黑龙江省精神卫生服务资源现状调查研究

目的:了解黑龙江省精神卫生机构及人力资源现状,为合理配置精神卫生资源提供数据支持。方法:采用“全国精神卫生医疗机构调查表”及“全国精神卫生防治技术管理机构调查表”进行调查,由市、县精神卫生项目办填写信息并汇总,由省精神卫生项目办进行统计分析。结果:截至2020年底,黑龙江省共有精神卫生机构123家,其中精神专科医院53家,综合医院内设精神(心理)科57家,中医院内设精神(心理)科4家,精神康复机构1家,其他精神卫生机构8家。现有精神科病床21556张,平均175.3张/家,床位密度为6.77张/万人。精神卫生机构由卫生健康系统主管81家(65.85%),民政系统主管9家(7.32%),其他系统主管2家(1.63%);非政府主办31家(25.20%)。提供精神卫生服务的机构中共有精神卫生服务人员5794人。精神卫生医疗床位使用率中位数为58.64%,平均住院日中位数为72天,精神科入院量为48748人/年,精神科出院量为48486人/年。2020年全省精神科门急诊总量为976607人次/年。结论:黑龙江省精神卫生医疗机构覆盖率较低,且床位资源的地域分布不公平,精神科卫生专业技术人员配置仍处于较低水平,应关注相应资源分布的合理性并增加投入。     

杭州市精神卫生服务机构资源调查

目的了解杭州市精神卫生服务机构资源现状,为政府相关部门合理配置精神卫生服务资源提供依据。方法杭州市精神卫生工作领导小组办公室(精卫办)组织实施,编制并下发《杭州市精神卫生服务基础情况调查表》,由各县(市、区)精卫办填报;对2015年杭州市精神卫生服务机构的分布、床位、门诊/住院人次、从业人员配置等资料进行分析。结果杭州市共有29家精神卫生医疗机构,其中24家位于城区;康复中心11家,全部位于城区;精神卫生服务工疗站128家,覆盖各县(市、区)。杭州市精神科编制床位3 079张,3.54张/万人;城区为3.86张/万人,县(市)为2.24张/万人。床位使用率均在80%以上。全市精神卫生医疗机构年门诊857 512人次、年住院25 041人次。全市精神科执业医师467人,5.37人/10万人,平均每名精神科医师年负担1 836人次,年负担住院53人次;精神科护士833人,9.57人/10万人。杭州市精神服务机构床位与卫生技术人员比例为1∶0.42。结论杭州市精神卫生服务资源在各县(市、区)之间分布不均衡;床位、从业人员密度虽高于全国平均水平,但仍不能满足社会需求。     

云南省精神卫生资源配置公平性调查

目的分析云南省2015年精神卫生资源配置现状及公平性,为全省精神卫生资源合理配置及制定相关政策提供参考依据。方法普查云南省16个州(市)的精神卫生资源配置情况,计算精神卫生资源按人口、地理面积和人均GDP配置的洛伦兹曲线、基尼系数及差别指数。结果云南省精神卫生机构的精神科执业医师、精神科注册护士、床位数按人口配置的基尼系数/差别指数分别是0.30/0.25、0.21/0.19和0.20/0.18,按地理面积配置的基尼系数/差别指数分别为0.49/0.36、0.47/0.36和0.46/0.34,按人均GDP配置的基尼系数/差别指数分别为0.42/0.35、0.43/0.38和0.43/0.35。结论云南省精神卫生资源按人口配置相对公平,按地理面积配置和人均GDP配置处于警戒水平,有待于进一步优化与提升。     

精神卫生资源配置与精神疾病服务供给的关系研究

目的分析2015年中国精神卫生资源配置和重性精神疾病管理相关服务的关系,分析当前中国精神卫生服务存在的缺陷,为精神卫生人力资源配置提供依据。方法使用Excel整理分析《中国卫生统计年鉴2016》和学者相关研究结果中的数据,采用SPSS分析精神卫生资源和服务供给之间的相关性。结果 2015年中国内地每10万人口精神科医师数量的均值为2.19人,每10万人口护理人员数量的均值为5.51人,每万人床位数为3.15张;精神科门急诊总人次为4005.1万人次,出院总人次为1987534人;精神卫生相关医生、床位和护士的数量和精神科门急诊人次、精神科出院人次存在相关关系(p<0.05),与重性精神疾病报告患病率、重性精神疾病患者规范管理率也存在相关关系(p<0.05)。结论不同省份之间精神卫生资源配置与服务供给不平衡,对社区精神疾病的管理和预防投入较少,资源配置与当前精神卫生服务的重点和发展趋势不匹配。     

