ABX MICROS 60-OT型血细胞分析仪的性能评价

目的　评价ABXMICROS 60 -OT(以下简称ABX -60 )血细胞分析仪的分析性能 ,推广临床应用。　方法　用EDTA -K2静脉抗凝血标本连续测定和每天随机插入常规标本测定及稀释法分别测定ABX -60的精密度 ,携带污染率和线性性能 ,并与COULTERJT -IR结果进行比较。　结果　ABX -60的批内和批间精密度的变异系数均 <5 ,病人标本测定携带污染率均≤ 0 4% ,对白细胞、红细胞、血红蛋白、血小板测定结果与COULTERJT -IR比较有良好的相关性。　结论　ABX -60是一种较为理想的中档血细胞分析仪 ,适合中心型单位使用。     

《江西医学院学报》五年引文分析

对1986年－1990年《江西医学院学报》的引文进行了数理统计与分析，定量描述其引文的类型，文种，时序以及在被引期刊中的分布。测定了该刊引用文献的半衰期与核心期刊，并对论著及著者分布作了分析。     

The future of cardiovascular imaging and non-invasive diagnosis

Advances in medical imaging now make it possible to investigate any patient with cardiovascular disease using multiple methods which vary widely in their technical requirements, benefits, limitations and costs. The appropriate use of alternative tests requires their integration into joint clinical diagnostic services where experts in all methods collaborate. This statement summarises the principles that should guide developments in cardiovascular diagnostic services.This paper is published simultaneously in the European Heart Journal (2006;27:1750–1753) and in the European Journal of Echocardiography (2006;7:268–273).     

Self-selection of enrollers at the creation of a managed care organization

Factors affecting choice between a managed care organization(MCO) and a fee-for-service insurance plan were examined whenthe University of Geneva health insurance plan was transformedinto an MCO, in October 1992. A case-control study using a mailedquestionnaire (response rate 84%) was conducted to compare formermembers who joined the MCO (joiners, n=421) to former memberswho opted out in order to keep fee-for-service coverage (non-joiners,n=222). Non-joiners were more likely to be women (odds ratio(OR) from multivariate model was 1.15, p=0.50), to be born inSwitzerland (OR=2.04, p<0.01), to have an annual income >75,000Swiss francs (OR=2.00, p<0.01), to have a personal physician(OR=1.96, p<0.01) and to have consulted a specialist (OR=1.69,p=0.02) or used unconventional medicine (OR=4.59, p<0.01)in the past year. During the previous year, non-joiners hadmore health care visits than joiners (14.6 versus 9.1, p=0.01).Non-joiners reported better mental health and fewer complainedof persistent fatigue (OR=2.18, p=0.03). The choice of healthplan was strongly influenced by socio-demographic characteristics,past patterns of health services utilization and health status.The self-selection process was paradoxical: MCO joiners hadused fewer health care visits than non-joiners, but their self-reportedhealth status was worse. The differences we have observed betweenself-selected populations have important implications for thefinancial performance of competing health care delivery systems.     

上海地区学生午餐营养及供应链状况研究

目的 了解上海地区学生午餐营养及供应链状况，为改善学生午餐营养状况，保障食品供应安全提供参考。方法 分析上海市学生午餐的营养、卫生、供应链、加工工艺等状况，采用定期抽检的方法，应用SNHAS对营养素、食品安全、感官进行综合评价。结果 各单位样本综合评价均合格，其中热量、蛋白质、脂肪均能达到或超过DRIs供给量的要求，但矿物质中Ca(仅为AI的32％)、视黄醇当量(仅为AI的57％)供给量较低。对供应链及卫生状况的分析表明，大型企业对各个环节控制严格，产品质量较好，但也存在保存时间过长等问题。结论 应进一步完善供应体系，建立高效的质量控制体系，推广营养配膳系统。     

