Outcome assessment of stroke convalescence using multiple scales based on different dimensions

BACKGROUND: Convalescence is an important stage of stroke treatment. A lot of patients have somatic and mental disorders at various degrees. The primary standard can only reflect partial conditions of somatic disorder; in addition, multiple dimensions of patients at the phase of stroke convalescence are further observed by using a lot of standards, such as signs and symptoms of traditional Chinese medicine, daily activity and psychological status. OBJECTIVE: To analyze the outcome assessments of the cases of stroke convalescence measured with different criteria consisting of various dimensions by a cross-sectional investigation of the condition of stroke convalescent patients. DESIGN: Scale evaluation. SETTING: Departments of Clinical Epidemiology Exploratory Development and Neurology, the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine; National Center for Training of Design, Measurement and Evaluation in Clinical Research,Guangzhou University of Traditional Chinese Medicine. PARTICIPANTS: A total of 194 stroke convalescent patients treated in the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from July 26, 2000 to February 28, 2001 were taken as subjects of the study. There were 126 males and 68 females aged from 40 to 89 years, and the illness course ranged from 14 to 181 days. All patients met diagnosis-treatment criteria of stroke (the second version)[DTCS(V2.0)] and various kinds of diagnostic points of cerebrovascular diseases; moreover, all patients provided confirmed consents. METHODS: They were assessed by assessment methods including the following assessment instruments: DTCS(V2.0), self-designed scale of traditional Chinese medicine (TCM) symptoms (28 symptoms and physical signs were scored as 0, 1, 2 marks from none to severity), modified Edinburgh-Scandinavia stroke scale (a total of 45 marks, 0 to 15 marks as mild defect, 16 to 30 as moderate defect, 31 to 45 as severe defect), modified Barthel activities of daily life (ADL) index (a total of 100 marks, less than 60 marks as unable self-care), vitality and mental health (subscales derived from Health Survey Questionnaire, SF-36). The collected data from scales and inter-scale correlation were processed by the statistic methods mainly including descriptive analysis, Spearmen correlation analysis, factor analysis, etc. MAIN OUTCOME MEASURES: ① Average scores of scales and criteria; ② correlation between modified Edinburgh-Scandinavia stroke scale and other scales. RESULTS: All of the patients completed the assessment, and analyzed in the final analysis. ① The average scores of the scales and criteria: The average scores of DTCS(V2.0), self-designed scale of TCM symptoms, modified Edinburgh-Scandinavia stroke scale, modified Barthel ADL index, vitality and mental health scales were 6.51±6.29, 13.73±6.97, 7.56±7.35, 63.58±23.68, 52.79±23.32 and 62.83±22.75 respectively. ② Correlation between modified Edinburgh-Scandinavia stroke scale and other scales: The Spearman correlation coefficients (R ’) of modified Edinburgh-Scandinavia stroke scale with diagnosis-treatment criteria of stroke, scales of TCM symptoms, modified Barthel ADL index, vitality scale and mental health scale were 20.885, 0.302, -0.824, -0.294 and -0.258 respectively. CONCLUSION: The modified Edinburgh-Scandinavia stroke scale and DTCS(V2.0) shared the same assessment dimension, so they can be mutually alternated in some clinical practices. Discrepancy in measurements of health status was gained due to the diverse dimensions applied in outcome assessments. It is necessary to build up a multi-dimensional assessment criteria system, such as signs and symptoms, daily activities and psychological status, for assessing the stroke convalescent cases in a more comprehensive scope and reflecting the efficacy of TCM treatment scientifically.

Flexner has fallen:Transitions in medical education system across time,a gradual return to pre-Flexnerian state(de-Flexnerization)

The modern medical education system has gradually evolved starting from 1910 incorporating the suggestions by Abraham Flexner,his public disclosure of the poor conditions at many medical schools provided a means to galvanize all the constituencies needed for reform to occur.He could say what other reformers could not,due to their links to the medical education community.But now we are again going back to a pre-Flexnerian state due to multiple reasons such as gradually diminishing importance of basic science subjects for the students,the decline in the number and quality of investigator initiated research among clinical researchers,lesser emphasis to bedside training by means of detailed clinical examination and making appropriate observation of signs to reach to a diagnosis rather than over reliance on the laboratory tests and radiological modalities for the diagnosis,poor exposure to basic clinical skills starting from college throughout residency and the trend of disrespect and absenteeism from both theoretical and clinical/practical classes.The attitude of students is just to complete their required attendance so that they are not barred from appearing in examinations.This de-Flexnerization trend and regression to pre-Flexnerian era standards,ideologies,structures,processes,and attitudes,are bound to beget pre-Flexnerian outcomes,for you get what you designed for.

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2020年新型冠状病毒的肆虐,使得教育进入了网络时代,计算机及网络在大家的生活、学习、工作中变得越来越重要。培养非计算机专业学生的计算机能力变得越来越重要。OBE(Outcomes Based Education,OBE)是一种基于学习产出的教育模式,该教育理念以问题解决为导向,以学生获得成果为评价机制,适合非计算机专业学生快速掌握计算机相关能力。基于此项目组设计计算机能力体系、配置相关的计算机课程群,以线上微信小程序为实施模式探索培养学生计算机能力的办法,并使之贯穿学生四年大学教育。

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食品卫生学和食品生物化学是高校食品类专业本科生有代表性的两门专业核心课程和专业基础课程。基于公共卫生大背景,针对两门课程基于OBE的教学模式进行探索。该教学模式聚焦“以学生为中心,以成果产出为导向”的理念,根据教育部高校大学生培养要求制定两门课程教学目标,优化教学理论和实践内容,采用OBE教学模式,推动课程建设。研究表明,基于OBE教学理念的食品卫生学和食品生物化学课程教学设计能够激发食品专业学生学习兴趣,提高学生的主观能动性,提升学生的专业素养,从而为食品类专业应用型人才的培养目标奠定坚实的基础。

面向OBE培养理念的《数字摄影测量》课程改革

《数字摄影测量》课程需要学生不仅要掌握基本的理论知识,而且具有较强的实际动手能力。结合武汉大学遥感科学与技术专业的定位,针对国际工程专业认证的具体要求,探讨了《数字摄影测量》课程教学大纲的修订,并设计了一套以产出为导向的学生综合能力培养的考核模式,加强了对学生能力和素质的评价。提出的改革措施对相关专业的培养模式革新有一定的参考价值。