ER "capture" of the skid-row alcoholic

In response to the spiraling anger and frustration voiced by the emergency room (ER) medical staff and the observed negative interactions between the alcohol-dependent patient and the ER staff, the author completed a 6-month retrospective review of all patients evaluated by the ER service with a complaint of alcohol abuse, chronic alcoholism, or requesting detoxification. As a result of that study, an ER-based comprehensive approach to the management of this population was proposed. Utilizing an existing Connecticut state statute, a specific approach to manage the skid-row alcoholic arriving repeatedly in the ER was developed. I report on this ER-based model and an approach to "capturing" the skid-row alcoholic.     

A Consideration on the new classification of latest lung ventilators

Concerning the classification of ventilators, Elam (1958), Faireley (1959), and Hunter (1961) reported some simple ones such as pressure limited, volume limited, pressure preset, or volume preset models. Mapleson (1969) also classified them by the generating force or cycling together with the above-mentioned types.The latest ventilators applicable to patients with respiratory failure usually have some cut-off function at high airway pressures as a safety measure. Therefore, all of them belong to the pressure limited type. Some ventilators are of two types such as the time cycled and pressure cycled type.Therefore, we attempted to classify ventilators into four groups, i.e. the time cycled, volume cycled, pressure cycled and selective time-pressure cycled types according to the fundamental mode of ventilator function, the so-called change of cycling from inspiration to expiration. Each group was further divided into subgroups according to preset dials such as respiratory rate, I/E ratio, inspiration time, expiration time, tidal volume, flow rate and airway pressure.By this method, fifty one ventilators on the market in Japan can be classified without overlapping. Although this classification seems complex, it will be of use in selecting ventilators by emphasizing preset dials according to the users needs, ability or both.(Goto Y, Takahashi K, Harada J et al.: A consideration on the new classification of latest lung ventilators. J Anesth 1: 178–182, 1987)     

情景模拟演练在儿科急诊新护士带教中的应用效果研究

目的研究在儿科急诊对新护士展开临床带教中,使用情景模拟演练教学法的实际应用效果。方法选择该院于2018年5月—2019年5月期间于该院儿科急诊中入岗新护士共计70名,设为该次实验对象。设立常规组与实验组后,将其平均分成两组并分别纳入作为对应组观察患者。其中常规组(2018年5—12月期间)的35名实习护士沿用传统带教模式展开教学,实验组(2019年1—5月期间)的35名实习护士沿用情景模拟演练模式展开教学。在两组同时期下收集各100例临床患者,在带教周期一月期间为其提供护理工作评价。并对其护士进科前后综合能力考评情况、护理技术考核成绩、护士带教护理满意度、患者满意度评价进行统计。结果进科前,两组对象综合能力考评能力于组间对比差异无统计学意义(P>0.05)。进科后,实验组新护士综合能力考评成绩相比常规组更高,同时实验组护士的儿科护士护理技术考核明显优于常规组,差异有统计学意义(P<0.05)。相比较常规组,实验组新护士对带教满意度明显更高,同时对应组患者对护理工作的满意性更高,差异有统计学意义(P<0.05)。结论给予儿科急诊中入岗新护士情境教学法,对培养其岗前护理技能操作技能效率较高,同时能改变其患者护理满意性,加强新上岗护士综合能力,拉近护患之间关系,是较好的临床带教方法。     

医院档案管理工作基于新形势的开展途径分析

医院是为人类提供公共卫生服务的一个单位,其存在具有至关重要的影响意义,是人们医疗卫生事业的主要承担场所,医院所提供的公共卫生服务水平主要受到两个方面因素的影响,其一是医疗卫生发展水平,其二是人们生活水平;而这两种因素均受到人类社会经济发展水平的影响,由此可见,医院可以直接反映人类社会的发展水平,医院管理治疗会对其实际运行水平产生直接性影响,同时也侧面体现了我国公共卫生服务质量。因此,基于此种社会现实下,结合新形势要求,分析医院档案管理工作存在的弊端,并探讨创新途径具有至关重要的影响意义,这不仅是国家发展、社会发展的要求,同时也是医院实现可持续运行的根本条件,是当前医院刻不容缓需要解决的主要问题。     

新建或迁建血站正式运行前的确认工作探讨

在迁建新业务大楼正式投入运行前,采用质量审核、试运行、目视检查等方法,分阶段确认新建血站的基础设施、设备、环境、工作流程等是否达到预期要求,探讨新血站系统化确认方法。新建或迁建后的血站在正式启用前应对其所涉及的建筑设施、设备、环境、工作流程等进行全面且系统的确认,以更好地保障血液质量与安全。     

医学科技期刊新媒体爆款文章的特征及生成策略——以《协和医学杂志》实践为例

【目的】 探析医学科技期刊新媒体爆款文章的特征及生成策略。 【方法】 以《协和医学杂志》为例,筛选出其在今日头条平台2018年10月至2020年12月阅读量为“10万+”的爆款文章,分析文章特征,并从资源挖掘、内容生产及推广传播环节提出有效策略。 【结果】 医学科技期刊新媒体爆款文章具有话题热、标题靓、排版精、互动深的特点;借力平台优势、融合科普定位、发挥“意见领袖”作用、巧搭新闻热点事件、精心设计版式以及多网媒滚筒式传播均为医学科技期刊新媒体爆款文章生成的有力之举。 【结论】 医学科技期刊新媒体深挖优势资源,把好内容及传播环节,策略性运营,可为爆款文章生成提供保障,进而提升期刊品牌影响力和新媒体综合实力。     

Rising Ethnic Inequalities in Acute Rheumatic Fever and Rheumatic Heart Disease,New Zealand, 2000–2018

We describe trends in acute rheumatic fever (ARF), rheumatic heart disease (RHD), and RHD deaths among population groups in New Zealand. We analyzed initial primary ARF and RHD hospitalizations during 2000–2018 and RHD mortality rates during 2000–2016. We found elevated rates of initial ARF hospitalizations for persons of Māori (adjusted rate ratio [aRR] 11.8, 95% CI 10.0–14.0) and Pacific Islander (aRR 23.6, 95% CI 19.9–27.9) ethnicity compared with persons of European/other ethnicity. We also noted higher rates of initial RHD hospitalization for Māori (aRR 3.2, 95% CI 2.9–3.5) and Pacific Islander (aRR 4.6, 95% CI 4.2–5.1) groups and RHD deaths among these groups (Māori aRR 12.3, 95% CI 10.3–14.6, and Pacific Islanders aRR 11.2, 95% CI 9.1–13.8). Rates also were higher in socioeconomically disadvantaged neighborhoods. To curb high rates of ARF and RHD, New Zealand must address increasing social and ethnic inequalities.     

COVID-19 and Infant Hospitalizations for Seasonal Respiratory Virus Infections,New Zealand, 2020

In March 2020, a national elimination strategy for coronavirus disease was introduced in New Zealand. Since then, hospitalizations for lower respiratory tract infection among infants <2 years of age and cases of respiratory syncytial or influenza virus infection have dramatically decreased. These findings indicate additional benefits of coronavirus disease control strategies.