HL7标准在医疗仪器通讯中的应用

介绍通过编程实现以HL7标准的检验数据在检验仪器与临床检验信息系统(clinical labora-tory information system,CLIS)之间的数据格式转换,从而解决各种检验仪器的接口软件重用性问题,并保证数据交换的准确性.国内外检验仪器的生产厂家应尽快应用HL7标准,规范仪器通讯接口的数据通讯.     

新型农村合作医疗的经济学思考——山东省茌平县个案

随着市场经济的不断深化发展,目前农业和农村经济面临许多新情况、新问题。据统计茌平县70％以上的贫困人口是因病致贫或因病返贫。农民群众医疗保健得不到有效保障,已成为直接制约农村经济发展、农民生活水平提高的重要因素。前不久召开的山东省新型农村合作医疗试点工作会议上,确定茌平县为全省建立新型农村合作医疗制度试点县。由于刚刚兴起,对于其经济学以及管理学思考是由切实必要的。通过下文的一系列论述,提出了一些对于合作医疗的实施切实可行的意见以及建议。     

基于二阶段随机规划的城市医疗废弃物回收网络设计

城市医疗废弃物日益增加,且回收需求量受诸多因素的影响,难以准确预测,假定回收需求为确定值的医疗废弃物网络优化设计不能与实际需求相匹配。本文考虑了离散随机参数环境下,医疗回收网络设计中选址规划、分配计划及运输规划的协同优化问题,建立了以选址成本、运输成本最小为目标,设施与车辆能力限制为约束的二阶段随机规划模型。根据模型特点,设计了基于Benders decomposition的求解算法,同时,设计了一系列加速技术用于提高算法的求解效率。最后,以国内某城市医疗回收网络为背景设计算例,检验本文模型和求解策略的可行性和有效性。结果表明：相比确定性规划,随机规划的解能够节约总成本,结合一系列加速技术的Benders decomposition方法比CPLEX与纯的Benders decomposition更有优势。     

考虑交通时间与设备转换时间的跨区域就医调度优化问题

在资源共享时代背景下,跨区域就医可以很好地解决患者日益增长的就医需求与医疗资源紧张的矛盾。本论文以医疗联盟为研究对象,在关键医疗资源共享的前提下,通过患者跨区域就医实现就医诊断延误最小化,以满足患者就医需求。本研究同时考虑了患者跨区域交通时间与基于患者诊断类型的设备转换时间,以最小化患者就医总延迟为目标,分配患者就诊医院及优化患者就诊/检查顺序。针对该问题,论文首次提出以最早交货期原则（EDD rule）为基础,以患者再分配为主导的EDD-ReAss1和EDD-ReAss2启发式算法,结合局部搜索算法以进一步提高就医调度方案的质量,缩短患者诊断/检查等待时间。实验结果表明,新启发式算法EDD-ReAss1和EDD-ReAss2算法性能显著好于EDD,SPT和LPT等调度规则;在较短运算时间内Swap局部搜索算法性能最优。     

治疗腰痛的气功功法和功理

本文扼要论述腰痛治疗三个层次的气功功法和功理.     

Severely Traumatized Siblings: A Treatment Strategy

Siblings who have suffered severe trauma and disrupted attachment relate to one another in ways that interfere with individual development, the chance to benefit from connections with adults, the establishment of healthy sibling relationships, and the working through of traumatic experiences. The authors use case examples to illustrate four distinct sibling patterns: absent, adult lockout, half and half, and trauma shield. The authors highlight the importance of recognizing these types and then varying the therapist's treatment stance to pursue five goals. These include suspending problematic sibling relationships to create room for bonding with caring adults, transferring attachment behaviors and impulses to a receptive adult, resuming healthy individual development, forming more adaptive sibling connections, and expressing shared traumatic content.     

Three Object Relations Models of Couple Treatment

This article describes three different approaches to the treatment of couples, all based on different versions of object relations theories. Object relations as a term has various meanings embodying different theoretical assumptions. It is used differentially to highlight certain aspects of clinical phenomena, to connote certain developmental paradigms, and to signal the importance of real, interactional aspects of human behavior. The three therapeutic approaches to work with couples illustrate some of the ways that the greater conceptual complexity of object relations theories affects how love is explained, couple conflicts defined, and what makes for change in couples treatment. Understanding the basic assumptions of a given theory will enable us to increase our informed consent to the use of theory in our practices.     

Culture and Organization: The Case of Transmanche-Link

The relationship between culture and organization has often been discussed, but rarely explored directly. This paper implements a cultural values instrument taken from Hofstede together with a behavioural instrument derived from Van de Ven to matched samples of British and French managers working on the Channel Tunnel project. The results largely replicate the findings of Hofstede regarding cultural values, but do not support the predicted implications for behaviour. In essence, the British were found to be more bureaucratic and more team-oriented than their French counterparts, who tended to be more fonceur and competitive. This indicates that the relationship between culture and behaviour might be more complicated than research to date suggests.     

基于医疗质量的公立医院绩效体系构建研究

目的：运用德尔菲法构建一套科学、可操作的公立医院绩效评价体系。方法：采用文献法研究国内外绩效评价理论,结合问卷结果形成初始量表。通过德尔菲法对指标进行两轮筛选及优化。结果：初步形成由“社会效益”、“质量安全”、“运行效益与效率”为基本结构的指标体系,包括3个一级指标、13个二级指标和72个三级指标。结论：该指标体系重点关注医院公益性及内涵质量,对公立医院绩效评价具有一定参考意义。