Influence of Medical Model on Therapeutic Environment

In its development history, man has always tried to be close to nature, and get physical and spiritual help from the nature. According to the development of medical model from the deity worship to modern medical science, a near-nature and ecological therapeutic and recuperative model has been more favored, thus in modern therapeutic environment, proper landscape designs can be combined with effective medical methods to achieve physical and mental immunoregulation and balance using natural and quality climatic factors. This paper introduced the development of natural science and medicinal model in different periods, and analyzed their impact on environment, concluded the benefi ts of therapeutic medicine, and demonstrated the signifi cance of therapeutic environment and landscape healing as the therapeutic factors for facilitating human rehabilitation from the perspective of therapeutic medicine. Taking "evidence-based design" as the basis of therapeutic environment design, this paper proposed landscape design methods for the therapeutic environment, in order to provide people opportunities for closing to, sharing and participating in the nature, help people to relax physically and psychologically using the positive impact of natural environment on human spirits, relieve their stress, and achieve physical and psychological peace. In addition, the development tendency of therapeutic environment in China was predicted according to the actual conditions of urban society.

Bring Affordable Medical Service to Farmers

Huo Yulan had suffered from hydrocephalus, a brain disease, for decades before she finally agreed to have an operation for it in the Beipiao County Hospital, Liaoning Province in Northeast China last March.

Evaluation of Google Glass^(■) with Camera Adaptor and GoPro^(■) as Teaching Tools for Endotracheal Intubation in the Austere Medical Environment

Objective: Endotracheal intubation (ETI) is a life-saving emergency procedure, but it is a complex skill that is difficult to teach. Recent studies have shown that video laryngoscopy is effective in teaching ETI to learners at various levels of medical expertise;however, it has proven to be costly and provides images of inconsistent quality. In this educational proof of concept feasibility convenience sample pilot study, we aim to explore and compare the effectiveness of using modified Google Glass? (GG) and GoPro? (GP) technologies to visualize and teach ETI to critical care physicians in the austere medical environment of a low-income country. We propose, based on our findings, that this inexpensive technology could teach lifesaving ETI to pre-hospital providers in the austere medical environment, medical students, rural emergency physicians, critical care physicians in low-income countries, far forward military medical providers, and other learners. Methods: A case series of twenty-five patients, five in the United States (US) at Memorial Hospital in South Bend, IN and twenty at Saint Luc’s Hospital in Port Au Prince, Haiti, is presented. These patients were collected from November 1st 2015 through February 1st of 2016. The anesthesiologist and the emergency physicians in the United States utilized GG to intubate five patients in the US prior to the twenty patients intubated during two separate trips to Haiti. On the two separate trips to Haiti, the GG was trialed and modified to obtain better exposure. These adaptations resulted in the final collection of twenty patients studied with the adapted GG system and GP. Physicians graded airway visualization based on LEMON and Cormack-Lehane scores. Previously published parameters for the assessment of failed intubation risk and passage of the cords were used as data points for analysis using a Likert-Scale analysis for each parameter. The data were analyzed by averages of Likert-Scale scoring with their respective standard deviations. Results: The results show that the GP is superior to GG for assessing the LEMON scoring system until visualization of the oropharynx, while the GG is markedly superior for calculation of Cormack-Lehane score (cord visualization) and passing of the endotracheal tube. Conclusion: A review of the twenty-five cases demonstrates that while GP allows for better visualization for the parameters that require a wider view of the patient, the modified GG allows for superior visualization in the parameters that require a more focused view of the cords. GG can serve as an effective educational tool in the ICU for physicians and other providers in the austere medical environment who require effective ETI training. In addition, we propose that these techniques can serve as an inexpensive yet effective means of teaching hands on endotracheal intubation skills to learners of varying levels of clinical experience.

Operating in Tandem Chinese experts in Sao Tome and Principe cooperate with local farmers to raise medical standards in the breeding industry

Santomean pig farmer Simao Vicente was hopeful when he came to ask Zou Rui for help. His pig was suffering from hernia, and Zou, a 42-year-old Chinese agricultural expert working in Sao Tomé and Príncipe, was the only person on the island who could provide emergency surgery.

