对23名归国劳务人员疟疾感染情况的筛查及思考

目的加强归国劳务人员疟疾筛查,探讨输入性疟疾传播规律,提出口岸疟疾防控工作措施。方法选择泰州市某劳务公司23名赤道几内亚归国人员,通过流行病学个案调查、医学检查等方法,筛查疟疾感染情况。结果 23名归国人员中,18人曾在国外感染疟疾,占筛查总人数的78.2%,其中出境1个月内发病15人,占总病例数的83.3%,归国后有1人被确诊为恶性疟疾。结论口岸疟疾防控工作应关注归国劳务人员群体,加强出国前健康宣教,坚决取缔"黑中介",加大归国后疟疾筛查力度,建立部门间联防联控机制,有效防止输入性疟疾的传入。     

影响WHO奖学金留学回国人员工作业绩因素分析

世界卫生组织(ＷＨＯ)奖学金项目作为全国卫生系统选派留学人员到国外学习的重要渠道之一,1978～1995年期间,全国共选派了1360余人。为全面、客观、公正地评价该奖学金渠道派出人员的留学效益及已回国人员的工作业绩,对影响留学回国人员工作业绩的若干因素进行科学的分析,提高ＷＨＯ奖学金派出人员的留学效益,更加充分地发挥留学回国人员的作用,我们在ＷＨＯ西太区的支持、资助下,对该奖学金留学人员进行了全国范围的综合情况调查。本文对影响ＷＨＯ奖学金留学回国人员工作业绩的若干因素进行分析。一、留学人员派出时的自身情况与回国后工…     

秦皇岛口岸1986～1999年出入境人员传染病监测报告

本报导了作对秦皇岛口岸1986～1999年23188名出入境人员的传染病监测分析情况：在秦皇岛口岸出入境人员中以交通员工最多,为14949人,占总人数的64．47％;检出的传染病疾病谱为：HBsAg( ),疟疾抗体阳性,病毒性肝炎,活动性肺结核,梅毒与HIV病毒感染;经统计分析发现HBsAg( )是影响出入境人员,特别是船员的主要健康问题,共计检出838例,占出入境总人数的3．83％;在1623名回国人员中发现26例疟疾抗体阳性人员,其中有24人为从西非归国的捕鱼人员;体检共计发现8名梅毒,艾滋病毒感染。     

丽水口岸出入境人员丙型肝炎病毒感染情况调查

目的了解丽水口岸出入境人员丙型肝炎病毒感染情况,为出入境口岸传染病监测工作和预防控制工作提供科学依据。方法对2006—2008年丽水口岸21588名出入境人员的丙型肝炎抗体检测资料进行统计分析。结果共检出丙肝病毒感染者33例,检出率为0．15％。其中入境人员检出率为0．46％,出境人员检出率为0．13％。抗-HCV阳性者当中男性19人,女性14人,男女性别比为1．4：1。在33例丙肝病毒感染者中,合并其它病原体感染共6例,占阳性总人数的18．18％（6／331;伴肝脏影像学改变共9例,占阳性总人数的27．27％（9／33）。结论丽水地区出入境人员丙型肝炎病毒抗体检出率低于中国人群一般水平,但入境人员（主要是归国人员）的阳性检出率要高于出境人员各人群。应重点加强对归国人员的丙型病毒性肝炎的监测工作监测,减少丙型肝炎通过频繁的国际交往而传入国内,严把国门,有效维护出入境检验检疫秩序。     

浙江省卫生监督派出机构基本情况调查及对策研究

目的：全面了解卫生监督派出机构的基本情况,分析问题,研究对策。方法：采用横断面调查方法,对派出机构人员情况、基础建设、经费保障及运行机制和模式等方面进行调查。结果：2008年,浙江省派出机构挂牌运行数为333个,人员1422名。人员主要集中在25～35岁年龄段,占总人数的43．92％;大专及以上学历人员占83．32％;人员职称以中级和初级为主,分别占29．16％和53．04％。工作场所人均建筑面积为31．82平方米,工作性质为自由产权的占2．5％。派出机构经费基本纳入县级卫生监督机构核算。现有派出机构工作职责明确,均进行业务考核。结论：派出机构人员队伍结构较优化,资深人才有待培养。基础建设需要进一步加强。建立有效的派出机构绩效评估体系有助于推进派出机构的进一步发展。     

