从“环太-2014”军演看美军卫勤演习特点及对我军的启示

笔者作为“和平方舟”号医院船海上医院卫勤指挥组主要成员,全程参与“环太-2014”军演,从演习中的所见所闻出发,总结美军组织开展卫勤演练及国际交流过程中,在工作、生活、管理、文化等方面的特点,并对我军未来开展多样化军事任务卫勤保障工作提出建议.     

医院机动卫勤分队抽组后持续保障能力提升探讨

机动卫勤分队多以“寓于”的形式编组在军队医院之中。在遂行多样化保障任务时,医院除抽组机动卫勤分队执行应急支援保障任务外,还要担负基地保障任务,在人员减少、任务加大的情况下,迅速提升保障能力,完成后续保障任务是一个亟待研究、迫切需要解决的难题。     

新时期军事斗争卫勤准备的任务与要求

文章从新军事变革要求卫勤全面转型、军事斗争要求卫勤加快保障能力建设、军队现代化建设要求深化军队卫生工作改革、反恐及应付突发公共卫生事件成为军队卫勤基本任务、保障打赢信息化战争需要卫勤信息化、战斗力发展要求建立新军人健康观和医疗观等六个方面全面分析了新时期军队卫勤发展环境背景；同时，从联勤医院的保障对象和保障方式，战时医院基本任务，在反恐和突发公共卫生事件中军队医院的任务，在卫勤保障一体化中军队医院的任务，创新发展强健医学、急救医学、创伤医学、“三防”临床医学成为军队医院的重要任务等五个方面阐述了军队医院任务的拓展；并且，提出了新时期军事斗争准备对医院的基本要求，即：加快培养联勤医护人员，提高战伤救治效率，组织装备模块化，加快医院与部队预防-医疗-保健“一体化”进程，加快医院信息化建设，以及加强康复治疗、军事作业医学和核化损伤救治研究。     

解放军第二三〇医院参加全军边海防部敝“三式一化”卫勤保障模式改革试点工作纪实

解放军第230医院（原志愿军总医院）,地处中朝边境最前沿,是一所具有辉煌历史和光荣传统的军队医院,医院党委紧餐围绕“能打仗、打胜仗”的强军目标,牢记“姓军为兵”使命,稳步推进卫勤保障工作。2013年8月,医院受领了全军三大卫勤保障模式改革试点之一的边海防部队“三式一化”卫勤保障模式改革试点任务,全院上下高度重视,在总后卫生部、沈阳军区卫生部及联勤第二分部的指导下,与保障区域内参与试点的单位密切配合,在新型卫勤保障模式适用范围与运行特点研究、规章制度建立、双向代职使式改进、功能中心建设、兼职卫生员培训及提高基层部队卫生机构建设水平与救冶能力等方面儿实开展了各项工作。     

全军卫生监测中心圆满完成“神舟六号”发射期间卫生监督保障任务

2005年10月，根据总后勤部、总装备部指示，全军卫生监测中心派专家参加“神舟六号”发射期间的卫生监督保障工作。专家们在卫勤保障指挥组的领导下，克服困难，努力开展工作，制订了“神六”发射期间《卫生监督监测工作保障计划》和《食物中毒应急处置方案》，     

战时后方医院卫勤保障演练的做法

遵照“战时怎么用，平时就怎么练”的原则，结合后方医院使命保障任务，想定作业，演练战役筹划、战役实施阶段卫勤支援保障内容、程序和方法，探索后方医院卫勤支援保障的特点、规律。通过贴近实战演练，全面评估后方医院保障能力现状，增强指挥机构组织指挥能力．总结目前后方医院实施卫勤支援保障过程中存在的不足，进一步规范医院战备规范化建设水平。     

新时期卫勤保障物资管理模式探析

针对我院所担负的卫勤保障任务，从卫勤物资的库房管理及承担卫勤保障任务医疗设备的日常监管方面，探索一种“立足平时、着眼战时”的卫勤物资及装备保障管理模式。     

从军队医院抗震救灾实践看卫勤保全

通过研究军队医院参加汶川地震救援实践,认为我军要完成多样化军事任务,必须提升军事医学的综合作用,在军队医院建设中推进卫生勤务的“保全”改革,提供适应时代需要的战斗力求全式保障,建设效能卫勤、主动卫勤和科技卫勤。     

