江苏省基层医务人员工作压力研究

对905名基层医务人员进行问卷调查,了解基层医务人员工作压力情况及其影响因素,为建立适合基层卫生机构的良性人才发展机制提供依据。基层医务人员整体工作压力得分为56.54分;单因素方差分析显示,不同性别、年龄、婚姻状况、学历、职称、机构类型、工作量、工作年数、受患者尊重程度和社会地位的医务人员工作压力得分差异具有统计学意义;多元线性回归分析结果显示,社会地位、工作量、工作年数、受患者尊重程度、最高学历和性别对基层医务人员工作压力的影响具有统计学意义。需要着重关注乡镇卫生院医生的工作压力情况,重点应放在提升基层医务人员社会地位、及时关注中坚力量等方面,从而减轻其工作压力,提高工作积极性。     

Effects of Firm-specific and Country-specific Advantages on Relative Acquisition Size in Service Sector Cross-Border Acquisitions: An Empirical Examination

Using a sample of 348 service sector cross-border acquisitions by U.S. firms in 44 countries during 1990–2006, our study seeks to identify factors that influence relative acquisition size (acquisition transaction value as a percentage of acquiring firm's asset value). Our findings indicate that firm-specific advantages (FSAs) in the form of available financial slack and target industry knowledge were positively associated with relative acquisition size. However, contrary to expectations, we observed a negative relationship between cross-border acquisition experience and relative acquisition size. In addition, our results suggest that country-specific advantages (CSAs) associated with higher market potential, lower political risk, and greater cultural similarity contributed to increased relative acquisition size in service industry cross-border acquisitions. Finally, our analysis reveals that the relationship between available financial slack and relative acquisition size is contingent on cultural similarity with the relationship being more pronounced when cultural similarity is high.     

Malaria in Pacific populations: seen but not heard?

Most Pacific Island countries are located in the tropics, where there is an abundance of mosquitoes with the potential to carry debilitating or life-threatening vector-borne diseases. This article examines three Melanesian countries in which malaria is endemic—Papua New Guinea, Solomon Islands and Vanuatu—but the threat posed by the spread of malaria gives the issues a broader significance to the Pacific region. After discussing the spatial distribution and prevalence of malaria in the Pacific, the article examines a number of health interventions through which people have sought to control malaria. Although the disease was nearly eradicated in the Pacific in the 1970s, it is no longer in retreat. The article concludes by examining why there are still grounds for cautious optimism, and the challenges that Pacific Island countries face in reducing the impact of malaria on their populations. There is a need for prompt and concerted action on malaria at the national, regional and international levels if the public health concerns arising from the disease are to be adequately addressed.     

福建省城镇居民医疗保险运行对策

福建省自实行医疗保障制度改革以来,基本完成了从公费医疗、劳保医疗到社会保险的历史性转变,但仍存在医疗保险覆盖人群有限、医疗卫生体制改革不到位、政府投入不足等问题。进一步完善和发展福建省居民医疗保险制度,必须强化政府在医疗服务体系建设与发展中的作用,发展社区医疗服务,逐步扩大医疗保险覆盖范围,实施第三方对医疗费用和医疗质量的控制。     

Every Minute Counts: Using Process Improvement and Performance Feedback to Improve Patient Flow in an Emergency Department

Prolonged emergency department (ED) visits are associated with a number of adverse outcomes for patients as well as lower patient satisfaction scores and increased costs. Several factors that influence the length of ED visits are out of the control of hospital employees, but some opportunities exist to improve performance. For this study, the ED department of a 150-bed hospital in the southeastern United States wanted to improve door-to-discharge time. To do so, a subprocess of door-to-discharge time was targeted, door-to-order. After analyzing the process, the team created standard orders for the 10 most common presenting conditions in the ER with preapproval, allowing nurses to submit the orders without the provider first visiting the patient. Following the process change, daily feedback was added to increase utilization of the preapproved orders. Reductions in door-to-order times and door-to-discharge were observed and patient satisfaction remained stable. Implications for future research in this area are discussed.     

Collecting feedback as a tool to reduce care paralysis: something for family group conferencing coordinators?

