安徽省繁昌,铜陵两县门诊抗生素使用分析

在安徽省繁昌与铜陵两县2532名门诊病人访问中,抗生素的使用比例平均为53.l％,抗生素使用种数平均为0.75种,针剂使用比例平均为48.4％,与其他国家的研究结果相比都处于偏高水平。在抗生素使用的种类中,以青霉素类为主,占所有抗感染药物的27.7％。单因素分析结果表明:男性的抗生素使用比例比女性高;随着年龄的增长抗生素使用比例、使用种数与针剂使用比例都是先下降而后上升;学生病人这三种指标都偏高;随着文化水平的提高,这三种指标都有下降的倾向;医疗保险病人抗生素使用比例处于高水平,而自费病人针剂使用比例最高;与乡镇卫生院及村卫生室相比,县医院这三种指标都处于低水平;而儿科病人这三种指标都处于高水平。多因素分析结果表明:县医院、去医院的目的是看病、教育程度、农民、妇产科、文教卫生人员、外科、预防接种及离、退休人员等因素对抗生素使用的数量都有影响,但仅看病这项因素是正向作用,而其他因素都是负向作用。     

干部门诊就诊质量的影响因素与对策

对900例干部门诊中的就诊患者进行问卷调查分析,探讨干部门诊就诊质量的各种影响因素,提出干预措施,在提高患者就诊质量的前提下节省卫生资源.     

"托管制"条件下医疗服务质量监控的实践

无锡市卫生局在"托管制"条件下,转变政府职能,加强医疗服务质量监控,在依法管理的基础上,严把"导、评、赛、奖"四个控制环节.     

提高卫生院管理水平改善卫生院服务质量--陕西省项目区卫生服务管理水平分析

目的对陕西省世界银行贷款卫生Ⅷ项目利用日本赠款改善乡镇卫生院基本卫生服务情况进行分析。方法采用访谈、参与性评估以及资料复习等。结果项目县的卫生院服务供给状况得到了改善．提高了卫生院管理水平．增强了卫生服务能力，提高了服务效率，特困人口医疗救助(MFA)实施效果得到提高。但是存在配套资金不到位的问题，应加大特困人口医疗救助工作的宣传力度。建议加大项目管理力度，完善项目监督机制，推广示范点经验。     

温州市农村贫困人群卫生服务需求和利用分析

通过对近2000份调查表的分析,评价温州市农村贫困人群在就诊过程中对医疗机构的选择、未就诊原因方面的特点,提出提高卫生服务利用的方法。     

饮食服务业58241名从业人员HBV感染状况调查分析

目的　了解饮食服务业从业人员乙型肝炎病毒感染状况。方法　应用ELISA方法对 5 82 4 1名饮食服务业从业人员进行了血清HBsAg、抗 HBc、HBeAg和抗 HBe检测。结果　 2 0 0 0～ 2 0 0 4年饮食服务业从业人员血清HBsAg、抗 HBc、HBeAg和抗 HBe总阳性率呈逐年下降趋势 ,依次为 4 .39%、3. 85 %、3. 4 7%、2. 84 %和 2 4 3% ,其差异有统计学意义 (χ2 =88. 4 1,P <0 . 0 1) ,每间隔 1年及其以上的两个年度的阳性率之间的差异均有统计学意义(均P <0. 0 1)。结论　饮食服务业从业人员HBV感染率呈逐年下降趋势。     

开展卫勤指挥员任职培训的教学实践和体会

近几年来,第二军医大学卫生勤务学系承担了大量卫勤指挥员的任职培训任务.通过几年的理论研究和实践摸索,在教学的组织、管理、实施、保障等方面积累了一些经验,获得了一些具体的体会.我们认为要做好卫勤指挥员的任职培训教学必须明确培训目标,科学制定教学方案,精心安排教学内容,做好施训教员的培训,并在教学中注重合理运用教学方法,特别是要做好下部队调研,切实提高教学实效.     

Integrating children's services in England: national evaluation of children's trusts

Background Poor co‐ordination of services can have severe consequences for disadvantaged children with complex needs. Since 2003 national and local governments in England embarked on sweeping reforms aimed at improving and integrating local health, education and social services for children. These were to be organized locally by children's trusts and piloted by 35 children's trust pathfinders. Methods This study described and compared the experience of integrating children's services in all 35 children's trust pathfinders, covering 20% of children in England. It had a prospective mixed‐methods design. Over 3 years we interviewed 147 managers and professionals working in the children's trusts, including 172 semi‐structured interviews, carried out two questionnaire surveys of the 35 children's trusts and analysed official documents. Results In most areas different agencies jointly commissioned children's services, especially for mental health, disabilities and multi‐purpose children's centres, and increasingly pooled finances. Provision of multi‐agency and multi‐professional services was increasing. Professionals generally supported these changes but found them stressful. All children's trusts appointed directors of children's services and established boards representing multiple agencies. Systems for sharing information about individual children were mostly in place but were still underused. Health services were generally less involved in joint work than were local authorities' education and social care services, with notable exceptions. Areas where local authorities and health authorities shared geographical boundaries made most progress. Some children's trusts made few changes beyond their statutory obligations. Conclusion Children's trusts enabled major changes to services in areas where local actors and organizations were motivated and empowered. In other areas the remit of children's trusts was often too broad and vague to overcome entrenched organizational and professional divisions and interests. Policymakers need to balance facilitation of change in areas with dynamic change agents with methods for ensuring that dormant areas and agencies are not left behind.     

Evolution of accommodative function and development of ocular movements in children

The evolution of the accommodative function and development of ocular movement are evaluated in a non-clinical paediatric population (1056 subjects) aged 6-12 years, providing means for each age in the optometric tests that evaluate the accommodative amplitude, accommodative facility, accommodative response (lag), and saccadic movements. A comparison of these values between ages (anova) established three distinct trends in the behaviour of these parameters. The accommodative amplitude, measured by modified dynamic retinoscopy, and the evaluation of the saccadic movements by the development of ocular movements [developmental eye movement (DEM)] test showed continuous change with age. The values for monocular and binocular accommodative facility, measured by +/-2.00 D flippers, indicated the need to divide the population into two age groups (6-7 and 8-12 years). Finally, the means of accommodative response, measured by monocular estimation model (MEM) retinoscopy, and the direct observation of saccadic movement revealed no significant differences between ages, establishing a single mean reference value for the age group studied.     

SOS抢救护理小组的组建与实施

介绍了上海交通大学附属一院SOS抢救护理小组的组建、运营和管理,提高了抢救病人的医护应急速度、效率和质量、并有利于护理队伍的培养和急救护理学的发展。