萧山区社区卫生防病人力资源现状分析

目的：分析评估萧山区社区卫生防病人力资源现状，为改善基层卫生防病人力资源结构提供依据。方法：设计统一调查表，由专业人员经培训后开展调查。结果：萧山区每千人拥有社区卫生防病人员0．081人。21～30岁组占总人数14．58％，〉51岁组占30．211％；大专及以上学历占44．79％．中专13．54％，职业高中7．29％，高中及以下34，38％；中级职称、初级职称、无职称分别占34．38％、60．42％、5．20％；34．38％有兼职工作；卫生防病人员待遇低于所在医院临床医务人员。结论：萧山区社区卫生防病队伍建设有待进一步加强。     

2009年某市免疫规划人力资源现状调查

[目的]调查某市免疫规划人力资源的配置现状,为科学配置免疫规划人力资源提供科学依据。[方法]调查该市疾病预防控制中心计划免疫人力资源状况,将数据录入数据库后进行统计分析。[结果]某市3区9县180个乡镇,从事免疫规划人员1278人,其中市级疾控机构从事免疫规划人员8人,县级免疫规划工作人员141人,乡镇从事免疫规划人员1129人。高级职称占1．7％,中级职称占27．3％,初级职称占53．6％,无职称占17．4％。大学本科学历占9．9％,大专学历占47．5％,中专学历占36．0％,高中以下者占6．6％。[结论]某市免疫规划工作人员现状难以满足形势的要求,卫生行政部门应在现有条件下通过适当的调控及合理配置,使免疫规划工作任务和人员相配套,以适应新时期扩大国家免疫规划工作的需要。     

郑州市某行政机关健康体检人员脂肪肝发病情况调查

目的调查郑州市某行政机关健康检查人员脂肪肝发病情况。方法对该行政机关1704人进行健康检查，根据腹部B超脂肪肝诊断标准确定患脂肪肝的病例，进行统计学处理，确定脂肪肝发病率。结果1704人中共检出脂肪肝745人，占总人数的43．7％，其中男性657例，占脂肪肝总人数的88．2％；女性88例，占脂肪肝总人数的11．8％。男：女=7．5：1。发病高峰年龄在40～49岁，占脂肪肝人数的41．6％。结论郑州市某行政机关健康体检人员中脂肪肝发病率较高，男性高于女性，应改变不良生活习惯，合理膳食和加强体育锻炼，以预防治疗脂肪肝。     

浙江省卫生系统1978～1989年出国留学人员回顾性调查及分析

自改革开放以来,大批医药卫生科技人员赴国外进修、留学,特别是近年来,呈迅猛增长趋势。然而,出国留学的渠道究竟有几种,有多少人已归国服务,不归的原因是什么,归国人员发挥作用情况如何,如何进一步加强对出国留学工作的科学管理等这些     

临床护理人员身心健康问题的探讨

的了解临床护理人员的疲劳和社会支持现状,探讨影响临床护理人员疲劳的主要因素。方法2013年6月-2014年6月,引用疲劳评定量表（FAI）,整群抽取临床工作1年以上的注册护士共计660人,进行横断面问卷调查,了解临床护理人员的一般情况,疲劳状况和社会支持状况。结果临床护理人员疲劳评分结果：疲劳程度4．95±1．29,疲劳对特异性环境敏感性5．20±1．04,疲劳可能导致的心理后果4．99±1．57,疲劳对休息／睡眠反应6．10±1．55;调查的527名临床护理人员中,疲劳404人,占调查总人数的76．70％;无疲劳123人,占调查总人数的23．30％。疲劳人数以30岁以下年龄组、临床工作5-9年组、内科工作性质病区分布最多（P〈0．05）。结论临床护理人员普遍存在不同程度的疲劳,其疲劳状况不容忽视,疲劳程度与个体对社会支持的利用度呈负相关,相关性较弱。     

The clinician-scientist: professional dynamics in clinical stem cell research

Clinical applications of biomedical research rely on specialist knowledge provided by professionals who straddle research and therapy, and possess both medical and scientific expertise. To date, this professional group remains under-explored in sociology. Our article presents a case study of clinician-scientists working in stem cell research for heart repair in the UK and Germany who are engaged in double-blind randomised clinical trials using patients' own stem cells. The analysis draws on sociological and medical literature, interviews and ethnographic fieldwork to analyse the experiences and self-rationalisations of a small number of clinician-scientists and the ways in which these professionals portray, explain and justify their role in the wider clinical research environment. We examine our participants' views on the clinical trials they conduct, the challenges they encounter and the ways through which they negotiate a complex disciplinary terrain, and argue that the recent clinical implementation of stem cell research brings clinician-scientists to the fore and provides a renewed platform for their professional legitimisation. The article helps increase our understanding of how randomised clinical trials are involved in consolidating the individual status of actors and the collective standing of clinician-scientists as leaders of change in translational medicine.     

