目的评价深圳和滁州两地区社区卫生服务中心0~6岁儿童的健康服务质量,为提升基层医疗卫生机构服务水平提供理论依据和改进建议。方法2021年2—5月采用基层医疗评价工具儿童版量表(Primary Care Assessment Tool Children Edition,PCAT-...目的评价深圳和滁州两地区社区卫生服务中心0~6岁儿童的健康服务质量,为提升基层医疗卫生机构服务水平提供理论依据和改进建议。方法2021年2—5月采用基层医疗评价工具儿童版量表(Primary Care Assessment Tool Children Edition,PCAT-CE)评价深圳市和滁州市各7家社区卫生服务中心的0~6岁儿童健康服务质量,比较分析两地区PCAT-CE量表得分差异,利用多元线性回归进一步探讨其影响因素。结果深圳地区共回收1130份有效问卷,滁州地区共回收2685份有效问卷。深圳地区PCAT-CE量表总评分(89.04±19.49)分高于滁州地区总评分(87.41±25.19)分,差异有统计学意义(t=2.159,P<0.05);在首诊服务、以患儿和家庭为中心、以社区为导向方面,深圳地区得分均高于滁州地区,差异有统计学意义(P<0.05)。多元线性回归分析显示,深圳地区儿童的自我健康状况评价为非常好/很好/好,就诊次数少于7次、签约家庭医生的社区卫生服务中心PCAT-CE量表评分更高;滁州地区研究儿童中母亲文化程度为本科及以上、家庭月收入处于3000~10000元、就诊次数少于7次、签约家庭医生的社区卫生服务中心PCAT-CE量表评分更高。结论深圳地区的社区卫生服务中心儿童健康服务质量水平整体高于滁州地区,具体表现在首诊服务、以患儿和家庭为中心以及以社区为导向维度方面。就诊次数和家庭医生的签约是影响两地区儿童健康服务质量的主要因素。展开更多
In the optimization of the process of steel valve plate grinding, it is necessary to take into consideration different processing parameters. This paper is going to describe the production of a steel valve plate with ...In the optimization of the process of steel valve plate grinding, it is necessary to take into consideration different processing parameters. This paper is going to describe the production of a steel valve plate with the focus on flat-grinding. It is also going to present the method of choosing grinding wheels and parameters, as well as their impact on the processing quality parameters （roughness, surface flatness and seat width）. The optimization of the grinding process ensures acceptable quality of the final product applying the smallest possible changes in parameters at non-uniform quality levels of the tools. Here we have to make sure that the machining process is acceptable in terms of processing cost as weIl. We are going to use the G-factor as the efficiency indicator for different tools.展开更多
This study represents an approach to investigate a force controlled short-stroke honing process and especially the dependency between the type of finishing tool and the resulting shape accuracy. Based on a finite elem...This study represents an approach to investigate a force controlled short-stroke honing process and especially the dependency between the type of finishing tool and the resulting shape accuracy. Based on a finite element analysis and a validation with special pressure measurement films, the contact mechanisms between the finishing tool and the workpiece are analyzed. In order to achieve a high surface quality without reducing the shape accuracy, the influence of different finishing tools with an individual material behavior on the resulting shape accuracy have been analyzed. With a variation of the geometry of the finishing tool as well as of the workpiece, different loading cases between the tool and the workpiece are considered in the finite element simulation. These results, combined with experimental investigations with different finishing films lead to an improvement of the surface quality without reducing the shape accuracy.展开更多
The thermal conditions like the temperature distribution and the heat fluxes during metal cutting have a major influence on the machinability, the tool lifetime, the metallurgical structure and thus the functionality ...The thermal conditions like the temperature distribution and the heat fluxes during metal cutting have a major influence on the machinability, the tool lifetime, the metallurgical structure and thus the functionality of the work piece. This in particular applies for manufacturing processes like milling, drilling and turning for high-value turbomachinery components like impellers, combustion engines and compressors of the aerospace and automotive industry as well as energy generation, which play a major role in modern societies. However, numerous analytical and experimental efforts have been conducted in order to understand the thermal conditions in metal cutting, yet many questions still prevail. Most models are based on a stationary point of view and do not include time dependent effects like in intensity and distribution varying heat sources, varying engagement conditions and progressive tool wear. In order to cover such transient physics an analytical approach based on Green＇s functions for the solution of the partial differential equations of unsteady heat conduction in solids is used to model entire transient temperature fields. The validation of the model is carried out in orthogonal cutting experiments not only punctually but also for entire temperature fields. For these experiments an integrated measurement of prevailing cutting force and temperature fields in the tool and the chip by means of high-speed thermography were applied. The thermal images were analyzed with regard to thermodynamic energy balancing in order to derive the heat partition between tool, chips and workpiece. The thus calculated heat flow into the tool was subsequently used in order to analytically model the transient volumetric temperature fields in the tool. The described methodology enables the modeling of the transient thermal state in the cutting zone and particular in the tool, which is directly linked to phenomena like tool wear and workpiece surface modifications.展开更多
