Time use and importance of instrumental activities of daily living

This study investigated time use and the importance of instrumental activities of daily living (IADL) tasks to an older community-dwelling population. In addition, the study compared occupational therapists' and older people's perception of importance of IADL tasks for maintaining community living. Thirty-three subjects completed a time diary and an interview-based questionnaire to ascertain their time use and the importance of IADL tasks. It was found that older people living in the community spent most of their time at home and alone, with nearly half the day being spent on IADL tasks. The subjects indicated that the three most important tasks were use of the telephone, use of transportation (including driving) and reading. Differences were found when the results from an earlier study of occupational therapists were compared with results from the present study of older people. The occupational therapists also considered use of the telephone as most important but then rated medication management and snack preparation as the most necessary activities for continued community living. These results emphasize the differences in the perception of 'important' between the two groups studied. The results from this research confirm the importance of IADL to both the occupational therapy profession and older people living at home in the community. Further, these results confirm the need for client-centred practice and collaborative intervention planning for occupational therapy.     

Criteria for use in the evaluation of health impact assessments

This paper reports the conclusions of a recent workshop that was established to discuss how health impact assessments (HIAs) might be evaluated. The main purposes of HIA are: (a) to predict the consequences of different decisions; (b) to make the decision-making process more open by involving stakeholders; and (c) to inform the decision makers. 'Prediction', 'participation' and 'informing decision makers' are thus the three domains in which HIA should be evaluated. In the 'prediction' domain, process criteria scrutinize the methods used to see if it is likely that they would produce reliable predictions. Outcome criteria involve verifying the predictions, but this is frequently impractical and predictions for the counter factual (the option not chosen) can never be verified. In the 'participation' domain, process criteria examine the ways in which stakeholders were involved, while outcome criteria explore the degree to which the stakeholders felt included. In the 'informing decision makers' domain, process criteria are concerned with the communication between decision makers and those doing the HIA, and should reflect upon the relevance of the HIA content to the decision makers' agenda. Outcome criteria explore the degree to which the decision makers considered that they had been informed by the HIA. This paper concludes with suggestions for the types of information that should be included in HIA reports in order to permit the readers to make an assessment of the 'quality' of the HIA using the three domain criteria outlined above.     

Principles and techniques of time management

Managing time efficiently is, or should be, part of the credo of every manager from supervisor to chief executive. For managers to take advantage of every tip and technique available, they must be prepared to increase their self-discipline and adjust their work style each time they climb the organization ladder.     

Criteria for the management of low back pain in health care workers

Low back pain represents one of the most frequent health problems in several working populations and is an important problem for occupation health doctors. In fact, these professionals are often required to face with the specific management of this condition, also by participating with other professionals into the implementation of organizational and structural measures. This contribute describes a variety of interventions aimed at treating the syndrome and recovering the working ability of the patient-worker, including the initial clinical evaluation, the assessment of the casual relationship between work and the syndrome, the treatment, the formulation of proposals to modify the worker's physical and working activity, the ongoing heath surveillance and a more in-depth clinical and instrumental evaluation, including surgical treatment.     

Application of management engineering techniques

Management engineering techniques have proven to be beneficial tools in the analysis and improvement of a medical organization's productive resources. Though used more extensively in the hospital setting, the techniques can be applied to medical groups as a means to furthering the quality of patient care while improving the utilization of resources. An overview of the concept of management engineering is presented through the definition of basic techniques and the illustration of projects employing these methods in the medical group practice setting.     

健康管理大数据构建与实践

全人群全生命周期健康服务需要依靠健康管理实践,大数据收集、管理与分析契合中国人口基数庞大的实际情况。大数据和健康管理在研究方法、安全性和伦理性方面的深度碰撞与聚焦,为研究者指明了实践和发展的方向,并且已经取得了大量有指导意义的成果。宜昌市模式更是在国内开启了健康管理大数据构建与实践的先河。     

The use of statistical techniques.

