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%.

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.

Research on the Application and Effectiveness of the DRG Model on Perioperative Medical Management of Cholecystectomy

Objective:This study aimed to explore the application and effectiveness of the DRG model in the perioperative management of cholecystectomy.By comparing the DRG model with traditional management methods,this study focused on evaluating the potential impact of the DRG model in improving surgical efficiency and reducing complication rates and medical costs.Methods:The random envelope method was used to divide patients scheduled for cholecystectomy from January 2021 to October 2023 into two groups:one group underwent surgery under the DRG model(experimental group),and the other group underwent the traditional management model(control group).Data including basic information,surgery-related data,length of stay,complication records,and medical expenses were collected.Data analysis was carried out using a t-test and chi-square(χ2)test.Results:Results showed that the DRG model shortened the average length of stay,decreased the incidence of complications,reduced medical expenses,and increased patient satisfaction.These results demonstrate the effectiveness of the DRG model in the perioperative management of cholecystectomy,especially in improving surgical efficiency,reducing medical costs,and improving patient satisfaction.Conclusion:The DRG model in the perioperative management of cholecystectomy can significantly improve medical service quality and efficiency and enhance patient satisfaction as compared to traditional treatment methods.

Evaluation of Sleep Quality in Undergraduated Medical Students

Objective: The aim of this study was to evaluate the sleep quality of medical students to identify the main factors that affect sleep patterns. Methods: According to the methodology, 154 students participated in the research, attending from the first to the sixth year of the course. The Pittsburg Sleep Quality Index questionnaire and the Epworth sleepiness scale were applied. Descriptive statistics techniques were applied and demonstrated in the form of tables and graphs. The comparison of variables was carried out using statistical tests. Results: The results showed that most students do not sleep very well. It was observed that 68.83% of a total of 106 students are bad sleepers. Conclusion: It is concluded that medical students sleep a low number of hours by period, which could interfere in impairment of attention, learning and memory formation, interfering in academic performance. On the other hand, they showed greater daytime sleepiness compared to the general population.

Advancements in medical treatment for pancreatic neuroendocrine tumors:A beacon of hope

This editorial highlights the remarkable advancements in medical treatment strategies for pancreatic neuroendocrine tumors(pan-NETs),emphasizing tailored approaches for specific subtypes.Cytoreductive surgery and somatostatin analogs(SSAs)play pivotal roles in managing tumors,while palliative options such as molecular targeted therapy,peptide receptor radionuclide therapy,and chemotherapy are reserved for SSA-refractory patients.Gastrinomas,insul-inomas,glucagonomas,carcinoid tumors and VIPomas necessitate distinct thera-peutic strategies.Understanding the genetic basis of pan-NETs and exploring immunotherapies could lead to promising avenues for future research.This review underscores the evolving landscape of pan-NET treatment,offering renewed hope and improved outcomes for patients facing this complex disease.

Evaluation of Attending Medical Teams and Their Impact on the DRG Components of Cholecystectomy

Objective:This study assessed the role of the attending medical team in the cost control of the cholecystectomy DRG components.Methods:The association between team structure,workflow,and treatment outcomes was analyzed using a mixed-methods approach combining quantitative data and qualitative interviews from 628 patients.Results:Inter-professional teamwork significantly affected length of stay,treatment costs,and recurrence rates,with experienced teams performing better in terms of emergency response and collaborative efficiency.Patient satisfaction was generally high,indicating that good teamwork enhances treatment outcomes.Significance:The study highlights the importance of optimizing team configuration to improve the quality,efficiency,and cost control of healthcare.

The Application Value of Sanitary Wipes and Medical Alcohol+Gauze Disinfection Method in the Management and Use of Medical Equipment

Objective:To analyze the effect of sanitary wipes and medical alcohol+gauze disinfection methods on the management and use of medical equipment in hospitals.Methods:From February 2023 to August 2023,80 anorectal surgery medical instruments and equipment were randomly sampled as observation samples,and they were grouped using the random number table method(40 instruments in each group).One group was managed with sanitary wipes and medical alcohol+gauze disinfection method(observation group),and the other group was managed with medical alcohol+gauze disinfection method(control group).The degree of contamination on the surface of instruments and equipment and the staff satisfaction of both groups was noted and compared.Results:After cleaning and disinfection,the relative luminescence luminosity(RLU)value of the surface contamination of the sample instruments and equipment decreased significantly(P<0.05);and after cleaning and disinfection,the relative luminescence luminosity(RLU)of the observation group’s instruments and equipment decreased significantly,and the value was lower than that of the control group,(P<0.05);the results of the nursing job satisfaction questionnaire showed that the scores of each survey item in the observation group were higher than those in the control group,(P<0.05).Conclusion:Integrating sanitary wipes and medical alcohol+gauze disinfection method into the management and use of medical equipment not only improves the disinfection of medical instruments but also improves the job satisfaction of nursing staff.Therefore,this method should be popularized.

