Application research of GLTC doctor-patient communication mode combined with case-oriented teaching in prosthodontics practice teaching / 中华医学教育探索杂志

Objective:To explore the application of GLTC (goodwill, listening, talking, and cooperation) doctor-patient communication mode combined with case-oriented teaching in prosthodontics practice teaching.Methods:Thirty undergraduates majoring in stomatology who practiced in West China/Hospital of Stomatology, Sichuan University from July 2019 to July 2020 were selected and randomly divided into the control group ( n=15) and the observation group ( n=15). The control group used the case-oriented teaching, and the observation group adopted the GLTC doctor-patient communication mode combined with the case-oriented teaching. The performance of clinical practice (theoretical performance, medical record analysis performance, operation performance, lecture performance), interns' doctor-patient communication ability, and interns' teaching subjective evaluation of the two groups were evaluated. SPSS 22.0 was used for t-test and Chi-square test. Results:The theoretical performance, medical record analysis performance, operation performance, and lecture performance of the interns in the observation group were better than those in the control group ( P < 0.05). The score of Liverpool doctor communication ability evaluation scale in the observation group was higher than that in the control group ( P<0.05). In the subjective evaluation of the teaching mode of the interns, the improvement of learning interest, collective awareness, language expression ability, comprehensive analysis ability, and clinical operation ability in the observation group were better than those in the control group ( P<0.05). Conclusion:The GLTC doctor-patient communication model combined with the case-oriented teaching method is effective in prosthodontics practice teaching, which can effectively improve the professional knowledge and skills of interns and improve their teaching satisfaction and doctor-patient communication ability.

Dinámica ambiental en la Eco-región Lachuá: una representación espacial desde la perspectiva de los guardarecursos / Environmental dynamics in Lachuá Ecoregión: a spatial representation from park rangers perspective

El mapeo participativo es una modalidad de interacción horizontal entre los actores implicados en procesos de toma de decisiones, que tiene como finalidad la representación gráfica del territorio. Para ello, se combina la percepción local con herramientas modernas de cartografía. Con la finalidad de documentar la percepción espacial de los guardarecursos del Parque Nacional Laguna Lachuá (PNLL) con relación a la dinámica de la biodiversidad actual en la Eco-región Lachuá, se utilizó la herramienta del mapa hablado durante un taller con los 11 guardarecursos del parque en 2018. Los mapas de la Eco-región se dividieron en cuatro zonas: Noreste (NE), Sureste (SE), Suroeste (SO) y Noroeste (NO), dentro del PNLL como en la zona de amortiguamiento. Se contabilizaron los elementos favorables y desfavorables para la biodiversidad reportadas para cada zona. Se comparó la información proporcionada por los guardarecursos con las imágenes satelitales de la Eco-región mediante un análisis de Sistemas de Información Geográfica (SIG). De esta manera, se brinda un enfoque integral para comprender los patrones del paisaje actual, ya que estos son resultado de procesos socio-económicos y políticos que culminaron en conflictos del manejo de la tierra y los recursos. Se identificó que en el PNLL los elementos desfavorables más reportados fueron los cultivos, carreteras y asentamientos humanos. En la zona de amortiguamiento los elementos desfavorables corresponden a los cultivos, (p.ej.: palma africana) y los asentamientos humanos. Además, las áreas con mayor cobertura boscosa son las zonas NE y NO en el PNLL.

Participatory mapping facilitates horizontal interaction among interested parties in decision-making processes, which pursues the graphic representation of the territory. This technique unifies local perception with modern cartography. It eases communication and has been used to document spatial representations and resource management thus, integrating tools such as a Geographic Information System (GIS) might facilitate solutions in land conflicts and community governance. In this article, we share the findings regarding the spatial perception biodiversity dynamics of park rangers in National Park Laguna Lachuá (PNLL) during a workshop in 2018, documented through the "talking maps" tool. To analyze each map, we used GIS sofware, by dividing the PNLL and its buffer zone into four quadrants: Northeast (NE), Southeast (SE), Southwest (SO), and Northwest (NO). We registered every record reported by the park rangers from a list of positive and negative elements that have an effect on biodiversity. We then compared the information reported with spatial layers in GIS to evaluate which elements were detectable and viceversa. This is relevant since participatory mapping allows a more integral understanding of landscape patterns than GIS on its own and given the fact that the actual landscape is the result of several socio-economic and political processes that have created land and resource management conflicts. We identified that the unfavorable elements inside the PNLL are agriculture, roads, and human settlements, and in the buffer zone were agriculture, African palm, and human settlements. The quadrants with more forest cover corresponded to NE and NO inside the park.

