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La cirugía académica requiere de un compromiso mayor comparado a la práctica quirúrgica fuera de centros académicos. Es mucho mas demandante por la carga docente y de investigación que involucra aparte de la labor asistencial, lo cual provoca conflictos en la relación laboral, familiar y desarrollo profesional integral. Las futuras generaciones tienen aspiraciones y visiones diferentes de cómo enfrentar el trabajo diario sin descuidar la calidad de vida. En este articulo se analizan los diferentes factores que afectan este equilibrio y como se espera que se manejará el escenario laboral en los próximos años.
Academic surgery requires a greater commitment compared to surgical practice outside academic centers. It is much more demanding due to the teaching and research load that it involves apart from the care work, which causes conflicts in the work, family relationship and comprehensive professional development. Future generations have different aspirations and visions of how to face daily work without neglecting quality of life. This article analyzes the different factors that affect this balance and how the labor scenario is expected to be managed in the coming years.
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Toda especialidad médica, y en especial las quirúrgicas, necesitan, de alguna manera, vislumbrar el futuro que puedan ofrecer a los miembros más jóvenes de la especialidad y eventuales interesados en esta, de manera de asegurarles las mejores posibilidades de desarrollo profesional y personal, para, a su vez, poder reclutar a los mejores. Empero, para imaginar y forjar el futuro, es necesario vivir y enfrentar el presente. Pero, todo presente se asienta en un pasado, que es necesario conocer y meditar. Y de esto trata este artículo especial: pasado, presente y futuro de la cirugía de corazón, desde la particular visión de su autor.
Every medical specialty, mainly surgical specialties, needs to envision the future they can offer to the specialty's younger members and those eventually interested in it to assure them of the best possibilities for professional and personal development and, in turn, to be able to recruit the best one. However, it is necessary to live and face the present to imagine and forge the future. But every present is based on a past, which must be known and meditated upon. This article is about the past, present, and future of heart surgery, according to the particular vision of its author.
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Objective:To evaluate the relationship among future self-continuity,family support and meaning in life in college students.Methods:A total of 912 college students(448 males and 464 females)were selected and assessed with the Future Self-Continuity Questionnaire(FSCQ),Family Support Scale(PSS-Fa)and Meaning in Life Questionnaire(MLQ).Results:The average score of FSCQ was(3.3±1.1),and those who were female,25 years old,senior,nonlocal census register,only child had lower FSCQ scores(P＜0.001).Regression analysis results showed that the scores of PSS-Fa and the MLQ scores of search for life meaning and presence for life mean-ing were positively correlated with the FSCQ scores(β=0.80,0.69,0.74).Conclusion:The study shows that the future self-continuity is at a medium level and improving family support and meaning in life may help to enhance their future self-continuity in college students.
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@#The high incidence and untreated rate of root caries, a common and frequently occurring oral disease with challenging treatment in elderly individuals, is the main cause of tooth loss among elderly people, as rapid development results in pulpitis and periapical periodontitis or residual crown and root, which has been regarded as one of the common chronic oral diseases seriously affecting the quality of life of elderly people. Thus, early intervention and prevention are important. Traditional dental materials for preventing root caries have been widely used in clinical practice; however, they have the disadvantages of tooth coloring, remineralization and low sterilization efficiency. A series of new dental materials for preventing root caries have gradually become a research hotspot recently, which have the advantages of promoting the mineralization of deep dental tissue, prolonging the action time and enhancing adhesion. Future caries prevention materials should be designed according to the characteristics of root surface caries and the application population and should be developed toward simplicity, high efficiency and low toxicity. This review describes current research regarding anti-caries prevention material application, serving as a theoretical underpinning for the research of root caries prevention materials, which is important for both promotion in the effective prevention of root caries and improvement in the status of oral health and the quality of life among old people.
