“教学、实践、科研、临床”四位一体的医学遗传学教学体系建设探索与实践

医学遗传学课程介于基础医学和临床医学之间,是一门应用性很强的学科,在现代医学教育体系中有着重要的地位。教学团队在多年的医学遗传学教学实践中,在建设省级精品课程的过程中,构建了“教学、实践、科研、临床”四位一体的医学遗传学教学体系,主要内容包括“课堂教学、社会实践、科学研究、临床应用”四者之间相互渗透、相互补充、相互促进,以课堂教学为基础,用社会实践补充教学,科学研究提升教学,临床应用促进教学。“四位一体”教学体系为基础课程与临床课程的有机整合探索了一条切实可行的路子。实施几年来,课程建设收到了良好效果,学科团队科研水平、社会声誉、医疗服务能力也有明显提高。     

Fidelity of implementation: development and testing of a measure

Background

There is a considerable evidence base for 'collaborative care' as a method to improve quality of care for depression, but an acknowledged gap between efficacy and implementation. This study utilises the Normalisation Process Model (NPM) to inform the process of implementation of collaborative care in both a future full-scale trial, and the wider health economy.

Methods

Application of the NPM to qualitative data collected in both focus groups and one-to-one interviews before and after an exploratory randomised controlled trial of a collaborative model of care for depression.

Results

Findings are presented as they relate to the four factors of the NPM (interactional workability, relational integration, skill-set workability, and contextual integration) and a number of necessary tasks are identified. Using the model, it was possible to observe that predictions about necessary work to implement collaborative care that could be made from analysis of the pre-trial data relating to the four different factors of the NPM were indeed borne out in the post-trial data. However, additional insights were gained from the post-trial interview participants who, unlike those interviewed before the trial, had direct experience of a novel intervention. The professional freedom enjoyed by more senior mental health workers may work both for and against normalisation of collaborative care as those who wish to adopt new ways of working have the freedom to change their practice but are not obliged to do so.

Conclusions

The NPM provides a useful structure for both guiding and analysing the process by which an intervention is optimized for testing in a larger scale trial or for subsequent full-scale implementation.     

Helminth communities in avocets: importance of the compound community

This paper reports patterns of similarity and overlap in species presence and patterns of linear distribution of intestinal helminths in 22 avocets from 4 populations. Avocets collected from ephemeral bodies of water in Alberta and Manitoba had communities composed largely of species that are avocet specialists plus some that are host generalists. The composition of helminth communities in these hosts was similar to that reported in earlier surveys of avocet helminths. There was little evidence for competition between helminth species in these communities. In contrast, avocets collected from permanent bodies of water in Alberta had communities composed largely of species that are specialists in various duck species, particularly lesser scaup. These helminths were superimposed on the normal community, fitting into linear gaps along the intestine but also overlapping the distributions of avocet specialists. These lesser scaup specialists exhibit interactive patterns amongst themselves and, to some extent, with avocet specialists. Helminth communities in avocets from ephemeral bodies of water have vacant niches and are largely isolationist in nature. Those in avocets from permanent bodies of water are saturated and are more interactive in nature.     

生物化学中厌氧消化代谢途径的教学实践

厌氧消化是乳酸和乙醇发酵之外的另一条重要的无氧分解代谢途径,对促进资源高效利用、维持生态平衡、优化能源结构、缓解能源危机、推动实施“双碳”战略都具有重要意义。如此重要的代谢过程在大学生物化学课程教材和教学中没有涉及,使得教学体系不完整,亟需教学改革。厌氧消化过程涉及的反应众多,代谢途径复杂,为了让学生全面了解这一过程,教师通过查阅大量文献,将厌氧消化的主要反应途径归纳成图,较为完整地展现厌氧消化代谢过程,并通过BOPPPS教学模式融入课堂教学中。以代谢途径全图的形式直观展示分散冗杂的代谢过程,可以帮助学生构建厌氧消化代谢的系统框架,有助其丰富代谢知识体系,达到了良好的教学效果。本文介绍了厌氧消化代谢途径的内容及教学过程的设计,为生物化学、环境工程微生物学、新能源工程等课程教材的修订及相关课堂教学改革提供参考和借鉴。     

Exine development: the importance of looking through a colloid chemistry ``window'

Most biological construction systems operate within the colloidal dimension. In view of this, it seems reasonable to reassess what is known of the early stages of exine development in the light of a brief excursion into colloid and micelle behaviour. The results of this analysis show remarkable similarity of structures and suggest that almost all of the features seen during early pollen wall development can be easily interpreted using simple, established colloidal principles. This study of exine framework and endexine development offers the possibility that growth of the early exine progresses by successive transitory mesophases of a constrained micellar system. The self-assembling micelle mesophases will all be clearly recognized as constituents of the developing exine. They include spherical, cylindrical, continuous layers of hexagonally-packed cylindrical units and lamellar mesophases which most probably correspond to future granules, columellae, complex columellar (and alveolar) microarchitecture and ``white-line-centred' lamellae. Furthermore, the various types of micelle involved have the potential to perform the functions previously loosely assigned to the exine.     

