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  • 文章类型: Journal Article
    BACKGROUND: This study introduces the curriculum of a discussion-based learning class for dental hygiene ethics education and evaluates the educational effect of discussion-based learning as applied to a dental hygiene ethics class.
    METHODS: This study was conducted with 48 sophomores from the Department of Dental Hygiene who took dental hygiene ethics in the second semester of 2019. For the DBL class, the following steps were conducted: (1) a pre-class group activity (discussion); (2) a group presentation and team discussion; and (3) a discussion among all groups. To improve the ability to aggregate, organise, and prepare the learner\'s resources, data, information search skills, and opinions by the team and to improve communication skills by actively listening to other people\'s opinions, the presentation team\'s opinions were modified after the discussion, and the performance of rational opinions on topics was added. The professor provided feedback and summarised and ended the discussion. The survey was conducted before and after the DBL class.
    RESULTS: Concerning critical thinking ability, critical objectivity increased significantly from 8.88 before to 9.38 after the DBL class, and critical confidence also increased significantly. The change in professional attitude significantly increased from 3.21 out of 5 points before the DBL class to 3.53 after the DBL class in the logical and critical thinking skills category and significantly increased from 3.27 to 3.66 in decision-making skills.
    CONCLUSIONS: Teaching methods applied in DBL classes, not traditional lecture-style classes, consistent with changing educational paradigms, are very effective and should change gradually. These results will be particularly helpful to faculty members who are inexperienced in DBL courses and performance but interested in them.
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  • 文章类型: Journal Article
    最近,有人建议,多达三分之一的痴呆症病例是可以预防的。虽然预防总是比治疗好,这在痴呆症领域尤为重要,因为目前的干预措施无法改变这种疾病。本文修改了“支持”和“反对”痴呆症一级预防的证据。
    “支持”的证据由柳叶刀痴呆症预防委员会维持,干预和护理,指出高收入国家与年龄相关的痴呆症发病率降低。根据大型队列研究的结果,并使用人群归因风险,该委员会的结论是,高达35%的痴呆症病例可以通过改变9个风险因素来预防:低教育程度,中年听力损失,肥胖,高血压,晚年抑郁症,吸烟,缺乏身体活动,糖尿病,社会孤立。在这个生命历程的概念框架中,危险因素的改变可以在临床疾病发作前几十年影响痴呆。然而,“反对”的证据得到了大型随机对照试验的支持(RCT,每只手臂>250名参与者,至少6个月随访),主要设置使用已显示适度或负面结果的生活方式干预来预防痴呆症。2017年美国国家医学院的报告得出的结论是,目前的证据是有限的,没有具体的干预措施来保证预防痴呆症的公共卫生建议。痴呆的发展涉及多种病理途径,理论上可以通过管理中年听力损失和高血压来治疗。通过体育锻炼和教育,正如稳健的观察研究所建议的那样。然而,来自大型临床试验的证据并不能确定是否可以预防三分之一的痴呆病例。当前在大型临床试验中测试生活方式干预效果的举措可能有助于解决这一争论。
    Recently, it has been suggested that up to a third of the dementia cases might be preventable. While prevention is always better than cure, this is particularly important in the field of dementia, as current interventions are not able to modify the disease. This article revises the evidence \"for\" and \"against\" dementia primary prevention.
    Evidence \"for\" is sustained by the Lancet Commission on Dementia Prevention, Intervention and Care that noted a reduction of age-related incidence of dementia in high-income countries. Based on results from large cohort studies and using population attributable risk, the commission concluded that up to 35% of dementia cases could be prevented by modifying nine risk factors: low education, midlife hearing loss, obesity, hypertension, late-life depression, smoking, physical inactivity, diabetes, and social isolation. In this life course conceptual framework, modifications of risk factors can influence dementia decades before clinical disease onset. However, evidence \"against\" is supported by large randomized controlled trials (RCT, > 250 participants per arm, minimum of 6 months follow-up), primarily set to prevent dementia using lifestyle interventions that have shown modest or negative results. The 2017 National Academy of Medicine report concluded that the current evidence is limited and there are no specific interventions to warrant a public health recommendation for dementia prevention. Multiple pathological pathways are involved in the development of dementia which are theoretically treatable by managing midlife hearing loss and hypertension, and with physical exercise and education, as suggested by robust observational studies. However, evidence from large clinical trials is not conclusive to support that a third of dementia cases might be prevented. Current initiatives testing the effect of lifestyle interventions in larger clinical trials may help to settle this debate.
