以“十九大精神”为指导的护理教研工作现状分析

目的了解以十九大精神为指导的护理教学科研开展现状,为进一步在护理队伍中深入贯彻十九大精神,并以十九大精神为指导更好地开展护理教研工作。方法调查云南省第二人民医院护理学教研室2017年1月—2018年12月的护理教研工作现状,并进行整理、分析描述。结果在十九大精神的指导下该院护理实习生总人数增长93人,本科实习生人数占比提高7.6%,针刺伤发生率降低1.7%,课堂教学课时数增加1112学时,护理人员论文发表数量增加79篇,专著发表增加3部,科研立项项目增加3项。结论在该院深入贯彻十九大精神后,护理教研工作百花齐放,护理人员仁心仁术,护理质量显著提升,有利于和谐医院的构建、有助于和谐社会的建设。     

从病区感染控制的角度谈中央空调的设计使用和管理

目的探讨医院中央空调的设计、使用、管理与病区感染控制的关系。方法根据医院病区室内微生物污染与感染的现状,结合医院中央空调设计、使用、管理中存在的问题及相关文献资料,研讨空调设计、使用、管理与感染控制的关系,结果,医院中央空调的设计体现“以病人为中心”的人性化设计,满足医院对污染与感染控制的要求,中央空调的使用、管理必须规范化,建立长效的设备维保与消毒机制。结论医院中央空调设计、使用、管理的科学性、安全性、规范性、与病区感染控制有直接关系,是减少污染、控制感染、提高医疗质量、保障医疗安全的有效手段之一。     

Nursing in the process of economic management of health services: limits and possibilities

The study presents some reflections on the possibilities and limitations of the rationalization and flexibilization of the management process of the health services under the economic perspective, focussing on the introduction of mechanisms and instruments centred in the economic and organizational responsibilization of the resources and nursing participation in these processes. Authors discuss the adoption of a system of economic control in order to coordinate the interests of the several subjects involved; to privilege the results of the processes and to improve the economic combination of the resources. Under this perspective, two concepts are considered relevant in the elaboration of the budget of the Nursing Services: the controllability of the resources and the negotiation in the processes of allocation and utilization of these resources. The use of these concepts in the organization of health services, especifically in nursing area, creates new possibilities of participation in the processes of services production, enabling more transparency in the decision processes and restructuring new modalities of management for the nursing services.     

武汉地区中医发展综合效益评价研究

目的 探讨武汉地区中医发展综合效益状况方法 选取20个指标组成指标体系,采用主成分综合评价法,对武汉地区2003-2008年的中医发展现状进行综合评价研究结果 中医人员构成比、中医高级职称人员构成比、中医本科以上人员构成比、中医住院量构成比、中医治疗有效率、中医病床使用率、中医病床周转次数、职工人均业务收入、每床日平均收费水平、每职工平均完成住院床日数、中医重点专科数以及中医每床位占用固定资产等指标在第一主成分上有较高的载荷,说明第一主成分基本反映了这些指标的信息;每出院人次平均住院业务收入在第二主成分上有较高载荷,说明第二主成分基本反映了这类指标的信息,所以提取的2个主成分可以基本反映全部20个指标的信息.2003-2008年武汉地区中医发展态势良好,并能从综合得分中看出医疗质量的提高程度,2008年为最高,排名情况依年份往前推,以2003年为最低结论 中医发展的主要决定因素有中医人员队伍建设状况、中医住院床位工作效率、中医职工工作效益及中医学科发展水平等,各大医院要寻求中医事业的发展,必须从以上几方面着手搞好中医建设发展工作,促进中医事业的进一步提高.     

护理干预对地诺前列酮栓治疗足月引产的临床疗效

目的 探讨护理干预对地诺前列酮栓治疗足月引产的临床疗效。方法 选取2017年3月—2018年8月在我院进行治疗的足月引产产妇86例,参照随机数字表法的分组方法,分为对照组和观察组,每组各43例。对照组产妇采用地诺前列酮栓治疗,观察组产妇在对照组产妇的治疗基础上联合护理干预,观察分析两组产妇的临床指标(用药至临产时间、第一产程时间、第二产程时间、第三产程时间)及妊娠结局状况。结果 观察组用药至临产、第一产程、第二产程及第三产程时间显著低于对照组,差异有统计学意义(P<0.05);观察组产后2 h及24 h的出血量显著低于对照组,差异有统计学意义(P<0.05);观察组不良妊娠结局发生率显著低于对照组,差异有统计学意义(P<0.05)。结论 采用护理干预对地诺前列酮栓治疗足月引产的产妇进行护理,能够促进产妇产程进展,降低不良妊娠结局发生率。     

