Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure

Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.

Mindfulness training in medical education as a means to improve resilience,empathy,and mental health in the medical profession

The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our profession.We contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of individuals.Additionally,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational abilities.Importantly,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their curricula.While we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.

Investigation on the Knowledge, Attitude and Practice of Oral Health among Medical College and University Undergraduate

Objectives: This study aims to investigate the status of knowledge, attitude and practice (KAP) of oral health among medical undergraduate students, and provide reference for implementing oral health interventions. Methods: A total of 528 undergraduate students enrolled in Fuzhou Medical College from February 2023 to September 2023 were selected as the research subjects. Their oral health KAP were investigated, and the oral health behavior habits of different types of medical students were compared, and possible influencing factors were analyzed. Results: The total awareness rate of oral health knowledge among medical students is 77.0%, with an average score of 3.85 ± 1.16 points. The overall positive rate of oral health attitudes among medical students is 80.0%, with an average score of 3.19 ± 0.72 points. The total qualified rate of oral health behavior is 65.9%, with an average score of 4.61 ± 1.23 points. The scores of oral health knowledge, attitudes, and behaviors among medical students are related to gender, major, smoking status, and oral health status. The frequency of brushing teeth in the female group was higher than that in the male group, while the habit of brushing teeth before bedtime and the frequency of timely replacement of toothbrushes when deformed were lower, with statistical significance (p 0.05). The frequency of timely replacement of toothbrushes varies among medical students from different majors, and the difference is statistically significant (p 0.05). People who have a habit of eating hot and cold food have a higher frequency of brushing their teeth every day, and the difference is statistically significant (p 0.05). Non smokers have a better habit of brushing their teeth before bedtime and a higher frequency of timely replacement when their toothbrush deforms, with a statistically significant difference (p 0.05). The frequency of using fluoride toothpaste or medicated toothpaste, having a habit of unilateral chewing, and timely replacement of toothbrushes when deformed in patients with existing oral problems is higher than that of those without oral problems, and the difference is statistically significant (p 0.05). Conclusion: The knowledge, attitude, and behavior of oral health among medical students in this school are above average. Students with different genders, dietary and smoking habits, and oral health status have different oral health behavioral habits. It is recommended to include oral health education in mandatory courses for various medical majors.

Implementation of an international medical student pen-pal club:survey outcomes of perceptions in cultural competency and global health

Background:Pen-pal clubs(PPC)are used worldwide for students to learn about different cultures and other skillsets without the need for travel.Many medical students are interested in global health opportunities abroad but costs,scheduling,and other barriers allow few to participate in such experiences.It is important that medical students have nuanced global medical perspectives and can contribute to the global medical community.Objective:The purpose of this study is to demonstrate that an international medical student PPC improves medical students'perspectives of cultural competency and global health engagement.Methods:In 2021,a novel medical student PPC was established that began between an American and Japanese medical school.Following a shareholders meeting,it was decided that the number of medical schools involved globally be expanded through previous institutional affiliations and online presences.In total,the club connected 50 American medical students and 52 medical students from 17 high-and middle-income countries.The primary form of communication was online;pen-pals were encouraged to communicate monthly using provided topics,although frequency and way of communication was their discretion.In February 2022,American PPC members were emailed a qualitative survey to assess the PPC's impact.Results:The survey was completed by 42%of American PPC members,95%of which were 22-26 years.Participants were preclinical medical students,60%whom were female and the majority either white(47%)or Asian(43%).Overall,the PPC positively influenced American medical students'perception of global medicine,medical education,and their cultural competency after joining the PPC compared to prior(P=0.004).Conclusion:PPCs encourage medical students to think from a global perspective and foster open-mindedness within varying social and cultural contexts.Having a global communication platform for students during medical school education may be an additional way to train aspiring global leaders.

