基于Kano模型的养老机构老年人护理服务需求属性分析

目的 分析养老机构老年人护理服务需求属性,为制订针对性干预措施提供参考.方法 基于Kano模型设计养老机构老年人护理服务需求调查问卷,对天津市7所养老机构共687名老年人进行调查.结果 养老机构老年人护理服务需求34个条目中,魅力属性需求10条(29.4％),均位于保留区Ⅳ;期望属性需求10条(29.4％),其中7条位于优势区Ⅰ;必备属性需求11条(32.4％),其中7条位于待改进区Ⅱ;无差异属性需求3条(8.8％),均位于次要改进区Ⅲ.生理健康与医疗需要维度中,魅力属性2条,期望属性4条,必备属性5条,无差异属性1条;安全需要维度中,期望属性1条,必备属性4条,无差异属性2条;尊重需要维度中,魅力属性1条,期望属性3条,必备属性2条;爱与归属需要维度中,魅力属性4条,期望属性2条;自我实现需要维度的3条均为魅力属性.结论 养老机构老年人必备、期望属性护理服务需求主要集中在生理健康与医疗、安全及尊重需要,魅力属性需求主要集中在爱与归属、自我实现需要.养老机构应在维持和完善必备、期望属性需求的基础上,发展和创新魅力属性需求,客观分析和优化改造无差异属性需求.     

Understanding the messages and motivation of vaccine hesitant or refusing social media influencers

BackgroundWhile anti-vaccine messages on social media have been studied for content, reach, and effectiveness, less is known about those who create and promote the messages. Online influencers, or ‘everyday people who are influential within their online social networks’, are viewed as trusted voices who are often making similar life decisions as their followers. Therefore, their experiences with and perspectives on health issues can be persuasive.MethodsWe collaborated with a formal network of online influencers to interview, using a semi-structured interview guide, vaccine hesitant influencer mothers about their views on vaccination; their process for developing health-related social media content; their motivation to promote anti-vaccine messages; and their opinions on current vaccination messaging. Prescreening ensured a diverse sample by race/ethnicity, age, education, number of children, and geographic residence. Interviews occurred by telephone, were audio recorded, and transcribed. Themes were generated independently by two coders using a deductive coding approach.ResultsWe interviewed 15 online influencer mothers from across the U.S. (average age 39 years old; all married; 13 Caucasian, 1 African American, 1 Hispanic). In some capacity, 5 of the 15 wrote about vaccination on their blog. Those who chose not to post anti-vaccine content did so for fear of alienating followers or having their platform be the site of combative discourse among readers. When researching their social media posts, the influencers did not trust mainstream sources of health information and relied on alternative sources and search engines.Implications: This exploratory study interviewed influential mothers who have the ability to spread anti-vaccine messages on social media. While most do not contribute to the anti-vaccine sentiment, understanding the motivation and practices of those that do assists the public health community in better understanding the online vaccination communication environment, leading to more effective messages to counterbalance anti-vaccine content on social media.     

基于SQL的报表系统开发及其在放疗流程质控中的应用

目的 有效利用放疗科日常运行中产生的临床数据,基于科室已有网络资源实现放疗信息无纸化,提高放疗流程质控水平。方法 分析科室放疗流程及所需文档,运用基于SQL数据库的报表工具Report Builder,对放疗科已有网络Aria产生的大量数据进行提取和分析,开发报表实现患者现有放疗文档的电子化;运用PDCA的方法分析流程中存在的薄弱环节,提出对策并设计相应报表量化指标,从而提高流程质控水平。结果 自2020年全面实施以来,科室实施放疗两千余人次,患者放疗信息一次登记后全部文档实现网络存档和查询。根据实际工作需求制定了13个日常统计报表、5个季度和3个年度统计报表,通过报表统计使用报表前后3个月的放疗前等待时间由16.2 d缩短至14.8 d,工作人员能够掌握患者治疗进度,及时发现12例中断治疗的患者。结论 通过报表工具的信息提取能够实现放疗全流程信息网络化和患者放疗数据电子化,提高了人员工作效率和沟通效率,科室能够根据报表数据实时优化资源配置,提高放疗的效率和质量。该方法具有普适性和实用性。     

医院输血管理系统的设计和应用

本文描述了医院输血管理系统的流程、功能、结构以及数据库设计过程.介绍了系统软件功能模块.系统的应用实现了安全用血、降低输血差错率,提升医院的整体医疗质量.     

