Providing Physical and Mental Health Support Using Medical Examination Data and Perceived Health

Without ascertaining workers’ perceived health, it is difficult to achieve behavioral modification even if health guidance is conducted. To investigate physical and mental health support emphasizing “positive health,” we used the Total Health Index (THI) survey with the purpose of elucidating the association between medical examination data and perceived health. After obtaining medical examination data from 90 men, we analyzed their responses to the THI survey. The results suggested that age and abnormal medical examination data are associated with physical and mental complaints. In the analysis by age group, we found that men in their 20s had more complaints of irregularity of daily life on the THI scale. The group who responded that they were not getting enough sleep had higher mean values of total cholesterol and fasting blood sugar. The group who responded that their meals were irregular had higher mean values of Body Mass Index, aspartate aminotransferase, and alanine aminotransferase. As confirmed by the THI, continuously supporting lifestyle improvement is important. The THI of the “health guidance” group indicated fewer physical health complaints and more aggression/extroversion than the “normal” group. In those for whom health guidance was applicable, participants who were “obese” and “hypertensive” had more aggression/extroversion and lesser extent of nervousness. Based on these findings, it was suggested that meaningful, personalized health support can be developed.

The current situation and issues there of related to nursing care at the time of medical examinations for children with developmental disabilities including autism

The objective of this study is to clarify the details regarding nursing care that is currently provided in terms of the situation regarding medical examinations for children with developmental disabilities and to discuss necessary nursing care. I conducted semi-structured interviews among 13 parents brining up children with developmental disabilities and analyzed the content of verbatim reports both qualitatively and functionally. Regarding those situations when they feel difficult at the time of undergoing medical examinations at the medical institute, the following four categories were extracted: painful treatment;difficulty in predicting;difficulty in communicating;and trouble in the waiting room. Regarding nursing care felt necessary at the time of undergoing medical examinations, the following six categories were extracted: technique while suppressing pain to a minimum;involvement in providing perspective;adjustment of surrounding environment;provision of opportunities to get acclimatized;provision of warm support;and understanding of patient characteristics. Many difficulties regarding medical examinations were revealed and it was found that they have concerns with regard to health management. It has been suggested that it is important to adjust the surrounding environment during medical examinations.

Prediction of Hyperuricemia Risk Based on Medical Examination Report Analysis

This study hopes to contribute to disease detection by analyzing a medical examination dataset with 123,968 samples.Based on association rules mining and related medical knowledge,6 models were constructed here to predict hyperuricemia prevalence and investigated its risk factors.Comparing different models,the prediction performances of Lasso logistic regression,traditional logistic regression,and random forest are excellent,and the results can be interpreted.PCA logistic regression model also works well,but it is not analytical.KNN's prediction performance is relatively poor,while data dimensionality reduction can significantly improve its AUC.SVC has the worst performance and its efficiency of processing high-dimensional large dataset is extremely low.The risk factors of hyperuricemia mainly belongs to 4 categories,which are obesity-related factors,renal function factors,liver function factors,and myeloproliferative diseases-related factors.Random forest,Lasso regression,and logistic regression all treat serum creatinine,BMI,triglyceride,fatty liver,and age as key predictive variables.Models also show that serum urea,serum alanine aminotransferase,negative urobilinogen,red blood cell count,white blood cell count and the pH are significantly correlated with the risk.

A review on rules for examination of licensing criteria for producing foods for special medical purpose in China

In this paper,the background,principles,and main contents of the rules for the examination of production licenses of foods for special medical purposes are introduced.The contents including general rules,production sites,equipment facilities,equipment layout,technological process,personnel management,management system and supplementary rules are interpreted item by item.This study has important value and historical significance for promoting the development of Chinese enterprises and industries of foods for special medical purposes.

