Kasurdi Health and Demographic Surveillance System: A Profile and Way Forward

Kasurdi Health and Demographic Surveillance System (Kasurdi HDSS) was established at Rural Health Training Center Kasurdi on February 16, 2018. Kasurdi HDSS has been established to increase the research potential of medical colleges and develop real?time data for research purposes to study the changes in population demography, health, and health?care utilization. Kasurdi HDSS currently follows 2755 individuals living in 549 households. The system collects the data from the population through annual rounds conducted by postgraduate residents of the department of community medicine. The data are collected in the digital format with the help of android-based tablets. HDSS has collected demographic data, reproductive data, data on diseases such as tuberculosis and noncommunicable diseases, and socioeconomic data. The HDSS is in the process to upgrade its data management system to a more integrated platform, coordinated and guided by national/international standards, and data sharing policy.

Investigation on the construction status of clinical skills training centers of general hospitals in Yunnan Province / 中华医学教育探索杂志

Objective:To investigate the construction status of clinical skills training centers of secondary and above comprehensive western hospitals in Yunnan Province, and to provide a basis for the scientific, specific and standardized construction and development of clinical skills training centers of hospitals at all levels in Yunnan Province.Methods:The evaluation index of the construction of clinical skills training center was established, and questionnaires were developed to investigate the current situation of the construction of clinical skills training center in the secondary and above comprehensive western hospitals in the whole province. SPSS 17.0 software was used for chi-square test.Results:According to the investigation, 79.1% (72/91) of secondary and above comprehensive western hospitals in Yunnan Province have established clinical skills centers of different scales, but 84.6% (77/91) of them have fewer than 50 teachers participating in clinical skills teaching each year, with weak faculty and big differences in the faculty of hospitals at all levels ( P<0.05). In 64.6% (84/130) of the centers, the simulated teaching courses are only single basic skill courses, and the training content is relatively single, with great differences in the current situation ( P<0.05). Only 33.0% (30/91) of the centers have initially established an internal quality control system, and there are statistically significant differences in the way of conducting quality evaluation ( P=0.023). Conclusion:The foundation of the connotation construction of the clinical skill center is to establish a complete, professional and gradient teaching team and a stepped clinical skills training curriculum system. The construction of a perfect internal quality control system is the vitality of the development of the clinical skill center, and scientific research is the source of the sustainable development of the center.

Awareness and sociodemographic factors of prehypertension among adult cases attending rural health training center of a medical college

Background: Prehypertension elevates the risk of cardiovascular disease and that of end-stage renal disease. The objectives of creating such a category in the classification were to increase awareness of the importance of identifying individuals in whom early intervention by the adoption of healthy lifestyles could lower blood pressure (BP) and thus decrease the rate of progression to hypertensive levels. Objectives: The objectives of the study were to determine the proportion and sociodemographic factors and other risk factors of pre-hypertension among the cases visiting Rural Health Training Centre (RHTC) of a Government Medical College, to know the awareness about prehypertension, and to create awareness among them. Materials and Methods: The present hospital-based cross-sectional study was conducted in RHTC of a Government Medical College from January to February 2015 (2 months). The sample size was 200. All patients 18 years and above visiting outpatient department of RHTC were enrolled in the study. Data were collected using a predesigned and a pretested questionnaire. Results: A total of 210 patients were enrolled in this study. Overall, 101 (48%) had pre-hypertension and 109 (52%) patient had normal BP levels. Increasing age, marital status, occupation, excess salt intake, lack of fruits and vegetables in the diet, addiction, lack of regular exercise, and the presence of obesity (as per body mass index) were significantly associated with pre-hypertension. No study subjects were aware of the concept of prehypertension. Conclusion: Our study highlights the high proportion of prehypertension. The study gives important information regarding various risk factors associated with prehypertension. Simple lifestyle modifications such as low intake of salt and inclusion of fruits and vegetables in the daily diet, quitting an addiction, and regular exercise decreases overall BP. Education regarding lifestyle and dietary practices at individual and family level are needed to bring about effective changes.

