微格教学方法在临床医学专业留学生儿科学在线见习教学中的应用

目的:探讨微格教学方法在临床医学专业留学生儿科学在线见习教学中的应用效果。方法:2020年5月,选择在哈尔滨医科大学附属第一医院儿科见习的2017级临床医学专业58名留学生作为研究对象,按照随机抽签方式分为试验组和对照组,每组29名留学生。试验组采用在线微格教学方法,通过角色扮演加深学生对临床知识的理解;对照组采用在线...     

Hybrids do it better: Lessons from websites of hybrid organizations in modern health movements

ABSTRACT

Hybrid organizations in modern health movements adopt multiple organizational logistics, allowing them to more effectively achieve social change. We conducted an analysis of 152 probreastfeeding organization websites categorized as institutionalized organizations, grassroots organizations, or hybrid organizations. Through a series of ANOVA analyses, we found that hybrid’s websites provide significantly more useful health care information, better maintained dialogue with members, more efficiently mobilized members, commoditized health care issues less, and created member identity while maintaining institutional ties. Ultimately, hybrids tended to incorporate the positive elements from both grassroots and institutional organizations, while rejecting many of the negative elements.     

长沙市留学生社会支持及生活质量满意度研究

目的了解长沙市留学生社会支持及生活质量现状,探讨留学生社会支持的途径,提高长沙市留学生身心健康水平。方法使用觉察社会支持量表（PSSS）和生活质量满意度调查问卷对长沙市4所大学的120名留学生进行问卷调查。结果长沙市留学生社会支持水平普遍较高,但生活质量满意度因专业、学校、宗教信仰、培养方式、性别和学历不同差异有统计学意义（P〈0.05）。结论长沙市高校关注留学生的身心健康,为其提供良好的社会支持。但留学生生活质量满意度因不同因素存在差异,需更多关注留学生中的弱势群体。     

深圳市药品集中采购对降低药品费用的成效研究

目的:测算深圳市药品集中采购模式下药品降幅。方法:采用拉氏指数法,将同一通用名、同一目录剂型、同一质量层次药品纳入同组分析,计算其加权平均数。结果:在维持2015年销售数量不变的前提下,测算理论金额为53.78亿元,预计节约费用15.16亿元,综合降幅21.99%。结论:总体来说深圳市GPO是药品采购模式的有益探索,在降低药品总费用的基础上保障了临床用药需求。     

Perceptions of environmental opportunities for physical activity in the European Union

Summary Objectives:This article is the last in a series of four that present data about physical activity in 15 members states of the European Union collected by the Eurobarometer 58.2. The focus of this article is on the perception of environmental opportunities for physical activity across the European Union. Methods:Data were collected in 2002 as part of the Eurobarometer by face-to-face interviews. A total of 16230 respondents age 15 years and older were interviewed. Sample sizes ranged about 1000 respondents in most nations. Physical activity was assessed with the last 7-days short version of the International Physical Activity Questionnaire (IPAQ). Results:Results indicate relationships between the perceptions of environmental opportunities; gross household income and physical activity level (in MET-hours/per week) of respondents. Respondents who reported lower income and less physical activity had also more negative perceptions of environmental opportunities. Across nations, respondents in Denmark, the Netherlands, Luxembourg, and Western Germany had the highest satisfaction with environmental opportunities for physical activity. In some nations, positive correlations between the perception of environmental opportunities and physical activity levels could be observed. Conclusions:Results show variations in the perception of environmental opportunities across the EU. Overall, the majority of respondents rated their environmental opportunities for physical activity favourable.     

出入境人群HIV感染者/AIDS患者血清生化指标分析

目的了解HIV感染后血清生化指标的变化,探讨HIV感染对机体组织的损伤程度。方法病例组为广西出入境人群发现的HIV感染者/AIDS患者,对照组为随机抽取的经广西口岸出入境正常人群。用全自动生化分析仪检测血清生化指标。结果各实验组ALT、ALP、BUN、Cre在正常范围;HBV/HCV/HIV混合感染组的AST明显高于HIV单感染组(P<0.01),而HIV单感染组与正常对照没有明显差异(P>0.05);各实验组γ-GT除吸毒传播感染组与正常对照没有明显差异(P>0.05)以外,其余各组都显著高于对照组(P<0.01);各实验组ALB除吸毒传播感染组与对照组没有明显差异(P>0.05)以外,其余各组都显著低于对照组(P<0.05)。结论单纯HIV感染对肝、肾组织似乎没有造成严重影响,HIV感染/AIDS者的白蛋白降低可能与慢性腹泻等消耗性疾病有关。     

