Three Meals a Day is Passé at Progressive Hospital

Modern medical simulation technology (MST) debuted in 1960 with the development of Resusci Annie (Laerdal 2007), which assisted students in the acquisition of proper ventilation and compression techniques used during basic life support. Following a steady stream of subsequent technological advances and innovations, MST manufacturers are now able to offer training aids capable of facilitating innovative learning in such diverse areas as human patient simulators, simulated clinical environments, virtual procedure stations, virtual medical environments, electronic tutors, and performance recording. The authors list a number of the most popular MSTs presently available while citing evaluative efforts undertaken to date regarding the efficacy of MST to the medical profession. They conclude by proposing a variety of simulation innovations of prospective interest to both medical and technology personnel while offering healthcare administrators a series of recommended considerations when planning to integrate MST into existing medical systems.     

新型农村合作医疗2型糖尿病患者自我管理现状的调查

目的调查新型农村合作医疗2型糖尿病患者自我管理现状。方法采用自行设计的自我管理问卷对205例患者进行问卷调查。结果 57.07%的糖尿病患者自我管理总体处于一般水平,29.27%处于较好水平,0.98%处于非常好水平。自我管理各维度得分指标由高到低依次为:药物管理、饮食管理、糖尿病足管理、低血糖管理、血糖监测、运动管理。结论新型农村合作医疗2型糖尿病患者的自我管理总体水平不高,护理人员应有针对性地对患者及家属开展健康教育。     

司法鉴定融入基础医学教育助力高素质医学人才的培养

通过医学生前期教育中增设司法鉴定相关的新生研讨课,将真实典型的法医病理案例融合贯通于基础医学理论和实验教育中,进一步开设法医学选修课,引导医学生申请司法鉴定和法医病理相关的科研训练,增加学生学习的兴趣和临床思辨能力,进行早期预警,提升防范和应对突发医疗事件的能力,同时提高老师的业务水平和教学质量,从多方面助力高素质医学人才的培养,减少和防范医疗纠纷的发生。     

Jewel of the seabed: sea cucumbers as nutritional and drug candidates

Marine sources have been attracting the attention of scientists and manufacturers worldwide hoping to find new alternatives for biological active substances. Promising new research indicates that sea cucumber, which is slug-like in appearance and has been a staple in Japan, China and other parts of East Asia since ancient times, is beginning to gain popularity as a dietary supplement in western countries. The roles of sea cucumber extracts in various physiological functions have spurred researchers to investigate the ability of sea cucumber to be an alternative in neutraceutical and medical applications. This article provides a brief introduction to sea cucumber and reviews its numerous bioactive compounds, such as triterpene glycosides, glycosaminoglycans, gangliosides, collagen, branched-chain fatty acid and lectins, which serve as potential sources of neutraceutical, pharmaceutical and cosmetic agents, thus providing a new platform in biochemical research.     

地震救援中实施远程医疗服务:把最好的医学专家送到灾区人民身边

目的和方法 总结解放军总医院远程医疗会诊系统在2013年“4·20”四川芦山地震救援中发挥其远程医疗服务的经验,探讨远程医疗会诊系统在灾难救援中的作用.结果和结论 在2013年4月20日四川芦山地震后,解放军总医院专家医疗队及时将无线便携式远程医疗会诊系统发送至地震灾区伤员集合点医院,第一时间组织开通面向灾区服务的远程医疗会诊系统,与位于地震灾区的多家医院及地震救援队救护车远程医疗系统联通,提供24h包括急诊和危重症救治、骨科、脑外科、肝胆外科、妇产科等相关专业的远程救援服务,对地震伤员的抢救提出了诊断和救治意见,形成了救灾现场专家与后方专家的良性互动,使灾区专家医疗队的救治能力倍增.解放军总医院在芦山地震中共进行远程医疗会诊110余例,在对灾难现场的受伤人员进行有效的紧急救治中实现了实时高清会诊和现场手术指导,并在业务层面实现了多媒体通信系统与医院医疗信息系统的对接,在功能层面实现了各联盟医院的视频、音频和数据以及医疗业务的互联互通,为我国在灾难救援中实施远程医疗抢救提供了可借鉴的经验.     

剖宫产分娩医疗费用的分析

目的分析单病种剖宫产医疗费用,探讨降低医疗费用的对策。方法利用2005年-2009年单病种住院医疗费用的统计报表,对住院病人的医疗费用增长情况进行统计学分析。结果剖宫产医疗费用呈上升趋势,药品费用及检查治疗费用增长是主要原因。结论降低剖宫产比率,减少医疗费用,节省医疗资源;为医疗体制的改革提供参考。     

Impact of the HITECH financial incentives on EHR adoption in small,physician-owned practices

BackgroundPhysicians in small physician-owned practices in the United States have been slower to adopt EHRs than physicians in large practices or practices owned by large organizations. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 included provisions intended to address many of the potential barriers to EHR adoption cited in the literature, including a financial incentives program that has paid physicians and other professionals $13 billion through December 2015.ObjectiveGiven the range of factors that may be influencing physicians’ decisions on whether to adopt an EHR, and given the level of HITECH expenditures to date, there is significant policy value in assessing whether the HITECH incentives have actually had an impact on EHR adoption decisions among U.S. physicians in small, physician-owned practices. This study addresses this question by analyzing physicians’ own views on the influence of the HITECH incentives as well as other potential considerations in their decision-making on whether to adopt an EHR.MethodsUsing data from a national survey of physicians, five composite scales were created from groups of survey items to reflect physician views on different potential facilitators and barriers for EHR adoption as of 2011, after the launch of the HITECH incentives program. Multinomial and binary logistic regression models were specified to test which of these physician-reported considerations have a significant relationship with EHR adoption status among 1043 physicians working in physician-owned practices with no more than 10 physicians.ResultsPhysicians’ views on the importance of the HITECH financial incentives are strongly associated with EHR adoption during the first three years of the HITECH period (2010–2012). In the study’s primary model, a one-point increase on a three-point scale for physician-reported influence of the HITECH financial incentives increases the relative risk of being in the process of adoption in 2011, compared to the risk of remaining a non-adopter, by a factor of 4.02 (p < 0.001, 95% CI of 2.06–7.85). In a second model which excludes pre-HITECH adopters from the data, a one-point increase on the incentives scale increases the relative risk of having become a new EHR user in 2010 or 2011, compared to the risk of remaining a non-adopter, by a factor of 3.98 (p < 0.01, 95% CI of 1.48–10.68) and also increases the relative risk of being in the process of adoption in 2011 by a factor of 5.73 (p < 0.001, 95% CI of 2.57–12.76), compared to the risk of remaining a non-adopter in 2011. In contrast, a composite scale that reflects whether physicians viewed choosing a specific EHR vendor as challenging is not associated with adoption status.ConclusionsThis study’s principal finding is that the HITECH financial incentives were influential in accelerating EHR adoption among small, physician-owned practices in the United States. A second finding is that physician decision-making on EHR adoption in the United States has not matched what would be predicted by the literature on network effects. The market’s failure to converge on a dominant design in the absence of interoperability means it will be difficult to achieve widespread exchange of patients’ clinical information among different health care provider organizations.