The effect of high-fidelity simulation in medical nursing based on the healthcare simulation standards of best practice

Background:High-fidelity simulation has been demonstrated to make great progress in learning.However,there is still ongoing exploration on how to fully harness the advantages of this teaching method and enhance its effectiveness.This study conducted high-fidelity simulation in medical nursing based on the Healthcare Simulation Standards of Best Practice and evaluated its effect.Methods:The study was conducted from September 2019 to June 2020.A total of 82 undergraduate nursing students from a university in Shanghai participated in the high-fidelity simulation in medical nursing.The simulation design scale,educational practices in simulation scale,and students’satisfaction and self-confidence were used to evaluate the effect.Results:The mean score of simulation design scale was 4.06±0.63 with the mean scores of all dimensions being over 3.0.The mean score of educational practices in simulation scale was 4.14±0.56 with the mean scores of all dimensions being over 4.0.The mean scores of students’satisfaction and self-confidence were 4.07±0.72 and 3.89±0.58,respectively.Conclusion:Students reported high levels of simulation design and educational practices in simulation.They were also satisfied with learning and reported high levels of self-confidence.Some key points need to be considered so that the learning effects might be optimized.

Flexner's legacy and the future of medical education:Embracing challenge and opportunity

This editorial comments on the article by Alzerwi.We focus on the development course,present challenges,and future perspectives of medical education.Modern medical education is gradually undergoing significant and profound changes worldwide.The emergence of new ideas,methodologies,and techniques has created opportunities for medical education developments and brought new concerns and challenges,ultimately promoting virtuous progress in medical education reform.The sustainable development of medical education needs joint efforts and support from governments,medical colleges,hospitals,researchers,administrators,and educators.

Reform and Implementation of Teaching Management for Medical Graduate Students

With the expansion of medical graduate enrollment, there are some problems in graduate teaching management, such as shortage of faculty, insufficient funding, and single assessment management. This can be solved by improving the quality of enrollment, strengthening process management and quality monitoring, enhancing the quality of mentors, and building a management team. This provides theoretical support and practical guidance for the management of graduate education in medical colleges, which helps to improve the quality of graduate education and cultivate more high-quality medical talents for the national healthcare industry.

Teaching Reform and Practice of Functional Experiment Based on the Cultivation of Excellent Medical Talents

In order to cultivate excellent clinical medical talents with a solid foundation, strong literacy, refined skills, excellent communication abilities, innovative thinking, and a strong focus on practicality, functional experiments have undergone a series of reforms in areas such as constructing new curriculum systems, improving teaching content, updating teaching equipment, introducing new teaching models, and enhancing teaching evaluation systems.

Compliance to Medication Management and Mental Health Status of Elderly Hypertensive Patients: Basis of Educational Health Program

Objective:The study aimed to assess medication management compliance and mental health in elderly patients with hypertension.Method:The study evaluated medication compliance and mental health status of elderly hypertensive patients in China using simple random sampling.Data was collected using the Morisky Medication Compliance Questionnaire,Hospital Anxiety and Depression Scale,and a checklist.Ethical practices were strictly observed.Results:A study of 100 elderly hypertensive patients found poor drug management compliance,with female patients showing worse compliance.Female patients were more vulnerable to anxiety and depression.The study also found no significant association between gender,age,education level,marital status,living standards,and medication compliance.Barriers to medication management included food and daily necessities,lack of awareness about the importance of drug treatment,and basic family needs.The lowest-ranked barriers were lack of support from government health clinics,low income,and lack of family support.Conclusion:Based on the results,the study proposes an educational plan for elderly hypertensive patients and their families,to be evaluated and implemented by the hospital and township community service center.The plan aims to improve medication management and lifestyle modification compliance,encourage active participation,and provide access to medical and mental health clinics,support groups,and counseling services.

COVID-19 Downgraded Already Impaired Mental Health of Medical Undergraduates during the Pandemic Years

Background: Measures to contain the COVID-19 transmission reached teaching routines of universities worldwide with possible mental health consequences for anxiety. This study assessed prevalence and risk factors for stress, depression, and anxiety (SDA) in medical students during quarantine by COVID-19. Methods: A cross-sectional observational study of medical students by means of the DASS-21 questionnaire. Risk factors for SDA were assessed based on epidemiologic questions related to COVID-19. Receiver Operating Characteristics (ROC) curves were calculated for each predictor, as well as sensitivity and specificity. Results: This survey reached 1009 responses. A prevalence of 77.5% for some SDA disorder was found, 63% being severe. Previous diagnosis of psychiatric disorder was a factor of risk for anxiety (OR 2.78 CI95% 1.44 - 14.25, p = 0.044), as well as for depression (OR 3.37 CI95% 1.98 - 6.02, p Conclusion: Psychiatric conditions as well as chronic illnesses were risk factors for high prevalence of anxiety, depression and stress during the COVID-19 pandemic among medical students.