Study of morbidity pattern among geriatric patients attending outpatient department of a rural health training center, Maner of IGIMS, Patna

Background: With increasing life expectancy, number of old age people increased throughout the world, particularly more in the developing countries like India. Globally there are an estimated 605 million people aged 60 years and above. As the ageing population is increasing, the burden of their health problems is on a rise. To provide appropriate care for them there is a need to attain information about their morbidity pattern. Objectives: to study the morbidity pattern among the geriatric patients attending outpatient department of RHTC, Maner of IGIMS, Patna and to find out the difference in health problems between males and females, if any.Methods: This hospital based cross-sectional study was conducted during September 2017 to February 2018 among 98 elderly patients, aged 60 years or above, who attended first time at the Out Patient Department of rural health training center, Maner of IGIMS, Patna and who fulfilled inclusion criterion.Results: In this study majority had normal nutritional status. Amongst morbidity, prevalence of locomotors problems was highest (63.26%) followed by depression (42.85%), refractive error (20.4%), hearing loss (18.2%) and cataract (15.3). Locomotors problems were significantly higher in women (93.75%) as compared to the men (34%). However, the prevalence of depression, refractory error, hearing loss and cataract were not significantly associated with gender.Conclusions: There is a need to deliver comprehensive geriatric health care services for prevention and control of chronic diseases and address the dual burden of disease among the elderly to promote healthy ageing.

Improvement of Epidemiology Intelligence Service Officer Program for Preparedness and Response against Future Health Issues Included Communicable and Non-communicable Diseases in Korea / 보건행정학회지

The development and management of epidemiology intelligence service (EIS) officer with more specialized competence to cope with and prepare for health threats, including pandemic of emerging and re-emerging infectious diseases, is a high priority policy issue in Korea. First of all, we need to establish the training goal of EIS officer. It is necessary to establish manpower training and management system with at least three tiers including quantitative and qualitative targets. Second, at least 50% of all EIS officer must secure a physician and secure expertise and competence for epidemic. Third, for the ultimate purpose of EIS officer, the establishment of a public health expert should expand the scope of epidemiologist's work to health and medical care, occupational environment, and various disasters. Fourth, it is essential to expand the epidemiologist training and education program to the level of advanced countries. Especially, the training course should be expanded at least twice of current times. Fifth, it is necessary to independently install and operate the ‘EIS Officer Training Center’ as a mid- and long-term goal. Stewardship and governance are secured with the organization, personnel, etc. that can fully manage the planning, management, and evaluation of the EIS system. In the future, it will be necessary to establish a systematic and phased operational base of education and training programs for EIS officer, and establish a sustainable implementation system for strategy development. In addition, it is urgent to revise the guidelines for training public health professionals and strengthening competencies, and for establishing professional educational institutions.

Practice and exploration of establishing blood purification training center with ppp (Public Private Partnership) model / 第二军医大学学报

Blood Purification Training Center of Shanghai University of Medicine & Health Sciences is the first blood purification training center with PPP (Public Private Partnership) model in China. In this paper, we systematically analyzed the background and different aspects of basic design and teaching management practice of the blood purification training center, and provided the specific improvement opinions for its ownership structure, operation mode and credibility while considering the existing problems of the blood purification training center.

The construction of clinical skills center under the mode of informatization Sun Bihai, Chen Qiao, Liu Hongpo, Xiao Hong / 中华医学教育探索杂志

Taking an actual case as an example, this paper discusses how to integrate the informa-tization concept into the actual construction of the clinical skill center, and introduces the two aspects of the construction and management of the site and the daily business management. The design concept of multimedia standard room has been proposed, and the necessary teaching auxiliary facilities are chosen according to local conditions, all of which ensure the versatility and high cost performance of teaching units. Through the concept of information remote management, the problem of multimedia teaching terminal management is solved. Besides, through the information process reengineering, the daily business problems such as room management, multi-station examination and asset management have been solved, and syn-chronously a multimedia network learning platform has been built. The scheme has highlighted the charac-teristics of practical, efficient and management science and has achieved remarkable results, so it has cer-tain reference and promotion value.

Internet Addiction: Prevalence and Risk Factors: A Cross-Sectional Study among College Students in Bengaluru, the Silicon Valley of India.

