广西医疗卫生资源配置公平性与效率研究

目的 分析2016—2018年广西医疗卫生资源配置公平性和效率,为优化广西医疗卫生资源配置提供科学依据。方法 运用基尼系数、泰尔指数和描述性统计分析医疗卫生资源配置公平性,使用DEA分析医疗卫生资源配置效率。结果 各指标基尼系数为0.2425~0.3247,基尼系数和各指标均值变化有所上涨,最大上涨幅度分别为0.0063和15.3%,泰尔指数均不超过0.012,且略有下降,其中“公共财政预算支出中医疗卫生与计划生育”的组间贡献率大于组内贡献率,其他三个指标的组间贡献率小于组内贡献率。在14个地市医疗卫生资源的配置效率中,4个地市DEA相对有效,3个地市DEA相对有弱有效,其余地市DEA相对无效。结论 广西医疗卫生资源配置公平性较合理,但不公平趋势波动上升,配置效率存在差异。     

人性滋养：医德存养的路径源头——提高医德教育实效之对策

通过分析道德教育与医德教育的本质，对德育性质与功能从本质上有了一定的认识，围绕此设题展开深入分析，给出了提高医德教育实效的对策建议，并阐述了理论与现实根据。     

康熙帝《庭训格言》的养生思想

康熙帝《庭训格言》是其对诸皇子的训诫，其中很多内容与养生相关。《庭训格言》的养生思想主要包括节、慎、劳、怡四方面内容。节指食物、酒、蔬菜、水果等要节制，不宜穷奢极欲；慎指的是日常生活起居要谨慎从事；劳指不贪图安逸，要勤于劳作；怡指要注意精神调摄，务使心情愉悦。     

Sexual Function in Patients with Deep Infiltrating Endometriosis

IntroductionEndometriosis is a benign condition that causes pain and infertility. Sexual dysfunction, particularly deep dyspareunia, is common in patients with endometriosis and interferes with quality of life and conjugal satisfaction.AimThe study aims to assess sexual function in women with deep infiltrating endometriosis.MethodFifty-seven women diagnosed with deep infiltrating endometriosis were recruited from Hospital Universitário Pedro Ernesto (HUPE) between July and December 2011. The control group comprised 38 healthy women recruited at the HUPE family planning clinic.Main Outcome MeasuresThe main outcomes are full-scale and individual domain scores on the Female Sexual Function Index (FSFI), a validated questionnaire for functional assessment of sexual function in women.ResultsPatients with endometriosis had more pain in intercourse than controls, which correlates with lower scores in the FSFI pain domain. However, there were no statistically significant between-group differences in overall (full-scale) FSFI scores.ConclusionWomen with endometriosis exhibit significant dysfunction in the pain domain of the FSFI questionnaire, but this finding was not sufficient to affect the overall sexual function. Evangelista A, Dantas T, Zendron C, Soares T, Vaz G, and Oliveira MAP. Sexual function in patients with deep infiltrating endometriosis. J Sex Med 2014;11:140–145.     

Withdrawal from familial ovarian cancer screening for surgery: findings from a psychological evaluation study (PsyFOCS)

Objective

A prospective psychological evaluation study of familial ovarian cancer screening (PsyFOCS) is underway in partnership with the UK Familial Ovarian Cancer Screening Study (UK FOCSS Phase 2). One of the aims of PsyFOCS is to examine factors associated with withdrawal from the UK FOCSS prior to the onset of 4-monthly screening.

Method

1999 of 3224 women completed a baseline questionnaire. 110 (5.5%) women withdrew from screening prior to their first routine Phase 2 screen, of which 73 (66.4% of withdrawals) had withdrawn because they had undergone removal of their ovaries and fallopian tubes (withdrawn group). The comparison group consisted of 1868 women who remained on screening. The baseline questionnaire included measures of cancer-specific distress, anxiety, depression and illness perceptions.

Results

Logistic regression analysis indicated that having had prior annual (Phase 1) screening (OR = 13.34, p < .01), past experience of further tests (OR = 2.37, p < .01) and greater cancer-specific distress (OR = 1.38, p < .01) were associated with withdrawal for surgery. Belief in ageing as a cause of ovarian cancer was also associated with withdrawal (OR = 1.32, p = .05).

Conclusion

These cross-sectional data suggest that withdrawal from familial ovarian cancer screening may be influenced by both clinical and psychological factors. These may reflect women's experience of the drawbacks of screening and increased concern about ovarian cancer risk, as well as having opportunities to consider surgery as an alternative risk management strategy whilst using screening as an interim measure.