应对非战争军事行动卫勤保障的思考

作为军队医院,担负平战时或其它特殊情况下卫勤保障任务,包括非战争军事行动应急保障。本文结合2008年医院遂行的汶川地震救灾卫勤保障任务,探讨了军队医院新时期应对非战争军事行动应急卫勤保障的做法与体会。     

信息化条件下“一链六系统”卫勤保障模式

目的研究探讨采取适当模式,更以有效执行信息化条件下卫勤支援保障任务;方法采用“一链六系统”模式,以“构建特定区域战斗医疗救治链”作为核心,以“基于电子伤票系统的伤员快速搜救”“基于野战救治系统的批量伤员救治”“基于军字二号系统的远程技术支持”“基于机动分队系统的模块抽组保障…‘基于心理评估系统的野战心理卫生服务”“基于政工网络系统的野战文化建设”六个系统为依托;结果六个系统从火线抢救、批量伤员救治、模块化抽组加强、手术过程的远程会诊、伤员的心理干预、参训人员的文化生活等方面有效保障了核心任务的完成;结论基于“一链六系统”的卫勤保障模式,充分提升了信息化条件下的救治效率和救治效果,满足了卫勤保障任务的需要。     

军队医院特勤医疗保障探讨

军队联勤体制下特勤医疗保障的特殊性,要求医院特勤保障建设要起点高、标准高。抓好特勤医疗的全面建设,不仅能增强特勤医疗的保障力,更能有效提升医院整体为特勤官兵服务的水平。本文就医院扎实推进特勤医疗服务综合支撑力、品牌影响力、全维保障力三方面建设,进行系统归纳和实践总结,对医院特勤医疗保障的深层次问题进行探索。     

A comparison of social support variables between women who intend to breast or bottle feed.

Social support has been identified as an important element for encouragement and success of lactation. The sources, types and amounts of perceived social support were determined for women during their third trimester of pregnancy and at four weeks of postpartum breastfeeding. Differences in social support were reported for women who stated an intention to breastfeed and those who planned to bottle feed. The tangible, emotional and informational functions of social support were measured as aggregate values across support sources. Tangible and emotional support were not significantly different between intended breast or bottle feeders. However, informational support was higher for women who intended to breastfeed compared to those who intended to bottle feed. Mean scores were then analyzed for specific individuals who might provide support. The baby's father was a more important source of tangible support for intended breastfeeders. Intended breastfeeders also indicated they received more emotional and informational support from the baby's father and prenatal classes. Tangible, emotional and information support did not change pre- and postnatally for women who breastfed. However, certain sources did provide more support postnatally. Finally, predictors such as level of education, a belief that breastfeeding was better for health and emotional closeness, fewer children, moderate tangible and emotional support and more informational support were identified for women who intended to breastfeed.     

Social support received by mothers of chronically ill children*

The main purpose of this study was to describe the characteristics of the social networks and social support of mothers of chronically ill children and adolescents. The data collected also allowed for the identification of the predisposing factors to receiving low social support among the mothers. Receipt of social support was assessed according to six dimensions: source of support, type of support, perceived need for support, satisfaction with the quality and the quantity of support, as well as most valued source of support. Results indicate that mothers wanted more support than they received, particularly in the areas of emotional, appraisal, and informative support. Furthermore, spouses, professionals, and immediate family members were identified by mothers as important sources of support. Discriminant analysis showed that the probability of receiving low support increased if the chronically ill child was an adolescent, the father had a higher level of education, and the family income was middle-low. Results are discussed in terms of the implications for intervention.     

Social support satisfaction in adults with eating disorders: Does stance matter?

Although the role of social support is clearly established in the recovery of youth with eating disorders, little is known about factors that contribute to support satisfaction and improved treatment outcome in adults. This study examined the contribution of patient factors and perceived support stance used by family and friends in determining social support satisfaction. Individuals meeting DSM‐IV criteria for an eating disorder (n = 182) completed measures of eating disorder and psychiatric severity, interpersonal functioning, perceived support stance used by family and friends, and social support satisfaction. Correlations indicated that both patient factors (lower psychiatric distress and fewer interpersonal difficulties) and perceived support stance (higher concerned and lower directive support) were associated with patient support satisfaction. Multiple regression analyses indicated that perceived support stance accounted for greater variance in social support satisfaction than did patient factors. Patient age was associated with differences in preferred support stance: expressions of caring were most critical for younger patients, whereas not being criticized or told what to do was most significant for older patients. This research suggests that the stance used when offering support is vital to the care of individuals with eating disorders.     

