几种具有抗疲劳、抗缺氧作用的藏药植物资源

由于藏民族主要生活在高海拔地区,因此在藏药中有许多著名的抗疲劳、抗缺氧药用植物资源,如红景天、沙棘等。本文整理了沙棘、冬虫夏草、蕨麻和红景天等几种(类)具有抗疲劳、抗缺氧作用藏药植物资源及其目前有关这些植物资源的开发利用研究状况,以期为开发运动员专用保健饮料和保健食品提供参考。     

建瓯市并殖吸虫种质资源及感染情况的调查

目的了解建瓯市并殖吸虫及媒介宿主的种类与感染情况。方法在调查点捕捉各种螺类与蟹类，检查其所携带的并殖吸虫并计算感染率。结果发现可充当并殖吸虫第一中间宿主的螺类有放逸短沟蜷、福建拟钉螺、建瓯洱海螺、小桥拟钉螺，其感染率分别为0、0．15％、0．42％与0．15％。充当并殖吸虫第二中间宿主的溪蟹有福建华溪蟹、福建马来溪蟹、角肢南海溪蟹，其感染率分别为46．60％、14．29％与12．50％。并殖吸虫虫种有卫氏并殖吸虫、斯氏狸殖吸虫、泡囊狸殖吸虫3种。其中，泡囊狸殖吸虫为新发现虫种。结论建瓯市并殖吸虫及媒介宿主物种资源丰富，为全省开展并殖吸虫病的调查和研究工作提供了病原线索。     

基于数据包络分析的重庆市卫生资源配置效率研究

目的 分析2015—2020年重庆市各区县卫生资源配置效率,为重庆市提升资源配置效率提供参考。方法 采用数据包络分析的BCC模型和Malmquist指数对2015—2020年重庆市各区县卫生资源配置效率进行分析。结果 在2020年,重庆市卫生资源配置的综合效率不高,38个区县中有7个区县处于DEA有效状态,8个区县处于DEA弱有效状态;2015—2020年,重庆市全要素生产率指数均值为0.945,3个区县的全要素生产率指数大于1。结论 重庆市各区县卫生资源配置效率有待提高,重点在于提升技术进步水平;重庆市四大区域内部和四大区域之间卫生资源配置效率差异较大,需整合医疗卫生资源,重视医学科技创新和成果转化,达到提升卫生资源配置效率的目标。     

2011—2020年四川省疾病预防控制机构人力资源动态分析

目的 了解四川省2011—2020年各级疾病预防控制中心人力资源变化情况,为合理规划四川省各级疾病预防控制中心人力资源提供依据。方法 利用四川省疾病预防控制基本信息系统对四川省2011—2020年各级疾病预防控制中心人力资源总量、年龄、学历、职称和专业技术人员构成等进行分析。结果 2020年四川省各级疾病预防控制中心人员总量达到10年来的最高值,全省每万人口疾控人员数由1.24人上升到1.69人,省、市、县三级疾控中心专业技术人员占比分别达到84.20%、81.60%、84.47%,55岁以上年龄段人数分别上升了237.50%、115.29%、38.88%,研究生学历人数分别上升了167.47%、105.88%、301.85%。结论 各级疾病预防控制中心人员学历水平和职称结构明显改善,专业技术人员占比稳步增长,但存在疾控人员总数相对不足、省级疾控中心年龄结构老化、县级疾控中心高学历人才不足、职称结构不合理等问题。     

公立医院招标采购对学科建设的影响

学科建设是医院建设的基础和核心工程,是医院核心竞争力提升的必要条件,学科建设的提升需要高质量的物力配备作为条件支持,而招标采购作为医院运营管理机制的重要组成,在服务学科建设方面发挥着关键性的作用,招标采购质量直接作用着学科建设质量、进程、结果。该文从公立医院招标采购切入,探讨对医院学科建设的影响和需要改进的措施。     

新型医疗体制改革后我国卫生人力资源现状分析

目的对新型医疗体制改革十年以来,我国卫生人力资源数量、学历、职称及分布等现状进行分析并提出建议。方法以2010、2019年国家卫生统计年鉴数据为依据,对相关数据进行描述统计和比较分析。结果我国卫生人力资源数量不断增长,学历水平持续提升,职称结构得到一定改善,其中,注册护士增长速度最快,年均增长率为9.21%,到2018年,卫生技术人员、执业(助理)医师、注册护士本科以上学历人员占比分别为36.2%、55.4%、21.0%。卫生人力资源数量呈东部地区>中部地区>西部地区分布,城市卫生人力资源优于农村。结论建议通过教育培训、政策激励、人才合理规划等措施,加强人才队伍建设,促进人力资源均衡、持续发展。     

Implementation of Goals of Care Communication Innovation Among Nursing Homes: A Multiple Case Study Design

