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.

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.

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.

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.

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.

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.

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.

Research on the Teaching Reform of Medical Higher Mathematics with BOPPPS Teaching Module

Using BOPPPS teaching module combined with the present situation of medical higher mathematics teaching in Guangxi University of Chinese Medicine, this paper introduces the application of this teaching method in medical higher mathematics teaching, and explores the thinking of teaching reform of medical higher mathematics in Guangxi University of Chinese Medicine, so as to improve classroom teaching efficiency.

Path Breakthrough of Medical Humanities Education From the Perspective of“All-Staff,Whole-Process,and All-Round Education”

Medical education is an important cornerstone for the development of healthcare,and medical humanities education,as an integral part of medical education,plays an irreplaceable role in cultivating people’s health guardians with high medical ethics.We adopted the method of stratified random sampling to select 309 students and 107 faculty members from three independent medical colleges in Sichuan province as the research subjects and distributed questionnaire surveys investigating in three dimensions:overall cognition of medical humanities,evaluation of medical humanistic qualities,and the current situation of medical humanities education,supplemented by an in-depth literature review and interviews with subject matter experts.We found that“tech-centrism”still has a great influence,the self-evaluation of medical students’humanistic quality is generally not high,the educational concept of“emphasizing professional skills over morality”of faculty and staff is still quite prevalent,and there is still the“last mile”phenomenon in medical humanities education.In order to promote the integrated development of“new medicine”and“new liberal arts”and break the barriers of“tech-centrism”and“instrumental rationality,”it is necessary to change the educational concept and strengthen the education of all employees,break through the bottleneck of internships and strengthen the whole process of education,integrate educational resources and strengthen all-round education,improve the incentive mechanisms,strengthen the assessment methods,and provide Chinese wisdom and Chinese solutions for the development of medical humanities education.

Current Situation and Prospect of the Application of Real-World Evidence in Health Care

Objective To summarize the application of real-world evidence(RWE)in the medical and healthcare field of various countries,including relevant policies,application scenarios and application methods.Methods Relevant policies and application scenarios were obtained by consulting the official websites and public documents of various countries’healthcare institutions.Systematic literature retrieval was adopted to search PubMed,EMBASE,Cochrane Library,CNKI,CBM and Wanfang databases,and all papers related to real-world study and application were included.Then,these papers were classified and analyzed by country and application method.Results and Conclusion The RWE was mainly applied to supporting the preliminary approval of a new drug,expanding drug indications,accelerating approval or supporting conditional marketing authorizations and drug safety evaluation,etc.The United Kingdom,the United States,Germany,the Netherlands,Italy,Sweden,and France admitted RWE,but they treated the data obtained from RWE with caution.After systematic literature retrieval,a total of 701 articles were obtained,including relevant studies from 36 countries,among which the United States published 264 in total.The most common study was about using real-world data(RWD)to calculate treatment-related costs,which had a total of 259 studies.Secondly,158 articles were used for epidemiological analysis.Then,138 articles were about establishing risk models to analyze disease risk factors.A total of 70 articles were real-world efficacy evaluation of the drug treatment schemes,54 articles were about pharmacoeconomic evaluation with RWD as parameters.A total of 29 articles used RWD to build predictive models,and 15 articles used RWD to evaluate the health-related quality of life in patients.The application of RWE has been used widely in the medical and healthcare field of various countries.The application scenarios are gradually diversified,the application methods of RWD become mature,and the evidence quality of RWE is also improved greatly.

