目的 了解上海市闵行区儿童家长对百日咳疫苗"蚕茧策略"的接种意愿及其影响因素.方法 采用简单随机抽样方法在闵行区所有预防接种门诊选择0-6岁儿童的家长开展问卷调查,分析百日咳疫苗"蚕茧策略"接种意愿及其影响因素.结果 共纳入1 176名0-6岁儿童家长,其中40.22％(473名)知晓"蚕茧策略",67.69％(796名)愿意接种百日咳疫苗.多因素Logistic回归分析显示,本科文化程度、知晓"蚕茧策略"、认为应遵守政府疫苗接种政策、认为成人百日咳可传染新生儿、认为百日咳疫苗安全、认为百日咳疫苗有效、可负担疫苗接种费用的家长更愿意接种百日咳疫苗[OR(95％CI):1.96(1.14-3.37)、1.95(1.33-2.85)、1.99(1.28-3.10)、4.96(2.91-8.46)、2.65(1.05-6.69)、4.55(1.93-10.72)、2.59(1.22-5.50)],有基础疾病的家长更不愿意接种百日咳疫苗[OR(95％CI):0.62(0.41-0.94)].结论 闵行区0-6岁儿童家长百日咳疫苗"蚕茧策略"知晓率低而接种意愿高.需加强对家长百日咳和"蚕茧策略"相关知识的健康教育,为未来百日咳疫苗"蚕茧策略"奠定基础.

目的 调查上海市闵行区社区老年人认知障碍现况及影响因素.方法 采用多阶段随机抽样方法,于2019年7-8月在上海市闵行区莘庄镇,选择60岁以上居民作为调查对象,使用AD8量表,结合基线调查,初步筛查认知障碍患者,并进行统计学分析.结果 共调查2528例老年人,其中认知功能受损291例,筛出率为11.51％;单因素分析显示,不同年龄、文化程度等15项因素的老年人认知障碍筛出率差异有统计学意义(P＜0.05);非条件Logistic回归显示,低年龄、无糖尿病、无高脂血症是可能导致认知功能障碍的保护因素;低文化水平、缺乏锻炼(散步、锻炼和相对重一点的家务活动)是可能导致认知障碍的危险因素.结论 社区老年人认知功能筛查十分必要,是慢病管理中不可缺失的部分.

目的 探求我国老年人的生活满意度及其影响因素,为有关部门制定提高老年人生活质量的有效措施提供建议和理论依据.方法 基于中国老年健康影响因素跟踪调查(CLHLS)2018年的数据,运用卡方检验和Logistic回归方法分析我国老年人生活满意度及其影响因素.结果 影响老年人生活满意度的因素为老年人的活动能力(OR=1.683,95％CI:0.533～0.662)、受教育程度(OR=1.221,95％CI:1.100～1.355)、经济水平(OR=6.667,95％CI:0.118～0.190)、生活来源(OR=1.741,95％CI:1.498～2.024)、及时到达医院(OR=1.753,95％CI:1.336～2.301)、进行常规体检(OR=1.311,95％CI:1.172～1.465)、以及社区支持(OR=1.283,95％CI:1.154～1.425,P＜0.001).结论64.7％的老年人对目前的生活比较满意,应该引导老年人改善自身健康水平,提升老年人的受教育程度和文化素养,提高老年人的经济水平,完善社会保障制度,合理配置医疗服务,提高卫生服务的可及性、加强社区支持与人文关怀,提升老年人的生活质量.

目的:了解上海市闵行区中学生精神卫生知识知晓情况现状,为进一步对中学生开展心理健康教育提供参考依据,促进中学生心理健康发展.方法:2019年9—10月采用多阶段抽样方法,在上海市闵行区初中预备班到高三在校学生中抽取2633人,进行《中学生心理卫生知识问卷》调查.结果:本次研究实际调查中学生2612人,闵行区中学生精神卫生知识总体知晓率为72.80％,其中重点初中、普通初中、重点高中和普通高中学生知晓率分别为72.05％、68.62％、76.82和75.55％;知晓率女生高于男生,重点学校高于普通学校,高中高于初中,差异均有统计学意义(χ2值分别为57.68、71.75、313.99,P值均<0.01).结论:上海市闵行区中学生精神卫生知识知晓率仍需进一步提高,同时应加强对男学生、普通中学学生和初中生的宣传教育并适时对学生开展心理干预.