国际全科医生制度发展历程:影响因素分析及政策启示

全科医生制度建设的国际经验可以为中国全科医生制度的建立和发展提供借鉴。本文首先梳理了国民健康服务体制、社会医疗保险体制、商业医疗保险体制等部分典型国家的全科医生制度发展历程,重点分析了全科医生制度建设的影响因素。结果发现,建立和发展全科医生制度的主要影响因素有:经济社会因素、卫生保健体制对卫生体系的控制力、医师对卫生体系的控制力、全科医学服务的激励机制、全科医学的发展程度等。最后,结合近年我国全科医生制度建设的实际提出几点政策启示,一要以满足我国公众健康需求为目标,构建中国特色全科医生制度;二要普及全科医学服务核心价值,为建立全科医生制度提供公众民意基础;三要建立健全促进全科医生制度发展的激励机制,提高全科医生地位;四要积极推动全科与专科医学的专业分工,促进全科医学发展。     

Assessment of functioning in Dutch primary care: Development study of a consultation tool for patients with chronic conditions and multimorbidity

BackgroundIn primary care, a shift from a disease‐oriented approach for patients with multimorbidity towards a more person‐centred approach is needed.AimTo transform a self‐report questionnaire for patients with chronic conditions in primary care, the Primary Care Functioning Scale (PCFS), into an understandable, visually attractive and feasible consultation tool for patients and health care providers. The consultation tool consists of a web‐based version of the PCFS, which is filled in by the patient and is processed to a feedback report that summarizes and visualizes the main findings. The feedback report can be discussed with the patient to facilitate a more person‐centred conversation for patients with chronic conditions and multimorbidity in general practice.Design and SettingIn this qualitative study, we developed the consultation tool by using design thinking in a participatory developmental process.MethodsIn the first phase, we constructed five different feedback report templates to summarize and display the results of a completed PCFS questionnaire in a series of two expert meetings with patients and general practitioners (GPs). In the second phase, we performed an exploratory qualitative interview study involving dyads of patients with chronic conditions and their practice nurses. In an iterative process, we explored their experiences with the consultation tool.ResultsPatients, as well as GPs, preferred a clear manner of presenting the results of the questionnaire in a feedback report. In 18 interviews with patients and practice nurses during three different interview rounds, we adjusted the feedback report and consultation tool based on the input from patients and practice nurses. After the final interview round, patients and practice nurses consented that the consultation tool was useful for having a more in‐depth consultation about functioning and patients'' preferences when integrated into the regularly scheduled consultations.ConclusionWe were able to develop an understandable and feasible consultation tool that is applicable in already existing chronic disease management programmes in general practice in the Netherlands.Patient or Public ContributionTo increase the understandability and feasibility of the consultation tool, we collaborated with end‐users and actively involved patients, GPs and practice nurses in a participatory development process.     

Adopting global tools for the advancement of pharmacy practice and workforce in Saudi Arabia

BackgroundThe continuing expansion of the pharmacist’s role necessitates continuous evaluation of current practice to identify strategies for improvements. The International Pharmaceutical Federation (FIP) has developed tools to support stakeholders in identifying development needs and planning advancement strategies. The aim of this research was to utilise the FIP Global Competency Framework, version 2 (GbCF v2), and FIP Development Goals (DGs) to evaluate competencies related to pharmacy practice in Saudi Arabia, and to understand the strategies needed to develop and improve the current practice.MethodsThe study involved four phases. Phase 1 involved translation of the FIP GbCF v2 into the Arabic language. Phase 2 was a consensus panel validation to establish the initial relevance of the competencies to current practice. Phase 3 included a national survey distributed to all registered pharmacists in Saudi Arabia. The final phase was conducted through mapping ‘not relevant’ competencies to FIP DGs to identify priorities.ResultsThe translation phase yielded a bilingual framework that could be utilized by pharmacists in Saudi Arabia. The initial validation phase identified 61 behavioral statements (from 124 in the GbCF v2) as ‘highly relevant’ or ‘relevant’ to pharmacy practice. Findings from the national survey identified a list of ‘not relevant’ competencies that could highlight gaps in current practice. The final mapping phase generated a list of three FIP DG priorities: DG5 (competency development), DG8 (working with others) and DG11 (impact and outcomes).ConclusionThe study indicated that competencies in the GbCF v2 were relevant to pharmacists practicing in the country. However, some competencies were perceived as ‘not relevant’ to current practice and these highlighted gaps in the current practice that need attention. Mapping ‘not relevant’ competencies to FIP DGs should be used as a starting point towards developing strategies, systems, and protocols to advance pharmacy practice in Saudi Arabia.     

关于中毒ICD编码分析

目的 了解中毒疾病分类编码不准确性的问题,分析错误原因,探讨对策.方法 利用医院现有的病案首页管理信息系统,检索2010年-2013年中毒疾病分类编码,并与相关病案进行逐一核对,从而统计错误编码量,计算错误率.结果 2010年-2013年共有中毒疾病分类编码619例,其中91个主要编码编错,错误率14.7％,201例附加编码存在错误,错误率32.4％.结论 病案编码人员应严格把握疾病分类编码的质量关,定期抽查编目质量,建议增加编码信息质量控制程序,提高编码准确性.