小儿与成人静脉留置针穿刺的护理成本比较与分析

目的 了解目前小儿与成人手术患者静脉留置针穿刺的护理成本投入。方法 根据项目综合评估和核算方法,分别核算小儿与成人静脉留置针穿刺的护理成本投入情况。结果 小儿与成人静脉留置针穿刺操作的平均护理成本已分别达到77.84元和25.62元,与现行收费标准存在巨大差异,小儿静脉留置针穿刺的护理成本远远高于成人。结论 全面客观地核算了静脉留置针穿刺的护理成本投入,为体现护理技术的价值提供了准确的依据。     

实施“优质护理服务示范工程”的实践探讨

目的 探讨“优质护理服务示范工程”的实施及影响。方法 树立“优质护理服务示范工程”护理服务文化理念,制定“优质护理服务示范工程”护理服务标准及实施方法。结果 提高了病人满意度及护理工作质量、健康教育覆盖率及合格率,增进护患感情。结论 开展“优质护理服务示范工程”, 能提高护理质量, 确保护理安全,能扩大医院的知名度, 提升护理服务的品牌。     

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。     

住院病人对医疗机构的评价及影响患者不满意的因素分析

目的 了解住院病人的看法,为提高患者满意度,促进医患和谐提供参考。方法 利用2008年第4次国家卫生服务调查的数据,用描述性方法和Logistic回归,分析住院病人对所住医院的评价以及影响住院病人不满意的因素。结果 一半以上的住院病人比较满意。费用高、设备差、手续繁琐、态度差是最不满意的4个方面。收入、住院时间、自费高低等因素会影响患者满意。 结论 提高住院患者满意度,改善医患关系需要医、患、政府三方共同努力。     

潍坊市乡镇卫生院人力资源现状分析

目的 了解潍坊市乡镇卫生院人力资源情况,为政府部门合理配置卫生人力资源和基层医疗机构综合改革提供参考。方法 对2010年潍坊市148个乡镇卫生院进行问卷调查。从整体上对乡镇卫生院的整体情况、年龄结构、学历结构、职称构成和专业构成情况进行分析。结果 潍坊市乡镇卫生院人员实有编制数及人员素质总体偏低。结论 应采取有效措施培训和引进人才,提高卫生技术人员的素质和能力。     

预约挂号爽约病人情况调查与对策探讨

目的 了解爽约人群的特点,分析爽约的原因,提出改进措施,提高预约诊疗服务质量。方法 通过立意抽样的方法,采用自行设计的问卷对2009年10—12月有爽约行为的人进行电话调查。 结果 爽约人群以上班族为主,且以本市居民为主,主要原因是因交通受阻。结论 建议加大社会宣传力度,增加预约者取号提示,增设退号专线方便退号,缩短爽约者预约卡停用时间等措施,降低爽约率,提高预约诊疗服务品质。     

综合性医院癌痛患者管理模式探讨

目的 探讨综合性医院癌痛患者的管理模式。方法 成立“癌痛治疗小组”,小组成员由麻醉或疼痛医生、护士、精神科医生、药师、肿瘤科医生及相应专科医生构成,其职责是负责全院癌痛患者的管理与治疗。同时观察15例采用此模式管理的癌痛患者（观察组）,并与传统管理方式相比（对照组）。结果 观察组镇痛效果评分及病人满意度评分均显著高于对照组（P<0.01）。结论 在综合医院建立“癌痛治疗小组”可提高癌痛病人镇痛效果及满意度,有效利用医疗资源、提高医疗质量。     

基于DEA的全国中医医院卫生资源配置效率评价

目的 对2003—2014年全国中医医院卫生资源配置效率进行比较研究,探讨其投入、产出是否适当及存在问题,寻找有效的措施和途径以进一步优化其卫生资源配置。方法 利用数据包络分析的理论和方法,对全国中医医院的卫生资源配置进行横向分析和纵向分析评价。结果 数据包络分析横向评估中,卫生资源配置效率存在地区差异;数据包络分析纵向评估中,2003－2014年全国中医医院卫生资源配置综合效率总体稳定,规模效益递减。结论 统筹规划,重点加强弱势地区中医医院的医疗卫生服务体系建设。     

湖北省县级公立医院偿债现状与发展能力分析

目的 通过了解和分析2011—2013年湖北省县级医院偿债能力和发展能力情况及发展趋势,为进一步深化县级公立医院改革提供参考。方法 在对样本县人民医院和县中医院的经济运行现状进行描述的基础上,结合有效的对比分析,以探讨湖北省县级公立医院偿债能力和发展能力变化情况。结果 湖北省县级人民医院的负债水平偏高,资产负债率持续升高。业务收入增长率逐年走低,净资产增长显示后劲不足,发展能力较弱。结论 合理控制医院发展规模,健全卫生服务网络体系,加强医院内部财务风险控制,以促进综合医院的可持续发展。     