Background: The Internet is a widely used tool known to foster addictive behavior, and Internet addiction threatens to develop into a major public health issue in the near future in a rapidly developing country like India. Objective: This cross-sectional study intends to estimate prevalence, understand patterns, and evaluate risk factors for Internet addiction among college students in the city of Bengaluru, India. Materials and Methods: Out of a total of 554 data samples from eight colleges selected through multistage cluster sampling, 515 samples were analyzed. Young’s 20-item Internet Addiction Test (IAT), an inventory including demographic factors and patterns of internet use, was administered. Results: This study of college students aged 16-26 years (mean ± SD 19.2 ± 2.4 years), with marginally high female representation (56%), identified 34% [95% confidence interval (CI) 29.91-38.09%] and 8% (95%, CI 5.97-10.63%) as students with mild and moderate Internet addiction respectively. Binary logistic regression found Internet addiction to be associated with male gender [adjusted odds ratio (AOR) 1.69, 95% CI, 1.081- 2.65, P = 0.021], continuous availability online (AOR 1.724, 95% CI, 1.018-2.923, P = 0.042), using the Internet less for coursework/assignments (AOR 0.415, 95% CI, 0.263-0.655, P < 0.001), making new friendships online (AOR 1.721, 95% CI, 1.785-2.849, P = 0.034), getting into relationships online (AOR 2.283, 95% CI, 1.424-3.663, P = 0.001). Conclusion: The results highlight the vulnerability of college students to Internet addiction. The findings provide explanations on the addictive behavior of the internet users, support the inclusion of “Internet Addiction” in the DSM-VI, and open up new paths for further research.

Mass Chemoprophylaxis in Control of Pneumococcal Pneumonia Outbreak in a Military Training Centre.

Background: Outbreaks of streptococcal pneumonia among young recruits in military training centers are welldocumented. A signifi cant outbreak of pneumonia occurred between November 19, 2011 and February 4, 2012 among the young recruits of a large training center located in Southern India. Objectives: The objective of this investigation was to identify the cause of the outbreak, to control the outbreak at the earliest, and to provide future strategies for containing such an outbreak. Materials and Methods: The outbreak was investigated using standard epidemiological methods so as to describe its epidemiology, to identify the causative organism, to guide the outbreak control efforts, and to provide future strategies for containing such an outbreak. Results: Over 2 months, 58 cases of pneumonia occurred among the recruits of the center, giving an attack rate of 4.81 cases per 1,000 person-months. Radiological positivity was found in 72.4% of the cases. Streptococcus pneumoniae (S. pneumoniae) was grown in all the three bronchoalveolar lavage (BAL) samples. The outbreak rapidly ended following prophylaxis with oral azithromycin. Conclusions: This outbreak of pneumococcal disease occurred in the setting of intense military training and a crowded environment. Oral azithromycin was found to be the suitable strategy for control of the outbreak.

Centro de excelência e ginástica artística feminina: a perspectiva dos técnicos brasileiros / Centre of excellence for women artistic gymnastics: the Brazilian coaches' perspective

Durante o período de 2001-2008, a Confederação Brasileira de Ginástica implementou o sistema de seleção permanente concentrada no Centro de Treinamento (CT) de Curitiba. Através de um formato semelhante às escolas-internato esportivas da antiga União Soviética, as ginastas passaram a treinar juntas sob o comando de um renomado técnico estrangeiro. Este artigo visa apresentar e discutir o contexto deste CT e o sistema de seleção permanente da ginástica artística feminina (GAF) brasileira, a partir da opinião dos técnicos que desenvolvem a modalidade no país. Procedemos a um estudo de campo e entrevistamos 34 treinadores de 29 instituições. Dentre os aspectos positivos da seleção permanente, os sujeitos relacionaram principalmente a infraestrutura disponível às ginastas. Sobre os aspectos negativos, foram citados problemas relacionados ao rigor do treinamento, à polarização e a consequente monopolização das atletas, o que revela que, provavelmente, não houve uma adaptação do modelo soviético às características da GAF desenvolvida no Brasil.