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“The Kampo Future Vision Study Group responsible for health and medical care of people” was established in 2016 with the aim of discussions to resolve various problems related to Kampo, and issued six proposals as important items. Among these proposals, the emphasized themes that are directly linked to clinical practice are “Kampo as a supportive treatment for cancer” and “Kampo as a countermeasure against frailty in the elderly.” The Japan Society of Oriental Medicine decided on a policy to be involved in these themes and established the Proposal-Discussing Committee (later absorbed into the Policy Advisory Committee). At first, the committee asked experts to present the research status of Kampo medicine as supportive care for cancer and as countermeasures against frailty. The committee, then, decided to lead clinical research by itself on frailty treatment with Kampo medicine. In such clinical research, evaluation criteria for judging therapeutic effects are necessary. Therefore, the existing well-defined diagnostic criteria were combined to create a Kampo frailty score. This article explains the Kampo frailty score, citing the supporting literature.
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Discrimination against patients with mental disorders and the resulting stigma will not only affect patients’ medical treatment, but also bring about community isolation and lack of resources. Mental health problems have become a major public health problem and a prominent social problem. From the perspective of bioethics, the existence of public mental disorders stigma violates the principles of justice and respect. This paper quantitatively described the status quo of public mental disorders stigma in China, and explored its influencing factors through factor analysis and binary logistic regression analysis. The public stigma of mental disorders score was (54.64±11.048). Factor analysis extracted 4 common factors, namely isolation, pain, contact, and empathy, with a cumulative explained variance of 68.948%. The results showed that age and contact history were the main factors affecting the public stigma of mental disorders. It is recommended to reduce discrimination by enhancing understanding and improving empathy. Specifically, it is to implement the personal liability for discrimination through ethical regulation and legal construction, and strengthen the concept of a community of shared future for mankind by creating a tolerant social atmosphere, so as to achieve an appropriate balance between public safety and individual rights and interests.
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BACKGROUND:Exosomes have become one of the frontiers of biomedical research in recent years because of their promising applications in clinical diagnosis and therapy. OBJECTIVE:To reveal the basic research and technology development trend of exosomes at home and abroad,and provide suggestions for related scientific and technological research and development in China. METHODS:This paper presented a quantitative analysis of the overall research and development situation,the frontier hotspots and future development trends in this research area by means of bibliometric methods and tools. RESULTS AND CONCLUSION:The research and development hotspots in this area have entered a high growth phase with the application of new tools and methods.Many new technologies and products are facing clinical applications and markets with the development of a large number of clinical translation experiments.Comparative analysis at home and abroad reveals that China has made more remarkable achievements in basic research in this field,but there are still weaknesses in the possession of independent intellectual property rights,clinical technology translation,and regulatory system standardization and management,which need to be further strengthened in the future.
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Objetivo: Analizar la relación entre las experiencias en las actividades de disfrute, la claridad en el autoconcepto y la percepción de un futuro significativo en jóvenes que cursan estudios superiores durante la pandemia de covid-19. Método: Participantes: estudiantes (n = 228), de ambos sexos de distintas carreras de nivel superior de Buenos Aires. Instrumentos: Cuestionario sociodemográfico. Cuestionario de los posibles sí mismos. Escala de propósito vital para estudiantes universitarios. Escala de claridad en el autoconcepto. Escala de Disfrute en la Actividad. Escala de Autorrealización en la Actividad. Escala de Indicadores Físicos y Psicoemocionales de Estrés. Resultados: más de la mitad de los estudiantes (65,8 %) percibe grandes cambios en su actividad de disfrute durante la cuarentena, pero estos no se relacionan con la percepción de un futuro significativo. La claridad en el autoconcepto predice la probabilidad de alcanzar los posibles sí mismos deseados y la búsqueda de propósito vital. La claridad, el afecto positivo y la autorrealización predicen la identificación de propósito vital. Las variables estudiadas se asocian a menores síntomas de estrés. Conclusión: los resultados muestran la necesidad de favorecer estas experiencias, así como la exploración del autoconocimiento, valores e intereses, que promuevan la identificación de metas, como factor de protección frente a los efectos y consecuencias del contexto actual.
