3种现代医院图书馆服务平台功能比较

探讨目前流行的3种网络信息交流工具——博客、微博和微信,比较分析其在医院图书馆发展中的作用及其特征。指出医院图书馆应根据自身需要应用这些交流工具开展相应服务,为用户搭建互动交流平台,促进服务质量的提高。     

Evaluation of contingency management as a strategy to improve HCV linkage to care and treatment in persons attending needle and syringe programs: A pilot study

BackgroundA greater proportion of HCV-infected people who inject drugs (PWID) need to be linked to care for HCV antiviral treatment. This study sets out to evaluate the efficacy of contingency management (CM) for improving HCV linkage to care, treatment initiation, adherence, and cure for PWID recruited from a needle and syringe program.MethodsBetween March 2015 and April 2016, 20 participants were enrolled into the CM arm, and then subsequently enrolled 20 participants in the enhanced standard of care (eSOC) arm. Participants in the eSOC arm received an expedited appointment and a round-trip transit card. Participants enrolled in the CM arm received eSOC plus $25 for up to ten HCV clinical visits and $10 for each returned weekly medication blister pack. Adherence was measured via electronic blister packs.ResultsOverall the median age was 47 years; most were men (67%) and Hispanic (69%). There were no significant differences in demographic characteristics between participants in the study arms. In the CM arm 74% were linked to HCV care, compared to 30% in the eSOC arm (p = 0.01). In the CM arm, 75% (9/12) of treatment eligible participants initiated treatment, compared to 100%(4/4) in the eSOC arm (p = 0.53). All patients (9/9) achieved cure in the CM arm, as compared to 75% (3/4) of patients in the eSOC arm. There were no differences in adherence between study arms.ConclusionsIn this pilot study, contingency management led to higher rates of HCV linkage to care for PWID, as compared to standard of care. CM should be considered as a possible intervention to improve the HCV treatment cascade for PWID.     

The Global Vaccine Action Plan – insights into its utility,application, and ways to strengthen future plans

BackgroundThe pace of global progress must increase if the Global Vaccine Action Plan (GVAP) goals are to be achieved by 2020. We administered a two-phase survey to key immunization stakeholders to assess the utility and application of GVAP, including how it has impacted country immunization programs, and to find ways to strengthen the next 10-year plan.MethodsFor the Phase I survey, an online questionnaire was sent to global immunization stakeholders in summer 2017. The Phase II survey was sent to regional and national immunization stakeholders in summer 2018, including WHO Regional Advisors on Immunization, Expanded Programme on Immunization managers, and WHO and UNICEF country representatives from 20 countries. Countries were selected based on improvements (10) versus decreases (10) in DTP3 coverage from 2010 to 2016.ResultsGlobal immunization stakeholders (n = 38) cite global progress in improving vaccine delivery (88%) and engaging civil society organizations as advocates for vaccines (83%). Among regional and national immunization stakeholders (n = 58), 70% indicated reaching mobile and underserved populations with vaccination activities as a major challenge. The top ranked activities for helping country programs achieve progress toward GVAP goals include improved monitoring of vaccination coverage and upgrading disease surveillance systems. Most respondents (96%) indicated GVAP as useful for determining immunization priorities and 95% were supportive of a post-2020 GVAP strategy.ConclusionsImmunization stakeholders see GVAP as a useful tool, and there is cause for excitement as the global immunization community looks toward the next decade of vaccines. The next 10-year plan should attempt to increase political will, align immunization activities with other health system agendas, and address important issues like reaching mobile/migrant populations and improving data reporting systems.     

