Ethical issues in the publication of clinical material

Some of the ethical issues involved in publishing clinical material are considered. These include the 'ownership' of such material, the responsibilities of the analyst towards patients and professional colleagues, the keeping and status of records, the nature of trust and confidentiality and its place in analysis, the question of obtaining consent for publication, the nature of consent, and its consequences for treatment. The issues of disguise, of authenticity, and of accuracy are also touched on, as is the potential role of the author's anonymity in protecting the anonymity of the patient.     

AN APPOINTMENT-KEEPING IMPROVEMENT PACKAGE FOR OUTPATIENT PEDIATRICS: SYSTEMATIC REPLICATION AND COMPONENT ANALYSIS

Child health-care appointments that are not kept are an important pediatric problem. Previous research has shown that reducing effort (with a parking pass) and reminding patients (with mailed and telephone reminders) significantly improved appointment keeping for first-time and patient-scheduled appointments. This study, using a posttest-only group design, evaluated the effects of various combinations of that intervention applied to clinic-scheduled follow-up appointments. All combinations of the intervention significantly increased cancellations, but none increased appointments kept or decreased appointments not kept significantly. Log linear analyses showed that the lag time between scheduling and the appointment significantly influenced appointment keeping. The results suggest that if clinics want to increase cancellations, a mailed reminder and effort reduction are sufficient. To increase appointment keeping, other interventions, such as reduced lag time, may be necessary.     

阅读速度与提要位置对不同认知方式学生信息保持的影响

本研究主要探讨阅读速度与提要位置对不同认知风格学生信息保持的影响。结果表明：读者认知方式的差异在很大程度上影响了对文章不同类型信息的保持．但对文章总回忆量没有显著影响。提要前置使场依存型读者对文章结构性信息的回忆量增多,场独立型读者对从属性信息的回忆量增多;提要后置使场依存型读者从属性信息的回忆量增多。阅读速度对文章不同类型信息和总信息量的保持均有显著影响．但在提要前置的情况下,对文章结构性信息的回忆量没有显著影响。     

三级查房制度在围手术期管理中的实践与思考——以日间手术为例

三级查房制度是我国十八项医疗质量核心制度之一。围手术期落实三级查房制度能够推动高质量手术开展,促进术后高效率康复,降低围术期医疗成本,实现良好的医疗体验。日间手术的开展存在“分散”“集中”两类管理形式,在三级医生的划分、查房形式、频率及记录等细节上仍存在问题。通过组建跨科三级医疗团队、借助信息化技术实现远程查房、拓展住院查房概念实现“院外+院内”全程查房与全程记录等措施,既符合三级查房制度的初衷,又实现该制度实施细节的优化,能够促进日间手术“更高质量、更快康复、更低成本、更优体验”的目标的实现。

     

THE ACCELERATED INTAKE: A METHOD FOR INCREASING INITIAL ATTENDANCE TO OUTPATIENT COCAINE TREATMENT

We examined whether offering an accelerated (same-day) versus a standard (1- to 7-day delay) intake appointment increased initial attendance at an outpatient cocaine treatment program. Significantly more of the subjects who were offered an accelerated intake (59%) attended than those who were given a standard intake (33%), χ² (2, N = 78) = 4.198, p < .05. The accelerated intake procedure appears to be useful for enhancing enrollment in outpatient addiction treatment.     

IMPROVING PEDIATRIC APPOINTMENT KEEPING WITH REMINDERS AND REDUCED RESPONSE REQUIREMENT

We evaluated the effectiveness of appointment reminders and a reduced response requirement for improving appointment keeping in a hospital ambulatory pediatric clinic. Participants received mailed and telephoned reminders along with a parking pass that reduced the time and effort required to attend the clinic. A multiple baseline analysis of 5,261 appointments over one fiscal year showed that the intervention increased the percentage of appointments kept and decreased the percentage of appointments broken in the continuity clinics of five pediatric health care providers. Social validation, consumer satisfaction, and cost-effectiveness measures, as well as an interrupted time-series analysis, all support the effectiveness of the intervention.     

REDUCING NONCOMPLIANCE TO FOLLOW-UP APPOINTMENT KEEPING AT A FAMILY PRACTICE CENTER

In this study, we evaluated follow-up appointment keeping at a family practice center. To determine if noncompliance could be reduced, four treatments were implemented: no-treatment control, modified appointment card, free follow-up, and a reduced rate follow-up. Thereafter, the reduced rate follow-up was implemented again to determine the extent noncompliance could be reduced for all eligible patients. Incentives significantly increased follow-up appointment keeping, whereas the modified appointment card was ineffective. A cost analysis suggested that the no-treatment control and modified appointment card conditions were the least expensive, but also the least effective. The incentive conditions were more expensive, but the reduced rate condition generated the most net revenue. Questionnaire data suggested that the incentive conditions had an effect on noncompliance and may be considered for use in other medical settings.     

《管子·内业》健身养生方法与西方体育文化观念探讨

利用文献资料研究法．对《管子·内业》健身养生方法和西方体育文化的内涵给予分析,发现两种不同体育文化形态虽然在价值观念上存在着“空间维度”和“时间维度”上差异,但无论是《内业》所论述的“精气养生”法,还是西方体育所崇敬的肉体健美法,其最终目标都是为促进人类的健康长寿和全面发展服务。     

《管子》"时"观初探

"时"观念是理解中国古代思想的重要线索。在一定层面上讲,"时"观念的延展及其实践承载着传统农业社会的绵延。"时"在《管子》中是一个基础性的核心概念,贯通全文,它传承"时"的原发观念和本质特性,融入气、阴阳、五行思想,与道、德、法相通融,"时"作为论理基准,在"治国安邦"、"经世致用"中具有统领性意义。