Misconception between palliative care and euthanasia among Thai general practitioners: a cross-sectional study.

BACKGROUND: Palliative care lower medical expenses and enhances quality of life, but misconception with euthanasia delays timely care and makes inappropriate patient management. OBJECTIVE: To examine the magnitude of misconceptions between palliative care and euthanasia among Thai general practitioners, explore the association with knowledge, attitudes, and practical experience, and assess the association between misconception and confidence in practicing and referring patients to palliative care centers. METHODS: All 144 general practitioners who were going to start residency training at Maharaj Nakorn Chiang Mai Hospital in 2021 participated in this observational cross-sectional study. A chi-square test was utilized to examine the relationship between misconception and knowledge, attitude, practical experience, confidence to practice, and confidence to refer patients. Multivariable logistic regression was carried out while controlling for age, sex, knowledge, attitude, and experience to examine the relationship between misconception and confidence to practice and refer patients for palliative care. Statistical significance was defined at p < 0.05. RESULTS: About 41% of general physicians had misconceptions regarding palliative care and euthanasia. High knowledge was associated with a lower level of misconception (p = 0.01). The absence of misconceptions was weakly associated with a higher level of confidence in practicing palliative care, with an adjusted odds ratio of 1.51 (95% confidence interval 0.73 to 3.10, p = 0.07). CONCLUSION: High misconception rates between palliative care and euthanasia among young Thai physicians might impact their confidence in delivering palliative care. Training initiatives for medical students and practitioners can mitigate misconceptions, fostering better palliative care utilization in Thailand.

Research on the Innovation Path of College Students’ Volunteer Service under the Background of Epidemic Prevention and Control: Taking Beijing University of Chinese Medicine as an Example / 中国医学伦理学

Volunteer service is an important way for contemporary Chinese college students to carry out social practice, and an effective carrier for strengthening ideological and political work in the new era. During the prevention and control of the COVID-19, college students, as a solid force in the volunteer team, actively participated in the anti-epidemic volunteer service, which not only improved their practical ability, but also practiced the core socialist values and inherited the excellent traditional Chinese culture. Based on the existing practical experience in volunteer service, Beijing University of Chinese Medicine has made use of multiple channels and resources to improve the volunteer training system, strengthen the guarantee of volunteer service, realize the high-quality leapfrog development of college students’ volunteer service, and provide experience and reference for the innovation of college students’ volunteer service in the new era.

Preparation Work and On-Site Management of Large-Scale COVID-19 Nucleic Acid Testing: Report From the Field.

Routine coronavirus disease 2019 (COVID-19) screening found 1 asymptomatic COVID-19 patient. An emergency sampling team was organized consisting of 1200 health-care workers, and a total of 3.2228 million COVID-19 samples had been collected and detected. This study summarizes the on-site management experience in large-scale COVID-19 nucleic acid testing from various aspects: staff preparation, materials preparation, site layout, logistics support, and information system support. Suggestions are put forward for the deficiencies and parts needing improvement. Such deficiencies included some sampling sites were not properly chosen, different areas were unclearly marked off from each other, and some site moving lines were confounding; how to communicate with the street service workers who had little professional knowledge on the epidemic spread or the working principles of the workflow and site layout; and the way to resolve conflicts on site.

An Approach to the Office-Based Practice of Food Oral Immunotherapy.

Oral immunotherapy (OIT) provides an active treatment option for patients with food allergies. OIT may improve quality of life and raise the threshold at which a patient with food allergy may react to an allergen, but it is a rigorous therapy that requires a high degree of commitment by the clinician, patients, and families. Recent guidelines from the Canadian Society for Allergy and Clinical Immunology have provided a framework for the ethical, evidence-based, and patient-oriented clinical practice of OIT, and the European Academy of Allergy, Asthma, and Immunology guidelines have also recommended that OIT can be used as a potential treatment. The recent Food and Drug Administration approval of an OIT pharmaceutical has accelerated the adoption of OIT. This review provides a summary of the recent Canadian Society for Allergy and Clinical Immunology guidelines and a consensus of practical experience of clinicians across the United States and Canada related to patient selection, office and staff preparation, the general OIT process, OIT-related reaction management, and treatment outcomes.