广东省精神卫生专业机构现况调查

目的了解广东省精神卫生专业机构现况,为合理配置精神卫生资源提供参考依据。方法采用普查方式收集2014年底全省所有精神卫生专业机构的基本情况,对其机构类型、所属区域、床位与医护人员和门诊与住院服务情况等数据进行描述性分析。结果截至2014年底,广东省一共195家精神卫生专业机构。精神科实际开放床位总数29 315张,密度27.34张/10万人;精神科执业医师总数1 936人,密度为1.81人/10万人;精神科护士总数4 484人,密度为4.18人/10万人。精神心理科日门诊量中位数为18人次/天,平均住院日中位数为58天,平均每床位周转次数中位数为3次/年。结论广东省精神卫生服务资源分布具有总量不足,医护人员缺乏更加明显,区域分布与经济发展水平不相称等特征。精神心理科门诊与住院服务需求旺盛,社区康复服务亟待完善。     

2010年河北省精神卫生机构床位资源现状调查

为全面了解河北省全省精神卫生服务资源与服务能力,为政府相关部门制定精神卫生工作规划与合理配置精神卫生资源提供科学依据,我们于2011年初开展了全省精神卫生机构现状调查.鉴于精神卫生医疗机构数是反映精神卫生服务的最基本指标之一,而精神科床位配置水平是反映精神科住院服务资源的主要指标之一,本研究主要对全省精神卫生机构和床位资源的现况进行分析,探讨现有资源能否满足目前的服务需要,现将调查结果报告如下.     

基于灰色系统GM(1,1)模型的广西卫生资源需求预测分析

[目的]预测广西卫生资源需求,为卫生资源的合理配置提供参考依据。[方法]运用灰色系统GM(1,1)模型预测广西卫生资源需求。[结果]2016-2020年卫生资源数的预测值看,广西卫生资源数呈平稳上升趋势,到2020年卫生机构数、床位数分别达到12,694个、336,463张,卫生技术人员数将达到414,800人。其中,执业(助理)医师数、注册护士数分别到达到121,058人、187,453人,每千常住人口卫生机构数、床位数、卫生技术人员数、执业(助理)医师数、注册护士数分别为0.25个、6.69张、8.25人、2.41人、3.73人。[结论]GM(1,1)模型适用于卫生资源需求量的预测;广西应当加大对执业(助理)医师的培养力度,适当增加卫生机构数,积极引进卫生技术人员。     

大连市县级精神卫生专科医院服务能力现状调查

目的了解大连市县级精神卫生专科医疗机构服务能力。方法采用整群抽样的调查方法,随机抽取大连4家县级精神卫生专科医院,对其硬件设施、人力资源和服务对象收集数据进行统计分析。结果 4所专科服务机构总建筑面积为31 842 m2,实际开放床位2 130张,平均每床面积为14.95 m2;建筑年限大多在30年以上,科室设置为精神科、心理科,无较新治疗设备;每10万人口有2.42名精神科医师、8.36名精神科护士,医师/床位比值为0.04,护士/床位比值为0.15,医护比是1∶3.45;医护人员学历层次偏低,大专及以下学历分别占55.29%和74.88%;有专业背景的精神科医师占医师总人数的8.97%;在服务对象特点方面以慢性精神分裂症为主(78.70%)。结论大连县级精神专科医院建筑机构及设备老化,床位密度高,床均建筑面积低,专科服务人员数量缺乏,业务素质较低,服务对象以精神分裂症占多数。     

江西省重性精神病患者免费救治卫生服务体系建设

2012年以来,江西省以实施重性精神病患者免费救治管理工作为抓手,整合精神卫生工作资源,在实施人才队伍建设、完善精防体系、构建重性精神病救治救助工作长效管理机制方面进行了积极探索和创新。2014年,江西省贫困家庭重性精神病患者免费救治被评为"中国医改十大举措"。据2018年数据显示,全省精神卫生服务机构246家,精神卫生编制床位数10 419张,开放床位数15 000余张,每10万人精神科医生数2. 83人,每10万人精神科病床数33. 7张,有基层精防网络的县(市、区) 100个,符合国家精神卫生服务医疗机构的配置标准,已形成以专科防治机构或专科医院为龙头,县级精神科门诊为枢纽,乡村(社区)精神卫生人员为网底的精神卫生服务体系。同时针对存在的现状问题,提出应对策略。     

河北省精神卫生资源现状调查

目的 了解河北省的精神卫生工作现状。方法 通过自拟问卷进行实地调查了解。结果 截至2001年12月，全省有精神卫生机构67个、病床6505张，平均9．71张／10万人。全省有精神科医生1030人，护士1450人。精神卫生机构分布全省。精神卫生工作以临床医疗和心理咨询为主。结论亟需开展社会服务，设置全省精神卫生工作统一管理协调机构和对全省精神卫生工作进行规划。     

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.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.