应用TOPSIS法综合评价医院医疗工作质量

目的对某院医疗工作质量进行综合评价。方法应用TOPSIS法对该院3个医疗区和中心医疗区18个科室2006年9项主要医疗工作指标进行综合评价。结果该院3个医疗区医疗工作质量以中心医疗区为最佳,中心医疗区各科室医疗工作质量以外科系统为好。结论评价结果与该院实际医疗工作情况相符。TOPSIS法在科学全面评价医院医疗工作质量中具有良好应用价值。     

对医疗行业安全生产标准化体系持续改进的探讨

以上海医疗行业开展的安全生产标准化工作为例进行分析,并对安全生产标准化工作的持续改进提出合理化建议,以此进一步完善医疗行业安全生产标准化工作,有效减少医疗行业安全生产事故的发生。     

医疗设备差异化维护体系的构建研究

目的:针对医疗设备快速发展的现状,研究构建医疗设备差异化维护工作体系,以保障医疗设备质量。方法:研究各种维护策略的优缺点,结合医疗设备特性,按照分类分级维护的原则,合理应用最佳维护策略,建立医疗设备差异化维护工作体系。结果:建立医疗设备差异化维护工作体系,开展针对性的维护工作,保障医疗设备应用质量。结论:医疗设备差异化维护体系的构建研究,对医疗设备的应用质量和医疗安全具有重要的意义。     

住院科室医疗质量环节评价子系统研究

目的：每月动脉评价住院科室医疗护理工作情况。促进医疗环节质量控制,提高医疗质量,方法;对医疗护理工作环节质量检查的评分,采用秩和比法计算,以环节指数动态显示各科室工作情况。结果：建立了环节评价系统,每月计算出各科室医疗检查、护理检查和环节指数,并反馈科室,促进医疗护理工作的改进。结论：该系统科学地评价了各临床科室的医疗护理工作质量。其系统的应用对提高医疗质量,确保医疗安全起到明显的促进作用。     

医疗质量管理体系的探讨

医院是以医疗技术医治疾病,为人民提供医疗保健服务的机构,它的工作质量,关系患者的生命安危,影响人民的健康水平。由于医院工作的这种特点,决定了医院工作必须以病人为主体,以医疗工作为中心,以保障人民健康为目的,通过加强质量管理,不断提高服务水平和服务质量,以保证医院整体功能的有效发挥。 医院质量管理是指按照医疗质量形成的规律,对医疗质量进行计划、组织、控制,以保证和提高医     

把握基本医疗推进社区医疗健康发展

社区医疗服务的发展与城镇职工基本医疗的普及是我国社会和经济发展、人们对健康与疾病以及相应的医学模式的新认识所引发的必然结果。而医学目的的调整与基本医疗的定位又与社区医疗及城镇职工基本医疗保险息息相关。社区医疗服务是以基本医疗为主导内容，城镇职工基本医疗保险是以基本医疗为保障水准。因此全社会，尤其是从事社区卫生工作及城镇职工基本医疗保险工作的同志必须对医学目的调整以及基本医疗的定位有充分的认识。     

解决贫困患者就医问题的实践与展望——江苏省惠民医疗工作再调查报告

对江苏省惠民医疗工作的现状展开调查,了解其运行机制与运行情况,分析目前惠民医疗运行中存在的问题,提出构建以社区卫生服务机构和乡镇卫生院为基础、惠民医院为中心和其他公立医疗机构为补充的惠民医疗服务网络,加强惠民医疗服务工作与医疗保险、社区卫生服务工作的衔接等政策建议。     

医疗设备采购风险及人员管理模式解析

随着现代医疗水平的不断发展,医疗设备在医疗活动中所发挥的作用越来越明显,如何做好医疗设备的采购及风险预防工作,如何落实现阶段的人员管理制度等一系列问题将直接影响到未来医疗服务的综合水平。以现阶段的医疗设备采购工作为论述点,探讨医疗设备采购环节存在的行业风险,并对对应的人员管理模式进行综合分析。     

综合指数法在评价医院医疗质量中的应用

目的 对近5年医院的医疗质量进行综合评价,为医院管理层提供客观、科学的统计分析资料.方法 采用综合指数法,分析某院 2003-2007年医疗工作质量.结果 近5年该院医疗质量指数逐年增长,其中以医疗工作强度的增长为主.医疗质量最优的是 2007年,最劣的是 2003年.结论 评价结果提示该院医疗工作在治疗质量指标方面有待提高.综合指数法计算直观,应用方便,在评价医院医疗工作上具有综合性、可行性.     