[Research on coronavirus disease 2019 field disinfection technology for prevention and control].

The coronavirus disease 2019 (COVID-19) epidemic has had a serious impact in the world. In the absence of vaccines and therapeutic drugs, disinfection has become an important technical means to block the spread of the virus. By analyzing the characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we studied a series of disinfection technologies for COVID-19. During the outbreak of COVID-19, Jinan Second Center for Disease Control and Prevention disinfected the houses of the cases to be investigated in a community. The effectiveness of the disinfection technology was verified through the process of disinfection preparation, sampling before disinfection, field disinfection, sampling after disinfection and evaluation of disinfection effect. Compared the data before and after disinfection, the killing rate of the total bacterial colonies in the air and on the surface of the object was more than or equal to 90%, and no SARS-CoV-2 was detected after disinfection. The results show that the disinfection effect of the disinfection technology meets the standard. Finally, through the analysis of the wrong way of disinfection and the harm of over disinfection, the importance of scientific disinfection and precise disinfection are emphasized, and the research has a good guiding value for prevention and control of the epidemic.

The impact of practical experience on theoretical knowledge at different cognitive levels.

Although theoretical training of veterinary students is uncomplicated even for larger groups, practical training remains a challenge. Much has been said about the value of practical training in curriculum design. Yet, the impact of practical training on theoretical knowledge needs further research. A cohort of 89 students with very limited clinical practical experience completed an assessment at the end of their theoretical training in small ruminants. The scores obtained by the students were compared with those obtained by a group of 35 veterinarians who volunteered to participate in the study. In addition to comparing the scores between students and practitioners, the cognitive level of each of the questions was considered. Overall, veterinarians achieved higher test scores than did the students. The veterinarians outperformed the students in all cognitive levels except for 'applying' type questions where there was no difference. Different levels of experience, namely young veterinarians (n = 11), established veterinarians (n = 13) and veterinarians approaching retirement (n = 11), were evaluated against the revised Bloom's cognitive levels. When modelling congress attendance frequency, years' experience, proportion of time spent with ruminants and revised Bloom's levels, congress attendance was not a significant variable, and thus, only the other three variables remained. This investigation found that practical experience has a positive effect on theoretical knowledge. The type of practical experience and where such practical experience is included in a curriculum need further research. Working for a number of years in a specific discipline will provide the best support for theoretical knowledge.

The efficacy of vestibular rehabilitation in patients with chronic unilateral vestibular dysfunction.

OBJECTIVES: Vestibular rehabilitation leads to a gradual diminution of the subjective and objective symptoms that accompany the vestibular disorders. The aim of the study was to compare the impact of 2 different types of vestibular rehabilitation on vestibular compensation in patients with chronic unilateral vestibular dysfunction. MATERIAL AND METHODS: The study was conducted on a group of 58 subjects (43 females and 15 males) aged 40-64 years, who presented with chronic unilateral vestibular dysfunction and were hospitalized. The patients were randomly assigned to either of the 2 groups established. The study was conducted in a 6-week period. Group 1 consisted of patients who underwent customized group vestibular rehabilitation in an outpatient setting. The program was performed once a week for 1 h 30 min, under the supervision of a physiotherapist and a physiatrist. Group 2 was instructed to perform Cawthorne-Cooksey exercises and simple balance exercises twice a day for 15 min. RESULTS: An improvement in the outcomes of the Dynamic Gait Index as well as the Berg Balance Scale was statistically significant for group 1. The time for fulfilling the task in the Timed Up and Go Test improved in both groups (p < 0.05). The subjective estimation of the symptoms evaluated with the use of the Dizziness Handicap Inventory and the Visual Analogue Scale revealed a statistically significant improvement in both groups, yet it was higher in group 1. CONCLUSIONS: The compensation achieved after 6 weeks of the customized, supervised outpatient rehabilitation program in group 1 was superior to the results of the home-based unsupervised Cawthorne-Cooksey and balance exercises. Int J Occup Med Environ Health. 2020;33(3):273-82.