Deletion and Recovery Scheme of Electronic Health Records Based onMedical Certificate Blockchain

The trusted sharing of Electronic Health Records(EHRs)can realize the efficient use of medical data resources.Generally speaking,EHRs are widely used in blockchain-based medical data platforms.EHRs are valuable private assets of patients,and the ownership belongs to patients.While recent research has shown that patients can freely and effectively delete the EHRs stored in hospitals,it does not address the challenge of record sharing when patients revisit doctors.In order to solve this problem,this paper proposes a deletion and recovery scheme of EHRs based on Medical Certificate Blockchain.This paper uses cross-chain technology to connect the Medical Certificate Blockchain and the Hospital Blockchain to real-ize the recovery of deleted EHRs.At the same time,this paper uses the Medical Certificate Blockchain and the InterPlanetary File System(IPFS)to store Personal Health Records,which are generated by patients visiting different medical institutions.In addition,this paper also combines digital watermarking technology to ensure the authenticity of the restored electronic medical records.Under the combined effect of blockchain technology and digital watermarking,our proposal will not be affected by any other rights throughout the process.System analysis and security analysis illustrate the completeness and feasibility of the scheme.

Investigation and analysis of mental health status and related influencing factors of medical staff in Karamay City who assisted Ili during the outbreak of COVID-19

Background:To investigate the mental health status and its influencing factors of medical staff in Karamay City who assisted Ili during the outbreak of COVID-19,so as to provide a reliable basis for timely and effective psychological intervention.Methods:Applied questionnaire survey and used the“questionnaire star”platform to investigate the mental health status of medical staff assisting Ili by the General information,the PHQ-9,the GAD-7 and the SCL-90.And the relevant influencing factors were analyzed by univariate analysis and multiple linear regression analysis.Results:Factors such as whether they will support again,whether they need to provide psychological staff,and whether they have a sense of guilt for their families have a significant impact on the PHQ-9 of medical staff(p<0.05);Whether they will support again,whether they need psychological staff,and whether they feel bored and lonely during the closed loop management have a significant impact on the GAD-7 of medical staff(p<0.05);The SCL-90 was compared with the norm,and the scores of somatization,interpersonal sensitivity and terror factors of medical personnel were statistically significant(p<0.05),scores in other aspects(diet sleep)are obvious(1.63±0.72).Conclusion:During the period of COVID-19,the medical staff in Karamay City who assisted Ili had anxiety and depression,and their mental health was not optimistic,more attention and the necessary intervention should be given.

Report on Cardiovascular Health and Diseases in China 2023:An Updated Summary

Since 1990,China has made considerable progress in resolving the problem of“treatment difficulty”of cardiovascular diseases(CVD).The prevalent unhealthy lifestyle among Chinese residents has exposed a massive proportion of the population to CVD risk factors,and this situation is further worsened due to the accelerated aging population in China.CVD remains one of the greatest threats to the health of Chinese residents.In terms of the proportions of disease mortality among urban and rural residents in China,CVD has persistently ranked first.In 2021,CVD accounted for 48.98%and 47.35%of deaths in rural and urban areas,respectively.Two out of every five deaths can be attributed to CVD.To implement a national policy“focusing on the primary health institute and emphasizing prevention”and truly achieve a shift of CVD prevention and treatment from hospitals to communities,the National Center for Cardiovascular Diseases has organized experts from relevant fields across China to compile the“Report on Cardiovascular Health and Diseases in China”annually since 2005.The 2024 report is established based on representative,published,and high-quality big-data research results from cross-sectional and cohort population epidemiological surveys,randomized controlled clinical trials,large sample registry studies,and typical community prevention and treatment cases,along with data from some projects undertaken by the National Center for Cardiovascular Diseases.These firsthand data not only enrich the content of the current report but also provide a more timely and comprehensive reflection of the status of CVD prevention and treatment in China.

