基于探索性因子分析的输血科人员胜任力模型构建

??????? 目的 构建医院输血科室人员胜任力模型。方法 采用横断面问卷调查收集数据,采用探索性因子分析对胜任力模型内部结构进行分析。 结果 医院输血科室人员胜任力模型包含了6个公因子和24个特征指标,维度分别为：专业技能、个人特质、能力素质、防控差错、遵守规范和职业素养。结论 构建医院输血科室人员胜任力模型可以极大的丰富医院人力资源管理策略,在甄选、培训和绩效测评输血科室人员等方面具有积极的现实意义。     

名医胜任特征模型的构建研究

目的 借鉴现代人力资源管理理论——胜任力及胜任力模型研究，探讨我国名医胜任特征，构建名医胜任特征模型。方法 在文献研究、问卷调查和专家访谈的基础上，编制“名医胜任特征辞典”；采用自设问卷对各项胜任特征指标的重要程度进行评价；利用因子分析法和层次分析法构建名医胜任力模型。结果 名医具有以下7个维度的胜任特征：业务水平、大家认可、信念操守、人文素养、知识经验、名声信誉、成就品质，每一维度胜任特征包含多项因素，各项胜任特征及其内在因素在名医胜任特征模型中所占的权重不等。结论 名医胜任特征模型能够综合衡量卓越医师的岗位胜任能力，并且具有较强的适用性与可复制性，同时还反映了新时期职业精神和理想信念对一位医生成长、成才、成功的重要性越来越突出。     

ICU护理人员岗位胜任特征模型的构建

目的 构建ICU护理人员岗位胜任特征模型,为专科护理人员甄选、培训和绩效考核提供科学依据。方法 根据文献分析和专家咨询结果,建立ICU护理人员岗位胜任特征词典,利用行为事件访谈法对26名ICU护理人员进行访谈,采用自编问卷调查200名ICU护理人员,对各胜任特征项目重要程度进行态度评价。结果 所建立的ICU护理人员岗位胜任特征模型共包含15项鉴别胜任特征和7项基准胜任特征,归类一致性系数0.839。结论 所构建的ICU护理人员岗位胜任特征模型具有较好的信度和效度。     

妇产科医师鉴别胜任特征研究

目的 获取绩效优秀妇产科医师区别于绩效普通妇产科医师的胜任特征。方法 在编制医师胜任特征词典的基础上,以10名绩优和10名绩平医师为研究对象,采用行为事件访谈法收集数据,对不同绩效组医师胜任特征的频次、平均等级分值和最高等级分值的差异采用Wilcoxon秩和检验进行分析。结果 鉴别胜任特征包括严谨细致、团队合作等18项特征。结论 鉴别胜任特征对妇产科医师人力资源规划、招聘、培训有一定参考价值。

     

黑龙江省县级医院绩效评价指标体系构建研究

目的 构建适用于黑龙江省县级医院的绩效评价模型和指标体系,为县级医院开展绩效评价、改善绩效管理提供决策参考。方法 应用文献分析法和专题小组讨论法构建评价模型和初始指标库,运用专家咨询法筛选评价指标并确定指标权重。结果 运用关键绩效指标理念构建了以工作质量、工作效率、医疗费用、综合管理及满意度评价为核心维度的县级医院绩效评价模型及指标体系。结论 指标体系的可信程度较高,能有效反映县级医院绩效管理的核心环节。     

我国口腔医师岗位胜任力自评研究

目的 通过分析我国“5+1”阶段口腔医师胜任力自评问卷,验证胜任力指标的科学性。方法 自行编制口腔医师胜任力自评问卷,对全国14所高校附属口腔医院的350名“5+1”阶段口腔医师开展问卷调查,分析问卷的信度和效度检验,根据问卷分数分成高低两组,并进行独立样本的t检验。结果 “5+1”阶段口腔医师胜任力自评问卷共由7个维度、50个条目组成, Cronbach’s α系数均在0.8以上;经探索性因子分析后得到7个因子,7个因子的累计方差贡献率达67.272％;高分组和低分组的差异有统计学意义。结论 “5+1”阶段口腔医师胜任力自评问卷具有良好的信度和效度,适用于我国“5+1”阶段口腔医师胜任力的评价。     

基于患者体验的医疗服务质量关键指标体系构建

??????? 目的 初步构建基于“患者体验”的医疗服务质量关键指标体系。方法 通过检索国内外相关文献,构建指标体系框架和专家咨询表并进行2轮专家咨询,确定了基于“患者体验”的医疗服务质量关键指标体系。结果 构建基于“患者体验”的医疗服务质量关键指标体系,一级指标有有形性、可靠性、反应性、保证性、关怀性和连续性6个,二级指标28个,三级指标83个。结论 基于患者体验的医疗服务质量关键指标体系具有很强的实用性,为患者体验量表开发奠定基础。研究结果对于改进我国医疗服务质量评价手段和策略具有重要意义。     

基于PATH模型的远程医疗绩效评价体系构建

目的 探索构建适用于我国远程医疗发展的绩效评价体系。方法 采用文献法、头脑风暴法初步构建评价框架和指标库,运用德尔菲法和层次分析法确定指标及其权重。结果 基于PATH模型建立了远程医疗绩效评价体系,包括以病人为中心、医疗效果与效率、员工为导向、安全性、反应性管理5个一级指标、11个二级指标和32个三级指标。结论 PATH模型适用于远程医疗绩效评价体系的建立,此外,以病人为中心的指标权重最高,因此,应加强对远程医疗服务费用的控制,同时从各个角度入手,提高患者满意度。     