Objective: Analyze the relationship between experiences in enjoyment activities, self-concept clarity and the perception of a significant future in young people who are pursuing higher education during the covid-19 pandemic. Method: Participants: students (n = 228), of both sexes who were studying different higher-level careers in Buenos Aires. Instruments: Sociodemographic questionnaire. Possible Selves Questionnaire. Purpose in Life Scale for College Students. Self-concept clarity Scale. Scale of Enjoyment in Activity, Scale of Personal Achievement. Scale of Physical and Psychoemotional Indicators of Stress. Results: More than a half of the students (65,8 %) perceive great changes in their enjoyment activity during the quarantine, but these are not related to the perception of a significant future. Self-concept clarity predicts the probability of attaining possible desired selves and the pursuit of purpose in life Clarity, positive affect, and self-actualization predict purpose in life identification. The variables studied are associated with fewer stress symptoms. Conclusion: The results show the need to favor these experiences, as well as the exploration of self-knowledge, values and interests, which promote the identification of goals, as a protective factor against the effects and consequences of the current context.
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Environmental laws and energy laws have always been a topic of debate among policymakers, legal scholars, and environmentalists. While environmental laws aim to protect the environment and natural resources, energy laws are designed to ensure a reliable and secure energy supply. The Indian government has implemented several laws and policies to protect the environment and promote renewable energy in recent years. This paper provides a comparative analysis of environmental laws and energy laws generally as well as in India to understand the effectiveness of the legal framework governing these areas and identify areas where improvements can be made. The Environmental Protection Act, Wildlife Protection Act, and Water (Prevention and Control of Pollution) Act are the major environmental laws in India, while the Electricity Act, National Tariff Policy, and National Electricity Policy govern the energy sector. Despite the efforts made by the government, India still faces several environmental and energy challenges, including air pollution, water pollution, deforestation, high cost of renewable energy, and limited availability of energy storage solutions. The paper highlights the need for the Indian government to take bold steps to enforce environmental laws and promote renewable energy to ensure a sustainable and secure energy future for its citizens while protecting the environment for future generations. The paper concludes that both environmental laws and energy laws are important for ensuring a sustainable future, and that there is a need to strike a balance between the two.
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Background: Formative assessment (FA) is part of the assessment process according to the new competency based medical education curriculum and is believed to improve learning. Feedback from students is an integral part of FA which, if incorporated, may help in optimizing content and application of future FAs. Hence, the current study was conducted to assess feedback from 2nd year medical students regarding FAs in Pharmacology. Aim and Objectives: The objectives of the study were to assess the emotional impact of FA on students and to analyze their suggestions regarding FA. Materials and Methods: A well-designed, structured, and pre-validated questionnaire was filled by consenting students who had written the FA. The responses were compiled in an excel sheet and statistically analyzed. Results: Out of 121 students, 115 took FA and of them 100 students filled the questionnaire (Response rate 86.95%). When it comes to emotional impact, 64% students did not find these assessments burdensome and 81% were motivated to study better. When it comes to future suggestions, 100% wanted to be pre-informed. About 88% wanted a written assessment. About 75% wanted only multiple choices questions (MCQs) and 70% wanted MCQs + Essay type questions. About 65% students wanted FAs in practicals but only 36% wanted it in the same paper as theory FA. Conclusion: FA is a good tool to enhance learning which is not a burden on students but a good motivator for better reading. Students prefer a pre-informed, written assessment with MCQs over essay type questions and want these FAs to be conducted in practical’s also but not in the same paper.
