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51.
Mark Foord BA MA Julie Savory BA MA MCiH Dianne Sodhi BA MA MCiH 《Health & social care in the community》2004,12(2):126-133
This paper reflects on a research project funded by a consortium of leading sheltered housing (SH) providers and their regulatory body, the Housing Corporation. The project aimed to ascertain which aspects of SH older people perceived to be central to their satisfaction and the methods they judged most appropriate to measuring this. We outline key policy developments of importance to SH (specifically the development of performance measurement regimes), and changes in the nature of SH, which are driving providers to re‐evaluate how they measure user satisfaction. We discuss the aims of the project, our methodology and findings, and conclude by raising critical questions about the process of measuring satisfaction within an increasingly managerialised housing system. We argue that this favours standardised methods of information gathering (such as questionnaires) rather than engage with clients in order to develop methods and systems capable of eliciting qualitative issues of concern to them. Our conclusions are, we believe, applicable to health and social care provision, where similar tensions exist around performance measurement and user satisfaction. 相似文献
52.
老年退行性腰椎管狭窄症的手术疗效分析 总被引:12,自引:0,他引:12
目的:探讨老年退行性腰椎管狭窄症患者减压手术的疗效。方法:1997年1月~2003年12月收治的70岁以上且获得2~6年随访的退行性腰椎管狭窄症患者106例,男49例,女57例;年龄70~82岁,平均76.3岁;病史4~10年,平均6.7年。42例并存1种内科疾病,55例并存两种或以上的内科疾病。均经过正规保守治疗无效。术前联合内科诊治并存的内科疾病。95例行单纯全椎板切除减压术;11例采用椎板减压、椎弓根固定、椎间植骨融合术,对手术疗效进行回顾性分析。结果:无围手术期死亡病例。出现并发症22例次,经对症及内科联合处理后好转。单纯减压组术后3周配戴腰围下床活动;内固定组术后3~5d下床活动。平均随访3年10个月,Oswestry评分从术前59.64±11.07分改善至16.81±7.36分。所有患者连续行走从术前不足15min改善到至少30min。95.2%患者自诉生活质量明显提高。结论:老年退行性腰椎管狭窄症患者在积极控制并存内科疾病的基础上,手术减压治疗对神经功能的恢复有重要作用,可获得较满意的临床疗效。 相似文献
53.
Paavo Riekkinen Jr. Minna Riekkinen Antti Valjakka Paavo Riekkinen Jouni Sirvio
《Brain research》1992,570(1-2):293-299
The present study examines the effects of noradrenergic lesions (either DSP-4 i.p. or 6-hydroxydopamine (6-OHDA) into the dorsal noradrenergic bundle on biochemical (noradrenaline (NA), dopamine (DA), serotonin (5-HT) and choline acetyltransferase (ChAT) activity) and cortical EEG (quantitative EEG (qEEG) and high-voltage spindle (HVS) activity in young and aged rats. Near complete 6-OHDA NA lesions, but not partial DSP-4 NA lesions, increased HVS activity in young rats. DSP-4 and 6-OHDA lesions produced no significant changes in the 5-HT or DA levels or in the ChAT activity in young rats. In some of the aged rats, DSP-4 produced similar biochemical and HVS effects, as it induced in young rats. In the remainder of the aged rats, NA levels were greatly and 5-HT levels slightly decreased. DA levels and ChAT activity were unaltered in either set of aged rats. HVS activity was increased only in that group of aged rats with the greatly lowered NA content. These results suggest that: (1) some of the aged rats are more sensitive to DSP-4 treatment than young adult rats; and (2) NA depletions have to be complete to produce an increase in HVS activity in young and aged rats. 相似文献
54.
C. W. Chow A. Poulos A. J. Fellenberg J. Christodoulou D. M. Danks 《Acta neuropathologica》1992,83(2):190-195
Summary Recognition of adrenal atrophy during a review of autopsy findings in two sisters who died at 8 months and 3 1/2 years prompted estimation of very long chain fatty acids, phytanic acid and pristanic acid on wet liver fixed in formalin for 12 years. These were shown to be markedly increased and defects in multiple peroxisomal functions and decrease in particulate catalase were shown in cultured fibroblasts, confirming an abnormality of peroxisomal biogenesis. The patients had presented with failure to thrive, recurrent diarrohea and vomiting, poor mental development, retinal pigmentation, blindness and in the older patient deafness, with only mild dysmorphic features. Autopsy in the older patient showed adrenal atrophy, cirrhosis, and foamy histiocytes in multiple organs. The brain showed no demyelination, little cytoarchitectural abnormality, occasional perivascular histiocytes in the grey matter and meninges and prominent Purkinje cells in the molecular layer of the cerebellum. In the younger patient the changes were very subtle in spite of the marked clinical similarity. Despite the young age at death the clinicopathological features are most suggestive of infantile Refsum disease. In many situations anatomical pathology can be very useful in the recognition and study of peroxisomal disorders. 相似文献
55.
56.
57.
温州市农村贫困人群卫生服务需求和利用分析 总被引:2,自引:0,他引:2
通过对近2000份调查表的分析,评价温州市农村贫困人群在就诊过程中对医疗机构的选择、未就诊原因方面的特点,提出提高卫生服务利用的方法。 相似文献
58.
59.
M. Engberg 《Acta psychiatrica Scandinavica》1994,89(1):35-40
The mortality and suicide rates for involuntarily committed patients in Denmark are presented. Two cohorts of psychiatric patients committed to a mental hospital from January 1, 1971 to December 31, 1975 (8322 people) and January 1, 1981 to December 31, 1985 (5253 people) have been followed. The standard mortality rate (SMR) in relation to the total Danish population were 4.9 (4.5–5.4) and 5.2 (4.7–5.8), respectively, for the two cohorts, during the first year after involuntarily commitment to a mental hospital. During the same period, the SMR for suicide among the committed patients were 44.9 (37.1–53.9) and 30.9 (24.2–38.9), respectively. The crude suicide rates among the committed patients during the first year after the commitment were 14.3 and 14.0, respectively, per 1000 years, unchanged between the cohorts. Short length of stay in hospital (< 14 days), a nonpsychotic main diagnosis, male sex, and age 35 years or more were equally related to high risk of suicide in the 1971 cohort as evaluated to proportional hazard methods (Cox regression), and short length of stay and commitment on the danger indication provided the most information in relation to high suicidal risk in the 1981 cohort. Methodological problems and the reasons for the results are discussed. 相似文献
60.
老年人健康行为与心理健康关系的调查 总被引:3,自引:0,他引:3
目的探讨老年人的健康行为与心理健康之间的关系。方法采用候玉波等编制的健康行为量表和症状自评量表(SCL-90)对300名老年人进行测试,并进行相关分析。结果不同年龄和文化程度老年人在健康行为与心理健康方面有显著性差异(P〈0.05);参与活动与心理健康水平呈显著正相关(P〈0.05);心理应激、不良生活习惯与心理健康呈显著负相关(P〈0.05)。结论积极参与各项活动、减少各种心理应激和建立良好的生活习惯有利于提高老年人的心理健康水平。 相似文献