The transition from children's to adult diabetes services: understanding the ‘problem’

Aims The importance of getting transition right for young people with diabetes is increasingly recognized and a strong professional consensus has emerged on best practice in this domain. Research evidence to inform the design of transitional healthcare services is weak, however, and prevailing views about ‘the problem of transition’ are based on a number of assumptions about adolescence, adulthood and chronic disease management which have been accepted uncritically. Methods Drawing on youth studies and the sociology of chronic disease management, in this paper we describe how ‘the problem of transition’ has been defined in the professional and UK policy literature and examine the assumptions that underpin it. Results We argue that the overwhelming emphasis is on how best to support young people in fitting in with the healthcare system. This has produced an orientation which is more concerned with supporting young people in the process of becoming adults rather than giving attention to their contemporaneous experiences and needs. Two years after the introduction of the UK National Service Framework for diabetes, the challenge of transitional services remains. Conclusions We suggest that the time has come to consider alternative formulations of the ‘problem’. Rather than asking how best to manage transition, we might ask how best to meet the needs of young people with diabetes at this stage of the life course. This requires an understanding of their experiences, the social networks in which they are embedded and consideration of how self‐management might be supported by the healthcare system.     

论医院卫勤应急指挥系统组成及其重要性

根据信息化战争理念,为使医院卫勤分队在战时、灾时能果断作出决策,配合部队的行动,医院参考现代战役中对医疗保障的要求,从评估、决策、部署、分配、信息交换等方面设计一套完整、迅速、有效的应急指挥系统,提高对人民生命财产的安全保障能力。     

玉林师范学院大学生因病休退学情况调查

目的了解玉林师范学院大学生因病休退学情况,为学院医院做好预防保健工作提供科学依据。方法对玉林师范学院2006—2010年5年来学生因病休退学情况进行分析。结果 2006—2010年玉林师范学院大学生因病休退学率平均为1.22‰,男生为1.32‰,女生为1.16‰。休退学学生以一、二年级学生为主。造成学生体退学的病因以精神类疾病、传染性疾病为主,分别占60.00%、25.33%,精神类疾病有逐年增加趋势,传染性疾病明显减少。结论应加强对大学生的心理卫生保健工作,继续做好传染病的防控工作,以降低大学生因病休退学率。     

Development and testing of a sustainable environmental restoration policy on eradicating the poverty trap in China's Changting County

It is widely accepted that environmental degradation and poverty are linked and that conservation and poverty reduction should be tackled together. However, success with integrated strategies has been elusive. Here, we present the results of a study that illustrates how development that combines environmental and economic perspectives and that provides appropriate compensation to affected populations can improve both nature and society, thereby eradicating the “poverty trap.” The results show that if we cannot improve the livelihood of local residents, we will be unable to restore degraded environments when state-owned property is transferred to private ownership to encourage better management by residents. In contrast, measures to eliminate poverty, combined with the development of green enterprises that improve the livelihoods of private land owners in the long term, is the precondition for successful ecological restoration.     

改革护理工作模式对提高优质护理服务的效果

目的探讨改革护理工作模式对提高优质护理服务的效果。方法选择2009年6-12月本院心血管内科收治的120例病人为对照组,选择2010年1-6月同科室的120例病人为实验组。对照组采用传统护理模式对病人实施护理,实验组采用改革后的护理工作模式对病人实施护理。比较两组病人日均输液呼叫铃声次数、护士到位时间、病人对护理工作的满意度及健康教育知晓率。结果实验组日均输液呼叫铃声少于对照组,护士到位时间短于对照组,病人对护理工作的满意度及健康教育知晓率高于对照组(均P<0.05)。结论改革护理工作模式,推行责任制护理和开展床边工作制,能更好地为患者提供连续、全程的优质护理服务,增强了护士的责任感,密切了护患关系,提高了病人对护理工作的满意度。     

滤筒式可移动除尘器净化效率测定探讨

[目的]对移动武除尘器的净化效率进行测定,为建设项目职业病危害控制效果评价中对卫生工程防护措施的效果量化评价提供技术支撑.[方法]测量除尘器进风口的静压和动压,测量现场的温度和气压,测量除尘器进出口面积,用自动烟尘烟气测试仪采集烟尘样品,测定除尘器进出口烟尘浓度,计算出移动武除尘器的净化效率.[结果]测定的两种移动武除尘器净化效率分别为92.3％和93.4％.[结论]评定除尘净化效率时,由于含尘气量、粉尘成分、粉尘浓度等的变化,实测值与除尘器标称的除尘净化效率之间可能产生较大偏差.用分级除尘净化效率表示,可以减少此偏差.     

三级医院护理人员服务意识相关因素的调查分析

目的了解护理人员的服务意识现状及相关因素，为制定相应的措施提供理论依据。方法采用问卷调查法，调查258名三级医院护理人员的服务意识及其相关因素。结果81.01％的护理人员服务意识较好；与服务意识呈正相关的因素是组织承诺、专业认同、工作满意度，呈负相关的是角色模糊、工作压力、角色冲突；不同职称、是否有离职倾向的护士服务意识差异具有统计学意义（P〈0．01）；回归分析显示，组织承诺（P〈0．01）和角色模糊（P〈0.05）是服务意识的主要预测因素。结论护士的服务意识较好，影响服务意识的因素是多方面的，尤其是组织承诺和角色模糊，管理者应采用相应的措施来增强护理人员的服务意识，以提高护理质量。     

ASSOCIATION BETWEEN HIP EXTENSION STRENGTH AND STAND-UP ABILITY IN GERIATRIC PATIENTS

Difficulty in rising from the seated position is a serious and frequent problem for elderly patients. Among the factors that may contribute to this difficulty are: pain, level of awareness, loss of joint motion, lose of neuromuscular control, loan of balance control, and muscle weakness. The importance of this last factor is not well documented in the geriatric population. This clinical pilot Study investigated the association between hip extension strength, when measured in the .seated position, and the ability to stand up in 58 nursing home patients, ages 44 to 98 yearn. Strength wan measured by a modified manual muscle test and stand-up ability wan determined by the commonly used clinical scale of assistance, maximal, moderate, minimal, and independent. The association between these two ordinal classification was found by a Chi square test to be statistically significant P < 0.01. This result is somewhat surprising because the significant association was found even though many of the patients had a diagnosis of CVA and/or OBS. The clinical implication is that hip extension muscle strength is an important factor in standing up. Thus, it may be an important target area for treatment remediation.     

Compulsory mourning

The bold decision was taken in Afghanistan in 2002 to provide donor-funded public health services by means of contracting-out of predefined health care packages. This study seeks to identify the extent to which progress has been made in public health services provision in the context of broader state-building agendas. The article argues that the provision of public health services was also intended to generate a peace dividend and to legitimize the newly established government. The widely portrayed success of the contracting model is backed up by very high official figures for health service coverage. This contrasts with evidence at household level, which suggests limited utilization of public health services, and perceptions that these offer inferior quality, and a preference for private providers. The dissonance between these findings is striking and confirms that public health care cannot remain immune from powerful market forces, nor from contextual determinants outside the health field.