医院医疗设备的质量管理

目前,医院的医疗卫生服务对医疗设备的依赖性较高,诊断、治疗及保健工作均离不开各类医疗设备的支持,因此,医疗设备主管部门必须重视并切实做好医院医疗设备的质量管理工作,以保证医疗设备的质量及其在运行过程中的效率、稳定性、安全性,从而为医疗卫生工作的开展提供更加坚实、有力的保障,更好地为人们的健康、安全服务。该文简单分析了医院医疗设备质量管理工作的重要性,并就如何做好该项工作提出了部分探讨性建议,以供参考。     

Influence of dietary carbohydrates upon the metabolism of lipids and minerals in rabbits

Rabbits were fed purified diets containing either corn starch, sucrose, glucose or fructose as 39.5% of the caloric content, or were fed a commercial diet. At the end of the 12-week trial period, glucose tolerance tests did not reveal a difference by treatment, and males had a lower tolerance than females. The serum cholesterol concentrations of the various density lipoproteins varied by treatment as determined weekly; often the HDL cholesterol was higher in the rabbits fed corn starch, and the VLDL cholesterol was higher in the rabbits fed corn fructose. Cholelithiasis at the end of the trial was prevalent in rabbits fed sucrose, glucose or fructose, was infrequent in the rabbits fed corn starch, and was absent in the rabbits fed the commercial diet. Lipid and cholesterol concentrations in the liver were greater in the rabbits fed the purified diets than in those fed the commercial diet. Cholesterol concentration in the thoracic aorta was greater in the rabbits fed the commercial diet than in those fed the purified diet. Analyses of liver and kidneys for Cr, Mn, Cu and Zn revealed treatment differences only in the case of the kidneys where Cr concentration was greater in the kidneys when the commercial diet was fed.     

Intérêts et limites du Programme National Nutrition Santé (PNNS) en faveur de l’éducation nutritionnelle: Enquête d’opinion auprès de patients diabétiques de type 2 et de type 1

A survey among 104 type 2 and 81 type 1 diabetic patients has explored their opinions on two major national educationnal programs on nutrition launched by the french health authorities: the “Program National Nutrition Santé” (PNNS1) (2001-2005) and the PNNS2 (2006-2010). The majority of the patients has acquired knowledge on the PNNS through the media and at the care setting level. The messages they have the best recorded concern the daily consumption of fruits and vegetables and the obesity. On the other hand, they know nothing on the printed educationnal guides distributed by the PNNS, nor on the local PNNS initiatives. If the half of the type 2 diabetic patients considers that the PNNS helps them to carry out food choices, a little number of patients estimates that PNNS plays an important role in preventing nutritionnal problems among the young people. Few patients considers also that the food industries may have a possible “perverse” influence on the food consumption and eating behaviors. The half of the type 2 diabetics is in favor of alternatives ways to the hospital-based therapeutic patient education programs, for example programs organized by the Health Social Insurance or by Mutual insurance companies, while respecting criteria of quality. Lastly, the majority of the patients estimates that, due to their own experience, they have a role to play in the nutritional education.     

Planning research

The starting point for any research project should be a question.Once this has been defined and the relevant scientific literaturereviewed, a protocol should be drawn up. This will be used notonly as a guide to the conduct of the study and in the preparationof the final report, but also in seeking any financial supportand approvals that are required for the investigation. A protocolis normally arranged in sections covering the background tothe study, the question(s) that it will address, the methodsthat will be used for the collection and analysis of data, thestatistical power of the investigation (where relevant), anyethical considerations, and the financial input that will beneeded. A pilot study is often helpful where aspects of thestudy method are untried or of uncertainvalidity.     

An Outbreak of Pruritic Skin Lesions in a Group of Laboratory Workers A Case Report

In May 1993, an outbreak of pruritic skin lesions occurred amonga group of employees located in tour laboratories in the basementof an office building. Medical interviews with the affectedworkers were performed and an industrial hygiene survey of thesite was conducted. Workers commonly reported a prickling sensationon exposed skin. Four of the workers had small (<5mm) erythematouspapules on their forearms. Just prior to the outbreak, the installationof fibrous glass insulation had commenced in the mechanicalrooms which provided air to the basement of the building. Becauseof the nature of the symptoms and the temporal relationshipwith the nearby insulation work, direct skin contact with fibrousglass fibres was thought to be the cause of the outbreak. Thepoorly maintained air handling unit supplying air to the laboratoriesprobably contributed to this outbreak by inefficient filteringof the circulating air.     

