Renovation and Protection Project of Peking Union Medical College:Renovation and Reconstruction Design of Concealed Works

Peking Union Medical College(PUMC),as the representative work of Chinese modern architecture,has had a great impact on the development of Chinese modern architecture.Its advanced and complete concealed works contain great value and are valuable materials for the study of Chinese modern architecture.This paper studies the concealed works of PUMC,enriches the research data in this field,and summarizes the transformation design scheme of concealed works in the protection and repair of ancient buildings of PUMC.

Chinese medical service and medical education in urgent need of reform in the context of public welfare-based medical reform

After six years＇medical reform,about 7.8 billion person-times of medical service has been achieved by2014,and the number of persons covered by basic medical insurance for urban employees,basic medical insurance for urban residents,and new rural cooperative medical insurance exceeded 1.3 billion,of which the coverage ratio reached as high as over 95%,establishing the largest basic medical security network in the world.

Association of post-traumatic stress disorder and work performance: A survey from an emergency medical service, Karachi, Pakistan

BACKGROUND: The purpose of the study was to explore the association between posttraumatic stress disorder(PTSD) and work performance of emergency medical services personnel in Karachi, Pakistan.METHODS: Emergency medical service personnel were screened for potential PTSD using Impact of Event Scale-Revised(IES-R). Work performance was assessed on the basis of fi ve variables: number of late arrivals to work, number of days absent, number of days sick, adherence to protocol, and patient satisfaction over a period of 3 months. In order to model outcomes like the number of late arrivals to work, days absent and days late, negative binomial regression was applied, whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores.RESULTS: Mean scores of PTSD were 24.0±12.2. No association was found between PTSD and work performance measures: number of late arrivals to work(RRadj 0.99; 0.98–1.00), days absent(RRadj 0.98; 0.96–0.99), days sick(RRadj 0.99; 0.98–1.00), adherence to protocol(ORadj 1.01; 0.99–1.04) and patient satisfaction(β 0.001%–0.03%) after adjusting for years of formal schooling, living status, coping mechanism, social support, working hours, years of experience and anxiety or depression.CONCLUSION: No statistically significant association was found between PTSD and work performance amongst EMS personnel in Karachi, Pakistan.

Association of overtime work and obesity with needle stick and sharp injuries in medical practice

BACKGROUND Needle stick and sharps injuries(NSIs)may cause infections among medical personnel.Obesity and overtime work among medical personnel increase the incidence of work injuries.AIM To investigate whether overtime work and obesity increase the risk of NSIs.METHODS This cross-sectional study used the data of 847 hospital personnel,including 104 doctors,613 nurses,67 medical laboratory scientists,54 specialist technicians,and nine surgical assistants.Of them,29 participants notified the hospital of having at least one NSI in 2017.The data collected included age,overtime work,body mass index,medical specialty such as doctor or nurse,and professional grade such as attending physician or resident.Theχ2 and Fisher’s exact tests were used to compare categorical variables.Multiple logistic regression analysis and the Sobel test were used to assess the risk of NSIs.RESULTS Overtime work,body weight,and medical specialty were significantly associated with NSIs(P<0.05).After adjustment for risk factors,heavy overtime work was an independent risk factor for NSIs,and healthy body weight and nursing specialty were independent protective factors against NSIs.After adjustment for risk factors,medical personnel with healthy body weight has half as many NSIs as those with unhealthy body weight;the proportion of NSIs in doctors with healthy body weight was 0.2 times that in doctors with unhealthy body weight;the proportion of injuries among residents was 17.3 times higher than that among attending physicians;the proportion of injuries among junior nurses was 3.9 times higher than that among experienced nurses;the proportion of injuries among nurses with heavy overtime work was 6.6 times higher than that among nurses with mild overtime work;and the proportion of injuries among residents was 19.5 times higher than that among junior nurses.Heavy overtime work mediated the association of medical specialty with NSIs.CONCLUSION In addition to promoting the use of safety needles and providing infection control education,managers should review overtime schedules,and medical personnel should be encouraged to maintain a healthy weight.

