Background Maternal weight status, before or during pregnancy, is a significant determinant of fetus development, birth weight, and the short-term and long-term health outcomes of the offspring. Objective This study aimed to evaluate the effect modification of pre-pregnancy body mass index (BMI) on the associations of gestational weight gain (GWG) and birth weight, as per the latest guidelines from the Chinese Nutrition Society. Methods This is a retrospective cohort study performed in a tertiary hospital with the largest deliveries in Shanghai, China. This study included all women who had singleton live births from 2021 to 2022 (n=50,391). Data on pre-pregnancy weight, GWG, and birth weight were extracted from the medical register system. Logistic regression models were used to estimate the associations of pre-pregnancy BMI and GWG with the risks of being small for gestational age (SGA) and large for gestational age (LGA). The potential for effect modification by BMI on the associations of GWG and birth weight was assessed using both additive and multiplicative scales. Results Pre-pregnancy BMI and GWG were consistently associated with birth weight. We observed a positive effect modification by underweight on the relationships between insufficient GWG and SGA both in multiplicative (adjusted odds ratio (OR), 2.49, 95% confidence interval (CI): 2.06-2.99), and additive (relative excess risk due to interaction (RERI), 3.04, 95% CI: 1.70-4.37) scales. Similarly, obesity was found to modify the effect of excessive GWG on the risk of LGA (adjusted OR, 3.82, 95% CI, 3.14-4.63; RERI, 14.67, 95% CI: 7.92-21.41). Conclusion Our findings indicate that increased GWG is associated with a higher risk of abnormal birth weight in singleton pregnancies. Additionally, there is evidence of an additive interaction between pre-pregnancy BMI and GWG on the risk of small for gestational age or large for gestational age.

患者安全文化测评有助于评估医疗机构的安全状况.美国医疗健康研究与质量机构(AHRQ)发布的HSOPSC是患者安全文化测评工具的典型代表.2019年,AHRQ根据相关意见和建议修订完成了HSOPSC 2.0版,在保留1.0版优势的基础上精简了维度和条目数量,具有良好的信度和效度,可以作为我国医疗机构患者安全文化测评的有效工具.但由于测量结果的定量特征,建议辅以定性研究对潜在文化价值和更深层次文化假设进行深入分析,同时思考如何将测评结果与干预措施结合起来,以更好地评估干预效果.

目的 探讨公立医院门诊大修搬迁中门诊安全维稳措施及方法.方法 回顾分析医院2018年1月1日至2018年12月31日期间6次门诊大规模搬迁的筹备、搬迁中遇到的问题和经验.结果 56间诊室调整搬迁期间,门诊业务量保持1.44％增长率,无患者不安全事件发生,门诊整体投诉量较同期下降.结论 利用历史数据科学决策,做好搬迁前准备工作,合理安排搬迁时间和实施事宜,职能部门和临床科室多部门联合参与,同时积极探索多渠道解决因搬迁引发的各类问题,强化风险安全防范,重视患者就诊满意度是门诊顺利搬迁的保证.

Objective To explore the role of administrative conversation system to reduce medical dis-putes.Methods Implementing retrospective analysis on 173 cases of administrative conversation conducted by one Maternity and Infant Hospital in Shanghai during January 2013 to September 201 .Using the performance evaluation methods to evaluate its effect.Results The highest proportion of departments that refers to administrative conver-sations is obstetrics department that accounts for 54.9%, followed by gynecology that accounts for 43.3%.The most common reason of administrative conversations is experimental invasive treatment which accounts for 38 .7%. After administrative conversation, none of the medical disputes occurred.Conclusion Administrative conversation system has effect on reducing medical disputes number of special patients.