Results of a French pilot database of standard of care of chronic subdural hematoma

BackgroundA registry of chronic subdural hematoma does not exist in France yet.ObjectiveTo present a monocentric pilot project of a French registry of surgical management of chronic subdural hematoma.MethodA monocentric pseudonymized formal database was created. From May 2020 to May 2021, all patients undergoing surgical evacuation of chronic subdural hematoma were entered into the database.ResultsOne hundred and twenty four surgeries from 113 patients were entered in the database. Patients’ demographic and surgical data as well as follow-up are described.ConclusionA local database is easy to implement. We propose a national registry of chronic subdural hematoma management.     

神经外科术中获得性压力性损伤的预防护理专案

目的 降低神经外科术中获得性压力性损伤发生率。 方法 将2019年10～12月的1 378例神经外科择期手术患者作为对照组,采取常规护理措施预防术中获得性压力性损伤。将2020年10～12月的1 551例患者作为观察组,成立护理专案小组,开展多学科协作,实施护理专案改善。 结果 观察组术中获得性压力性损伤发生率为0.90%,对照组为2.18%,两组比较,差异有统计学意义（P＜0.05）;两组术中获得性压力性损伤治愈率比较,差异无统计学意义（P＞0.05）。观察组预防术中获得性压力性损伤关键监测指标落实率较好,除术后规范交接班落实875例（61.40%）外,其他指标均＞88.00%。 结论 多学科协作护理专案能够有效降低术中获得性压力性损伤发生率,提高术中获得性压力性损伤预防和管理质量。     

高新技术在医学领域的应用

就21世纪高新技术在医学领域的应用情况作一阐述。     

Implementing healthcare information systems – Mirroring a wide spectrum of images of an IT project

The main purpose of this paper is to discuss the spectrum of interpretations that can be related to the implementation and use of a healthcare information system (HIS). The empirical part of this paper is based on a qualitative case study of a Swedish healthcare provider, called “Alpha”, where a HIS was implemented. By studying how different actors interpret technological and organizational changes in a healthcare case, we mirror different images of the implementation project. Put together, this diversity of images provides an illustration of the complexity associated with the process of implementing a HIS. We apply an adjusted version of Orlikowski's practice lens, with its roots in Structuration Theory, in order to study technology in organizations (focusing inertia, application and change). The implementation process of a HIS is much too complex to be judged as being either entirely positive or negative; instead it offers an illustration of the multi-faceted and reciprocal relation between IS and organization. This challenge literature on critical success factors. This study illustrates several images of HIS implementation and use. Highlighting images is one way to illustrate reluctance, support, complexity and power that are present in HIS implementation and use. This is one important contribution from this article. The complexity in the implementation is linked to healthcare organizations as professional bureaucracies, being highly politicized and institutionalized and to the IT artefact as an integrated HIS. Viewing images as rational myths is also discussed in this paper as an original approach to understand HIS implementation.     

Mental health service users’ experiences of an education intervention based on a European Union project: A comparison between nine European countries

Mental health service users (MHSUs) often face difficulties in achieving successful participation in education; however, the tools that could help them succeed are rarely investigated. This study aimed to illuminate the experiences of MHSUs in an education intervention based on a European Union (EU) project. Their experiences are compared across nine EU countries. The data were collected through individual interviews with MHSUs (n = 47) at day activity centres that provide mental health services. An inductive content analysis was used as the method of analysis. Three main categories, which include seven subcategories, are revealed by the analysis. The main categories are as follows: (i) the factors related to MHSUs’ educational preparedness, (ii) the dimensions of the learning environment, and (iii) the effects of training intervention. The MHSUs’ experiences with the education intervention were similar across all countries. The findings showed that this education intervention is a multidimensional process. It contains social, mental, and physical dimensions linked to a learner and learning environment. These dimensions influence the MHSUs’ ability to participate in the education process. At its best, the education intervention supports the personal growth of MHSUs and prepares them for social integration. An education intervention can be a usable tool in the rehabilitation of MHSUs if the multidimensional nature of education is taken into consideration. Therefore, designing and executing education interventions requires the attendance of the MHSUs in cooperation with mental health and education professionals. Our findings suggest a tentative framework that can be used in designing and executing education for MHSUs.     

北京中关村地区1984—2000年急性冠心病事件的流行病学研究

目的:了解中关村地区25～74岁人群1984—2000年急性冠心病事件发病率的分布特点、变化趋势及可能的影响因素。方法:依照北京MONICA研究中心的研究方案,1984—2000年在北京中关村地区对25～74岁近4万人群开展了心血管病危险因素及发病、死亡的监测工作。以中关村地区资料为依据,按年度、性别、年龄分别计算急性冠心病事件发病率的变化趋势。结果:1984—2000年中关村地区急性冠心病事件发病率呈轻度上升变化,但无统计学意义。男性合计发病率为128.5/10万,大于女性51.4/10万;其差异有统计学意义(P<0.01)。研究初期与研究末期相比,男性65～74岁组每10万人群发病率的绝对增加幅度最大,差率为307.8/10万,男性55～64岁组发病率相对增加幅度最大,差率为211%,均有统计学意义。医疗救助率为73.6%,高于北京市平均水平。发病集中在冬、春季,占总发病人数的58%。结论:中关村地区中老年男性急性冠心病事件发病率呈显著上升,应加强这一人群冠心病防治工作。