Awareness of hepatitis C prevention and control knowledge among clinicians in Jiaxing City / 预防医学

Objective@#To investigate the hepatitis C prevention and control knowledge among clinicians in Jiaxing City, Zhejiang Province, so as to provide the evidence for intensified training and improved diagnosis and treatment of hepatitis C among clinicians.@*Methods@#In November, 2021, clinicians were sampled using a stratified random sampling method from a city-level and a county (district)-level hepatitis C designated hospital in Jiaxing City. A questionnaire survey was performed using the Questionnaire for Hepatitis C Prevention and Control Knowledge among Clinicians, and the awareness of basic knowledge, professional knowledge and related knowledge about hepatitis C prevention and control among clinicians were descriptively analyzed. @*Results@# A total of 186 questionnaires were allocated and 179 valid questionnaires were recovered, with an effective recovery rate was 96.24%. The respondents included 107 men (59.78%) and 72 women (40.22%) and had a mean age of (37.06±9.46) years. There were 107 respondents with a bachelor degree (59.78%), 56 with junior professional titles (31.28%), and 170 from non-infectious disease departments (94.97%). The awareness of basic hepatitis C prevention and control knowledge was 96.09%, and the awareness of “Transfusion of blood containing hepatitis C virus may acquire hepatitis C” was high (98.88%), and the awareness of “Hepatitis C can be cured” was low (77.09%). The awareness of professional hepatitis C prevention and control knowledge was 3.91% to 100.00%, and the awareness of “Pathogens of hepatitis C” (100.00%) and “Recommended screening populations for hepatitis C” (86.59%) was high, while the awareness of “There are two categories of hepatitis C cases: clinically diagnosed cases and confirmed cases” (3.91%) and “Clinical diagnosis of hepatitis C: positive anti-HCV antibody + any one of abnormal liver function or epidemiological history or clinical symptoms” (3.91%) was low. The awareness rates of “The state has included antiviral agents against hepatitis C into medical insurance” was and “Antiviral agents against hepatitis C are reimbursed in outpatient and inpatient departments of our hospital” were 81.56% and 59.78%, respectively. There were 69 clinicians participating hepatitis C-related training within one year (38.55%), and the awareness of clinicians that had participated in hepatitis C-related training had a higher awareness rate of basic hepatitis C prevention and control knowledge than those without participation (100.00% vs. 93.64%, P<0.05).@*Conclusion@#The awareness of basic hepatitis C prevention and control knowledge is high among clinicians in Jiaxing City; however, the training on diagnosis and classification criteria of hepatitis C and related medical insurance policy require to be improved.

Exploring the attitudes and practices among student clinicians in India on multilingual issues in the field of speech-language pathology

ABSTRACT Purpose Student clinicians (graduates and undergraduates) in speech-language pathology deal with various multilingual issues while providing clinical services to individuals with language impairments. This study explores the attitudes and practices of undergraduate and graduate speech-language pathology students in India towards multilingualism and handling these issues. Methods One hundred and twenty-eight students (71 graduates and 57 undergraduates) participated in the study. Phase 1 of the study included the development of a questionnaire to explore the attitudes and practices of student clinicians in speech-language pathology. The questionnaire was converted into an online survey in Phase 2. Phase 3 comprised data and statistical analysis to summarize and interpret collected data. Results Graduate and undergraduate students significantly differed in their attitudes and perception toward multilingual issues (p<0.05). Most clinicians demanded a change in the current views on assessment/intervention, considering the linguistic background of the patient/caregivers. Other issues surrounding multilingualism included parents' education levels, lack of sufficient assessment tools, unavailability of translators/interpreters, and poor linguistic competency of clinicians. Conclusion These findings assist academic programs in planning and developing modules to aid students in handling the major multilingual issues encountered during clinical interactions.

Statistical approaches to make sense of data in biology and medicine

There are four major paradigms in statistics: Frequentist, Bayesian, likelihood, and modeling. A quadrangle approach that makes use of all these four paradigms is proposed to get a complete understanding of any biological phenomenon. Each of these paradigms can be used to study different aspects of a biological phenomenon. The elements are defined here as an observer, observed, and context, and the model generated should have information derived from these three elements. They can be analyzed, respectively, by Bayesian, frequentist, likelihood, and modeling methods. There is a continuous debate on frequentist and Bayesian approaches in statistics. Biologists often use frequentist methods whereas clinicians are interested in Bayesian methods. In this article, the debate on both these approaches has been discussed in light of understanding uncertainty. The Dempster-Shafer theory addresses the relationship between belief and plausibility but has been criticized for producing counterintuitive results in conflict situations. It is argued here that this can be resolved by inferring that frequentist and Bayesian approaches are inverse to each other.

