吉林省在院农村老年荣复军人健康需求状况调查

??????? 目的 了解吉林省在院老年农村荣复军人健康需求现状。方法 采用自行设计的健康需求调查问卷进行调查。结果 被调查的93名老年荣复军人中66人（71%）认为自身健康状况良好,6人（6.5%）认为自身健康状况一般,20人（22.5%）认为自身健康状况不好;健康认知测试总体正确率只有32.7%;健康知识的获取途径主要来自电视广播;最希望参加的健康活动依次为健康检查、饮食指导、健康知识讲座和心理健康咨询;最想了解的健康知识排在前3位的依次为心脑血管疾病的防治、饮食营养知识、家庭护理知识。结论 吉林省在院农村老年荣复军人健康状况自我评价较好,但健康认知水平较低,健康需求主要以初级卫生保健为主。     

军队医院在基层部队中实施多元化健康教育效果分析

目的 调查军队医院在基层部队实施多元化健康教育效果,为实施健康教育提供依据。方法 自2009年1月开始,解放军第181医院对体系部队官兵实施多元化的健康教育,分析部队官兵健康素养,对比2008年和2009年相关医疗数据（年发病率、运动伤发生率、门诊率和住院率）的变化。结果 通过实施多元化的健康教育,部队官兵健康素养得到提高,健康状况改善。结论 加强军队医院在基层部队中实施多元化健康教育,对维护官兵健康具有重要意义。     

教学医院医患关系与医德医风评价研析

目的 调查医护人员医德自我评价和患者对医护人员医德评价。方法 对某教学医院306名患者、266名医护人员进行问卷调查,调查信息通过Epidata录入,使用SPSS13.0软件进行统计描述和分析。结果 在医护人员的服务态度、医护人员对患者需求的反应、尊重患者的知情同意权、医药费用问题、患者的信任、医患沟通等方面存在差异。结论 主要从以下几方面进行改善：完善医德医风管理制度,提高医护人员整体素质,注重对医学生医德信念的培养,转变医德医风的教育方式,提高医务人员的待遇。     

对普通门诊预约诊疗服务的定性分析

?????? 目的 描述制约普通门诊预约诊疗服务的因素,分析提高普通门诊预约诊疗服务的途径。方法 依据调查、访谈等定性方法对影响普通门诊预约诊疗服务的因素进行归纳。结果 主要的影响因素包括：患者就医观念尚未转变、信息系统的缺失、缺乏制约患者行为的手段、临床实践的属性和缺少标准化的评价指标。结论 医患双方逐渐意识到普通门诊预约诊疗服务的价值,但其适宜性和开展方式需要得到进一步分析。基于普通门诊的基础性作用,推动预约诊疗服务对医疗机构具有积极的作用。     

医疗保险总额预付试点三级医院患者就医感受调查

目的 调查上海市实行医疗保险总额预付的三级医院中患者的就医感受。方法 经培训的调查员应用结构式调查问卷对上海市10家实行医疗保险总额预付的三级医院的699名患者进行面对面访谈，数据分析主要采用描述性统计。结果 城保患者对门诊医生明显减少处方金额（或处方天数）的感受强于非城保患者，城保和非城保患者的住院就医感受差异无显著统计学意义。结论 医疗保险总额预付对上海三级医院患者就医感受的总体效应似偏弱，而且有限的影响主要集中于门诊而非住院环节。     

医疗卫生市场中专病门诊的卫生服务需求研究

目的 了解青岛市市立医院专病门诊的运行现状,分析患者对专病门诊的卫生服务需求情况。方法 通过调查问卷,抽样调查青岛市市立医院的门诊病人。结果 专病门诊的设立适应了患者的卫生服务需求,是门诊未来的发展趋势。结论 总结试点经验,增设更多的专病门诊,满足患者的卫生服务需求。     

基于Kano模型的三甲医院门诊服务调查分析

目的 以西部一所综合性三级甲等医院为例,验证kano模型应用在三级甲等医院门诊服务内容调查分析中的可行性与开展后的应用效果。方法 运用自行设计的kano调查问卷,对门诊700名就诊的患者开展调查,通过kano模型质量属性分类方法将门诊服务内容进行归类。结果 本次门诊服务内容按照kano质量属性的分类为必备质量、一维质量、魅力质量、逆向质量的分别有8项、8项、3项、2项。结论 kano模型应用在三级甲等医院门诊服务内容的分类中能够从定性层次上挖掘出服务需方对医疗机构潜在的服务需求。一次卓有成效的管理,在控制基本质量的同时,我们还需要不断完善一维质量与创造魅力质量。     

