利用早死所致生命损失年评价大兴县人群的主要卫生问题

目的 利用死因监测资料寻找大兴县人群的主要卫生问题。分析各死亡评价指标的不同。方法 采用死亡率和死因构成,潜在寿命损失年（PYLL）,早死所致生命损失年（YLLs)指标分别进行死因顺位。结果 按死因构成排序,前五位死因为脑血管病,心脏病,恶性肿瘤,呼吸系病,损伤中毒;按PYLL排序前五位死因为损伤中毒,脑血管病,恶性肿瘤,心脏病,呼吸系病;按YLLs排序前五位死因为脑血管病,损伤中毒,心脏病,恶性肿瘤、呼吸系病。结论 大兴县的主要卫生问题为损伤中毒和慢性非传染性疾病;全面地评价一个地区的主要卫生问题,须将各种统计指标综合分析。     

出院记录质量专项检查问题分析及对策

目的对住院病案的出院记录部分存在的问题进行分析,提出相应对策以提高病案质量。方法依据国家卫生部颁发的《病历书写基本规范（试行）》的有关规定,结合我院病历书写要求对613份归档病案进行出院记录质量的专项检查,检查包括出院记录中的一般情况、入院情况、入院诊断、诊疗经过、出院情况、出院后注意事项以及医师签名等共12项内容。结果问题较多的是出院时无专科检查的占73.90%,出院诊断与病案首页、入院记录中的最后诊断不一致的现象占33.44%。结论通过出院记录专项检查,更加体现出病案质量检查从形式检查重心向诊疗行为干预检查转移的重要性,从而进一步提升病案质量控制的内涵。     

Sexual Sensation Seeking,Sexual Compulsivity,and Gender Identity and Its Relationship With Sexual Functioning in a Population Sample of Men and Women

IntroductionDespite awareness of the importance of psycho-affective factors in the development of sexual problems, there is a lack of studies exploring the relation of sexual sensation seeking (SSS) and sexual compulsivity (SC) to sexual functioning. Because sex differences in SSS and SC have been reported, gender identity (GI; an individual’s own experience of his or her gender that is unrelated to the actual biological sex) might act as a moderator in this relation.AimTo understand the role of SSS and SC for men and women's sexual functioning and to explore whether these potential associations are moderated by GI.MethodsA population-based cross-sectional online survey targeted 279 individuals (69.2% women, 30.8% men; mean age = 32 years). Validated questionnaires, including the Sexual Sensation Seeking Scale, the Sexual Compulsivity Scale, the Female Sexual Function Index, the Premature Ejaculation Diagnostic Tool, and the International Index of Erectile Function, were applied.Main Outcome MeasuresVariations in SSS and SC and their association with sexual functioning were investigated using Spearman rank correlation. Moderation analyses were conducted using regression models in which the interaction terms between SSS and GI and between SCS and GI as predictors of sexual functioning were included.ResultsA statistically significant correlation between SSS and SC could be detected in men and women (r = 0.41 and 0.33, respectively; P < .001 for the two comparisons). In women, higher levels of SSS were associated with higher levels of desire, arousal, lubrication, and orgasm and less sexual pain (P < .05 for all comparisons). No moderating effect of GI could be detected. In men, GI was a significant moderator in the relation between SC and erectile function (β = 0.47; P < .001) and between SSS and erectile and ejaculatory function (β = −0.41 and 0.30; P < .001 for the two comparisons).ConclusionThe present study is the first to show a link between SSS and SC and sexual functioning. The results might have important clinical implications and can provide useful information for programs aimed at sexual health enhancement.     

医学影像本科实习现状分析及改进措施探讨

分析医学影像本科临床实习现状及存在的问题,并就改进措施进行探讨,包括强化岗前培训,加强基础知识学习、临床基本技能的培训,实行专人负责制,实行动态监控管理等,以提高实习生的临床技能,促进高层次医学影像人才的培养。     

计算机打印病案存在的问题及改进措施

目的电子病案将是未来医院现代化发展的必然趋势。在现阶段,由于电子病案的法律效力尚未得到认可,故绝大多数医院仍采用计算机书写并打印纸质病历存档的做法。本文就计算机打印病历中存在的问题以及采取的管理措施进行分析,旨在提高病案的管理质量,保证病历的真实性、准确性、及时性。     

The Role of Socioregional Factors in Moderating Genetic Influences on Early Adolescent Behavior Problems and Alcohol Use