Farmers’risk preference and fertilizer use

This study examines the role of farmers’risk attitudes toward fertilizer use in cotton production in China.Contradicting previous studies,this paper theoretically shows that the relationship between farmers’risk aversion and fertilizer use is not always monotonic.Field survey data were collected to test this relationship using the Cobb–Douglas production function.Results suggest that when the elasticity of fertilizer use and the probability of achieving the desired effects from fertilizer use are high,risk-averse farmers apply more fertilizer than risk-taking farmers.Conversely,when the elasticity of fertilizer use and the probability of achieving the desired effects are low,risk-taking farmers apply more fertilizer than risk-neutral or risk-averse farmers.

Intelligent Autonomous-Robot Control for Medical Applications

The COVID-19 pandemic has shown that there is a lack of healthcare facilities to cope with a pandemic.This has also underscored the immediate need to rapidly develop hospitals capable of dealing with infectious patients and to rapidly change in supply lines to manufacture the prescription goods(including medicines)that is needed to prevent infection and treatment for infected patients.The COVID-19 has shown the utility of intelligent autonomous robots that assist human efforts to combat a pandemic.The artificial intelligence based on neural networks and deep learning can help to fight COVID-19 in many ways,particularly in the control of autonomous medic robots.Health officials aim to curb the spread of COVID-19 among medical,nursing staff and patients by using intelligent robots.We propose an advanced controller for a service robot to be used in hospitals.This type of robot is deployed to deliver food and dispense medications to individual patients.An autonomous line-follower robot that can sense and follow a line drawn on the floor and drive through the rooms of patients with control of its direction.These criteria were met by using two controllers simultaneously:a deep neural network controller to predict the trajectory of movement and a proportional-integral-derivative(PID)controller for automatic steering and speed control.

Design of an Information Security Service for Medical Artificial Intelligence

The medical convergence industry has gradually adopted ICT devices,which has led to legacy security problems related to ICT devices.However,it has been difficult to solve these problems due to data resource issues.Such problems can cause a lack of reliability in medical artificial intelligence services that utilize medical information.Therefore,to provide reliable services focused on security internalization,it is necessary to establish a medical convergence environment-oriented security management system.This study proposes the use of system identification and countermeasures to secure systemreliabilitywhen using medical convergence environment information in medical artificial intelligence.We checked the life cycle of medical information and the flow and location of information,analyzed the security threats that may arise during the life cycle,and proposed technical countermeasures to overcome such threats.We verified the proposed countermeasures through a survey of experts.Security requirements were defined based on the information life cycle in the medical convergence environment.We also designed technical countermeasures for use in the security management systems of hospitals of diverse sizes.

IoTFLiP： IoT-based flipped learning platform for medical education

Case-Based Learning （CBL） has become an effective pedagogy for student-centered learning in medical education, which is founded on persistent patient cases. Flippped learning and Internet of Things （IoTs） concepts have gained significant attention in recent years. Using these concepts in conjunction with CBL can improve learning ability by providing real evolutionary medical eases. It also enables students to build confidence in their decision making, and efficiently enhances teamwork in the learning environment. We propose an IoT-based Flip Learning Platform, called IoTFLiP, where an IoT infrastrneture is exploited to support flipped case-based learning in a cloud environment with state of the art security and privacy measures for personalized medical data. It also provides support for application delivery in private, public, and hybrid approaches. The proposed platform is an extension of our Interactive Case-Based Flipped Learning Tool （ICBFLT）, which has been developed based on current CBL practices. ICBFLT formulates summaries of CBL cases through synergy between students＇ and medical expert knowledge. The low cost and reduced size of sensor device, support of IoTs, and recent flipped learning advancements can enhance medical students＇ academic and practical experiences. In order to demonstrate a working scenario for the proposed IoTFLiP platform, real-time data from IoTs gadgets is collected to generate a real-world case for a medical student using ICBFLT.

