家庭正向行为支持方案的构建及应用研究

目的构建家庭正向行为支持(positive behavior support,PBS)方案,并探讨其在学龄前恶性肿瘤患儿情绪行为影响中的应用效果。方法以家庭系统理论为框架构建家庭PBS方案,选取2019年3月—2020年2月于重庆市某三级甲等儿童医院就诊的100例学龄前恶性肿瘤患儿为研究对象,采用随机数字表法分为试验组(n=50)和对照组(n=50)。试验组在常规护理基础上接受为期3个月的家庭PBS方案,对照组实施常规护理。比较两组干预前后家庭亲密度与适应性量表得分、养育心理灵活性问卷得分及长处与困难问卷得分。结果两组干预后长处与困难问卷得分低于干预前(均P<0.001),家庭亲密度与适应性量表得分高于干预前(均P<0.001);试验组干预后养育心理灵活性问卷得分高于干预前(P<0.001);干预后试验组长处与困难问卷得分低于对照组(P<0.001),家庭亲密度与适应性量表得分和养育心理灵活性问卷得分高于对照组(均P<0.05)。结论应用家庭PBS方案可减少学龄前恶性肿瘤患儿情绪行为问题的发生,改善家庭亲密度与适应性,提高父母养育心理灵活性。     

Sleep problems in early childhood and early onset of alcohol and other drug use in adolescence

BACKGROUND: No prospective studies exist on the relationship between sleep problems early in life and subsequent alcohol use. Stimulated by the adult literature linking sleep problems to the subsequent onset of alcohol use disorders in some adults, we examined whether sleep problems in early childhood predicted the onset of alcohol and other drug use in adolescence and whether such a relationship was mediated by other known predictors of this relationship, namely, attention problems, anxiety/depression, and aggression in late childhood. METHODS: This study is part of an ongoing longitudinal study of the development of risk for alcohol and other substance use disorders. Study participants were 257 boys from a community-recruited sample of high-risk families. RESULTS: Mothers' ratings of their children's sleep problems at ages 3 to 5 years significantly predicted an early onset of any use of alcohol, marijuana, and illicit drugs, as well as an early onset of occasional or regular use of cigarettes by age 12 to 14. Additionally, although sleep problems in early childhood also predicted attention problems and anxiety/depression in later childhood, these problems did not mediate the relationship between sleep problems and onset of alcohol and other drug use. CONCLUSIONS: This is, to our knowledge, the first study that prospectively examines the relationship between sleep problems and early onset of alcohol use, a marker of increased risk for later alcohol problems and alcohol use disorders. Moreover, early childhood sleep problems seem to be a robust marker for use of drugs other than alcohol. Implications for the prevention of early alcohol and other drug use are discussed.     

某院药品采购过程存在的问题及其对策

目的为药品采购管理提供依据。方法本文对我院长期以来药品采购管理过程中存在的问题进行分析及总结。结果可通过加强药品采购平台硬件建设及维护、加强沟通及协调、加强人血白蛋白的临床应用管理、建立有效的临时用药采购管理体系等措施来规范和完善药品采购工作。结论药剂科应制定药品采购管理制度,有计划的制定采购计划,保障药品质量,汇总药品采购过程中遇到的各种问题,总结经验,全方位为临床和患者提供安全、质优、价格合理的药品。     

当前我省新版GMP认证存在问题及对策研究

目的了解我省药品生产企业新版GMP认证现场检查缺陷项目情况,找出企业实施新版GMP存在主要问题,提出加快推进我省药品生产企业实施GMP的对裳和建议。方法对我省2011年5月～20134-6月认证的16家企业的缺陷项目进行汇总,对主要问题进行分类、归纳。结果与结论应严格执行规定,注重源头设计,加大培训力度,建立专职检查员队伍,妥善处理善后问题,确保新DKGMP得到正确贯彻实施。     

浅析医疗设备维修中存在的问题

随着现代医学的迅猛发展,各类先进的医疗设备不断进入医院,医疗设备在现代临床诊疗活动中有着举足轻重的作用。在迅速更新各类医疗设备的同时,与之配套的设备维修工作也越来越频繁而重要。维修工作直接影响着设备的使用及医疗技术的应用,并能直接或间接影响医院的经济效益等现实问题,然而在对医疗设备的维修中还存在着各种各样的问题,严重制约着维修效率,影响着医疗技术的应用。本文结合多年维修工作实际分析了医疗设备维修中存在的问题,并提出了相应的解决措施,对医院医疗设备维修的发展具有借鉴意义。     

