内含报酬率法在医院大型项目投资决策中的应用

根据财务管理中内含报酬率原理，介绍其在医院实际工作中的具体运用。同时提出：为了保证分析评价的科学性、客观性，必须遵循实际现金流量原则和增量原则，做好对沉没成本、机会成本、分摊费用、业务收支、折旧费用等5方面的判断和识别。     

Feasibility of measles vaccine: Experience with live attenuated virus vaccine in and around Sevagram

301 susceptible children between 9 months to 59 months of age from villages around Sevagram were immunised against measles with the live attenuated Schwartz strain. Ouster approach was adopted. 95 percent coverage was achieved. Follow up for next 15 days by village health worker revealed mild reactions to measles vaccine in 70(23.25%) Upper respiratory cattarh with or without fever was the commonest finding. Measle like rash was a rare finding (only two children). Acute allergic edema of the vaccinated limb within 12 hof vaccination and rapid response to antihistaminics was an interesting observation in one child. By and large, duration of postvaccinal illness confined to 3–4 days. Thus, considering 95 percent coverage with the single dose vaccine and mild nature of reactions, it is felt that measles vaccine can easily be accepted in rural India.     

CURRENT STATUS AND EVALUATION OF TRANSNASAL ESOPHAGOGASTRODUODENOSCOPY

We reviewed the current status of transnasal esophagogastroduodenoscopy (EGD) with regard to tolerance, safety, feasibility and accuracy. Comparison of standard and ultrathin scopes and recently reported endoscopic techniques with transnasal insertion are also described as well as the current status of transnasal EGD in European countries compared with Japan. As several studies concluded that transnasal EGD can facilitate comfortable endoscopy without the need for sedative drugs, it has been tried in countries in which a relatively high number of unsedated EGD are carried out in daily practice. Long‐tube intubation of the jejunum with the assistance of transnasal EGD will also be a part of the daily practice in the near future. However, its safety and accuracy should be further investigated. Even a standard scope whose charge‐coupled device (CCD) has the same resolution as an ultrathin scope is superior to an ultrathin scope in terms of luminosity and resolution. Given the small number of procedures reported to date, the absolute complication rate of unsedated transnasal EGD is unknown. Methods of nasal anesthesia, as well as informed consent, indications and contraindications for transnasal EGD are not standardized. A guideline of transnasal EGD is under discussion by the Japanese Gastroenterological Endoscopy Society.     

Non‐invasive cardiovascular profiling using combined electrocardiogram–Doppler ultrasonography and impedance cardiography: An experimental approach

相似文献   

Feasibility of Momentary Sampling Assessment of Cannabis Use in Adolescents and Young Adults

This study examines the feasibility of recruiting and retaining adolescents and young adults with frequent cannabis use for a 2-week momentary sampling study of cannabis use. Participants responded to random signals on a handheld computer with reports of their use. Participants also initiated reports pre- and post-cannabis use. Participants had high rates of completion (93%) and response to signals (74%) and low study burden. Cannabis use influenced the validity of the data (p < .05). These findings highlight the feasibility of recruiting and retaining adolescent/young adult cannabis users in a momentary sampling study. Data validity may be affected by substance use.     

Single-Session Motivational Interviewing for Drug Detoxification Inpatients: Effects on Self-Efficacy,Stages of Change and Substance Use

Thirty-five inpatients at a Stockholm hospital drug user detoxification unit received single-session Motivational Interviewing (MI) between 2006 and 2008. At baseline and after 3?months, they were compared to a semirandomized control group of 52 patients with treatment as usual. In the MI group, self-efficacy increased regarding abstention in connection with positive feelings, appreciation of positive drug effects increased, and participants tended to transition toward preparation/action stages of change. Despite implementation challenges, the study demonstrates the feasibility and effectiveness of single-session MI delivery in the inpatient drug detoxification setting and suggests paths for future research on delivery of single-session MI.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Feasibility of assessing public health impacts of air pollution reduction programs on a local scale: New Haven case study

Background

New approaches to link health surveillance data with environmental and population exposure information are needed to examine the health benefits of risk management decisions.

Objective

We examined the feasibility of conducting a local assessment of the public health impacts of cumulative air pollution reduction activities from federal, state, local, and voluntary actions in the City of New Haven, Connecticut (USA).

Methods

Using a hybrid modeling approach that combines regional and local-scale air quality data, we estimated ambient concentrations for multiple air pollutants [e.g., PM_2.5 (particulate matter ≤ 2.5 μm in aerodynamic diameter), NO_x (nitrogen oxides)] for baseline year 2001 and projected emissions for 2010, 2020, and 2030. We assessed the feasibility of detecting health improvements in relation to reductions in air pollution for 26 different pollutant–health outcome linkages using both sample size and exploratory epidemiological simulations to further inform decision-making needs.

Results

Model projections suggested decreases (~ 10–60%) in pollutant concentrations, mainly attributable to decreases in pollutants from local sources between 2001 and 2010. Models indicated considerable spatial variability in the concentrations of most pollutants. Sample size analyses supported the feasibility of identifying linkages between reductions in NO_x and improvements in all-cause mortality, prevalence of asthma in children and adults, and cardiovascular and respiratory hospitalizations.

Conclusion

Substantial reductions in air pollution (e.g., ~ 60% for NO_x) are needed to detect health impacts of environmental actions using traditional epidemiological study designs in small communities like New Haven. In contrast, exploratory epidemiological simulations suggest that it may be possible to demonstrate the health impacts of PM reductions by predicting intraurban pollution gradients within New Haven using coupled models.