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31.
合理使用抗菌药物不仅能有力保护人类珍贵的药物资源,而且可促进感染病患者的规范诊治与健康。患者之间、病原菌之间、感染病之间及抗菌药物之间均存在明显差异,抗菌药物个体化治疗是合理用药的必由之路,关注感染病诊治中的人体、病原体、疾病与药物是个体化治疗的关键,值得临床高度重视。 相似文献
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33.
Jeroen M. van de Pol Jurjen G. Geljon Svetlana V. Belitser Geert W.J. Frederix Anke M. Hövels Marcel L. Bouvy 《Research in social & administrative pharmacy》2019,15(1):70-76
Introduction
The nature of community pharmacy is changing, shifting from the preparation and distribution of medicines to the provision of cognitive pharmaceutical services (CPS); however, often the provision of traditional services leaves little time for innovative services. This study investigated the time community pharmacists spend on the tasks and activities of daily practice and to what extent they are able to implement CPS-related services in daily practice.Methods
Self-reporting work sampling was used to register the activities of community pharmacists. A smartphone application, designed specifically for this purpose, alerted participants to register their current activity five times per working day for 6 weeks. Participants also completed an online survey about baseline characteristics.Results
Ninety-one Dutch community pharmacists provided work-sampling data (7848 registered activities). Overall, 51.5% of their time was spent on professional activities, 35.4% on semi-professional activities, and 13.1% on non-professional activities. The proportion of time devoted to CPS decreased during the workweek, whereas the time spent on traditional task increased.Discussion and conclusion
This study shows it is feasible to collect work-sampling data using smartphone technology. Community pharmacists spent almost half of their time on semi-professional and non-professional activities, activities that could be delegated to other staff members. In practice, the transition to CPS is hampered by competing traditional tasks, which prevents community pharmacists from profiling themselves as pharmaceutical experts in daily practice. 相似文献34.
目的:探讨醛-酮还原酶家族7成员A3(AKR7A3)在肺腺癌中的异常表达及与临床病理特征的关系,并探究其临床意义。方法:采用生物信息学数据库分析、免疫组化、Western Blot、Real-time PCR等方法对肺腺癌组织及不同细胞中AKR7A3的表达进行检测与分析。结果:Oncomine数据库分析结果显示,在肺腺癌中,AKR7A3的表达普遍高于正常肺组织,分别为正常肺组织的1.811倍(P=0.022)、1.356倍(P<0.01)、1.413倍(P=0.002)。Kaplan-Meier Plotter数据库分析结果显示,AKR7A3高表达的患者较低表达的患者生存时间缩短,差异具有统计学意义(P=0.003 7)。免疫组化染色显示肺腺癌组织中AKR7A3的表达较癌旁增高,在与临床病理特征的相关性分析中,发现其与肿瘤分化程度(P<0.01)、淋巴结转移情况(P=0.029)以及TNM分期(P<0.01)相关,且会造成患者生存时间缩短(P=0.031)。Cox多因素分析表明AKR7A3可能是影响肺腺癌患者预后的独立危险因素(P=0.012)。Western Blot及Real-time PCR实验提示不同肺腺癌细胞中AKR7A3蛋白及mRNA表达普遍增高。结论:AKR7A3在肺腺癌中表达增高,对预后有不良影响,有促进肿瘤发生发展的作用。 相似文献
35.
In recent years, there has been an increased focus on patient involvement in treatment planning in the health care system. To reduce the risk of the clinician moving towards paternalism, various methods have been introduced—shared decision making, among others. The goal of shared decision making is for the clinician and patient to share available evidence on the best treatment and to raise awareness on the needs and preferences of the patient as to make a genuinely informed choice. However, in the present article, we discuss to which degree paternalism can be avoided in light of the clinician's role as an authority with certain knowledge and expertise. Through the philosophical theory of reasons‐responsiveness, we discuss to which extend free will and control applies to the patient. Through theoretical analysis, we come to suggest that the clinician has a role as an ally rather than manipulator. 相似文献
36.
ABSTRACTTake-Away Points:1. Geriatric palliative care requires integrating the disciplines of hospital medicine and palliative care in pursuit of delivering comprehensive, whole-person care to aging patients with serious illnesses.2. Older adults have unique palliative care needs compared to the general population, different prevalence and intensity of symptoms, more frequent neuropsychiatric challenges, increased social needs, distinct spiritual, religious, and cultural considerations, and complex medicolegal and ethical issues.3. Hospital-based palliative care interdisciplinary teams can take many forms and provide high-quality, goal-concordant care to older adults and their families. 相似文献
37.
《Vaccine》2020,38(28):4448-4456
BackgroundThere is currently limited data in the United States on the proportion of immunization doses given at pharmacies outside the influenza vaccine. This study aims to obtain baseline information on the percentage of vaccine doses administered at pharmacies in Wisconsin and to understand the immunization barriers for Wisconsin pharmacists, to inform interventions to increase immunization access at pharmacies.MethodsAggregated data from the Wisconsin Immunization Registry (WIR) was obtained for all vaccines administered at pharmacies to patients over the age of six from July 2017 through June 2018. In addition, a survey on attitudes towards and barriers to vaccination was sent to 2000 Wisconsin pharmacists with 236 respondents yielding a 12% response rate.ResultsWIR data demonstrates that zoster and influenza vaccines have the highest proportion of doses administered at pharmacies (39% and 20%, respectively). Human papillomavirus (HPV) vaccines have the lowest proportion of doses at 0.2%. Pharmacy survey shows that 86% provide immunizations. Most stock influenza vaccines (84%), whereas much fewer stock HPV vaccines (21%). The greatest immunization barriers for the pharmacy respondents include billing and reimbursement challenges and competing demands for staff.ConclusionsDespite the barriers, community pharmacies have significant potential to address vaccination gaps. Physicians, patients, and legislative bodies are generally well-accepting of pharmacists as immunizers. Pharmacists, in order to be fully utilized as immunizers, must engage in active communication with patients and be willing to collaborate with physicians. Legislative policy and health insurance reimbursement reforms are also necessary to facilitate further pharmacist participation in immunization. 相似文献
38.
社会办医作为我国基层卫生服务的重要组成部分,可以弥补基层卫生机构发展总量与质量不足等问题,对于推进整个基层卫生服务高质量发展也是有着重大裨益。文章从物理学的"力"出发,运用支持力,推力,引力,阻力,摩擦力五种"力"探讨社会资本参与基层卫生服务的动力形成机制,并构建动力斜坡图,针对存在问题,提出加大支持力和引力,合理利用推力,减少摩擦力,消除阻力等优化建议,以期助力社会资本参与基层卫生服务建设平稳进行。 相似文献
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40.
强化护理安全减少护理差错 总被引:2,自引:1,他引:1
目的 通过对护理差错原因分析,制定护理安全管理措施。方法 对近7年的护理差错及发生率进行统计学分析,P〈0.001,有显著差异。结果 差错发生率逐年下降,护理质量平均达标率达99%。结论 强化护理安全管理,制定切实可行的管理措施,才能减少护理差错的发生, 相似文献