Personality variables as moderators between hassles and subjective indications of distress

The research was designed to investigate the moderating effect of some personality traits on subjective distress caused by daily hassles. The traits were internal locus of control, repression, ego strength, and barrier (as studied and defined by S. Fisher). The last two variables were negatively correlated both with the somatic and emotional distress indications and with the frequency of hassles reportED; internal locus of control showed an inverse relationship only with frequency of hassles. The hypothesis is formulated that ego strength and barrier are personality factors influencing not only the outcomes of coping (ie the stress response), but also event appraisal.     

人心肌肌钙蛋白T的提取、纯化及鉴定研究

目的 :探究一种简便易行的人心肌肌钙蛋白T(cTnT)的提纯方法并进行鉴定。　方法 :采用匀浆、离心、70℃加热、冰浴、饱和硫酸铵盐析、透析、DEAE 纤维素层析等方法提纯cTnT ,并进行鉴定和免疫活性检测。　结果 :1 0 0g心肌组织中获得cTnT 2 1 .35 6mg ,纯度最高达 91 .7%。　结论 :建立的方法能成功提取纯度较高 ,且具有免疫活性的人心肌cTnT ,为建立适用于临床的cTnT检测方法奠定基础     

基于OKR理念的医院核心工作指标体系建设及应用

以三级公立医院绩效考核及院长绩效考核为指导,结合医院实际情况,构建医院核心工作指标体系。运用目标与关键成果法管理理念,从医院的发展目标和核心问题出发,通过流程优化、任务分解、全员参与,聚焦有挑战性的目标,从而实现管理模式转变。认为核心工作指标体系可赋能医院绩效管理,充分发挥绩效考核在医院管理中的“指挥棒”作用。     

医院感染防控绩效评价体系构建研究

目的建立契合医院感染防控实际的绩效评价体系,用于科学评价医院感染防控工作。方法应用头脑风暴法、文献荟萃法等建立指标池,通过咨询专家组完成指标的筛选、层次构建、评价和权重计算。结果成功构建医院感染防控绩效评价体系,包含一级指标3个、二级指标17个、三级指标27个。咨询信度Cronbach's α系数为0.901,内容效度指数为 0.800～1.000。结论构建的医院感染防控绩效评价体系可对医院感染管理工作进行科学、客观地评价。     

下颌骨髁状突骨折坚固内固定的临床评价

目的　探讨下颌骨髁状突骨折坚固内固定术的手术适应证与技术要点。方法　髁状突骨折 4 3例 ,4 1例行开放复位坚固内固定手术 ,所有患者手术前后仔细记录面形、张口受限、面神经损伤及关系紊乱情况 ,手术前后 X线曲面断层片对照骨折复位与愈合改建状况。结果　髁状突骨折 X线复查骨折解剖复位率达90 % ( 37/41) ,张口受限 7例 ,错 3例 ,钛板断裂 1例 ,面神经损伤 7例 ,伤口感染 3例。结论　开放复位坚固内固定术是下颌骨低位髁颈与髁颈下骨折的理想方法 ;髁头与高位髁颈骨折及陈旧性骨折应灵活掌握。     

混合方法研究评价工具的介绍——MMAT

混合方法研究（MMR）作为第三种研究范式，是指将定量和定性研究混合或结合到一个单一的研究中。近年来，MMR在医疗领域的应用已成为一种趋势。与单独使用定性或定量研究相比，MMR可以用来说明某一特定现象的不同方面或从不同的角度阐明问题，获得各种不同类型的信息。而MMR系统综述（MMSR）也被研究者青睐，因为通过MMSR可以综合与特定主题相关的大量信息，并产生指导决策的证据。严格评价工具使MMSR研究人员能够评估所纳入原始研究的可信度和相关性。混合方法评价工具（MMAT）为MMSR严格评价阶段的一种工具，可以对定性研究、随机对照试验、非随机研究、定量描述研究和MMR 5类研究的方法学质量进行评价。针对每个纳入的研究，在回答两个筛选问题后，选择适当的研究类别进行评估，然后依照所选类别的标准进行评分。本文全面介绍新版MMAT，以进一步规范和完善MMR和MMSR在我国的应用。     

