加强医院药学管理 创新医院药学服务

随着科学技术的进步,医院药学发展的总趋势是进行医院药事管理,药学技术工作和药学服务要向临床靠拢。这就要求医院药学部门应掌握国内外药学发展动态,根据实际情况不断引进、吸收和应用现代药学新知识、新技术和新方法,创新医院药学管理。文章对此进行了分析,并就创新医院药学管理提出了建议。     

An activity week for children with cancer: who wants to go and why?

Many children now live with cancer rather than die from it, and such children need both to continue their social, emotional and cognitive development and to make long-term psychological adjustments. This paper presents the findings of a research project set up to explore issues pertinent to the current provision of an activity week experience for a group of British paediatric cancer patients. The aims of the study included finding out which factors discriminate between families who apply for a place to attend the week for their child and families who do not, and to develop a knowledge of what factors are considered by parents and children. The findings suggest that the week appeals to children who are confident, active and able to separate from parents and whose parents are keen to encourage independence and new experiences. Children diagnosed and treated at a younger age and further away from treatment were more likely to express concerns about being homesick and safety and to not apply for the week. Issues of protection, independence and disability are discussed with reference to the importance of parental attitude on children's psychological accommodation to disease and treatment and to the experiences of adult survivors of childhood cancer.     

加强内涵质量建设 提升服务保障水平

本文阐述医院近几年着力加强内涵质量建设,推动医院健康快速发展,提升服务保障水平的做法。具体包括突出龙头,加强实备,有效提高应急卫勤保障能力;盯住细节,持续改进,建立服务官兵的新型模式;把住关口,严格标准,着力提升医疗质量层次水平;重视人才,创新技术,系统助推各个学科健康发展;精细管控,阳光操作,切实保证经济管理的最佳效益;严格制度,保安促稳,科学推动医院和谐有序发展。     

Dependency, social factors, and the smoking cessation process: the doctors helping smokers study

We analyzed data obtained from a representative sample of the smoking patients (n = 1,338) of 66 family physicians to determine predictors of attempts to stop smoking, desire to quit smoking, and successful smoking cessation. Compared to subjects who made no attempt to quit smoking, subjects who tried to quit smoking tended to be younger, had tried to quit smoking in the year prior to the study, waited longer before smoking their first cigarette of the day, had more desire to quit smoking, and had more social support for quitting. Education and cigarettes smoked per day were not independently related to the subject making a quit attempt. Desire to quit smoking was associated with an attempt to quit in the year prior to the study and social support for smoking cessation (support of spouse, second most important social contact, and physician). Desire to quit smoking was not independently related to age, education, or dependency on cigarettes (measured by the number of cigarettes smoked per day and the length of time a subject waited before smoking the first cigarette of the day). Compared to subjects who tried to quit and failed, subjects who succeeded were older, smoked fewer cigarettes per day, and waited longer to smoke their first cigarette of the day. Spouse support, support of the second most important social contact, and advice of a doctor to quit smoking were not independently related to whether or not a cessation attempt would be successful. These data suggest that successful smoking cessation requires two components: social support to make an attempt to quit and the ability to overcome dependency on cigarettes to make the attempt successful.     

社区产后访视健康教育对母乳喂养的影响

目的:通过社区产后访视健康教育知识宣传让产妇和家属了解和接受母乳喂养知识和技能,提高母乳喂养率.方法:社区产后访视人员在产妇及新生儿出院后3天、28天各进行上门访视一次,先了解产妇及新生儿健康状况、母乳喂养知识了解程度和喂养技能掌握情况,再根据当前存在的问题给予纠正.对可能发生的问题给予预防措施指导.利用健康教育宣传母乳喂养知识,使产妇及家属了解和接受母乳喂养知识.结果:社区产后访视健康教育宣传指导使产妇及家属接受和正确实施母乳喂养,从而提高了母乳喂养率.结论:社区产后访视利用健康教育宣传和指导母乳喂养知识和技能对提高母乳喂养率有很大的促进作用.     

医疗质量考评体系改革的方法和策略

介绍了在医院等级评审全面展开的背景下,参照医院评审标准要义,进行医院医疗质量考评体系改革,即以建立健全2个体系、全面加强2项管理、持续改进4项质量、保障患者安全为目标,设置关键指标考评模块,构建医疗质量考评三级网络,设置关键指标考评模块,突出质量,兼顾效率,向服务倾斜,注重消费和成本控制,成立医疗质量与安全管理基金,实行奖惩两条线等.     