Insights into Conflicts and Harmony in Doctor Patient Relationship through Transactional Analysis

Doctor Patient Relationship (DPR) in India seems to be deteriorating. Remedial measures are incoherent compared to the multitude of factors associated. Transactional Analysis (TA) is a Social Psychology Theory and practice appropriate to analyse changing paradigms of DPR. TA shows that traditional stable DPR model was symbiosis inappropriate for modern era. Current DPR model is game relationship occurring due to failed attempts at symbiosis. Contractual relationship is a stable model of DPR appropriate for modern era and medical fraternity shall work towards bringing a paradigm shift in a coherent manner. TA may be one of the systems that offers models and tools useful for a paradigm shift

Exploration of clinicians′ practice competency evaluation based on medical record homepage data / 中华医院管理杂志

The professional title evaluation of health professionals needs to highlight the clinical performance and actual contribution, and make full use of the information system of medical and health institutions to collect relevant data as an important basis for such evaluation.Based on this, the project team innovatively developed a " clinical work data extraction system" , to extract and calculate the performance indexes of clinicians using data from homepages of medical records. Meanwhile, the team established a reference scale based on the data in the hospital quality monitoring system; developed a " health workers evaluation data platform" , visually presenting the comparison results between the clinical work performance evaluation data of a clinician, and the reference scale and the data of other applicants. In the 2021 annual evaluation of senior professional titles among some medical institutions directly under the National Health Commission and such provinces as Sichuan, Shandong and Chongqing, this method was used to extract homepage data of medical records of 7 833 applicants from 39 medical specialties in 1 416 medical institutions, and finally 6 093 people (77.79%) completed the calculation of clinical work evaluation index data. The initial application results showed that the evaluation of senior clinicians′ professional competence based on homepage data of the medical record was feasible in the senior professional title evaluation of various medical institutions at all levels equipped with the electronic medical record database system, and could effectively present the performance level and actual contribution of the applicant.

A retrospective review of rabies post-exposure prophylaxis queries, South Africa, 2016­2019

Background: The National Institute for Communicable Diseases (NICDs) of South Africa (SA) provides technical support to healthcare workers (HCWs) with regard to infectious diseases through the NICD clinician hotline. Queries to the hotline are often about rabies prophylaxis. An analysis of these queries may help to identify knowledge gaps amongst HCWs regarding prevention of rabies in humans in SA. Methods: A retrospective descriptive review was conducted to analyse rabies post-exposure prophylaxis (PEP) queries received by the NICD from 01 January 2016 to 31 December 2019. Results: A total of 4655 queries were received by the NICD clinician hotline for the study period, of which 2461 pertained to rabies PEP (52.87%). The largest number of calls were placedby HCWs (n = 2313/2437; 94.9%). Queries originated mainly from Gauteng (n = 912/2443; 37.3%) and KwaZulu-Natal (n = 875/2443; 35.8%) provinces. A total of 50 different types of animals were related to exposures involving humans. Dogs (67.7%) and cats (11.8%) were the animals most frequently reported and exposure category III was most common (88.6%). Approximately equal numbers of callers were advised active management of administering rabies PEP and conservative management of withholding PEP. This did not seem to be affected by the exposure category related to the call. Conclusion: This analysis shows the ongoing demand by HCWs for technical support regarding patient management following potential exposure to rabies. Gaps in HCWs rabies knowledge provide unique learning points on guiding training to achieve the goal of eliminating dog-mediated human rabies deaths by 2030.

Viewpoint: Physician as a Clinician, Researcher, and Academician

@#The daily work life of physicians who function as clinicians, researchers, and academicians is focused on improving public health and patient outcomes in three usually compartmentalized settings: clinics, classrooms, and centers for research. In these settings, physicians are addressing patients’ medical concerns based on evidence, and at the same time, considering if new information could lead to research and discovery for better patient outcomes. The physician then proceeds to mentor, teach, and train medical students in quality evidence-based clinical practice and the conduct of scientific research. The importance of operationally blending these three disciplines with research as a common thread is not only a big challenge for these physicians but also an opportunity to innovate for better public health.

