Conducting a Physical Examination on a Woman with a Disability

Sexuality and Disability -     

Is a bed centre in a hospital a hygienic hazard?

The contamination of linen and air in a bed centre, supply station and ward were compared, as well as the contamination of gowns used by the staff working in the ''clean'' and the ''dirty'' rooms of the bed-centre. The contamination of linen and air was low and there was no significant difference between the tested areas. The contamination on gowns used by the staff working in the ''dirty'' room was significantly higher than that on gowns used by the staff working in the ''clean'' room. This stresses the importance of dividing a bed centre into ''clean'' and ''dirty'' rooms. So organized, a bed centre does not seem to be a hygienic hazard.     

四川省1起甲型肝炎暴发的流行病学分析

目的探讨四川省阆中市西山中心校甲型肝炎(甲肝)暴发因素和控制措施.方法应用描述性流行病学方法对西山中心校甲肝暴发疫情进行分析.结果本次甲肝暴发,发病77例,罹患率120.1‰.发病年龄主要集中在11～16岁(占77.92%),患者中有55例(71.43%)为住校学生,住校生罹患率是走读生的3.64倍.结论报告迟缓,疫情蔓延历时54 d,而学生普遍未进行甲肝疫苗接种,造成易感人群的大量积累是本次暴发的直接原因.     

Determinants of a merger in a publicly-funded health system: a political-economy perspective

This article reports the results of a case study, spanning a period of 10 years, of the merger of two hospitals in a publicly-funded health system. A political economy model was used to analyse the determinants of the merger. Results show that external political economy factors, mainly pressure from the state to rationalize health services and the organization's needs to acquire critical resources, significantly contributed to the merger decision. At the internal political economy level, groups and individual strategies also played a determinant role. Our study suggests that merger in the public sector may not necessarily result from efficiency motives.     

Impact of a postcard versus a questionnaire as a first reminder in a postal lifestyle survey.

STUDY OBJECTIVE--The study aimed to consider the impact of two different types of reminder on response rates and costs in a postal survey. DESIGN--The study was a cross sectional survey. A self-completion lifestyle questionnaire was used. Those who did not respond after the initial mailing were randomly allocated to receive either a postcard or questionnaire as a first reminder. All outstanding non-responders received a questionnaire as a second reminder. SUBJECTS--A representative sample of 698 adults aged 16-70 was used, drawn from a family health services authority register. MAIN RESULTS--Postcard reminders were as effective as questionnaire reminders in increasing response whether one or two reminders are sent. The costs per response were calculated. Two questionnaires as reminders were found to be 1.7 times more expensive than a postcard plus questionnaire. Including the initial mailing, the cost per response using all questionnaires was 1.3 times the cost when a postcard was used for the first reminder. CONCLUSIONS--To increase the response to a postal survey effectively and economically, two reminders should be sent--first a postcard and then a questionnaire.     

Endometrial morphology during a normophasic and a triphasic regimen: a comparison

It is expected that cycle control during oral contraceptive regimens may be correlated with the pattern of gradual endometrial maturation. Therefore the objective of the present study was to investigate the endometrial histology during a normophasic and a triphasic preparation. Biopsies were obtained at different intervals in the second treatment cycle from 21 women taking a triphasic pill and from 21 women taking a normophasic pill. The morphology of the endometria during the two regimens was evaluated and compared, as well as with the normal cycle histology. The study showed an early progestational effect and a rather hypoplastic growth during the triphasic regimen. The normophasic preparation was characterised by a better development and a more balanced glandular growth in proportion to the stroma, imitating the normal physiological mucosal changes very closely. From these observations it is concluded that a more reliable cycle control may be achieved by the use of this normophasic oral contraceptive as compared with the triphasic pill.     

单病种限额医疗的实践与思考

实行单病种限额医疗对于减轻病员负担,提高医院两个效益有着十分重要的意义。由于此项工作难度较大,牵涉的问题比较多,因此必须严密组织,本着“合理检查,合理用药”的基本原则,在保证医疗质量的前提下,根据各病种的不同情况,制订切合实际的医疗费用“额度”。