医院知识管理研究现状及发展分析

采用文献研究与系统思考的方法,对国内外医院知识管理现状与发展动态进行分析,以期为改进医院管理方法提供理论依据。发达国家医院早已引入知识管理。目前国外医院知识管理研究处于理论与实践相结合阶段,而我国医院知识管理的研究尚处于初级阶段。未来发展与研究方向应突出表现在知识管理与医院核心竞争力、医患关系知识管理、医院与供应商关系知识管理、虚拟医院知识管理等方面。     

实习医师病历书写的现状与措施

病历书写可拓宽实习医师的临床视野,培养临床思维能力,提高医疗综合素质。但随着公众法律及维权意识的增强、《医疗事故处理条例》的出台和医疗纠纷的日益增多,病历质量越来越重要,实习医师病历书写标准也越来越高。本文对当前实习医师书写病历存在的问题进行分析探讨,并提出应对措施。     

Cancer Prevention Behaviors in Low-Income Urban Whites: An Understudied Problem

Low-income urban whites in the United States have largely gone unexamined in health disparities research. In this study, we explored cancer prevention behaviors in this population. We compared data on whites with low socioeconomic status (SES) from the 2003 Exploring Health Disparities in Integrated Communities Study in Southwest Baltimore, Maryland (EHDIC-SWB) with nationally representative data for low SES white respondents from the 2003 National Health Interview Survey (NHIS). Rates for health behaviors and health indicators for whites from the EHDIC-SWB study as compared to NHIS prevalence estimates were as follows: current cigarette smoking, 59% (31% nationally); current regular drinking, 5% (5% nationally); overweight, 26% (32% nationally); obesity, 30% (22% nationally); mammography in the past 2 years, 50% (57% nationally); Pap smear in the past 2 years, 64% (68% nationally); screening for colon cancer in the past 2 years, 41% (30% nationally); and fair or poor self-reported health, 37% (22% nationally). Several cancer prevention behaviors and health indicators for white EHDIC-SWB respondents were far from the Healthy People 2010 objectives. This study provides rare estimates of cancer-related health and health care measures in an understudied population in the United States. Findings illustrate the need for further examination of health behaviors in low SES white urban populations who may share health risks with their poor minority urban counterparts.     

Price sensitivity and smoking smuggled cigarettes

Background: This study analysed the socio-economic factors thatinfluence a smoker's decision to consume smuggled cigaretteswhen faced with the rising costs of legal cigarettes. We hopeour findings will help public health authorities create policiesthat simultaneously discourage consumption of smuggled cigarettesand lower overall smoking levels. Methods: We conducted a national telephone survey from Aprilto June 2004. We then applied Multiple Logistic Regression tothe collected data to answer the following questions: do socio-economicallydisadvantaged smokers differ significantly in their characteristics?If so, which characteristics are most influential in the decisionto purchase smuggled cigarettes? Results: Smokers with a personal monthly income of less thanNew Taiwan dollar (NT$) 10 000 are 24% more likely to smokesmuggled cigarettes than are smokers who earn NT$10 000 or more.Smokers with the least amount of education are 21% more likelyto smoke smuggled cigarettes than those with higher levels ofeducation. Smokers with the most experience purchasing smuggledcigarettes are 31% more likely to do so than those with lessexperience. Finally, smokers who have a personal monthly incomeof less than NT$10 000 and the least amount of education are54% more likely to smoke smuggled cigarettes than those withjust one—or none—of these characteristics. Conclusion: Low-income, poorly-educated smokers are most likelyto purchase smuggled cigarettes. To alter such behaviour, governmentmust understand the motivations and opinions of this populationand create marketing messages targeted specifically to theirneeds.     

Neuroprotective effects of cyanidin 3-O-glucopyranoside on amyloid beta (25–35) oligomer-induced toxicity

Recent studies suggest that the oligomers of short amyloid beta (Aβ) peptides such as Aβ_25–35 as well as full-length Aβ peptides (i.e. Aβ_1–40 and Aβ_1–42 peptides) are responsible for synaptic dysfunction and/or neuronal loss in Alzheimer's disease (AD). Among antioxidant phytochemicals derived from fruit and vegetables, cyanidin 3-O-glucoside (Cy-3G) has recently gained attention for its neuroprotective properties. In this in vitro study, we demonstrated that Cy-3G can inhibit Aβ_25–35 spontaneous aggregation into oligomers and their neurotoxicity in human neuronal SH-SY5Y cells. In particular, the pre- and co-treatment of SH-SY5Y cells with Cy-3G reduced the neuronal death, in terms of apoptosis and necrosis, elicited by Aβ_25–35 oligomers. Cy-3G also shows the interesting ability to prevent the early events leading to neuronal death such as the Aβ_25–35 oligomer binding to plasma membrane and the subsequent membrane integrity loss. Taken together, these findings suggest that Cy-3G may be considered a phytochemical with neuroprotective properties useful in finding potential drug or food supplements for the therapy of AD.     

Associations between childhood intelligence (IQ), adult morbidity and mortality

Intelligence is a life-long trait that exerts powerful influences on educational success, occupational status, use of health services, life style and recreational choices. Until recently, the influence of cognitive performance on time to death was thought largely to be based on failing cognition in the time immediately before death or because lower mental ability was associated with low socioeconomic status and socioeconomic disadvantage. Children who were systematically IQ tested early in the twentieth century have now completed most of their life expectancy and permit evaluation of a possible link between childhood IQ and survival. This link is discussed as it affects people with intellectual disability and as a possible contributor to the acquisition of a healthy life style or use of health services. Studies on the topic are affected by many methodological pitfalls. Recently, as cohorts IQ tested as adolescents have completed middle age, new relevant data have become available. These suggest that earlier attempts to tease out the confounding effects of socioeconomic status on the relationship between childhood IQ and mortality did not take account of the full effects of childhood adversity on IQ and disease risk. When statistical models that include childhood adversity are tested, these attenuate and sometimes remove the contribution of IQ to morbidity and premature death.     

Bone mineral density and prediction of non-osteoporotic disease

It is widely recognized that bone mineral density (BMD) is one of the best predictors of osteoporotic fractures. Sex hormone status clearly affects bone either directly or indirectly and a longer estrogen exposure appears to be a major determinant of postmenopausal BMD. Accordingly, several studies have led to the hypothesis that BMD might represent a marker of the accumulated lifetime exposure of estrogen and therefore be used as a predictor factor of the risk of other postmenopausal conditions such as breast cancer or cardiovascular diseases (CVD).     

Comparison of two nutritional assessment methods in gastroenterology patients

AIM:To investigate and compare efficacy and differences in the nutritional status evaluation of gastroenterology patients by application of two methods:subjective global assessment(SGA) and nutritional risk index(NRI).METHODS:The investigation was performed on 299 hospitalized patients,aged 18-84 years(average life span 55.57 ± 12.84),with different gastrointe-stinal pathology,admitted to the Department of Gastroenterohepatology,Clinical and Hospital Center “Bezanijska Kosa“ during a period of 180 d.All the...