医院战略性绩效评价指标体系研究

目的 基于医院战略,构建同医院战略相匹配的绩效评价指标体系。方法 运用Delphi法对绩效指标体系进行全面的筛选与整理,利用层次分析法来确定绩效指标体系的各级指标的权重。结果 设计出最能反映医院绩效的12个方面共50个指标,构建了以战略为导向的医院绩效评价指标体系。结论 基于医院战略的绩效评价,有利于提升医院核心竞争力,促进医院战略的实现。     

国家综合性医疗中心评价指标筛选研究

目的 探索建立国家综合性医疗中心评价指标框架，为我国国家区域医疗中心的建设和评价工作提供参考。方法 综合运用文献分析法、专题小组讨论法和专家咨询法，对国家综合性医疗中心评价指标进行了筛选研究。结果 确定了包括6个一级指标、22个二级指标、94个三级指标在内的国家综合性医疗中心评价指标框架。结论 评价指标的专家积极系数和权威系数较高，但二级和三级指标的协调系数偏低，需要经过多轮专家咨询后进一步提高专家意见的一致性。     

Recent advances in the study of Kaposi's sarcoma-associated herpesvirus replication and pathogenesis

It has now been over twenty years since a novel herpesviral genome was identified in Kaposi's sarcoma biopsies. Since then, the cumulative research effort by molecular biologists, virologists, clinicians, and epidemiologists alike has led to the extensive characterization of this tumor virus, Kaposi's sarcoma-associated herpesvirus(KSHV; also known as human herpesvirus 8(HHV-8)), and its associated diseases. Here we review the current knowledge of KSHV biology and pathogenesis, with a particular emphasis on new and exciting advances in the field of epigenetics. We also discuss the development and practicality of various cell culture and animal model systems to study KSHV replication and pathogenesis.     

The structure, reproduction and taxonomy of Vidalia and Osmundaria (Rhodophyta, Rhodomelaceae)

Comprises species occurring mostly in subtidal habitats in tropical, subtropical and warm-temperate areas of the world. An analysis of the type species, V. spiralis (Sonder) Lamouroux ex J. Agardh, a species from Australia, establishes basic characters for distinguishing species in the genus. These characters are (1) branching patterns of thalli, (2) flat blades that may be spiralled on their axis, (3) width of the blade, (4) primary or secondary derivation of sterile and fertile branchlets and (5) position of sterile and fertile branchlets on the thalli. Application of the latter two characters provides an important basic method for separation of species into three major groups. Osmundaria , a genus known only in southern Australia, was studied in relation to Vidalia , and its separation from the Vidalia assemblage is not accepted. Species of Vidalia therefore are transferred to the older genus name, Osmundaria. Two new species, Osmundaria papenfussii and Osmundaria oliveae are described from Natal. Confusion in the usage of the epithet, Vidalia fimbriala Brown ex Turner has been clarified, and Vidalia gregaria Falkenberg, described as an epiphyte on Osmundaria pro/ifera Lamouroux, is revealed to be young branches of the host, Osmundaria prolifera.     

New or rare chromosome counts in Artemisia L. (Asteraceae, Anthemideae) and related genera from Kazakhstan

Fifteen chromosome counts of six Artemisia taxa and one species of each of the genera Brachanthemum, Hippolytia, Kaschgaria, Lepidolopsis and Turaniphytum are reported from Kazakhstan. Three of them are new reports, two are not consistent with previous counts and the remainder are confirmations of very scarce (one to four) earlier records. All the populations studied have the same basic chromosome number, x = 9, with ploidy levels ranging from 2x to 6x. Some correlations between ploidy level, morphological characters and distribution are noted.     

肝癌中HBV和HCV基因和抗原的分布及意义

采用原位分子杂交方法检测HCV RNA及HBV X基因;采用免疫组织化学方法研究HCV核心抗原,非结构区C33c抗原及HBxAg在肝细胞肝癌中的定位及分布.结果表明(1)HCV RNA、HBV X基因在肝细胞肝癌组织检出率分别为40%(55/136)和82%(112/136).HCV RNA定位于癌细胞的胞浆内,阳性细胞呈散在、灶状及弥漫分布三种形式;HBV X基因在肝癌细胞中的分布呈胞浆型、核型及核浆型,阳性细胞也呈上述三种分布形式;(2)HCV C33c抗原、核心抗原在肝细胞肝癌中的阳性率为81%(133/164)及86%(141/164).C33c抗原定位于癌细胞及肝细胞的胞浆内;核心抗原既定位于癌细胞核中,又可定位于胞浆中.C33c抗原阳性细胞以灶状分布为主;而核心抗原阳性细     

Selection with two alleles and complete dominance

For a plant selection model with frequency-independent viabilities, fertilities and selfing rates, it is shown that apart from global fixation, for certain parameter combinations a protected polymorphism and facultative fixation (either allele may become fixed according to initial frequencies) may both occur. Facultative fixation requires different selling rates for the dominant and recessive type. Protection of the polymorphism requires resource allocation for male and female function. In this connection the problem of purely genetically caused population extinction is discussed.
For general frequency dependence and regular segregation, the chances for establishment of a completely recessive gene are compared to those of a completely dominant gene. It is proven that the process of establishment of the recessive gene, despite a fitness advantage, may be considerably endangered by drift effects if random mating prevails. The recessive gene may reach the same effectivity in establishment as a dominant gene, only if the recessive homozygote mates exclusively with its own type during the period of establishment.