Out of the boxes,out of the silos: The need of interdisciplinary collaboration to reduce poor-quality medical products in the supply chain

In this paper, we argue that understanding and addressing the problem of poor-quality medical products requires a more interdisciplinary approach than has been evident to date. While prospective studies based on rigorous standardized methodologies are the gold standard for measuring the prevalence of poor-quality medical products and understanding their distribution nationally and internationally, they should be complemented by social science research to unpack the complex set of social, economic, and governance factors that underlie these patterns. In the following sections, we discuss specific examples of prospective quality surveys and of social science studies, highlighting the value of cross-sector partnerships in driving high-quality, policy-relevant research in this area.     

Constructing queer mother‐knowledge and negotiating medical authority in online lesbian pregnancy journals

Medical interactions around reproduction are increasingly extending beyond the physician's office and onto the Internet, where negotiation with medical authority occurs in complex and dynamic ways. Recently, scholars have noted the Internet's potential for creating spaces where women can dialogue with and reconstruct medical authority, yet this growing body of work is overwhelming heteronormative. This paper thus interrogates how lesbian women use the Internet to challenge, deploy, and rework medical authority around reproduction while navigating the transition to parenthood. I draw from 17 online journals authored by lesbian couples during the conception, pregnancy, and birth of their first child, each spanning between 18 months and 2 years, in order to understand how the transition process unfolds over time. I argue that lesbian couples engage with medical authority when seeking affirmation and normalisation yet discard and publicly reject the heteronormative assumptions that accompany reproductive medicine. Further, they chart a new process that I term ‘constructing queer mother‐knowledge’, in which they critique and balance knowledges from institutionalised medicine, their own bodies, and their queer communities. With this new concept, I complicate understandings of lesbian mothers‐to‐be and their interactions with medical authority as they build subversive families.     

When the standards aren't standard: Evidence-based medicine in the Russian context

This paper examines the uses of evidence-based medicine (EBM) in post-Soviet Russia through the use of semi-structured interviews. It asks what it means to talk about practicing evidence-based medicine in a setting where the context of practice presents considerable barriers to the implementation of EBM principles. Drawing on interviews with Russian physicians, medical students and users of the healthcare system, the paper argues that in post-Soviet Russia EBM serves as a strategic discourse for segments of the medical profession. With the collapse of the U.S.S.R. the healthcare system has been going through a period of crisis, and Russian physicians are finding that they have to redefine their professional identity with respect to the domestic and the international context and have to seek new sources for legitimating their professional position. The western origins of EBM endow this rhetoric with considerable power in the Russian context and render it a very useful tool in the project of redefinition.     

Infant and Neonatal Mortality for Primary Cesarean and Vaginal Births to Women with “No Indicated Risk,” United States, 1998–2001 Birth Cohorts

ABSTRACT: Background: The percentage of United States’ births delivered by cesarean section has increased rapidly in recent years, even for women considered to be at low risk for a cesarean section. The purpose of this paper is to examine infant and neonatal mortality risks associated with primary cesarean section compared with vaginal delivery for singleton full‐term (37–41 weeks’ gestation) women with no indicated medical risks or complications. Methods: National linked birth and infant death data for the 1998–2001 birth cohorts (5,762,037 live births and 11,897 infant deaths) were analyzed to assess the risk of infant and neonatal mortality for women with no indicated risk by method of delivery and cause of death. Multivariable logistic regression was used to model neonatal survival probabilities as a function of delivery method, and sociodemographic and medical risk factors. Results: Neonatal mortality rates were higher among infants delivered by cesarean section (1.77 per 1,000 live births) than for those delivered vaginally (0.62). The magnitude of this difference was reduced only moderately on statistical adjustment for demographic and medical factors, and when deaths due to congenital malformations and events with Apgar scores less than 4 were excluded. The cesarean/vaginal mortality differential was widespread, and not confined to a few causes of death. Conclusions: Understanding the causes of these differentials is important, given the rapid growth in the number of primary cesareans without a reported medical indication. (BIRTH 33:3 September 2006)     