目的:比较上海市青浦区社区居家老人与养老机构住养老人的生活质量及其影响因素.方法:应用SF-36简明健康测量量表、基本日常生活活动(BADL)量表等对老人的生活质量、生活活动能力等开展测评,并进行描述性统计分析、单因素方差分析,秩和检验及多元线性回归分析.结果:32.6％的社区居家老人与28.4％的机构住养老人在过去半年患慢性病;机构住养老人为轻度及中度能力受损的占比为50％,远高于社区居家老人的16.9％;对于社区居家老人而言,生活自理能力BADL评分、患慢性病数量、医疗保险、曾经职业、性别、年龄对生存质量得分的影响较大.结论:空巢老人的心理健康问题较多,慢性病影响社区居家老人的生活质量,生活活动能力影响了老人的生存质量.

通过分析上海市浦东新区公共场所卫生行政处罚案件,了解上海市浦东新区公共场所卫生管理情况和存在问题,为进一步做好公共场所卫生监督管理工作提供科学依据.方法:使用Execl2007对公共场所卫生行政处罚案件数量、违法行为案由等方面进行统计分析.结果:上海市浦东新区2012-2016年对违反《公共场所卫生管理条例》及《公共场所卫生管理条例实施细则》进行行政处罚的案件数为2 427例,分别为2012年621起,2013年519起,2014年519起,2015年465起,2016年303起,呈逐年下降趋势.处罚案由集中在少数案由,以未取得公共场所卫生许可证擅自营业和安排未获得有效健康合格证明的从业人员从事直接为顾客服务工作为主,占总案由的88.17％.结论:建议进一步完善法制体系,加强卫生监督队伍建设,做好宣传和培训工作.

Objective:To evaluate the effects of the training for the new graduate students of major of health services management by using the Kirkpatrick model and to provide suggestions for optimizing the training scheme.Methods:The questionnaire survey including 32 new graduate students and the focus group interview including 2 teachers and 5 students were conducted.The Kirkpatrick model was applied to assess the effects of the training for the new graduate students through the four levels of reaction,learning,behavior and results.Results:The recognition proportion of the importance and necessity of the training for new students was 81.3％.The training courses were well perceived,which enabled the new graduate students to adapt to the new environment,integrate into the research team and master the basic research skills more quickly.Conclusion:The training has achieved positive effects through the evaluation of the Kirkpatrick model,which could be improved in time schedule and course arrangement.

Objective: Based on medical care buyers'intention to survey the understanding and influence of sinking high-quality medical resources policy and find the majority implementation barriers.Methods:We collected the quantitative and qualita-tive data based on the household survey and the key person interview .Results: Up to 76.90%of residents were not familiar with this policy and 53.50%of them considered this policy has no or uncertain effect on changing their medical institutions selection. Conclusion: The key barrier of the implementation of the sinking high -quality medical resources policy is the solidified behavior of seeking medical treatment of residents at the grass-roots level.The limited policy perceived degree also plays a key role in hindering grassroots residents to be benefit from this policy.

The doctor-patient relationship plays an important role in protecting lawful rights and interests of both doctors and patients.Through literature analysis and expert consultation,the problems in establishing are figured out and advice on it is proposed based on American experience and the situation of China.The telemedicine has challenged traditional doctor-patient relationship by changing the subject,condition and identification.The government should allow and formulate a stricter way to establish doctor-patient relationship in telemedicine,and promote the legal and technical means way to identify it.