上海家庭病床患者对社区护理的需求调查与分析

目的 调查家庭病床患者护理服务需求情况及影响因素,为卫生管理部门制定家庭病床护理服务规范提供决策依据。方法 采用问卷调查方法,对本辖区2013年1月—2014年12月建立的160例家庭病床患者进行护理服务需求调查。结果 被调查的160名家庭病床患者中,以高龄患者为主,平均年龄（82.95±1.43）岁;疾病构成中脑血管意外后遗症康复期居首位（占58.75%）,有2种及以上慢性病者143名（占89.37%）;生活需要他人帮助的或完全不能自理146名（占91.25%）。家庭病床患者对居家护理指导、康复指导等服务项目需求较高,尤其对膀胱冲洗、居家护理指导和送药上门等存在巨大缺口,文化程度、生活自理程度、疾病了解程度和医疗保险类型为家庭病床患者对社区护理需求的影响因素。结论 要增加居家护理指导、康复指导等家庭病床护理服务项目种类,加大对患者健康知识宣教力度,增强患者的自我护理意识。     

住院医师/专科医师对规范化培训带教师资和培训管理的满意度调查分析

目的 调查参加规范化培训的住院/专科医师对带教师资综合职业能力和培训管理的满意度,进一步了解不同医院开展毕业后医学教育所面临的问题和进行毕业后医学教育规范化培训异同。方法 采用自制问卷对成都市4所三级甲等医院598名住院/专科医师进行问卷调查,对收集的数据进行因子分析和方差分析。结果 受调查的598名住院/专科医师对带教师资的综合职业能力的满意度评分在3.83～4.11之间﹝满分为5分﹞,而对培训管理的满意度评分在2.91～3.75之间,且不同医院住院/专科医师的满意度有差异性﹝P﹤0.05﹞。结论 无论教学医院还是非教学医院,都应加强带教师资建设和培训管理,才能提高住院/专科医师对规范化培训的满意度,以促进住院/专科医师规范化培训的顺利开展。     

潮汕文化背景下医师组织公民行为维度研究

目的 探索潮汕文化背景下医师组织公民行为的维度及其构建途径。方法 采用随机抽样的方式对200名各级医师进行组织公民行为问卷的调查。结果 具有积极主动、助人行为、保护和节约组织资源、组织忠诚、人际和谐五个维度,其中,助人行为表现水平最高。结论 潮汕文化背景下医师组织公民行为的五个维度是其内涵的外在表现,可以通过医院的传统文化建设等方式培育医师们的组织公民行为。     

Comparison of rates of fecal colonization with extended‐spectrum beta‐lactamase‐producing enterobacteria among patients in different wards,outpatients and medical students

Because asymptomatic carriage of extended‐spectrum beta‐lactamase (ESBL) producers is a risk factor for infection, data on colonization dynamics are important when planning infection control. This study investigated fecal colonization with ESBL producers among inpatients, outpatients and medical students and compares the characteristics of ESBL producers among these groups. Carriage rates were investigated in 5581 fecal samples; 4343 from inpatients (330, 1397, 619 and 1864 from adult ICUs [intensive care units], adult non‐ICUs, pediatric ICUs and pediatric non‐ICUs, respectively), 814 from outpatients and 424 from screening of medical students. ESBL producers were characterized by co‐resistance, integrons carried, and aminoglycoside resistance and ESBL genes. Dynamic regression models were built to identify relationships between combinations of time series of monthly antibiotic consumption, prevalence of carriers and infected subjects. Inpatients, ICU patients and adults showed higher prevalence than outpatients, non‐ICU patients or children (7.4%, 9.3% and 12.0% vs. 3.1%, 6.1% and 4.1%, respectively). Klebsiella pneumoniae was more frequent in ICU patients; dominance of CTX‐M‐15 producers was more marked in adult than in pediatric inpatients. ESBL carriage was shown to be a consequence of infection in adults in the time‐series analysis; antibiotic consumption had little effect. The epidemiology of colonization with ESBL producers differed between pediatric ICU, adult ICU and adult non‐ICU patients. In adults, carriage of ESBL producers seems to be the consequence of infection, especially in ICU patients; the main source of colonization is nosocomial acquisition. In contrast, children are less likely to acquire colonizer strains in hospitals; importation of ESBL producers by colonized children seems to be significant.     