During the period of 2001 and 2008, the Brazilian Gymnastics Confederation implemented the gymnasts training boarding center system at the Curitiba Training Center (TC). Using the former Soviet Union model of sports boarding schools, the Brazilian gymnasts started to train together under the supervision of a technical team led by a renowned foreign coach. This article aims to discuss the context of the TC and the system of centralized preparation of the Brazilian women artistic gymnastics (WAG) showing the point of view of the coaches. We conducted a field survey and we interviewed 34 coaches of 29 sport institutions. Among the positive aspects, the coaches reported about the better infrastructure available to the gymnasts. The negative aspects refer to the problems regarding rigorous training, the polarization and the consequent monopolization of athletes showing lack of adaptation of the Soviet model to the WAG characteristics developed in Brazil.

Postgraduate clinical training program at Fujita Health University Hospital / 医学教育

  Since 2003, Clinical training center of Fujita Health University hospital has been cooperated with the Office for medical education of Fujita Health University, school of medicine, in reorganizing the previous training system based mainly on individual departments. After 9 years since then, we established Yanegawara style training system and the trainee–centered curriculums. Outcomes from new system are as follows:<br>1. Self–establishment by problem based learning became common understandings between trainers and trainees.<br>2. Teaching by trainers to trainees and between trainees （R2 to R1） became common in the hospital.<br>3. Trainees can learn the standardized approach in diagnosis and treatment of the patients in ER.<br>4. Unified understanding of the training system was established in the hospital.Although new system brought several good aspects, we found a large heterogeneity in fulfillment of our curriculums not only by the capability of individual residents but also by the effort induced by each department.

Colangiopancreatografía retrógrada endoscópica: prácticas en un centro hospitalario privado / Endoscopic retrograde cholangiopancreatography: practices in a private hospital

Colangiopancreatografía Retrógrada Endoscópica (CPRE), es un método endoscópico avanzado que posibilita el estudio y tratamiento de la vía biliar y pancreática. Este procedimiento requiere alto nivel de conocimientos y destrezas técnicas para garantizar mínimas complicaciones en el paciente. En nuestro país, existen pocos centros para la formación de gastroenterólogos para desarrollar habilidad en la realización de CPRE. Determinar la casuística en procedimientos de CPRE en un centro privado para proveer los estándares más altos en la capacitación teórica y práctica en las técnicas avanzadas de este procedimiento. Estudio retrospectivo, descriptivo, que incluyó pacientes con patologías bilio-pancreáticas que acudieron a la Policlínica Metropolitana y se les realizó CPRE. Durante el período de estudio se realizaron 815 procedimientos, 486 (59,6%) y 329 (40,36%) eran del sexo femenino y masculino respectivamente. La edad promedio de los pacientes fue 53,34 años, con edades comprendidas entre 2 y 98 años, con 18 menores de 12 años. Las indicaciones más frecuentes: colestasis, litiasis biliar, pancreatitis aguda y crónica. Otras indicaciones: fístula biliar, recambio de prótesis, colangitis y pacientes con tumor bilio-pancreático. Los procedimientos terapéuticos abarcaron desde esfinterotomía hasta ampulectomía, toma de biopsia, colocación de prótesis tanto en vía biliar como pancreática, con resolución del problema en la mayoría de los pacientes. Hubo complicaciones en 36 pacientes (4,17%), las más frecuentes fueron hemorragia (16) y pancreatitis post-CPRE (7), de los cuales 3 fueron severas. No se reportaron muertes debido al procedimiento. En nuestro estudio demostramos que estamos dentro de lo que realiza cualquier centro de entrenamiento reportado en la literatura mundial (número de procedimientos, indicaciones, hallazgos, procedimientos terapéuticos y tasa de éxito...

