护理质量管理信息化的研究及效果

目的 探讨研究护理质量信息化管理的模式.方法按现代医院护理管理要求,针对护理人力资源管理、物资管理、护理人员技术档案管理、护理质量管理等4个方面提出管理设计方案,由计算机专家编制软件,在医院HIS系统上运行.结果加快了各类信息的传递,提高了工作效率,降低了护理风险和院内感染的风险.结论护理质量管理信息化提高了护理管理者的管理水平和工作效率.减少由组织管理上的漏洞而引起的责任风险,从而降低护理风险.提高管理效率,降低管理成本.     

基于红外光谱法的云南重楼及其近缘种的亲缘关系研究

目的傅里叶变换红外光谱(fourier transform infrared spectroscopy,FTIR)结合化学计量学方法分析云南重楼Paris polyphylla var.yunnanensis及其近缘种的亲缘关系,为重楼属药用植物资源的开发利用提供理论依据。方法采集云南重楼、白花重楼Paris polyphylla var.alba、毛重楼Paris mairei、南重楼Paris vietnamensis、五指莲Paris axialis var.axialis共50份样品的红外光谱信息,对光谱数据进行自动基线校正、自动平滑、纵坐标归一化、多元散射校正、二阶求导等预处理,采用主成分分析(principal component analysis,PCA)、偏最小二乘判别分析(partial least squares discriminant analysis,PLS-DA)及系统聚类分析(hierarchical cluster analysis,HCA)分析光谱数据。结果原始红外光谱中,1 653、1 156、1 082、1 021、925、851、759、572、524 cm~(-1)等为重楼属植物的共有峰,主要归属为黄酮、淀粉和糖苷类成分的吸收峰;毛重楼和五指莲分别在1 535和1 369 cm~(-1)附近有特征吸收峰,可与另外3种重楼属植物相区分。以全波段光谱数据进行PLS-DA和PCA,PLS-DA对重楼属植物分类效果优于PCA,能够准确区分5种野生重楼属植物。系统聚类分析(HCA)及向量夹角余弦相关性分析能够反映5个重楼属植物的亲缘关系,云南重楼与白花重楼和南重楼的亲缘关系较近,与毛重楼和五指莲的关系较远。结论 FTIR结合化学计量学方法,能够快速区分不同种类重楼属植物,明确云南重楼及其近缘种之间的亲缘关系,为重楼属植物亲缘关系研究提供一种快速、有效的方法,同时为重楼种质资源开发和利用提供理论基础。     

中药资源产业化过程废弃物资源化的理论与模式分析

随着我国中药产业快速发展,中药资源产业化过程中产生的废弃物所带来的环境与生态问题日益突出。基于经济学中的外部性理论、循环经济与价值创新理论,对中药资源产业化废弃物资源化思路与模式进行了深入探索,并提出了粗放低值资源化模式-转化增效资源化模式-精细高值增值资源化模式相结合的"三位一体的资源化模式",最后提出了促进中药资源产业化过程中废弃物资源化的策略。     

The Commerce and Crossover of Resources: Resource Conservation in the Service of Resilience

Conservation of resources (COR) theory was originally introduced as a framework for understanding and predicting the consequences of major and traumatic stress, but following the work of Hobfoll and Shirom (1993), COR theory has been adopted to understanding and predicting work‐related stress and both the stress and resilience that occur within work settings and work culture. COR theory underscores the critical role of resource possession, lack, loss and gain and depicts personal, social and material resources co‐travelling in resource caravans, rather than piecemeal. We briefly review the principles of COR theory and integrate it in the crossover model, which provides a key mechanism for multi‐person exchange of emotions, experiences and resources. Understanding the impact of resource reservoirs, resource passageways and crossover provides a framework for research and intervention promoting resilience to employees as well as to organizations. It emphasizes that the creation and maintenance of resource caravan passageways promote resource gain climates through resource crossover processes. Copyright © 2014 John Wiley & Sons, Ltd.     