Recommendations for the Conduct,Reporting,Editing,and Publication of Scholarly Work in Medical Journals

I.ABOUT THE RECOMMENDATIONSA. Purpose of the Recommendations ICMJE developed these recommendations to review best practice and ethical standards in the conduct and reporting of research and other material published in medical journals, and to help authors, editors, and others involved in peer review and biomedical publishing create and distribute accurate, clear, reproducible, unbiased medical journal articles. The recommendations may also provide useful insights into the medical editing and publishing process for the media, patients and their families, and general readers.

A Research on the Translation of Medical Literature Under the Guidance of Newmark's Communicative Translation

This is a translation report. The selected source text is a medical experimental report published in September 2018 on Immunobiology, an American academic journal. The content is about the experimental research process and results of AIDS vac?cine, and the target readers are immunologists. According to Newmark's text typology theory, the text intended to convey infor?mation to target readers belongs to informative text, and should be guided by communicative translation. Therefore, the translator completed the translation report under the theoretical guidance of Newmark communicative translation.

《中华男科学杂志》与《Asian Journal of Andrology》引文比较分析

目的:了解我国主办的两种男科学期刊引文引用规律及情报吸收能力,发现我国男科学研究领域科研人员的文献需求特征,为该学科研究人员查阅文献提出建议。方法:采用引文计量分析法统计《中华男科学杂志》(以下简称NJA)与《Asian Journal of Andrology》(以下简称AJA)2004年刊载的论文所引用的参考文献从引文数量、引文类型、引文年代、普赖斯指数、自引率、高被引期刊等几个方面进行了比较分析。结果:AJA和NJA篇均引文数分别为20.43和10.18条,期刊占引文比例为95.84%和93.00%;AJA和NJA的普赖斯指数分别为38.50%和55.01%,自引率分别为6.20%和5.82%,AJA和NJA分别引用了358种和725种期刊,引用前12种期刊占期刊引用的比例42.47%和37.41%。结论:AJA与NJA引文类型以期刊为主,NJA涉猎文献范围广,引用文献比较新,专业人员利用新文献能力较强,作者能紧跟本学科的发展。AJA篇均引文数较高,引用文献半衰期较长,引用期刊相对集中。

Physical literacy in the field of physical education——A challenge and a possibility

Publications of articles with physical literacy as a topic have increased dramatically since the beginning of 2000 s. The aim of this paper is to,through an explorative literature overview with an inductive approach, analyze frequent, and significant themes in published peer reviewed articles,with a focus on physical literacy. The database EBSCO has been used with the identifiers “physical literacy” and “physical literacy and evidence”.Furthermore ICSSPE Bulletin＇s special issue on physical literacy has been included in the overview. The findings have resulted in three key themes： assumptions of the concept physical literacy and its educative role, sports development and physical literacy, and assessment and physical literacy. Future studies are needed to examine if the advocated pedagogical strategies based on the concept physical literacy have led to a reorganized and revitalized school subject. There is also an existing critique towards making physical literacy an idealistic neutral concept or synonym with fundamental movement skills or sports talent identification. The role of higher education emerges as crucial for the next step of the development of the scientific framework as this involves how physical literacy will be socially configured, nurtured, and embodied in practice.Copyright ó 2015, Shanghai University of Sport. Production and hosting by Elsevier B.V. All rights reserved.

Academic health sciences libraries as connectors to knowledge beyond literature

Libraries at large academic medical centers in the United States are undergoing a transformation from their traditional role as knowledge repositories to a new role as connectors to knowledge. This transformation is fueled by the move away from library-held print resources as the primary source of information used by researchers,clinicians and students. Knowledge resources critical to the missions of academic medical centers now include online books and journals,very large data sets,software tools,and expertise far beyond the walls of the library. This article illustrates how Bernard Becker Medical Library at Washington University in St. Louis has seized the opportunity to recast itself as a connector to knowledge beyond literature and strengthen its vital role within the university as a catalyst for learning and discovery.

