Reference significance of the teaching model of flipped classroom combined with group learning in the course of biostatistics in Duke University / 中华医学教育探索杂志

This article summarizes the experience in the teaching model of flipped classroom combined with group learning in the course of biostatistics in Duke University and discusses the application of this teaching model in universities and colleges in China.The study results show that this teaching model introduces group learning in flipped classroom to develop continuous peer-assisted learning.Meanwhile,this teaching model follows the process of knowledge internalization and designs four successive steps of individual readiness assessment,team readiness assessment,mini-lectures,and application activity,in order to strengthen the understanding and practical application of key points.This teaching model also establishes a transparent mechanism for individual and curriculum evaluation and feedback collection to find and solve the issues in this course.These teaching experiences provide a good reference for the application of flipped classroom in large-class teaching in China.

The control effect of comprehensive community intervention on cardiovascular risk factors in metabolic syndrome high risk group / 中国医师进修杂志

Objective To observe the effect of comprehensive community intervention on cardiovascular risk factors in metabolic syndrome (MS) high risk group.Methods One hundred MS high risk patients were divided into intervention group (50 patients) and control group (50 patients) by random digits table.The intervention group accepted intervention on health education,health action,health habit and individual intervention on drug.The control group accepted natural intervention.The changes of waistcircumference,body mass index (BMI),blood pressure,fasting plasma glucose (FPG),lipids and serum uric acid (UA) were observed.Results In intervention group,the number of physical exercise,alimentary control and medication compliance increased 12％,16％ and 18％,and the number of smoking and alcohol drinking decreased 8％ and 6％.But in control group,the number of physical exercise,alimentary control,medication compliance increased 2％,0 and 4％,and the number of smoking and alcohol drinking decreased 4％ and 2％.There was significant difference (P＜ 0.05).Before treatment,the level of waist circumference,BMI,systolic pressure,diastolic pressure,FPG,total cholesterol,triacylglycerol,high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C) and UA between two groups had no significant difference (P ＞ 0.05).After 1 year's intervention,except HDL-C,the level of other index had significant difference between two groups (P ＜ 0.05 or ＜ 0.01).Conclusion Comprehensive community intervention can improve the status of obesity and dyslipidemia,and reduce blood pressure,plasma glucose and UA.

Health expenditure analysis for urban and rural residents in China / 中华医院管理杂志

Objective To probe into the health expenditure and medical expenditure of Chinese people in rural and urban areas as objective references to improve the funding strategy of China's health care system. Methods Statistics annuals from 1999 to 2007 were called into play to analyze the status quo and trends of both expenditures. Results Definite proportion of funds raised for rural and urban health expenditure has grown by 200%;a distinct gap exists between the growth of per-capita medical expenditure in rural and urban residents (152. 86% in urban and 172. 77% in rural areas);medical expenditure maintains a steady growth along with rising per-capita income, yet the health consumption remains at a low level in general, especially among rural residents;since 2003, the income elasticity of the medical expenditure among rural residents keeps rising, narrowing the relative gap with urban residents. Conclusion It is recommended to push up the income of rural residents with greater resources, and to encourage the trend of marginal social medical expenditure. In addition, it is necessary to upgrade medical services, expand medical service coverage, and encourage reasonable consumption of medical services by both rural and urban residents;and to focus the role of cultural factors for greater awareness of the people in health investment and self-healthcare.

Cost-effectiveness Assessment of the Cataract Operation Modes / 中国慢性病预防与控制

Objective To assess the cost-effectiveness of different modes of the cataract operation. Methods Firstly, 291 cases of cataract inpatient were divided four groups according to operation modes (PHACO and ECCE) and the prices of intraocular lens (IOL) (high and low). Then the comparisons of inpatient cost, operation cost, postoperative VA, postoperative VF and QOL were made among four groups respectively. Finally, the cost-effectiveness of different cataract operation modes was analyzed by comparing the differences of their costs with the VA, VF and QOL improvement. Results There were significant differences in the above indicators among four groups in general (P 0.01). The VA improvement amount of PHACO was higher than that of ECCE whereas the VF and QOL improvement lower than those of ECCE. The price of IOL had no effect on the improvement quantity of VA, VF and QOL. When one unit amount of VA improvement wanted, the cost-effectiveness ratio of inpatient with PHACO and low-price IOL was the lowest. When one unit amount of VF and QOL improvement wanted, the cost-effectiveness ratio of patients with ECCE and high-price IOL was the lowest. When one unit amount of VA and QOL improvement wanted, the operation cost-effectiveness ratio of ECCE with low-price IOL was the lowest. And when one unit amount of VF improvement wanted, the operation cost-effectiveness ratio of ECCE with high-price IOL was the lowest. Conclusions There were cost differences among different cataract operation modes. The cost of PHACO was higher than that of ECCE. The ECCE mode and price of IOL were the main determinants of cost. The effects of improving VA and QOL by ECCE were better and the effect of improving VA by PHACO was better than by ECCE. The homemade or low price IOL had no influence on the cataractous operative effectiveness, but could decrease the operation cost. ECCE with low-price IOL was the optimal cost-effectiveness strategy and operation mode, especially for poor rural and remote areas.

Perceptions of Shigella and of Shigella vaccine among rural Chinese: compatibility with Western models of behavioral change.

Shigella remain a major source of morbidity and mortality in developing countries, including China. In response, national and international researchers are actively working to develop vaccines that will be effective against dysentery and diarrhea caused by shigella dysentariae. With the growing recognition of the problems associated with sustained vaccine acceptance and usage, researchers and policy makers recognize the importance of conducting theory-based qualitative research to inform vaccine development program efforts. Accordingly we undertook this qualitative study involving 81 residents of one of China's rural communities with high rates of dysentery. The semi-structured interviews suggest that a Western model of behavioral change offered a useful research construct. Consistent with the model is the community's strong perception of 'response efficacy' of vaccines, particularly in comparison with water and sanitation and disease treatment. Residents were eager to vaccinate their children despite variable perception of disease severity, while they were less consistent in their interest in vaccinating adults; this enthusiasm for vaccinating children was attributed to China's 'one child per couple' policy. Intervention implications are discussed.

The Reliability and Item Quality of Ten Medical Academic-courses From Two Angles / 中华医学教育探索杂志

Underlying both the angles of norm-referenced test and criterion-referenced test, the qualitative or(and)quantitative analysis and evaluation were made on the tests of 10 medical academic courses in recent 4 years in reliabil-ity and item quality. From the angle of norm-referenced test, 67.4 percent of the items had good quality, 60 percent ofthe tests could differentiate the classes and 12.5 percent of the papers could differentiate the individual person accord-ing to their reliability. However, from the angle of criterion-referenced test, approximately 90 percent of the items werequalified; 87.5% had high reliability to determine whether an examinee passes the test or not.[