护理业务流程再造现状分析及对策

目的了解护士对护理业务流程再造的知晓度及需求,找出流程再造存在的问题,针对存在问题提出相应的对策。方法采用问卷调查方法,调查广东省16所县级以上医院287名护士对护理业务流程再造的认识情况。结果护士对护理流程再造的知晓现状与临床状况不尽人意;护士认为进行护理流程优化再造是必要的和重要的;现有的护理流程存在的问题是流程流于形式、不完善及实用性不强。结论要进行护理流程再造,必须转变观念,加强在职培训,设计精简、方便、实用的护理流程。     

不同海拔高度健康藏汉族青年脉象图研究

本文通过对不同海拔高度藏汉族健康青青年的４００幅脉图分析后认为，健康藏汉族青年的脉象以滑、平、弦、缓为多。结古和西宁的藏汉族青年脉力图的主要生理参数中不同海拔高度上有一定差异，表现为结古青年弦脉较多，而西宁教地区滑脉较多，究其形成原因，主要与高海拔缺氧、寒冷环境有密切关系；在民族间也存在一定差异，表现为汉族弦脉多，藏族滑脉多，它们的形成与移居高原后心血管的反庆和代偿机制有关，在性别间有明星的差异。     

PCA在过程故障检测与诊断中的应用

讨论了基于主无分析（PCA）的过程故障检测与诊断的原理,运用T^2统计、Q统计方法,结合贡献图对一典型过程进行了仿真分析,结果表明PCA方法可对简单传感器故障进行检测与诊断,并指出了该方法中的不足,提出了将PCA方法同基于过程动态模型的故障诊断方法相结合的研究思路。     

The effect of flow and mass transport in thrombogenesis

The paper presents a mathematical analysis of the contributions of flow and mass transport to a single reactive event at a blood vessel wall. The intent is to prepare the ground for a comprehensive study of the intertwining of these contributions with the reaction network of the coagulation cascade. We show that in all vessels with local mural activity, or in “large” vessels (d>0.1 mm) with global reactivity, events at the tubular wall can be rigorously described by algebraic equations under steady conditions, or by ordinary differential forms (ODEs) during transient conditions. this opens up important ways for analyzing the combined roles of flow, transport, and coagulation reactions in thrombosis, a task hitherto considered to be completely intractable. We report extensively on the dependence of transport coefficient k_L and mural coagulant concentration C_w on flow, vessel geometry, and reaction kinetics. It is shown that for protein transport, k_L varies only weakly with shear rate in large vessels, and not at all in the smaller tubes (d<10⁻² mm). For a typical protein, k_L∼10⁻³ cm s⁻¹ within a factor of 3 in most geometries, irrespective of the mural reaction kinetics. Significant reductions in k_L (1/10–1/1,000) leading to high-coagulant accumulation are seen mainly in stagnant zones vicinal to abrupt expansions and in small elliptical tubules. This is in accord with known physical observations. More unexpected are the dramatic increases in accumulation which can come about through the intervention of an autocatalytic reaction step, with C_w rising sharply toward infinity as the ratio of reaction to transport coefficient approaches unity. Such self-catalyzed reactions have the ability to act as powerful amplifiers of an otherwise modest influence of flow and transport on coagulant concentration. The paper considers as well the effect on mass transport of transient conditions occasioned by coagulation initiation or pulsatile flow. During initiation, instantaneous flux varies with diffusivity and bulk concentration, favouring the early adsorption/consumption of proteins with the highest abundance and mobility. This is akin to the ‘Vroman effect’ seen in narrow, stagnant spaces. The effect of flow pulsatility on k_L has the potential, after prolonged cycling, of bringing about segregation or accumulation of proteins, with consequences for the coagulation process.     

Quality of diabetes care in a university health center in Lebanon.

OBJECTIVE: To assess the quality of care provided to diabetic patients by family physicians in a university health clinic, using measures of glycemic and cardiovascular risk control as well as documentation of and adherence to World Health Organization (WHO) guidelines for diabetes primary care. DESIGN: Chart review of the previous year's medical notes for all identified diabetics in the practice over 2.5 years. RESULTS: Two-hundred and four diabetic patients were identified, with an estimated prevalence of 4.1%. The majority was type II diabetics, on oral hypoglycemic agents. Glycosylated hemoglobin was documented in 39.7% of patients, fasting plasma glucose in 99%, cholesterol in 93.1%, triglycerides in 91.2% and blood pressure in 85.8%; optimal control of these indicators was noted in 28.4%, 17.8%, 34%, 29.6% and 55.4% respectively. Fifty percent of the diabetics were referred for retinal checks. Physicians documented the presence of nephropathy in 46.8% and neuropathy in 59.6%; however, they documented patient instruction on foot care, diet, exercise and diabetes self-care poorly. CONCLUSION: There is a need for interventions to improve management and documentation in diabetes care in order to achieve early detection and prevention of complications. Developing a protocol for the clinic based on standard guidelines, and the use of flow sheets may be helpful in improving these intermediate indicators of quality of care.     

高海拔地区健康藏汉族青年脉象图的研究

通过对高海拔地区（海拔３７０３ｍ）健康藏汉族青年的２００幅脉图分析后认为，健康藏汉族青年的脉象以滑、平、弦、缓为多。该地区藏汉族青年脉图的主要生理参数在不同民族间没有明显的差异；而在不同性别上存在着差异，表现为男性滑脉较多，女性弦脉较多，究其形成差异的原因，与男女血液动力学的差异有一定的关系。     

深圳市工业企业外来工心理健康状况调查

[目的]了解深圳市工业企业外来工心理健康状况 ,以便有针对性地开展心理健康促进工作。[方法]采用症状自评量表 (SCL_90)对深圳市福田区2家工业企业240名外来工 (男102人 ,女138人 )进行测试。[结果]外来工除恐怖因子外 ,SCL_90总均分及其余各因子分均明显低于常模 ;女性外来工恐怖因子分高于男性外来工 ,差异有非常显著的统计学意义 (P<0.01) ;不同年龄外来工间焦虑、恐怖和精神病性等因子分有显著差异 ,且呈现中间年龄段 (20～岁组 )因子分高 ,较高年龄段 (30～岁组 )因子分低的现象 ;不同学历外来工间总均分及躯体化、敌对、偏执、精神病性和其他因子分有显著差异 ,且呈现随学历升高各因子分升高的趋势。外来工SCL_90因子分≥2分的前3位因子是男性为强迫、人际关系敏感和精神病性 ,女性为强迫、偏执和人际关系敏感。[结论]深圳市工业企业外来工心理卫生状况较健康 ,但仍需针对性地开展心理健康促进工作     

质量控制图在农村互助医疗保险项目监测中的应用

以中国农村互助医疗保险项目试点乡铁厂镇的门诊服务利用人次和门诊补偿费用的监测为例，介绍了质量控制图的制作方法以及质量控制图在项目运行监测中的应用，旨在探索我国的医疗保险制度的监测管理方法。