Quantity and quality of complementary and alternative medicine recommendations in clinical practice guidelines for type 2 diabetes mellitus: A systematic review

AimsApproximately 70% of Americans with diabetes have used complementary and alternative medicine (CAM) in the past year. Healthcare providers often receive minimal training on these therapies and subsequently rely on clinical practice guidelines (CPGs) to supplement their knowledge about the safe and effective use of CAM for the treatment/management of type 2 diabetes mellitus (T2DM). The purpose of this systematic review is to determine the quantity and assess the quality of CAM recommendations in CPGs for the treatment and/or management of T2DM.Data synthesisMEDLINE, EMBASE, and CINAHL were systematically searched from 2009 to 2020, in addition to the Guidelines International Network and the National Center for Complementary and Integrative Health websites. CPGs containing treatment and/or management recommendations for T2DM were eligible; those with CAM recommendations were quality-assessed with the AGREE II instrument twice, once for the overall CPG and once for the CAM sections. Twenty-seven CPGs were deemed eligible, of which 7 made CAM recommendations. Mean scaled domain percentages were (overall, CAM): scope and purpose (89.7%, 79.8%), clarity of presentation (85.7%, 48.4%), stakeholder involvement (67.9%, 28.2%), applicability (54.8%, 20.2%), rigour of development (49.7%, 35.7%), and editorial independence (44.1%, 44.1%).ConclusionsQuality varied within and across CPGs; domain scores across CAM sections generally scored lower than the overall CPG. Given that CAM therapies for T2DM are only represented in one-quarter of eligible CPGs and are of lower quality, a knowledge gap exists for healthcare providers who seek evidence-based information on this topic in order to effectively counsel inquiring patients.     

借鉴管理体系认证经验保证医院评审规范公平

回顾了国内外医院评审的现状、分析了我国医院评审管理中存在的问题.介绍了国内外管理体系认证的方法,提出我国医院评审应在评审研究、审核员注册、持续改进措施、评审咨询及评审机构管理等方面吸收借鉴.     

The accuracy of diagnostic tests for adenoid hypertrophy: A systematic review

BackgroundAdenoid hypertrophy may cause sleep-disordered breathing and altered craniofacial growth. The authors conducted a study to gauge the accuracy of alternative tests compared with nasoendoscopy (reference standard) for screening adenoid hypertrophy.MethodsThe authors conducted a systematic review that included searches of electronic databases, hand searches of bibliographies of relevant articles and gray literature searches. They included all articles in which an alternative test was compared with nasoendoscopy in children with suspected nasal or nasopharyngeal airway obstruction.ResultsThe authors identified seven articles that were of poor to good quality. They identified the following alternative tests: multirow detector computed tomography (sensitivity, 92 percent; specificity, 97 percent), videofluoroscopy (sensitivity, 100 percent; specificity, 90 percent), rhinomanometry with decongestant (sensitivity, 83 percent; specificity, 83 percent) and clinical examination (sensitivity, 22 percent; specificity, 88 percent). Lateral cephalograms tended to have good to fair sensitivity (typically 61-75 percent) and poor specificity (41-55 percent) when adenoid size was evaluated but excellent to good specificity when airway patency was evaluated (68-96 percent).ConclusionsNo ideal tool exists for dentists to screen adenoid hypertrophy, owing to access constraints, radiation concerns and suboptimal diagnostic accuracy. Research is needed to identify a low-risk, easily acceptable, highly valid diagnostic screening tool.Practical ImplicationsAlthough lateral cephalograms (which have good to fair sensitivity) and a thorough medical history (which has good specificity) are imperfect individually, when they are used together, they can compensate for each other's weaknesses. This combined approach is the best tool available to dentists for screening adenoid hypertrophy.