Evaluation of Blood Pressure Control Medicines Using Health and Medical Checkup Data in Japan: Alternative Methods for Randomized Controlled Trials

Background: Many people take medicines to control high blood pressure (BP), or hypertension. Randomized clinical trials (RCT) are usually used for the evaluation of effects of medicines. However, RCT have some serious problems. Data and Methods: We evaluated the effects of BP medicines in Japan using a dataset containing 113,979 cases. We employed four statistical methods in the analysis. First, we simply compared the systolic blood pressure (SBP) of individuals with and without BP medicines. We then used a regression model with a dummy variable, representing taking medicines or not. We replaced the dummy variable by its expected value, and estimated the regression model again. Finally, we selected individuals who had both taken and not taken medicines at different times. The effect of sample selection was also considered in the estimation. Results: For the simple comparison, SBP with BP medicines was 11 mmHg higher than without medicines. In the next regression analysis, SBP with BP medicines was still 5 mmHg higher. When the dummy variable was replaced by its expected value, SBP with medicines decreased by 7 mmHg. For individuals taking medicines at some times and not at others, SBP decreased by 9 and 8 mmHg in models with and without a sample bias correction, respectively. Conclusion: The methods eliminated some problems of RCT and might be attractive. However, we obtained contradictory conclusions depending on the statistical methods employed, despite using the identical dataset. Statistical methods must be selected carefully to obtain a reliable evaluation. Limitations: The dataset was observatory, and the sample period was only 3 years.

Chinese medical service and medical education in urgent need of reform in the context of public welfare-based medical reform

After six years＇medical reform,about 7.8 billion person-times of medical service has been achieved by2014,and the number of persons covered by basic medical insurance for urban employees,basic medical insurance for urban residents,and new rural cooperative medical insurance exceeded 1.3 billion,of which the coverage ratio reached as high as over 95%,establishing the largest basic medical security network in the world.

Impact of mobile health and medical applications on clinical practice in gastroenterology

Mobile health apps (MHAs) and medical apps (MAs) are becoming increasinglypopular as digital interventions in a wide range of health-related applications inalmost all sectors of healthcare. The surge in demand for digital medical solutionshas been accelerated by the need for new diagnostic and therapeutic methods inthe current coronavirus disease 2019 pandemic. This also applies to clinicalpractice in gastroenterology, which has, in many respects, undergone a recentdigital transformation with numerous consequences that will impact patients andhealth care professionals in the near future. MHAs and MAs are considered tohave great potential, especially for chronic diseases, as they can support the selfmanagementof patients in many ways. Despite the great potential associated withthe application of MHAs and MAs in gastroenterology and health care in general,there are numerous challenges to be met in the future, including both the ethicaland legal aspects of applying this technology. The aim of this article is to providean overview of the current status of MHA and MA use in the field ofgastroenterology, describe the future perspectives in this field and point out someof the challenges that need to be addressed.

Impact of Tobacco Smoking on Health Care Utilization and Medical Costs in Chronic Obstructive Pulmonary Disease,Coronary Heart Disease and Diabetes

Objective To determine the impact of smoking on disease-specific health care utilization and medical costs in patients with chronic non-communicable diseases(NCDs).Methods Participants were middle-aged and elderly adults with chronic NCDs from a prospective cohort in China.Logistic regressions and linear models were used to assess the relationship between tobacco smoking,health care utilization and medical costs.Results Totally,1020 patients with chronic obstructive pulmonary disease(COPD),3144 patients with coronary heart disease(CHD),and 1405 patients with diabetes were included in the analysis.Among patients with COPD,current smokers(β:0.030,95%CI:−0.032-0.092)and former smokers(β:0.072,95%CI:0.014-0.131)had 3.0%and 7.2%higher total medical costs than never smokers.Medical costs of patients who had smoked for 21-40 years(β:0.028,95%CI:−0.038-0.094)and≥41 years(β:0.053,95%CI:−0.004β0.110)were higher than those of never smokers.Patients who smoked≥21 cigarettes(β:0.145,95%CI:0.051-0.239)per day had more inpatient visits than never smokers.The association between smoking and health care utilization and medical costs in people with CHD group was similar to that in people with COPD;however,there were no significant associations in people with diabetes.Conclusion This study reveals that the impact of smoking on health care utilization and medical costs varies among patients with COPD,CHD,and diabetes.Tobacco control might be more effective at reducing the burden of disease for patients with COPD and CHD than for patients with diabetes.