Endoscopic Retrograde Cholangiopancreatography (ERCP) is an advanced endoscopic procedure that allows the study and treatment of biliary and pancreatic ducts. This procedure requires a higher level of knowledge and technical skills, to ensure a minimal complications outcome of the patient. In our country there are few training centers for gastrointestinal specialists for developing the necessary skills for performing ERCP. To asses the statistics of ERCP procedures that were performed in our private hospital between January 2005 until January 2009, to demonstrate that we possessed the high standars on capacitation, both theorical and practical on performing ERCP. ItÊs a descriptive and retrospective study, including all patients that came to our center with pancreatic or billiary pathology and underwent the procedure. 815 ERCP were performed during the time of the study, 486 (59.6%) were female and 329 (40, 36%) were male. The mean age was 53, 34 years, with range between 2 and 98 years, and 18 patients were younger than 12 years. The main indications for the procedure were cholestasis, billiary litiasis, acute and chronic pancreatitis. Also other indications were billiary fistulae, billiary prothesis placement and replacement, cholangitis and tumors of the pancreas and billiary ducts. The therapeutics procedures performed were sphinctectomy, ampullectomy, biopsy, billiary and pancreatic prothesis placement. In most of the cases the problem was solved. There were complications in 36 patients (4, 17%), the most common being bleeding 16 and post ERCP acute pancreatitis 7 there were no deaths attributed to the procedure. In our study we show that our statistics are well placed among the standards of any reported trainning center in the world, regarding number of procedures, indications for the procedure, findings, therapeutic procedures and a very low morbility/mortality rate...

Reflection on Setting up the Clinic Skill Training Center / 中华医学教育探索杂志

With the development of all kinds of new simulative training equipment,the way of medico's clinic skill training method will change radically.Their clinic skill will be greatly improved.This article analyzed the necessities and imminence of setting up the clinic skill training center,and discussed how to manage it.At last we discussed how to build the clinic skill training center in the large comprehensive hospitals.

Common Sports Injuries among National Players in Korea

To become a national player and after becoming one, athletes usually overtrain themselves. Also they often get injured during their competition. There are many kinds of sports injuries, which are rather specific to each sport. In this study, the author analyzed the sports injuries of athletes who had visited the medical clinic in the Taereung National Training Center from January to July in 2005. There were 5 events and 7 groups of sports including men judo, men wrestling, men and women weight lifting, men and women hockey, and men gymnastics. The results showed that low back problems were the most common injury among all these sports. Besides low back problems, athletes from each sport had different patterns of injuries. Men judo players frequently had medial collateral ligament injuries of the knee. Men wrestling players commonly had neck problems. Many men and women weight lifters had wrist injuries and rotator cuff impingement, respectively, and many of them also had patellar ligament injuries. Hockey players commonly had ankle problems, and especially many women hockey players had hamstring strains. Remarkable injuries in men gymnastics were wrist and finger injuries. These results can be of help to optimize the strategies to prevent injuries and to rehabilitate the injured athletes.

Reformation of the Medical Educational Institutes and Training of General Doctors during the Early Period of Japanese Rule / 의사학

The Japanese government downgraded a Korean medical college being attached to the Daehan hospital to a medical training center blaming upon a lack of education in Korea. But the actual curriculum and the years required for completing a course of study in the Korean medical college were equivalent to those of the Japanese medical college. Furthermore, the Japanese government discarded the financial support for medical school students. So they should pay their tuitions and other stipends by themselves. The Japanese government forced a private institute to establish an endowed school by the legal act of college. It enabled to classify a medical education system with the judicial support. For the example of Severance Medical School, it reformed faculty, curriculum and facility according to the legal standard of a college act. Therefore, Severance Medical School was able to be upgraded to a medical college. But there was a limitation even for the government schools under the colonial era. It was not possible to train important medical human resource who enabled to supervise the modern medical system in Korea. On one hand, almost every important medical human resource such as a military doctor, and a professor, who should have trained in Korea in the Great Han Period, was trained in Japan. On the other hand, fostering general doctors, who practiced medicine with hands-on experience, was the purpose of medical education in Korea whether the medical school was governmental or private. Since the purpose of Severance Medical College was to foster general doctors, it was able to grow within the colonial medical system. The purpose of medical missionaries, who promoted the spread of gospel with the western medical support, enforced the Japanese colonial logics that the Japanese government could educate and develop Korea with the introduction of western civilization. Although it was later comparing to the government medical school, Severance Medical College enabled to certify the medical license automatically to the graduates from the school. The reason that the Japanese government allowed for Severance Medical College to issue the automatic medical license was to keep the colonial structure of Japanese in Korea.