重庆市3所高校不同年级大学生社会支持的特点

目的比较重庆市3所高校不同年级大学生社会支持的特点。方法采用修订过的社会支持评定量表（SSRS）对重庆市3所高校大一至大四的400名学生进行集体测试，并做了分类比较。结果不同年级学生在朋友支持、邻居支持、同学支持、舍友支持、恋人支持、安慰关心、倾诉方式、求助方式、参加活动方面差异有统计学意义（P〈0．05或P〈0．01）；不同年级学生在客观支持、支持利用度以及总支持上有统计学意义（P〈0．05或P〈0．01）。结论不同年级大学生的社会支持在多数方面都存在显著差异。在实践中应注意调节这些差异，不同年级学生在遇急难时所获支持的来源有差异；不同年级学生在支持利用度的具体方面存在差异。     

海军航空兵社会支持特点分析

目的研究海军航空兵社会支持的发展特点,为制定心理健康教育方案提供依据。方法采用社会支持评定量表(SSRS)对某海军航空兵844名军人进行团体测试,进行组间比较。结果(1)除支持利用度和男性主观支持外,海军航空兵支持总分,客观支持分及女性主观因子得分均低于军人常模(P<0.01);(2)海军航空兵支持总分、主观支持和客观支持在不同性别、军龄上差异均有显著性(P<0.05),并且不同工种的海军航空兵,其社会支持各因子分除主观支持外,其余各因子分差异均有显著性(P<0.05)。结论海军航空兵的社会支持在不同性别、年龄、军龄、和工种之间,存在明显差别     

Prospects for single payer coverage after Harry and Louise

PURPOSE OF THE STUDY: This paper considers evidence of indirect influences of the Harry and Louise media campaign on public support of single payer health coverage in a conservative state. DESIGN AND METHODS: Data from a statewide, representative public opinion survey on health reform conducted in Oklahoma over a two-year period, 1992-1994, were combined with data on the Harry and Louise media campaign broadcasts. A two-stage structural-equation model tested the hypothesis that support for single payer varied inversely with support for "mainstream" health reform. RESULTS: Findings support the hypothesis, providing evidence that a campaign affecting support for mainstream health reform inversely affects support for single payer, despite the tendency for support for health reform to correlate with support for single payer. IMPLICATIONS: Findings suggest that an unintended indirect effect of a campaign against mainstream health reform may have been increased support for single payer. Those proposing future reforms should be aware of available media technologies and how they will be used.     

老年低视力患者家庭支持现状及影响因素分析

目的探讨老年低视力患者的家庭支持现状及影响因素分析。方法对126例就诊的低视力老年患者进行家庭支持情况的问卷调查,数据分析采用Logistic回归分析。结果低视力患者的家庭支持总分为（16．68±4．05）分,其中情感支持为（6．13±1．37）分,治疗支持为（6．65±2．66）分,结构支持为（2．37±1．25）分,信息支持为（1．98±0．48）分。对患者影响因素单因素分析后,差异有统计学意义的进行多因素分析,确定影响低视力患者家庭支持的主要因素为经济因素、病程、婚姻状况。结论对老年低视力患者提高家庭支持度及社会支持度,能提高老年低视力患者的生活质量。     

Social Support Communication in Unplanned Pregnancy: Support Types,Messages, Sources,and Timing

Pregnancy is a time of uncertainty and stress for many women, and these aspects are compounded for those facing unplanned pregnancies. Social support communication is considered a vital part of healthy outcomes in pregnancy but is largely unexplored in the unplanned pregnancy context, particularly for college-aged young women. The present study aimed to identify various dimensions of social support in unplanned pregnancy for this population, including support types desired and enacted, sources of support, support types helpful in various stages of this health experience, and message strategies used in helpful support communication. Results of an online semi-structured survey exploring message content and these other elements were analyzed through qualitative and quantitative content analysis as well as statistical analysis. Nurturing support, specifically network support, was found to be most desired in this health context, and the message strategies found in the most helpful support messages differed according to support type. Source and timing of support were also factors in the most helpful types of support in this context. Implications of these results will be discussed in terms of future research in social support in the unplanned pregnancy context.