PDCA管理后死亡医学证明书填写质量分析

目的探讨PDCA管理对死亡医学证明书填写质量的影响。方法选择2018年10月—2019年5月我院实施PDCA管理前开具的死亡医学证明书68份作为对照组,选择2019年10月—2020年5月我院实施PDCA管理后开具的死亡医学证明书71份作为研究组,比较两组填写质量。结果研究组的死亡医学证明书患者基本信息填写完整率、准确率高于对照组(P<0.05)。研究组的死亡医学证明书死因项填写不规范率低于对照组(P<0.05)。研究组的网络直报数据不准确率低于对照组(P<0.05)。研究组的死亡医学证明书填报延时率低于对照组(P<0.05)。研究组的死亡医学证明书填写质量评分高于对照组(P<0.05)。结论PDCA管理可保证死亡医学证明书填写完整性、准确性及规范性,提高填报质量,促进了上报的时效性,从而有效提高人口死亡信息登记管理水平。     

新冠肺炎疫情期间医院出生医学证明签发服务风险与策略

为切实做好新冠肺炎流行期间孕产妇和新生儿防护工作,保障母婴安全,国务院下发相关文件对加强孕产妇和新生儿安全管理提出明确要求。福建省妇幼保健院响应国家政策,认真做好各项防控工作,积极开展日常医疗工作。其中出生医学证明签发服务采取分时段线上线下预约,优化出生医学证明办理流程,加强科学防护知识、办理流程的宣教,同时做好签发现场的卫生消毒,对公众进行正面引导等防控措施,有效地减少人员聚集和密切接触,切实保障了出生医学证明签发工作顺利进行,提升了医院管理效率。     

Being in charge: Older women and their younger female kin

Our cross-cultural study of the relationship between older women and their younger female kin examines women's hierarchies based on age and focuses on the exercise of authority by women, when such authority is traditional and accepted. Data were collected for two world-wide samples each consisting of 30 societies, varying in complexity, subsistence base, geographic location, and in customs related to women's lives. Three hypotheses were tested. The findings, which are statistically significant, suggest that the relationships between older women and their younger female kin are patterned and predictable, determined by the role of women in subsistence activities, by rules for post-marital residence, and by descent.When domination can only be exercised... directly, between one person and another, it can not take place overtly and must be disguised under the veil of enchanted relationships, the official model of which is presented by the relations between kinsmen.The gentle, invisible form of violence, which is never recognized as such... can not fail to be seen as the most economical mode of domination...The system is such that the dominant agents have a vested interest in virtue. (Bourdieu 1991191, 192, 194)     

基于分级角色的访问控制

结合RBAC模型,提出了一种基于分级角色的访问控制模型,将系统用户依据职能的不同分为不同的角色,同一类角色又划分不同的等级。定义了基本概念和等级-角色矩阵,进行了形式化的描述,并应用在实际系统中。每一个实际用户通过不同等级的角色,对应于不同访问权限的资源,并可动态地进行角色转换和等级变迁,从而使访问控制机制更为灵活。     

《出生医学证明》书写和办理中存在的问题分析与对策

目的：通过对《出生医学证明》质量的检查，指出存在的问题，分析产生的原因，提出改进的方法。方法：2011年3月～2013年5月办理证件6398例，分成两组，比较文书书写管理改进前后的质量。结果：书写管理改进后质量较前有明显好转，差错率分别为0．6％和0．2％。结论：加强护理人员法制教育、文书质量管理及业务培训，可有效提高护理文书书写质量。     

学术论文作者机构规范文档构建

以中国生物医学文献数据库为基础,面向基于学术论文开展机构检索、分析与评价相关知识服务需要,对学术论文作者机构名称规范目标与内容、体系结构与组织方式以及构建过程与实现策略进行研究、实践总结。