Regional Differences in Specific Health Examination Utilization and Medical Care Expenditures in Japan

Background: Despite having one of the most successful health systems in the world, annual medical expenditures in Japan have been increasing year to year. We sought to clarify regional differences in medical expenditures by analyzing the relationship between the specific health examination coverage and medical care expenditure by prefecture of Japan. Methods: We used data from the National Database of Health Insurance Claims and Specific Health Checkups (NDB) Open Data Japan (2015) and Overview of 2015 National Medical Expenses to compare medical care expenditure per capita and proportions of persons receiving specific health examination between Japan nationally and individual prefectures. Results: National medical expenditures were 42.3 trillion Japanese yen (JPY) (3851 hundred million dollars), with a national per capita rate of JPY347,219 (USD3156). Per capita medical expenditure rates by prefecture ranged from JPY290,900 (USD2645) in Saitama Prefecture to JPY 444,000 (USD4036) in Kochi Prefecture. The proportion of persons receiving specific health examinations was 49.0% for Japan overall and ranged from 39.3% in Hokkaido Prefecture to 63.4% in Tokyo Prefecture. We observed a significant negative correlation between per capita medical expenditures and the proportion of persons receiving specific health examinations (R = 0.553, p < 0.001). Conclusion: We found a significant negative correlation between per capita medical expenditures and the proportion of persons receiving health examinations: prefectures with lower expenditures tended to have higher rates of medical examinations. Interventions to increase the proportion of persons receiving specific health examinations by prefecture could reduce per capita medical expenditures and reduce prefectural disparities in expenditures.

Knowledge, attitude and practice of breast self examination and breast cancer among female medical students in Taif, Saudi Arabia

Introduction and Research Problem: Breast cancer is the most common of all female cancers in Kingdom of Saudi Arabia. Different studies conducted in the Kingdom have shown that knowledge of females regarding breast cancer is poor. Aim of the study was to determine knowledge, attitude and practice among students of Saudi female medical university towards Breast Self Examination (BSE) and also to explore their knowledge about breast cancer. Research Methodology: An observational cross-sectional study was conducted at Faculty of Medicine, Taif University during October 2013. Sample size was 378 with mean age of 19.9 ± 1.5. A self administrated questionnaire was used to obtain data about knowledge, attitude and practice towards BSE and knowledge about breast cancer. Data were collected and fed to SPSS version 16. Shape of distribution for numerical data was tested by using one sample Kolmogorov-Smirnov test. Chi-Square Test & Fissure Exact Test (FET) were used for testing relation between categorical variables while correlation analysis was used to test the strength of relation between numeric variables. Main Results: The study revealed that only 8.2% of participants had good overall knowledge about breast cancer and BSE. Although 66% of the study sample had positive attitude towards BSE, only 17% reported that they practiced BSE monthly. A significant positive moderate correlation was found between overall knowledge score and attitude towards BSE (r = 0.449 & p = 0.000). The same was for the frequency of BSE practice but it was found to be in a weak magnitude (r = 0.223 & p = 0.000). Conclusion and Recommendations: Although there was lack of knowledge about breast cancer and BSE yet, positive attitude towards BSE was encouraging. Most female medical students in our sample did not perform BSE or perform it irregularly. Therefore, more intensified awareness programs among students of medical university are necessary to keep in view their current status of breast cancer and BSE knowledge. Further researches are needed to identify causes of inadequate knowledge and practice of BSE among medical students in Taif.

The Infection Control Measures Taken in MRI Examination During the COVID-19 Pandemic Prevention and Control Period

Objective:To optimize the magnetic resonance imaging(MRI)detection process in view of the COVID-19 pandemic,standardize and strengthen the infection control and management MRI rooms.Methods:According to the Technical Guide for COVID-19 Prevention and Control in Medical Institutions(3rd Edition),with reference to the current COVID-19 infection control plan,there are three aspects involved in the planning of MRI examination:MRI room management,medical staff management and protection,and patient management,especially the use of full plastic nose strip medical masks.Infection prevention measures are formulated,scientific prevention and control are made,and accurate policies are implemented.Results:MRI examination was carried out according to the infection control and management of MRI room plan during the epidemic,so as to ensure the safety of examination,the safety of patients and the safety of medical staff and no cross infection in hospital.Conclusion:The implementation of proper infection prevention measures during MRI examination in light of COVID-19 ensures that patients wear medical surgical masks with full plastic nose strips throughout the process to avoid cross-infection,ensure the safety of doctors and patients,and maintain the health of the population.

