premise of the kindergarten, current social needs, and their interactions in affecting kindergarten programs in the United States. Six critical questions are raised and discussed: 1) what are the developmental characteristics of kindergarten children? 2) what are the needs of kindergarten children? 3) what environment best meets these needs? 4) what is the appropriate role of the kindergarten in meeting children's needs? 5) what is the responsibility of the public school system to meet their needs? 6) what is the responsibility of society as a whole to meet their needs?     

《素问》"治未病"学术思想选讲(二)

《黄帝内经》是我国最早的中医经典著作。从医学、养生角度对《黄帝内经.素问》里有关"治未病"的条文进行诠释与讲解。     

浅谈医学检验教学实习的现状与对策

教学实习是检验医学专业教学过程中非常重要的环节,教学实习可以使实习生对检验这门学科有个综合的把握和全新的认识。但目前医学检验教学实习工作中还存在诸多如对实习生的管理难度增加,考核制度不完善、就业对实习的冲击等问题,发现这些问题并提供相应的对策和建议对于医学检验教学实习的工作至关重要,对于培养检验专业人才的实践操作能力和爱岗敬业的精神,更好地适应检验人才市场的要求也有积极促进作用。