Johns Hopkins University School of Medicine (JHUSOM) has been a leader in medical education since its inception in 1893. The influence of John Dewey on the founders of the school is evident in the design of the curri...Johns Hopkins University School of Medicine (JHUSOM) has been a leader in medical education since its inception in 1893. The influence of John Dewey on the founders of the school is evident in the design of the curriculum,which included serious study of basic science for two years,followed by 'learning by doing' in the 3d and 4th clinical years. After the Flexner report in 1910 which lauded the school as an exemplary model,this became the standard curricular structure of undergraduate medical education in the US. Since its founding Hopkins,like other medical schools,has struggled with burgeoning biomedical knowledge and the tension between time and content. The last curricular revision was implemented in 1992,and had several themes,including:(1) decreased lecture time and increased small group learning; (2) early clinical experience and more ambulatory clinical experience; (3) integration of the basic sciences to improve learning and reduce redundancy; (4) development of a longitudinal course for the social sciences,(named 'The Physician and Society' course); (5) a required thesis project for graduation. All but the last were implemented. Our students have done well in this curriculum. 98-100% pass the licensing board exams,and over 90% obtain their first choice for residency positions,often in highly competitive programs such as Dermatology,Neurosurgery and Ophthalmology. Approximately 30% of graduates are listed in the AAMC faculty roster-one of the highest percentages of graduates going to academic medicine in the country.展开更多
目的探讨骨质疏松性骨折人群的骨密度与跌倒风险、体质量指数(body mass index,BMI)、肌力、体脂含量的相关性。方法通过对4 632例社区45岁以上绝经后女性的问卷调研及骨密度筛查,筛查出既往有脆性骨折史的骨质疏松性骨折人群。测定骨...目的探讨骨质疏松性骨折人群的骨密度与跌倒风险、体质量指数(body mass index,BMI)、肌力、体脂含量的相关性。方法通过对4 632例社区45岁以上绝经后女性的问卷调研及骨密度筛查,筛查出既往有脆性骨折史的骨质疏松性骨折人群。测定骨质疏松性骨折人群的骨密度、身高、体质量、跌倒风险、肌力和腹部脂肪含量。采用Spearman检验分析跌倒指数、体脂含量、年龄、身高、体质量、BMI与骨密度(bone mass density,BMD)之间的相关性。BMD校正年龄、身高、体质量、BMI、体脂含量,采用ANCOVA分析跌倒指数对BMD的影响;校正年龄、身高、体质量、BMI、跌倒指数,分析体脂含量对BMD的影响。结果对筛查出的839例骨质疏松性骨折患者的BMD、BMI、跌倒风险、腹部体脂含量、肌力等相关性分析结果显示,骨质疏松性骨折人群BMI、跌倒指数、肌力与BMD均显著相关(BMI r=0.161,跌倒指数r=0.238,肌力r=0.198,P均<0.001)。BMI、肌力、跌倒风险与BMD呈正相关;校正年龄、身高、体质量、BMI等因素,采用ANCOVA分析跌倒指数与BMD无显著相关(F=1.011,P>0.05)。结论跌倒风险和低BMD为骨折的主要危险因素。本研究显示体脂含量与BMD呈显著相关性。展开更多
文摘Johns Hopkins University School of Medicine (JHUSOM) has been a leader in medical education since its inception in 1893. The influence of John Dewey on the founders of the school is evident in the design of the curriculum,which included serious study of basic science for two years,followed by 'learning by doing' in the 3d and 4th clinical years. After the Flexner report in 1910 which lauded the school as an exemplary model,this became the standard curricular structure of undergraduate medical education in the US. Since its founding Hopkins,like other medical schools,has struggled with burgeoning biomedical knowledge and the tension between time and content. The last curricular revision was implemented in 1992,and had several themes,including:(1) decreased lecture time and increased small group learning; (2) early clinical experience and more ambulatory clinical experience; (3) integration of the basic sciences to improve learning and reduce redundancy; (4) development of a longitudinal course for the social sciences,(named 'The Physician and Society' course); (5) a required thesis project for graduation. All but the last were implemented. Our students have done well in this curriculum. 98-100% pass the licensing board exams,and over 90% obtain their first choice for residency positions,often in highly competitive programs such as Dermatology,Neurosurgery and Ophthalmology. Approximately 30% of graduates are listed in the AAMC faculty roster-one of the highest percentages of graduates going to academic medicine in the country.
文摘目的探讨骨质疏松性骨折人群的骨密度与跌倒风险、体质量指数(body mass index,BMI)、肌力、体脂含量的相关性。方法通过对4 632例社区45岁以上绝经后女性的问卷调研及骨密度筛查,筛查出既往有脆性骨折史的骨质疏松性骨折人群。测定骨质疏松性骨折人群的骨密度、身高、体质量、跌倒风险、肌力和腹部脂肪含量。采用Spearman检验分析跌倒指数、体脂含量、年龄、身高、体质量、BMI与骨密度(bone mass density,BMD)之间的相关性。BMD校正年龄、身高、体质量、BMI、体脂含量,采用ANCOVA分析跌倒指数对BMD的影响;校正年龄、身高、体质量、BMI、跌倒指数,分析体脂含量对BMD的影响。结果对筛查出的839例骨质疏松性骨折患者的BMD、BMI、跌倒风险、腹部体脂含量、肌力等相关性分析结果显示,骨质疏松性骨折人群BMI、跌倒指数、肌力与BMD均显著相关(BMI r=0.161,跌倒指数r=0.238,肌力r=0.198,P均<0.001)。BMI、肌力、跌倒风险与BMD呈正相关;校正年龄、身高、体质量、BMI等因素,采用ANCOVA分析跌倒指数与BMD无显著相关(F=1.011,P>0.05)。结论跌倒风险和低BMD为骨折的主要危险因素。本研究显示体脂含量与BMD呈显著相关性。
