对影响病人满意度相关因素的医学伦理思考

设计调查问卷对深圳某基层医院实施病人满意度调查及相关因素的医学伦理分析。结果显示病人满意度不高,门急诊病人的总满意度明显低于住院病人;病人对服务态度、就医环境和诊疗费用等都较不满意。其中医院未能遵循及时、准确、有效、择优和自主原则是主要影响因素。     

医学生临床实习应掌握的几种哲学思维方式

为适应全球卫生事业的迅猛发展,面对医学教育落后于医学发展的现状,转化医学教育迫在眉睫。在第三代“以系统为基础”的教育改革中,培养医学生的哲学思维无疑是其重要环节之一。思维方式必须在医学生步入临床时就要开始正确培养,一旦开始阶段就养成不正确的思维方式、不但会导致医疗过程中的失误,而且再想改变将会有很大难度。本文通过对医学哲学重要性的探讨,剖析医学生哲学思维的不足,阐述了医学生,临床实习过程中应掌握的几种哲学思维方式。旨在提高医学生的哲学理念,促进以岗位胜任能力为导向的医学教育转型发展。     

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.

     

Driver performance due to small unmanned aerial system applications in the vicinity of roadways

Small unmanned aerial systems (sUAS), or drones, have become increasingly utilized for a myriad of applications in the vicinity of roadways and can offer a low-cost alternative to many labor-intensive data collection techniques, including infrastructure inspection, roadway marking data collection, and more. To collect much of this data with a desired degree of accuracy, sUAS must be flown near moving vehicles, pedestrians, and/or bicyclists. However, sUAS, and their operators, have the potential to be a distraction to drivers. Through a full-immersion driver simulator study and post-experiment questionnaire, this study furthered the current state-of-the-literature and investigated the potential for sUAS to be flown in the vicinity of roadways in the future as well as potential safety implications of those circumstances. Specifically, driver performance due to drone height and the presence of drone operators was evaluated. The results of the driving simulation study revealed that participants were more visually distracted in situations where the operators and drone were both present compared to the drone only scenarios. Furthermore, in 11% of all analyzed situations, drivers were critically visually-distracted as shown by a continuous glance of two seconds or more at the drone or operators. The post-experiment questionnaire revealed that approximately 30% of participants had seen a drone in flight near a roadway prior to this study. Ultimately, this research provides recommendations to policymakers for creating regulations on the use of sUAS in the vicinity of roadways.     

The Double Face of Christian Mission and Education in India from Dalit and Decolonial Perspectives

Missionaries from Europe came to India starting in the 15th century to preach the gospel. Their mission works have both intended and unintended consequences that affect people even today. Missionaries brought modern education to India and gave Western education to Dalits, leading to the social uplifting of Dalits, who were denied education by the oppressive caste system. Some missionaries also spoke against the social evils during their time. On the other hand, some missionaries’ work at times highlighted the Brahmanic religion as a pan-India religion which placed popular religions in a disadvantaged position. Furthermore, their work also helped the British colonial government to maintain control and become powerful. The translation work of the missionaries and the educational institutions helped the colonial government to strengthen its control over the local population. This article discusses the mission work of Robert de Nobili, Bartholomew Ziegenbalg, and William Carey and evaluates their mission works from Dalit and decolonial perspectives.     

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.