医学影像学见习应用PACS教学法与传统读片教学法的对比研究

将中南大学湘雅医学院2010级临床医学五年制197名学生随机分成两组,在医学影像学见习教学过程中分别应用影像存储及传输系统（PACS）教学法（98人）及传统读片教学法（99人）,学期结束时对两组学生考试成绩进行分析,并对PACS组学生进行问卷调查及结果分析.统计数据显示,PACS组学生读片测验及卷面考试中,病例分析题成绩显著高于传统读片组,问卷调查显示PACS组学生大多数认可该教学方法.因此,应用PACS教学有助于提高学生的临床分析能力及主动学习的能力,是学生欢迎的教学方式.但对医学影像学基本知识的传授,应用PACS法较传统读片法并无明显优势.     

医疗机器人的研究进展及伦理学思考

随着现代科技的日新月异,医疗机器人被广泛应用于医疗行业,大大推动了医学的发展,并成为机器人研究领域的热门方向之一。在简要介绍国内外医疗机器人研究进展及应用现状的基础上,本文指出该项技术存在的医疗责任追究机制不完善、缺少法律保障和规范、对医疗岗位冲击、无法体现对患者人文关怀等伦理问题;提出积极发展和推广医疗机器人技术的同时,推动人们对医疗机器人观念的更新,进一步制定和完善相关法律法规是解决该项技术伦理问题的关键。     

关于医疗、科研的一点认识

临床医疗是医院的根本使命,在权重上医疗自然重于科研.医疗实践是科研的出发点与归宿,决定了科研的基本走向.当前,科研工作受到前所未有的重视,科研作为医疗人员绩效考核的权重过大,偏离了医院的根本使命,会对科研、医疗、医护人员乃至整个社会造成伤害.SCI论文与临床关系不密切,不宜用来评价临床医师的水准.应该建立科学的考评机制,考核标准应细化、全面,对科研的奖励应适度.对于医护人员的考核应以医疗为主、科研为辅.     

临床医学整合：中心化整合关键在于观念转变

医学转型的实质是推进医学的整合,微观层面以临床医学的整合为核心部分,宏观上则以临床医学与预防医学的整合为核心。在诸多整合之中,以临床医学的整合最为迫切,它是整个医学整合过程中的基础和开端。当前进行的临床中心化整合似乎已成为一种主导的趋势,然而,如何进行中心化整合却仍然存在诸多问题需要探讨,某些医院对专科化的热衷和偏爱更令人担忧,医学资本的诱惑也是当今临床整合的一道障碍,因此,医学整合任重而道远,不仅需要医学形式上的重组,更需要有观念上的根本转变。     

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.     

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.

     

On Quantitative and Qualitative Parsimony

The distinction between quantitative and qualitative parsimony is supposed to allow David Lewis to dismiss one of the charges against his modal realism: that is, the charge of bloated ontology. The aim of this paper is to undermine Lewis's response to this objection. In order to do this, a distinction between multipliable and nonmultipliable objects is introduced. Based on this it is argued that the acceptance of Lewis's response requires one to believe in modal realism in the first place—that is, one has to believe in the view that the existence of nonactual spatiotemporal worlds does not affect the quality of the ontological commitment. Although the paper focuses on the problem of the metaphysics of possible worlds, this should be regarded merely as a case study. Accordingly, the results of this analysis should find applications in other metaphysical debates as well.     

The Problem of Necessary and Sufficient Conditions and Conceptual Analysis

In this article the standard philosophical method involving intuition‐driven conceptual analysis is challenged in a new way. This orthodox approach to philosophy takes analysanda to be the specifications of the content of concepts in the form of sets of necessary and sufficient conditions. Here it is argued that there is no adequate account of what necessary and sufficient conditions are. So, the targets of applications of the standard philosophical method so understood are not sufficiently well understood for this method to be dependable.     

Ernest Gellner's Words and Things: A Case Study of Empirical Philosophy

This article considers how Ernest Gellner used sociology and anthropology to attack ordinary language philosophy in Words and Things. It argues that this attack can be seen as a part of the movement to make philosophy more empirical or “naturalized,” something that has not been generally noted. It also discusses what general lessons to draw from Words and Things regarding how empirical knowledge should be used in philosophy. Among other things, the article argues that one important lesson is that empirical philosophers should make more use of “soft” social sciences, such as sociology and anthropology, and not focus exclusively on “harder” disciplines, such as physics and experimental psychology. Another upshot of the discussion is that philosophers should draw on empirical knowledge not only when they solve problems but also when they formulate them.