2004年光山县部分新生儿乙型肝炎疫苗接种率及影响因素调查

[目的]了解新生儿乙肝疫苗接种情况，分析影响接种率的相关因素。[方法3z005年8～10月，在光山县15个乡（镇）按容量比例概率抽样方法抽取2004年出生的1000名本地户口新生儿进行调查。[结果]调查新生儿1000名，乙肝疫苗首针及时接种率、全程及时接种率和全程接种率分别为59．40％、58．10％、68．10％。新生儿首针及时接种率、全程及时接种率、全程接种率，医院出生的高于家中出生者，父母文化程度高者高于文化程度低者，家长乙肝相关知识知晓率高者高于知晓率低者。未接种乙肝疫苗的原因占55．85％是不知道要接种；家长获得乙肝疫苗接种信息86．70％来源于接生医生。[结论]光山县乙肝疫苗接种工作存在较大差距。     

Migration and Hansen's disease in Mato Grosso

Studies on medical geography about leprosy discuss the role of the detailed report of the occupation of the territories as a basis of the permanence of leprosy focus. In Brazil, the states that present the highest rates of detection historically are in the Amazon region, which shows an uneven regional evolution of the disease. This paper analyzes the evolution of leprosy contextualizing the migratory processes that occurred in the State of Mato Grosso since the second half of the 20th century. The economic dynamism that occurred in the State in the 1970s, 1980s and 1990s caused population growth rates higher than the national average. The data analyzed permitted an association between the evolution of leprosy and the process of occupation of the mato-grossense territory. However, the permanence of leprosy in the municipalities of the Baixada Cuiabana, as well as in other municipalities that lost population, seem to point to the existence of geographic contexts of different vulnerability to the social production of the disease in the tate. The migration would explain the appearance and evolution of leprosy. However, we consider that the maintenance of the endemic can be associated to contextual factors related to environment.     

Hygienic prognosis of metal circulation in the ecological system of water reservoirs]

Studies of the circulation of mercury in various objects of the environment (water of reservoirs, bottom-reservoir sediment, flood-plain soil and the soil of agricultural lands irrigated with the water from the river and canal, water organisms, products of plant-growing etc.) in areas located downwards from the points of long-term discharge into the ecosystem of mercury with industrial wastes have been carried out, with the aim to establish real stress on the organism of people living within the basin of the reservoir. Discharge of mercury into water sources has been found with the warmed-up and industrial waste waters following mechanical and biological treatment at the plant producing synthetic rubber, with filtration waters from slime tanks and also secondary contamination of the water with mercury coming from bottom--reservoir sediment, and quantitative parameters of circulation of the chemical in the ecosystem of the reservoir basin. Intake of mercury into human organism under the conditions of formation of biogeochemical provinces in the reservoir basin (through water, fish, agricultural products) leads to the increase of the level of morbidity of the nervous system and a number of other diseases, which is associated both with the specific effects of the element and with the non-specific influence it produces as a result of decrease of general resistance of the organism.     

Biliary excretion of diethyl lead after administration of tetraethyl lead in rabbits

In order to investigate into whether the large amount of inorganic lead excreted into the feces following intravenous injection of tetraethyl lead to rabbits is derived from the diethyl lead excreted into the bile, we administered 12 mg/kg of tetraethyl lead to rabbits which had been fistulated into the bile duct for taking the bile out of the body. The total lead excreted into the bile during the first 24 hours after the injection of tetraethyl lead amounted to about 8% of the injected amount of lead (with 97% of the excreted lead made up of diethyl lead). The amount of total lead contained in the cecal contents of unfistulated rabbits 24 hours after the injection of tetraethyl lead was equivalent to about 12% of the injected amount of lead (with inorganic lead accounting for about 90% of the excreted lead), but the counterpart of the fistulated rabbits was equivalent only to about 0.6%. The amount of lead excreted into the bile, when measured in terms of the total lead content of the liver, was slightly less in the fistulated rabbits than in the unfistulated ones. These findings indicated that the amount of total lead excreted into the bile of the fistulated rabbits was almost the same as that contained in the cecal contents of unfistulated rabbits, and that the major portion of the lead contained in the cecal contents or feces was composed of inorganic lead. From these results, we came to the conclusion that the large amount of inorganic lead detected in the feces after the injection of tetraethyl lead is derived from the diethyl lead excreted into the bile.     

