特需医疗服务机构中护士工作满意度的调查分析

目的：了解目前从事特需医疗服务工作的护士对自身工作的满意程度及其影响因素，探讨提高护士工作积极性及护理管理效率的途径和方法，为护理人力资源的有效管理提供依据，方法：采用自行设计的问卷对61名相关的临床护士进行问卷调查。结果：被调查护士的工作满意度为中等水平，影响满意度的原因由强到弱依次为个人发展机会少、福利待遇低、工作负荷过重、专业交流机会少等。此外，针对特需医疗服务的特点，对如何提高该领域护士工作满意度提出了建议。     

香港与澳门中小学学校辅导发展的比较

目的 探讨香港与澳门两地中小学学校辅导的发展，就辅导工作的内容、开展情况、辅导人员在建设上的差别以及发展速度相异的原因等方面作分析。方法 本研究以香港及澳门中小学的学校辅导员／社工为调查对象，利用自编问卷方式进行调查．结果 （1）两地的辅导员都一致认为，通过学校辅导服务可以帮助中学生建立良好的社交行为及人际关系，（2）两地的中小学都在帮助学生更好地接纳他人及尊重他人这个项目上都做得较好；（3）两地的中小学校辅导的目标不再是以处理学生的偏差行为为主，转而注重学生的个人潜能发展；（4）就课堂辅导活动开展的情况来看，香港在班级辅导、全年级辅导及全校性辅导方面都做得比较好，而澳门的全校性辅导通有待加强。至于课堂以外的辅导活动，两地均以个别晤谈，团体辅导、心理卫生讲座以及工作坊等方式开展辅导活动为多。（5）在持介制度上，香港中小学都做得比较完善；（6）咨询服务方面，香港小学做得较多，而澳门则是中学做得较多；（7）新生适应服务方面，香港较澳门做得较多；（8）香港的学校比澳门学校更多地与其它机构共同合辩小区教育；（9）香港及澳门的中学辅导员主要是学校自聘／校内编制，两地的中学社工主要是由政府资助民间志愿机构派驻。香港的小学导员以学校自聘／校内编制和政府派驻为主，香港的小学社工以政府直接派驻为多；澳门的小学辅导员为政府派驻，小学社工则由政府资助民间志愿机构派驻为多。（10）对于两地学校辅导人员学历的比较，香港中学及小学专职辅导贝、专职社工的学历均较澳门为高．结论 两地在学校辅导目标上比较一致；两地均建立了发展辅导为主，预防辅导及治疗辅导并重的辅导模式；家庭问题及人际关系问题为两地中小学生的困扰问题；两地的学校辅导活动呈现一个多元化的局面，但香港较澳门丰富；澳门需要建立完善的转介机构。     

澳门中学生精神信仰的现状研究

目的考察澳门中学生精神信仰的现状与特点。方法采用中学生精神信仰问卷对1379名澳门中学生的精神信仰进行调查。结果1澳门中学生在一级信仰因素上的均值排列顺序由高到低依次是实用信仰、社会信仰、超自然信仰。在7个二级信仰维度上的均值排列顺序由高到低依次为家庭主义、生命崇拜、国家民族、政治信仰、神灵崇拜、金钱物质、宗教信仰。2女生在宗教信仰和神灵崇拜上的得分显著高于男生。3高三年级学生在金钱物质和国家民族的信仰程度最高,得分高于其他年级。4学生干部在国家民族、政治信仰、生命崇拜和家庭主义上的得分显著高于非学生干部。5学习成绩好的学生和成绩中等的学生在国家民族、政治信仰和家庭主义上的得分显著高于学习成绩差的学生。结论澳门中学生的精神信仰总体上是积极健康向上的。     

Real-time automatic extraction of lumen region and boundary from endoscopic images

A new approach to the automatic extraction of the lumen region and its boundary for gastrointestinal (GI) endoscopic images is presented. First, a quasi region of interest, the darker regions of the image, is segmented using a region splitting scheme termed progressive thresholding. The centre of mass of this segmented region acts as a seed for further processing. Then the lumen region is obtained using a region growing technique called the integrated neighbourhood search (INS). A new quad structure based technique is introduced to enhance the INS speed significantly. A back projection algorithm is suggested to optimise the search for pixels belonging to the lumen region and boundary. A boundary-thinning algorithm is also proposed to remove the redundant pixels from the lumen boundary and to generate a connected single pixel width boundary. The proposed approach does not need a priori knowledge about the image characteristics. The experimental results indicate that the proposed technique enhances the speed of conventional INS by 45.5% to 28.6% based on the lumen size varying from 22,709 pixels to 4947 pixels. The main advantage of the proposed technique is its high-speed response that facilitates real-time analysis of endoscopic images.     