Identity, Care and Rights: the Experience of Talking Circles about the Health of Indigenous People / Identidade, Cuidado e Direitos: a Experiência das Rodas de Conversa sobre a Saúde dos Povos Indígenas

Abstract: Introduction: There is a historical fragility regarding the training of health care professionals working with the Indigenous Health System in Brazil and the awakening of the growing sensitivity for the promotion of intercultural dialogue is recognized as essential in this context. Thus, the project "Talking Circles about the Indigenous People's Health" in the university emerged in 2016, developed in a partnership between medical school professors and indigenous students from the Indigenous Tutorial Education Program - PET Indígena - Health Actions, UFSCar. Method: This report is based on the qualitative documental analyses, aiming to present and discuss the experiences, perspectives and dialogues carried out during those meetings, the construction of diversity, the description of the activities performed and the exposure of their potentialities and limits. Results: Based on both Paulo Freire's Culture Circles and active teaching-learning methodology tools, those meetings dealt with topics related to Indigenous People's Health, the results of which were here grouped into three categories: Identity; Care; and Indigenous Rights. The Talking Circles format fostered the construction of new knowledge in indigenous health's field related to different cultures, specific health policies, concepts of health-disease process, providing an initial approach on the indigenous health context in Brazil. Additionally, they provided a space with indigenous leadership that dared to indicate innovative perspectives on identity issues and health understandings, disease and healing processes, as well as raising the epistemology inherent to these populations. Conclusions: Based on the dialogue between different actors, it was possible to arouse interest of the health professionals regarding ethnic and cultural issues and give visibility to the indigenous people at the University. Moreover, it can be a first step towards the construction of optional interdisciplinary disciplines and the insertion of the topic in undergraduate school curricula in the health area.

Resumo: Introdução: Há uma fragilidade histórica na formação dos profissionais da atenção à saúde indígena no Brasil e reconhece-se o despertar da sensibilidade para situações de diálogo entre diferentes culturas como essencial nesse contexto. Assim, surge em 2016 o projeto de extensão "Rodas de Conversa sobre a Saúde dos Povos Indígenas", criado numa parceria entre professores de Medicina e estudantes indígenas do Programa de Educação Tutorial Indígena - Ações em Saúde, da Universidade Federal de São Carlos. Método: Este é um relato sobre os três anos dessa experiência, tendo sido construído a partir de uma análise documental de abordagem qualitativa. Os objetivos foram resgatar os temas e conteúdos desenvolvidos e discutir as vivências, as perspectivas e os diálogos desse espaço de encontro. Ao longo do texto há descrição das atividades realizadas e reconhecimento de suas potencialidades e seus limites. Resultados: Com base nos círculos de cultura e instrumentos de metodologias ativas de ensino-aprendizagem, os encontros trataram de temas relacionados à saúde indígena, aqui agrupados em três categorias: identidade, cuidado e direitos indígenas. O formato em rodas de conversa possibilitou a construção de saberes no campo da saúde indígena relacionados às diferentes culturas, às políticas de saúde específicas e às concepções do processo saúde-doença, propiciando aproximação inicial com o contexto de saúde indígena no Brasil. Adicionalmente, proporcionou um espaço com protagonismo indígena que ousou apontar para olhares inovadores sobre questões identitárias e compreensões de saúde, doença e processos de cura, levantando inclusive epistemologias intrínsecas a essas populações. Conclusões: A partir do diálogo entre diferentes atores, foi possível despertar o interesse dos participantes para especificidades étnico-culturais e dar visibilidade à presença dos indígenas na universidade. Além disso, pode ser um primeiro passo para a construção de disciplinas interdisciplinares optativas e a inserção da temática nos currículos de graduação na área da saúde.

Living with a Chronic Disease: Preparation, Information, Talking and Thoughts about the Disease

Chronic diseases have an impact on and change the lives of people with them. The chronic disease is part of coping strategies relating to the way a person thinks and acts in order to cope with a stressful situation. The study focuses on four chronic diseases: Asthma-allergy, diabetic mellitus, cancer, inflammatory rheumatic arthritis. All the diseases influence daily life in a practical as well as emotional way. The diseases may seem different, but they can all have a life-threatening component, even if the focus on this may vary in common opinion. The objectives of this article are to describe how patients with a chronic disease were prepared for having a chronic disease, experienced the information they receive if they can talk about the disease and what they think about the disease. Despite there being four diseases in this study, the result pointed to similarities between them. Talking to others about their disease can help patients cope with the situation of having a chronic disease. For all health care professionals meeting patients with chronic diseases, the knowledge from the study can be helpful when the treatment in different ways as well as practical and emotional support to help those patients live as good a life as possible.

