医院档案电脑管理信息系统初探

医院电脑管理信息系统的建立是一种必然的发展趋势。管理信息系统可分为事务处理系统、管理信息系统、决策支持系统等不同层次。事务处理是系统的基本功能，比如数据输入输出、单据报表打印等。在此基础上通过对数据加工处理形成信息提供给管理人员，则是管理信息系统的工作。决策支持系统一般是利用特定的决策模型结合数据库中的数据进行推演，反复尝试，结果供管理人员决策参考。依医院的实力及需要可建立不同层次的系统。     

基于ORACLE双库结构解决历史数据的查询

随着HIS的长期运行 ,数据库中存储的数据增多。同时 ,统计、分析需求增加 ,导致数据库的吞吐量降低。本文提出建立在用数据库和历史数据库的方法 ,该方法将联机事务处理在用的数据存储在在用数据中 ,联机事务处理不再用的数据存储在历史数据库中。文章对在用数据库中历史数据的标识、删除 ,在用数据库和历史数据库之间的数据归档和回迁等进行了论述。     

基于0RACLE双库结构解决历史数据的查询

随着HIS的长期运行，数据库中存储的数据增多。同时，统计、分析需求增加，导致数据库的吞吐量降低。本文提出建立在用数据库和历史数据库的方法，该方法将联机事务处理在用的数据存储在在用数据中，联机事务处理不再用的数据存储在历史数据库中。文章对在用数据库中历史数据的标识、删除，在用数据库和历史数据库之间的数据归档和回迁等进行了论述。     

X线CT影像伪影故障简析

Ｘ线ＣＴ（以下简称ＣＴ）技术的问世以及不断发展 ,越来越使ＣＴ检查成为医院临床诊断的重要的常规手段。而依赖于诊断的影像的质量成为医生常常关注一个关键指标 ,他们无法借助于有伪影的影像进行正确诊断 ,一旦出现了影像伪影则是工程师维修过程中最伤头的问题。下面列举一些在ＣＴ影像中可见的伪影图像。图１Ｘ -ＣＴ若干可见伪影图像为了便于说明 ,不妨给出ＣＴ机基本的数据采集和影像形成流程图如下 :图２ＣＴ基本的数据采集和影像形成流程图目前不同厂家 ,不同型号产品虽然具体设计各有差别 ,但它的数据采集及重建总体设计流程则基本…     

论医院RIS系统与PACS共享资源系统的实现

1影像存储系统与传输系统(PACS)PACS是近年来随着数字成像技术、计算机技术和网络技术的进步而迅速发展起来的,旨在全面解决医学图像的获取、显示、存储、传送和管理的综合系统。可以肯定地说,PACS是医院迈向数字化信息时代的重要标识之一,是医疗信息资源达到充分共享的关键。1.1PACS的原理PACS主要分为医学图像获取、大容量数据存贮、图像显示和处理、数据库管理及用于传输影像的局域或广域网络等几个单元。PACS和其他管理系统的显著不同点是要从影像设备获得影像,还要对影像能进行各种加工和浏览。PACS的产品技术分成两层:设…     

关于胸部计算机X线摄影质量控制的探讨

目的:探讨胸部计算机X线摄影质量控制的方法,进一步提高胸部影像质量。方法:选择质量控制前后胸部CR照片各100例,评价胸部七个部位的显示情况。结果:经统计学χ2检验,质量控制前后胸部CR照片两者之间有显著统计学差异(χ2=7.44,P<0.01),质量控制后胸部CR照片质量明显提高。结论:通过对胸部计算机X线摄影各环节进行质量控制,胸部CR影像质量明显提高。摄影技术是胸部X线成像的关键,可以通过图像后处理技术对胸部影像进行补偿。     

面对新技术浪潮的医学影像学科建设

现今的医学影像诊断手段和方法已经与过去不可同日而语,面对异彩纷呈的影像诊断技术,如何进行科学的学科管理是一个重要课题。统观我国影像医学的现状,我们必须承认与世界发达国家或地区相比,我们还是落后了。制约学科发展的因素是复杂的,但关键体现在以下几点:学科定位偏颇、学科体系混乱、缺乏有效的人才培养机制、科研观念淡薄。我们必须加强医学影像学科建设,促进学科健康发展。一、准确地进行学科定位,完善学科体系准确地进行学科定位,明确学科体系关系是推动学科健康发展的先决条件。由于多种原因,目前我国不同地区不同医院的影像学学…     