Promoting Clinician Well-Being and Patient Safety Using Human Factors Science: Reducing Unnecessary Occupational Stress

Our healthcare delivery system has accumulated complexity of payment, regulation systems, expectations and requirements. Often these are not designed to align with clinical thinking process flow of patient care. As a result, clinicians are utilizing enormous mental (cognitive) resource to comply with these complexities, over and above the baseline mental effort required to give good care to the patient. Recent studies suggest a significant number of physicians, advanced practice providers and nurses no longer want to stay in healthcare due to difficult work expectations and conditions that have become unreasonable. Technology has benefitted healthcare delivery, but also is a conduit of many expectations that have been grafted upon clinician workloads, exceeding the resources provided to accomplish them. Cognitive load is a measure of mental effort and is divided into Intrinsic, Germane and Extraneous Cognitive Load. Extraneous Cognitive Load (ECL) is what is not necessary and can be removed by better design. High cognitive load is associated with increased risk of both medical error and clinician burnout. Chronic high level occupational stress occurs from dealing with this job/resource imbalance and is showing serious personal health impact upon clinicians and the quality of the work they can provide for patients. Since organizational systems have become more complex, leadership methods, clinician wellbeing and patient safety efforts need to adjust to adapt and succeed. Safety efforts have tended to predominantly follow methods of a few decades ago with predominant focus upon how things go wrong (Safety I) but are now being encouraged to include more of the study of how things go right (Safety II). Human Factors/Ergonomics (HFE) science has been used in many industries to preserve worker wellbeing and improve system performance. Patient safety is a product of good system performance. HFE science helps inform mechanisms behind Safety I and II approach. HFE concepts augment existing burnout and safety interventions by providing a conceptual roadmap to follow that can inform how to improve the multiple human/technology, human/system, and human/work environment interfaces that comprise healthcare delivery. Healthcare leaders, by their influence over culture, resource allocation, and implementation of requirements and workflows are uniquely poised to be effective mitigators of the conditions leading to clinician burnout and latent medical error. Basic knowledge of HFE science is a strategic advantage to leaders and individuals tasked with achieving quality of care, controlling costs, and improving the experiences of receiving and providing care.

Generalizable items of quantitative and qualitative cornerstones for personnel requirement of physicians in anesthesia

Anesthesiologists perform a broad spectrum of tasks. However, in many countries, there is no legal basis for personnel staffing of physicians in anesthesia. Also, the German diagnosis related groups system for refunding does not deliver such a basis. Thus, in 2006 a new calculation base for the personnel requirement that included an Excel calculation sheet was introduced by the German Board of Anesthesiologists(BDA) and the German Society of Anesthesiology and Intensive Care Medicine(DGAI), and updated in 2009 and 2015. Oriented primarily to organizational needs, in 2015, BDA/DGAI defined quantitative and qualitative cornerstones for personnel requirement of physicians in anesthesia, especially reflecting recent laws governing physician's working conditions and competence in the field of anesthesia, as well as demands of strengthened legal rights of patients, patient care and safety. We present a workload-oriented model, integrating core working hours, shift work or standby duty, quality of care, efficiency of processes, legal, educational, controlling, local, organizational and economic aspects for calculating personnel demands. Auxiliary tables enable physicians to calculate personnel demands due to differing employee workload, non-patient oriented tasks and reimbursement of full-equivalents due to parental leave, prohibition of employment, or longterm illness. After 10 years of experience with the first calculation tool, we report the generalizable key aspects and items of a necessary calculation tool which may help physicians to justify realistic workload-oriented personnel staffing demands in anesthesia. A modular, flexiblenature of a calculation tool should allow adaption to the respective legal and organizational demands of different countries.

Hospital Employer Attractiveness Considering the Increasing Shortage of Skilled Medical Professionals—A German Review

The main goal of this review is to give an overview of scientific publications concerning the employer attractiveness of German hospitals from the perspective of medical doctors in order to identify future research possibilities. After a summary of central problems concerning the German health sector and its current challenges, the study design behind the systematic content analysis as well as its criteria are presented. Selected results describe characteristics of expert literature for employer attractiveness in general, the attractiveness of German hospitals as employers (“hospital employer attractiveness” for short) as well as employer attractiveness from a medical doctor’s point of view. For each of these areas, focal points of research and main results are summarized and research gaps are pointed out.

Implementation of a Return to Work Strategy in Germany—Are There Changes in Work-Related Rehabilitation Measures and Employment Status in Chronic Conditions?