Analysis on the current situation and trend of doctors′ salary and satisfaction rate in tertiary public hospitals in China / 中华医院管理杂志

Objective:To analyze the current level and dynamic change of the salary and income satisfaction rate of doctors in Chinese tertiary public hospitals in recent years.Methods:In January 2018, March 2019 and March 2021, the project team of " the third party evaluation of the China Healthcare Improvement Initiative" conducted a questionnaire survey among doctors of 136 tertiary public hospitals in 31 provinces. The first-line clinicians were investigated by stratified sampling method. The salary level and satisfaction of doctors were investigated by questionnaire. Chi square test was used for comparison between groups.Results:The sample size of the three surveys was 20 786, 23 289 and 22 836 respectively. The median value of doctors′ actual income after tax in 2017, 2018 and 2020 was 100 800 yuan, 120 000 yuan, 150 000 yuan respectively, and the median expected annual income after tax was 196 000 yuan, 250 000 yuan and 250 000 yuan. The proportion of doctors satisfied with the current income was 16.5%, 17.8% and 26.9% respectively. The salary and satisfaction rate of doctors had an upward trend, but the overall level was still low.Conclusions:In recent years, the salary of doctors in tertiary public hospitals in China has been improved to a certain extent, but on the whole, it is at a low level, and there is still much room for improvement. In the future, the government needs to improve the hospital salary system and increase the salary of doctors continuously, especially needs to pay attention to the doctors with high education level and intermediate titles.

Accelerating research evidence translation through dyadic engagement: A developing model for evidence-based practice implementation

@#Evidence-based practice (EBP) has been regarded as the gold standard of clinical practice in the health profession. However, even though the importance of EBP is well documented in the nursing literature, in developing countries, its implementation remains a challenge. In addition to individual and organizational barriers to EBP implementation, the existence of the academician-clinician divide is a critical concern. This seeming disconnect has significantly hampered the translation of knowledge into practice. Hence, collaborative dyadic engagements between the academician and clinicians have to be nurtured. The Accelerating Research evidence translation through Dyadic Engagement (ARDE) Model, a pragmatic way of facilitating the enculturation of EBP, is proposed and collaborative efforts in solving clinically relevant nursing issues will pave the way for EBP to become an integral part of clinical practice.

COVID-19 Pandemic: Fear of Contagion among Frontline Healthcare Professionals

@#Throughout history when an infectious epidemic strikes a community, healthcare professionals are challenged to preserve their own safety and fulfilling their commitment to continue serving their patients and the community in dealing with the infectious epidemic. This innate fear can subvert the effective functioning of the frontline doctor in the epidemic. This article applies the principles of professional ethics to the keeping of frontline healthcare professionals safe and empowered to continue discharging their professional duties and responsibilities. Central to this is the healthcare professional’s wellness and professional resilience.

Research on influencing factors of precision medical service implementation based on clinician cognition / 中华医院管理杂志

Objective@#To investigate the influencing factors of the implementation of precision medical services based on clinician cognition, and provide a scientific reference for the implementation and advancement of precision medical services.@*Methods@#Using electronic questionnaires, clinicians from 48 hospitals in 12 provinces(autonomous regions and municipalities directly under the Central Government) were surveyed from July to September 2019, with 341 valid questionnaires collected. Descriptive statistics and factor analysis were performed on the survey data.@*Results@#Three dimensions that affect precision medical services were identified from the recovered questionnaires, namely external support factors, hospital drive capabilities, patient information provision and protection. The contribution rate of variance after orthogonal rotation was 35.157%, 22.234% and 16.343% respectively.@*Conclusions@#The external supporting factors should be developed, the hospital driving ability should be strengthened, and the patient information reception and privacy information security should be ensured to provide an important basis and guarantee for the implementation of precision medical service.

Effects of long-term studying abroad on scientific research ability of clinical doctors / 中华医院管理杂志

Objective To analyze whether studying abroad has any influence on clinicians′scientific research ability, and study the rationality of the indicators reflecting the scientific research ability. Methods A total of 36 clinicians who studied abroad more than 3 months between 2008 and 2010 were selected as the abroad group, and the control group of 36 clinicians was selected from the clinician information database of the hospital by the method of Propensity Score Match.A comparison and analysis were made regarding the number of papers(SCI), grants and scientific and technological achievements between the two groups. Meanwhile, covariance analysis was used to compare the difference in the number of scientific research achievements between the two groups.Logistic regression analysis was used to compare the changes in scientific research achievements of clinicians before and after their abroad study. Results The number of articles( SCI) published and grants obtained in the 3 years after going abroad was significantly higher than that of the control group, and the number of grants obtained in the 4-6 years after going abroad was also significantly higher than that in the control group.The number of papers(SCI)published in the three years after going abroad was more than that in the 3 years before going abroad.The number of grants obtained in the 4-6 years after going abroad was more than that in the 3 years before going abroad.These differences were statistically significant. Conclusions Studying abroad has a beneficial effect on the improvement of clinicians′ scientific research ability. It is reasonable and practical to take the number of SCI articles published as the indicator of short-term changes and the number of funds obtained as the indicator of long-term changes in scientific research ability.

