Understanding the effects of a decentralized budget on physicians' compliance with guidelines for statin prescription – a multilevel methodological approach

Background  

Official guidelines that promote evidence-based and cost-effective prescribing are of main relevance for obvious reasons. However, to what extent these guidelines are followed and their conditioning factors at different levels of the health care system are still insufficiently known.     

Style of management and the relevance for workplace health promotion in small and medium sized enterprises

In a small company, the whole company culture, including the management style, is dominated by the owner. The management culture in small companies and above all the management style of the owner determine the chances of successfully introducing workplace health promotion (WHP). For this reason a typology was developed that describes the management personalities who affect the company culture in small enterprises. This provides a guide to the possible success of WHP in connection with the management style. Although a summary of the management and corporate culture of small companies in a few categories cannot show the variety of social reality, it can provide orientation. The typical categories of company social order (a mixture of ownership and leadership) in small and medium-sized enterprises are given below. Furthermore, there is an assessment of what the chances of realising workplace health promotion are in each type of company. Small and medium-sized companies (SME) have a number of organisational characteristics which are just ideal for the introduction and implementation of workplace health promotion. The work of the employer and employees is often the same. Information in the company is generally comprehensive and easily available. The lack of information which employees often complain about in large companies is not a problem. There is a good flow of communication. Small companies have a flat hierarchy that enables participation, the essential requirement for WHP. There is a close social relationship between the company head and the workforce, although it must be said that this closeness can be dangerous, particularly if it is misused as complete social control. The readiness to implement Workplace Health Promotion (WHP) in SME and the degree of success depends largely on the personality of the company manager and the style of leadership. Considering the importance of a manager’s personality for WHP in SME, modules and instruments to assist company owners and managers in SME are to be developed. On behalf of and in co-operation with the Austrian Network for Workplace Health Promotion several modules have been introduced to assist owners and managers of SMEs.     

交叉韧带重建手术中可吸收挤压螺钉的应用

目的探讨交叉韧带重建术中可吸收挤压螺钉的使用方法和疗效。方法总结53例交叉韧带重建病例使用可吸收挤压螺钉的情况，在术中、术后并发症、术后康复、膝关节功能状况等方面进行回顾性分析。结果三例出现韧带切割现象。两例股骨侧螺钉拧入后导引针无法拔出。一例挤压螺钉断裂。术后Lysholm评分平均92.4±4．1。结论交叉韧带重建术中使用可吸收挤压螺钉固定的方法固定牢固，术后恢复快，利于早期康复。     

Homocysteine levels in preterm infants: is there an association with intraventricular hemorrhage? a prospective cohort study

Background  

The purpose of this study was to characterize total homocysteine (tHcy) levels at birth in preterm and term infants and identify associations with intraventricular hemorrhage (IVH) and other neonatal outcomes such as mortality, sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, and thrombocytopenia.     

Long-term neuroretinal full-thickness transplants in a large animal model of severe retinitis pigmentosa

Background The purpose of this study was to explore neuroretinal transplantation in a large animal model of severe retinitis pigmentosa and to establish graft development, long-term survival, graft-host integration, and effects on the host retina. Methods Rhodopsin transgenic pigs, aged 6 months, received in one eye a fetal full-thickness neuroretinal sheet in the subretinal space by means of vitrectomy and retinotomy. Six months postoperatively, eyes were studied in the light microscope and with immunohistochemical markers. Full-field electroretinography (ERG) was performed at 4 and 6 months. Results Laminated grafts with well-organized photoreceptors, rod bipolar cells, and Müller cells were found in five of six eyes. Neuronal connections between graft and host retina were not seen. In the five eyes containing a graft, the number of surviving rods in the host retina was significantly higher compared with unoperated eyes. The ERG did not reveal any significant difference in b-wave amplitude between operated and control eyes, but the cone-derived response in operated eyes increased significantly from 4 to 6 months while the rod response in control eyes decreased significantly. Conclusions Fetal full-thickness neuroretina can be transplanted safely to an eye with severe retinal degeneration. In their major part, the transplants develop a normal laminated morphology and survive for at least 6 months. Graft and host retinal neurons do not form connections. Retinal function in the host is reduced initially by the surgical trauma, but the presence of a well-laminated graft counteracts this effect and rescues rods from degeneration. Supported by The Foundation Fighting Blindness (grant# C-NC02-798-0078), The Faculty of Medicine, University of Lund, The Swedish Research Council, The Princess Margaretas Foundation for Blind Children, The 2nd ONCE International Award for New Technologies for the Blind.     

冰点下降法测定血、尿渗透压的临床应用及注意事项

本文应用溶液冰点下降法测定了178例正常血清渗透压。结果为287±13毫渗量/kg水。并对20例尿崩症病人在限水加压素试验过程中测定血清,尿渗透压。尿崩症病人尿渗透压明显低于正常人。注射加压素后,尿渗透压升到正常。在多尿症的鉴别诊断中,此法是一种简便,灵敏的手段。有重要的诊断价值。     

Alagille syndrome and optic pit

Background Optic disc anomalies are frequently associated with Alagille syndrome. We report here the first case of a patient with Alagille syndrome combined with optic pit and serous macular detachment. Methods A male patient with Alagille syndrome was referred from the pediatric hepatology department for investigation of visual loss in the right eye. Anterior segment examination showed evidence of posterior embryotoxon, confirmed by gonioscopic evaluation. Dilated fundus examination revealed serous macular detachment and optic pit. Results OCT 3 scans confirmed the clinical findings. Conclusions Optic pit is uncommon and should prompt a search for genetic disorders or development abnormalities. The association between the two syndromes in this patient might be due to failure of correct neuroectodermal development, for which a common genetic pathway is likely.     

Strong decline in female sterilization rates in Norway after the introduction of a new copayment system: a registry based study

Background  

January 1, 2002, copayment for outpatient female sterilization in Norwegian public hospitals increased from 33 euros to 750 euros after a revision of the health care system. The aim of the present study was to investigate the effect of the new copayment system on female sterilization epidemiology.