Reviewing the Values of a Standard Operating Procedure

This article addresses the values of a standard operating procedure based on review of articles. It describes the application and importance of a standard operating procedure from different perspectives while emphasizing its critical relevance to medical practice and pharmaceutical service. The review further discusses shortcomings related to nonexistence of standard operating procedure including inconsistent quality of service; performance variation; procedural mix-ups; and misinterpretation or miscommunication of information. In conclusion, standard operating procedure, if realized and materialized as a component of an effective management system, helps cultivate transparent functions; implement error prevention measures and facilitate corrective actions and transfer knowledge and skill.     

甘肃省欠发达地区乡镇卫生院基本业务模式探讨

目的:通过调查新添中心卫生院基本业务现状,研究发现存在的不足,旨在初步建立一套适合欠发达地区基本型乡镇卫生院基本业务模式。方法:采用专题访谈法调查新添中心卫生院基本业务现状,结合当地实际情况,初步探索建立基本业务模式,并在该院试点施行。结果:①新添中心卫生院各种业务基本全面开展,业务开展水平参差不齐。②新添中心卫生院业务开展过程中,存在着重医轻防业务发展不平衡、基本业务不全面、服务重点不突出、业务水平低下等问题。结论:新添中心卫生院建立并试行包括公共卫生服务、基本医疗服务、医药卫生管理在内的基本业务模式,该业务模式优势与不足并存,在试行过程中需建立保障措施以保证基本业务模式的顺利实施。     

Oral Health Among Older Adults With Complex Needs Living in the Community and in Aged Residential Care Facilities within New Zealand

ObjectivesTo describe the oral health status and dental service use of older adults with complex needs living within the community and aged residential care (ARC) facility settings, and to determine associations between dental service utilization and sociodemographic variables.DesignSecondary analysis of 2 continuously recruited national cohorts.Setting and ParticipantsAdults aged ≥65 years having standardized assessments between July 1, 2012, and May 31, 2018, within New Zealand and who provided consent.MethodsAll community-living older people with complex needs undergo a standardized assessment, using the Home Care International Residential Assessment Instrument (interRAI-HC), whereas all ARC facility residents undergo Long Term Care Facilities assessments (interRAI-LTCF). Anonymized data from consenting participants were extracted. Cross-sectional analyses of oral health status and dental service use variables employed logistic regression models, whereas longitudinal analysis of factors influencing dental service utilization employed binary generalized estimating equation models.ResultsOverall, 144,380 interRAI-HC assessments from 97,229 participants, and 195,549 interRAI-LTCF assessments from 62,798 participants were eligible. At first assessment, their average age was 81.9 years (range: 65-109 years) and 84.4 years (range: 65-110 years), respectively. Approximately 65% of the participants wore dentures; 9% had broken, fragmented, loose, or otherwise nonintact natural teeth; and 10% reported difficulties chewing. Overall, only 25.3% of community-dwelling older adults and 17.5% of ARC residents had a dental examination within the previous year. Stark inequalities were observed with, for example, Māori participants having adjusted odds 3.14 [95% confidence interval (CI): 2.88, 3.42] and 2.08 (95% CI: 1.81, 2.39) of not having a dental examination in community and ARC facility settings compared with their New Zealand European counterparts.Conclusions and ImplicationsHeavy and unequal oral health burdens were observed among older adults with complex needs, together with low dental service uptake. New Zealand needs an oral health policy for older adults.     

Comparative study of the main characteristics and composition of the mainstream smoke of ten cigarette brands sold in Spain

In this study 10 commercial top selling cigarette brands in Spain have been machine smoked and the mainstream smoke has been analyzed. Multifunctional analysis has been satisfactorily employed to correlate the effect of the main design features of the cigarettes including amount of tobacco, filter size or paper weight with the amount of smoked tobacco and with the ratio CO₂/CO. The composition of the vapor phase and that of the particulate matter have been analyzed. The particulate matter retained in the filter of the cigarettes has also been analyzed showing a distinct behavior of the compounds condensed in the cigarette filters and in the traps, related to their retention time. A general trend for the relative yield of some compounds in the different brands have been identified and confirmed by multifunctional analysis. Nevertheless, there are some noticeable compounds that behave differently in the different brands.     

