The Management of Mental Health, and Service Networks in Italy

Madness has attracted and frightened for centuries,and talking about this means discussing how this diversity was built and managed in different social contexts and historical periods.Not all societies have had,and still have,the same relationship with madness.It is only with the affirmation of the Modern State,and of Capitalism,that the idea of“normality”indispensable to be able to conceive diversity as something dangerously distant and different from the norm takes over.In our post-modern society,people with mental illness in Italy can resort to specialists and social-health services.But the heterogeneous answers given after the approval of law 180 appear to be increasingly diversified.In this research,much attention will be paid to how the social and health services,located in different areas of Italy(Messina,Rome,Trento)face the current growing risk of social,housing and economic isolation of these fragile subjects.The aim of the research is to explore the possibility of a new relationship between the social-health service and the local community.On the one hand,research investigates what the contribution of the services could be.On the other what the spaces of protagonism and participation of the community could be in inclusion process account.In order to better understand the differences between these two dimensions,a qualitative research approach was chosen through the conduct of in-depth interviews.In this way it was possible to investigate:(1)the partial representations characteristic of the single individual,family members,operators and stackholders in general;(2)the services around the topic dealt with is articulated.From the first results of the research it emerges that the territory can no longer be considered as an abstract entity,but becomes the social space within which the construction of a new community welfare can and must take place.

The Impact of Total Quality Management on Health Services Improvement, Sana’a Hospitals, Yemen (2017-2020)

Background: Total quality management (TQM) plays a major role in quality health services improvement. The aims of the study are to identify the concepts of total quality management in health institutions to know the nature of the relationship between the application of TQM and improving the quality of health services in Sana’a Governorate. Method: This applied research is a descriptive cross-sectional study in which the TQM of 13 affiliated Sana’a Governorate hospitals during “2017-2020”, were evaluated based on self-administered questionnaires. Data were collected by questionnaires including demographical variables, TQM dimensions variables. Data were analyzed by using SPSS version 16. Results: A total of 281 users 98.6% had responded. The employee’s responses for sixth study dimensions were the top manager’s commitment (TMC) 80.46%, customers focusing CF 81.55%, continuous improvement (CI) 82.32%, training (T) 71.51%, and strategic planning of the quality (SPQ) 74.76%, health services quality improvement (HSQI) 74.25%. There is a strong relationship between TQM and HSQI. There is no relationship between demographic factors gender, profession, years of experience, except age with TMC, T, HSQI, qualification with the TMC, CI, T, HSQI and job with all study variables. Conclusion: The application of TQM at hospitals in quality of health services improvement has several challenges, lacking staff experience and lacking leadership support, weakness of the training, customers focusing, continuous improvement, and strategic planning of the quality. Therefore, benefiting from the experiences of leading hospitals in implementing total quality management programs by sending some cadres to these hospitals for training and gaining experience or by hosting experienced cadres to conduct training courses is recommended.

Research progress on the health status and community management service needs of mobile elderly people

The health status of the floating elderly population and the need of community management services are complex and important problems.Owing to the change of living environment and the insecure medical care,the mobile elderly people have more health and psy-chological problems compared to the rest of the elderly population.Therefore,the community should take a variety of measures to meet their needs and help them to better adapt to the new living environment,and maintain their physical and mental health.This paper aims to summarize recent studies on the physical and emotional health problems of mobile elderly people and related community management service needs.

Scientific Management of Capital Construction in Health Service

On the basis of discussing the existing problems of the capital constrution in health service inHeilongjiang province and summing up the experience,the article points out that in order to makea good job of the scientific management of capital construction in health service,great importanceshould be attached to the following points:1.Make a good job of the reform of the managementsystem of capital construction,and strengthen and perfect the rational setups;2.Do not take onextra-programming project.Act strictly according to the procedure of examination and

The Role of Library and Information Science Education in the Development of Community Health Information Services for People Living with HIV/AIDS: Perspectives of Directors and Managers of Public Libraries

This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are presented from semi- structured qualitative interviews that were conducted with eleven directors and managers of local branches in the Knox County Public Library (KCPL) System that is located in the East Tennessee region in the United States. Select feedback reported by research participants is summarized in the article about strategies in LIS education that can help local public librarians and others in their efforts to become more responsive information providers to PLWHA. Research findings help better understand the issues and concerns regarding the development of digital and non-digital health information services for PLWHA in local public library institutions.