宪法视野下的婚检制度变革与完善——基于《民法典》第1053条告知义务的履行

《民法典》第1053条对禁婚疾病传统作出重大调整,成为新时代背景下婚检制度设计的重要法律依据。在婚姻宪法保护框架下,“婚姻自由—私人告知—自愿婚检”的传统思路忽略了比“婚姻自由保护”更为根本的“婚姻传统功能保护”。婚姻的公共性及解决相关司法实践难题的客观需要,使得婚检融入履行环节成为可能。从《宪法》到《民法典》再到《婚姻登记条例》,民法典时代婚检制度设计应沿循“婚姻保护—法定告知—弱强制婚检”设计思路,采取“程序强制+形式审查”模式,即当事人于婚前相互告知专业健康检查结论,婚姻登记机关仅要求当事人填写知晓声明并进行必要口头提示而不对告知内容及其真实性进行实质审查。

以执业医师考试为导向的医学免疫学网络试题库建设与应用

医学免疫学是一门重要的医学基础课程,也是执业医师考试的考核内容。本文以执业医师考试为导向,采用考易网络题库与考试评价系统,从试题库的建设内容和题型方面进行医学免疫学网络试题库建设,目前试题库总题量达到2 400余题,逐步应用于开设医学免疫学课程的考试,并根据临床医学和预防医学专业学生考试成绩,采用难度、区分度、信度等指标评价试卷质量,分析课程教学效果。在试题库的建设和应用过程中,需要教师不断探讨研究,更新和完善试题库,将试题库建设成为动态高效的课程考核工具。该试题库建成后,既有利于提高执业医师考试的通过率,也有利于实行考教分离,为培养新时代具有岗位胜任能力的医学人才奠定基础。

基于能力培养导向临床实习轮转模式的应用意义

目的结合国家执业医师考试及全国大学生医学技术技能大赛的考试要求,探讨基于能力导向临床实习轮转模式改革的应用效果。方法选取实习的2017级临床医学“5+3”一体化儿科及临床专业实习生各90名,随机分为试验组和对照组,每组90人。试验组采用调整后实习轮转计划,对照组采用传统实习轮转计划,应用综合考评得分、个人综合能力、自我超越、职业抱负、教学满意度评分量表进行统计比较。结果试验组综合考评、个人综合能力、岗位胜任能力、自我超越、职业抱负、教学满意度明显高于对照组,差异有统计学意义(P<0.05)。结论实习模式改革有助于提高医学生的整体素质,改善医学生的学习环境,激发医学生的临床学习兴趣和主动性,增强医学生的临床实践能力,提高医学生的满意度,同时提升国家执业医师考试通过率以及为全国大学生医学技术技能大赛培养优秀赛手,值得继续深入探索和推广应用。

标准化病人在肝胆外科急重症临床教学中的应用价值

目的探讨标准化病人在肝胆外科急重症临床教学中的应用价值。方法选取2022年4—5月在重庆医科大学附属第二医院肝胆外科轮转的规范化培训学员为研究对象,共40名。将其随机分为研究组与对照组,各20名。研究组教学引入标准化病人,对照组采用传统的教学方法。出科时比较2组学员的病史采集及体格检查水平,以及标准化病人对学员的医患沟通能力及人文关怀进行评分。结果研究组病史采集成绩高于对照组[(88.70±0.61)分vs.(82.00±0.41)分],体格检查成绩高于对照组[(89.40±0.61)分vs.(82.55±0.39)分],差异有统计学意义(P<0.05)。研究组在医患沟通及人文关怀方面的得分高于对照组,[(13.15±0.32)分vs.(9.15±0.29)分],差异有统计学意义(P<0.05)。问卷调查结果显示,研究组100%(20/20)的学员认为标准化病人的应用可以提高学习兴趣,95%(19/20)的学员认为可以提高临床思维能力,90%(18/20)的学员认为可以提高医患沟通技巧。结论在肝胆外科急重症临床教学中应用标准化病人,可以提高学员的病史采集、体格检查、医患沟通等能力,尤其增强了人文关怀的意识,提高了学员的综合素质。