Background: Twin and family studies have demonstrated that adolescent alcohol use and behavior problems are influenced by a combination of genetic and environmental factors. More recently, studies have begun to investigate how genetic and environmental influences may interact, with efforts underway to identify specific environmental variables that moderate the expression of genetic predispositions. Previously, we have reported that community‐level factors, including urban/rural residency, migration rates, and prevalence of young adults, moderate the importance of genetic effects on alcohol use in late adolescence (ages 16 to 18). Here, we extend these findings to test for moderating effects of these socioregional factors on alcohol use and behavior problems assessed in a younger sample of adolescent Finnish twins. Methods: Using data from the population‐based Finnish twin study, FinnTwin12, biometric twin models were fit to data on >1,400 twin pairs to examine the significance of each of the socioregional moderating variables on alcohol use measured at age 14, and behavior problems, measured at age 12. Results: We find no evidence of a moderating role of these socioregional variables on alcohol use; however, there was significant moderation of genetic influences on behavior problems, with effects limited to girls. Genetic influences assumed greater importance in urban settings, communities with greater migration, and communities with a higher percentage of slightly older adolescents. Conclusions: The moderation effects observed on behavior problems in early adolescence paralleled the effects found on alcohol use late in adolescence in an independent sample, providing further support for the idea that behavior problems may represent an earlier manifestation of the predisposition to subsequent alcohol problems. Our findings also support the growing body of evidence suggesting that females may be more susceptible to a variety of environmental influences than males.     

福州市台江区398名低年级中学生的心理健康状况及其影响因素

目的通过对福州市台江区在校低年级中学生心理健康状况的调查研究,为学校采取适当的心理干预提供科学依据。方法采用长处与困难问卷（学生版）对398名学生进行问卷调查。结果福州市台江区中学低年级学生常见的心理行为问题为多动注意不能和同伴交往问题;不同年级、性别、学习成绩、同伴关系和师生关系的学生心理健康状况显著不同。结论学校及家长应重视中学低年级学生的行为和情绪表现,针对可能的影响因素采取相应措施,以促进其健康成长。     

Methodological problems related to alcohol research among Turks and Moroccans living in the Netherlands: findings from semi-structured interviews

Objectives. To identify factors related to alcohol use among Turks and Moroccans living in the Netherlands. Furthermore, to reveal methodological problems related to research among Turks and Moroccans in general and to alcohol research among these groups in particular.

Design. Individual face‐to‐face interviews were carried out with Dutch researchers (n=9), Turkish and Moroccan (health) practitioners working in the field with Turks (n=4) or Moroccans (n=2), and members of the target population with a Turkish (n=3) or a Moroccan background (n=2). Furthermore, focus‐group interviews were held with Turkish women (n=4), Turkish men (n=3), Moroccan women (n=4) and Moroccan men (n=3) working as health professionals.

Results. Alcohol use seems prevalent particularly among second‐generation Turks and Moroccans and is related to: upbringing, influence of peer groups, integration and the degree in which Islamic rules are practised. Written questionnaires seem more appropriate for second‐generation Turks and Moroccans, because they have fewer language problems and are more familiar with Western bureaucratic society. However, both generations may prefer face‐to‐face interviews since both groups fear that ‘written’ answers about the sensitive subject ‘alcohol use’ may somehow become known among community members. Similarly, an interviewer with a Dutch background may elicit more reliable answers about alcohol use than an interviewer with a Turkish or Moroccan background.

Conclusion. In alcohol research special attention should be paid to second‐generation Turks and Moroccans. Although it is probably easier to conduct alcohol studies in this group than in first‐generation Turks and Moroccans, quantitative research is needed to test the hypothesis that written questionnaires elicit more reliable answers about alcohol use than face‐to‐face interviews. Furthermore, the influence of ethnic matching on response and data quality should be tested further.     

医院传染病疫情网络直报中存在的问题与对策

目的探讨医院传染病疫情网络直报的质量管理. 方法通过对非典之后400余例医院传染病疫情网络直报病例的分析,找出影响网络直报工作质量的因素. 结果诊断标准、报告时限和疫源地址是影响网络直报质量的主要因素. 结论加强对医院传染病疫情网络直报的诊断标准、报告时限、以及疫源地址等重要环节的质量管理才能提高疫情报告工作的质量.     

我国公共卫生服务系统的历史沿革和存在的问题

目的为我国公共卫生服务系统建模与模拟提供研究基础。方法通过对我国公共卫生服务系统的历史沿革分析,探讨我国公共卫生服务系统发展历程、运行模式、补偿方式方面的情况,应用层次分析、文献归纳法,逻辑归纳出公共卫生服务系统存在的问题,并进一步明确存在的焦点问题。结果公共卫生服务系统的财政投入不足,各类公共卫生服务机构不得不依靠自身业务收入弥补服务支出,补偿方式转变为财政投入和业务收入两大部分。在客观上影响了公共卫生服务系统功能的落实,导致公共卫生服务系统整体绩效欠佳。结论国内的各类研究尚缺乏系统性和针对性,对公共卫生服务系统的焦点问题把握欠缺,系统总结归纳我国公共卫生服务系统的问题,有利于下一步继续建模与模拟。