Plant Breeding for Harmony between Modern Agriculture Production and the Environment

The world population is estimated to be 9.2 billion in 2050. To sufficiently feed these people, the total food production will have to increase 60% - 70%. Climate models predict that warmer tem-peratures and increases in the frequency and duration of drought during the present century will have negative impact on agricultural productivity. These new global challenges require a more complex integrated agricultural and breeding agenda that focuses on livelihood improvement coupled with agro-ecosystem resilience, eco-efficiency and sustainability rather than just on crop productivity gains. Intensifying sustainability agro-ecosystems by producing more food with lower inputs, adapting agriculture to climate change, conserving agro-biodiversity through its use, and making markets to work for the small farmers are needed to address the main issues of our time. Plant breeding has played a vital role in the successful development of modern agriculture. Development of new cultivars will be required while reducing the impact of agriculture on the environment and maintaining sufficient production. Conventional plant breeding will remain the backbone of crop improvement strategies. Genetic engineering has the potential to address some of the most challenging biotic constraints faced by farmers, which are not easily addressed through conventional plant breeding alone. Protective measures and laws, especially patenting, must be moderated to eliminate coverage so broad that it stifles innovation. They must be made less restrictive to encourage research and free flow of materials and information. Small farmers have an important role in conserving and using crop biodiversity. Public sector breeding must remain vigorous, especially in areas where the private sector does not function. This will often require benevolent public/private partnerships as well as government support. Active and positive connections between the private and public breeding sectors and large-scale gene banks are required to avoid a possible conflict involving breeders’ rights, gene preservation and erosion. Plant breeding can be a powerful tool to bring “harmony” between agriculture and the environment, but partnerships and cooperation are needed to make this a reality.

Medical Waste Management: A Case Study of the Souss-Massa-Drâa Region, Morocco

Medical waste management is of major concern due to the potentially high risks to both human health and the environment caused by inadequate waste management practices. In Morocco, as in many developing countries, little information is available regarding generation handling, and disposal of medical waste. The specific objective of this study was to analyse the medical waste management practices in the Souss-Massa-Draa region, Morocco. The study was carried out in seven of the twelve hospitals in the region, covering 66.2% of the bed capacity. A total of 219 healthcare personnel and their assistants were included: 35 doctors, 98 nurses, and 86 housekeepers. Site visits, interviews, and survey questionnaires were implemented to collect information regarding different medical waste management aspects, including medical waste generation, separation, collection, storage, transportation, and disposal. The results indicated that the medical waste generation rate ranged from 0.4 to 0.7 Kg/bed-day with a weighted average of 0.53 Kg/bed-day. The percentage of infectious and hazardous wastes in the total medical waste stream was about 30.5%. The remaining 69.5% was general wastes similar in properties to municipal wastes. Concerning waste separation, housekeepers demonstrate a slightly higher knowledge about waste separation, with 49.4% of correct answers, with nurses at 45.7%, and doctors the lowest value at 38.6%. The results about other management aspects indicated that practices in most surveyed hospitals did not comply with the principles stated in Moroccan legislation. Based on the findings, some measures are suggested to improve the present conditions and ensure that potential health and environmental risks of medical waste are minimized.

Problems in the Use of Pesticides by Farmers and Countermeasures

Pesticide safety is an important guarantee for food security.At present,there are many problems in the process of choosing pesticides by farmers,such as low discernment ability and difficulty in retroactive blame,slow replacement of medical equipment,slow promotion of technology assistance,lack of professional knowledge,difficult to grasp the key points of application,improper use of pesticides,large resistance to reducing quantity and increasing efficiency,etc.In order to use pesticides rationally and realize safe production,countermeasures and suggestions on pesticide application are put forward from the aspects of drug development and application,promotion of biopesticides,change of farmers concept and cultivation of new farmers.

The Hospital Assessment Tool： An Integrated Solution to Evaluate and Reduce Solid Medical Waste

