A framework for health promoting emergency departments

Since 1986, the World Health Organization (WHO) has been advocating for the health sector to move increasingly in a health promotion direction, beyond its responsibility for providing clinical and curative services (WHO, 1986). Some Emergency Departments (EDs) have partially achieved this through providing patient health information, screening and early intervention programs, injury prevention and asthma education. While EDs are a suitable setting for health promotion, they are grounded in a medical paradigm where most of the staff are educated to think exclusively of relation care. As such, a significant organizational shift is required for EDs to be more inclusive of health promotion principles. Following a comprehensive literature review, a theoretical framework was developed for the Health Promoting Emergency Departments Program (HPEDP). It describes the opportunities for health promotion in EDs through combining the 'strategies for health promotion' with the 'spectrum of health and disease'. This forms a matrix to enable health development, primary prevention and secondary prevention interventions to be planned in EDs. The framework is a tool to support the development of coordinate and comprehensive health promotion programs and to avoid the use of isolated victim-blaming strategies. Beyond EDs, planners in other health care institutions may also find the framework useful-particularly those settings where staff health promotion training and experience is limited.     

Word-category specific deficits after lesions in the right hemisphere

A speeded lexical decision task was used to investigate word-category deficits in patients suffering from lesions in the right hemisphere and in neurological controls without cortical lesion. In all patients from one group (n = 12), the right frontal lobe was affected causing a left-sided hemiparesis. In the second group (n = 6), lesions primarily affected areas in the right inferior temporo-occipital lobes. Patients with motor deficits due to lesions in the spinal cord or in the periphery served as neurological controls (n = 9). Processing of three categories of words was investigated: verbs referring to actions (action verbs (acVs)); nouns with strong visual associations (visually-related nouns (viNs)); and nouns with both strong action and visual associations (bimodal nouns (biNs)). Stimulus categories were matched for word length and normalized lexical frequency. Error scores revealed a significant word category by patient group interaction. Patients with lesions in the right frontal lobe showed most severe deficits in processing action verbs, whereas those with lesions in their right temporo-occipital areas showed most severe deficits in processing visually-related nouns. Neurological controls did not show any differences between word categories. The double dissociation of the processing impairments seen in frontal versus temporo-occipital patients demonstrates that specific word-category deficits can arise from lesions in the right non-dominant hemisphere. An account for these results in terms of distributed neuronal systems representing words is offered.     

I've come for his throat': roles and identities in doctor-parent-child communication

Previous studies on doctor-parent-child communication at the general practitioner's surgery showed that the GP and the parent differ fundamentally in the way they enable or constrain child participation. The question how to explain these differences is at the core of the present study. The aim is to describe how the three participants display their orientation to their institutional roles and identities; how they collaboratively co-construct the course of action; and how these discursive constructions structure the ongoing interaction. A qualitative analysis of 106 videos shows that although GP and parent initially show incongruent orientations toward child participation, in the further course of the encounter all three participants jointly establish a situation in which child participation appears to be rather an exception. It is concluded that parental speaking for the child is, in a way, institutionally co-constructed; parents take their responsibility, which is hardly ever questioned by children, and GPs ratify this behaviour by refraining from meta-communicative comments and by aligning with the parent in the course of the interaction. The results are discussed in terms of enabling child participation and implications for medical practice.     

澳大利亚全科医学服务质量管理框架、措施及借鉴

本文系统地介绍了澳大利全科医学服务的质量管理框架,并从以病人为中心的战略;全科医生教育、培训、认证和持续发展;全科医学服务质量标准;促进信息管理和信息技术应用等4个方面,阐述澳大利亚持续改善全科医学服务质量的具体措施,为我国全科医学和社区卫生服务的发展提供可借鉴的经验。     

Java并发模型框架的构建及应用

介绍了框架的基本概念,详细说明了依据实例构建框架的基本思想。构造了一个实用并发模型框架,利用该框架解决了Client/Server模型的XML文档数据的一致性和有效性问题。     

北约保障供应组织与北约保障供应局

北约保障供给组织(NAMSO)是北约的一个生产和后勤组织,北约保障供给局(NAMSA)是NAMSO的具体执行机构,是北约主要的后勤保障管理机构,具体负责应北约成员国要求对其共用的武器装备系统提供后勤保障。NAMSO的任务是在平战时对两个或多个北约成员国军队以最低的成本实施最有效的后勤保障。NAMSA由后勤规划调控部,采购部,财政部和资源部四个部门组成。NAMSA提供后勤保障服务的主要范围是：供应、保养、采购、合同管理和工程技术支持。     

浙江大学医学院附属邵逸夫医院治理结构分析

通过对浙江大学附属邵逸夫医院的个案调查，明确了该院的治理结构。揭示邵逸夫医院新型治理结构为其推行的现代医院管理模式提供了制度空间。通过梳理邵逸夫医院建院10年来治理结构的变迁过程，指出其董事会功能弱化且治理结构有向传统公立医院治理结构回归的趋势，主要原因是缺乏对新型治理结构文化和理念上的认同。通过深入剖析邵逸夫医院案例，从中抽象出公立医院改革面临的共同问题及在公立医院实行公益法人治理结构的约束条件。     

数字化医院建设存在的问题与解决方法

随着病人对医疗质量和服务水平需求的提高 ,以及计算机和网络技术的普及 ,各种信息系统开始在医院中投入使用 ,建设数字化医院 (DigitalHospital,DH )已经成为当今医院发展的必然趋势。但由于国内外对数字化医院的研究还处于探索阶段 ,对数字化医院的概念还没有一个标准的定义 ,并且缺乏相应的规范与理论来指导实践 ,因此在目前数字化医院的建设中仍存在着不少问题。文章在介绍国内外数字化医院建设发展的基础上 ,提出了目前在建设数字化医院中出现的一些问题 ,并给出了相关的解决方法。     

PACS在我院的建设和应用

目的:通过构建医学影像与传输系统(PACS),实现医院医学影像信息工作的管理和服务的数字化网络。方法:根据医院的特点,进行整体的规划,采用适合的系统架构和单元设计,逐步予以实施。结果:目前已完成全部建设任务,并对系统进行不断地测试,使其更加完善,同时进行了一些临床应用。结论:我院PACS 2 a来运行的结果表明,该系统性能稳定,达到了设计和实际运行的要求。     

经外奇穴研究概况

回顾和分析了近50年有关经外奇穴的文献,总结归纳了经外奇穴的义界范畴、有关编著、归经、命名规律、取穴法和临床应用等方面的研究整理概况,为今后的深入研究提供了相关的依据。