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1.
《Vaccine》2022,40(41):5997-6000
Coronavirus disease 2019 (COVID-19) vaccine administration started in February 2021 in Japan. As of December 2021, approximately 75% of the population aged ≥12 years had received two doses of vaccine. We conducted a study to investigate vasovagal reactions (VVR) after COVID-19 vaccination using data on adverse events following immunization. The crude reporting rate of VVR (cases/1,000,000 doses) after vaccination was 9.6 in all age groups combined, and was more frequent in the younger age groups: 28.6 and 37.2 in individuals aged 10–19 years and 20–29 years, respectively. In individuals aged 10–29 years, the rate was similar in males and females (33.0 and 34.2, respectively, p = 0.53); but was higher after dose 1 than after dose 2 (57.4 and 8.8, respectively, p < 0.001). Based on these results, caution needs to be exercised when vaccinating adolescents and young adults, especially with dose 1 of COVID-19 vaccines.  相似文献   
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Context

In most resource-rich countries, a large and growing proportion of older adults with complex needs will die while in a residential aged care (RAC) facility.

Objectives

This study describes the impact of facility size (small/large), ownership model (profit/nonprofit) and provider (independent/chain) on resident comfort, and symptom management as reported by RAC staff.

Methods

This retrospective “after-death” study collected decedent resident data from a subsample of 51 hospital-level RAC facilities in New Zealand. Symptom Management at the End-of-Life in Dementia and Comfort Assessment in Dying at End of life with Dementia (SM-EOLD and CAD-EOLD, respectively) scales were used by RAC staff who were closely associated with 217 deceased residents. Data collection occurred from January 2016 to February 2017.

Results

Results indicated that residents of large, nonprofit facilities experienced greater comfort at the end of life (CAD-EOLD) as indicated by a higher mean score of 37.21 (SD = 4.85, 95% CI = 34.4, 40.0) than residents of small for-profit facilities who recorded a lower mean score of 31.56 (SD = 6.20, 95% CI = 29.6, 33.4). There was also evidence of better symptom management for residents of chain facilities, with a higher mean score for symptom management (SM-EOLD total score) recorded for residents of chain facilities (mean = 28.07, SD = 7.64, 95% CI = 26.47, 29.66) than the mean score for independent facilities (mean = 23.93, SD = 8.72, 95% CI = 21.65, 26.20).

Conclusion

Findings suggest that there are differences in the quality of end-of-life care given in RAC based on size, ownership model, and chain affiliation.  相似文献   
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IntroductionImproved routine immunizations in Japan have led to a reduction in vaccine-preventable diseases. Due to changes in the vaccination program, current young adults received their second vaccination for measles and rubella at different times depending on their birth year, and most of them have not been vaccinated against varicella and mumps. This study investigated the effect of vaccine programs on the immunity of people in Japan.MethodsImmunoglobulin G antibody (IgG) titers against four viruses were determined by enzyme immunoassay in 795 students at a medical university. Titers for measles and rubella were compared according to the students’ birth dates (Group 1: April 2, 1990–April 1, 2000; Group 2: April 2, 2000–).ResultsThe titers of students that satisfied the standard IgG values against measles, rubella, varicella, and mumps were 24.3%, 56.9%, 87.4%, and 47.2%, respectively. Measles and rubella titers were lower in group 2 (estimated mean period from last vaccination, 7.0 years) than group 1 (13.5 years) (p = 0.023 measles, p = 0.037 rubella), indicating attenuation of titers over time. Varicella and mumps antibody prevalence indicated that these infections were endemic, whereas rates of negative titers were higher than those for measles and rubella.ConclusionsIgG titers against viruses were affected by vaccination programs. Declining titers after vaccination should be monitored when the diseases are almost eliminated and boosting is absent. Antibody testing is meaningful for recommending vaccinations and for surveillance of waning immunity. Continuous improvements of vaccination program should be considered to prevent and eliminate diseases.  相似文献   
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目的:了解福利院老年人的生存状况,便于今后更有效地开展扶老助老活动。方法通过发放问卷对社会福利院中的120位老年人进行调查。结果①福利院老年人平均年龄为83.8岁,37.5%老年人处于半自理和完全不能自理状况,心血管疾病是影响老年人身体健康的最大因素,大多数老年人存在2种或2种以上的疾病。②有孤独感的老年人占46.7%,每天以发呆为主的老年人高达69.2%,从事有益身心活动的老年人较少。③老年人对福利院院内环境和护理服务比较满意,但对居住条件和饮食满意度相对较低。④老年人最大的愿望是被人关怀。结论社会福利院的老年人生理、心理和交往能力方面存在较大问题,建议个人、家属、院方和社会力量共同有效介入。  相似文献   
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《Vaccine》2020,38(44):6941-6953
Addressing vaccine management bottlenecks, including high vaccine wastage rates, has traditionally been addressed through health worker training and other didactic methods of technical assistance or support as required. It has been shown, though, that the high level of technical skills, expertise, and responsibility required in vaccine handling and management cannot be achieved by mere didactic learning. While gains have been made in vaccine management and handling with these approaches, there remain challenges of high vaccine wastage rates and poor vaccine management practices across the board. Interestingly, approaching vaccine management through social behavior change has not been documented. Through Participatory Action Research (PAR), which is increasingly being used in health sciences, we explore an attempt at strengthening vaccine management and thus reducing high vaccine wastage rates by working together with health workers to identify plausible, realistic solutions to vaccine management through social behavior change. Select health workers directly involved with the immunization program in the four major provinces of the Solomon Islands were identified purposively to use action media and come up with concepts and materials for social behavior change communication that will have an impact on effective vaccine management and reducing wastages. This is the first documented use of such methodology in addressing vaccine management issues.  相似文献   
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目的对我国公立医院绩效考核政策进行评述,为推动我国公立医院绩效考核提供参考。方法从宏观、中观、微观3个层面,按照坚持公益性、调动积极性和提升群众获得感三个方面,从利益相关者角度进行绩效考核政策分析。结果宏观层面将公立医院综合改革纳入绩效考核,中观层面建立健全绩效考核指标体系,对院长年度工作进行考评,微观层面主要是以服务质量和效率为核心。坚持公益性要建立健全以公益性质为核心的绩效考核体系,调动积极性要充分发挥绩效考核的激励、导向作用,提升群众获得感主要是控制医疗费用。利益相关者在公立医院绩效考核中利益损益各有不同。结论宏观层面顶层设计不够清晰,需建立健全行政能力考核机制;中观层面多部门治理协调性不足,需要加强部门联动性;微观层面绩效考核配套政策缺位,需落实考核指标的范围和内容。  相似文献   
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本文简要概述两宋煎点茶汤、以茶入药之俗,并以四君子汤为例对《太平惠民和剂局方》所载“白汤”实物及其方剂学意义进行探讨。《太平惠民和剂局方》所记载“白汤”在方剂的运用中具有一定的规律性,笔者粗考两宋药事、茶事民俗,认为《太平惠民和剂局方》所载“白汤”或为两宋时期冲点团茶。四君子汤中虽无“大行气”之品,然得“白汤”之助却获“大行气”之用。诸家或循此“以茶入药”之实践,终成四君子汤后世“行补兼施,补而不滞”之衍化。  相似文献   
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