中国古代医学教育与考试制度概述

我国是世界上最早实行医学教育和考试制度的国家,医学教育起源南朝刘宋时期,考试制度则源于西周,二者基于政治、思想和经济等因素的影响,不断推动中医药事业进步。研究中国古代医学教育与考试制度,总结其中的经验,寻绎其中的规律,是中国医学史研究的一个重要内容,对于我们把握中国医学教育与考试的特色与规律、更好地继承与发展中医学、培养中医学人才,具有重要的现实意义。该文主要概括中国各朝代的医学教育和考试制度,尽力发掘与勾勒我国古代医学教育与考试制度在不同时代的特点、意义及其发展、演变的规律,对于指导中医药院校的教学、培育和选取优秀中医药人才具有重要意义。

基于体检数据的糖尿病风险预测方法研究

糖尿病是一种疑难慢性病,对其实施风险预测可有效降低发病率。文章基于体检数据提出了一种糖尿病风险预测方法。该方法利用了数据挖掘思想,首先对体检电子病历数据进行预处理,其次采用递归特征消除算法进行特征选择,最后使用逻辑回归、支持向量机、XGBoost模型3种机器学习算法进行建模预测以探究适合糖尿病预测的方法。结果显示,XGBoost模型的预测精度优于逻辑回归和支持向量机,更适合用于糖尿病预测。相关研究结果验证了基于电子病历数据的糖尿病预测的有效性和可行性,具有较高的应用价值。

依据民法典精神重构婚前医学检查制度的法治路径

全国人大常委会法工委在《关于2021年备案审查工作情况的报告》中提出将与国务院有关部门沟通,推动根据民法典精神适时统筹修改完善我国婚前医学检查领域的相关法律法规制度。纵览《民法典》的相关规定及其司法实践,如果没有合理的婚前医学检查制度作为支撑,《民法典》第一千零五十三条规定的婚姻撤销制度以及第一千二百二十六条规定的患者隐私权保护制度,既难以实现拟结婚当事人彼此权利的有机平衡,亦无法有效落实《宪法》为国家设定的“保护婚姻”的立法义务。同时,自愿免费婚检模式还会每年浪费20亿左右的公共财政资金。采用“知情—自主”婚前医学检查模式既可有效化解婚检领域不同法律规范和不同权利之间的冲突,又可以让免费婚检产生的公共财政资金发挥应有的财政效果,因此是该领域落实宪法精神和民法典精神的合理方式。

备案审查背景下婚检法律制度之重构

2003年国务院《婚姻登记条例》通过后,在实践层面取消了强制婚检制度,而母婴保健相关立法仍要求在婚姻登记前进行婚检,两者长期存在的冲突引发学界关注。《民法典》实施后,其作为调整民事关系的基本法律,为重构婚检法律制度提供了新的思路。从历史维度看,新中国婚姻登记制度以法治运动引导规则和实践变迁;在规范层面,婚检制度与婚姻登记中禁止性要件规定相关联。当《民法典》不再将身体疾病作为禁止结婚要件后,婚姻登记机关通过婚检干涉宪法上婚姻自由的正当性难以证成。为服务优生法治化的目标,建立婚前健康咨询、免费自愿婚检、个人声明制度等,保障当事人建立婚姻关系时的意思自治,是《民法典》实施背景下婚检法律制度构建的正当方式。

《民法典》实施后强制婚检的合宪性争议

《民法典》的实施导致强制婚检合宪性问题浮出水面,也改变了其中争议的宪法评价。一方面,强制婚检规定作为一项保护性立法的定性并未改变。尽管强制婚检规定在《民法典》实施前后的立法目的有所区别,不再立足婚姻关系,而是回归到母婴健康保护,但由于婚姻基本权利条款已将家庭及其成员的国家保护纳入其中,所以强制婚检规定依然是对婚姻基本权利的保护而非干预,原则上可以被推定为合宪。但另一方面,随着《民法典》实施带来的婚姻自由观的更新,婚姻受国家保护的限度有了新的内涵,继续从国家管制角度推行强制婚检有违宪之虞。根据民法典精神,从私法角度对婚检的“强制”属性作出解释,统筹协调相关民事法律规则,应是强制婚检制度的改革方向。