关于PACS存储体系的思考与认识

近年来PACS已成为影像科室的必然发展趋势。由于需要长时间保存医学数字化影像，以及要求能在较短的等待时间内调阅任意时间的历史影像资料，所以存储方式的选择一直是构建PACS时最关心的问题之一，而且PACS存储系统对整个PACS运行性能和总投资的影响最大，是PACS设计规划中的关键。本文结合我院在PACS建设中的体会，对PACS存储体系选择的策略和方案进行探讨。     

瓦里安影像部件事业部无锡中心落成 服务中国X射线设备生产商

2016年3月18日,瓦里安医疗系统公司(Varian Medical Systems,简称瓦里安)于无锡召开瓦里安影像部件事业部无锡中心-江苏瓦里安医疗设备有限公司落成并投入使用发布会。该中心具备X射线设备关键影像部件生产和维修双重功能。瓦里安影像部件事业部无锡中心占地面积约3,700平方米,拥有两条X射线球管生产线和一个数字平板探测器维修服务     

Oracle 11g数据库的OLTP表压缩评测

目的使用量化指标,对比压缩表和非压缩表的查询及更新操作性能进行评测,为大型联机事务处理的数据库应用做技术准备。方法进行实验设计,创建量化平台,分别在压缩与非压缩的数据表上执行特定的数据操纵语句及查询语句,生成结构化查询语言(SQL)数据库执行计划,记录运行时间及结果并进行对比。结果压缩表的空间占用较未压缩表降低1倍多,全表扫描操作的性能提升1倍,而压缩表与未压缩表的数据更新操作和查询操作性能无明显差异。结论联机事务处理的大型应用,可以利用Oracle11g数据库的新特性,采用OLTP表压缩技术,既不影响操作响应时间还可以明显降低磁盘占用空间,从而获得改善数据库性能的好处。     

IHE XDS与医学影像区域共享相关问题研究

目的:探索医院临床信息系统与医学影像集成方案,解决以IHE XDS集成方案为基础的医学影像区域共享的相关问题.方法:将医学影像纳入到区域医疗信息共享范围,扩展了IHE XDS集成方案.提出了XDS-I应用于区域临床影像共享系统的新方法,讨论了在实际应用中面临的问题.结果:XDS-I是区域医疗影像信息共享的较好方案,能够应用于区域医疗信息共享.结论:IHE XDS-I对医学影像区域共享方案的设计有借鉴参考作用.     

Profile of paediatric occupational therapy practice in Australia

Background:  The purpose of the present study was to describe a profile of Australian paediatric occupational therapy practice in terms of theories, assessments and interventions used with the most frequently seen client groups.
Methods:  An ex post facto survey design was utilised. A purpose-designed survey was mailed to 600 occupational therapists identified by OT Australia as working in paediatrics.
Results:  The response rate was 55% ( n =  330). Respondents in the sample worked chiefly with children with developmental delays, learning disabilities, neurological impairments, and infants/toddlers. Theoretical models used by paediatric clinicians that were common to the most frequently seen client groups focused on sensory integration/multisensory approaches, occupational performance, and client-centred practice. Assessment tools most frequently used were the Test of Visual Motor Integration, Sensory Profile, Bruininks-Oseretsky Test of Motor Proficiency, Handwriting Speed Test, and Motor-Free Visual Perception Test. The most often used treatment methods across the four most frequently seen client groups were parent/caregiver education, sensory integration/stimulation techniques, and managing activities of daily living.
Conclusions:  Paediatric occupational therapists appeared to draw on a range of theoretical models. With the exception of the Sensory Profile, the assessment and treatment methods most frequently used are not congruent with the most commonly used theoretical models. It is critical that the assessment and treatment methods used are conceptually consistent with the theoretical models that guide practice. Occupational therapists need to examine the evidence and determine whether their clinical practice is grounded in the best contemporary theoretical models, assessments and interventions.     