Child developmental and special education service receipt: The intersection of health and poverty

BackgroundChildren born of low birth weight (LBW) and/or premature may have developmental delays and difficulties. The vulnerability, without early intervention, would have detrimental lifelong effects.ObjectivesThis study examined 1) the relationship between LBW and prematurity and the occurrence and timing of children's receipt of developmental and special education services; and 2) whether poverty intersects with LBW and prematurity affecting service receipt.MethodsThis population-based study used cross-sectional data from the National Survey of Children's Health which consisted of approximately 52,000 participants aged 1–17 between 2017 and 2018 in the United States. We conducted logistic regression to analyze the predictive relationship of LBW/prematurity and the occurrence of receiving developmental and special education services. We then conducted ordered logistic regression to examine whether LBW and prematurity predicted the timing of receiving developmental and special education services. Further, we conducted moderating analyses to examine whether the predictive relationships above varied with poverty. The analyses listed above were weighted to reflect the population drawn.ResultsChildren born with LBW and prematurity were more likely to receive developmental and special education services and they tended to receive services earlier than those born at normal weight and term. Educational disparities were evident among children in low-income families. Children of LBW in low-income families were less likely to receive earlier services than those in affluent families.ConclusionsThis study indicates developmental and special education needs of children born LBW and/or premature. With restrained assets, low-income families may need more assistance to promote optimal development for their children.     

Matching Special Olympics registration data with administrative health databases: Feasibility and health status differences in children and youth with IDD

BackgroundChildren and youth with intellectual and developmental disabilities (IDD) experience health disparities. What is unknown is if data collected from children and youth with IDD who participate in Special Olympics is representative of children and youth with IDD who do not.ObjectivesAim 1: determine the feasibility of matching a database of registrants from Special Olympics Ontario (SOO), with population-based health services databases in Ontario, Canada housed at ICES. Aim 2: evaluate the differences between the database sources with regards to demographic variables and clinical status.MethodsUsing deterministic and probabilistic matching, registration data from SOO were matched to administrative health databases. Established algorithms were used to determine the prevalence of asthma, diabetes, and mental disorder in addition to demographic variables.ResultsThe matching rate was over 90%; 8404 were attributed to children and youth between the ages of 0–19 years. When comparing SOO participants with IDD to non-SOO participants with IDD, children and youth who participate in SOO were, on average, older with no further differences between groups on clinical or demographic variables. When comparing those previously not identified in the health services databases (from SOO) to those with IDD identified by ICES, the SOO participants appear to use the health system less, possibly indicating a better health status.ConclusionsResearch conducted on child and youth who participate in Special Olympics Ontario can be generalized to the broader population of children and youth with IDD in Canada when adjusted for age; however, care should be taken when comparing levels of overall morbidity.     

Comparison of local influenza vaccine effectiveness using two methods

BackgroundIn some settings, research methods to determine influenza vaccine effectiveness (VE) may not be appropriate because of cost, time constraints, or other factors. Administrative database analysis of viral testing results and vaccination history may be a viable alternative. This study compared VE estimates from outpatient research and administrative databases.MethodsUsing the test-negative, case-control design, data for 2017–2018 and 2018–2019 influenza seasons were collected using: 1) consent, specimen collection, RT-PCR testing and vaccine verification using multiple methods; and 2) an administrative database of outpatients with a clinical respiratory viral panel combined with electronic immunization records. Odds ratios for likelihood of influenza infection by vaccination status were calculated using multivariable logistic regression. VE = (1 ? aOR) × 100.ResultsResearch participants were significantly younger (P < 0.001), more often white (69% vs. 59%; P < 0.001) than non-white and less frequently enrolled through the emergency department (35% vs. 72%; P < 0.001) than administrative database participants. VE was significant against all influenza and influenza A in each season and both seasons combined (37–49%). Point estimate differences between methods were evident, with higher VE in the research database, but insignificant due to low sample sizes. When enrollment sites were separately analyzed, there were significant differences in VE estimates for all influenza (66% research vs. 46% administrative P < 0.001) and influenza A (67% research vs. 49% administrative; P < 0.001) in the emergency department.Conclusions:The selection of the appropriate method for determining influenza vaccine effectiveness depends on many factors, including sample size, subgroups of interest, etc., suggesting that research estimates may be more generalizable. Other advantages of research databases for VE estimates include lack of clinician-related selection bias for testing and less misclassification of vaccination status. The advantages of the administrative databases are potentially shorter time to VE results and lower cost.     

2012—2018年澳门新确诊HIV感染病例流行病学特征

目的了解澳门新确诊艾滋病病毒(HIV)感染病例流行病学特征。方法回顾性分析2012—2018年澳门卫生局的艾滋病感染情况统计有关数据。结果澳门总体HIV报告发病率从2012年的5.67/10万下降至2018年的5.54/10万,男性HIV报告发病率从2012年的7.14/10万升至2018年的9.91/10万,女性则由4.31/10万降至1.69/10万,但变化趋势均无统计学差异。男性HIV报告发病率高于女性,澳门新确诊HIV病例以澳门本地居民、男性为主,主要分布于20~39岁。2012—2018年,≤19岁新确诊HIV病例构成比有下降趋势。2013—2015年澳门新确诊HIV病例传播途径以异性性接触为主,2016年异性性接触与同性性接触所占比例相等,2017—2018年则以同性性接触为主。新确诊HIV病例共用针筒注射传播的构成比呈下降趋势。结论澳门HIV报告发病率低于全球水平,澳门HIV感染防控关键人群为男男性行为者。     

专科医院住院部各科医疗质量综合评价的初步探讨

目的：探讨专科医院住院各科工作情况综合评价方法,向临床科室提供医疗质量信息,促进医疗质量的提高。方法：以医院工作报表为数据来源,用秩和比法从诊疗质量,工作强度和经济效益三方面量化科室医疗质量考核指标。结果：综合数能更全面、有效、合理地评价住部各科医疗质量优劣等级,提出科室改进的指标。结论：此评价方法简便,实用,有利于深化院内改革,强化行政部门管理。