Role Expectation of Nurse Managers in Geriatric Health Services Facilities

Back ground: The characteristics of geriatric health services facilities (GHSF) in Japan include provision of care focused on the life of the residents, and there is a need for cooperation between care workers and physical therapists responsible for the care. Thus, it is expected that a nurse manager occupies specific roles suited for the above characteristics that are different from those of medical facilities. Thus, we aimed to clarify the role expected of nurse managers via a questionnaire survey administered to nurses and care workers in GHSF. Methods: We used a descriptive, cross-sectional design. The study was conducted in 56 GHSF all over Japan. The instrument used for data collection was a questionnaire. The questionnaires consisted of 35 items for determining role expectation of nurse managers, the background information of respondents. The role of nurse managers was analyzed using principal factor analysis (promax rotation). Findings: A total of 259 nurses and care workers participated in this study. We extracted 34 items by factor analysis, which were classified into three factors (promotion of home nursing, management of medical care, and environment creation for collaboration and education). Among care workers, four factors consisting of 33 items were extracted. Factors one, two, and three were similar to those of nurses;“intervention to ethical problem” was extracted as the additional fourth factor. Conclusion: The roles required for nurse managers in GHSF are the promotion of home nursing, which is the original role of the health services facilities, exhibition of the specialty as a healthcare professional, creation of a work environment that promotes mutual understanding for collaboration with other professionals, and enhancement of the education and training system.

Comparison of Family Clinic Community Health Service Model with State-owned Community Health Service Model

Based on a survey of com munity health service organization in several cities,communi- ty health service model based on the family clinic was compared with state- owned com munity health service m odel,and status quo,advantages and problems of family comm unity health service organization were analyzed.Furtherm ore,policies for the management of comm unity health ser- vice organization based on the family clinic were put forward.

Satisfaction of Village Doctors with the Township and Village Health Services Integration Policy in the Western Minority-inhabited Areas of China

Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the target goals in China＇s new healthcare reform, is to gradually integrate rural health services and appropriately allocate rural health resources. This study aims to assess the village doctors＇ satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM. A cross-sectional study was carried out in which 162 village doctors from Qinghai, Inner Mongolia and Xinjiang in western China were interviewed. Descriptive analysis, independent t-test, one-way ANOVA, Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors＇ personal characteristics and their satisfaction with TVHSIM and six subscales. Village doctors with different years of practice, social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels（all P〈0.05）. Age（P〈0.05） and years of practice（P〈0.01） were negatively correlated with Drug and Medical Device Management and Financing Management. Essential medical knowledge level（P〈0.05） was negatively correlated with Operations Management as well. However, social insurance status（P〈0.05） was positively correlated with Human Resources Management and Drug and Medical Device management. Gender, age and years of practice respectively had significant influence on village doctors＇ satisfaction with TVHSIM（P〈0.01）. In conclusion, in order to further promote TVHSIM policy in rural China, a well-rounded social insurance model for village doctors is urgently needed. In addition, the development of TVHSIM is regionally imbalanced. Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.

Prediabetes and cardiovascular complications study:Highlights on gestational diabetes, self-management and primary health care

International collaboration on the prediabetes and cardiovascular complications study started in 2013.In 2017,a reflection was reported.Incompleteness of documentation and screening of antenatal cases for gestational diabetes mellitus(GDM)was concerning.Hence,further observations have been made that warrant an update.The objective of this review is to highlight gaps between clinical knowledge and practice in GDM,diabetes self-management and primary health care(PHC)for rural dwellers.We followed a descriptive field notes method.Antenatal records of patients screened for GDM with incomplete documentation were examined to determine incompleteness of data in those that also met the criteria for GDM risk assessment.Experiences on development of a diabetes register and education and notes on behavioural change wheel were also reviewed.Other data included cross-sectional evaluation of activities of daily living at two private hospitals.Up to 29%had high GDM risk factors,which fulfilled selection criteria for laboratory screening.Demographic data was complete in all women;however,incomplete documentation was observed with as much as 98%of basic data.High levels of physical activity were found in the population,and health lectures proved effective in food choices.The workforce need for diabetes care seems underestimated,but this may be better understood with reactivation of PHC services.The observations highlight behavioural change wheel issues on GDM and PHC services that need concerted focus.Two proposals are to advance the use of a‘risk assessment and screening sheet’for GDM screening and enlightenment of stakeholders on the central hub role of PHC in diabetes management.