文摘目的评价深圳和滁州两地区社区卫生服务中心0~6岁儿童的健康服务质量,为提升基层医疗卫生机构服务水平提供理论依据和改进建议。方法2021年2—5月采用基层医疗评价工具儿童版量表(Primary Care Assessment Tool Children Edition,PCAT-CE)评价深圳市和滁州市各7家社区卫生服务中心的0~6岁儿童健康服务质量,比较分析两地区PCAT-CE量表得分差异,利用多元线性回归进一步探讨其影响因素。结果深圳地区共回收1130份有效问卷,滁州地区共回收2685份有效问卷。深圳地区PCAT-CE量表总评分(89.04±19.49)分高于滁州地区总评分(87.41±25.19)分,差异有统计学意义(t=2.159,P<0.05);在首诊服务、以患儿和家庭为中心、以社区为导向方面,深圳地区得分均高于滁州地区,差异有统计学意义(P<0.05)。多元线性回归分析显示,深圳地区儿童的自我健康状况评价为非常好/很好/好,就诊次数少于7次、签约家庭医生的社区卫生服务中心PCAT-CE量表评分更高;滁州地区研究儿童中母亲文化程度为本科及以上、家庭月收入处于3000~10000元、就诊次数少于7次、签约家庭医生的社区卫生服务中心PCAT-CE量表评分更高。结论深圳地区的社区卫生服务中心儿童健康服务质量水平整体高于滁州地区,具体表现在首诊服务、以患儿和家庭为中心以及以社区为导向维度方面。就诊次数和家庭医生的签约是影响两地区儿童健康服务质量的主要因素。
文摘In the optimization of the process of steel valve plate grinding, it is necessary to take into consideration different processing parameters. This paper is going to describe the production of a steel valve plate with the focus on flat-grinding. It is also going to present the method of choosing grinding wheels and parameters, as well as their impact on the processing quality parameters （roughness, surface flatness and seat width）. The optimization of the grinding process ensures acceptable quality of the final product applying the smallest possible changes in parameters at non-uniform quality levels of the tools. Here we have to make sure that the machining process is acceptable in terms of processing cost as weIl. We are going to use the G-factor as the efficiency indicator for different tools.
文摘This study represents an approach to investigate a force controlled short-stroke honing process and especially the dependency between the type of finishing tool and the resulting shape accuracy. Based on a finite element analysis and a validation with special pressure measurement films, the contact mechanisms between the finishing tool and the workpiece are analyzed. In order to achieve a high surface quality without reducing the shape accuracy, the influence of different finishing tools with an individual material behavior on the resulting shape accuracy have been analyzed. With a variation of the geometry of the finishing tool as well as of the workpiece, different loading cases between the tool and the workpiece are considered in the finite element simulation. These results, combined with experimental investigations with different finishing films lead to an improvement of the surface quality without reducing the shape accuracy.
文摘The thermal conditions like the temperature distribution and the heat fluxes during metal cutting have a major influence on the machinability, the tool lifetime, the metallurgical structure and thus the functionality of the work piece. This in particular applies for manufacturing processes like milling, drilling and turning for high-value turbomachinery components like impellers, combustion engines and compressors of the aerospace and automotive industry as well as energy generation, which play a major role in modern societies. However, numerous analytical and experimental efforts have been conducted in order to understand the thermal conditions in metal cutting, yet many questions still prevail. Most models are based on a stationary point of view and do not include time dependent effects like in intensity and distribution varying heat sources, varying engagement conditions and progressive tool wear. In order to cover such transient physics an analytical approach based on Green＇s functions for the solution of the partial differential equations of unsteady heat conduction in solids is used to model entire transient temperature fields. The validation of the model is carried out in orthogonal cutting experiments not only punctually but also for entire temperature fields. For these experiments an integrated measurement of prevailing cutting force and temperature fields in the tool and the chip by means of high-speed thermography were applied. The thermal images were analyzed with regard to thermodynamic energy balancing in order to derive the heat partition between tool, chips and workpiece. The thus calculated heat flow into the tool was subsequently used in order to analytically model the transient volumetric temperature fields in the tool. The described methodology enables the modeling of the transient thermal state in the cutting zone and particular in the tool, which is directly linked to phenomena like tool wear and workpiece surface modifications.
