护理学硕士生心理健康状况及其影响因素分析

目的 探讨护理硕士研究生心理健康状况及其影响因素.方法 采用症状自评量表(SCL-90)、社会支持量表(SSRS)和应对方式量表,对273名护理学硕士研究生进行调查.结果 (1)护理硕士生SCL-90阳性检出率为12.45％.(2) Logistic回归分析显示,学费来源(OR=2.982)、自责(OR=2.731)是护理学硕士研究生心理健康的危险因素,年龄(OR=0.242)、解决问题(OR=0.357)是保护因素,以上4项可预测护理硕士生心理健康变异量的36.9％.结论 护理学硕士研究生心理健康状况较好,但仍存在一些心理问题；教育者应关注年龄较小、自费的学生群体,在护理学硕士研究生教育中,需注重培养其成熟的应对方式.     

Why France is making eight new vaccines mandatory

France is one of the countries with the highest prevalence of vaccine hesitancy in the world. In an attempt to raise vaccination coverages, the French government made on January 1, 2018 eight more vaccines mandatory in addition to the three required until then. The process that led to this policy choice is of particular interest. We describe how vaccines became contentious in France and how French authorities came to view mandatory vaccination as the solution to the rise in vaccine hesitancy. In a bold move, French public health authorities turned to a new type of institutional device grounded in the ideal of democracy and public participation to political decision-making: “a citizen consultation”. This consultation anchored the idea that legal coercion could be the solution to France’s crisis with vaccines. Time will tell whether the French extension of mandatory vaccination will reduce tensions around vaccines.     

2006～2008年陕西省鼠疫健康教育及效果评估

目的提高陕西省鼠疫疫区干部、群众和医务人员鼠疫防治知识水平,评估近年来鼠疫健康教育活动的效果。方法调查县政府相关部门和重点乡（镇）开展鼠疫防治知识宣传教育活动情况,计算目标人群鼠疫临床、流行病学及预防、＂三不三报＂知识知晓率,健康教育效果评估采用笔试、问卷调查及访谈法,对148名接受过鼠疫防治知识宣传教育的目标人群,用选择题和简答题形式按教育内容设计测试题,测评人员根据掌握的情况自行答题并统一收回,统一评定。评分采用百分制,60分以上为合格。结果目标人群鼠疫临床、流行病学及预防、＂三不三报＂知识知晓率,干部为50.50%、63.69%和78.67%;村民为64.71%、87.91%和76.47%;医务人员为64.18%、68.51%和67.02%。鼠疫防治知识健康教育效果评估测试合格率分别为70.00%（35/50）、92.16%（47/51）和74.47%（35/47）。结论健康知识培训和宣传教育是必要的,可以强化干群健康意识,提高医务人员处置鼠疫突发疫情的能力。     

Influenza vaccination in healthcare workers; comparison of side effects and preferred route of administration of intradermal versus intramuscular administration

ObjectiveTo explore the nature and severity of side effects and future preference of intradermal versus intramuscular influenza vaccination in healthcare workers.DesignProspective cohort study.SettingTwo University Medical Centers in The Netherlands.ParticipantsHealthcare workers receiving an influenza vaccination.MethodsHealthcare workers that were vaccinated during the influenza vaccination season of 2012–2013 were approached for participation in a questionnaire study. The questionnaire was divided into two parts. The first part had to be answered directly after vaccination and the second part two weeks after vaccination. The motivation for vaccine uptake, whether or not the HCWs had direct contact with patients and the prevalence and severity of local and systemic side effects of influenza vaccination were explored. In addition, it was assessed how participants experienced the vaccination and which type of administration they preferred for future vaccination.ResultsSide effects of vaccination were more prevalent in the intradermal group versus the intramuscular group (56% versus 26%, p < 0.001). Local side effects were perceived as more severe in healthcare workers receiving the intradermal vaccine. Directly after vaccination, healthcare workers preferred the intradermal vaccination. Two weeks after vaccination both types of vaccine were equally appreciated.ConclusionsThis study shows that there are significant differences in the nature and severity of side effects upon intramuscular and intradermal influenza vaccination. This difference did not result in a preference among the vaccinated subjects for one type of vaccine.     

Brief communication: The Mid-South Clinical Data Research Network

The Mid-South Clinical Data Research Network (CDRN) encompasses three large health systems: (1) Vanderbilt Health System (VU) with electronic medical records for over 2 million patients, (2) the Vanderbilt Healthcare Affiliated Network (VHAN) which currently includes over 40 hospitals, hundreds of ambulatory practices, and over 3 million patients in the Mid-South, and (3) Greenway Medical Technologies, with access to 24 million patients nationally. Initial goals of the Mid-South CDRN include: (1) expansion of our VU data network to include the VHAN and Greenway systems, (2) developing data integration/interoperability across the three systems, (3) improving our current tools for extracting clinical data, (4) optimization of tools for collection of patient-reported data, and (5) expansion of clinical decision support. By 18 months, we anticipate our CDRN will robustly support projects in comparative effectiveness research, pragmatic clinical trials, and other key research areas and have the capacity to share data and health information technology tools nationally.     

Assessing quality of primary diabetes care in South Korea and Taiwan using avoidable hospitalizations

Quality of primary diabetes care is a key health policy concern in many OECD countries with an aging population. This cross-national, population-based study examined the extent and attributes of diabetes-related avoidable hospitalizations (DRAHs) in South Korea and Taiwan, both of which have social health insurance-based health systems with limited gate-keeping for hospitalizations. We analyzed comparable, nationally representative health insurance beneficiary datasets for the two countries (2002–2013), linked with community health resource data. The age- and sex-standardized DRAH rates were calculated, and multivariate, multi-level longitudinal modeling approaches were adopted. The DRAH rate decreased in Taiwan consistently during 2002–2013 and in Korea after 2011 only. Under the universal health coverage, people enjoyed high accessibility to care. A higher number of physician visits reduced DRAHs in Korea but not in Taiwan. Socio-economic disparities in DRAHs still existed in both countries, especially in Taiwan. We found a different trajectory in two similar health systems for the selected health system performance indicator for primary diabetes care. This can be partly explained by different policy approaches to diabetes management in the two countries over the years. Necessary are policy efforts to improve the quality and equality of primary diabetes care and better control of hospital admissions in these two health systems that provide generous access to care at a low cost in East Asia.