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  • 文章类型: Journal Article
    背景:女同性恋,同性恋,双性恋,和变性(LGBT)青少年经常忍受相当大的逆境,因为他们遇到与身份相关的污名。因此,LGBT青少年往往面临不成比例的风险,因为他们经历了负面的社会和健康结果。
    方法:这个四模块课程允许学习者探索LGBT青少年临床护理中常见的挑战,同时也提供暴露于LGBT健康的当前趋势和证据。通过结合反思练习,说教讲座,基础读数,促进案例讨论,和辩论,课程向学习者介绍评估问题,治疗,并支持他们与LGBT青年有关。该课程是为代表医学学科的跨专业培训计划中的学习者编写的,护理,营养,社会工作,和心理学。
    结果:四年的评估数据表明,该课程对于使学习者了解服务和支持LGBT青年以及确定可能需要进一步发展的个人技能的复杂性特别有用。学习者在识别地方和国家LGBT资源方面有更大的信心。
    结论:融入文化谦逊是培养对终身学习的承诺和在与边缘化人群合作时保持学习者信心的关键。当所有学科的学习者做出贡献时,就会发生最佳讨论,然而,当所有学科的学习者都不在场时,教师可以单独教授模块或修改模块。此外,学习者在与外部资源联系方面有更大的信心,这有助于患者的转诊和自我指导的学习。
    BACKGROUND: Lesbian, gay, bisexual, and transgender (LGBT) adolescents frequently endure considerable adversity as they encounter identity-related stigma. As a result, LGBT adolescents are often at disproportionate risk for experiencing negative social and health outcomes.
    METHODS: This four-module curriculum allows learners to explore challenges common to the clinical care of LGBT adolescents while also providing exposure to current trends and evidence in LGBT health. Through a combination of reflective exercises, didactic lectures, foundational readings, facilitated case discussion, and debate, the curriculum introduces learners to issues of assessment, treatment, and support as they relate to LGBT youth. The curriculum was written for use with learners in an interprofessional training program representing the disciplines of medicine, nursing, nutrition, social work, and psychology.
    RESULTS: Four years of evaluation data indicate that the curriculum is particularly useful for exposing learners to the complexities of serving and supporting LGBT youth and identifying personal skills that may require additional development. Learners emerge with greater confidence in identifying local and national LGBT resources.
    CONCLUSIONS: Incorporating cultural humility is key to fostering a commitment to lifelong learning and maintaining learners\' confidence when working with marginalized populations. Optimal discussion occurs when learners in all disciplines contribute, yet instructors can teach modules separately or modify them when learners from all disciplines are not present. In addition, learners emerge with greater confidence in connecting with outside resources, which assists both referrals for patients and self-directed learning.
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  • 文章类型: Journal Article
    Globally, tobacco kills more people than HIV-related conditions or AIDS, tuberculosis and malaria combined. In 1991, The World Bank, the world\'s largest lender, pledged that it would no longer support tobacco-related projects. It was expected that other financial investors would follow, but most did not respond to this call. As a result, several financial institutions continue to invest in tobacco and fuel an epidemic to an unprecedented scale. Using tobacco as a case in point, this review highlights the continuing investments among financial institutions which do not conform to \'socially responsible investments\' and calls for monitoring and reporting such unethical practices. The paper also underscores the need to harmonise the numerous criteria, principles and voluntary codes that govern socially responsible investing and ensure that financial institutions comply with them.
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