Réflexion sur la péréquation financière de psychiatrie en France

For 25 years work has been underway in France for the implementation of an alternative to public financing of health care. In the absence of progress, some regional health agencies are engaged in work related to the reallocation of public finances between psychiatric institutions. We propose a reflection with suggestion on the method proposed by the Provence Alpes Côte d’Azur Regional Health Agency. Without questioning the need for a reallocation of resources between psychiatric institutions, the method proposed here needs to evolve further to be applied in a legitimate and appropriate manner. There is a kind of urgency for a reallocation of resources between psychiatric institutions in France, but it implies a collective thinking and especially the definition of evaluation procedures for the selected models. These conditions are necessary to guarantee the quality of French psychiatry and equity in access to psychiatric care.     

不同排牙方法对全口义齿咀嚼效能的影响

目的:探讨不同排牙法的全口义齿咀嚼效能的异同。方法:采用上颌排牙法、下颌排牙法和综合排牙法为10名无牙颌患者分别制作3副全口义齿。戴用3个月后,通过吸光度法测定咀嚼效率,比较不同排牙法的全口义齿咀嚼效能的异同,并与有牙颌进行对比。结果:在单侧咀嚼和双侧咀嚼2种咀嚼方式下,全口义齿患者的咀嚼次数和咀嚼效能均少于有牙颌组,本实验3组全口义齿在3个月后均发挥了良好的咀嚼效能。下颌排牙法和综合排牙法全口义齿的咀嚼次数和咀嚼效能无统计学差异,但均好于上颌排牙法全口义齿。结论:下颌排牙法和综合排牙法的全口义齿排列的人工牙能够减少在咀嚼过程中不利于全口义齿稳定因素的影响,提高咀嚼效能。     

民族医药古籍保护性研究意义及现状

各民族医药在发展历史进程中,均通过文献、典籍、碑刻、口耳相传等形式起到了传播、传承、发展的重要作用。但经过几百年甚至几千年的传承,有遗失,有破损,有传承人断代致家传秘籍不能传承的危境等等,为此,需要开展藏医药古籍的保护性整理研究工作。课题组在全国范围内开展藏医药古籍文献的普查、收集、整理,经过5年多的努力,课题组首次以出版名录的形式对藏医药古籍文献进行文化产权的保护,首次以藏文、汉文、英文和藏文拉丁文转写作为国际规范和标准及成果进行推广,首次以信息化平台建设的形式对藏医药古籍文献进行永久性数字化保存、保护及传播,并以发明专利、著作权登记等形式对藏医药古籍文献进行知识产权的保护。     

实施整体护理中改进护士排班的做法

目的　通过改进护士排班方法 ,充分挖掘现有护理人力资源的潜力 ,使整体护理各项程序得以落实。方法　采用护理人员相对固定的排班方式。结果　保证了责任护士护理工作的连续性、系统性 ,为责任护士给患者提供良好的护理服务奠定了基础。同时 ,职责明确 ,加强了护士的责任心 ,增强了护士竞争意识和主动服务意识。结论　护士乐于接受 ,护理服务的满意度提高 ,相对缓解了护理人员不足的问题     

海南古代医药卫生类文献的收集与整理

基于文献调研、收集与整理的成果,探讨了海南古代医药卫生类文献的内涵、外延,分析了其在时间、体裁、内容、馆藏上的分布及相关特征,并以与医药卫生有关的特产药材、医学教育、卫生行政、流行病疫情、医学人物、医学著作等内容为类别,分述了相关古代文献收集、整理的标准、方法、体例及成果概况。     

Costs of introducing pneumococcal,rotavirus and a second dose of measles vaccine into the Zambian immunisation programme: Are expansions sustainable?

BackgroundIntroduction of new vaccines in low- and lower middle-income countries has accelerated since Gavi, the Vaccine Alliance was established in 2000. This study sought to (i) estimate the costs of introducing pneumococcal conjugate vaccine, rotavirus vaccine and a second dose of measles vaccine in Zambia; and (ii) assess affordability of the new vaccines in relation to Gavi’s co-financing and eligibility policies.MethodsData on ‘one-time’ costs of cold storage expansions, training and social mobilisation were collected from the government and development partners. A detailed economic cost study of routine immunisation based on a representative sample of 51 health facilities provided information on labour and vaccine transport costs. Gavi co-financing payments and immunisation programme costs were projected until 2022 when Zambia is expected to transition from Gavi support. The ability of Zambia to self-finance both new and traditional vaccines was assessed by comparing these with projected government health expenditures.Results‘One-time’ costs of introducing the three vaccines amounted to US$ 0.28 per capita. The new vaccines increased annual immunisation programme costs by 38%, resulting in economic cost per fully immunised child of US$ 102. Co-financing payments on average increased by 10% during 2008–2017, but must increase 49% annually between 2017 and 2022. In 2014, the government spent approximately 6% of its health expenditures on immunisation. Assuming no real budget increases, immunisation would account for around 10% in 2022. Vaccines represented 1% of government, non-personnel expenditures for health in 2014, and would be 6% in 2022, assuming no real budget increases.ConclusionWhile the introduction of new vaccines is justified by expected positive health impacts, long-term affordability will be challenging in light of the current economic climate in Zambia. The government needs to both allocate more resources to the health sector and seek efficiency gains within service provision.     

提高手术室护士工作效率的排班方法研究及应用

目的 通过更新排班方法，使千差万别的护理工作者在很短时间内达到最佳身心状态。确保单位时间内的工作效率，提高护理质量，杜绝差错事故发生。方法 对本科室38名护士，分A、B、C3组，通过每组不同排班方法探讨，观察手术室护士的工作激情和精神状态及工作的主动性。结果实验组A与对照组B、C2组比为P＜0．01，差异有显著性，两对照组比较有差异，但无统计学意义。结论 护士长的合理搭配排班是保证护理工作顺利完成的前提，是提高护理质量、杜绝差错事故的重要保障，更是提高手术室护士满意度的一种新举措。