Systems-Based Interactome Analysis for Hematopoiesis Effect of Angelicae sinensis Radix: Regulated Network of Cell Proliferation towards Hemopoiesis / 中国结合医学杂志

OBJECTIVE@#To explore the molecular-level mechanism on the hematopoiesis effect of Angelicae sinensis Radix (ASR) with systems-based interactome analysis.@*METHODS@#This systems-based interactome analysis was designed to enforce the workflow of "ASR (herb)→compound→target protein→internal protein actions→ending regulated protein for hematopoiesis". This workflow was deployed with restrictions on regulated proteins expresses in bone marrow and anemia disease and futher validated with experiments.@*RESULTS@#The hematopoiesis mechanism of ASR might be accomplished through regulating pathways of cell proliferation towards hemopoiesis with cross-talking agents of spleen tyrosine kinase (SYK), Janus kinase 2 (JAK2), and interleukin-2-inducible T-cell kinase (ITK). The hematopoietic function of ASR was also validated by colony-forming assay performed on mice bone marrow cells. As a result, SYK, JAK2 and ITK were activated.@*CONCLUSION@#This study provides a new approach to systematically study and predict the therapeutic mechanism for ASR based on interactome analysis towards biological process with experimental validations.

História de uma análise interrompida / Story of an interrupted psychoanalysis / Historia de un análisis interrumpido / Histoire d'une psychothérapie interrompue

A brusca interrupção de um processo analítico remete o autor a uma reflexão, em que constata indícios de hostilidade surgidos no vínculo com o paciente, ressaltando-se a importância do binômio inveja-gratidão. O analista correlaciona aspectos de inveja e ressentimento, experimentados pelo analisando, com o comprometimento da capacidade de sonhar a dois e o prejuízo para a evolução do trabalho. Aborda ainda a teorização sobre a função desobjetalizante como elemento essencial para uma compreensão atual do conceito de pulsão de morte.

The sudden interruption of a psychoanalytic process leads the author to this written reflection. He notices evidences of hostility which has arisen from his relationship with the patient. The author highlights the importance of the envy- gratitude binomial. He relates the feelings of envy and resentment the patient experiences to the hindering of their abitlity to “dream together”, and therefore, the hindering of the analytic work and its progress. The author deals with the theory of the disobjectalizing function as a vital element to today's comprehension of the concept of death drive.

La interrupción brusca de un análisis remite al autor a una reflexión en la que constata indicios de hostilidad surgidos en el vínculo, señalando la importancia del binomio envidia-gratitud. El analista correlaciona aspectos de envidia y resentimiento, experimentados por el paciente, que compromete la capacidad de “soñar a dos” y el perjuicio para la evolución del trabajo. Aborda también la teorización sobre la función desobjetalizante como elemento esencial para una comprensión actual del concepto de pulsión de muerte.

La brusque interruption d'un processus analytique mène l'auteur à une réflexion où il constate des indices d'hostilité surgis dans le lien établi avec le patient, en soulignant l'importance du binôme envie-gratitude. L'analyste met en corrélation des aspects d'envie et de ressentiment éprouvés par l'analysant avec l'endommagement de la capacité de « rêver à deux ¼ et la détérioration du travail. Il aborde encore la théorisation concernant la fonction désobjectalisante en tant qu'un élément essentiel pour une compréhension actuel du concept de la pulsion de mort.

Os corpos falantes e a normatividade do supersocial / The speakers bodies and the normativity of supersocial

À convite de Tania Coelho dos Santos, Lêda Guimarães realiza uma leitura do texto “Do supereu sujeitado à lei simbólica à normatividade supersocial dos corpos falantes” (Coelho dos Santos, 2014). Na leitura que Lêda Guimarães realiza sobre o texto de Tania Coelho, dois temas indispensáveis para a formação dos psicanalistas de orientação lacaniana ficam em destaque: o exame dos elementos estruturais das neuroses contemporâneas e a política do dispositivo do passe da Associação Mundial de Psicanálise...