示范区创建活动与社区卫生服务长效机制的建立和可持续发展对策的思考

通过第三方评估全国社区卫生服务示范区是我国社区卫生服务发展史上的一大创举。此项活动的开展,极大的提高了各地政府对发展社区卫生服务的思想认识、政策理解和经费投入力度。通过创建和评估活动,系统总结了各申报地区社区卫生服务的经验和特色,分析了存在的问题和不足,提出了发展社区卫生服务的对策和建议,制定了社区卫生服务可持续发展的长效机制,取得了预期效果,达到了预期目的。随着《国务院关于发展城市社区卫生服务的指导意见》的出台,示范区的典型示范效应会日益凸显出来,对我国社区卫生服务的发展将起到不可估量的作用。     

Developing policy in the provision of parenting programmes: integrating a review of reviews with the perspectives of both parents and professionals

Background   Parenting programmes are a key component of the delivery of children's services, but evidence-based policy has often proved difficult to implement.
Methods   The present review addressed this issue by integrating a review of systematic reviews of parenting programmes and a series of focus groups with parents and professionals involved in parenting across three agencies in a regional area (health, education and social work). The review summarizes parenting interventions targeting infant mental health, emotional and behavioural difficulties, autism spectrum disorder and attention deficit hyperactivity disorder, abuse/neglect, alcohol/substance abuse and 'vulnerable' parents. The focus groups discussed topics such as the range of parenting services across the three agencies, accessibility, gaps in the service and future directions.
Results and conclusions   Twenty systematic reviews were summarized. These reviews demonstrated that there is a wide range of parenting programmes available that have the potential to benefit families who are affected by problems ranging from emotional and behavioural difficulties to adolescent substance abuse. However, the findings of the focus groups reveal that the success of these programmes will depend in part on how they can be tailored to meet the social context of the families targeted. These integrated findings are discussed in terms of their implications for policy and practice.     

'Jumping through hoops': parents' experiences with seeking respite care for children with special needs

Background   Respite care may act as a means to reduce stress and fatigue in people caring for a dependent who has a disability. Despite this, a variety of barriers may exist to obtaining such services. This study explored caregivers' experiences seeking respite care for their children with special needs within a province in Canada.
Methods   Caregivers were recruited from two agencies providing respite care for children with fetal alcohol spectrum disorders and other mental health and developmental difficulties. In total, 10 caregivers participated in in-depth individual interviews. A constructivist grounded theory approach was employed in the design and analysis of the data.
Results   Caregivers discussed their frustrations with the process of finding and obtaining respite care, a course of action described as 'jumping through hoops'. This construct was composed of subcategories emphasizing the complexity of 'navigating the system', the bidirectional process of 'meeting the requirements' and the challenges of 'getting help'.
Conclusions   The collective experiences of these caregivers point to the need for more flexibility and co-ordination of respite care services for children with special needs.     

To market! To market! A new dawn for community care?

The public sector in Britain has been subjected to over a decade of major reform aimed at breaking up public service monopolies, at containing costs while at the same time opening services up to greater consumer choice. Health and social services have not been exempt from this revolution in the organization and management of public sector services. The long-standing policy of care in the community is being subjected to market principles and the introduction of a ‘contract culture’ very similar to the NHS reforms introduced in 1991. This paper reviews the origins of these developments in the doctrines of ‘new public management’, a movement which has proved attractive to policy-makers in many countries. Local authority social services departments have been identified as the lead agency for the development of a mixed economy of care following a review of community care policy by the government's health adviser, Sir Roy Griffiths, and a subsequent white paper. This paper examines the limited empirical evidence available on how managers and providers are meeting the challenge bestowed upon them, and concludes that most authorities are moving ahead cautiously if at all. Only a handful of authorities studied have embraced the reforms with any degree of enthusiasm. The paper concludes with an assessment of the reforms from two perspectives: a pessimistic one and an optimistic one. There are many worrying features of the reforms, not least among these being a lack of clarity over their intended purpose. Tensions and contradictions are plentiful, which places in jeopardy the certainty of the reforms in becoming user led rather than provider driven. A more optimistic scenario is that the changes are leading to a loosening up of services and practices which have often suffered from sclerotic tendencies, paternalism and sometimes complacency. If the reform process is skilfully handled and not rushed and if the ends are clearly established and communicated then users and carers could prove to be the principal beneficiaries.