The statistical techniques used to increase the reliability and validity of the examination are described. Results of generalizability and reliability analyses indicate that the effect of the questions asked is a significant one in determining candidates'' scores. There is a need to increase the number of questions in the MEQ, oral examination, and any future means of assessment. Factor analysis supports the idea that a significant proportion of marks on the MCQ and oral examination are gained by recall of knowledge whereas MEQ and PTQ scores are affected more by problem-solving ability and ''case specificity''.     

试析项目管理技术在医院管理中的运用

项目管理技术在企业管理中,经过数十年发展,已逐步形成一整套完整的理论与方法体系,随着医疗卫生改革,医院走向市场,项目管理技术在医院管理中,既有运用的可能,又有运用的需要.该文介绍了项目管理的主要内容和与传统方法相比的优势,以及项目管理在我国医院管理中应用的现状,分析了在医院采用项目管理法必须注意的有关事项,说明在当前形势下,运用项目管理技术,对推进医院管理创新和医院发展是十分有益的.     

Criteria for the use of recombinant human growth hormone in short bowel syndrome.

Extensive resection of the intestinal tract with resulting malabsorption is known as short bowel syndrome (SBS). Adaptation and rehabilitation of the remaining small bowel occurs spontaneously after resection and can be enhanced by diet, medications, and use of intestinal trophic factors such as recombinant human growth hormone (r-hGH). Many trials have been published on the influence of r-hGH therapy in SBS patients, with varying results. Analysis of the trials has produced a set of criteria that can be used to define the patient most likely to benefit from r-hGH therapy.     

Care management cuts ED use for pain

A pain care management program at Kootenai Medical Center has resulted in a 77% decrease in emergency department visits by patients whose primary complaint was pain. Case managers are alerted when patients with a history of repetitive visits present to the emergency department. They work with the emergency department physicians on a treatment plan and help them identify a primary care physician and make an appointment for follow-up care. Patients receive non-narcotic pain relief whenever possible and may be referred to a physical therapist if appropriate.     

Transforming data for use in management decisions

Conclusion The three transformations are not difficult to perform and are similar to techniques used for years in the business world. It is felt that use of these measures to remove irrelevant variance from our statistics will provide the administrator with better data and facilitate better decisions. Absolute totals are, of course, essential as measures of overall amount of staff activity, but they are of much less value when used for comparitive purposes. On those occasions, transformed data are preferred.     

医疗设备使用管理系统

本文着重介绍医疗设备使用管理系统的功能、设计结构及运行环境。     

加强管理 合理用药

合理用药是从管理和使用的角度，以现代医学和药学知识为指导，使药物的应用符合安全有效、及时方便和经济的要求。该院合理用药工作采取以下做法：①完善合理用药制度。②成立三级用药监察组织。③强化监测检查措施：一是定期对合理用药监察员进行培训；二是药理科合理用药监察小组坚持每月两次单项查房；三是定期开展病案合理用药分析；四是每季度至少一次用药审查统计；五是设置病人住院用药记帐卡和门诊举报箱，接受病人监督。④开展合理用药研究。⑤举办专题学术讲座。通过实施以上措施，取得良好成效。     

Lithium use and perioperative management

A 62-year-old man presented with diminished consciousness, hypotension, hypoglycaemia and agitation. He had undergone heart surgery 1.5 weeks earlier. Due to a stroke as a postoperative complication, antihypertensive medication had been added. His lithium medication had been interrupted only on the first postoperative day. The presenting complaints were due to delirium as a result of lithium intoxication. The delirium faded away after interruption of the lithium medication and treatment with haloperidol and oxazepam. The patient and his family were informed as to the nature of the delirium and the precautions to be taken in case of any future disease or operation. Lithium should be discontinued preoperatively in all patients. If necessary, alternative psychiatric medication must be prescribed. After restarting lithium, the serum levels of lithium must be monitored.