Upon Tania Coelho dos Santos’s invitation Leda Guimarães performs a reading of the text: “From the superego subject to the symbolic law to the supersocial normativity of the talking bodies” (Coelho dos Santos, 2014). Two topics of fundamental importance for the training of Lacan oriented psychoanalysts arise from Leda Guimarães’s reading of Tania Coelho’s work: the exam of the structural elements of contemporary neurosis and the politics involving World Psychoanalysis Association, pass mechanism...

Invitée par Tania Coelho dos Santos, Leda Guimarães réalise une lecture de son texte “Du surmoi assujetti a la loi du symbolique a la normativité super sociale des corps parlants” (Coelho dos Santos 2014). De la lecture réalisée par Leda Guimarães du texte de Tania Coelho surgissent deux thèmes de la plus grande importance pour la formation des psychanalystes d’orientation lacanienne: l’examen des éléments structurels de la névrose contemporaine et la politique du dispositif de la passe de l’Association Mondiale de Psychanalyse...

Participación comunitaria para la construcción e lineamientos de uso y conservación de humedales altoandinos. experiencia piloto en el sector el ocho y páramo de letras / Communty particiipation in the construction of guidelies for the use and conservation of the high andean wetlands, a pilot experience in the ocho and páramo de letras arass

La participación comunitaria es un aspecto relevante en la toma de decisiones para la implementación de acciones relacionadas con la protección del patrimonio natural. Objetivo: En el presente trabajo el principal objetivo es la construcción participativa de los lineamientos de uso y conservación de humedales en el sector El Ocho y Páramo de Letras. Método: La metodología comprende los siguientes pasos: 1) revisión de información secundaria; 2) una zonificación ambiental participativa de los sistemas productivos mediante la técnica de mapas parlantes, con la ayuda de la herramienta de AutoCAD; y 3) análisis del potencial turístico y florístico con base en los saberes tradicionales, y utilizando entrevistas con la comunidad, potenciales turistas y charlas informales. Resultado principal: La comunidad tiene conocimiento tradicional de los beneficios que ofrecen los recursos del ecosistema, pero no tiene las herramientas para lograr un sistema productivo sostenible; la zona de estudio tiene un gran potencial turístico, debido a las ventajas de paisaje e infraestructura; el uso actual del suelo es inadecuado con respecto a la normatividad ambiental. Conclusión principal: Es necesario formular e implementar estrategias de uso y conservación de humedales altoandinos que sean adecuados a las particularidades del ecosistema bajo estudio, puesto que las estrategias existentes a nivel nacional e internacional son muy generales.

Community participation is a relevant aspect in decisions making concerning the implementation of actions related to protection of natural heritage. In the present work, the main purpose is the participative construction of the guidelines for the use and conservation of wetlands in El Ocho and Páramo de Letras. The methodology includes the following steps: 1) review of secondary information; 2) a participatory environmental zoning of the productive systems using the talking maps technique and the AutoCAD tool; and 3) floral and touristic potential analysis, on the basis of traditional knowledge, by means of interviews to the community, potential tourists and informal talks. The main result of this research indicates that the community has traditional knowledge of the benefits offered by the ecosystem resources, but they do not have the necessary tools to achieve a sustainable productive system. The study area has a great touristic potential, due to its advantages of landscape and infrastructure but the current use of the land is inadequate according to the environmental law. The main conclusion of the work is that it is necessary to formulate and implement strategies for use and conservation of High Andean Wetlands which are adequate for the ecosystem under study, as the current national and international strategies are too general.

A emergência da cura pela palavra na medicina mental do século XIX / The emergence of the talking cure in 19-century mental medicine / La naissance de la thérapie par la parole au 19e siècle / La emergencia de la terapia por la palabra en la medicina mental del siglo XIX

Este artigo analisa algumas das condições de possibilidade da emergência da terapia pela palavra no rol de terapêuticas médicas no fim do século XIX. A hipótese é de que o processo de construção do psiquismo, como objeto médico, está relacionado à emergência de categorias de doença referidas a sintomas sem explicação anatômica, como foi o caso da neurastenia, da histeria e da psicastenia, que contribuíram para tornar insuficiente a referência à organicidade como causa de doenças mentais e para a criação de um novo gênero de clínica centrado na fala.

This paper analyses the conditions present for the emergence of the talking cure as one among other medical therapies in the late 19th century. The hypothesis is that the construction of the psychism as a medical object is related to the emergence of medical categories for symptoms that seem to have no anatomical basis, such as neurasthenia, hysteria and psychosthenia. These categories helped show that purely organic explanations were insufficient to explain many symptoms. They therefore contributed to the establishment up a new style of clinical treatment based on speech.