Breast feeding: instinctive? Natural? The biological paragon X the reproductive rights in debate

The objective of this essay was to reflect about the naturalization of the breastfeeding, inserting the field of the breastfeeding in the range of the women rights, seeking to destroy the paragon that biologizes the female body to the maternal functions, in special to the breastfeeding in the range of the reproductive rights. In discussion we protrude the importance of the actions which estimulate the breastfeeding are embrased in the notion of the reproductives rights, which will allow the health professionals to comprehend the meaning of the breastfeeding in the women's mark of life and their everyday. By the end, we propose that the reproductive rights drive the actions of breastfeeding incentive developed by the health professionals, in the perspective of to redeem the view of the women while the main subject of this practice.     

Family planning under the view of development

The present essay has as objective to critically analyze the current limitations of the family planning applied in public health and to consider changes considering the model of social sciences applied to health and the perspective of the family development. The proposal of this work appeared because of the high number of women who requested maternity assistance in the region of the Rec?ncavo of Bahia in the year of 2006. By analyzing the variables and methods involved in the family planning, it was possible to verify the following fault: responsibility and exclusive participation of the women, focus in the individual, the number of children as main goal of the planning, biological model, disrespect of the cultural aspects of the partner. In this essay we present the proposal of family planning of the perspective of the development that will be tested as a model of intervention in a future study.     

京沪妇女保健部门职责明确与工作改善的关系分析

目的:明确京沪妇保各部门职责明确程度变化对各要素指标的影响程度。方法:分析2000~2017年京沪妇保业务部门、支撑部门职责明确程度的演变趋势,运用相关分析职责明确程度与工作改善之间的关系。结果:京沪两地业务部门通过发布政策文件等明确和细化妇保机构、医院等职责分工,北京业务部门职责明确程度的变化主要集中在2008~2011年间,从17.9%逐步提升至55.7%;上海则有2个明显跳跃阶段,2001~2002年从26.6%上升至48.4%,2010~2011年从53.5%提升至71.6%;而两地支撑部门的职责明确程度始终为0%。业务部门职责明确程度的变化带来了组织体系、管理运行等要素适宜程度不同幅度的提升,且均呈现了显著正相关(相关系数均超过0.6)。结论:业务部门重视下,能够提升专业机构职责明确程度,并带来体系内部要素的改进;但无法影响支撢部门,资源配置等体系外部要素几乎未变。     

The dynamic binding of resources for health in Brazil: 1995 to 2004

The aim of this study is to discuss the Brazilian Federal participation in the financing health sector from 1995 to 2004, having the basis the resources of the institutional initiatives related to the indexation of expenses, considering the macroeconomic adjustment practiced in that period and the institutions role to protect the cash flow. Examining the performances of the institutional mechanism actually adopted with the purpose of guarantee the flow regularity and extension of the values, by the analisys of the Temporary Contribution on the Financial Movement (TCFM) and the Constitutional Amendment Number 29 (CA 29) whose initiatives has their efficiency questioned. It demonstrates the impact of the destination of such measures from the statistics analysis of the use of the resources of the TCFM regarding its levies and the indexation of Union resources effects measures from the CA 29 before and after the application of its determinations.     

中国医疗质量效益时期的卫生经济学思考

针对当前中国正全面步入的医疗质量效益时期，越来越多的中国人把自己的安全、健康、快乐以及生活质量置身于医疗质量的防护大堤之下，并将医疗质量预期目标与现实经济状况有要地联系起来思考，从医疗质量效益目标的有机统一，互动发展和双重实现等三个方面论述了中国医疗质量效益时期的经济学特征；阐述了质量效益时期中国卫生体制改革和医疗管理理念变革的经济学内涵，并从医院医疗质量绩效评价体系，医疗价值工程，药物经济学方法和医疗技术性能价格比等方面论述了中国质量效益时期医院管理新技术应用的经济学意义。     

A study regarding the relation between the level of the loss of hearing and educational systems in Romania

Loss of hearing seriously affects individual development. Especially, a profound loss of hearing has effects in the evolution of a child's verbal language. Keeping in mind the level of the loss of hearing, a specific educational and recovering methodology has been adopted: on one hand, the stimulation of the hearing potential and the achieving of the verbal language with the implication of the mimic language or, on the other hand, the development of the communication, making use of the dactylleme and of the mimic language. The acceptance of children with big differences between the level of additive reception in the same educational group stands in the way of the optimum evolution of the most adequate communicational style for each one of them.     