The"4+4"Medical Doctor(MD)Pilot Program at PUMC:Implementation,Performance,and Prospects

Peking Union Medical College(PUMC)launched the"4+4"Medical Doctor(MD)pilot program in 2018,admitting students with non-medical backgrounds from top universities,aligning with national medical talent training policies to foster diverse and eager learners in medicine.On the occasion of the graduation of the first class of the"4+4"MD pilot class at PUMC in 2023,we reviewed the teaching reform in the pilot program and carried out a systematic survey and interviews with students,faculties,and management staff of the pilot class.This article reports on the measures taken by the pilot class at PUMC in enrollment and curriculum setting,and demonstrates the achievements of the pilot class in terms of student academic background structure,knowledge acquisition and skill learning,scientific research ability,and course evaluation.The results indicated that the pilot class had met the national demand for the"Medicine+X"talent training model.More specifically,with a diverse academic backgrounds,the pilot class graduates had academic levels comparable to the eight-year medical education graduates,and their scientific research abilities were satisfactory.The pilot program at PUMC will optimize the curriculum setting,strengthen the construction of faculty,learning resources,and teaching facilities,and reform the academic evaluation methods,thus deepening the reform of medical education and improving the"4+4"MD program as a novel medical education model.

Using AI and Precision Nutrition to Support Brain Health during Aging

Artificial intelligence, often referred to as AI, is a branch of computer science focused on developing systems that exhibit intelligent behavior. Broadly speaking, AI researchers aim to develop technologies that can think and act in a way that mimics human cognition and decision-making [1]. The foundations of AI can be traced back to early philosophical inquiries into the nature of intelligence and thinking. However, AI is generally considered to have emerged as a formal field of study in the 1940s and 1950s. Pioneering computer scientists at the time theorized that it might be possible to extend basic computer programming concepts using logic and reasoning to develop machines capable of “thinking” like humans. Over time, the definition and goals of AI have evolved. Some theorists argued for a narrower focus on developing computing systems able to efficiently solve problems, while others aimed for a closer replication of human intelligence. Today, AI encompasses a diverse set of techniques used to enable intelligent behavior in machines. Core disciplines that contribute to modern AI research include computer science, mathematics, statistics, linguistics, psychology and cognitive science, and neuroscience. Significant AI approaches used today involve statistical classification models, machine learning, and natural language processing. Classification methods are widely applicable to problems in various domains like healthcare, such as informing diagnostic or treatment decisions based on patterns in data. Dean and Goldreich, 1998, define ML as an approach through which a computer has to learn a model by itself from the data provided but no specification on the sort of model is provided to the computer. They can then predict values for things that are different from the values used in training the models. NLP looks at two interrelated concerns, the task of training computers to understand human languages and the fact that since natural languages are so complex, they lend themselves very well to serving a number of very useful goals when used by computers.

Ozone Sterilizer for Treatment and Health Care

Ozone is a green broad-spectrum bactericidal disinfectant, and a trace amount of ozone in the atmosphere makes many viruses and bacteria lose their biochemical activity and infectivity. Nature produces trace amounts of ozone in the air through lightning to purify the ecological environment. The product of ozone decomposition is oxygen, without secondary pollution. Ozone sterilizer is widely used in the epidemic prevention and control of intensive breeding farms and achieved remarkable results. If the concentration and action time of ozone can be accurately controlled, then ozone can quickly eliminate pathogens, without harming the normal cells in the human body. How to use medical ozone for epidemic prevention, treatment and health care is a subject worthy of serious study, which should arouse the attention of the experts in the field.

Exploration on Teaching Reform of Medical Functional Experimental Science for International Students

Medical Functional Experiment Science, a bridge between basic medicine and clinical medicine, integrates classical experimental teaching contents of three courses including physiology, pathophysiology and pharmacology. This course not only helps students to verify and reinforce theoretical knowledge, but also cultivates their capability of scientific thinking to discover and solve problems. Based on the characteristics of international students and current situation of the teaching platform in the laboratory at Yangtze University, this paper discusses a series of problems in the Medical Functional Experiment Science teaching for international students and puts forward some measures for teaching reform including optimizing experimental content, innovating experimental teaching methods and establishing effective experimental evaluation mode, in order to cultivate more international medical students with innovative ability.