Knowledge and Perceptions about Clinical Trials and the Use of Biomedical Samples: Findings from a Qualitative Study in Rural Northern Ghana

IntroductionClinical trials conducted in sub-Saharan Africa have helped to address the prevalent health challenges. The knowledge about how communities perceive clinical trials is however only now evolving. This study was conducted among parents whose children participated in past clinical trials in northern Ghana to assess their knowledge and perceptions of clinical trials and the use of biomedical samples.MethodThis was a qualitative study based on eighty in-depth interviews with parents. The participants were randomly selected from among parents whose children were enrolled in a clinical trial conducted in the Kassena-Nankana districts between 2000 and 2003. The interviews were transcribed and coded into emergent themes using Nvivo 9 software. The thematic analysis framework was used to analyze the data.ResultsStudy participants reported that clinical trials were carried out to determine the efficacy of drugs and to make sure that these drugs were suitable for human beings to use. The conduct of clinical trials was perceived to have helped to reduce the occurrence of diseases such as malaria, cerebrospinal meningitis and diarrhea. Quality of care was reported to be better in clinical trials than in the routine care. Parents indicated that participation in clinical trials positively influenced their health-seeking behavior. Apprehensions about blood draw and the use to which samples were put were expressed, with suspicion by a few participants that researchers sold blood samples. The issue of blood draw was most contentious.ConclusionParents perception about the conduct of clinical trials in the study districts is generally positive. However, misconceptions made about the use of blood samples in this study must be taken seriously and strategies found to improve transparency and greater community acceptability.     

Children’s book series and associated curricula support elementary education and outreach in water resources

Background: Water resources are of fundamental importance to society, and are better managed by stakeholders who understand resource issues. Gaining such knowledge is a lifelong process best begun at an early age and best supported by educational approaches integrating across science, technology, engineering and mathematics (STEM). Research scientists can bring resource education to young audiences through children’s books and curricula that emphasise and integrate across STEM principals.

Aims: To encourage empathy for the environment in younger students, researchers at the Niwot Ridge Long Term Ecological Research site have developed a children’s book series and methods for training teachers in water science education.

Methods: Children’s books in the My Water series are paired with curricula, hands-on learning kits, teacher development training and dissemination of materials through school districts to further water science education.

Results: Thousands of children and educators have received training through the My Water book series, and a more broadly focused, federally funded Schoolyard Children’s Book Series has grown out of these efforts towards water resource education.

Conclusions: Children’s books and curricula that integrate STEM principals can play a key role in the development of environmental empathy and lifelong learning to support resource management.     

Hospitalization-induced exacerbation of the ill effects of chemotherapy on rest-activity rhythm and quality of life of breast cancer patients: a prospective and comparative cross-sectional follow-up study

ABSTRACT

Chemotherapy administration may result in the disruption of circadian rhythms and impairment of quality of life (QoL) of cancer patients. Nevertheless, we have little knowledge on the long-term consequences of chemotherapy and the effects of hospitalization. In the present study, we employed the two-factor repeated-measure cross-sectional design to determine the effects of chemotherapy and hospitalization on rest-activity (RA) rhythm and QoL of breast cancer patients. Initially, we randomly selected 39 inpatients and 42 outpatients, scheduled to receive six cycles of chemotherapy, from the Regional Cancer Center (RCC), Raipur, India. Finally, 30 patients in each group were included in the current study. We monitored circadian RA rhythm and QoL using wrist actigraphy and QLQ-C30 and QLQ-BR23, respectively, during the 1st (C1), 3rd (C3) and 6th (C6) chemotherapy cycles. Results revealed that with the progression of chemotherapy cycles (from C1 to C6), all rhythm parameters, namely mesor, amplitude, acrophase, rhythm quotient (RQ), circadian quotient (CQ), peak activity (PA), dichotomy index and autocorrelation coefficient, significantly decreased in both cancer in- and outpatients. In both groups of patients and during C1–C6, all functional and global QoL measures of QLQ-C30 and QLQ-BR23 significantly decreased and the symptoms significantly increased, except constipation, body image, sexual functioning and future perspectives in outpatients. The hospitalization exacerbated the problems associated with the RA rhythm and the QoL of the patients. In conclusion, the current study highlighted the negative consequences of hospitalization among inpatients, irrespective of the stage of cancer. We, therefore, recommend that cancer patients should be administered with chemotherapy as outpatients. The proposed protocol might have a covert bearing on the expression of better physiological state leading to satisfactory treatment outcomes.     

不同地区三级医院患者公益性评价比较及影响因素研究

????? 目的 了解不同地区患者对三级公立医院公益性的评价,探究公益性评价的影响因素。方法 通过问卷的形式,在东、中、西3个地区选择在三级医院就诊的患者进行调查, 使用Pearson Chi-square、非参数检验和Logistic回归方法对数据进行分析。 结果 患者对于公立医院的公益性评价存在一定的地区差异,但公益性总体评价的影响因素类似,医疗服务的适宜性和公平性是主要影响因素。结论 加强三级公立医院的公益性应该着重提高医疗服务的适宜性,提高医疗服务的公平性。     

