Access to Care: End-to-End Digital Response for COVID-19 Care Delivery

The coronavirus disease 2019 pandemic disrupted health care, requiring organizational leaders to act quickly to manage the health-related concerns of individuals and communities. The ability to offer a variety of digitally enabled telehealth services with 24/7 access to nurse practitioners and physician assistants allowed us to care for patients in their homes. It reduced the spread of the virus, protected our employees from further disease spread, and provided early interventions to those in need. The roles of nurse practitioner leaders, the enacted strategies, and patient outcomes demonstrate the impact of an innovative digital care delivery model on care across the continuum.     

Health education and primary health care in Costa Rica: the role of the health assistant

Health status indicators for the population of Costa Rica comparedfavorably in the 1980s to those of more developed nations. Morbidityand mortality had been lowered, and health status differentialsbetween population subgroups had been narrowed. By 1984, mostof the objectives set by the World Health Organization had beenexceeded. These outcomes have been attributed to the successof a national primary health care program and to the role ofthe health assistant/asistente de salud in the operation ofthis program. This article examines the approach taken in achieving theseoutcomes. Of particular interest is the role of the health assistantas health educator in attaining the health promotion and diseaseprevention goals of the primary care program. Contemporary challenges which may diminish the role of the healthassistant and the possible consequences of this for public healthare considered, as is a recent government experiment which affordsa potential response to these issues. The latter, a new modelfor the organization and delivery of health services, featuresa partnership between government and a private sector providergroup. This arrangement retains the traditional role of thehealth assistant in primary care and enhances the health educationfunction of the health assistant. Under pressure and in transition, the health sector in CostaRica is striving to safeguard the admirable achievements ithas attained and to plan for further advances. It is clear thatunder present circumstances difficult choices must be made.One hopes that in the trade-offs made, those elements of theprimary health care program which have been essential to thisnation's success are not assigned a lower priority.     

基于PDA的嵌入式ECG监护分析仪

目的为了方便快捷地实时监测心律失常,设计一种基于PDA的嵌入式ECG监护分析仪。方法仪器功能包括低功耗MSP430系列单片机控制心电信号的采集、放大、滤波、转换和在PDA上实时显示、存储和分析,并实现心电数据的远程传输。对仪器工作原理进行分析,把监护分析仪总体结构划分为子模块,并具体介绍各子模块的功能与实现。结果与结论与医院现有的三导全自动心电图机、Holter动态心电图机进行对照,本监护分析仪携带方便、操作简单、接收的心电信号无失真,连续工作时间大于20h等。各高频干扰信号对ECG信号无影响;软件可对心电信号进行实时显示,可连续记录15h的原始心电数据。     

基于基因表达综合数据库与中医传承辅助系统分析气虚血瘀型脑梗死的中医药防治策略

目的：利用GEO芯片数据及中医传承辅助系统,获取气虚血瘀型脑梗死的差异基因及中医药防治方剂,并分析其作用机制,为气虚血瘀型脑梗死的中医药防治策略提供理论依据。方法：采用生物信息学、数据挖掘、网络药理学等多学科交叉方法,对气虚血瘀型脑梗死的中医药防治策略进行探讨。整合基因表达综合数据库（GEO）、中医药整合药理学研究平台（TCMIP）、GeneCards、PubChem、中药系统药理学数据库与分析平台（TCMSP）、STRING、WebGestalt、DAVID多数据库资源及Cytoscape、R语言软件工具,对气虚血瘀型脑梗死疾病靶点、中药靶点进行筛选,从蛋白质-蛋白质相互作用（PPI）网络、基因本体（GO）及京都基因与基因组百科全书（KEGG）富集的角度,对中医传承辅助系统数据挖掘获取的气虚血瘀型脑梗死基础方的作用机制进行探讨。结果：获取2 542个气虚血瘀型脑梗死疾病靶点,其中差异基因结果显示HIF1A、PIK3CA、PIK3R1、TP53、NFKB1、HSP90AA1、CREBBP、CASP8、IL6、TNF、ITGB等表达上调,APOE、IGF1、CXCL5、SRC、ADCY5、PTGS2等表达下调,可作为疾病诊断治疗的潜在靶点。58首气虚血瘀型脑梗死方剂的用药规律,包括频次、关联及新方组合,获得气虚血瘀型脑梗死基础方剂,由黄芪、川芎、当归、地龙、党参、西洋参、白术、桃仁、赤芍、枳实10味中药组成,具有益气活血、行气化痰的功效,其作用机制可能与调控差异基因以多组分、多功能、多途径的方式,主要通过HIF-1、TNF、NF-kappa B、Apoptosis、PI3K-AKT等通路发挥作用。结论：气虚血瘀型脑梗死的中医药防治当以差异基因靶点为中心,筛选出临床基础方,根据临床辨证施治加减中药,同时可采用多学科交叉方法对气虚血瘀型脑梗死的方剂从多组分、多途径、多靶点层面进行临床与实验验证。本研究为中医药治疗气虚血瘀型脑梗死提供了方法理论上的指导,对推动中医药现代化具有重要意义。     

智慧医院背景下医院科研信息管理系统建设探索与实践

介绍医院科研信息管理系统内涵,分析系统建立的必要性,详细阐述系统总体框架构建及功能设计,指出该系统可高效辅助科研决策,提高科研管理水平,推动智慧医院建设.     

刍议医务部（处）助理员管理能力培养

在国家经济快速发展和居民医疗保障体系逐步完善的新形势下,军队医院面临的竞争压力越来越大。军队医院若要把握好发展机遇,实现内涵式发展新跨越,必须建设一支业务精、能力强的管理干部队伍。本文就提高军队医院医务部（处）助理员管理能力进行探讨,以期对其提高才干和执行力有所帮助。     

A personal digital assistant for improving independent transitioning in adolescents with high-functioning autism spectrum disorder

Objective: This study evaluated the effectiveness of a personal digital assistant (PDA) on independent transitioning between activities in a day treatment centre for youth with high-functioning ASD.

Methods: Within a multiple baseline design across four participants, data were collected on participant's transitioning and staff's prompting behaviour. Intervention by staff consisted of one technical instruction session on use of the PDA and non-specific instruction following incorrect transitions while not using the PDA, in the natural setting.

Results: Analysis revealed a significant increase in percentage independent daily transitions, which resulted from the independent use of the PDA. The change in staff's prompt use during intervention was mainly the result of a significant decrease in the use of non-specific prompts in correcting participant's transition behaviour.

Conclusion: A brief intervention was effective in improving independent transitioning using a PDA. Findings are evaluated in light of their clinical implications and suggestions for future research are discussed.