Evaluation of an intervention supporting breastfeeding among late-preterm infants during in-hospital stay

BackgroundLate-preterm infants show lower breastfeeding rates when compared with term infants. Current practice is to keep them in low-risk wards where clinical guidelines to support breastfeeding are well established for term infants but can be insufficient for late-preterm.ObjectiveThe aim of this study was to evaluate an intervention supporting breastfeeding among late-preterm infants in a maternity service in the Basque Country, Spain.MethodsThe intervention was designed to promote parents’ education and involvement, provide a multidisciplinary approach and decision-making, and avoid separation of the mother-infant dyad. A quasi-experimental study was conducted with a control (n = 212) and an intervention group (n = 161). Data was collected from clinical records from November 2012 to January 2015. Feeding rate at discharge, breast-pump use, incidence of morbidities, infant weight loss and hospital stay length were compared between the two groups.ResultsInfants in the control group were 50.7% exclusive breastfeeding, 37.8% breastfeeding, and, 11.5% formula feeding at discharge, whereas in the intervention group, frequencies were 68.4%, 25.9%, and 5.7%, respectively (p = 0.002). Mothers in the intervention group were 2.66 times more likely to use the breast-pump after almost all or all feeds and 2.09 times more likely to exclusively breastfeed at discharge. There were no significant differences in morbidities and infant weight loss between groups. Hospital stay was longer for infants who required phototherapy in the intervention group (p = 0.009).ConclusionThe intervention resulted in a higher breastfeeding rate at discharge. Interventions aimed to provide specific support among late-pretem infants in maternity services are effective.     

读《永生医院》，想象“永生”——从“写什么”说到“生生”

文章以郝景芳在《永生医院》中遭遇到的"永生"问题为切入点,在中西方生命哲学的大背景下,对当代科技手段制造出来的"新人"所带来的文化冲击和个体生命的意义危机进行了深入的思考。作者从中国传统的"生生"哲学出发,深入剖析了以技艺人的工作经验为基础的古希腊"制造"哲学借助于当代科技手段造成的生命哲学危机,指出"永生"不是生命的最高目标,唯有在变动不息的"生生"之中,才有生命的真实意义。     

Pragmatic decisions in the evaluation of consumer satisfaction with mental health treatment

This article examines pragmatic choices which must be made in conducting consumer satisfaction assessment of mental health treatment. It is argued that choices involving sample, format, and procedure for examining satisfaction may influence the results of such research, and must be considered when creating or evaluating these efforts. These choices are examined in detail.     

我国医院经济未来发展问题研究

医院建设和发展的实践充分证明，作为管理经济不可缺少的资本积累，已越来越被人们所重视，这也是未来我国医院发展迫切的一种经济活动方式。     

Efficacy of Statistical Outlier Analysis for Monitoring Quality of Care

Researchers have proposed that hospitals with excessive statistically unexplained mortality rates are more likely to have quality-of-care problems. The U.S. Health Care Financing Administration currently uses this statistical “outlier” approach to screen for poor quality in hospitals. Little is known, however, about the validity of this technique, since direct measures of quality are difficult to obtain. We use Monte Carlo methods to evaluate the performance of the outlier technique as parameters of the true mortality process are varied. Results indicate that the screening ability of the technique may be very sensitive to how widespread quality-related mortality is among hospitals but insensitive to other factors generally thought to be important.     

《后出师表》真伪考释

有学者对诸葛亮《后出师表》提出置疑。笔者提出几点意见：一、《后表》虽不载于《诸葛亮传》,但见于《诸葛恪传》;二、《后表》不是张俨、诸葛恪伪造;三、《后表》用语与诸葛亮习惯用语符合;四、《后表》立意与诸葛亮行为一致。由此可知,《后表》是诸葛亮的作品。     

从丁玲《在医院中时》看知识分子革命者的成长

知识分子革命者的成长,是一个漫长而艰巨的历程。丁玲《在医院中时》是一部真实展现知识分子成长的代表作。抗战时期,大批知识分子奔赴革命圣地延安,壮大了革命力量。然而由于知识分子自身的弱点,对他们的改造也很艰巨。文中陆萍的成长具有普遍的代表性,透过她经历的过程,可以看到大批知识分子革命者成长的轨迹。     

基于SCI数据库的在宁三甲综合医院科研能力研究——以南京医科大学第一附属医院为例

科技论文是科研成果的重要载体,在一定程度上可以反映一个单位或机构的科研能力和水平.文章采用文献计量学方法,对SCI收录的南京医科大学第一附属医院的论文情况,从论文数量、年代分布、来源期刊及其影响因子、国家和机构等多个角度进行分析,了解和认识该院的科研和学术水平,并对统计中发现的问题进行分析探讨.     

Linking Electronic Medical Records Use to Physicians’ Performance: A Contextual Analysis

Electronic Medical Records (EMR) studies have broadly tested EMR use and outcomes, producing mixed and inconclusive results. This study carefully considers the healthcare delivery context and examines relevant mediating variables. We consider key characteristics of: (i) interdependence in healthcare delivery processes, (ii) physician autonomy, and (iii) the trend of hospital employment of physicians, and draw on theoretical perspectives in coordination, shared values, and agency to explain how the use of EMR can improve physicians’ performance. In order to examine the effects of physician employment on work practices in the hospital, we collected 583 data points from 302 hospitals in 47 states in the USA to test two models: one for employed and another for nonemployed physicians. Results show that information sharing and shared values among healthcare delivery professionals fully mediate the relationship between EMR use and physicians’ performance. Next, physician employment determines which mediating variable constitutes the pathway from EMR use to physicians’ performance. Finally, we highlight the impact of shared values between the hospital and physicians in enhancing information sharing and physicians’ performance, extending studies of these behaviors among network partners in industrial settings. Overall, our study shows that EMR use should be complemented by processual (information sharing), social (shared values), and structural (physician employment) mechanisms to yield positive effects on physicians’ performance.     

我国医院经济运行管理信息化研究

随着医院信息化进程不断加速，海量数据仅靠人工处理几乎是不可能实现的，因此亟需一套完整的信息化系统，来整合分析数据，提高医疗效率和医疗效果。