Family group conferencing (FGC) coordinators in public mental healthcare are confronted with clients who have little faith in professionals and organizations, who hold off decisions in their family life, who avoid care and who sometimes behave in a hostile manner. A lack of initiative to deal with their situation is not only reserved for clients – all bystanders, including professionals, can suffer from it. The multiplicity and severity of the client's problems lead to a situation wherein everyone involved waits for the initiative of the other. The independence of the FGC coordinator – a fellow citizen, who is free of organizational loyalties and comes to assist other citizens in establishing a plan – seems to work well with the client group of the public mental healthcare. However, the coordinator cannot always prevent deferral or failure of conferences. Drawing on empirical and theoretical findings, this paper considers the possibility of collecting feedback as a way to contribute positively to the alliance between FGC coordinators and those for whom a conference is deployed. We highlight findings from three case studies that centred on multiproblem families. The findings indicate the importance of feedback theory for FGC coordinators in enhancing trust and engagement.     

A Hitchhiker's Guide to caring for an older person before and during coronavirus‐19

Coronavirus‐19 (COVID‐19) has reconfigured working lives with astonishing velocity. Older people have suffered the worst effects of the pandemic, with governments marginalizing or overlooking their needs. Women perform the majority of care for older people, often compromising their working lives and health. Yet in academic articles their voices are often filtered or aggregated in quantitative studies. Based on a weave of personal experiences and secondary research, the article traces a path through UK forms of care and shows how the inadequate response to COVID‐19 stemmed from existing policies embedded in health and social care. COVID‐19 has severed important informal care work, rendering the vulnerable yet more exposed and carers anxious and bereft. Longitudinal research capturing the trajectory of care from the perspective of older people and their carers would lead to improved support hence gender equality.     

Healthcare 4.0: trends,challenges and research directions

Abstract

This paper aims at examining the trends, challenges and theoretical gaps in the implementation of Healthcare 4.0 (H4.0) based on a scoping review of the literature. For that, we searched journal articles in four widely known databases and screened the retrieved articles to obtain a publications’ portfolio. Our findings indicate that, despite the recency of the subject, research in H4.0 has been conducted in an interdisciplinary way with a diversified set of applications and functionalities. In terms of its implementation, H4.0 has been more commonly found in hospitals’ information flows, especially the ones related to healthcare treatments. The identified implementation trends, however, neglect a more holistic approach for H4.0, which originated three main research directions for this topic. Although identified as a trending topic in the area of healthcare operations management, literature on H4.0 may be viewed as randomly conceived, lacking academic alignment and practical orientation based on a grounded theory, which we aim at providing with the present study.     

Top management departures in cross-border acquisitions: Governance issues in an international context

This study examined top management team departures in U.S. manufacturing firms acquired by a foreign multinational during the six-year period following acquisition. Results indicated that greater cultural distance between the United States and the home country of the foreign multinational, higher levels of international integration in the target industry, and poor preacquisition performance in the U.S. target company were related to greater postacquisition top management departures. These effects were moderated significantly by the foreign acquirer’s international business and U.S. acquisition experience and showed different patterns over the short-term, intermediate-term, and long-term. Implications for future research on top management teams involved in cross-border acquisitions are discussed.     

Helping parents to manage infant crying and sleeping: a review of the evidence and its implications for services

Infant crying and night waking are common concerns for parents, costly problems for health services and may trigger infant abuse or lead to serious child disturbances. Parents are given contradictory advice on how to manage infant crying and sleeping, indicating the need for evidence‐based guidance. This review of recent research draws distinctions between infant crying and sleeping problems, between the problem identified by parents and the infant behaviour underlying the problem, between different types of crying behaviour and their causes, and between the types of cases which present at different ages. It proposes that the two main approaches to parenting advocated by baby‐care experts, ‘infant‐demand’ and ‘structured’ parenting, have different benefits, and costs. Comparative studies have found that infant‐demand parenting is associated with low amounts of fussing and crying in the first three months of age, but with night waking which continues beyond three months. Randomised controlled trials have provided evidence that structured parenting leads to more overall fussing and crying during the first three months, but reduced night waking and crying after that. The findings are translated into recommendations for preventing and treating infant crying and sleeping problems, for policy debate, and for further research. Copyright © 2007 John Wiley & Sons, Ltd.