济宁市淡色库蚊抗药性检测分析

目的了解济宁市淡色库蚊对常用化学杀虫剂的抗性状况,为合理有效地进行蚊虫化学防治提供依据。方法采用WHO生物测定方法测定敏感品系和现场淡色库蚊对5种杀虫剂的抗性。结果5个现场的淡色库蚊对三氯杀虫酯、DDVP、残杀威、溴氰菊酯、氯氰菊酯抗性水平分别为敏感品系的1．14～7．99倍、6．10～21．18倍、3．46—6．67倍、8．50～16．50倍、28．33～135．83倍。结论济宁市淡色库蚊对5种常用化学杀虫剂均产生不同程度的抗药性,对氯氰菊酯和DDVP抗性较高,对三氯杀虫酯和残杀威抗性较低,应采取适当措施克服或延缓蚊虫抗药性的产生和发展。     

Improving the system of preventing vibration and noise-induced pathology

Due to the long-term study of various machines under industrial and test conditions it became possible to determine the specific role of each chain of the man-machine system in the intensification of vibroacoustic effect on a worker and to develop a system of medical, technical and organizational preventive measures. Introduction of a set of such measures at one of the plants helped to reduce vibration disease rates by dozens of times. In order to control noise- and vibration-caused diseases it was necessary not only to improve machines' quality and service conditions but also to pay special attention to the choice of operators and to the quality of monitoring their adaptation process.     

Coordinating Canada's research response to global health challenges: the Global Health Research Initiative

The Global Health Research Initiative (GHRI) involving the Canadian International Development Agency, the Canadian Institutes of Health Research, Health Canada and the International Development Research Centre seeks to coordinate Canada's research response to global health challenges. In light of numerous calls to action both nationally and internationally, an orientation to applied health policy and systems research, and to public health research and its application is required to redress global inequalities in wealth and health and to tackle well-documented constraints to achieving the United Nations Millennium Development Goals. Over the last four years, the GHRI has funded close to 70 research program development and pilot projects. However, longer-term investment is needed. The proposed dollars 100 million Teasdale-Corti Global Health Research Partnership Program is such a response, and is intended to support teams of researchers and research users to develop, test and implement innovative approaches to strengthening institutional capacity, especially in low- and middle-income countries; to generating knowledge and its effective application to improve the health of populations, especially those most vulnerable; and to strengthen health systems in those countries. While Canada stands poised to act, concerted leadership and resources are still required to support "research that matters" for health and development in low- and middle-income countries.     

加强妇幼卫生信息管理 提高妇幼保健工作质量

为全面提高珠海市妇幼保健工作质量,通过采取提高认识,摸清现状,明确管理模式;加强妇幼卫生信息网络建设,建立健全信息管理制度和常规;以提高人员素质为突破口,提高妇幼卫生信息质量;规范妇幼卫生信息收集的标准工具;狠抓妇幼卫生信息的质量控制;及时准确地向管理决策部门提供科学、有效的信息等强化妇幼卫生信息管理措施,使珠海市１９９０～１９９８ 年婴儿死亡率由２２４９‰降至１０７３‰,５ 岁以下儿童死亡率由２６５８‰降至１２９６‰,孕产妇死亡率由４５６８／１０ 万降至１２８０／１０ 万,３ 岁以下儿童保健系统管理率由 ３８９７％ 提高到８１１４％ ,孕产妇保健系统管理率由４９２５％ 提高到６６７９％ ,住院分娩率由７６２３％ 提高到９９７１％ 。     

以人为本科学发展推动医院工作全面进步

推进医院工作全面进步,必须以“三个代表”重要思想统揽医院工作的全局;必须用科学发展观指导医院的建设和发展;必须注意把握医院改革的方向和重点;必须探索和推行以服务第一为理念的经营战略。     

谈医学实习生临床带教中的问题

本文就医学实习生临床带教工作中,带教方和实习生方面存在的一些问题进行分析。从建立健全教学管理体制,试行实习生导师制,加强对带教导师的培养教育,实现带教方式多样化;注重人文素质教育,学习沟通技巧和艺术;加强风险意识教育,严格基本技能训练,调动实习积极性等方面提出相应的解决对策。     

高新技术的发展和应用对医院管理的影响及要求

高新技术在医院的应用，促进了医疗技术的发展，更新卫生观念，拓展了医院功能，改变了医院的服务方式及管理模式，对医院管理产生着不可忽视的重要影响，也对医院管理者了更高的要求，要求医院管理者加强学习，更新知识，提高驾驭全局的能力。要求医院顺应应用高新科技和棉理顺关系，充分发挥职能作用；努力建设一支医德医风优良的高素质科技干部队伍；依据自身的功能、任务、规模、制定适宜的发展目标，协调发展；遵章守法、不断完     

The design of pilot telecare projects and their integration into mainstream service delivery

We studied the introduction of a telecare and rehabilitation scheme in north-west Surrey. It was decided not to create a new team to provide the new services, but to involve established teams and individuals. The introduction of telecare therefore added to the roles and responsibilities of these teams. This staffing policy helped to establish awareness of the project within the local care system and to support its subsequent deployment. An education and training unit was established to demonstrate what the technology could do and to act as a focus for training health and social care professionals. The study suggested that for telecare to achieve its full potential, pilot projects must be designed to be evaluated, and more attention must be paid to the degree of integration with the care system as a whole.     