Construction of a New Model of Contactless Medical Services for Outpatients Based on the Project-Achieving Quality Control Circle

Objective: To carry out empirical research on the role of project-achieving quality control circle (QCC) in constructing a new model of contactless medical service for outpatients. Methods: A QCC, consisting of information office members from a grade A tertiary hospital in Wenzhou, was established to conduct a research project with the theme “Constructing a new model of contactless medical service based on outpatients’ experience.” According to the ten steps and PDCA cycle, an analysis was carried out before and after the QCC activities, focusing on improving pre-consultation services, providing steward-like services, and facilitating post-consultation management. Results: After the QCC activities, the mobile appointment rate, missed appointment rate, the proportion of smart check-ins, and the average check-in time were 55.68%, 4.02%, 39.75%, and 8.24 ± 3.66 min, respectively;in contrast, before the activities, they were 32.00%, 7.88%, 0.00%, and 14.96 ± 4.98 min, respectively;the difference between the two groups was statistically significant (χ2 = 3480.112, 4994.496;Fisher’s exact probability = 963788.570;t = 5.323, P < 0.001). Many experts have also visited the hospital to learn about this system, thus rendering social and economic benefits. Conclusion: Project-achieving QCC activities are suitable for complex situations, such as constructing a new model of contactless medical service, and can significantly improve outpatient service quality, enhance patients’ experience, and improve the abilities of circle members.

Clinical effects of detailed nursing management interventions on medication adherence and disease perception in patients with drugresistant tuberculosis

BACKGROUND Tuberculosis(TB)is a chronic respiratory infectious disease that considerably jeopardizes human health,and there is no effective vaccine suitable for its prevention in the entire population.AIM To investigate the promotion of medication adherence and disease cognition in patients with drug-resistant(DR-)TB using detailed nursing management.METHODS In total,114 patients with DR-TB who were diagnosed and treated at our hospital between January 2019 and January 2023 were included in this study.Patients in the control group(n=57)were managed with conventional nursing care,while those in the observation group(n=57)were managed with detailed nursing care.Medication adherence,disease awareness scores,medication safety,and nursing satisfaction were compared between the two groups after the intervention.RESULTS The post-intervention medication compliance rate was 91.23%in the observation group and 75.44%in the control group,with the former being 15.79%higher than the latter(P<0.05).There was no statistically significant difference in the disease awareness scores between the two groups before the intervention;the disease awareness scores of the observation group were significantly higher than those of the control group after the intervention(P<0.05).The incidence of gastrointestinal reactions,joint swelling and pain,hearing loss,electrolyte disorders,and liver and kidney function abnormalities were lower in the observation group than those in the control group.The total nursing satisfaction of the observation group was higher than that of the control group(P<0.05).CONCLUSION Implementation of detailed nursing management for patients with DR-TB can effectively improve medication adherence,enhance awareness of the disease,ensure safety of medication,and improve satisfaction with nursing care.

Application and Effect Evaluation of the Integrated“5A and 3+3”Management Model in the Safe Medication Use for Chemotherapy Patients

Objective:To explore the application and effect evaluation of the integrated“5A and 3+3”management model in ensuring safe medication use for chemotherapy patients.Methods:A total of 100 intravenous chemotherapy patients admitted to the oncology department of Shaanxi Provincial People’s Hospital were randomly divided into two groups using a random number list method.Both groups received conventional nursing management during chemotherapy,while the study group additionally received the integrated“5A and 3+3”safety management model.The nursing intervention effects between the two groups were compared.Results:After the intervention,the study group showed higher levels of self-management ability,compliance,and nursing satisfaction compared to the control group.The overall incidence of adverse events during hospitalization was lower in the study group,with statistically significant differences(P<0.05).The knowledge scores of medical staff in the study group,related to the prevention and treatment of chemotherapy drug side effects,daily symptom management,and daily life management,were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion:Implementing the integrated“5A and 3+3”model in the safe medication management of intravenous chemotherapy patients can effectively enhance patients’self-management abilities and compliance,improve medical staff’s ability to safely administer chemotherapy drugs,reduce adverse events caused by chemotherapy,and increase patient satisfaction.

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.

Cultivate Innovative and Entrepreneurial Qualities among Medical Students through Curriculum Ideology and Politics

As the main body of promoting the development of medical science and technology, medical students play an extremely important role in promoting the construction of new medical science. New medicine is a new concept based on the development of traditional medicine, breaking the discipline barrier, aiming to cultivate composite talents, taking reality as the orientation, and combining with the Internet, big data and artificial intelligence. Cultivating medical students’ innovation and entrepreneurship literacy is not only the internal need of the construction of innovative medical talents in new medical sciences, but also the development need of promoting the optimization of medical disciplines and effectively promoting the construction of an innovative country. As the main place for training medical talents, medical colleges and universities should integrate classroom ideology and politics with the new medical background to improve medical students’ professional knowledge, professional ethics, humanistic quality and scientific and technological quality, promote the cultivation of medical students’ innovative spirit, and further innovate medical theories, technologies and concepts. It lays a solid foundation for cultivating top medical talents with both innovative thinking and cultural self-confidence and building an innovative country.