Objectives: Aging workforces with increasing numbers of chronic conditions require health initiatives with greater workplace focus. A regional pension insurance introduced a Return To Work (RTW) strategy for insurants with chronic conditions. The objective was to identify the degree of implementation of work related measures in medical rehabilitation and the extent of RTW outcomes. Methods: 5883 insurants were considered. Severe Restriction of Work Ability (SRWA), Work-related Medical Rehabilitation (WMR), and Case Management (CM) were examined for 2008 and 2012. An Index of Employment status (IoE) was used in a logistic regression. Results: Utilization of WMR raised from 12.3% in 2008 to 66.1% in 2012. The proportion of insurants with SRWA and WMR grew from 8% up to 40.1%. In 2008, 14.7% of insurants with SRWA received WMR;in 2012, it grew to 76.6%. On the other hand, in 2012 26% got WMR without SRWA and 12.2% had SRWA and got no WMR. CM was not conducted in 2008 but reached 20.2% in 2012. Across all indications, WMR resulted in positive RTW as measured by IoE: OR = 0.75 (KI-95%: 0.67 - 0.86). Conclusion: WMR was successfully implemented according to the German guideline. There is a need to optimize the linkage between SRWA and WMR and CM to provide need-based care.

Literature Research on Drug Use Regulation of Miao Medicine in Suppression of Gastric Cancer

Objective: To investigate the rule of medication used by Miao medicine to inhibit gastric cancer. Methods: Taking the coil named Miao Medicine of Chinese Materia Medica as data source, formulating "drug name"+"gastric cancer" or "drug name"+"stomach tumor" as the key words to search papers in China Knowledge Network, Weipu Chinese database, Wanfang database to gather drugs that have the effect of inhibiting gastric cancer, this paper made statistical analysis from the views of Wu Xing, Zou Guan, Ru Jia, Efficacy and Toxicity. Results: There are 81 kinds of drugs that suppress stomach cancer eligible for inclusion. And the Soil Xing medicines are the mainstay in the Wu Xing classification, accounted for 70.4%;the distribution of Zou Guan drugs are dominated by Middle and Interior Guan drugs which accounted for 87.7%;Every kinds of Jia group was involved in the distribution of Jiu Jia groups, but the Body Jia, abdomen Jia, Lung Jia and Cave Jia have the most frequent occurrences accounted for 66.9%;the efficacy distribution mainly includes antidote and tonification accounted for 71.6%;the toxicity distribution mostly is non-toxic drugs which is up to 70 kinds. Conclusion: Treating poison and tonifying body are mainly used in the treatment of gastric cancer in Miao medicine, with Middle and Interior Guan medicine, most of which are non-toxic drugs effective in disease location.

New concept on teaching English literature to college English majors

The teaching of English literature to English majors in universities should emphasize on both the introduction of literary history and the analysis of specific literary works. In view of the present situation in the teaching of English literature, such as limited teaching hours, excessive contents and the outmoded teaching methods, the teachers should change their concept and mode of teaching, improve their teaching methods, and fully explore new concepts to promote the effectiveness and realize the targets of teaching.

The law of oral traditional Chinese medicine for insomnia based on Chinese medical code

Objective:This study aimed to collect,sort out and excavate the literature on the diagnosis and treatment of insomnia in Chinese Medical Code,and to explore the law of internal administration of traditional Chinese medicine in the treatment of insomnia.Methods:We used"Chinese Medical Code"as the source of data retrieval,"insomnia","not sleepy","no sleeping"and"eye not sleeping"as the key words,and excluded temporary insomnia,physiological insomnia,insomnia caused by other diseases,and excluded other methods such as acupuncture and massage,the medical cases.Prescriptions of insomnia treated with traditional Chinese medicine were screened out.The database was established by using Microsoft excel 2010.Descriptive statistics were used to analyze the frequency,menstruation of nature,taste and efficacy of traditional Chinese medicine.We analyzed the association rules between drugs and mined the rules of prescriptions by the Apriori algorithm in SPSS Modeler 14.1.Results:A total of 147 prescriptions,138 traditional Chinese medicines,20 pairs of core drugs,57 common drug combinations and 3 core pharmaceuticals were included.The basic prescription is:Suan Zao Ren,Bai Zi Ren,Fu Shen,Fu Ling,Yuan Zhi,Dang Gui,Gan Cao(Zhi).Conclusion:In summary,according to the drug analysis above,the main disease of insomnia is in the heart,involving the liver,spleen and kidney.Because it involves different viscera and syndrome,the methods of treatment are also different.However,there is a basic pathogenesis,that’s the loss of mental nourishment.By excavating the law of the use of traditional Chinese medicine in the treatment of insomnia on the Chinese Medical Code,we expect that it can guide the treatment of insomnia.