Research on coronavirus disease 2019 field disinfection technology for prevention and control / 生物医学工程学杂志

The coronavirus disease 2019 (COVID-19) epidemic has had a serious impact in the world. In the absence of vaccines and therapeutic drugs, disinfection has become an important technical means to block the spread of the virus. By analyzing the characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we studied a series of disinfection technologies for COVID-19. During the outbreak of COVID-19, Jinan Second Center for Disease Control and Prevention disinfected the houses of the cases to be investigated in a community. The effectiveness of the disinfection technology was verified through the process of disinfection preparation, sampling before disinfection, field disinfection, sampling after disinfection and evaluation of disinfection effect. Compared the data before and after disinfection, the killing rate of the total bacterial colonies in the air and on the surface of the object was more than or equal to 90%, and no SARS-CoV-2 was detected after disinfection. The results show that the disinfection effect of the disinfection technology meets the standard. Finally, through the analysis of the wrong way of disinfection and the harm of over disinfection, the importance of scientific disinfection and precise disinfection are emphasized, and the research has a good guiding value for prevention and control of the epidemic.

Evaluating the preceptor-preceptee relationship among Pharm D students at the King Saud University School of Pharmacy.

OBJECTIVE: To evaluate preceptee satisfaction concerning preceptorship and the preceptor-preceptee relationship among pharmacy students. METHODS: A cross-sectional study was conducted from May 2017 to August 2017 on senior Pharm D students at King Saud University (KSU) College of Pharmacy. A survey instrument was used to get feedback from students regarding their clinical rotations and internships and to evaluate their satisfaction toward preceptorship to meet the goals of the curriculum. Data were entered into SPSS, version 24. RESULTS: Of the 52 students surveyed, 36 (69.2%) were female. More than half of respondents were somewhat satisfied with their preceptors and 11.5% were satisfied. Additionally, only 17% of students rated their preceptors as having excellent clinical teaching skills; about 19% of students rated them as "needs improvement." About 40% of students rated their preceptors as very good, concerned, competent, and safe in their care for persons living with serious co-morbidities and diseases. About half of students (48.1%) rated their non-faculty KSU preceptors' teaching behavior as not satisfactory compared with only four respondents with respect to KSU faculty preceptors' teaching behavior. CONCLUSION: Pharm D students were somewhat satisfied with their preceptors' teaching behaviors in communication skills, practice, and teaching skills as well as feedback and evaluation to students. To enhance the quality of experiential education, preceptors should be trained to develop programs that direct and energize advancement.

Survey of Pharmacy Preceptors' Expectations and Experiences with Students on Rotations in an Inaugural Combined BScPhm/PharmD Class.

BACKGROUND: In September 2011, the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, began offering a combined BScPhm/PharmD program to third-year students and postbaccalaureate graduates. Learning consisted of in-class teaching and Advanced Pharmacy Practice Experience (APPE) rotations. OBJECTIVE: To explore preceptors' expectations and perceptions of student performance in the APPE rotations of the new combined degree program. METHODS: A survey was distributed via email to 132 pharmacists from the Toronto Academic Health Science Network who had acted as preceptors for the combined degree program in academic year 2011/2012. The 17 questions were designed to gather information on preceptors' demographic characteristics and their expectations and evaluations of the combined-program students. Responses were analyzed qualitatively for common themes and quantitatively using sums and means. Survey responses were compared to identify alignment and discrepancies between preceptors' expectations and evaluations of students. RESULTS: The survey response rate was 48% (63/132). Most respondents (46 [73%]) were from a teaching hospital, and the same proportion (46 [73%]) reported being preceptors for a direct patient care rotation. Forty-four (70%) of the respondents expected students to be at the level of traditional PharmD students, hospital residents, or advanced-level Structured Practical Experience Program students, and 35 (80%) of these 44 respondents reported that their students met or exceeded expectations. According to survey responses, 31% of respondents (18/58) ranked students at the corresponding level of performance on the faculty's assessment form, while 62% (36/58) ranked students at a higher level (5 respondents did not complete the question). Only one-third of respondents felt that they personally had received adequate training before taking on preceptor duties for combined-program students. CONCLUSIONS: Preceptors' perceptions of the rotation and their expectations of students varied widely and were influenced by prior teaching and learning experiences. There was a disconnect between preceptor-specific expectations and preceptors' final evaluations of students. Training to standardize the expected level of performance and additional training for preceptors would further enhance the APPE rotations of the combined degree program.