Mechanisms for the Application of Health Services Marketing Policies in Algeria

In this paper, we tried to give health services marketing mix and raise patients＇ interest in health services with the contribution to highlighting the possible application mechanisms of different marketing policies on health services in Algeria. Because we see that, health foundations in Algeria like other foundations live in an environment marked with constantly economic, social, politic, and cultural changes. And to respond to change requirements, especially with the appearance of health services market liberation signs, these foundations are obliged to adapt to ensure their existence and development by giving best services to meet the patients＇ needs in order to gain their satisfaction and loyalty. These ones, who became more conscious about the quality of services they are given quantitatively, qualitatively, and timely.

SWOT Analysis on healtli management development in China

从政府、企业和个人三个角度阐述了我国目前健康管理行业的发展现况,结合相关理论与实践对我国 健康管理的发展进行SWOT分析,提出明确定位完善配套政策、落实健康管理行业和相关产业的责任部门、以 需求为导向推动产业结构升级、规范学科建设创新发展模式完善服务内容、提高宣传力度增强国民认知度和接 受度的意见和建议.

微服务架构Service Mesh的设计与应用

微服务架构正处于兴起阶段,在SpringCloud,Dubbo框架的支持下,微服务框架成为了最主流的分布式应用解决方案,然而随着微服务实施水平的不断深化,不论是市面上的哪种框架,都会存在一些问题,本文将分析当前微服务架构存在的一些问题,并且针对这些问题找到基于Service Mesh的Istio框架这种比较好的解决方案。最后在实际的运用场景区域卫生综合管理平台进行探讨,说明了Service Mesh的这种架构思想优于传统的微服务的架构思想。

Participation of private general practitioners in disease management of malaria in Myanmar

Objective:Myanmar has been trying to improve the disease management of malaria through public health services. The involvement of private general practitioners(GPs) is recognized as one of the key contributory issues in malaria control,but no one has yet made an attempt to study the efficiency of their role.This study aimed to assess the participation of GPs in improvement of disease management.Methods:The study was conducted with all 32 GPs practicing at three randomly selected townships with high malaria load situated in Upper Myanmar from June 2006 to March 2007 using a pretest-posttest design to assess their knowledge of the disease management prior to and after intervention.The intervention package consisted of a one-day workshop on diagnosis and treatment of malaria and the supply of facilities for microscopy.Questionnaires filled in before and after tests were compared to assess the change of knowledge after the intervention.Diagnosis and treatment practice during the study period was analysed by review of registers kept by GPs,together with a follow-up survey of their patients for the reliability of data.Results:An overall improvement of knowledge was observed and significant changes were apparent for three variables:the criteria for referral of severe malaria,the effect of incomplete treatment and recommended treatment of Plasmodium vivax.Pre-test results showed that only 65.6%of GPs perceived microscopy or Rapid Diagnostic Test kits(RDTs) for confirmation of malaria necessary,while only 15.6%and 40.6%of the GPs knew the recommended treatments of falciparum and vivax malaria,respectively. However,after intervention 92%of the patients were diagnosed as malaria by RDTs and 3%by microscopy throughout the study.The GPs prescribed artemisinin-based combination therapy(ACTs) to 95%of confirmed falciparum cases and treated 82.4%of RDT confirmed falciparum negatives with chloroquine and primaquine.Concurrent with our study,an international NGO,Population Service International,supplied GPs with RDTs and ACTs at subsidized rate which was helpful.Conclusion:The study suggests that participation of GPs may help improve the disease management of malaria and thus assist in the country’s effort to control ma- laria.

Effectiveness of the Service Mapping Method in Re-designing the Bariatric Surgery Clinical Pathway of a Public Hospital

Background： Nowadays obesity is the world＇s common disease. Bariatric surgery is the only therapy that providessignificant cost savings within Public Health Service, but the lack of diagnostic paths universally accepted causes enormous waste ofresources and disruptions. Service Mapping is the ideal methodology to describe work＇s organization and to plan a new service model.Methods： The Service Mapping has been used to represent the actual state of the bariatric surgery service and starting from the criticalaspects found, we have developed a desirable state of the service. Results： Experience-based design has given centrality to thebeneficiary, making the bariatric service sensitive to patient＇s needs and expectations. The micro-organization of work has improvedprofessionals＇ integration, avoiding the creation of new operational entities or additional costs. The service has been simplified both forclinicians and hospital managers. The strategic repositioning of the dietician and general practitioner＇s recognition within the bariatricpath allowed us to achieve better clinical outcomes. Conclusions： Service Mapping has highlighted clinicians＇ difficulties in providingthe service, emphasizing the importance of the beneficiary. The iconic representation is a powerful explicit framework, fundamental formanagement purposes, to understand the role of every subject involved in the service, to rationalize work＇s organization, and integratehealthcare activities.

