Perceived Stress,Positive Resources and Their Interactions as Possible Related Factors for Depressive Symptoms

Objective The present study aimed to explore how the patterns of interaction between stress and positive resources differ according to the severity of depression and which resources play the most important role among the various positive resources. Methods The study included 1,806 people who had visited a health screening center for a mental health check-up to evaluate the levels of perceived stress, positive resources, and depressive symptoms. The participants were divided into a depressive group (n=1,642, mean age 50.60, female 68%) and a non-depressive group (n=164, mean age 48.42, female 66.6%). We conducted hierarchical regression analyses and simple slope analyses to examine the interaction between perceived stress and positive resources. Results The interaction between perceived stress and optimism was significantly associated with depression in non-depressive groups. In depressive groups, the interactions between five types of positive resources (optimism, purpose in life, self-control, social support and care) and perceived stress were all significantly related to depression. Conclusion Interventions that promote optimism can be helpful for preventing inevitable stress from leading to depression. A deficiency in positive resources may be a factor in aggravating depression in stressful situations for people reporting moderate to severe depressive symptoms.     

基于时空分析的急诊护理人力资源管理

目的 探讨急诊患者的时空分布规律,优化急诊护理人力资源的管理。方法 回顾分析2017-2019年笔者所在医院急诊科就诊患者的资料,对患者每年不同月份、不同工作日、不同时间段及省内外就诊辐射特点进行时空分布的统计分析。结果 急诊患者就诊量呈逐年上升趋势,节假日的日均就诊量最高,就诊患者大部分集中在1-4月和9-12月,9∶00和20∶00是全天就诊的2个高峰时间点。空间上以笔者所在医院为中心就诊患者呈中心辐射状分布,人群主要为湖北省内患者为主,省内集中在武汉、黄冈、孝感等城市;省外以河南居首,其次为江西、湖南、浙江。结论 应根据患者的时空分布规律,科学合理地配置及利用护理人力资源,以保障患者安全和提高急救护理质量。     

以财务一体化为切入点的医院资源整体协同管理

以安徽省一所三甲医院的实际情况为例,重点探讨如何有效利用财务一体化手段,整合医院各类资源,对医院进行科学高效的管理,为提高医院整体资源利用效率提供可以借鉴的经验。     

HIV drug resistance mutations following poor adherence in HIV‐infected patient: a case report

Acquired HIV drug resistance following poor adherence is common. We report a case of HIV‐infected patient with poor CD4 gain and self reported poor adherence. Investigations revealed high viral load and resistance to NRTIs and NNRTIs with sensitivity to boosted PIs. HIVDR mutations create treatment challenges in resource limited settings.     

Long-stay patients in pediatric intensive care units: Five-years, 2-points,cross-sectional study

Objectives:To explore the changing patterns of long-stay patients (LSP) to improve the utilization of pediatric intensive care units (PICUs) resources.Methods:This is a 2-points cross-sectional study (5 years apart; 2014-2019) conducted among PICUs and SCICUs in Riyadh, Saudi Arabia. Children who have stayed in PICU for more than 21 days were included.Results:Out of the 11 units approached, 10 (90%) agreed to participate. The prevalence of LSP in all these hospitals decreased from 32% (48/150) in 2014 to 23.4% (35/149) in 2019. The length of stay ranged from 22 days to 13.5 years. The majority of LSP had a neuromuscular or cardiac disease and were admitted with respiratory compromise. Ventilator-associated pneumonia was the most prevalent complication (37.5%). The most commonly used resources were mechanical ventilation (93.8%), antibiotics (60.4%), and blood-products transfusions (35.4%). The most common reason for the extended stay was medical reasons (51.1%), followed by a lack of family resources (26.5%) or lack of referral to long-term care facilities (22.4%).Conclusion:A long-stay is associated with significant critical care bed occupancy, complications, and utilization of resources that could be otherwise utilized as surge capacity for critical care services. Decreasing occupancy in this multicenter study deserves further engagement of the healthcare leaders and families to maximize the utilization of resources.     

新时代图书馆文献资源共建共享的挑战与机遇

通过调研国内外图书馆文献资源共建共享现状和梳理当前图书馆资源建设的资源海量化和多样化、内容服务智慧化、获取去中心化、技术智能化、传播泛在化、保存战略化等新特征,分析了文献资源实现共建共享在资源数量、规范、存储和服务等方面的挑战和机遇,从政策和资金、资源和技术、理念和信任、机制和沟通等方面提出了开展共建共享工作的相关建议,为有效推进图书馆资源建设、提高文献资源服务能力提供参考。     

基于适应症的医用耗材监管体制建立

目的通过建立医用耗材监管体制,促进医用耗材的合理规范使用,加强医院对于医用耗材的监管,做到廉洁使用。方法通过建立医用耗材适应症管理方法,明确医用耗材准入管理规则及引入后使用管理监管的标准化业务流程,实现医用耗材全周期的监管,避免出现监管盲区及对其监管的不专业性。结果通过建立医用耗材监管体制,有效地避免了医用耗材多用、乱用情况的发生,保障了医疗质量及安全,为医院临床科室申请医用耗材营造了良好的环境,有效地提高了医院对于医用耗材监管的精细化管理水平。结论医院耗材监管体制的建立是贯彻执行国家对于耗材监管政策,只有完善的监管机制、科学的管理才能为医用耗材提供有力的保障。医院必须对医用耗材准入及使用各个环节把关,加强监管,才能实现医院医用耗材管理制度化、科学化、人性化。     

柴胡属药用植物的鉴别研究

目前柴胡市场使用情况较为混乱,地方标准收载的柴胡药材也比较复杂,文章拟从传统的鉴别方法中对常用的柴胡药材进行比较分析,为柴胡的初步鉴定提供参考依据。