Association between intimate partner violence during pregnancy and maternal pregnancy complications among recently delivered women in Bangladesh

Intimate partner violence (IPV), an actual or threatened physical, sexual, or psychological abuse by a current or former partner or spouse, is a common global public health issue. Understanding both the prevalence of IPV during pregnancy and its potential impact on the health of pregnant women is important for the development and implementation of interventions to prevent maternal morbidity and mortality. The purpose of this study was to explore the association between maternal experiences of IPV during pregnancy and pregnancy complications. A health‐facility‐based cross‐sectional study was conducted from July 2015 to April 2016 among 400 randomly selected women who were admitted to the postnatal wards of Rajshahi Medical College Hospital for delivery. Data were collected through face‐to‐face interviews using a structured questionnaire. Multivariable logistic regressions were performed to assess relationships between variables of interest after controlling for potential confounders. Results indicated that 39.0% of women reported physical IPV and 26.3% of women reported sexual IPV during pregnancy. Additionally, 69.5% of women experienced medical complications (MCs); of this group, 44.3% experienced obstetric complications (OCs) and 79.3% experienced any pregnancy complication (AC) during their last pregnancy. The experience of physical IPV during pregnancy was significantly associated with the experience of MCs (adjusted odds ratio (AOR): 2.05, 95% confidence interval (CI): 1.15–4.01), OCs (AOR: 4.23, 95% CI: 2.01–7.12) and AC (AOR: 5.26, 95% CI: 2.98–10.52). Women who experienced sexual IPV during pregnancy were also at increased risk of suffering from any MC, any OC, and AC. Maternal experience of IPV during pregnancy is positively associated with pregnancy complications. Preventing IPV directed at pregnant women might reduce maternal morbidity and mortality in Bangladesh.

     

The impact of empathy on burnout in medical students: new findings

Introduction: Research on medical students has shown they are at a higher risk for burnout and that this burnout may become more prevalent as they advance in medical school. The literature, thus far, has not explored the construct of ,emotional empathy and whether this can impact burnout in medical students. Objective: To understand the relationship between empathy (Empathic Concern [EC] and Personal Distress [PD]) and burnout in medical students. Method: Five successive classes of medical students enrolled at a new medical school were given the Maslach Burnout Inventory and Davis’ Interpersonal Reactivity Index over the course of three successive years (n = 353). Two dimensions of empathy were evaluated to determine if they have an impact on three dimensions of burnout (Emotional Exhaustion/EE, Depersonalization/DP, Personal Accomplishment/PA). Results: data was analyzed using a linear mixed model for each of the three components of burnout based on gender, age, year in medical school, and two types of empathy: EC, and PD. Conclusion: It was discovered that students with high levels of EC had statistically lower scores of burnout over time while students with high levels of PD empathy showed statistically higher scores of burnout over three years. Implications for these findings are discussed.     

Tolerant enactivist cognitive science

Enactivist (Embodied, Embedded, etc.) approaches in cognitive science and philosophy of mind are sometimes, though not always, conjoined with an anti-representational commitment. A weaker anti-representational claim is that ascribing representational content to internal/sub-personal processes is not compulsory when giving psychological explanations. A stronger anti-representational claim is that the very idea of ascribing representational content to internal, sub-personal processes is a theoretical confusion. This paper criticises some of the arguments made by Hutto and Myin (2013, 2017) for the stronger anti-representational claim and suggests that the default Enactivist view should be the weaker non-representational position.     