目的:了解上海市老年护理服务机构护理人力的配置与培训教育现状.方法:横断面调查与典型案例分析相结合.对上海市305家老年护理相关机构进行普查,调查分析2011-2014年护理人力配置.以金山区某老年护理医院为典型案例,调查分析2006-2015年护理人员的培训教育情况.结果:老年护理服务每床位配置护理人员仅0.46人,低于国家0.8人的标准要求;护士与护理员比例为1∶1.41,未达国家1∶2～2.5的比例标准;分别仅有12.80％的机构达到国家护理人员配置总量、17.60％的机构达到护士与护理员人数比例的标准要求.护士的学历构成以大专/高中与中专/技校为主,而护理员的学历构成中最多的是小学/文盲.10年内仅11位护士参加了在职培训与教育.结论:目前上海市老年护理服务护理人员总数不足,护理员严重匮乏,素质水平偏低,在职教育与培训机会缺乏,建议完善相关政策,大力扶持老年护理服务护理人力的发展.

为了解当前医科类研究生就业现状,对上海市某高校所有医科类研究生毕业生为调查对象进行调研,结果发现家庭背景对个人就业过程影响较大、在校期间的实践经历有助于缓解就业压力,医科细分专业去向差异较为显著,提示高校在医科研究生就业指导时应关注家庭背景的影响、搭建实践平台、推动信息共享平台建设,促进医科细分专业就业的共繁荣.

This paper proposes UniStream, a unified stream architecture based on point-to-point stream channels combining both bitstream configuration and data stream processing. In addition, unified APIs are provided to support bitstream configuration and data stream processing, as well as the stream interconnect. A cost model is also presented for the overhead on the stream interconnect, hardware task configuration and data stream processing at system level, which can be used during the early stage of development. The flexibility and high efficiency of UniStream are demonstrated on Xilinx Virtex-5 and Virtex-6 FPGAs. Experimental results on bitstream configuration/read-back, data encryption/decryption and Discrete Cosine Transformation show that performance can be significantly improved with different stream modes.

自1981年6月5日人类首次发现并记载以来，艾滋病在世界范围内迅速传播、蔓延，成为威胁人类健康和阻碍社会发展的严重问题。2013年WHO宣布，及早启动抗病毒治疗有助于降低病毒数量，延长感染者寿命。艾滋病作为一种新型慢性疾病，艾滋病人及感染者（People living with HIV and AIDs, PLWHA）的卫生服务利用为国内外研究所注重；同时，世界各国广泛关注PLWHA治疗及费用负担情况。我国从2000年开始重视艾滋病患者医疗保障问题，2005年开始实施抗病毒免费治疗，2013年将艾滋病机会性感染纳入新农合大病保障范围， PLWHA相关医保政策不断推进。复旦大学公共卫生学院、中国疾病预防控制中心和云南省大理州疾病预防控制中心的一批中青年专家和学者，由复旦大学王颖副教授领衔，在艾滋病全球基金项目、国家自然科学基金、全球卫生政策制定和治理核心机构等项目资助下，基于国内外研究，综合运用就医经济风险、灾难性卫生支出、因病致贫测量、现况调查、文献归纳分析等定性定量相结合的方法，对PLWHA卫生服务需求与利用、医疗保障相关政策及其落实、就医经济风险及负担等展开研究，旨在科学回答上述系列实践难题。

The health care reform was to build the basic health care system in China. As a health care organizers’ goal,this target is too remote and abstract. People couldn’t understand the relation between it and their life and what it was going to bring about to them. For the governments at different levels in local areas,they couldn’t be aware of grasping what they should do with commitment and service to the people during the reform. Based on the research results over the past 30 years from Collaborative Innovation Center for Social Risks Governance in Health,the paper discovered that China needs the social target for the public during health care reform to get the people cohere and local government perform their function.“Basic health protection for all”and“defending high expense disease”is the dream for so many people. More than 85%of the people have been dreaming of the National Health Care System,which protects Chinese from high medical expenditure and somewhat basic risks. China has enough resources to develop this system under the scientific design. The key to develop the system is the government’s decision under the scientific and mature technology.

