艺术嗓音歌声客观评价初探

目的探讨客观评价艺术嗓音歌声的方法。方法对48名声乐专业青年大学生录制专业训练歌声信号,提取歌声平均能量、频率误差、音域误差作为评价参数,使用神经网络方法和多元线性回归方法客观评价歌声质量,并与资深专业教师的主观评价进行比较。结果客观评价歌声质量的方法中,神经网络方法误差在4%之内,而线性回归方法误差在6%之内,前者较优。结论神经网络方法利用评价参数能正确客观评价歌声质量,有助于科学地指导选拔和训练艺术嗓音人才。     

The development and evaluation of Student Training, Education and Practice for Dietetics CD-ROM: a computer-assisted instruction programme for dietetic students

The Student Training, Education and Practice for Dietetics (STEP‐DIET) CD‐ROM was developed at the University of Surrey to prepare dietetic students for the practical dietetic training component of their Nutrition/Dietetics degree. This study aimed to evaluate student response to the programme and its effectiveness as a teaching tool, based on the evaluation framework of D.L. Kirkpatrick (Evaluating a Course, 2nd edn. London, Kogan Page). Quantitative and qualitative methodologies were employed, with 41 dietetic students, separated by year group, completing questionnaires and taking part in six focus groups, at the University of Surrey. Student attitudes towards the instruction method and the STEP‐DIET programme itself were investigated, in conjunction with their perceived learning achievements. Students rated the programme highly in terms of design and content, however, there was a reluctance to accept computer‐assisted instruction (CAI) as a sole teaching method. A number of learning achievements relevant to dietetic practice were reported including a perceived increase in ability to conduct a dietetic interview and an increased understanding of the management of Type 2 diabetes. In general students reacted positively to the STEP‐DIET programme and it was perceived by students to be effective in preparing them for the practical component of their dietetic training.     

临床科室工作量评价方法及其应用

目的：探讨测量、评价临床科室工作量的指标和方法，加强医院科室管理，促进效益评价与核算。方法：应用医院病案和报表资料，每月计算科室工作强度指数并进行排位，用相对比方法初步分析科室临床工作量和排位变动的状况。结果：选取了实际占用床位数、危重病人抢救次数、门急诊人次数、出会诊人次数、出院病人数5项指标，计算出各科室工作强度指数和排位，并对各科室工作量排位变动进行了比较。结论：临床工作量评价指标和方法的代表性、灵敏性和可靠性较好，实际评价效果也较客观地反映了各临床科室的实际工作量大小。     

中国急性心肌梗塞的疾病经济负担

主要通过对急性心肌梗塞疾病经济负担的研究，总体描述进行二线预防的重要性。资料主要来源于中文文献检索、政府统计报表。主要利用直接医疗费用来计算疾病经济负担，而未考虑直接非医疗费用和间接费用。中日急性心肌梗塞的发病率约为45／10万。55／10万。城市高于农村，男性高于女性。在2000年，急性心肌梗塞的死亡率在城市为32．39／10万，农村为17．99／10万，其死亡率随年龄增长而相应增长。与发病率一样，城市高于农村，男性高于女性。25岁以上人群因急性心肌梗塞而损失的DALY在2000年为3．57DALYs／千人口。怎性心肌梗塞的直接医疗费用在国家卫生部部属医院为28257元／例，省级医院为8663元／例，县级医院为5447无／例。测算2000年急性心肌梗塞的疾病经济负担为13亿元。19亿元。但由于只有10．6％的急性心肌梗塞病人得到临床床治疗，因此，本测算结果可能低估了在中国实际发生的疾病经济负担。     

中国部分地区妇幼卫生信息系统的现状分析

本文通过研究卫生 项目地区报表资料和现场调查 ,对项目地区妇幼卫生信息系统的建设及运作情况进行了分析 ,并对报表数据质量进行了评价。分析显示 :卫 项目推动了贫困地区信息系统建设 ,项目地区已建立起系统的妇幼卫生信息管理体系 ,但分析也反映出项目地区妇幼卫生常规报表的数据质量仍存在一定问题。分析结果提示 ,应进一步加强妇幼卫生信息系统建设 ,提高妇幼卫生统计信息专业队伍的业务水平。     

网络模式下临床医师绩效评价指标体系研究

为了充分利用医院信息网络信息，更为全面、客观地对医生进行评价，阐述建立网络模式下临床医师绩效评价指标体系的原则、方法，并对的建立指标体系的可信度及合理性进行了分析。     

A comprehensive strategy for the evaluation and triage of the chest pain patient: A cost comparison study

BACKGROUND: Our objective was to determine the cost-effectiveness of a comprehensive, risk-based triage system, composed of multiple critical pathways, with the use of early myocardial perfusion imaging (MPI) in low-risk patients. We found previously that a chest pain evaluation system that uses MPI in low-risk patients was safe and effective, but the cost-effectiveness of this approach was not studied. METHODS AND RESULTS: We compared two groups. The Acute Cardiac Team (ACT) group (n = 874) was assigned prospectively to 1 of 4 risk levels by emergency department (ED) physicians. Level 1, 2, and 3 patients were admitted; level 4 patients were evaluated in the ED. Level 3 and 4 patients underwent ED MPI. The control group (n = 713) represented consecutive patients evaluated in the prior year according to standard care and assigned retrospectively to an ACT level based on the presenting electrocardiographic and clinical data. Record and hospital administrative data were assessed for clinical variables, outcomes, lengths of stay, and all expenses incurred within 30 days of the index visit. The baseline characteristics of the two groups were similar, including age, sex, myocardial infarction prevalence, and 30-day revascularization rates within each level or between the two groups. Mean costs per encounter were reduced for the ACT patients for each level, which was significant when all patients were compared ($5,030 +/- $7,081 vs $6,044 +/- $10,432, P =.02). Use of MPI in the low-risk patients was associated with reduced costs (level 3, $4,958 +/- $4,948 vs $5,051 +/- $7,036; level 4, $1,529 +/- $2,664 vs $1,794 +/- $6,854) and was associated with a significantly lower angiography rate and shorter length of stay. CONCLUSIONS: Implementation of a comprehensive strategy for chest pain evaluation and triage reduced overall costs for patients with chest pain on presentation. Acute MPI in the ED setting did not increase net cost.     

我国医学高校筹资、成本和效率评价--基本框架和概述

“中国高等医学院校筹资、成本分析和经济效益评价研究”是国家教育部高教司和卫生部科教司立项课题，共产出5篇论文。主要分析研究课题的基本框架，重点介绍研究背景、研究思路、研究目的、资料来源与调查方法，以及产生出的几篇论文的安排。     

173例支气管哮喘特异性脱敏治疗的进一步评价

对173例支气管哮喘特异性脱敏治疗的疗效及影响疗效的因素进行了分析。结果表明:显效为30.6%(53/173).有效为56.1%(97/173),无效为13.3%(23/173)。影响疗效的因素与病情的程度有关,而与年龄、病程、皮试阳性反应强弱及脱敏治疗前4个疗程内是否应用曲安缩松等无关。并对特异性脱敏治疗支气管哮喘的优缺点进行讨论。