1981～2000年《南通医学院学报》学术质量指标综合评价

采用文献计量学方法对《南通医学院学报》20卷78期4713篇论文的多项学术质量指标进行统计分析。结果：（1）信息量指数0．55篇／页;（2）单元作者系数2．33人／篇;（3）论文合著率64．52％;（4）出版时滞8．5个月;（5）国家自然科学基金资助等省部以上课题论文86篇;（6）平均引文量4．81条／篇;（7）衰减系数41．6％,其中中文衰减系数54．6％,外文衰减系数33．4％。统计结果表明,信息量指数呈上升趋势,单元作者系数和论文合著率偏低,出版时滞改善显著,基金资助论文数所占,平均引文量偏少,衰减系数增长明显。     

知识经济与高校信息服务业的战略转变

知识经济的迅猛发展,使我国高等学校的信息服务业面临着变革和发展的新机遇,本文在分析信息服务业内部各服务环节功能的传统性、局限性的基础上,提出了高校信息业发展的战略目标,以及为实现战略目标必须对各服务环节功能进行调整和改革的具体意见。同时强调指出：转变观念是实现改革与发展的先导。     

Social HMOs and Other Capitated Arrangements for Children with Special Health Care Needs

Objective: Children with special health care needs are increasingly enrolling in managed care arrangements. However, existing managed care organizations, including traditional HMOs, are often poorly suited for caring for this population. In the adult health care area, new managed care entities, called Social HMOs (S/HMO) and Programs for the All-inclusive Care for the Elderly (PACE), have been created to integrate health and health-related services for chronically ill and disabled adults. We describe these models and assess their potential for serving children with special health care needs. Method: We reviewed the literature on managed care for children with special health care needs and evaluation findings from the S/HMO and PACE models for the elderly. Results: Evaluations of the S/HMO and PACE models have yielded mixed findings. Some of the more positive accomplishments include lower use and expenditures for long-term care services compared to other demonstration projects, greater integration of primary care physicians in decision making concerning long-term care, and improved management of transitions between care levels. On the negative side, start-up has been slow, prospective members have been hesitant to enroll, intermittent and sometimes frequent operating deficits have emerged, no discernible positive effects on health or social outcomes are apparent, and no significant overall savings have emerged. Conclusions: With mixed results so far, caution is required in applying these or similar models for vulnerable child populations. However, given the inadequacies of traditional managed care for this population, we believe experimentation with new models of care that integrate health and health-related services is important. Such experimentation should be fostered only to the extent that the models are carefully designed and then implemented in a manner that protects the interests of children with special health care needs.     

Sexual Knowledge,Experience and Feelings Among People with Disability

The current study was designed to evaluate the sexual knowledge, experience, feelings and needs of people with intellectual disability or physical disability, and compare them to people from the general population. Sixty people with mild intellectual disability (28 males, 32 females, mean age=27.62 years), 60 people with physical disability (33 males, 27 females, mean age=28.65 years) and 100 people from the general population (40 males, 60 females, mean age=30.10 years) participated in the study. Each respondent completed the Sexual Knowledge, Experience and Needs Scale (SexKen). This scale assesses levels of knowledge, experience, feelings and needs in 12 different areas of sexuality. The results demonstrated that people with intellectual disability experienced lower levels of sexual knowledge and experience, more negative attitudes to sex and stronger sexual needs than people with physical disability, in all areas of sexuality. People with physical disability demonstrated these same trends when they were compared to people from the general population. An interpretation of these results as they relate to the sexuality of people with intellectual or physical disability is provided.     

实验动物质量监测管理办公系统的开发

作为实验动物质量管理的中枢,实验动物监测管理工作程序中的许多信息是实验动物信息来源的重要而不可缺少的部分。这些数据需要通过特定的数据传输程序进入实验动物数据库进行处理分析,成为实验动物信息网络中的共享资源,这是实验动物信息网络开发的重要一环。本研究利用编程软件MSVBasic 6.0 和大型数据库管理系统MSSQL7-0 , 在实验动物数据库和信息网络的基础上针对实验动物质量监测管理专业性和第三方公正性的工作程序和岗位特点,编制实验动物质量监测管理办公网络系统,实现了软件客户化和实验动物质量监测工作信息化的要求。本文以广东省实验动物监测所( 简称监测所) 办公系统的建设为例,介绍该系统设计的原则和实现过程。     

Redefining community care social work: needs or risks led?

This reflective paper assesses whether the focus of community care social work is shifting from responding to needs to reducing or containing risks. Whilst public response to unacceptable risk has instigated major developments in health and welfare services and an overt concern with risk management is a key feature in elder abuse and mental health work, notions of risk have featured less explicitly in the community care literature. This paper suggests that community care assessment is increasingly concerned with risk management, as containing risks becomes a means of rationing scarce resources, when situations of high risk attract more resources than those where the risk is less. In addition, this emphasis on only the negative connotations of risk and the need for protection may constrain empowering service users to define their own positive risks.