Cet article analyse quelques conditions qui ont favorisées le surgissement de la thérapie par la parole parmi d'autres thérapeutiques médicales à la fin du XIX siècle. Notre hypothèse défend que le processus de construction du psychisme comme objet de la médicine va de pair avec le surgissement des catégories des maladies dont les symptômes n'ont pas de cause anatomique, comme la neurasthénie, l'hystérie et la psychasthénie. Celles-ci ont contribué à la conclusion que les explications organiques sont insuffisantes, ainsi qu'à la création d'un nouveau genre de clinique centrée sur la parole.

Este artículo presenta algunas condiciones que permiten tratar el psiquismo através del surgimiento de la terapia por la palabra en las terapéuticas medicas a finales del siglo XIX. La hipótesis que se defiende es la de que el proceso de construcción del psiquismo como objeto médico está relacionado con el surgimiento de categorías de enfermedades para síntomas sin explicación anatómica, como la neurastenia, la histeria y de la psicoastenia que contribuyeron para tornar insuficiente como causa la organicidad y para la creación de un nuevo genero de clínica centralizado en la palabra.

The Effect of Mother-fetus Interaction Promotion Program of Talking and Tactile Stimulation on Maternal-fetal Attachment / 아동간호학회지

The purpose of this study is to investigate the effect on mother-fetus attachment through mother-fetus interaction promotion program of talking and tactual stimulation aimed at enhancing sensitivity of primipara Non-equivalent control group posttest design was used. Fifty primiparas (26 mothers for intervention group and 24 mothers for control group) were recruited from three general hospital and an OBGY clinic located in Gang Nung city. Data was collected from January 30th to December 20th in 2001. For the intervention group, programed education which focused on mother-fetus interaction promotion of talking and tactile stimulation in the 1st trimester. Telephone counselling was provided with interval of two weeks. For two groups, home visiting for data collection of mother-fetus attachment was conducted at 36 to 38 weeks of gestational age. The data were analyzed using chi-square test and Fisher' Exact test to test the equivalence of two groups, and the effect of intervention program was determined with t-test. The result was as follow: The significant difference was found in mother-fetus attachment between two groups(t= 2.772, P= 0.0079). It indicated that intervention program was effective in improving mother-fetus attachment. In conclusion, this study has shown that the applied nursing intervention aimed at enhancing sensitivity of primiparas to fetus's movement promoted mother-fetus attachment. Therefore, this study suggests that this nursing intervention to increase maternal sensitivity to the fetus's movement should be broadly applied to primiparas, which can be beneficial for formation of mother-infant relationship, and for promotion of the social, affective, and cognitive developments of their children.

Factors Related to Patient Satisfaction in an Outpatient Clinic

BACKGROUND: Recently, physicians have been challenged to see more patients per office session while maintaining patient satisfaction. We examined the variables related to patient satisfaction with the time spent with physician during office visit. METHODS: In the department of family medicine of an university hospital, a trained researcher observed patient visits by VTR and collected additional data using medical record reviews and patient exit questionnaires from July 1 to July 31, 2002 The data was analyzed statistically by SPSS ver11.0/PC . RESULTS: Visits by 103 patients were observed in this study. Age, functional health status, time of Dr.'s talking to patients and the ratio of Dr.'s talking time to visit length were significantly associated with patient satisfaction (P<0.05). Sex, marital status, education level, new vs. established patient, reason for visit, visit length, number of problems, number of medications, body mass index, and satisfaction for time spent were not significantly associated with patient satisfaction. According to logistic regression analysis, greater patient satisfaction were associated with better perceived health status, with more ratio of Dr.'s talking time to visit length and with age younger than 40 years. CONCLUSION: Physician can enhance patient satisfaction during an office visit by spending sufficient time to talk with patients during each visit and should take an interest in elderly patients and patients with multiple problems.

Elementary lntdroduction of Applying the lndividual Talking to the Medical Ethice Education / 中国医学伦理学

lndividual talking is an important method to solve the concrete medical ethics problems.The contents of the individual talking must be touching,authentic and true.And the teacher should be like a doctor to suit the remedy to the case.Moreover,the teacher should choose the right opportunity and pay attention to the ways of expression,in order to get better practical result in medical ethics education,and raise the medical ethics level of the medical students.