颞浅筋膜瓣包裹高密度聚乙烯-肋软骨复合支架一期耳廓再造术

目的探寻耳廓再造的良好手术方法。方法将高密度聚乙烯耳基架与肋软骨外耳轮形成复合支架，支架采用颞浅筋膜瓣包裹，颞浅筋膜瓣的表面采用邻近皮瓣和皮片覆盖，完成耳廓再造。结果自2000年1月至2003年8月利用该方法对8例先天性小耳进行耳廓再造术效果良好。结论通过该方法行耳廓再造，具备良好的外形和一定的弹性，外观逼真，手感良好。     

对十四年“毕业综合考试”方法的回顾与探讨

本文回顾分析了我院14年来采用“毕业综合考试结构成绩”(下称“结构成绩”)的做法与体会。“结构成绩”由毕业理论考试成绩、临床操作考试成绩、图象考试成绩三个板块组成。其分别占毕业成绩的40％、50％和l0％,体现了医学教育实践性很强的特点;培养了学生的分析综合能力及临床思维能力;实现了对学生知识结构、智力结构和能力结构的整体培养目标要求;避免了一次考试的偶然性;能全面的反映学生的实际水平和能力,受到了师生的普遍欢迎。     

国境口岸突发公共卫生事件应急预案框架体系的构建

[目的]提高政府保障公共安全和处置突发公共卫生事件的能力,最大程度地预防和减少突发公共卫生事件及其造成的损害,保障公众的健康和生命财产安全,维护国家安全和社会稳定,促进经济社会全面协调、可持续发展。[方法]结合国境口岸应对突发公共卫生事件的实际情况,从3个方面对如何构建国境口岸突发公共卫生事件应急预案框架体系进行了研究。[结果]构建国境口岸突发公共卫生事件应急预案框架体系应包括构建框架体系的准则、框架体系内容、编制框架体系应把握的要点。[结论]构建国境口岸突发公共卫生事件应急预案框架体系对于提高检验检疫机构预防和处置口岸突发公共卫生事件的能力,全面履行卫生检疫行政职能具有十分重要的意义。     

Promoting family-focused approaches within adult drug services: The potential of the ‘Senses Framework’

BackgroundPolicies across countries promote family-focused engagement with adult drugs services however this is rarely offered routinely and relationships with carers are often poor. Research in mental health and older people's services suggests that improving the relationships between carers and service providers is fundamental to enhancing the quality of services. One example is the Senses Framework which assesses the extent to which services are relationship-centred and provides deeper insight into the areas that require further improvement. The aim of this paper is to establish the extent to which relationship-centred care, as defined by the Senses Framework, is expressed in the interactions between carers, services providers and policy makers in adult drug service settings.MethodsA qualitative study, involving 8 focus groups and 32 individual interviews, was undertaken to explore carers’, service providers’ and policy makers’ experiences and understandings of family and carer involvement with drug services in Scotland, United Kingdom.ResultsTensions exist between carers, service providers and policy makers however there are also areas of commonality in which participants shared experiences and understandings of family and carer involvement with services. Our findings go beyond existing research which focuses largely on describing of the poor quality of relationships between carers, service providers and policy makers by providing a deeper theoretical insight into the nature of these relationships. In so doing, by focusing on the senses of belonging, continuity, security, achievement, purpose and significance, we present the possibility of resolving such tensions.ConclusionsWe think that implementing relationship-centred approaches to care, such as that in the Senses Framework, would provide a greater sense of therapeutic and strategic direction for those delivering and commissioning adult drug services in many countries.     

European countries in the race to attract successful biopharma investment: Winners and laggers

The post-coronavirus era will open myriad opportunities for the biopharma industry. However, the extent to which each country will take advantage of this promising new scenario will largely depend on its position in a few key areas. Here, we offer an overview of the European countries that are winning and those that are lagging behind in the race to attract the greatest investment in this industry and to attain the highest rate of successful new ventures. Our results highlight the vital importance of a sound, active funding base, especially in terms of venture capital. Our findings also suggests that general scientific foundations are not enough to secure an advantage in new venture formation.     

Comparison of NITAG policies and working processes in selected developed countries

BackgroundVaccines are specific medicines characterized by two country-specific market access processes: (1) a recommendation by National Immunization Technical Advisory Group (NITAG), and (2) a funding policy decision.ObjectivesThe objective of this study was to compare and analyze NITAGs of 13 developed countries by describing vaccination committees’ bodies and working processes.MethodsInformation about NITAGs bodies and working processes was searched from official sources from June 2011 to November 2012. Retrieved information was completed from relevant articles identified through a systematic literature review and by information provided by direct contact with NITAGs or parent organizations. An expert panel was also conducted to discuss, validate, and provide additional input on obtained results.ResultsWhile complete information, defined as 100%, was retrieved only for the UK, at least 80% of data was retrieved for 9 countries out of the 13 selected countries. Terms of references were identified in 7 countries, and the main mission for all NITAGs was to provide advice for National immunization programs. However, these terms of references did not fully encompass all the actual missions of the NITAGs. Decision analysis frameworks were identified for 10 out of the 13, and all NITAGs considered at least four criteria for decision-making: disease burden, efficacy/effectiveness, safety and cost-effectiveness. Advices were published by most NITAGs, but few NITAGs published meeting agendas and minutes. Only the United States had open meetings.ConclusionsThis study supports previous findings about the disparities in NITAGs processes which could potentially explain the disparity in access to vaccinations and immunization programs across Europe. With NITAGs recommendations being used by policy decision makers for implementation and funding of vaccine programs, guidances should be well-informed and transparent to ensure National Immunization Programs’ (NIP) credibility among the public and health care professionals.     

A Medical Education as an Investment: Financial Food for Thought

Every year that the training period can be shortened increases the value of a medical education. Tuition covers only a fraction of the cost of medical education, making the societal investment in older students less financially robust. Shortening training periods would immediately solve the shortage of residency training positions. With a few exceptions, a medical education is a good investment for women. We are skeptical of the proposals to address the skyrocketing student debt because they do not confront the primary problem. The best way to minimize debt is thrift, and the best way to make a career in medicine more desirable is to shorten the training time.     

Claims in vapour device (e-cigarette) regulation: A Narrative Policy Framework analysis

BackgroundThe electronic cigarette or e-cigarette (vapour device) is a consumer product undergoing rapid growth, and governments have been adopting regulations on the sale of the devices and their nicotine liquids. Competing claims about vapour devices have ignited a contentious debate in the public health community. What claims have been taken up in the state arena, and how have they possibly influenced regulatory outcomes?MethodsThis study utilized Narrative Policy Framework to analyze the claims made about vapour devices in legislation recommendation reports from Queensland Australia, Canada, and the European Union, and the 2016 deeming rule legislation from the United States, and examined the claims and the regulatory outcomes in these jurisdictions.ResultsThe vast majority of claims in the policy documents represented vapour devices as a threat: an unsafe product harming the health of vapour device users, a gateway product promoting youth tobacco uptake, and a quasi-tobacco product impeding tobacco control. The opportunity for vapour devices to promote cessation or reduce exposure to toxins was very rarely presented, and these positive claims were not discussed at all in two of the four documents studied.ConclusionThe dominant claims of vapour devices as a public health threat have supported regulations that have limited their potential as a harm reduction strategy. Future policy debates should evaluate the opportunities for vapour devices to decrease the health and social burdens of the tobacco epidemic.