Professionalism of clinicians at public hospitals in China / 中华医院管理杂志

Objective To investigate the present professionalism of clinicians at public hospitals in China and its relationship with practicing environment and hospital management system. Methods From April 2015 to March 2016, 659 clinicians of 11 public hospitals, from Guandong, Hubei and Guangxi provinces, were recruited into the study based on multi-stage sampling. The questionnaire included professional attitude(20 items)and professional behavior(10 items).Descriptive statistics and spearman rank correlation analysis were applied for analysis.Results For professional attitude, 15 items were agreed by over 80% of respondents.All the positive professional behaviours were agreed by over 80% of respondents and all the negative professional behaviours were denied by less than 30% of respondents. Professional attitude was positively correlated with professional behaviour(r=0.157, P<0.01), practicing environment (r= 0.269, P < 0.01 ) and management system ( r = 0.199, P < 0.01). Professional behaviour was uncorrelated with practicing environment or management system ( P >0.05 ). Conclusions Clinicians at public hospitals in China present positive professional attitude which is correlated with professional behaviour, but they are not in high accordance with each other. Clinicians have low satisfaction with the practicing environment and management system, which are important factors influencing professional attitude of clinicians.

Medical research as a clinician: hoping for golden era

Despite the successful development of modern medical educational systems within the last century, such systems need improvement in terms of developing better ways to educate medical students as future clinicians while also nurturing them to be good physician scientists. The period from 1964 to 1972 was called the Golden Era of Nobel Laureates in Medicine. Nine laureates, all graduates from American medical schools, came to the United States National Institute of Health (NIH). During the Vietnam War, many medical doctors substituted military service for service in the NIH, became members of the United States National Academy of Sciences, and attained brilliant medical and scientific achievements. There is a crucial lesson to learn from this golden time of the NIH: ambitious young physicians given opportunities to become cutting-edge scientists can make fundamental discoveries. In hopes of encouraging a similar “golden era” for medical research in Korea, I suggest three steps. First, medical schools and the educational system should provide medical students with more opportunities to conduct in-depth medical research in various fields. Second, the Physician Scientist Program should be further expanded to include more medical students and clinical board holders. Better treatments and approaches are essential for gathering both bright candidates and brilliant mentors, who will support each other in making outstanding scientific discoveries. Finally, the flexibility of the medical educational system in terms of medical students and clinical residency needs updating. In conclusion, a national medical educational system that is well balanced can maintain and support both excellent physician scientists and skillful clinicians.

Reliability and Validity of the Korean Version of Clinician-Administered Posttraumatic Stress Disorder Scale for DSM-5

BACKGROUND: For diagnosis of post-traumatic stress disorder (PTSD), the Clinician-Administered PTSD Scale (CAPS) is one of the most widely used structured diagnostic interviews. METHODS: In this study, we aimed to develop and validate the Korean version of CAPS for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition ([DSM-5] K-CAPS-5). Seventy-one subjects with PTSD, 74 with mood disorder or anxiety disorder, and 99 as healthy controls were enrolled. The Korean version of the structured clinical interview for DSM-5-research version was used to assess the convergent validity of K-CAPS-5. BDI-II, BAI, IES-R, and STAI was used to evaluate the concurrent validity. RESULTS: All subjects completed various psychometric assessments including K-CAPS-5. K-CAPS-5 presented good internal consistency (Cronbach's α = 0.92) and test-retest reliability (r = 0.91). K-CAPS-5 showed strong correlations with the structured clinical interview for DSM-5 PTSD (k = 0.893). Among the three subject groups listed above there were significant differences in the K-CAPS-5 total score. The data were best explained by a six-factor model. CONCLUSION: These results demonstrated the good reliability and validity of K-CAPS-5 and its suitability for use as a simple but structured instrument for PTSD assessment.