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In recent years there is a rapid rise in coming out of sexual and gender minority adults to their family members and society. Unfortunately, studies on unmet health needs of transgenders with a special focus to mental health is under-researched in India. The current paper aimed to explore about the mental health of transgenders and a literature search was done using PubMed, Google Scholar, and Scopus databases for the following medical subject headings (MeSH) key terms “transgender”, “mental Health”, “social stigma”, “LGBT”, “gender dysphoria”, “genderqueer”, “intersex”, “MSM”, “hijra”, “gay”, “lesbian”, “bisexual”, and “homosexual”. Transgender individuals were found to show high rates of mental health concerns. The most common mental health problems that we have shown in this review article are depression, obsessive-compulsive disorders, generalized anxiety disorders, suicidal attempts and bipolar disorders. Transgender people are at more risk for mental health problems than their heterogenous counterparts. The intervention program to eliminate or reduce these problems needs to be planned carefully, considering all the determinants
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Introduction: the first COVID-19 case in Brazil was confirmed on February 26, 2020. As of March 17, 2023, the Ministry of Health reported 699,634 deaths from COVID-19, with a case fatality rate of 1.9%. The impact of the COVID-19 pandemic in Brazil extends to socioeconomic and healthcare systems, reflecting significant regional disparities. Objective: To analyze mortality, incidence, and case fatality rates for COVID-19 in the states of Paraná and Santa Catarina, in the southern region of Brazil. Methods: This is an ecological time-series study using official Brazilian secondary data for COVID-19 cases and deaths. Data were extracted from the dashboard of the State Health Department of Santa Catarina and Paraná. Temporal series were developed for trend analysis using the Prais-Winsten regression model. Statistical analyses were performed using STATA 14.0 software (College Station, TX, USA, 2013). Results: In the analysis of rates over the entire period, trends for mortality, case fatality, and incidence in the state of Santa Catarina are decreasing, decreasing, and stationary, respectively. In Paraná, rates over the entire period showed a stationary trend for mortality, decreasing for case fatality, and increasing for incidence. Conclusion: COVID-19 had a devastating effect on the states of Santa Catarina and Paraná. Both states experienced the progression of the COVID-19 pandemic, with higher case fatality and mortality rates observed in Paraná, while Santa Catarina had a higher incidence rate over the three years of the COVID-19 pandemic.
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Described as a "don't eat me" signal, CD47 becomes a vital immune checkpoint in cancer. Its interaction with signal regulatory protein alpha (SIRPα) prevents macrophage phagocytosis. In recent years, a growing body of evidences have unveiled that CD47-based combination therapy exhibits a superior anti-cancer effect. Latest clinical trials about CD47 have adopted the regimen of collaborating with other therapies or developing CD47-directed bispecific antibodies, indicating the combination strategy as a general trend of the future. In this review, clinical and preclinical cases about the current combination strategies targeting CD47 are collected, their underlying mechanisms of action are discussed, and ideas from future perspectives are shared.
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ObjectiveTo explore the influence of future time insight on academic procrastination and the role of self-control among secondary vocational students， and to provide references for mental health education of them. MethodsA total of 1 419 secondary vocational students from 2 secondary vocational schools in Huangshan City Anhui Province were selected as the research objects in June 2022. The future time insight questionnaire for adolescents， the academic procrastination questionnaire for middle school students and the Self-Control Scale （SCS） were used to assess the future time insight， academic procrastination and self-control ability of secondary vocational students. The mediating effect test of PROCESS was used to analyze the mediating role of self-control between future time insight and academic procrastination. Results①There was a positive correlation between the future time insight questionnaire for adolescents score， the SCS score and the academic procrastination questionnaire of middle school students score （r=0.558， 0.470， P<0.01）. ②Both future time insight and self-control could positively predict academic procrastination （β=0.463， 0.218， P<0.01）， while future time insight could positively predict self-control （β=0.348， P<0.01）. ③Self-control partially mediated the relationship between future time insight and academic procrastination ［indirect effect=0.076 （95% CI： 0.052~0.101， P<0.01）， and the indirect effect accounted for 16.41% of the total effect］. ConclusionThe future time insight of secondary vocational students can affect academic procrastination directly or indirectly through self-control， which partially mediates the relationship between future time insight and academic procrastination.
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Objective:To explore the chain mediating effect of future orientation and academic engagement between perceived teacher support and academic procrastination in high school students.Methods:From December 2021 to February 2022, a survey was conducted on 550 high school students by the perceived teacher support questionnaire, the adolescent future orientation scale, the academic engagement scale, and the general procrastination scale-for student populations (GPS). Data were entered by EpiData 3.1 software, and SPSS 26.0 software was used to process and analyze the data by one-way ANOVA, Pearson correlation analysis and Bootstrap method test.Results:The scores of perceived teacher support, future orientation, academic engagement and academic procrastination were (3.77±0.80), (3.22±0.48), (68.11±18.08) and (52.32±11.78) respectively.The results of correlation analysis showed that academic procrastination was negatively correlated with perceived teacher support, future orientation and academic engagement ( r=-0.32, -0.38, -0.49, all P<0.01), while perceived teacher support was positively correlated with future orientation and academic engagement ( r=0.40, 0.43, both P<0.01). Future orientation was positively correlated with academic engagement ( r=0.56, P<0.01). The mediating effect analysis showed that perceived teacher support had a significant direct effect on academic procrastination (effect value: -0.10, 95% CI =-0.19--0.02), accounting for 32.26% of the total effect.The mediating effect between perceived teacher support and academic procrastination was found between future orientation and academic engagement (effect value: -0.05, 95% CI =-0.09- -0.02; effect values: -0.09, 95% CI=-0.15--0.05), accounting for 16.13% and 29.03% of the total effect respectively.Future orientation and academic engagement had a chain mediating effect between perceived teacher support and academic procrastination (effect value: -0.07, 95% CI=-0.10--0.04), accounting for 22.58% of the total effect. Conclusion:Perceived teacher support can influence academic procrastination, not only through the direct path, but also through the indirect path of future orientation and academic engagement, as well as chain mediating path between these two variables.