支气管哮喘患儿病情控制的影响因素及其家长知信行问卷调查分析

摘要 目的：调查支气管哮喘患儿家长知信行情况,并分析支气管哮喘患儿病情控制的影响因素。方法：于2016年7月~2020年7月期间,选取我院收治的500例支气管哮喘患儿及其家长作为研究对象。患儿家长知信行情况采用《哮喘患儿家长知信行问卷》调查。患儿近4周的病情控制水平参照《诸福棠实用儿科学(第8版)》中的相关标准进行确定,病情控制水平包括良好控制、部分控制和未控制。将良好控制、部分控制的患儿纳为哮喘控制组,将未控制的患儿纳为哮喘未控制组。采用本院自制的调查量表调查患儿及其家长的信息,分析支气管哮喘患儿病情控制的影响因素。结果：支气管哮喘儿童家长知信行情况不容乐观。支气管哮喘患儿病情控制率为38.06%（187/491）。单因素分析结果表明,支气管哮喘患儿病情控制与家庭人均月收入、患儿个人过敏史、家长受教育程度、哮喘家族史、是否坚持长期用药、是否定期复诊有关（P<0.05）。多因素Logistic回归分析结果显示,家长受教育程度、家庭人均月收入、患儿个人过敏史、哮喘家族史、是否坚持长期用药、是否定期复诊均是支气管哮喘患儿病情控制的影响因素（P<0.05）。结论：本研究中支气管哮喘患儿病情控制水平一般,且支气管哮喘儿童家长知信行情况不容乐观,其中家长受教育程度、家庭人均月收入、患儿个人过敏史等均是支气管哮喘患儿病情控制的影响因素,临床中应结合相关因素进行针对性的干预或治疗,以期实现对支气管哮喘患儿病情的良好控制。     

New PCR ribotypes of Clostridium difficile detected in children in Brazil

A total of 35 Brazilian isolates of Clostridium difficile from faecal stools and four isolates from hospital environments were analyzed by PCR ribotyping. A whole cell protein profile (as an alternative for serogrouping), in vitro toxin production and susceptibility to vancomycin, metronidazole and clindamycin were also investigated. All strains were typeable by both phenotypic and genotypic methods, and a total of 13 different PCR ribotypes were identified, of which seven (132, 133, 134, 135, 136, 142 and 143) were considered new types and accounted for 78.5% of all samples evaluated (including hospital environments). A non-toxigenic C. difficile PCR ribotype 133 was detected in all children groups examined (inpatients, outpatients and healthy children), whilst toxigenic PCR ribotypes 015, 131, 134 and 135 were associated mostly with symptomatic children. Serogroups G and D were disseminated both in patients from the community and from the pediatric hospital, with group G prevalent among outpatient children. All strains were susceptible to vancomycin and metronidazole but high levels of resistance to clindamycin were found, especially among serogroups G and D. Co-existence of different ribotypes and serogroups in the same individual was observed. The new seven ribotypes found in this investigation may represent strains characteristic of this region of Brazil.     

Effects of Having Pets at Home on Children's Attitudes toward Popular and Unpopular Animals

ABSTRACT

Having pets at home provides various social, health, and educational benefits to children. The question of how keeping pets at home affects the attitudes of children toward wild animals still has not been answered, due to various methodological issues, such as ignorance of some attitude dimensions and/or questionnaires that include items focused on very different animals. We conducted three independent research surveys (using three independent samples) of Slovakian primary school children aged 10 to 15 years (n = 1297). These surveys focused on the effects of keeping pets on the attitudes of children towards, and knowledge of, three unpopular animals in Slovakia. These animals were pests (potato beetle) (Study 1), predators (wolf) (Study 2), and those that pose a threat of disease to humans (mouse) (Study 3). Each survey also included a popular animal (ladybird beetle, rabbit, and squirrel, respectively), which served as a “control”; these were compared by pair-wise statistics. Results consistently showed that children had better knowledge of, but less favorable attitudes towards, unpopular animals compared with popular ones. Having pets at home was associated with more positive attitudes to, and better knowledge of, both popular and unpopular animals. Girls were less favorably inclined than boys to animals that may pose a threat, danger, or disease to them. Implications for humane education are discussed, especially in terms of keeping pets, the link between knowledge and attitudes, and children's understanding of ecological adaptations.     

原发性肾病综合征患儿家长对疾病营养知识的调查与分析

目的:研究原发性肾病综合征患儿家长疾病营养知识,分析其相关影响因素。方法:选取2014年5月到2015年5月在我院门诊及住院的原发性肾病综合征患儿150例,应用自制问卷对患儿家长的一般资料及营养知识进行调查,应用非条件Logistic回归分析患儿家长营养知识影响因素。结果:150例原发性肾病综合征患儿家长对基本营养知识回答的正确率介于30.7%-96.7%,对具体营养知识回答的正确率为2.0%-42.0%;Logistic回归分析显示:家长文化程度、患儿病程、居住地、发病情况以及首次就诊是否接受营养指导均是家长疾病营养知识影响因素。结论:原发性肾病综合征患儿家长对疾病具体营养知识知晓率低,应根据影响因素对家长进行营养宣教。