Objective:To understand the policy suggestions by the intention of the elderly care services managers,organizers and providers about the development of the elderly nursing system in Shanghai. Methods:Literature review and focused group discussion were conducted to figure out strategies to solve key problems of this system,meanwhile,intention survey on the service supplier was made to understand their agreement degree on these strategies and their priorities. Results:The elderly care providers considered that“more attention,support and guide from government”,“increasing government financial investment”,“making certain related department responsibility”,“developing the elderly care human resources”,and“making sure of function orientation”were top five strategies to be implemented for the elderly care institutions development. Conclusion:Strategies for the development of the elderly care system from suppliers had high consistency. It is suggested that relevant departments should pay great attention to them and implement them soon.

This paper presents a parameterized system-level design framework, which enables rapid and powerful research for hybrid multicore architecture exploration and hardware/software co-design. The framework comprises the component-based hardware design and application compiler, which make it easy for a designer to build stream-oriented applications with FPGA-based hybrid multicore architectures. The high modularity and parameterization of the framework supports fast multicore architecture exploration of different topologies, routing schemes, processor types, customized hardware processing units and memory system organizations. The compiler tool chain is used to map C/C++ based applications onto the soft processing units. Experimental results targeting the JPEG encoding application demonstrate the feasibility and performance improvement of this framework.

Objective:To figure out the current situation and existing problems of nursing care beds allocation in Shanghai. Methods:Beds data of skilled care facility were obtained through a cross-sectional survey,some data cited from health statistics yearbook and health financial annual report to analyze if the quantity and composition of nursing care beds were reasonable through vertical and horizontal comparison. Results:The elderly aged 65 years and above owned 49.3 nursing care beds per one thousand elders on average in Shanghai in 2012,the same as that in developed countries. Only 6.4 medical nursing care beds for every thousand elders,and beds for elder daily life care were 42.9. However,the bed utilization rate of the skilled nursing care beds came near to 90%,while only around 70%for daily life care beds. Conclusion:The nursing care beds for the elders in Shanghai have met the requirements on the whole,while the phenomenon of medical nursing beds in shortage and the daily care beds being adequate coexists. Thus,solutions to current problems should be paid more attention and what the government should do is to make sure of the function of nursing care and evaluate requirements of the elder’s care to guide them reasonably to choose skilled care facility,intermediate care facility or group/congregate care.

Objective:To realize human resource allocation of the elder’s nursing service system in Shanghai. Methods:A general survey on 71 elderly care facilities and 36 community health service centers providing the elder’s nursing services was conducted in Shanghai,among which human resource allocation was analyzed from 2006 to 2010. Results:Among the elderly care institutions,there were 19.9 nurses per institution in average,0.67 staff per bed,lower than the standard requirement of 0.8 staff per bed. Only 39.2%of the aged care institutions met national configuration standards for nurses. As to their education background,nurses mainly graduated from junior college, technical secondary school and polytechnic school. However,the majority of care-workers were from junior high school or below. Conclusion:Nowadays,both the quantity and quality of the elder’s nursing staffs in Shanghai were in short. It is suggested that related policies should be made to develop the human resources of the elder’s nursing system.

This paper designs an embedded system with remote and dynamic reconfigurable ability based on reconfiguration technology and Internet Reconfigurable Logic(IRL) method.A software/hardware unified multi-task programming model which greatly reduces the complexity of reconfiguration system is designed to provide unified interface and management for software/hardware task.The remote features increase the ability to upgrade and maintain the system remotely by Internet.Experimental results show the profits of the programming model and the good speedup of the hardware task.

目的了解浙江省各级医院对护理人才的需求及对不同学历层次护理人才职业能力素质的要求,为高等院校制定护理专业发展规划及人才培养计划提供参考。方法分层随机抽取浙江省32所医院,采用自编问卷对其进行调查。结果32所调研医院2012～2016年每年计划招聘护士2 000人左右,需要的护理人才学历主要为本科(50.96%)和大专(46.65%);26所医院(81.25%)预计5年左右护理人才需求将达到饱和。医院对不同学历层次护理人才的职业能力、素质要求不尽相同。结论未来5年护理人才需求较高。护理教育者培养不同学历层次护理人才时,在知识、能力上应凸显差异,使其拥有各自的职业优势。