临床路径系统的建立与计算机应用

临床路径是指针对某一类患者或疾病定制的常规的、可行的治疗方案,使每个患有相同疾病的患者按照统一的流程进行治疗。     

A cost analysis of the management of attention-deficit/hyperactivity disorder (ADHD) in children in the UK

SUMMARY

A decision analysis was performed to model the effects and health economic differences of current UK management approaches to attention-deficit/hyperactivity disorder (ADHD) in children aged between 6 and 16 years. The approaches modelled were: medication using a standard immediate-release methylphenidate (MPH-IR) (once, twice or three times daily); medication using CONCERTA®XL (OROS®* methylphenidate; MPH), a long-acting once-daily formulation of methylphenidate; or behavioural therapy (BEH). Starting treatment with BEH alone resulted in the highest annual cost (UK£2,147), while the costs of starting treatment with MPH-IR alone (£1,332), or OROS®* MPH alone (£1,362) were comparable. Treatment switches to behavioural treatment or combined treatment (medication and behavioural) due to treatment failure occurred in 11.8% of OROS®* MPH and 24.2% of MPH-IR patients. Probabilistic sensitivity analyses showed that the results were sensitive towards treatment success and the proportion of patients with comorbidities, although conclusions were not altered. UK treatment costs over 1 year appear comparable regardless of whether patients were treated first with OROS®* MPH or MPH-IR. Treating patients first with BEH and then adding stimulant medication if needed resulted in higher overall annual treatment costs.

CONCERTA® XL and OROS® are trademarks of ALZA Corporation, USA.     

独立办学医科院校临床医学科研竞争力评价研究

为深入了解全国独立办学医科院校临床医学科研竞争力现状,基于InCites数据库采用因子分析法从科研产出规模、科研产出影响力两个维度对2017—2021年全国27所独立办学医科院校的临床医学科研竞争力进行客观评价,获得27所高校临床医学科研生产力、科研影响力和科研竞争力排名。结果表明,临床医学科研生产力排在前3名的是首都医科大学、北京协和医学院、南京医科大学,科研影响力排在前3名的是广东医科大学、哈尔滨医科大学、广州医科大学,科研竞争力排在前3名的是北京协和医学院、首都医科大学、广州医科大学。建议各高校结合自身的优势和不足,有针对性地进行改进,进一步提高临床医学科研竞争力。     

综合性医院临床护士压力分析与对策

本文分析了综合性医院中临床护士的工作环境和压力,进而提出缓解临床护士压力的对策。     

CLINICAL AUDIT,GUIDELINES AND STANDARDS: A PRODUCTIVE RELATION FOR MANAGING CLINICAL PRACTICES

This paper contributes to the knowledge about the process of standardisation within the domain of medicine. Standardisation has become an important form of governance and co‐ordination, and there is limited empirical knowledge about its nature and consequences ( Brunsson et al., 2000 ). This paper aims to explore the development, circulation and standardisation process of a specific clinical audit programme: the Scottish Hip Fracture Audit. This audit started as a local initiative and now has developed into a sophisticated arena (Sahlin‐Andersson, 2000) which provides Scottish hospitals with monthly ‘real‐time reports’ outlining their performance against Scottish government targets. The paper argues that the interrelation between clinical audit and evidence‐based medicine (EBM) can become a ‘productive relation’ (Mykhalovskiy, 2003), that opens up spaces of intervention, in which the clinical communities engage with processes of change of clinical procedures, and in these spaces, clinicians and managers are in a position to refine clinical practice and service organisation, to reflect upon their own actions and to allow insight into the rationalities of their work (Berg, 1997).     

浅谈多媒体技术在护理带教中的应用

随着信息技术的不断发展,多媒体技术被广泛应用于课堂教学,借助多媒体技术实施护理教学已成为教学的发展方向之一。带教护士在带教过程中如果能巧妙利用多媒体技术,不但能激发新护士学习兴趣、增强教学效果,而且可以有效提高课堂教学效率。     

增强医学生实践能力与创新精神的新路径探讨

加强医学生创新精神和实践能力的培养,对国家、医学院校、临床医学生以及医疗卫生事业的发展都极其重要。分析临床医学生实践能力和创新精神培养的现状,积极探索临床医学生实践能力和创新精神培养的途径和方法,培养临床医学生的创新精神和实践能力,是近年来医学教学研究的重要课题。     

论诊所法律教育在我国法学教育中的地位

诊所法律教育作为一种全新的法学教育模式在我国尚处于探索阶段。法律教育的实践性和开放性客观上需要我国发展诊所法律教育。诊所法律教育应该与传统法律教育有机地结合在一起,共同构筑适合我国国情的法学教育模式。     

脐带脱垂的护理与临床分析

目的 探讨脐带脱垂的护理与防治措施,降低围产儿死亡率.方法 回顾分析2009 年2 月～2012 年2 月我院收治的5 例脐带脱垂患者,密切观察产程进展,对产时和产后进行护理,分析影响脐带脱垂的因素.结果 脐带脱垂的发生率0.02%,与胎位异常、胎产次、脐带长度有关.结论 重视产前检查,加强孕期保健,做好相应的护理措施,可降低脐带脱垂的发生率.     

健康教育在肝硬化食管胃静脉曲张破裂出血治疗中的作用

为探讨健康教育对肝硬化食管胃静脉曲张破裂出血治疗的影响,将71例患者随机分为2组：试验组（35例）与对照组（36例）,2组病例均根据出血程度,采取药物及其他治疗。对照组患者予常规护理指导,试验组患者在常规护理的基础上实施健康教育。对2组患者情况包括止血有效率、再出血率及并发症发生率进行观察、评估。结果为试验组的止血有效率明显高于对照组（P〈0.05）,而再出血率和并发症发生率较对照组降低（P〈0.05）。健康教育是对肝硬化食管胃静脉曲张破裂出血有重要影响的基础护理措施。