江苏省实施麻风病防治一体化策略的可行性调查研究

目的:论证江苏省实施WHO所倡导的麻风病防治一体化策略的可行性。方法:选择试点,查阅现有资料,了解当地麻风病防治卫生资源利用情况,和一体化策略与国家现行的卫生政策适应情况;随机分层抽样确定实施一体化策略利益相关者,采取描述性定性研究,根据研究人群的不同,分别设计访谈提纲,并经预试验修正,开展关键人物访谈以及焦点小组讨论,了解利益相关者对实施一体化策略的认识和态度。结果:江苏省已具备实施一体化策略的卫生资源,且这些资源已经得到了利用;实施一体化策略与国家现行的发展社区卫生服务和农民健康工程等卫生政策相适应;多数利益相关者认为实施一体化策略是可行的,并完全符合病人的切身利益。结论:江苏省实施一体化策略是可行的,应尽快开展现场实施性研究,以探索适合全省乃至全国类似地区实现麻风防治工作可持续发展的防治工作模式。     

Tracking the use and impact of a community social report: where does the information go?

The purpose of this paper is to report on a study evaluating the extent to which a social report (entitled "Hamilton-Wentworth Profile on Children and Youth") was read and used by recipients. Subjects were divided into two groups: an Active Group which had worked on producing the Profile and/or requested copies of it once it had been released, and a Passive Group which had received copies of the Profile through a general mailing list used for other research reports. Approximately one year later, 90% of the Active Group recalled the Profile compared to 21% of the Passive Group. Similarly, 83% of Active Group respondents had read the Profile compared to 8% of Passive Group subjects. 80% of Active Group respondents and 5% of Passive Group respondents used the Profile. The results suggest that if social reports are read by local community agencies and individuals, they will be used to help improve conditions for children and youth. Social reports at the local level are more likely to be read if potential users are engaged in the process of report production and if the reports are disseminated to the appropriate target audience.     

Building an interoperable regional health information network today with IHE integration profiles

One of the key challenges of architecting electronic record sharing solutions that are scalable and can provide acceptable performance is how to create a longitudinal record for a patient when the desired data will be stored in several distributed point-of-service systems. This paper will review the design and standards selection process that has been made by Integrating the Healthcare Enterprise, a multi-national collaborative of care providers and developers that analyzed a variety of approaches. In particular, the requirements, issues, and alternative solutions for scalable, standards-based data locating services supporting regional and national health information exchange solutions will be discussed. Guidance will be offered to architects of regional health information organizations to take advantage of this experience and leverage the IHE Technical Framework, its testing processes, and tools to accelerate their projects and facilitate the interfacing of EHR systems serving different care settings from different vendors or developers. The implementation experience in 2005-2006 of the IHE Integration Profile specifications supporting an interoperable RHIO solution among various EHR systems from more than 30 vendors will be analyzed, with key lessons summarized.     

The Well-being Profile--an Internet tool for school health promotion

For years, the WHO has, in accordance with the 'settings' idea, encouraged a whole school approach when trying to promote health and well-being in schools. This developmental study analyses the implementation and pilot phase experiences of a holistic well-being evaluation tool for schools, the School Well-being Profile, on the Internet. The Profile is based on the theoretically established School Well-being Model. The School Well-being Profile consists of electronic survey forms and an automatic facility that analyses and produces results on the data in graphic and numeric form. After the data has been entered, the primary user within the school can immediately view and print out the results. The figures can be compared with the averages of all schools to pinpoint areas where well-being is different from that in the other schools. The Profile resides on a Finnish National Board of Education server (www2.edu.fi/hyvinvointiprofiili) and its use is free of charge for all schools. The Profile became popular in its first year: it was used by 33 primary schools, 28 lower secondary schools and 9 upper secondary schools with a total of 9,169 respondents. Overall, 94% of the students and 99% of the personnel expressed that it had been at least fairly easy to fill in the questionnaire. The paper shows that theoretical research in health promotion can effectively be put into practice using information technology tools. The project that produced the School Well-being Profile ended in 2004, yet the WWW-Profile continues to gain new users. The school administrators, personnel and students have found the Profile easy to use and worth the time and effort invested by the school. The strategies adopted in the design and dissemination of the Profile seem to have been successful in providing a sustainable resource to contribute to the future promotion of well-being in schools.     