在多基因PCR中对dNTP与Mg^2＋的浓度关系的研究

目的　通过实验介绍在单一浓度下的Mg2 与在不同浓度情况下的dNTP及在单一浓度下的dNTP与在不同浓度下的Mg2 进行多基因PCR的反应过程。方法　通过多基因PCR分析比较Mg2 和dNTP在不同浓度下的反应结果。结果　PCR反应在 10×PCRBuffer为 0 0 2mol/LMg2 浓度时 ,随着dNTP浓度的增大 ,PCR反应增强 ,特别是较大片段PCR产物反映更为明显。但随着dNTP浓度的继续增大 ,PCR反应抑制 ,扩增条带度减弱 ,直至条带完全消失。而在0 0 0 2mmol/LdNTP浓度下 ,随着Mg2 浓度的不断增大 ,反应逐渐增强。但随着Mg2 浓度的继续增大 ,扩增条带亮度有减弱趋势。结论　在Mg2 单一浓度下 ,较大浓度dNTP有增强条带亮度的作用 ;在dNTP单一浓度下 ,过高的Mg2 浓度能抑制反应。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Les cellules endothéliales du tissu adipeux

The adipose tissue plays a major role in energy homeostasis through the storage and release of fatty acids as well as adipokine production. The endothelial cells of the adipose tissue vascular network constitute a barrier between the blood and the adipocyte compartments. They are key players in the metabolic status of the fat mass controlling the exchanges of nutrients, hormones, oxygen and immune-inflammatory cells. Recent data highlight the process of lipid handling at the endothelial cell surface and of the transendothelial transit of fatty acids. The extension of the vascular network and its functionality are necessary for the adipose tissue integrity. Insufficient oxygen supply generates hypoxic area within the tissue that favors metabolic abnormalities and the recruitment of immuno-inflammatory cells. The present review relates to the role of adipose tissue endothelial cells in the adipose tissue physiology. Their involvement and more particularly the role of accelerated ageing, in the link between obesity and associated metabolic and cardiovascular pathologies are described.     

Occupational Health Services in Manufacturing Industries in Nigeria

The provision of adequate health care facilities to cater forthe health of workers is an important consideration in the managementof manufacturing industries, since productivity is dependenton the health status of the workers. There are very few studiesevaluating the health care provision in Nigerian industries.This study elucidates such health care services in Edo and DeltaStates of Nigeria. One hundred and thirty-five (56%) of the241 registered manufacturing industries in Edo and Delta Statesof Nigeria were randomly selected and investigated. The responserate was 91.1% and the result showed that the medical staffcomprised 2.5% of the total workforce, with the large scaleindustries contributing the highest proportion of these. Fourpoint five per cent of the medical staff had formal trainingin occupational health and 15.6% of them visited the factoryshop floor. The doctor:staff ratio in the medium and large scaleindustries were 1:819 and 1:618 respectively. It was found thatall the industries used the health care facilities providedby the government, there were no clinics in all the small scaleindustries and group practice was not used by any of the industriesstudied. Pre-employment medical examinations were carried outin each of the groups of industries (100%, 39.4% and 5%) respectively,as were periodic medical examinations during employment, althoughto a lesser extent (100%, 13.2%, 0%) for the large, medium andsmall scale industries respectively. These finding suggest theavailability of a reasonable standard of health care provisionfor large scale industries and somewhat less availability formedium and small scale industries. Health education of boththe employers of labour, and the employees and the enforcementof existing laws are needed to improve the existing standardof occupational health services.     

Ethical requirements for occupational health research--compliance arrangements for a single company in relation to a recent major nuclear industry study.

The media coverage given to occupational health studies in the field of ionizing radiation has, on occasion, been the cause of very real distress to radiation workers and their families. In response to this situation the Chief Medical Officers of the major UK nuclear companies developed an ethical policy for future involvement in research, based on the duty of care which researchers owe to a key customer of such studies: the worker. The policy consists of four principal elements: medical confidentiality; worker information; worker consent and the guarantee of the availability to the workers of pre-publication knowledge of the results. The policy issued in 1991/92 has achieved growing acceptance among researchers and medical journals, though the medical officers involved have been aware of some scepticism, particularly in relation to the practicalities of the dissemination of pre-publication information. The Record Linkage Study published in November 1997 marked a major piece of research work involving data from 120,000 radiation workers that had been carried out since the development of the policy. This paper reports on the successful compliance arrangements to meet the ethical requirements of that study within a single UK nuclear company, and is published to demonstrate that with commitment from researchers, the journal and occupational health staff such ethical requirements, and particularly the need for pre-publication information can be met in full.