中青年楼宇人群的家庭医生签约服务需求满足状况及影响因素研究

背景 上海市正逐步将家庭医生签约服务拓展至楼宇功能社区，目前中青年楼宇人群的服务需求满足状况尚不知晓。研究中青年楼宇人群的家庭医生签约服务需求满足状况，分析其影响因素，可以为制定和调整家庭医生楼宇服务相关政策提供参考。 目的 探讨中青年楼宇人群的家庭医生签约服务需求满足状况，并分析其影响因素。 方法 于2019年12月至2020年12月，在上海市虹口区、浦东新区、静安区采用典型抽样法抽取楼宇，在选中楼宇内采用整群随机抽样法抽取中青年人群（18~59岁）开展问卷调查，共回收有效问卷2 272份，本研究以其中有家庭医生服务利用经历的1 137例受试者为研究对象。涉及的主要调查内容为受试者的社会人口和经济学特征、健康状况、对家庭医生签约服务的了解度及家庭医生签约服务需求满足状况（包括基本服务需求、个性化服务需求两方面，均采用Likert 5级评分法）。采用多元有序Logistic回归分析中青年楼宇人群家庭医生签约服务需求满足状况的影响因素。 结果 39.61%（425/1 073）的受试者表示家庭医生签约服务比较满足/完全满足其基本服务需求，39.01%（419/1 074）的受试者表示家庭医生签约服务比较满足/完全满足其个性化服务需求。多元有序Logistic回归分析结果显示：户籍、职业类别、年收入、自评健康状况、对家庭医生"1+1+1"签约服务了解度、对家庭医生信任度、对家庭医生服务能力评价是中青年楼宇人群基本服务需求满足状况的影响因素（P<0.05）；性别、年收入、患慢性病情况、对家庭医生"1+1+1"签约服务了解度、对家庭医生团队组成了解度、对家庭医生服务能力评价是中青年楼宇人群个性化服务需求满足状况的影响因素（P<0.05）。 结论 约40%的楼宇人群认为家庭医生签约服务能够满足其基本服务需求/个性化服务需求，主要影响因素可概括为楼宇人群的社会经济状况、健康状况、对家庭医生签约服务的认知度、家庭医生的服务能力4个方面。建议加强对家庭医生签约服务的宣传，并针对楼宇人群特点和差异化需求，为其定制个性化的服务方案；同时，着力提升家庭医生服务能力，丰富签约服务内涵。     

提升“湘九味”品牌价值 高质量发展湖南中药材产业

湖南省历经8年聚力打造“湘九味”中药材品牌，已逐渐形成品牌品种引领的产业链发展模式。为达成湖南省中药材产业链千亿发展目标，梳理了“湘九味”品牌培育历程，厘清并阐释了相关概念，分析了产业发展现状及问题，研判了大健康应用背景下未来的中药材产业的发展趋势，并提出相关发展建议。     

全国2015-2020年精神科医师转岗培训状况

目的:调查全国精神科医师转岗培训情况,为优化精神科医师转岗培训和制定精神卫生人才培养体系建设提供参考。方法:设计精神科医师转岗培训调查问卷,调查全国31个省(自治区、直辖市)和新疆生产建设兵团2015-2020年转岗培训情况。采用描述性分析方法,对全国精神科医师转岗培训和培训区县覆盖等情况进行分析;采用χ~2检验比较东中西部地区转岗医师中已提供精神科诊疗服务情况。结果:全国共13 388人完成精神科医师转岗培训,9923人变更或加注了精神科执业资质,6538人已提供精神科诊疗服务,无精神卫生资源空白区县数减少85.1%。结论:转岗培训短期内缓解了精神卫生人才紧缺现状,提高了精神卫生服务可及性。     