Improving the Patient Discharge Planning Process through Knowledge Management by Using the Internet of Things

The UK National Health Service (NHS) is faced with problems of managing patient discharge and preventing the problems that result from it such as frequent readmissions, delayed discharge, long waiting lists, bed blocking and other such consequences. The problem is exacerbated by the growth in size, complexity and the number of chronic diseases in the NHS. In addition, there is an increase in demand for high quality care, processes and planning. Effective Discharge Planning (DP) requires practitioners to have appropriate, patient personalised and updated knowledge in order to be able to make informed and holistic decisions about a patients’ discharge. This paper examines the role of Knowledge Management (KM) in both sharing knowledge and using tacit knowledge to create appropriate patient discharge pathways. The paper details the factors resulting in inadequate DP, and demonstrates the use of Internet of Things (IoT) and Machine2Machine (M2M) as candidate technologies and possible solutions which can help reduce the problem. The use of devices that a patient can take home and devices which are perused in the hospital generate information, which can serve useful when presented to the right person at the right time, thus harvesting knowledge. The knowledge when fed back can support practitioners in making holistic decisions with regards to a patients’ discharge.

人工智能大语言模型在基层医疗卫生服务中的应用与挑战

基层医疗系统是实现健康公平的关键。我国面临医疗资源分布不平衡、基层医生数量短缺以及慢性病防治形势不容乐观的严峻挑战。人工智能大语言模型在医疗系统中发挥出了强大优势,本文深入探讨了大模型在基层医疗系统中的应用及其面临的挑战,提出应进一步深化大模型的应用,以辅助基层医生常见病诊疗,推动智能化健康教育和慢性病管理,托底“老少边穷”地区基层卫生服务,激发全科医学的飞跃性发展,并推进大模型在全科诊疗与基层卫生服务中的产业化,为健康中国建设提供重要支撑。

An automated management system for the community health service in China

Objective:To explore a useful tool for health administrative departments to manage the com-munity health service(CHS).Methods:On the basis of existing health laws and regulations in China,we describe the design of an automated management system for the CHS with a supervision system and an evaluation system using computer technology and corresponding design software.Results:Four changes to the management of the CHS were made:repetitive work became automated,complicated work became simplified,nonregular services decreased,and obscure in-structions became clear and specific.Conclusion:The automated management system will promote the development of CHS man-agement.

我国农村家庭医生签约服务老年人健康管理实践影响因素:一项范围综述

背景以家庭医生签约服务为载体的健康管理服务是我国农村老年人实现健康老龄化的必要途径,而该项服务在实践中受到多种因素影响。目的对影响我国农村家庭医生签约服务老年人健康管理实践的因素进行范围综述,为提高该项服务的可及性和有效性提供参考依据。方法于2023年1—4月,遵循范围综述报告规范清单,于Web of Science、PubMed、Embase、Medline、CINAHL、中国知网、万方数据知识服务平台、维普网和中国生物医学文献数据库检索有关家庭医生签约服务老年人健康管理的文献,检索时限为建库至2022-12-31。根据纳入和排除标准,基于社会生态学模型审查、总结和分析影响农村家庭医生签约服务老年人健康管理实践的因素。结果共纳入27篇文献,提取了与农村家庭医生签约服务老年人健康管理相关的个人、人际、组织、社区及政策5个层面的影响因素。结论农村家庭医生签约服务老年人健康管理实践受到多层面、多因素影响,推动农村地区签约服务老年人健康管理发展需综合考虑其影响因素,明确各责任部门、主体的权利和义务,合力促进以家庭医生签约服务为载体的健康管理服务提质增效。

Knowledge management and services for smart health

With the rapid development and integration of modern information technologies(such as Big data,Cloud computing,Internet of Things,and Mobile Internet),waves of"Internet+medical"and artificial intelligence have swept the world,driven rapid expansion of health intelligent terminals.