A review on current status of antiviral siRNA

Viral diseases like influenza, AIDS, hepatitis, and Ebola cause severe epidemics worldwide. Along with their resistant strains, new pathogenic viruses continue to be discovered so creating an ongoing need for new antiviral treatments. RNA interference is a cellular gene‐silencing phenomenon in which sequence‐specific degradation of target mRNA is achieved by means of complementary short interfering RNA (siRNA) molecules. Short interfering RNA technology affords a potential tractable strategy to combat viral pathogenesis because siRNAs are specific, easy to design, and can be directed against multiple strains of a virus by targeting their conserved gene regions. In this review, we briefly summarize the current status of siRNA therapy for representative examples from different virus families. In addition, other aspects like their design, delivery, medical significance, bioinformatics resources, and limitations are also discussed.     

Efficacy of CT-guided biopsies of the spine in patients with spondylitis--an analysis of 164 procedures

Objective

To evaluate efficacy of CT-guided spinal biopsy (CTSB) in patients with spondylitis considering patient characteristics, technical issues, antibiotic therapy, histopathological, and microbiological findings.

Materials and methods

All CTSB procedures performed between 1995 and 2009 in patients with proven spondylitis were re-evaluated. Patient sex and age, antibiotic treatment, biopsy approach, number of specimens, length of needle path, laboratory results (CRP, WBC), and histopathological/microbiological findings were documented and compared to the final diagnosis of spondylitis. Statistical analysis was performed using Chi-square test and Student's t-test. The p-value was set to 5%.

Results

164 CTSB procedures were performed in 159 patients (mean age 65 years, 60% men) in which spondylitis was histopathologically verified in 95%. Neither patient sex nor age, positioning, localization of the spinal lesion, bioptic approach, number of specimens, or depth of the needle showed significant impact on the rate of positive histopathological findings. A causative germ was identified in 40/127 biopsies (32%) with Staphylococcus aureus being identified in 50%. Tuberculous spondylitis was diagnosed in ten cases (6%). CRP significantly correlated with bacterial growth (13.3 ± 12.2 mg/dl versus 8.8 ± 7.6 mg/dl; p = .015) whereas administration of antibiotics did not show any significant impact on bacterial growth (29% versus 36% in patients without antibiotics; p = 0.428). Patients with histopathological signs of active spondylitis showed a significantly higher CRP (16.5 ± 15.8 mg/dl versus 8.9 ± 8.0 mg/dl, p < .001). Complication rate was 0.6% (one focal bleeding).

Conclusion

CTSB of the spine in suspected spondylitis is an effective and safe procedure for establishing final histopathological diagnosis. However, microbiological yield is low regardless of technical issues and antibiotic therapy. Other than CRP values, laboratory investigations added little useful information to diagnose infection in our study group. CRP values significantly correlated with bacterial growth and with histopathological signs of active spondylitis.     

Strategic Provider Behavior Under Global Budget Payment with Price Adjustment in Taiwan

Global budget payment is one of the most effective strategies for cost containment, but its impacts on provider behavior have not been explored in detail. This study examines the theoretical and empirical role of global budget payment on provider behavior. The study proposes that global budget payment with price adjustment is a form of common‐pool resources. A two‐product game theoretic model is derived, and simulations demonstrate that hospitals are expected to expand service volumes, with an emphasis on products with higher price–marginal cost ratios. Next, the study examines the early effects of Taiwan's global budget payment system using a difference‐in‐difference strategy and finds that Taiwanese hospitals exhibited such behavior, where the pursuit of individual interests led to an increase in treatment intensities. Furthermore, hospitals significantly increased inpatient service volume for regional hospitals and medical centers. In contrast, local hospitals, particularly for those without teaching status designation, faced a negative impact on service volume, as larger hospitals were better positioned to induce demand and pulled volume away from their smaller counterparts through more profitable services and products such as radiology and pharmaceuticals. Copyright © 2014 John Wiley & Sons, Ltd.     

Are natural resources bad for health?

The purpose of this paper is to empirically examine whether economic dependence on various natural resources is associated with lower investment in health, after controlling for countries׳ geographical and historical fixed effects, corruption, autocratic regimes, income levels, and initial health status. Employing panel data for 118 countries for the period 1990–2008, we find no compelling evidence in support of a negative effect of resources on healthcare spending and outcomes. On the contrary, higher dependence on agricultural exports is associated with higher healthcare spending, higher life expectancy, and lower diabetes rates. Similarly, healthcare spending increases with higher mineral intensity. Finally, more hydrocarbon resource rents are associated with less diabetes and obesity rates. There is however evidence that public health provision relative to the size of the economy declines with greater hydrocarbon resource-intensity; the magnitude of this effect is less severe in non-democratic countries.