Nursing and planning in health: management report as an instrument of health planning

The involvement of the future nurse in the construction of the Management Report of the Actions of Health of a city in the interior of Rio Grande do Sul was the main objective of this study. The methodological strategy consisted of meetings with coordinators and technicians responsible for the sanitary units, the General Director Group and planning team of the health of the city, participation in the collection of data and elaboration of the related report. The literature revision contemplated: politics of health, a management report as an instrument of health planning, continued education and the role of the nurse on SUS improvement. This work contributed to the improvement of the report of health management, with sights to the planning and implementation of resolute and effective actions.     

The public health association and the proletarian naturopathy movement (1891-1933)

The Public Health Association emerged from the proletarian nature healing movement developing in the late 19th century and united organizations that were interested in the preservation of health of the working people. As against the bourgeois nature healing movement, the Association searched for the reasons of the absolutely unsufficient protection of health of the working class in the capitalist society. The fall of this system and the setting-up of socialism were - in the opinion of the Association - the preconditions of social safety and protection of the health of all people. As a self-help organization of the working class, the Association strove for education in the field of health and a healthy life-style and for the application of natural cures. Progressive physicians supported the work of this organization.     

新生儿脉搏血氧灌注指数的分布以及不同监测部位的差异性研究

目的:研究新生儿脉搏血氧灌注指数(PI)的分布特性以及血氧常用监测部位灌注指数的差异性,通过观察新生儿外周局部组织血流的实时变化,及时识别外周循环灌注不足的新生儿。方法:索引医院患者监护期监护信息历史数据库,选取医院产科的72例新生儿,采用监护仪记录新生儿处于静止状态下3 min血氧数据,测量新生儿血氧监测常用部位(左右侧手腕和手掌、左右侧脚腕和脚掌)的灌注指数(PI),并采用数学统计方法分析不同部位PI的差异以及性别、体重等因素对PI的影响。结果:新生儿的PI约75%分布在0.3%~2.0%区间,其左右手腕、手掌、脚腕和脚掌的不同监测部位灌注指数相近,差异无统计学意义;新生儿性别对不同监测部位的脉搏血氧PI比较,差异无统计学意义,但随着体重的增加,脉搏血氧PI则呈现逐渐升高的趋势,体重<1.5 kg、1.5~2.5 kg和>2.5 kg的左侧及右侧手掌、手腕、脚掌和脚腕的脉搏血氧PI比较,差异有统计学意义(F_左侧=26.0632,F=6.2331,F=7.5187,F=3.7076;F_右侧=12.3997,F=7.2997,F=7.6909,F=5.2254;P<0.05)。结论:新生儿脉搏血氧PI的分布特性以及血氧常用监测部位灌注指数的差异性研究结果可为临床PI监测部位的选择提供理论参考。     

医院主要临床工作量目标值的制定与完成系数的计算

目的 为了实现对医院内临床工作绩效科学考核和医院间客观比较评价,本研究依据资源配置和投入产出原理,探寻构建医院主要临床工作量目标值的制定与完成系数的计算方法.方法 根据国务院和卫生部制定的关于人员和病床配置标准的相关规定,采用医院主要临床工作量同一化转换方法,以编制床位和编制人员数推算基础工作量,并对编制人员与标准配置及实际在编人员的偏差进行校正,制定医院主要临床工作量的目标值;在此基础上,以在编人员对医院主要临床工作量贡献比的估算方法,计算在编人员实际完成总工作量,并与目标值比较计算医院主要临床工作量完成系数.结果 以10家医院编制床位和编制人员数推算基础工作量,并对编制人员与标准配置及实际在编人员的偏差进行校正,得到主要工作量目标值,再与同一化后在编人员实际完成工作量比较,得到医院主要临床工作量完成系数,实现了对医院主要临床工作量完成情况的合理评价和对医院间的客观比较.结论 医院主要临床工作量目标值的制定方法与完成系数的计算是科学合理的,有利于实施和操作.医院主要临床工作量完成系数的应用,为设计一种新的公立医院绩效工资分配模式提供了可能性和可行性.