基于系统论的护理不良事件管理模式构建与探讨

目的 以贝塔朗菲系统论为依据,构建新的医院护理不良事件管理模式,杜绝或减少各类不良事件的发生,保证患者安全。方法 通过一线护士将临床工作中的安全隐患上报护理部,护理部与相关处室沟通,医院各处室管理层及时解决存在的问题。结果 通过扩大隐患事件上报范围,护理隐患事件上报率较未扩大前增加275.7%;同类护理隐患事件未再发生或明显减少。结论 “护理部首接,多职能科（处）合作”的不良事件管理模式,促进了医院服务效率与质量的提高,保障了患者的就医安全。     

Race and Racism in America and in Anthropology

Race in North America: Origin and Evolution of a Worldview . Audrey Smedley
Anthropology and Race . Eugenia Shanklin     

Degradation and conversion of somatostatin in normal and diabetic rats in vivo and in vitro

Plasma somatostatin-like immunoreactivity in the portal and jugular veins of streptozotocin diabetic rats was compared with that in normal control rats. In the diabetic group, somatostatin levels in the portal (p less than 0.05) and jugular (p less than 0.01) veins were both elevated compared with those in the control group. Moreover, the degree of elevation was greater in the jugular vein than in the portal vein. To further investigate the role of the liver in the clearance of somatostatin-28 in vivo, 2 micrograms of somatostatin-28 was administered as a bolus into the external jugular vein of intact and functionally hepatectomized rats. The mean half-time of somatostatin-28 was significantly longer in intact diabetic rats than in controls (p less than 0.05). The functional hepatectomy did not cause a significant difference in the half-time in diabetic rats but made it longer in control rats. These results suggest that the longer half-time of somatostatin-28 in diabetic rats in vivo is due to its slower hepatic clearance. The hepatic clearance of somatostatin-28 and somatostatin-14 was further studied in vitro using a recirculating liver perfusion method. The hepatic clearance of 1.2 nM of either somatostatin-28 or somatostatin-14 was significantly lower in diabetic rats than in controls (p less than 0.01). This indicates that elevated plasma somatostatin levels in diabetic rats are caused at least in part by decreased hepatic clearance of somatostatin.(ABSTRACT TRUNCATED AT 250 WORDS)     

MPD and DNA Bending in Crystals and in Solution

Bending of 15 to 24° is observed within crystal structures ofB-DNA duplexes, is strongly sequence-dependent, and exhibits no correlation with the concentration of MPD (2-methyl-2,4-pentanediol) in the crystallizing solution. Two types of bends are observed: facultative bends or flexible hinges at junctions between regions of G·C and A·T base-pairs, and a persistent and almost obligatory bend at the center of the sequence R-G-C-Y. Only A-tracts are characteristically straight and unbent in every crystal structure examined to date. A detailed examination of normal vector plots for individual strands of a double helix provides an explanation, in terms of the stacking properties of guanine and adenine bases. The effect of high MPD concentrations, in both solution and crystal, is to decrease local bending somewhat without removing it altogether. MPD gel retardation experiments provide no basis for choosing among the three models that seek to explain macroscopic curvature of DNA by means of microscopic bending: junction bending, bent A-tracts, or bent general- sequence DNA. Crystallographic data on the straightness of A-tracts, the bendability of non-A sequences, and the identity of inclination angles in A-tract and non-A-tractB-DNA support only the general-sequence bending model. The pre-melting transition observed in A-tract DNA probably represents a relaxation of stiff adenine stacks to a flexible conformation more typical of general-sequence DNA.     

Update in research and methods in proteomics and bioinformatics

The 3rd International Conference on Proteomics & Bioinformatics (Proteomics 2013)

Philadelphia, PA, USA, 15–17 July 2013

The Third International Conference on Proteomics & Bioinformatics (Proteomics 2013) was sponsored by the OMICS group and was organized in order to strengthen the future of proteomics science by bringing together professionals, researchers and scholars from leading universities across the globe. The main topics of this conference included the integration of novel platforms in data analysis, the use of a systems biology approach, different novel mass spectrometry platforms and biomarker discovery methods. The conference was divided into proteomic methods and research interests. Among these two categories, interactions between methods in proteomics and bioinformatics, as well as other research methodologies, were discussed. Exceptional topics from the keynote forum, oral presentations and the poster session have been highlighted. The topics range from new techniques for analyzing proteomics data, to new models designed to help better understand genetic variations to the differences in the salivary proteomes of HIV-infected patients.     

Parasitism and epibiosis in native and non-native gammarids in freshwater in Ireland

The introduced amphipod crustaceans Gammarus pulex and G. tigrinus are displacing the native G. ducheni celticus in a number of freshwater sites in Northern Ireland. We investigated parasite and epibiont infection in populations in the Rivet Lagan and Lough Neagh where both native and invading species occur. Prevalence of the four parasites and epibionts observed was higher in the native G. d. celticus than in the invading amphipods at both field sites. In Lough Neagh. G. d. celticus individuals suffered higher burdens of the rotifer Embata parasitica and the protozoan Epistylis in comparison with the invading species. These patterns may reflect host specificity by the parasites or may result from different susceptibilities of the native and invading host species. We consider the influence of parasitism on host invasions and resulting species distributions.