Balancing Accessibility and Selectivity in 21st Century Public Mental Health Services: Implications for Hard to Engage Clients

This research highlights the importance of expanding examinations of service accessibility for hard to engage client populations to include assessments of individuals’ ability to gain entrance to services and the system’s ability to meet the service needs of particular client populations. The results of this research provide a framework to support these examinations. The increasing levels of selectivity and targeting of mental health services to particular client populations found in this study raise fundamental questions about the goals of service accessibility in 21st century public mental health services generally, and for hard-to-engage clients particularly. These findings also point to the need for examinations of the eligibility criteria and gatekeeping mechanism that are used to target services to particular client populations to determine if they are working as intended and to assess what impact these mechanisms have on hard to engage clients’ ability to gain entrance to needed services.     

Science and social responsibility in public health

Epidemiologists and environmental health researchers have a joint responsibility to acquire scientific knowledge that matters to public health and to apply the knowledge gained in public health practice. We examine the nature and source of these social responsibilities, discuss a debate in the epidemiological literature on roles and responsibilities, and cite approaches to environmental justice as reflective of them. At one level, responsibility refers to accountability, as in being responsible for actions taken. A deeper meaning of responsibility corresponds to commitment to the pursuit and achievement of a valued end. Epidemiologists are committed to the scientific study of health and disease in human populations and to the application of scientific knowledge to improve the public's health. Responsibility is also closely linked to reliability. Responsible professionals reliably perform the tasks they set for themselves as well as the tasks society expects them to undertake. The defining axiom for our approach is that the health of the public is a social good we commit ourselves to pursue, thus assuming an obligation to contribute to its achievement. Epidemiologists cannot claim to be committed to public health as a social good and not accept the responsibility of ensuring that the knowledge gained in their roles as scientists is used to achieve that good. The social responsibilities of environmental health researchers are conspicuous in the environmental justice movement, for example, in community-based participatory research. Responsibility is an ethical concept particularly well suited to frame many key aspects of the ethics of our profession.     

区域中心医院住院服务需求及利用分析

根据某区域中心医院45153例住院患者的病案信息和1250名住院患者的医疗需求问卷调查资料，采用回顾性分析和因素分析，了解社区患者的医疗需求和该院对社区患者医疗需求的满足程度，并提出四项对策：1、确立目标市场，进行市场定位；2、加强专科建设，发展适宜技术；3、狠抓质量管理，提高服务水平；4、调整内部结构，优化资源配置。     

河南省卫生资源配置的城乡差异与对策

河南省城乡卫生资源配置的比例不平衡,乡村医疗机构承担的工作量比例要高于其拥有的卫生资源比例,在卫生资源的结构状况和整体质量上．城市医院也要优于乡村医疗机构。相应的对策是在资源调整方向上,引导卫生资源向预防保健、社区和农村流动,同时继续健全和巩固农村县、乡、村的三级卫生服务网络,加大卫生人力资源培养的力度,稳步推进农村合作医疗制度。     

Establishing centers to address treatment effectiveness in diverse ethnic groups: the MEDTEP experience

Objective. To investigate racial ethnic and socioeconomic disparities in health outcomes amenable to improvement through more effective delivery of health care services. Design. The Medical Treatment Effectiveness Program (MEDTEP) Research Centers on Minority Populations were a group of centers in the USA funded to improve the effectiveness of medical diagnosis and treatment to provide technical assistance to ethnic minority health researchers to train new researchers and to disseminate information to help ethnic minority patients and their health care providers. Results. Centers often provided many specific findings related to assessment of the magnitude of disparities in health outcomes and to approaches for eliminating these outcomes. The Centers were able to build community partnerships using an approach now defined as community-based participatory research. Centers changed the culture of their institutions by making them more aware of the need to train diverse investigators and do more to eliminate health disparities. Conclusions. A key to the success of the Centers has been the unification of a cadre of committed investigators dedicated to the mentoring of minority health researchers and to the elimination of ethnic and socioeconomic disparities in health. The MEDTEP Centers provide a model but there remains a need for continued work.