Patterns of response to sensory stimuli encountered in daily activities: A comparison between 3-10-year-old Israeli and American children without disabilities

The purpose of this study was to examine the extent to which patterns of response of typical children aged 3 to 10 in Israel, as reported in the Sensory Profile (Dunn, 1999), were similar to typical children in the United States. The Sensory Profile is a caregiver questionnaire designed to assess sensory processing abilities. A translated Hebrew version of the Sensory Profile was completed by parents of 714 typically developing children who were recruited from across Israel. The mean scores of the Israeli children were compared to the published mean scores of the American children at the section and factor level to determine whether the scoring system of the Sensory Profile would be applicable for Israeli children. The findings revealed that, in some sections and factor clusters, the scores of Israeli children were lower than the scores of the American children across all ages. Although the Israeli children scored lower, overall, their scores were within the established range of typical performance. Initial support for the application of the scoring system of the Sensory Profile in Israel is suggested. Due to the nature of the sample of Israeli children, future studies are recommended with a national representative sample and with specific disability groups to further validate the clinical use of the Sensory Profile in Israel.     

Assessing disability status: The reliability of the Multiple Sclerosis Disability Profile

The present study reports on the reliability of the Multiple Sclerosis Disability Profile. Multiple sclerosis (MS) is an enigmatic disease that affects people differently. The Disability Profile is a 68 item assessment instrument with the aim of providing a brief overview of the health status of an individual with MS. Internal consistency was assessed using the split-half technique and Cronbach's alpha. The findings demonstrated excellent internal consistency. Inter-rater reliability was assessed using Cohen's kappa. Kappa was computed with four options per item and then again with two options per item of the Disability Profile. The findings indicated that reliability was satisfactory when the responses for each item were reduced from four to two options. The recommendations are that items with poor inter-rater reliability should be reviewed and a simpler more reliable version of the Disability Profile should be adopted.     

Interrater reliability of the Social Profile: Assessment of community and psychiatric group participation

Background/Aim:  The Social Profile was developed based on the theoretical concepts of activity group participation skills: Parallel, Associative, Basic and Supportive Cooperative and Mature activity levels. The aim of this study is to assess the interrater reliability of observations in groups of children and adults using the Social Profile.
Methods:  Two community and two hospital populations were used to determine the interrater reliability of the Social Profile as observed by clinicians and graduate students. These groups included preschool children, older adults, general, geriatric and substance abuse psychiatric patients. Observers consisted of clinicians and graduate student pairs.
Results:  Moderately high intraclass correlation coefficient (ICC) scores of interrater reliability were found in separate and combined scores from the Social Profile measurements.
Conclusion:  These ICC reliability rates indicate that the Social Profile interrater scores are adequately high for acceptable measurement of social and activity participation levels in clinical, community and school groups.     

The effect of incarceration on prisoners' perception of their health

The aim of the study is to assess the quality of life among male prisoners using the French version of the Nottingham Health Profile, then to investigate the influence of incarceration on emotional reaction. Before the obligatory medical examination at reception into prison, self-administration by prisoners of the French version of the Nottingham Health Profile. Two prisons in Toulouse (south-western France) are concerned: 199 men are included. The score of each dimension on the French version of the Nottingham Health Profile questionnaire and the responses to questions on socio-demographic and penal characteristics and results of medical survey have been studied. The response rate and rate of completion for each dimension are excellent (100%). Considerable evidence is found for the reliability of the Nottingham Health Profile (Cronbach a > 0.72 for all dimensions except energy 0.64 and physical mobility 0.64) and for construct validity in terms of distinguishing between groups with expected health differences. Three variables concerning aspects of life in prison are correlated with variation of the emotional reaction dimension. The Nottingham Health Profile can be used in prison populations. It is easy to use, acceptable to inmates, and fulfils stringent criteria of reliability and validity. It allows recognition of the factors correlated with variation of emotional reaction classically connected with suicidal behaviour in prison.