利用微信平台延续性护理对老年腰椎间盘突出症术后患者康复及生活质量的影响

目的探讨微信平台延续性护理对老年腰椎间盘突出症术后患者康复及生活质量的影响。方法选取2015年6月—2018年5月在郑州市骨科医院接受手术治疗的老年腰椎间盘突出症患者96例进行研究。对照组行常规延续性护理,观察组行微信平台延续性护理。对比两组康复效果、治疗依从性及生活质量。计数资料采用卡方检验分析,计量资料采用t检验分析。结果观察组有效率为95.83%,明显高于对照组的81.25%。观察组总依从率为91.67%,明显高于对照组的77.08%。干预前两组生活质量量表得分相当,治疗后两组生活质量均有明显改善,但观察组改善程度更为明显。结论微信平台延续性护理相比传统延续性护理可明显提高老年腰椎间盘突出症患者康复效果、提高治疗依从性和改善生活质量。     

End-user acceptability study of the nanopatch™; a microarray patch (MAP) for child immunization in low and middle-income countries

A promising new delivery technology, the microarray patch (MAPs) consists of an array of small solid-coated or dissolvable needles, up to one mm in length, that administers a dry formulation of a vaccine or pharmaceutical. This study is not a real-life evaluation study but determines the anticipated acceptability of the Nanopatch™, a solid microarray patch device, in Benin, Nepal and Vietnam for vaccine delivery, and identifies factors that could improve the acceptability of the technology to increase measles immunization coverage.This study combined several evaluation methods, including simulation of vaccine administration on children and in-depth interviews with key stakeholders, healthcare workers, community health volunteers, caretakers, and community representatives.A total of 314 people participated in the study. The overall rate of total acceptability of the patch for child immunization was 92.7%. General opinions were very positive, providing clinical studies confirm that MAP administration is demonstrated to be painless, safe and effective for infectious disease prevention. The study participants were asked to consider the best strategy to introduce such vaccine delivery innovation. Firstly, delivery by skilled healthcare workers at the healthcare facilities will be preferred to establish the technology. Following this, administration by selected volunteers and outreach delivery may be possible, though under the supervision of skilled healthcare workers.This study’s protocol received approval from the World Health Organization (WHO) Ethical Research Committee (ERC0002813) and the national IRB in Benin, Nepal and Vietnam.     

微信平台结合病例教学模式在超声专业住院医师规范化培训中的应用探索

超声专业的住院医师培训既需要重视理论教学，更讲究“看图说话”，即以大量的超声病例为基础，训练住院医师从超声图像中寻找、发现并判别病变，从而形成敏锐的识别诊断能力。本研究利用即时通讯工具微信建立虚拟学习平台，通过该平台实施以病例教学模式，可以避免时间和场地的限制，使得师生之间交流更快捷。根据问卷调查，住院医师普遍认为该培训模式可有效提高学习效率、提升专业能力，希望在传统教学模式基础上加入该培训模式。住院医师的病例分析结果显示培训过程中住院医师的诊断准确率逐步提升。微信平台结合病例教学的模式可以为超声专业住院医师规范化培训提供新的思路和方法。     

Using business/law negotiation techniques in response to a ‘difficult’ family

Effective communication between clinicians, patients, and families at end of life is associated with better clinical outcomes. A large body of literature describes the key skills needed for effective communication. We believe that clinicians could also benefit from communication skills more commonly associated with business or law negotiations. We will demonstrate via analogy (i.e. buying a house) how four key business/law negotiation techniques – 1. Determine your Reservation and Aspiration Value; 2. Separate People from their Positions; 3. Separate Positions from Interests; and 4. Logrolling of Interests – can be applied to a difficult family meeting in a home hospice patient.     

微信式医院家庭协作延续护理在直肠癌结肠造口患者中的应用

目的 探索基于微信的医院家庭协作延续护理在直肠癌肠造口患者中的应用效果.方法 将80名直肠癌肠造口患者随机分入两组,观察组给以基于微信的医院家庭协作延续护理,对照组实行常规护理模式.对比两组患者护理前后自护能力,生活质量以及并发症发生情况.结果 护理后,观察组自护能力评分明显优于对照组(P<0.05);护理后两组生活质量评分明显提高,且观察组高于对照组(P<0.05).观察组和对照组并发症发生率分别为7.50%和37.50%,显示差异具有统计学意义(P<0.05).结论 基于微信的医院家庭协作延续护理可有效提高直肠癌肠造口患者自护能力,改善生活质量,减少并发症.     

微信平台在住院病人健康教育中的应用现状

对微信平台在住院病人健康教育中的应用现状进行总结,分析其目前成果、平台构建现状与存在的问题,为医院护理人员进行健康宣教提供参考。