Association of clinicians' perceived social support and development of anxiety and depression / 中国职业医学

OBJECTIVE: To explore the relationship of clinicians' perceived social support and development of anxiety and depression. METHODS: A total of 434 clinicians from 3 comprehensive grade A hospitals in Guangdong Province were selected as study subjects by cluster random sampling method. The questionnaires of Perceived Social Support Scale,Selfrating Anxiety Scale and Self-rating Depression Scale were used to investigate their perceived social support,anxiety and depression respectively. RESULTS: The total scores of perceived social support,anxiety and depression in clinicians were(60. 6 ± 9. 9),(40. 9 ± 8. 3),and(45. 0 ± 10. 2),respectively. The detection rates of high perceived social support status,anxiety and depression were 56. 7%(246/434),15. 9%(69/434),and 23. 5%(102/434),respectively. The scores of perceived social support of clinicians with anxiety or depression were significantly lower than the scores of those without anxiety or depression( P < 0. 01). There was a negative correlation between anxiety,depression and perceived social support( P < 0. 01). CONCLUSION: The clinicians' perceived social support is closely related to the occurrence of anxiety and depression. Effective perceived social support can alleviate some of the clinicians' anxiety,depression and other adverse psychological reactions,and improve their mental health.

Discussion on the Role Conversion and Difference of the Clinicians and Clinical Investigator / 中国医学伦理学

Clinical research differs from routine diagnosis and treatment,and the clinicians and clinical investi-gators differ due to their different responsibilities.From the aspects of personnel qualification requirements,activity implementation process and role conflict balance in clinical research and routine diagnosis and treatment work,this paper compared and analyzed the roles of clinicians and clinical investigators and differences,deepening clini-cians'understanding and grasping on the connotation of their different roles,enhancing the sense of responsibility of clinicians as clinical investigators and improving the quality of clinical research.

An Adapted Clinical Measurement Tool for the Key Symptoms of CLN2 Disease

Abstract Neuronal ceroid lipofuscinosis type-2 (CLN2) disease is a rare, autosomalrecessive,pediatric-onset,neurodegenerative lysosomal storage disease caused by mutations in the TPP1 gene. Cerliponase alfa (Brineura®), a recombinant form of human tripeptidyl peptidase-1, was recently developed as a treatment for CLN2 disease. In clinical trials, the primary end point to evaluate treatment effect was the aggregate score for the motor and language (ML) domains of the CLN2 Clinical Rating Scale, an adaptation of the Hamburg scale's component items that include anchor point definitions to allow consistent ratings in multinational, multisite, clinical efficacy studies. Psychometric analyses demonstrated that the ML score of the CLN2 Clinical Rating Scale and individual item scores are well defined and possess adequate measurement properties (reliability, validity, and responsiveness) to demonstrate a clinical benefit over time. Additionally, analyses comparing the CLN2 Clinical Rating Scale ML ratings to the Hamburg scale's ML ratings demonstrated adequate similarity.

Resident research: why some do and others don't

<p><b>INTRODUCTION</b>Although research is widely considered to be a relevant and essential skill to resident development, the actual participation rate of residents in research remains low, and the factors associated with participation are unclear.</p><p><b>METHODS</b>We examined the participation rate of junior residents in research, and their attitudes and perceived barriers toward research, via an anonymised survey carried out from October to November 2013. The residents were from an established Accreditation Council for Graduate Medical Education-accredited internal medicine residency training programme in Singapore.</p><p><b>RESULTS</b>The overall response rate was 64.1% (82/128 residents). The most frequently cited barrier was lack of time. Only a third of the residents surveyed were actively participating in research. Those with postgraduate qualifications were more likely to be involved in research (odds ratio 4.71, p = 0.015). Among the 82 residents, 40.2% reported an interest in research as part of their career; these were mainly graduates from overseas universities or postgraduates. A belief that research is an intrinsically valuable activity distinguished residents who chose research as a career path from those who were undecided (p = 0.004). The belief that research is a means to better clinical practice also divided those who chose research from those who rejected it (p = 0.02).</p><p><b>CONCLUSION</b>Our findings suggest that specific beliefs determine the level of research activity and career interest among residents. Novel strategies may be incorporated in training programmes to improve the interest and participation of residents in research, and to facilitate the development of academic clinicians.</p>

Current Situation, Insufficiency and Countermeasures of Performance Allocation Model for Clinicians in China / 中国医院管理

The scientific construction and optimization of performance assessment of physicians,focusing on technical services reflecting the value of the medical staff,and paying attention to the connotation of medical services have important significance for effectively mobilizing the enthusiasm for work,and improving public hospital operation efficiency and management level.Through extensive literature research,the paper systematically analyzes the current situation and existing problems of the performance allocation model of public hospitals in China,and puts forward some corresponding suggestions and countermeasures according to the main existing problems.