医院离退休干部参与社会治理现状

通过文献研究、问卷调查、专家访谈、现地调研等方法,分析医院离退休干部参与社会治理的现状及影响因素,探讨社区对离退休干部参与社会治理的需求,提出通过党建引领医院离退休干部参与社会治理的“1235”模式,并给出具体的操作路径,以期为推动医院离退休干部积极参与社会治理提供参考。     

Family-centered Care for Sick Newborns: A Thumbnail View

Family-centered care (FCC) for sick newborns is emerging as a paradigmatic shift in the practice of facility-based newborn care. It seeks to transforming a provider-centered model into a client-centered one and thus build a new therapeutic alliance. FCC is the cornerstone of continuum of care, imparting caregiving competencies to parents/caregivers both within institutions as well as after the discharge. This has potential gains for the newborn, family members, and facility-level staff. The initial model piloted in tertiary-care settings is now undergoing translation at five sites across the country; the outcomes are keenly awaited.     

Natural compulsive‐like behaviour in the deer mouse (Peromyscus maniculatus bairdii) is associated with altered gut microbiota composition

Obsessive–compulsive disorder (OCD) is a psychiatric illness that significantly impacts affected patients and available treatments yield suboptimal therapeutic response. Recently, the role of the gut–brain axis (GBA) in psychiatric illness has emerged as a potential target for therapeutic exploration. However, studies concerning the role of the GBA in OCD are limited. To investigate whether a naturally occurring obsessive–compulsive‐like phenotype in a rodent model, that is large nest building in deer mice, is associated with perturbations in the gut microbiome, we investigated and characterised the gut microbiota in specific‐pathogen‐free bred and housed large (LNB) and normal (NNB) nest‐building deer mice of both sexes (n = 11 per group, including three males and eight females). Following baseline characterisation of nest‐building behaviour, a single faecal sample was collected from each animal and the gut microbiota analysed. Our results reveal the overall microbial composition of LNB animals to be distinctly different compared to controls (PERMANOVA p < .05). While no genera were found to be significantly differentially abundant after correcting for multiple comparisons, the normal phenotype showed a higher loading of Prevotella and Anaeroplasma, while the OC phenotype demonstrated a higher loading of Desulfovermiculus, Aestuariispira, Peptococcus and Holdemanella (cut‐off threshold for loading at 0.2 in either the first or second component of the PCA). These findings not only provide proof‐of‐concept for continued investigation of the GBA in OCD, but also highlight a potential underlying aetiological association between alterations in the gut microbiota and the natural development of obsessive–compulsive‐like behaviours.     

Update on the global neurosurgery movement: A systematic review of international vernacular,research trends,and authorship

In 2015, key global and neurosurgical organizations increased collaboration to improve neurosurgical care access, delivery, and outcomes, particularly in low- to middle-income countries (LMICs); sparking what has been termed the global neurosurgery movement. The authors sought to assess trends in usage of the term ‘global neurosurgery’ in academic literature with particular focus on author affiliations, world regions most frequently discussed, and topics of research performed. A PubMed search for articles indexed as ‘global neurosurgery’ was completed yielding 277 articles which met inclusion criteria. It was found that over time, use of the term ‘global neurosurgery’ has increased, with increasing growth notable starting in the year 2008 and continuing into October 2019. Statistical comparisons showed authors with affiliated global neurosurgery centers were more likely to publish studies related to the continent of Africa (47.4% vs 15.9%, p < 0.001), and less likely to focus on countries in Asia (2.6% vs 20.9%, p = 0.023). Use of the term ‘global neurosurgery’ in the article abstract/title/keywords was associated with focus on LMICs (18.6% vs. 5.1%, p = 0.006). Use of the term ‘global neurosurgery’ was associated with workforce and capacity as research topics (41.9% vs 22.6%, p = 0.036). While fairly new, the global neurosurgery movement has seen a rapid increase in publications utilizing the term ‘global neurosurgery.’ Articles frequently have focused on collaborative, targeted workforce capacity building in LMICs. We encourage the development of more global neurosurgery academic centers, especially in non-USA countries, to continue this momentum.