结合三级综合医院评审谈病区药房药品管理中存在的问题与对策

目的：总结医疗机构病区药房药品管理中存在的问题并对其进行规范。方法：结合三级综合医院评审的要求以及工作实践,针对病区药房药品管理存在的问题如贮存条件及硬件设施不完善、药品摆放不科学、药品过期失效、退药等7个方面进行分析并提出对策。结果与结论：提出了如规范药品贮存、完善硬件设施、科学设置药品货位、制作警示标签、加强药品有效期和领药计划的管理、规范退药制度等方法及对策,实施制度化、规范化、系统化的管理,以保障药品质量和临床用药安全,使病区药房能够更好地为临床用药服务。     

The Role of Religion and Spirituality in Recovery from Drink Problems: A Qualititative Study of Alcoholics Anonymous Members and South Asian Men

Aim: The purpose of this study was to explore the spiritual aspect of recovery for people with drink problems through carrying out a comparative analysis of South Asian men recovering from drink problems and White members of AA. Method: In-depth semi-structured interviews were carried out with participants to explore significant factors that assisted recovery. Interviews were analysed using grounded theory. Participants: Ten participants in total were interviewed, five were South Asian men receiving individual and/or group counselling with South Asian therapists either in an NHS or non-statutory specialist alcohol treatment service, five were white members of AA. Findings and Conclusions: Models of recovery for the two groups were developed and are presented. Spirituality and religion played an important role in the experiences of recovery described by AA and South Asian participants respectively. For AA participants their experiences reflected those described in AA's Big Book although concepts such as that of a Higher Power were complex and multi-layered, with spirituality just one, albeit significant, aspect. South Asian participants generally underwent a re-affirmation of existing beliefs rather than the conversion type of experience described by AA participants. The findings are discussed in relation to implications for service delivery and development and directions for future research.     

What May we be Learning from So-called Spontaneous Remission in Ethnic Minorities?

This study describes a small-scale attempt to compare people from two populations in an English county who have grown out of alcohol problems without formal assistance from treatment agencies. The populations were the indigenous white population and the ethnic minority population who originated from the Indian sub-continent, although 40% were born in Britain. There may be more spontaneous remitters and less problematic drinkers in need of specialist services than one would expect on the basis of population and consumption levels in the ethnic minority communities. For both white indigenous and ethnic groups, physical health, self-esteem, ability to cope and work were important motivating factors in reduction or cessation of alcohol use. For the ethnic minority group, social networks, including religiously-based ones, family status and honour were important, whereas accommodation and psychological state were more important to the white indigenous sample. Although the study is anecdotal, a case is made to have services for people with alcohol problems which offer treatments and goals consistent with the attitudes and beliefs of the communities of origin of presenters.     

农村健康社区的构建：困境与对策

健康社区是一个包括健康人群、健康环境和健康社会有机结合的整体。建设农村健康社区对于促进农村社会和谐,实现农村公共卫生和基本医疗服务均等化,提升农村社区居民的健康保障水平具有重大的现实意义。目前,构建农村健康社区遭遇一系列困境。针对这些困境进行分析,尝试性地提出走出困境的对策。     

垫江县基层卫生工作存在的问题及建议

医改,政府在围绕解决人民群众看病难、看病贵等方面做了大量的工作。但一些如绩效工资分配不合理、医保报账定额限制、医技人员缺乏、医疗机构城乡布点不均、临床医疗与公共卫生信息不能共享等问题,在基层越发突出,一定程度更加重了群众“看病难”和基层医疗机构的发展。提出绩效工资分配政策,适度向基层医疗机构倾斜,稳定基层队伍;提高基层医疗机构医保报账分配额度和病人报销比例,引导病人分级诊疗、科学就医;加强医技人才培训和引进,不断提高基层医疗卫生机构的服务能力;加大财政投入力度,进一步完善基层医疗服务条件等建议。