ObjectiveNursing homes (NHs) provide care to residents with serious illness and related complex health care needs. As such, discussions about end-of-life care between NH staff and residents and families are necessary to ensure residents receive care consistent with their goals. Interventions such as video decision aids have been developed to promote discussions and improve advance care planning, but few studies have examined how NH characteristics may relate to the implementation of these interventions; such information might lead toward more use of successful interventions. The purpose of this study is to understand NH characteristics that are associated with the implementation of the Goals of Care (GOC) intervention, which combined a video decision aid with a structured discussion to guide decision-making in advanced dementia.DesignA multiple case study.Setting and ParticipantsStaff surveys were conducted to examine factors related to implementation effectiveness in 11 NHs in North Carolina that participated in the GOC trial.MethodsQuestions measured the dependent variable of implementation effectiveness: the consistency and quality of use of the GOC intervention. NH organizational characteristics were measured using publicly available data and an administrator survey. The analysis consisted of pattern matching logic.ResultsHigh management support aligned with implementation effectiveness within NHs. In addition, the within case pattern analysis indicated additional characteristics related to implementation effectiveness. Facility size, Medicare beds, residents’ racial composition, and star rating were related to implementation effectiveness across 6 of the 11 NHs. NH financial resources, such as size and number of Medicare beds, may be important factors for successful implementation.Conclusion and ImplicationsNHs seeking to implement advance care planning interventions should focus on within and across NH differences, such as adequate management and financial support prior to implementation to increase the likelihood of implementation effectiveness.     

Satisfaction with neighbourhood environment moderates the associations between objective neighbourhood environment and leisure-time physical activity in older adults in Beijing,China

Asia is ageing fast. To develop more effective health promotion initiatives among older adults, more knowledge of the environmental correlates of physical activity is needed. However, research in this age group is rare, and most existing studies have been conducted within Western contexts. The present study explores the interaction effects of objective neighbourhood environment and satisfaction with neighbourhood environment on leisure-time physical activity in older adults in Beijing, China. This study follows a cross-sectional design and involves older adults aged 65 years and over. The questionnaire was collected in 2018 and 2,061 older adults living in Yanshan, Beijing, China were included in the analysis. Linear regression was applied to examine the effects. The findings show that residents who live in places with higher levels of walkability, or those who are more satisfied with neighbourhood environment (either path/road/street condition or recreational resources) spent significantly longer participating in leisure-time physical activity. However, the objective neighbourhood accessibility of recreational resources was not a significant factor of physical activity. Satisfaction with neighbourhood recreational resources can significantly moderate the relationship between objective neighbourhood accessibility of recreational resources and leisure-time physical activity respectively. This is the first study conducted in China examining the relationships between objective neighbourhood environment, satisfaction with neighbourhood environment and leisure-time physical activity among older adults. This study may have implications for urban planning and service provision planning. The design of built environments that considers quality rather than only quantity can play a significant role in improving older adults' leisure-time physical activity.     

基于GMCR-AHP的床位资源利用冲突分析

目的分析我国床位资源优化利用过程中涉及的各主体之间的利益关系,为解决床位资源供求失衡、利用倒置问题提供参考建议。方法利用冲突分析图模型(Graph Model for Conflict Resolution,GMCR)和层次分析法(Analytic Hierarchy Process,AHP),构建GMCR-AHP模型,分析优化床位资源利用过程中有关利益主体之间的矛盾冲突,探讨均衡各方利益的全局稳定状态。结果冲突模型均衡解为YNNYNYYN,即当政府推行分级诊疗并对医院进行政策约束、大医院依靠医联体组织、基层医院积极加入医疗联合体并提高医疗服务质量、患者合理就医时,有利于解决医疗机构床位利用不足和过度利用的极端化问题。结论为缓解床位资源合理利用中的各方利益冲突,政府应该对大医院收治住院患者给予一定的政策约束,各级医院充分发挥联动互助作用,提升整体卫生服务质量,同时积极发展基层医疗卫生服务,提高基层医院公信力。     

“十三五”以来广西村卫生室卫生资源配置公平性分析

目的 评价广西“十三五”以来村卫生室卫生资源配置公平性,为优化村卫生室卫生资源配置提供依据。方法 运用洛伦兹曲线、基尼系数、泰尔指数,从人口和地理两个角度,分析2016—2019年广西村卫生室卫生资源配置状况及公平性。结果 2016—2019年,广西村卫生室卫生资源数量逐年减少并低于同期全国、东部、中部和西部平均水平。桂北与桂东地区卫生资源拥有量较高,桂西地区较少。各卫生资源指标的基尼系数按人口分布在0.113 2～0.484 3之间;按按地理分布在0.371 7～0.652 6之间。总泰尔指数在0.225 2～0.791 6之间,区域内的泰尔指数贡献率大于区域间。结论 广西村卫生室卫生资源总量不足,分布存在地区差异;卫生资源配置按人口分布的公平性优于按地理分布;卫生资源配置的不公平性主要受区域内差异的影响。