广东省家庭医生式服务试点地区居民健康行为及影响因素分析

目的了解广东省家庭医生式服务试点地区居民健康行为及影响因素,为开展健康教育提供依据。方法2015年7—10月抽样选取1010名家庭医生式服务试点地区居民进行问卷调查,以吸烟、饮酒、早餐、吃水果、锻炼及睡眠等6项行为为调查内容,同时选用P-CAT量表测量基层医疗服务质量。结果 6项行为方式共赋值12分,被调查者平均得分(8.72?0.65)分,得分从高到低依次为吃早餐、限酒、不吸烟、体育锻炼、吃水果和睡眠。多重线性回归分析结果显示:女性、已婚或慢性病患者的健康行为优于各对应组;收入对健康行为有正面影响;基层医疗服务可及性、服务提供综合性对健康行为有正向影响。结论试点地区居民整体健康行为较好。健康教育和健康促进应聚焦于合理膳食、锻炼及睡眠等健康行为;男性、单身或离异及低收入群体是重点关注的对象;提高基层医疗服务可及性和服务提供综合性有利于促进居民的健康行为。     

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。     

Migrant Workers in Agriculture: A View from Thailand

There has been a dramatic increase in the global movement of workers during the last few decades. As Thailand has developed rapidly over the past 20 years, it has attracted laborers (both authorized and unauthorized) from the neighboring countries of Myanmar, People’s Democratic Republic of Lao (Lao PDR), and Cambodia. Given that agriculture has been Thailand’s most important industry, its continued growth has been dependent on migrant workers. Both crop agriculture and animal-production agriculture have employed migrant labor. Migrants have been hired to plant, weed, fertilize, spray pesticides, and harvest crops such as rice, corn, sugar cane, and cassava. They have worked at rubber and coffee plantations, as well as in the production of ornamental crops. Also, migrants have labored on pig, beef, and duck farms. There have been numerous documented health problems among migrant workers, including acute diarrhea, malaria, and fever of unknown causes. Occupational illness and injury have been a significant concern, and there has been limited health and safety training. This article reviewed the demographic changes in Thailand, studied the agricultural crops and animal production that are dependent on migrant labor, discussed the health status and safety challenges pertaining to migrant workers in agriculture, and described several recommendations. Among the recommendations, the conclusions of this study have suggested that addressing the cost for health care and solutions to health care access for migrant labor are needed.     

Setting the bar: Standards for ecosystem services

Progress in ecosystem service science has been rapid, and there is now a healthy appetite among key public and private sector decision makers for this science. However, changing policy and management is a long-term project, one that raises a number of specific practical challenges. One impediment to broad adoption of ecosystem service information is the lack of standards that define terminology, acceptable data and methods, and reporting requirements. Ecosystem service standards should be tailored to specific use contexts, such as national income and wealth accounts, corporate sustainability reporting, land-use planning, and environmental impact assessments. Many standard-setting organizations already exist, and the research community will make the most headway toward rapid uptake of ecosystem service science by working directly with these organizations. Progress has been made in aligning with existing organizations in areas such as product certification and sustainability reporting, but a major challenge remains in mainstreaming ecosystem service information into core public and private use contexts, such as agricultural and energy subsidy design, national income accounts, and corporate accounts.     

Standards for the Use of Telemedicine for Evaluation and Management of Resident Change of Condition in the Nursing Home

Objectives

This document offers guidance to clinicians and facilities on the use of telemedicine to deliver medically necessary evaluation and management of change of condition for nursing home residents.

Fracture liaison programs

In view of the high imminent risk of having subsequent fractures after a fracture, early evaluation and treatment decisions to prevent subsequent fractures are advocated. After a hip fracture, the fracture liaison service (FLS) and orthogeriatric care are considered the most appropriate organisational approaches for secondary fracture prevention following a recent fracture.Their introduction and implementation have been shown to increase evaluation and treatment of patients at high risk for subsequent fracture. Of real-world cohort studies, most, but not all studies, indicate a lower incidence of fracture and longer survival after treatment with nitrogen-containing bisphosphonates.     

Patient satisfaction on the utilization of traditional and complementary medicine services at public hospitals in Malaysia

BackgroundTraditional and complementary medicine (T&CM) has been integrated into the Malaysian public healthcare system since the establishment of the first T&CM unit at a public hospital in 2007. Assessing patient satisfaction is a vital component of health service evaluation. The main objective of this study is to determine the level of patient satisfaction with the utilization of T&CM services at public hospitals in Malaysia and assess the sociodemographic influence on the overall reporting of satisfaction. This study also aims to analyze the response of the patients towards expansion of T&CM services in the public sector in Malaysia.Materials and methodsA study was conducted to analyze data on the utilization of T&CM services within public hospitals. Secondary data on 822 patients’ satisfaction with services offered at 15 T&CM units was analyzed to examine the overall levels of satisfaction with T&CM services in public hospitals in Malaysia.ResultsOverall, 99.4% of patients were satisfied with T&CM services and most patients (91.8%) felt that T&CM treatment positively impacted their health. Overall satisfaction was not affected by lower levels of satisfaction with subcategories of service, such as the number of treatment sessions received (90.7% satisfied), date to the next appointment (90.7% satisfied), and the absence of adverse effects of treatment received (87.1% satisfied). There were no significant associations between the socioeconomic status of the respondents and the level of satisfaction reported; however, respondents with a monthly salary of Ringgit Malaysia (RM) 1000 to RM 3000 were more than twice as likely to be strongly satisfied with services received (adjusted odds ratios [AOR]: 2.12, 95% CI: 1.19–3.78).ConclusionThis study revealed a high level of satisfaction among patients who had received T&CM treatment at public hospitals in Malaysia. High satisfaction with T&CM treatment validates the integrative management approach adopted in patient care within the public hospitals in Malaysia.     

Barriers to vaccination service delivery within general practice: opportunity to make a sustainable difference in Aboriginal child health?

Objective: To identify behavioural barriers of service provision within general practice that may be impacting the vaccination coverage rates of Aboriginal children in Perth, Western Australia (WA). Methods: A purposive developed survey was distributed to 316 general practices across Perth and three key informant interviews were conducted using a mixed‐methods approach. Results: Of the surveyed participants (n=101), 67.4% were unaware of the low vaccination coverage in Aboriginal children; 64.8% had not received cultural sensitivity training in their workplace and 46.8% reported having inadequate time to follow up overdue child vaccinations. Opportunistic vaccination was not routinely performed by 30.8% of participants. Key themes identified in the interviews were awareness, inclusion and cultural safety. Conclusion: Inadequate awareness of the current rates, in association with a lack of cultural safety training, follow‐up and opportunistic practice, may be preventing greater vaccination uptake in Aboriginal children in Perth. Cultural safety is a critical component of the acceptability and accessibility of services; lack of awareness may restrict the development of strategies designed to equitably address low coverage. Implications: The findings of this study provide an opportunity to raise awareness among clinicians in general practice and inform future strategies to equitably deliver targeted vaccination services to Aboriginal children.