The Hospital Assessment Tool （HAT） is an assessment technique that provides technical support to the healthcare industry for accessing solid waste generation, selecting products, and work practices to eliminate or reduce environmental hazards and solid waste, and to maintain quality patient care. Since 2007, this tool has been applied as part of an innovative partnership between the Lucas County Solid Waste Management District and College of Engineering of the University of Toledo. The purpose of this paper is to provide a complete overview and framework of this program and the HAT so that other institutions may learn from it and adopt similar concepts to help reduce solid waste generation and improve economic conditions in their regions. A focus of this paper is a discussion of a case study that details the process and results of an assessment conducted at a large hospital in Northwest, Ohio, USA. Also, included in this paper is a discussion of the project＇s background, a comparison to similar project＇s between colleges and government agencies, and results and benefits of the program, and an overview of the opportunities and barriers to this type of research. The project demonstrates that through a cooperative effort and a creative alliance, businesses, governments, universities, and industries can work together to improve environmental quality, reduce waste, and improve profitability. The project also educates college students through practical, real-world environmental work experience and trains them to become future environmental leaders

Analysis on the Current Situation of Social Security for Landless Farmers Under the Background of Urbanization

With the rapid development of China's social economy,the economy of various regions has rapidly improved.At the same time,people are paying more attention to the issue of farmers' social security.In order to realize the rapid development of regional economy and form a relatively stable social order,there is a need to improve the social security system of farmers so as to ensure that more people acquire basic social security rights.On this basis,based on the background of urbanization,this article studies the social security status of landless farmers in R city,and analyzes the old-age security as well as the medical insurance of landless farmers in R city.

On Rural Medical Care and Health Undertaking Development during New Medical Reform

Based on in-depth survey of township hospitals in Lushan County of Henan Province, this paper studies the development situations of rural medical care and health undertaking in the course of new medical reform. Results show that both rural medical institution and public health undertaking have considerable development in this course. Working capital situation gradually turns better. However, there are still problems and challenge of shortage of high quality medical care personnel, lack of employment mechanism, poor medical environment, and imperfect bidding and purchasing system of medicines. To further develop rural medical situation, it should improve medical environment, speed up informationization construction, and give prominence to functional orientation.

农村人居环境整治中妇女参与的组织路径与实践机制——以赣州“清洁家园”活动为例

农村人居环境整治是满足人民对美好生活的向往,实施乡村振兴战略的重要任务。作为面向农民生活的治理,其在实践中遭遇农民冷漠和不满的困境,需要激活和重建农民主体性,实现外部行政力量与内部自治力量的融合。在村妇女的“主内”特性及上升地位使其成为重要的治理主体资源,赣州“清洁家园”活动表明借助制度吸纳、事务匹配和双重激励等方式将妇女组织起来后,妇女能够通过调动村内治理资源,明确治理单元,累积自身治理权威等方式参与农村人居环境整治,实现治理的低成本与高效能。基于此,面向农民生活的治理要充分重视并推动在村妇女参与,但同时也应警惕生活化治理事务带来的固化女性家庭角色的风险,真正推动妇女参与公共事务,让妇女在村庄治理中发挥更大治理效用。

儿科学混合式教学中的医学教育环境感知与学生学习自主性的关系研究

目的分析基于儿科学混合式教学的医学教育环境感知与学生学习自主性的关系。方法选取武汉大学第一临床学院临床专业、已完成儿科学混合式教学课程学习的学生作为研究对象,采用教育环境评估量表(Dundee ready education environment measure,DREEM)和大学生学习自主性量表进行医学教育环境感知和学习自主性调查。结果临床医学生的医学教育环境感知整体较好,各维度得分率比较,学生对教师的知觉>对学习的知觉>对学术的知觉>对环境的知觉>社交和自我知觉。学生的自我调控、学习策略、内容与环境、学习动机和学习自主性量表总分得分率分别为67.85%、72.86%、65.56%、70.63%和68.97%。相关分析显示,DREEM量表、大学生学习自主性量表的内部各维度得分与各量表总分均呈正相关,各维度得分之间均呈正相关(P<0.05),且大学生学习自主性量表各维度得分、总分与DREEM量表各维度得分及总分也均呈正相关(P<0.05)。结论基于儿科学混合式教学的临床医学生的医学教育环境感知整体较好,学习自主性可且与教育环境感知密切相关。在混合式教学实施过程中,不断优化教学内容、提升教师教学素养和积极改善医学教育环境,将有助于提升临床医学生对医学教育环境的满意度及学习兴趣和自主学习能力,更高效地促进医学教育教学改革的持续性发展。

