基于高通量测序中江丹参“发汗”过程中优势微生物群落与主要药效成分相关性研究

目的 探究中江丹参Salvia miltiorrhiza“发汗”过程中主要微生物群落及变化特征,以及优势微生物群落与主要药效成分之间的关系,以科学阐释传统“发汗”加工方式对中江丹参品质的影响。方法 采用高通量测序技术对“发汗”过程中江丹参的微生物多样性进行研究,结合化学品质分析,将优势微生物群落丰度与“发汗”丹参主要药效成分含量相关联,以期进一步判定“发汗”过程中影响中江丹参药材品质的主要微生物群落。结果 21个中江丹参“发汗”样品共检出221个真菌菌属,677个细菌菌属。“发汗”过程中始终存在的优势真菌有小戴卫霉属Davidiella、轮枝菌属Verticillium;优势细菌有绿菌门未归类菌属Chloroplast＿unclassified和根瘤菌属未归类菌属Mitochondria＿unclassified 2个未归类菌属,已知细菌有节细菌属Arthrobacter、链霉菌属Streptomyces等。同时,相关性研究表明,真菌小戴卫霉属与样品中紫草酸含量呈显著负相关;子囊菌门未归类霉属Ascomycota＿unclassified与丹参酮ⅡA含量呈显著正相关。细菌绿菌门未归类菌...     

县域医共体总额预付激励效应的影响因素研究——基于24个案例的清晰集定性比较分析

目的：发现影响制约医共体医保总额预付改革激励效应的因素,为促进县域医共体医保总额预付改革提供研究证据。方法：以样本地区医共体医保总额预付政策文本及其激励效应为研究对象,采用清晰集定性比较分析方法揭示医共体医保总额预付模式的设计要素与其激励效应之间的因果关系。结果：超支分担、购买服务范围、结算方式是影响医共体医保总额预付方案激励效应的决定性因素。结论：采取供方承担超支风险、购买服务范围包含县域外医疗服务和预付制结算方式的设计,有利于提高医共体医保总额预付模式的激励效应。     

我国居家社区医养结合服务人力政策分析

目的：分析我国居家社区医养结合政策中人力政策的特征和不足,为完善医养结合人才队伍提供政策建议。方法：以我国国家级部门2013年1月—2021年9月发布的31份居家社区医养结合人力政策为样本,借鉴人力资源管理六模块构建分析框架对政策文本内容进行分析。结果：我国居家社区医养结合人力政策协同性较好,系统性、可操作性不足;政策措施偏重于人才开发环节,人才引进、保障和流动环节适中,人才激励政策不足;居家社区医养结合人力的相关规定融合在医养结合人力政策框架下,缺乏专门性、针对性的政策。结论：需进一步细化完善配套政策,制定居家社区医养结合人力相关的专门性政策,并不断完善人才激励政策。     

低血糖生成指数膳食对糖调节受损患者的影响

目的:探讨低血糖生成指数(low glycemic index,LGI)膳食干预对社区糖调节受损(IGR)患者血糖和血脂代谢的影响。方法:选取广州市人民街18个居委会,随机分为对照组和实验组,每组各9个居委会,每组随机选取IGR患者38例。在接受GI知识教育后,实验组采取LGI膳食干预8个月,观察患者的血糖、血脂的变化。结果:膳食干预后,实验组空腹血糖、餐后2 h血糖、糖基化血红蛋白、甘油三酯、总胆固醇、低密度脂蛋白和胰岛素抵抗水平均显著低于对照组,高密度脂蛋白胆固醇显著高于对照组。结论:在社区糖尿病防治工作中,采取低GI膳食可有效地控制IGR患者的血糖、血脂水平,降低胰岛素抵抗。     

Rural and remote oral health, problems and models for improvement: a Western Australian perspective

Oral healthcare in rural communities shares many of the dilemmas faced by medicine in providing services to large geographical areas with dispersed populations. This study examined the population data and service provision data relevant to the geographical distribution of oral health care in Western Australia (WA). Of the 1.7 million people resident in WA, 72% were resident in the five major urban centres with only 13% in rural and remote regions. Of the 320 postcode regions, 186 had a population of less than 2500, 31 had a population from 2500 to 5000, 42 from 5000 to 10 000, 37 from 10 000 to 20 000, and 24 had a population greater that 20 000. Almost 80% of postcode regions with a population less than 2500 are in non-urban regions. Of the total of 690 dentists who were analysed in this study, it was found that the vast majority (greater than 85%) worked in practices in postcode regions within metropolitan Perth or the major urban centres. A total of 43 postcode regions did not have a dental practice within their bounds. In order to address this disparity in service availability, strategies including the development of training for medical practitioners and auxiliaries, the use of modern technology, school-based programs and the development of interdisciplinary links should be implemented. These strategies would also facilitate the development of closer links between medical and dental practitioners and the development of skills within the medical fraternity that would facilitate improved oral health in rural and remote communities.     

Strengthening primary health care: building the capacity of rural communities to access health funding

ABSTRACT: Present health funding models can place onerous pressures on rural health services. Staff may lack the time, resources, access to data, and the expertise needed to complete complex and lengthy funding submissions. This present study describes an innovative capacity-building approach to working with Victorian rural communities seeking to access health care funding through the Regional Health Services Program. This approach used several strategies: engaging stakeholders in targeted rural communities, developing an information kit and running a workshop on preparing submissions to the Regional Health Services Program, facilitating community consultations, and providing ongoing support with submissions. Six rural communities were supported in this way. Four have been funded to date, with a combined annual recurrent budget for new primary health care services of over $2.5 million. Each community has developed a service delivery model that meets the particular needs of their local area. This capacity-building approach is both effective and replicable to other health funding opportunities.     

Prioritising home care needs: research with older people from three ethnic minority community groups

This paper draws on research with three minority ethnic community groups in Manchester. The aim of the study was to examine and prioritise social care needs. Focus groups were chosen as a way of beginning discussion about these issues. The findings suggest that some quality issues are relevant to all communities of older people. However, some were specific to the community groups. This paper describes some of the lessons learned about running focus groups with people whose first language is not English and suggests some considerations for future research.