Demands and influencing factors of digital transition care service in discharged older patients:a cross-sectional study

Objective:To identify the group classification of discharged older adults’digital transition care demands and analyze its influencing factors.Methods:From July to August 2022,we used stratified random sampling to recruit older patients who were discharged between July 2021 and July 2022 from tertiary hospitals in Shanghai.We used latent profile analysis to classify the older patients into distinct groups based on their service demands:low,medium,and high.We use multiple logistic regression to explore the factors influencing the different demand levels.Results:The degree of discharged older patients’demand was classified as low(Category 1(C1),34.2%),medium(Category 2(C2),49.5%),high-demand levels(Category 3(C3),16.3%).Compared to those have C2,older adults in C1 are more likely to be male(Odds Ratio(OR)=2.81,P=0.02),have 2 chronic diseases(OR=3.91,P=0.03),and are less likely to be junior high and below(OR=0.09,P=0.00),hospitalized for 1–2 times in the past year(1 times:OR=0.19,P=0.07;2 times:OR=0.14,P=0.02),living with children(OR=0.32,P=0.05),have less insurance(OR=0.48,P=0.03),less understanding of digital transitional care(OR=0.47,P=0.01),have less eHealth literacy(OR=0.80,P=0.00),have less degree of importance attributed by family(OR=0.52,P=0.03);Compared to those have medium demand level,older adults in high demand level are more likely to have self and spouse as primary income(self:OR=26.35,P=0.00;spouse:OR=24.06,P=0.02),walking to the nearest health facility(self:6.74,P=0.03),have higher eHealth literacy(OR=1.88,P=0.00),degree of importance within the family(OR=5.19,P=0.01),higher self’s influence on medical decisions-making(OR=5.69.P=0.01).They are less likely to be in 60–79 years group(OR=0.00–0.37,P=0.00–0.03),Household Annual Income<5,000 CNY(OR=0.05,P=0.02).Conclusion:Digital transitional care demands of discharged older patients can be divided into three categories.Constructing a digital transitional care service system that aligns with the demands of discharged older patients is essential.Communication,care plan development,and follow-up are the most fundamental services.Additionally,it is essential to understand the characteristics of high-demand populations to provide tailored services and identify vulnerable populations from health and social perspectives to offer cost-effective transitional care services.

Analysis of Internal Control Management Problems in Hospital Finance and Accounting

This paper outlines the internal control management of hospital accounting and finance,introducing its concept,importance,and objectives.It then analyzes the problems existing in the internal control management of hospital accounting and finance,including an unsound management system,insufficient system implementation,inadequate risk assessment and control capabilities,poor information communication,weak internal supervision,and uneven personnel quality.The reasons for these problems are also analyzed,including outdated management concepts,irrational organizational structures,imperfect training and incentive mechanisms,low levels of information technology,and changes in the external environment.This paper proposes improvement measures for the internal control management of hospital accounting,including enhancing the management system,strengthening system implementation,improving risk assessment and control capabilities,enhancing the information communication mechanism,strengthening internal supervision,improving personnel quality,advancing information technology,and adapting to changes in the external environment.

A Comparative Analysis of the Old Medical Structure and the ACO Vision 2030 in Saudi Arabia

This article explores the progress of the healthcare sector in the Kingdom of Saudi Arabia over the past two decades. Through continuous coordination and efforts to improve the quality and quantity of health services, the government has significantly increased the availability of health facilities across the nation. This steady growth has allowed the country to maintain an upward trajectory in healthcare sector development in comparison to other countries. The Saudi Arabian government is preparing to implement Accountable Care Organizations (ACOs) as part of their “Vision 2030.” By aligning with the goals of this visionary roadmap, the government aims to address the challenges faced by the existing healthcare system under the Ministry of Health (MOH). This strategic move is expected to transform the healthcare sector, positioning Saudi Arabia at par with its international counterparts and bolstering its economic competitiveness. This article highlights the historical context of Saudi Arabia’s healthcare system, and compares it with the forthcoming ACO implementation under “Vision 2030.” This information provides valuable insights into the trajectory of the country’s healthcare landscape and the potential impact of ACOs in shaping the Kingdom’s future in healthcare and economic development overall.