Analysis of Professional Quality Cultivation Strategies for Infant and Child Care Service Talents from the Perspective of Collaboration of Medical Care,Parenting,and Education,and Integration of Industry and Education

The collaboration of medical care,parenting,and education aims to integrate nursing,midwifery,infant and child care services,and management with speech and hearing rehabilitation technology,among other elements related to the infant care industry chain.This integration targets pediatrics talent training in nine infant care positions,including nursing,infant health care and management,and child rehabilitation,to ensure that the capabilities and quality of professional talents can meet the health care needs of infants and young children.This article briefly explains the background of the“collaboration of medical care,parenting,and education,and integration of industry and education.”It analyzes the necessity of cultivating infant and child care service talents based on the perspective of“collaboration of medical care,parenting,and education,and integration of industry and education.”Based on this perspective,we conducted an in-depth study of the cultivation of professional qualities of infant and child care service talents.

Medical management of ischemic stuttering priapism： a ：ontemporary review of the literature

Priapism is defined as a prolonged and persistent erection of the penis without sexual stimulation. This is a poorly understood disease process with little information on the pathophysiology of this erectile disorder. Complications from this disorder are devastating due to the irreversible erectile damage and resultant erectile dysfunction （ED）. Stuttering priapism, though relatively rare, affects a high prevalence of men with sickle-cell disease （SCD） and presents a challenging problem with guidelines for treatment lacking or resulting in permanent ED. The mechanisms involved in the development of priapism in this cohort are poorly characterized; therefore, medical management of priapism represents a therapeutic challenge to urologists. Additional research is warranted, so we can effectively target treatments for these patients with prevention as the goal. This review gives an introduction to stuttering priapism and its clinical significance, specifically with regards to the patient with SCD. Additionally, the proposed mechanisms behind its pathophysiology and a summary of the current and future targets for medical management are discussed.

Effect of medical care linkage-continuous management mode in patients with posterior circulation cerebral infarction undergoing endovascular interventional therapy

BACKGROUND Acute cerebral infarction is a severe type of ischemic stroke that can be divided into anterior circulation cerebral infarction and posterior circulation cerebral infarction(PCCI).PCCI affects the structure of the posterior circulation brain,because posterior part of the brain,which has more complex anatomical structures and more prone to posterior circulation vascular variation.Therefore,improving the prognosis of PCCI patients is necessary.AIM To explore the effect of medical care linkage-continuous management mode(MCLMM)on endovascular interventional therapy(EIT)for PCCI.METHODS Sixty-nine patients with PCCI who received EIT and conventional nursing intervention were selected as the control group,and 78 patients with PCCI who received EIT and MCLMM intervention were selected as the observation group.The incidence of postoperative complications,compliance and disease selfmanagement behavior after six months of intervention,modified Rankin scale(mRS)and Barthel index(BI)scores in the acute phase and after one year of intervention,and recurrence within one year were compared between the two groups.RESULTS The total incidence rate of postoperative complications in the observation group(7.69%)was lower than that in the control group(18.84%)(P<0.05).The scores for medical compliance behavior(regular medication,appropriate diet,and rehabilitation cooperation rates)and disease self-management behavior(self-will,disease knowledge,and self-care ability)in the observation group were higher than those in the control group(P<0.05).After one year of intervention,in the observation group,the mRS score was significantly lower,and the BI score was significantly higher than those in the control group(P<0.05).The recurrence rate within one year in the observation group(3.85%)was significantly lower than that in the control group(13.04%)(P<0.05).CONCLUSION MCLMM can reduce the incidence of complications after EIT for PCCI,improve patient compliance behavior and disease self-management ability,and promote the recovery of neurological function.

Medical Waste Management and Control

Medical centers including hospitals, clinics and places where diagnosis and treatment are conducted generate wastes that are highly hazardous and put people under risk of fatal diseases. Although the understanding of medical waste management and control techniques is important, technical elective courses that are offered in undergraduate chemical, civil or environmental engineering place less emphasis on this area of education. In this paper, the meaning of medical waste, the risks of exposure, medical waste management regulatory acts, medical waste management procedures and control techniques are presented. The contents presented in this paper served as a supplementary material in an undergraduate elective course on waste management and as an educational guide for medical staff training on waste handling.

