卫生统计管理信息系统构建

简要阐述基于卫生综合管理信息平台的卫生统计管理系统建设目标和指导思想,具体介绍系统建设内容、原则与架构,并对卫生统计管理信息系统的使用效果进行总结。     

Orienting response elicitation by personally significant information under subliminal stimulus presentation: Demonstration using the Concealed Information Test

Considerable evidence suggests that subliminal information can trigger cognitive and neural processes. Here, we examined whether elicitation of orienting response by personally significant (PS) verbal information requires conscious awareness of the input. Subjects were exposed to the Concealed Information Test (CIT), in which autonomic responses for autobiographical items are typically larger than for control items. These items were presented subliminally using two different masking protocols: single or multiple presentation of the masked item. An objective test was used to verify unawareness to the stimuli. As predicted, PS items elicited significantly stronger skin conductance responses than the control items in both exposure conditions. The results extend previous findings showing that autonomic responses can be elicited following subliminal exposure to aversive information, and also may have implications on the applied usage of the CIT.     

Contraception des femmes françaises de 15 à 45 ans : enquête nationale sur un échantillon représentatif de 5963 femmes

ObjectivesTo describe French women's use of contraceptive methods and study their satisfaction and expectations about contraception.Patients and methodsA survey carried out by mail questionnaire filled in by a representative sample group of French women aged 15 to 45 years (Panel Postal Metascope TNS Sofres) in June 2007.ResultsOf 10,000 questionnaires sent out, 6044 questionnaires were returned, of which 5963 were usable. Seventy-three percent of women surveyed used some method of contraception, of which 46% was an oral contraceptive, 15% an IUD and 7% used condoms. A minority used new contraceptive methods (implant, patch, vaginal ring). The average age at first sexual relationship was 17.8 years. It was 18.5 among 40–45-year-olds and gradually reduced to 16.7 in the under 25-year-olds. Twenty-three percent of pregnancies remain unwanted and unplanned. For 96% of patients, the choice of contraception was considered to be important. Thirty-six percent thought that contraception could be harmful to health. Only 63% of women believed themselves to be well informed the first time they used contraception. Satisfaction for contraception method was evaluated from 7.3/10 (condom) to 9.7/10 (sterilization).Discussion and conclusionTwenty-seven percent of women do not use any contraception and 23% of pregnancies are unwanted despite a large offering of contraceptives. Our study enables the drawing of ‘patient-profiles’ for the main methods of contraception in order to better determine women's expectations and to pass the findings on to health professionals.     

社区随访信息化管理对2型糖尿病患者的效果分析

目的探讨社区随访信息化管理对2型糖尿病患者自我管理能力与疾病控制的效果。方法对社区内212例2型糖尿病患者通过建立健康档案，同时建立电子健康档案，进行随访信息化管理。结果实施社区随访信息化管理1年后，患者的自我管理能力明显提高，患者的体重指数、空腹血糖、餐后2 h血糖、糖化血红蛋白、总胆固醇、甘油三酯与管理前比较，差异有显著意义（P〈0．01）。结论多样化、个性化、持续有效的社区随访信息化管理，能够提高2型糖尿病患者的自我管理能力和血糖控制水平，减缓并发症的发生，提高生存质量。     

Using conceptual work products of health care to design health IT

This paper introduces a new, model-based design method for interactive health information technology (IT) systems. This method extends workflow models with models of conceptual work products. When the health care work being modeled is substantially cognitive, tacit, and complex in nature, graphical workflow models can become too complex to be useful to designers. Conceptual models complement and simplify workflows by providing an explicit specification for the information product they must produce. We illustrate how conceptual work products can be modeled using standard software modeling language, which allows them to provide fundamental requirements for what the workflow must accomplish and the information that a new system should provide. Developers can use these specifications to envision how health IT could enable an effective cognitive strategy as a workflow with precise information requirements. We illustrate the new method with a study conducted in an outpatient multiple sclerosis (MS) clinic. This study shows specifically how the different phases of the method can be carried out, how the method allows for iteration across phases, and how the method generated a health IT design for case management of MS that is efficient and easy to use.     

