基于Client／Server结构的医院图像处理系统

作者介绍了一种医院图像处理系统，可将医院的各种设备所产生的医疗图象资料，动用先进的可读写光盘为存储介质有效地进行存储，再通过通信网络及时地传送到医院的各个部门，辅助医生进行临床诊断及科研，提高有关科室及整个医院的工作效率及经济效益。     

Is Subjective Outcome Evaluation Related to Objective Outcome Evaluation? Insights from a Longitudinal Study in Hong Kong

Study ObjectivesEmpirical studies investigating the inter-relationships among subjective outcomes and objective outcomes are sparse in the scientific literature. This study examined the relationship between these 2 forms of outcome evaluation data in Chinese adolescents, utilizing longitudinal data.DesignIn Wave 3 and Wave 4 of a randomized group trial, 2,784 Chinese secondary school students responded to the Chinese Positive Youth Development Scale (CPYDS) assessing objective outcome at pretest (Wave 3) and posttest (Wave 4). Students in the experimental schools also responded to a measure of client satisfaction assessing the subjective outcome of a positive youth development program at posttest (Wave 4).ResultsSubjective outcome evaluation measures (eg, process, program, and effectiveness) at Wave 3 were significantly correlated with CPYDS scores at Wave 4 and difference scores. Subjective outcome evaluation measures also predicted changes in the objective outcome evaluation measures scores across time.ConclusionsThe present findings replicated the previous findings that subjective outcome and objective outcome evaluation findings were intimately related, and subjective outcome measures predicted posttest measures and their changes over time. The present study suggests that subjective outcome evaluation findings may yield useful information regarding program effectiveness in youth work settings.     

A Cognitive-Behavioral Therapy Group Intervention for Hypersexual Disorder: A Feasibility Study

BackgroundThe proposed criteria of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition for hypersexual disorder (HD) included symptoms reported by patients seeking help for excessive and out-of-control non-paraphilic sexual behavior, including sexual behaviors in response to dysphoric mood states, impulsivity, and risk taking. Although no prior studies of cognitive-behavioral therapy (CBT) for the treatment of HD have been performed, CBT has been found effective for dysphoric mood states and impulsivity.AimTo investigate the feasibility of a CBT manual developed for HD explored through symptom decrease, treatment attendance, and clients’ treatment satisfaction.MethodsTen men with a diagnosis of HD took part in the CBT group program. Measurements were taken before, during, and at the end of treatment and 3 and 6 months after treatment.OutcomesThe primary outcome was the Hypersexual Disorder: Current Assessment Scale (HD:CAS) score that measured the severity of problematic hypersexual symptoms and secondary outcomes were the Hypersexual Disorder Screening Inventory (HDSI) score, the proportion of attended sessions, and the Client Satisfaction Questionnaire (CSQ-8) score.ResultsMain results were significant decreases of HD symptoms from before to after treatment on HD:CAS and HDSI scores and a decrease in the number of problematic sexual behaviors during the course of therapy. A high attendance rate of 93% and a high treatment satisfaction score on CSQ-8 also were found.Clinical ImplicationsThe CBT program seemed to ameliorate the symptoms of HD and therefore might be a feasible treatment option.Strengths and LimitationsThis study provides data from a CBT program for the treatment of the specific proposed criteria of HD. Because of the small sample and lack of a control group, the results can be considered only preliminary.ConclusionAlthough participants reported decreased HD symptoms after attending the CBT program, future studies should evaluate the treatment program with a larger sample and a randomized controlled procedure to ensure treatment effectiveness.Hallberg J, Kaldo V, Arver S, et al. A Cognitive-Behavioral Therapy Group Intervention for Hypersexual Disorder: A Feasibility Study. J Sex Med 2017;14:950–958.     

The Use and Intended Outcomes of Presence: A Focus Group Study

PURPOSE

To explore and understand the use and intended outcomes of presence from the perspective of and as experienced by nurses.

METHODS

Twenty‐seven nurses participated in one of four focus groups. Data were analyzed using Giorgi's phenomenological method.

FINDINGS

Four themes emerged: (1) therapeutic communication; (2) nurse well‐being; (3) dimensions of presence; and (4) intention to improve client outcomes.

CONCLUSIONS

Presence was described as a multidimensional intervention that required therapeutic communication and nurse well‐being with the intention of improving client outcomes. Study findings provide evidence of the significance of presence in the face of human interaction that is shifting to virtual, impersonal communication.     

云南德宏州嫖客高危性行为的定性调查

目的深入了解嫖客的高危性行为特征,为进一步制定艾滋病防治策略提供决策依据。方法在调查地区采用方便抽样方法选择艾滋病病毒阳性嫖客24人和阴性嫖客25人进行深入访谈,访谈的主要内容包括接受性服务情况、艾滋病防治知识掌握情况、安全套使用情况以及就医行为等。结果嫖客平均年龄为35.7岁,嫖客中农民、外出务工者较多,喝酒和嫖娼常伴随发生,艾滋病知识相对缺乏,存在错误认识,商业性行为中安全套使用率较低。除嫖娼外,大多数嫖客还有姘居行为。结论在制定经性途径传播艾滋病的防治策略时,不应忽视对嫖客的干预,在开展暗娼人群干预时,同时要加强嫖客人群的宣传教育,提高其对艾滋病的认知水平。     

What's said and what's done: the reality of sexually transmitted disease consultations

OBJECTIVE: Indirect data collection methods, or approaches which disturb usual practice, are generally used in health care evaluation. We have compared what doctors report at interview what is observed by an identified researcher with an unobtrusive measure of their usual practice. DESIGN: Private practitioners who provide a service to sexually transmitted disease (STD) patients were interviewed regarding their usual case management. An identified researcher carried out structured observations of consultations between physicians and patients. Simulated clients then sought consultations, presenting a standardised history and symptom profile. Structured reporting of the history taking, examination, treatment and counselling aspects of these consultations was undertaken. SUBJECTS: Eighteen private practitioners in Madras (now Chennai), India. MAIN OUTCOME MEASURES: Comparisons between interviews, observations by identified researchers and the experiences of simulated clients were carried out. RESULTS: Interviews with physicians and observations by identified researchers indicated more favourable practice than was seen during simulated client visits. These differences were substantial and would lead to a severe misrepresentation of the actual situation-and thus of intervention needs, if data from interviews or observations were relied upon. CONCLUSIONS: The usual methods used in the evaluation of medical services and in carrying out medical audit may produce highly unreliable findings. STD services in the study area are failing to realise their potential of improving the sexual health of populations. The methodological and substantive findings of this study could be combined through the introduction of simulated client visits in the monitoring, improvement and licensing of STD (and perhaps other medical) services.     

Unambiguous test results or individual independence? The role of clients and families in predictive BRCA-testing in the Netherlands compared to the USA

It has been frequently acknowledged that results of predictive genetic tests may have implications for relatives as well as for the individual client. Ethicists have noted that an individual’s right to know her genetic risk may conflict with a relative’s right not to know this risk. It is hardly recognised, however, that family members may have a role in the production of test results as well.     

检验科多台全自动生化分析仪网络数据管理系统的开发与应用

目的 开发检验科多台自动生化分析仪网络数据管理系统，实现资源共享。方法 应用Micmsoft SQL2000建立数据库．按数据活跃程度和操作预测将其分为四种不同状态，建立客户机／服务器加单机本地数据库相结合的数据库：结果 建立了检验科自动生化分析仪网络数据管理系统，经一年运行效果良好：结论 本系统客户机／服务器加单机本地数据库相结合的数据库的方案能有效地满足检验科生化室网络数据库的实时性要求。