通用型医疗服务价格项目比价关系研究——以诊察费为例

目的:为各地动态调整通用型医疗服务价格提供指导和参考,以最受关注的诊察费为例,分析区域间、项目间比价关系。方法:区域间比价关系方面,采用描述性统计分析方法;项目间比价关系方面,采用其他诊察费与主治医师门诊诊察费的比价系数中位数或中间值来确定合理的比价系数。结果:区域间比价关系不够合理,一半以上的省份项目价格与价区不匹配,部分诊察费项目省际间价格差异系数较大。项目间比价关系也不够合理,其他诊察费与主治医师门诊诊察费间的比价系数区间范围较大。结论:对于区域间、项目间比价关系不合理的诊察费项目,建议各地基于建议价区,合理设置主治医师门诊诊察费价格基准,采用项目间合理比价系数同步调整其他诊察费项目价格。

基于中医师岗位胜任力模型的考试评价体系研究

中医类考试是评价学生知识、技能、素质掌握情况的基本形式,岗位胜任力是人才培养产出的最终目标。当前岗位胜任力与中医类考试之间存在结合不紧密、结果利用不充分,以及评价不深入等问题。本研究基于中医师岗位胜任力模型,根据四大中医类考试建立考试评价体系,探讨考核结果与学生岗位胜任力的匹配度,建立了5个一级指标,14个二级指标,27个三级指标及相应具体观测点的评价体系,从院校、专业,以及个人三个角度进行评价。同时选取10所中医药院校考试数据进行分析,研究结果显示,院校代码为2101的院校学生的综合能力较好;针灸推拿专业学生整体得分情况低于中医学专业学生;随机抽取的针灸推拿学专业学生水平测试与国家执业医师资格考试成绩显示该学生国家执业医师资格考试中的中医诊断学与中药学成绩有所下降。考试评价体系能够有效将考试结果与选拔人才所需要的岗位胜任力相结合,能够提供客观的人才培养评价结果,有利于发挥考核评价的积极作用,提升中医药人才培养质量。

ChatGPT作为医学教育工具的思考——以心血管内科主治医师资格考试为例

为评估人工智能语言模型ChatGPT在医学考试中的表现,采用横断面研究方法,将Chat-GPT回答的心血管主治医师资格考试的模拟试题结果与标准答案进行比对。在排除2道图片题后,ChatGPT正确回答了333道问题中的189道,准确率为56.8%,其在四个单元的回答正确率分别为67.0%、61.0%、58.2%及11.4%。逻辑错误是最常见的回答错误原因。题目属于第四单元、案例分析题是回答错误的影响因素。研究显示ChatGPT未通过心内科主治医师资格模拟考试,尚不推荐将其用于心血管内科医师的日常教育。

婚检制度的法理反思与制度重构——以婚姻自主为核心的讨论

自愿婚检制度自实施以来产生了诸多社会问题,并引发了对婚检是否应当强制的学术争论,但当前争论仅停留在制度表面,缺乏深入的理论反思。我国婚检制度从“形式”与“实质”双重强制的强制婚检制度转变为“无强制”的自愿婚检制度,这体现国家从“硬家长式”立场转变为尊重和保障公民婚姻自由的“自由式”立场。“自由式”立场将婚姻自主视为一种主权权利,这成了自愿婚检制度产生诸多社会问题的根源,并面临理论批判。这些批判促使婚姻自主从一种主权权利转变为一种品格理想。基于这种转变,婚检制度应立基于一种保障和促进公民婚姻自主的“软家长式”立场,并重构为采纳“形式强制”但拒绝“实质强制”的“弱强制”婚检制度。