Management of Adult Growth Hormone Deficiency at Peking Union Medical College Hospital:A Survey among Physicians

Objective To evaluate physicians' attitude and knowledge about the management of adult growth hormone deficiency(AGHD) at Peking Union Medical College Hospital and impact factors associated with better decision-making.Methods A 21-question anonymous survey was distributed and collected at Peking Union Medical College Hospital,a major teaching hospital in Chinese Academy of Medical Sciences.Data of physicians' educational background,clinical training,patient workload per year and continuing medical education in AGHD were collected.Factors associated with appropriate answers were further analyzed by multivariate regression models.Results One hundred and eighteen internal medicine residents,endocrine fellows,attending physicians and visiting physicians responded to the survey.Among them,44.9% thought that AGHD patients should accept recombinant human growth hormone replacement therapy.Moreover,56.8% selected insulin tolerance test and growth hormone-releasing hormone-arginine test for the diagnosis of AGHD.Logistic regression analysis of physician demographic data,educational background,and work experience found no consistent independent factors associated with better decision-making,other than continued medical education,that were associated with treatment choice.Conclusions The physicians' reported management of AGHD in this major academic healthcare center in Beijing was inconsistent with current evidence.High quality continued medical education is required to improve Chinese physician management of AGHD.

Spontaneous Resolution of Cataract and Medical Management of Corneal Opacity in an Indian Parrot—<i>Psittacula krameri manillensis</i>

A 35-year-old Indian parrot (Psittacula krameri manillensis) was presented to the Department of Veterinary Surgery & Radiology, West Bengal University of Animal and Fishery Sciences with a history of blepharospasm and corneal lesion OS. Test with fluorescein dye was negative. The dense corneal opacity (macula) was identified as involving the posterior corneal layer. The further ophthalmic examination was done and hypermature phacolytic cataract was diagnosed. No other abnormality was detected. Medical management with topical nepafenac prednisolone and triple antibiotic was instituted. The corneal lesion subsided completely within one week followed by spontaneous resorption of the cataract. The treatment protocol was successfully eliminated the discomfort and intraocular lesions in the senile parrot.

Knowledge and Skills for Management of Sexually Transmitted Infections by Rural Medical Practitioners in Bangladesh

Sexually transmitted infection (STI) management is considered rudimentary among rural medical practitioners (RMPs) in Bangladesh. We sought to understand the level of knowledge and skills in STI management and to assess the impact of a two-day training orientation among RMPs in Tangail district. Data were collected through a baseline survey of 225 practicing RMPs in the study area and a three-month follow-up survey of 99 RMPs who participated in a two-day STI/HIV orientation training. The level of formal training among RMPs ranged from none (22.7%), to paramedical training (14.7%) and local medical assistant training (62.6%). The baseline survey revealed a low level of STI/HIV knowledge and misconceptions about the transmission of STI/HIV among RMPs. RMPs mostly prescribed first line antibiotics for treatment of common reproductive tract infections (RTIs) including STIs, but they rarely prescribed the correct dosages according to the national RTI/STI management guidelines. Only 3% of RMPs were able to correctly answer all four HIV transmission (unprotected sexual intercourse, blood transfusion, needle sharing and mother to child transmission) questions at baseline, while 94.9% of RMPs answered all four correctly at three months following the training (p = 0.001). Only 10% of RMPs reported suggesting the recommended drug (azithromycin) and only 2% mentioned about the recommended dosage (2 gm single dose) for the treatment of urethritis/cervicitis;compared to 49.5% suggested azithromycin at follow-up with 39.4% mentioned the recommended 2 gm single dose (p = 0.001). Our study found low level of knowledge and poor practices related RTI/STI management among RMPs. Short orientation training and education intervention shown promise to increase knowledge and management skills for RTIs/STIs.

Discussion on Management Model of Medical Equipment Maintenance in Hospital

With the development of technology, medical equipment plays a more important role in the modern hospital. Medical equipment provides images, physiological results or other schematics of the patients to help doctors deal with the routines. It is also the major tool to the lab assistant in the clinical teaching and studies. It becomes one of a symbol of the technological level in modern hospital. The director of the hospital should establish an effi cacious management pattern to manage the medical equipment, so that it will be operated in good condition to insure the safety of the patients. Since the maintenance is an important part of medical equipment management, it is significant that the hospital should establish a system to fit for itself. The study reviews the issues in hospital medical equipment maintenance management, the development of the maintenance management model and the characteristics, as well as the status at home and abroad. The research has been fi nished by using literature research method, questionnaire survey method and data analysis method. Then we analyze the current status of hospital medical equipment maintenance management model to fi nd the problems. Based on the authentic and effective data from the survey, we can deduce the overview about the maintenance model in Beijing. The paper discusses the advantages and the disadvantages between the different model, and it makes suggestions on the follow aspects, such as system management, quality management, personnel management, cost management, information management perspective.