CONTEXTE: En septembre 2011, la Faculté de pharmacie Leslie Dan de l'Université de Toronto à Toronto, en Ontario, a commencé à offrir un programme de double diplôme, B. Sc. Phm.­Pharm. D., aux étudiants de troisième année et aux diplômés titulaires d'un baccalauréat. Le programme reposait d'une part sur un enseignement en classe et d'autre part sur des stages offrant une expérience pratique avancée de la pharmacie (Advanced Pharmacy Practice Experience [APPE]). OBJECTIF: Étudier les attentes des précepteurs envers la performance des étudiants participant aux stages APPE du nouveau programme de double diplôme ainsi que la perception qu'ils en ont. MÉTHODES: Un sondage a été envoyé par courriel à 132 pharmaciens œuvrant dans le Toronto Academic Health Science Network et ayant agi à titre de précepteurs dans le programme de double diplôme durant l'année universitaire 2011­2012. Les 17 questions du sondage ont été conçues dans le but de recueillir des informations sur les caractéristiques démographiques des précepteurs ainsi que sur leurs attentes envers les étudiants et les évaluations qu'ils ont faites de ceux-ci dans le cadre du programme double. Les réponses ont été analysées qualitativement pour établir des thèmes communs ainsi que quantitativement à l'aide de sommes et de moyennes. Les réponses au sondage ont été comparées afin de relever des concordances et des divergences entre les attentes des précepteurs envers les étudiants et les évaluations qu'ils ont faites d'eux. RÉSULTATS: Le taux de réponse au sondage était de 48 % (63/132). La majorité des répondants (46 [73 %]) travaillaient dans un hôpital universitaire et un même nombre de répondants (46 [73 %]) ont indiqué agir à titre de précepteurs pour un stage de soins directs aux patients. Quarante-quatre (70 %) des répondants s'attendaient à ce que les étudiants soient à la hauteur des étudiants du programme de Pharm. D. traditionnel, des résidents hospitaliers ou des étudiants de haut niveau dans le programme structuré d'expérience pratique (Structured Practical Experience Program) et 35 (80 %) de ces 44 répondants ont déclaré que leurs étudiants avaient satisfait aux attentes ou les avaient dépassées. Selon le sondage, 31 % des répondants (18/58) ont classé les étudiants au niveau de performance correspondant sur le formulaire d'évaluation de la faculté, tandis que 62 % (36/58) ont classé les étudiants à un niveau supérieur (cinq répondants ont négligé cette question). Seul le tiers des répondants estimaient avoir reçu une formation suffisante avant d'endosser le rôle de précepteur auprès des étudiants du programme de double diplôme. CONCLUSIONS: Les perceptions des précepteurs envers le stage de même que leurs attentes envers les étudiants variaient grandement et étaient influencées par des expériences d'enseignement et d'apprentissage passées. Il y avait un écart entre les attentes des précepteurs et leurs évaluations finales des étudiants. Un enseignement visant à normaliser le niveau de performance attendu ainsi qu'une formation supplémentaire pour les précepteurs amélioreraient davantage les stages APPE du programme de double diplôme.

Nursing student placements in clinical research.

Research is part of the remit of the NHS and consequently many patients participate in research studies. Clinical nurses have a vital role in research, since they care for patients who participate in studies and act as patient advocates during research. However, nursing students are rarely provided with an opportunity to undertake a research placement. They therefore have a limited understanding of what being a research participant involves for patients. This article describes the type of research carried out in an NHS trust in northwest England, how research placements were set up in that trust and the beneficial effects on learning of such placements. The aim of the article is to encourage other research nurses to set up student placements and encourage nursing students to request research placements.

Exquisite Lectures,Mutual Participation,Personal Experience,and Sublimation——Exploration and Introduction of a New Model in Teaching Medical Ethics / 中国医学伦理学

This article introduces the development and experience of the educational reforms in the teaching of medical ethics at Sun Yat-Sen University,concerning the "three-in-one" model,constituting "classroom instruction,practical experience,and independent research".Practical experience is considered an effective way of implementing and consolidating theories and practices,just as knowledge in professional ethics are exercised in coherence.It is an important step for medical students to have early contacts with society,enhance social responsibility,increase understanding and practices of medical ethics and developing practical and creative abilities.