Infectious diseases and medical institutions in the late Chosen dynasty / 의사학

The first Korean record on the smallpox can be found in the Hyangyak-Kukupbang compiled during the period of late Koryo dynasty. The record told on the cause, symptom, preventive and curative method of the disease but it did not touch upon its infectivity. Jeong Yak-Yong and Lee Jong-In of late 18th and early 19th centuries recognized first that the disease is infectious and it can be prevented by the vaccination method. But the vaccination against smallpox had not been carried out in public until 1880. From 1879 Chi Suk-Young began to try it privately to his relatives and neighbors. For sometime the smallpox vaccination was considered foreign and heretical by many people and some officers, so the trial of Chi and his colleagues had to go through an ordeal until the Reform of 1894. In 1895 the government first proclaimed an Ordinance on the Smallpox Vaccination in October and an Ordinance on the Training Center for Smallpox Vaccination in November. And two years later, in 1897 to bring up the vaccination doctors the government established the Training Center for Smallpox Vaccination, which was in 1899 integrated into the Medical school, the first modern and westernized medical school run by Korean government. Many of the vaccination doctors were posted at the newly established Office of Smallpox Vaccination by the government to perform their activities there until 1907.

The Early History of National Education of Western Medicine in Korea / 의사학

On the record 1995 is the 100th anniversary of Western medical education in our country which began with the opening of the Vaccinators' Training Center, but the actual history of Korea's Western medical education is 97 years old. To become vaccinators the students underwent training for a month including the manufacturing of vaccine and the practicing of vaccination. These vaccinators were the first vaccination specialists trained in Western medicine in our country. Their service included vaccination as well as education. These professionals of Western medicine. in spite of a short period of their training, saved countless human lives, contributing greatly to the welfare of society. In the years 1897-1898, there were quite a number of foreign missionary medical doctors in Korea, who were providing Western medical education each according to their own need. Some of the examples were Wells and Follwell in Pyongyang, Johnson in Taegu, and Scranton, Avison, and Rosetta Hall in Seoul. They were all medical doctors who received regular medical education and were engaged in clinical medicine. Meanwhile, Japanese medical doctors, who were educated in Western medicine, were operating hospitals in Pusan, Wonsan, Inchun, and Seoul. They did not provide medical education, but they employed Koreans as their assistants. Under such circumstances. the Chosun Government-General belatedly inaugurated the Uihakkyo Medical School. This medical school had a three-year course of Western medicine, but there was only two instructor trained in Western medicine and the remaining teaching members were all doctors of Oriental medicine. By regulations the curriculum included such subjects of Western medicine as zoology, botany, chemistry, physics, anatomy, physiology, pharmacology, diagnosis, internal medicine, surgery, pediatrics, ophthalmology, etc. The fact that to teach these subjects, non-medical persons were nominated as professors simple because they were equipped with knowledge of medicine, law and medicaments, makes it easy for us to imagine what the contents of the lectures would have been. After 1905, the Western medical education in Korea was severely interfered in by the Japanese authorities, and the name of the medical school was changed several times -Taehan Hospital Educational Department, Medical Educational Department, Attached Medical School, etc. The entire faculty of this medical school consisted of Japanese. Accordingly, the control over Government medical education in Korea was placed in the power of the Japanese authorities. To learn Western medicine Korean students had to endure humiliation and disdain from Japanese professors who took pleasure in showing off their talent and knowledge and satisfying their sense of superiority. After 1910 when Korea was annexed to Japan, Koreans had to receive Japanese education unconditionally. The government Uihakkyo Medical School was transformed into the status of a medical training center and was attached to the Medical Educational Section of the Government-General Hospital, barely retaining the name of a medical school. Korean students received medical education submissively suffering the haughtiness, disdain and prejudice from Japanese professors and follow students. Even after their graduation, Korean students had to meet the same situation. Thus, some academically eager graduates, for the purpose of furthering their study and research under liberal circumstances, went to Germany, which at that time was known for its most advanced medical sciences in the world. However, since the Japanese authorities including the professors did not make much of the Koreans studying in Germany, some of the graduates who were eager for further study had to continue their study under the Japanese professors. Thus the achievements of the Korean medical pioneers were the product of their sacrificial efforts and hardships. In this connection the author has described the achievements of the Korean professors, though small in number (5 professors, 6 assistant professors, and 10 instructors), who did their study and research at their alma mater. Also given in this article are data on the dissertations by 104 of our medical pathfinders, including the titles, the dates when degrees were awarded and the names of colleges where their dissertations were defended etc.