Membrane-associated mucins of the ocular surface: New genes,new protein functions and new biological roles in human and mouse

The mucosal glycocalyx of the ocular surface constitutes the point of interaction between the tear film and the apical epithelial cells. Membrane-associated mucins (MAMs) are the defining molecules of the glycocalyx in all mucosal epithelia. Long recognized for their biophysical properties of hydration, lubrication, anti-adhesion and repulsion, MAMs maintain the wet ocular surface, lubricate the blink, stabilize the tear film and create a physical barrier to the outside world. However, it is increasingly appreciated that MAMs also function as cell surface receptors that transduce information from the outside to the inside of the cell. A number of excellent review articles have provided perspective on the field as it has progressed since 1987, when molecular cloning of the first MAM was reported. The current article provides an update for the ocular surface, placing it into the broad context of findings made in other organ systems, and including new genes, new protein functions and new biological roles. We discuss the epithelial tissue-equivalent with mucosal differentiation, the key model system making these advances possible. In addition, we make the first systematic comparison of MAMs in human and mouse, establishing the basis for using knockout mice for investigations with the complexity of an in vivo system. Lastly, we discuss findings from human genetics/genomics, which are providing clues to new MAM roles previously unimagined. Taken together, this information allows us to generate hypotheses for the next stage of investigation to expand our knowledge of MAM function in intracellular signaling and roles unique to the ocular surface.     

护士档案信息管理系统的设计与效用

2008年5月12日《护士条例》颁布实施后,我国临床护士人力紧缺的状况正在逐步改善,护士队伍数量迅速增加,这队护士档案信息的管理也提出了更高的要求.我院是一所三级甲等综合性教学医院,现阶段开床位1 283张,护士794名,2008年以来新聘用护士354名.我院护理部自2010年10月起,结合我院护理人员的实际情况,在临床调研的基础上,开发研制了电子“护士档案信息管理系统”,实现了信息化、无纸化档案管理,为我院科学、规范、快捷、准确地管理护士档案工作提供了便利,现介绍如下.     

On measurements and their quality: Paper 3: Post hoc pooling and errors of discreteness

This is the third in a short series of papers on measurement theory and practice with particular relevance to research in nursing, midwifery, and healthcare. In this paper I demonstrate how the decisions we make regarding the post hoc treatment of our measurements impact the quality of our data and influence the validity of the inferences we draw from them. I address two variations of this practice, pooling data over response options found on self-report measures, and transforming measurements of continuous variables, such as age, into ranges or ordered categories. The problems inherent in this practice are examined using concepts from information theory. Pooling more precise measurements into less precise ones creates errors of discreteness that introduce unpredictable (positive or negative) bias in our results.     

Why common carrier and network neutrality principles apply to the Nationwide Health Information Network (NWHIN)

The Office of the National Coordinator will be defining the architecture of the Nationwide Health Information Network (NWHIN) together with the proposed HealtheWay public/private partnership as a development and funding strategy. There are a number of open questions—for example, what is the best way to realize the benefits of health information exchange? How valuable are regional health information organizations in comparison with a more direct approach? What is the role of the carriers in delivering this service? The NWHIN is to exist for the public good, and thus shares many traits of the common law notion of ‘common carriage’ or ‘public calling,’ the modern term for which is network neutrality. Recent policy debates in Congress and resulting potential regulation have implications for key stakeholders within healthcare that use or provide services, and for those who exchange information. To date, there has been little policy debate or discussion about the implications of a neutral NWHIN. This paper frames the discussion for future policy debate in healthcare by providing a brief education and summary of the modern version of common carriage, of the key stakeholder positions in healthcare, and of the potential implications of the network neutrality debate within healthcare.