医务社会工作介入的灵性视角：理论、实践与展望

灵性健康被学者视为所有健康层面中最深沉、最核心的部分,可以支持和影响其他的健康层面。不过,在当前中国的医务社会工作实践中,灵性资源相对匮乏,还没有得到应有的重视。在不同历史时期,医务社会工作中的灵性视角有着多层次、多维度的丰富内涵。在医务社会工作实践中,灵性视角的运用体现在非线性的介入策略、丰富的实务技术,重视服务对象的生命意义问题。灵性视角具有独特的意义和价值,与医务社会工作有较强的契合性。在医务社会工作实务、研究和教育中,需要加强对灵性视角的理解和自觉应用。

     

宋代医官磨勘制度初探——兼论王安石思想对其影响

磨勘是宋代对于官员进行考核迁转的制度。但宋代初期在制定官员磨勘制度之时医官并未涵盖在内,并且医官的转任也有着相当的限制。北宋历次重大改革均将医学教育作为改革的重要内容,自此培养了大批医学人才,医官转任的限制也有逐渐放松的趋势。在王安石变法思潮的影响下,宋政府出于管理的需要,于熙宁年间正式确立医官磨勘制度。至宋徽宗重新启用变法派,于国子监设立中央医学,医官磨勘制度结合中央医学的设立有了进一步的细化和发展。虽然在制度的实施过程中由于管理不善出现过种种乱象,但医官磨勘制度对后世的医学发展有深远影响。

     

记忆中枢海马体的发现与命名

海马体是大脑存储记忆的主要位置,一直是神经科学领域研究的重点。20世纪对海马体功能的揭示得益于解剖学的早期研究。海马体解剖学研究始于文艺复兴时期,但囿于大脑结构的复杂性和解剖学技术的不完善,当时对海马体的认识存在局限性。在16世纪～18世纪初期解剖学界对海马体的命名产生了分歧,出现了公羊角、阿蒙角等一系列用于描述海马体的术语,18世纪末期海马体形态学研究的突破,结束了两个世纪海马体命名的分歧。从医学史的角度出发,构建了海马体发现及命名的历史过程,旨在从中借鉴经验,更好地推动神经科学的发展。

     

“助手”还是“杀手”：用ChatGPT求医问药的风险分析

ChatGPT正在影响人们求医问药的传统方式,将医疗保健应用场景从院内转移到院外,提高了医学知识和诊疗信息的可及性。但ChatGPT在回答医学问题时也存在不足,如回答内容的不准确性和随意性,也难以将每个患者视为独立个体并给出体现医者智慧、思想和精神关怀的答案。用ChatGPT求医问药还存在生命健康、道德伦理、安全隐私和医疗公平风险。未来,在人工智能赋能医疗发展并促进人类健康的同时,仍应警惕ChatGPT对生命健康权、知情同意权、隐私保护权的冲击。

     

我国公立医疗机构转型政策量化分析

分析我国城市一二级公立医院转型为康复医院、老年护理院等接续性医疗机构政策的内外部特征,为后续政策的制定与完善提供参考。通过构建政策工具、政策利益相关者、政策力度三维政策分析框架,对相关政策进行多维分类分析。得出相关政策发文量呈波动增长趋势;环境型政策工具使用过溢,供给型政策工具内部结构配置失衡,需求型政策工具应用匮乏;对不同政策利益相关方的关注度存在差异;政策顶层设计欠缺,整体政策效力不高。建议优化政策工具使用,平衡各利益相关方需求,完善政策体系内容。

     

我国医科类高校医学(生命)伦理学课程现状调查

为了解我国部分医科类高校医学(生命)伦理学课程的开展现状,对国内48所高校中68名从事医学(生命)伦理学教学工作的教师进行问卷调查。结果显示,23所高校教师人数超过4人;女性教师中学历为硕士的人数最多;32.4%的教师第一专业具备临床或医药背景;学时为32学时~36学时的高校仅1所,学分为2学分的高校也只有1所,以必修课形式开设的高校只有2所;28所高校开设了医学(生命)伦理学相关的讲座,其中2所高校年均开设次数达到5次或以上。调查显示,高校整体师资力量较薄弱、女性教师学历水平有待提高、教师知识结构较单一、课程受重视程度低、医学人文环境较差。建议扩大、优化师资结构,重树学科定位,加强医学人文建设,营造医学人文氛围。