某三甲医院继续医学教育减负政策的效果与思考

目的 评估北京某三级甲等医院继续医学教育(continuing medical education,CME)减负政策的实施效果。方法 选择北京某三级甲等医院的2016年11月—2022年10月接受医院CME 2 087名人员相关资料,应用资料分析方法分析相关CME情况。结果 国家级/市级项目方面,实施时间对CME得分有负面影响(P <0.001),职称对CME得分的影响不显著(P=0.641),专业对CME得分有正向影响(P <0.001);区级项目方面,实施时间、职称、专业对CME得分均有负面影响(均P <0.001);线上学分回归结果显示,实施时间为正面影响(P <0.001),职称和专业对得分影响不显著(P=0.889、0.058)。结论 减负政策对CME得分有正面影响,需要进一步完善政策以支持医务人员的学习。CME已经进入继续职业发展阶段,应重视自主学习,了解医务人员教育需求,提供多样化的学习方式,扩展线上教育,加强激励和约束机制。

医院日间手术中心及其建设标准的发展

回顾了国内外日间手术中心及其建设标准的发展历程。结合我国日间手术中心的特点,参照国外的相关标准以及我国多年来日间手术室建设的经验教训,阐述了我国颁布的《日间手术中心设施建设标准》中的新成果、新措施,详细介绍了日间手术中心的管理模式、医疗流程与布局以及医疗环境控制。

基于医工交叉的人工环境方向人才培养探究

随着中国社会经济快速发展,人类健康需求增加,这都为工程科学更加全面地介入医学领域、更加深入地开展医工交叉研究解决国家在医疗健康领域的重大问题提出了更高的要求。本论文就突发“公共卫生事件”与“学生培养”进行关联检索,探讨人工环境学生培养的问题。从学生培养的基本内涵出发,在分析研究疫情常态化的工科研究生培养环节中的关键构成要素的基础上,以人体健康需求下人工环境工程与医学交叉领域教学实践为背景,结合人工环境方向学生培养要求,凸显学科交叉的特色,优化理论课程与实际课程培养体系,以项目为载体,引入多学科背景,主要是医学反向的校外导师,组建导师团队,全方位培养学生综合应用能力。搭建了人工环境工程专业多模块融合式医工交叉领域体系。对拓展人工环境工程学生思维方式和科研能力,增强创新意识,培养复合型创新人才和促进交叉科学发展都具有重要的理论价值和现实意义。

放射治疗培训虚拟环境在肿瘤放射治疗临床教学中的应用

目的本研究通过在放射肿瘤学本科教学中应用放射治疗培训虚拟环境,并与传统的教学方法进行比较,观察放射治疗培训虚拟环境教学模式在放射肿瘤学本科教学工作中的效果。方法选择徐州医科大学附属临床学院2020年7月—2021年6月的67名放射医学专业学生作为研究对象,根据教学方法的不同分为放射治疗培训虚拟环境组(n=32)及传统教学组(n=35)。传统教学组采用传统授课方法,放射治疗培训虚拟环境组采用案例教学方法进行授课。教学结束后比较2组学生对知识掌握程度、自主学习能力、学习兴趣、学习效率、课程难易度、课程参与度、教学满意度、课堂气氛以及教学节奏的自我评价,并评价理论考试,病理分析考试和靶区勾画考试成绩。结果放射治疗培训虚拟环境组的理论考试成绩[(73.26±5.28)分]、病例分析考试成绩[(82.36±6.33)分]和靶区勾画考试成绩[(75.28±4.24)分]高于传统教学组[(70.29±4.93)分、(79.22±6.32)分、(67.23±5.35)分],差异均有统计学意义(P<0.05)。放射治疗培训虚拟环境组和传统教学组医学生的自主学习能力、课程难易度得分差异无统计学意义(P>0.05),放射治疗培训虚拟环境组学生知识掌握程度、学习兴趣、学习效率、课程参与度、教学满意度、课堂气氛以及教学节奏得分高于传统教学组,差异均有统计学意义(P<0.05)。结论在放射肿瘤学本科教学过程中,放射治疗培训虚拟环境在放疗肿瘤学教学效果好于传统教学,放射治疗培训虚拟环境组医学生的满意度较高,学习积极性较强。