助产士产前门诊对初产妇情绪及满意度的影响

目的探讨助产土产前门诊对初产妇焦虑抑郁情绪和初产妇对门诊助产士提供护理服务态度和方式的满意度的影响。方法应用随机数字表法将2011年12月～2012年12月在本院产科建卡并定期产检的106例正常初产妇分为对照组和观察组，对照组给予常规产前门诊，观察组在对照组基础上给予助产士产前门诊，观察并比较两组初产妇焦虑、抑郁情绪和初产妇对门诊助产士提供护理的服务态度和方式的满意度。结果观察组焦虑、抑郁标准分均明显低于对照组，且观察组初产妇对门诊助产士提供护理的服务态度和方式的满意度明显高于对照组，差异均有统计学意义（P〈0．05）。结论助产土产前门诊能够有效减少初产妇的焦虑及抑郁程度，提高初产妇对门诊助产士提供护理服务态度和方式的满意度。     

Insulin gene variable number of tandem repeats is associated with increased fat mass during adolescence in non‐obese girls

Obesity and related disorders have become a major health problem. Understanding the interaction between genetic and environmental factors influencing the susceptibility to develop obesity is important when pinpointing people at risk. In a longitudinal study of 256 non‐obese adolescents, the influence of the insulin gene (INS) variable number of tandem repeats (VNTR) on anthropometric measures and fat mass was investigated. The adolescents were examined at the age of 12.4 (2.3) (mean, SD) and 16.2 (2.3) years, and at follow‐up with dual x‐ray absorptiometry (DXA) for measurement of body composition. INS VNTR classes I and III alleles were investigated using the ?23T/A single nucleotide polymorphism as a surrogate marker. There was a non‐significant trend towards increased body mass index (BMI) and fat mass with the class III allele in girls. Homozygotes for the INS VNTR class III allele had a greater increase in BMI compared with those that were homozygous or heterozygous for the class I allele (3.8 (1.6) versus 2.4 (1.9)?kg/m², p?=?0.03), and they had higher fat mass (36.4 (3.9) versus 31.3 (6.8)%, p?=?0.02) at follow‐up. Our finding that homozygosity of the INS VNTR class III allele seems to predispose to increased weight gain and fat mass raises the possibility that this genotype may be one of the important factors in the gene‐environment interaction that eventually results in overweight and insulin resistance.     

新医改视角下社区医院的定位与思考

本文从总结当前社区卫生服务发展的现状及弊端入手,结合新医改赋予社区医院的功能定位和发展目标,提出了发展社区卫生服务必须遵循公益性质原则,以建立＂法律机制＂作为解决问题的入脚点,着重从发挥政府职能、健全配套措施、建立健全人才、投入、医药价格和监管机制等方面开展专项改革,从而改善社区卫生事业的发展状况,使这项事业能更好地惠及人民.     

医学图像处理远程虚拟实验教学平台的设计与实现

为帮助学生深入理解医学图像处理的概念和算法原理,提出了基于Matlab Web Server医学图像处理远程虚拟实验教学平台的构思。该平台采用B/S模式,利用ASP.NET和数据库技术结合Matlab Web Server组件实现。同时,指出该实验教学平台的构建,既满足了医学图像处理实验教学的需求,也解决了传统实验系统受时间和地域限制的问题,为教师提供了一种方便、快捷管理实验的平台,为学生提供了一个自主开放的实践环境。     

Multivariate analyses of patient financial systems and oral health‐related quality of life

Johansson V, Axtelius B, Söderfeldt B, Sampogna F, Paulander J, Sondell K. Multivariate analyses of patient financial systems and oral health‐related quality of life. Community Dent Oral Epidemiol 2010; 38: 436–444. © 2010 John Wiley & Sons A/S Abstract – Objectives: Since 1999, the public dental health service (PDHS) in the county of Värmland, Sweden, has two co‐existing patient financial systems, i.e. ways for the patient to pay for dental care services. Alongside the traditional system of fee‐for‐service payment, i.e. paying afterwards for provided services, a new system of contract care is offered. In this system, dental care is covered by a contractual agreement, for which the patient pays an annual fee and receives care covered by the contract without additional costs. The aim of this article was to study whether patient financial system was associated with oral health‐related quality of life (OHRQoL). Methods: A questionnaire was answered by 1324 randomly selected patients, 52% from contract care and 48% from fee‐for‐service. The questionnaire contained questions about how much one was prepared to pay for dental care, how much one paid for dental care the previous year, OHIP‐14 (measured OHRQoL), dental anxiety, humanism of caregiver, SF‐36 (measured general health), multidimensional health locus of control, sense of coherence (SOC), self‐esteem and demographics. Data on patient financial system, gender and age were obtained from the sampling frame. The material was analysed with a hierarchical block method of multiple regression analysis. Results: When controlling for all other variables, patient financial system was one of the strongest associations with OHRQoL: patients in fee‐for‐service had worse OHRQoL than those in contract care. OHRQoL was also associated with general health, SOC and to some extent also with psychological and economic factors. Of the social variables, only being foreign born was significant: it was associated with worse OHRQoL. Conclusions: Patient financial system was associated with OHRQoL when controlling for confounding factors: patients in contract care had better OHRQoL than those in fee‐for‐service care.     

医院后勤现代化管理实践

医院后勤保障服务是医院服务价值链中不可或缺的重要一环。实施医院后勤现代化管理则会大幅度提升后勤保障服务绩效。东阳市人民医院近年来在后勤保障领域实施一系列现代化管理的主要做法,其梳理的创新理念、运用的创新举措及取得的系列成效,具有十分明显的应用推广价值。