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Health behavior decision-making often involves the balance of gains and losses at different time points,which affects the choice and maintenance of health behaviors.As a cognitive processing method of"pre-experiencing"future events,Episodic Future Thinking(EFT)can promote the formation of health intentions and health behavior change by increasing the value of future health outcomes.This paper reviews the concept,intervention model and action effect of EFT in health behaviors,in order to provide references for nurses to innovate health education and behavior management from the perspective of behavioral economics.
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Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can induce accelerated regeneration of future liver remnant (FLR) and provide the opportunity of radical resection for previously inoperable patients with liver cancer, which has been considered to be one of the most important breakthroughs in liver surgery during the 21st century. It is of great significance to fully understand the mechanism of accelerated liver regeneration induced by ALPPS. This article comprehensively reviews the research progress in this field during the past 10 years.
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Constructing a doctor-patient community with a shared future requires efforts from both the medical supply side and the patient demand side, with special attention to the needs of patients. Continuously meeting and improving the needs of patients is the starting point, ultimate goal, and evaluation standard for constructing a doctor-patient community with a shared future. Therefore, this paper proposed the proposition of "what patients need", that is, what needs do patients have and how to meet their needs. The fundamental needs of patients are to diagnose and treat diseases and recover from illness, which are specifically manifested in the demands to narrate the disease’s feelings, the willingness to participate in medical decision-making, the experience of diagnosis and treatment in the process of medical treatment, and the satisfaction evaluation of the hospital’s performance appraisal. On the basis of clarifying the needs of patients, this paper proposed the paths and methods to meet patients’ needs, and provided new ideas for constructing a doctor-patient community with a shared future.
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Doctor-patient shared decision-making is a medical decision-making model that involves mutual interaction and communication between doctors and patients. The lack of patient’s subjectivity is mainly manifested in the departure of patients’ "subject" caused by the deviation of medical purpose and the influence of traditional culture, the weak position of patients formed by the difference in the strength of social role, the obstacle of doctor-patient communication caused by the difference of disease situation perception, etc., which has become a prominent problem hindering the development of doctor-patient shared decision-making mode. Taking the mutual subjectivity of doctors and patients as the premise, effective doctor-patient communication as the basis, and doctor-patient shared decision-making as the main axis, the construction of concentric medical care under a doctor-patient community with a shared future can help build up the subjectivity and mutual relationship between doctors and patients, and provide a path for the retrieval of patient subjectivity.
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Since the first medical reform, China has carried out three reforms and improvements to the medical system. However, there are still some shortcomings, the problems at different levels are mainly reflected in the doctor-patient relationship. Doctor-patient conflict has become one of the hot topics of social focus. Under the development of the country and the joint efforts of all parties, doctor-patient conflict has been alleviated to a certain extent, and the doctor-patient relationship has been developing in a better direction. With the proposal of the concept of "doctor-patient community with a shared future", the joint construction of a community between doctors and patients has become a further goal. Mencius’ theory of original goodness of human nature echoes the construction of the contemporary doctor-patient community with a shared future. It criticizes the empirical theory of human nature and emphasizes the constructive and initiative of goodness in nature, that is, to achieve goodness in nature through preservation and expansion. In the doctor-patient relationship, goodness in nature is the construction of doctor-patient community with a shared future, which requires both doctors and patients to work together with firm confidence and gradually complete the construction of the community by continuous practice.