Clinical governance implementation in a selected teaching emergency department: a systems approach

ABSTRACT: BACKGROUND: Clinical governance (CG) is among the different frameworks proposed to improve the quality of healthcare. Iran, like many other countries, has put healthcare quality improvement in its top health policy priorities. In November 2009, implementation of CG became a task for all hospitals across the country. However, it has been a challenge to clarify the notion of CG and the way to implement it in Iran. The purpose of this action research study is to understand how CG can be defined and implemented in a selected teaching emergency department (ED).Methods/designWe will use Soft Systems Methodology for both designing the study and inquiring into its content. As we considered a complex problem situation regarding the quality of care in the selected ED, we initially conceptualized CG as a cyclic set of purposeful activities designed to explore the situation and find relevant changes to improve the quality of care. Then, implementation of CG will conceptually be to carry out that set of purposeful activities. The activities will be about: understanding the situation and finding out relevant issues concerning the quality of care; exploring different stakeholders' views and ideas about the situation and how it can be improved; and defining actions to improve the quality of care through structured debates and development of accommodations among stakeholders. We will flexibly use qualitative methods of data collection and analysis in the course of the study. To ensure the study rigor, we will use different strategies. DISCUSSION: Successful implementation of CG, like other quality improvement frameworks, requires special consideration of underlying complexities. We believe that addressing the complex situation and reflections on involvement in this action research will make it possible to understand the concept of CG and its implementation in the selected setting. By describing the context and executed flexible methods of implementation, the results of this study would contribute to the development of implementation science and be employed by boards and executives governing other clinical settings to facilitate CG implementation.     

Natural physical disturbance and predation: their importance in structuring a marine sessile community

Settling panels were used to determine the distribution of sessile organisms. Experimental and control cages were located at two study sites that were of different physical exposures. Twenty-nine species of sessile organisms were recorded for the two sites. Data on the presence or absence of each species, for each sample, were classified. The resulting hierarchy showed natural physical disturbance to be the major structuring factor in the community. Predation was of less importance in the physically stressed study site and had no effect on species distribution in the protected site.     

Integrating guideline development and implementation: Analysis of guideline development manual instructions for generating implementation advice

ABSTRACT: BACKGROUND: Guidelines are important tools that inform health care delivery based on best available research evidence. Guideline use is in part based on quality of the guidelines, which varies. Others hypothesized this is due to limited instructions in guideline development manuals. The purpose of this study was to examine manual instructions for implementation advice. METHODS: We used a directed and summative content analysis approach based on an established framework of guideline implementability. Six manuals identified by another research group were examined to enumerate implementability domains and elements. RESULTS: Manuals were similar in content but lacked sufficient detail in particular domains. Most frequently this was Accomodation, which includes information that would help guideline users anticipate and/or overcome organizational and system level barriers. In more than one manual information was also lacking for Communicability, information that would educate patients or facilitate their involvement in shared decision making, and Applicability, or clinical parameters to help clinicians tailor recommendations for individual patients. DISCUSSION: Most manuals that direct guideline development lack complete information about incorporating implementation advice. These findings can be used by those who developed the manuals to consider expanding their content in these domains. It can also be used by guideline developers as they plan the content and implementation of their guidelines so that the two are integrated. New approaches for guideline development and implementation may need to be developed. Use of guidelines might be improved if they included implementation advice, but this must be evaluated through ongoing research.     

The importance of juveniles in structuring a littoral macrobenthic community

The relationships between individual dry weight and bodycontent of the essential metals copper and zinc and of therespiratory pigment haemocyanin have been investigated in fourBritish species of caridean decapod crustaceans, Palaemonelegans, Palaemon longirostris, Palaemonetesvarians and Crangon crangon. Also considered were thebody concentrations of soluble copper and copper associatedwith haemocyanin. These decapods regulate total bodyconcentrations of copper and zinc to approximately constantlevels which can vary interspecifically. An attempt is made tointerpret these regulated concentrations in terms of essentialrequirements for the metals in the physiological functioningof haemocyanin, the body concentration of which variesinterspecifically and intraspecifically with environmentalvariables.     

植物学野外实习教学改革实践与探讨

探讨植物学野外实习教学改革与实践,改革野外实习内容和形式,引导学生主动探索自然界,主动获得植物学知识的能力。加强野外实习,培养学生学习植物学基本研究方法。野外实习结合科研活动,提高学生科学素质和创造能力。提出实施野外实习改革的奈件,为提高植物学野外实习教学质量提供参考。     

Methodology capture: discriminating between the best and the rest of community practice

Background  

The methodologies we use both enable and help define our research. However, as experimental complexity has increased the choice of appropriate methodologies has become an increasingly difficult task. This makes it difficult to keep track of available bioinformatics software, let alone the most suitable protocols in a specific research area. To remedy this we present an approach for capturing methodology from literature in order to identify and, thus, define best practice within a field.