Based on the Chinese medical canon to excavate the medicine law of yellowish leucorrhea disease

Background:In order to collect and analyze the literature on yellowish leucorrhea disease in Chinese Medical Canon,and to explore its treatment and medication law with data mining.Methods:The Chinese Medical Canon was used as the data retrieval source,and“Huangdai”(yellowish leucorrhea disease)and and other keywords were used as the keywords to do literature search.After excluding“gestational yellowish leucorrhea”,“jaundice and yellowish leucorrhea”and other diseases,the literature retrieval and data sorting and analysis were carried out,and the database was established by using Microsoft Excel 2010.Descriptive statistical method was used to analyze the nature,flavour,channel tropism and efficacy of medicine.Combined with the method in“the Research Platform for Inheritance of Traditional Chinese Medicine Academic Thoughts of Famous Gynecologists of Traditional Chinese Medicine”,the association rules between drugs were analyzed and their rules were excavated.Results:Eighty-seven prescriptions,152 traditional Chinese medicines,20 core drug pairs,39 common drug combinations and 5 core drug groups were collected and included.Conclusion:“Damp-Heat”is the fundamental pathological product of yellowish leucorrhea disease,and the basic treatments are“Releasing Heat”and“Eliminating Dampness”,“Regulating Liver Qi”and“Promoting Blood Circulation”,and“strengthening spleen”and stopping leucorrhea.

Research on Red Culture Merging into Ideological Work in Colleges and Universities Under the Background of Integration of Culture and Tourism-Taking Red Culture Resources in Wuhan as an Example

The aim is how to integrate the Red Music Culture into the ideological and political work of colleges and universities and the sustainable development under the background of the integration of culture and tourism.The main content is the development of local red cultural resources,red cultural education around me,the development of local red cultural resources as the theme of cultural and creative products.The enlightenment is that the ideological and political work of colleges and universities should make full use of the red cultural resources around them to bring the ideological and political education of students into effect.

大宣传观视域下医学院校治理能力和文化创新能力提升路径探索——以北京协和医学院为例

医学院校是建设“健康中国”、医学教育改革和卫生健康文化传播的重要基石。大宣传工作格局构建为医学院校提升治理能力和文化创新能力提供了新的驱动力。为应对当前医学院校普遍存在的对宣传思想文化工作的内涵和主体、融媒体时代新闻传播规律和医学教育规律认识不足的问题,北京协和医学院坚持大思政、大文化、大传播的理念,为医学院校创新机制、打造大宣传合力提供了实践经验。医学院校应以此为鉴,坚持巩固壮大主流思想舆论,加强宣传文化思想工作制度建设,理顺工作机制,提升新闻宣传队伍专业能力,加强媒体融合等,推进大传播工作格局构建,以大宣传观提升宣传思想文化工作时度效,推进新时代医学教育高质量发展。

政府购买服务背景下医务社会工作嵌入性发展类型的研究:基于深圳市15家公立医院的医务社工视角

背景随着我国医疗服务模式从单向治疗向全人健康的转变,以“助人自助”为宗旨的医务社会工作获得了更多嵌入医院场域的机会。目的探讨医务社会工作在嵌入医院场域的过程中所呈现的嵌入路径、策略和结果,从而对医务社会工作嵌入性发展的类型进行归纳,为医疗体系大力发展医务社会工作提供重要启示。方法基于格兰诺维特的嵌入理论,采用目的抽样法对深圳市15家公立医院政府购买服务的33位医务社工进行深度访谈,借助Nvivo12.0软件,运用主题分析法进行资料分析。结果在政府购买服务背景下,医务社会工作的嵌入路径包括结构嵌入和关系嵌入;嵌入策略主要分为结构嵌入下的“迂回顺从”和“被动妥协”以及关系嵌入下的“互惠互利”和“自我增能”;嵌入结果亦产生了“行政化”与“专业化”的两种不同的影响。结论本研究认为可以将医务社会工作嵌入性发展归纳为“浅层嵌入”“行政主导”“互惠发展”和“专业互构”四种类型。