Why do people cooperate with medical research? Findings from three studies

In this paper, we distinguish decisions about cooperation with medical research from decisions about research participation. We offer an empirical and theoretical exploration of why people in three different UK-based medical research projects chose to cooperate. Data analysis of the accounts of 128 participants across the three studies was based on the constant comparative method. Participants' cooperation was engaged by a perception that they would be contributing to the ‘public good’, but they also wanted to justify their decision as sensible and safe. Critical to their cooperation was their belief that researchers would fulfil their side of the cooperative bargain, by not exposing participants to risks of harm or exploitation. Although participants were generally unaware of the details of the regulatory regime for research, they demonstrated a generalised reliance on regulation as a feature of everyday life that would provide a safe context for cooperation. In their assessment of particular projects, participants made judgements about whether to cooperate based on more specific cues, which acted as signs to assure them that researchers shared their cooperative intentions. These cues included organisational and professional credentials, the role identities and perceived trustworthiness of those involved in recruiting to research, and visible signs of reasonable practice mandated by regulatory systems. Thus participants drew on their understandings of an institutional field that was much broader than that of research alone. We propose that the social organisation of research is fundamental to the judgements people make about cooperation with research. Cooperation may be a more useful way of thinking about how people come to engage in collaboratively oriented actions such as research participation, rather than currently dominant individualistic models. Attention to the institutional context of research is critical to understanding what makes cooperation possible, and has important implications for the design of regulatory regimes for research.     

留学期限与后效益分析

目的：了解出国人员留学期限与个人及社会效益之间的关系。方法：采用对某医院有留学经历的科技人员发放问卷调查的方法。结果：在留学一年、半年和两年3组人员中,分别有89．7％、90．5％和91．3％的人认为,留学对他们观念的更新有很大或较大影响;93．1％留学一年、95．7％留学两年人员认为,外语水平有很大或较大的提高;留学一年的社会效益指标普遍高于留学半年,而留学二年的社会效益指标与留学一年组相比无明显差异;93．2％人员认为,最合适、最经济的出国留学期限为一年。结论：出国留学一年是获得个人和社会效益较为适宜的选择。     

临床医学科研与医学科研伦理探析

医学工作者在从事临床医学科研和临床医疗过程中,都存在医学科研的价值与道德判断问题。作为道德理性的医学科研伦理可以增强医学科研工作者对医学科研后果的道德责任感,在临床医学科研中把握好医学伦理观,是每个医学科研工作者所进行的科研得以顺利进行和完成的保证。     

Making a difference: researching master's and doctoral research programmes in medical education

CONTEXT: The Association for the Study of Medical Education states that its aim is to improve the quality of medical education. As a consequence, it commissioned through its Education Research Group a small-scale project to explore the quality of the research methods elements in currently available UK master's and doctoral programmes. OBJECTIVE: This study aimed to explore the breadth, depth and diversity of the research methods provision of those programmes currently available to course participants. METHODS: The study comprised a 3-phase approach which utilised: a web-based search of curricula format and content; semi-structured interviews with key informants, and case studies and site visits to conduct documentary analysis of dissertations and in-depth interviews with core personnel. RESULTS: The study revealed wide variation across taught programmes. These discrepancies applied to length of course, requirements for the dissertation in terms of both length and time allowed to complete the study and, crucially, a wide variance in the quality and quantity of the levels of supervision provided for students during this research phase. DISCUSSION: This study raises concerns about the aims and functions of courses offering qualifications in medical education. It identifies a number of obstacles to the development of educational researchers who are skilled in the philosophical underpinnings of research activity or equipped to undertake educational research that is of a quality sufficient to withstand the scrutiny of the authors' scientific and clinical counterparts. We argue that if research into medical education is to thrive, it requires the full commitment of all those who are engaged in teaching the topic and supporting researchers.     

Health psychology and the study of the case: from method to analytic concern.

This paper recommends that the study of the case be seen as of primary analytic concern to social scientists, and particularly to health psychologists. Criticism is made of the idea that a case is merely a medical instance or a methodological option. Instead, we argue that health psychologists should re-direct their attention to the 'study of the case' as being central to issues concerning health, illness and healing. There are three reasons for doing this. First, case study is basic to any procedure that involves collecting information about the context in which medicine is practiced. Second, communication between health professionals involves presenting the clinical situation of their patients as storied accounts, so that cases are made, not found. Third, there is presentational work by patients, involving communications of (as well as about) suffering and relief. This last feature is basic to how doctors and health psychologists, especially those engaged in clinical work, understand individuals as 'cases'. The paper explores differences between these different forms of case, while emphasizing portrayal as a key feature of all of them. In justifying the study of the case on conceptual as well as on clinical and methodological grounds, we highlight the position of health psychology in its attempts both to study and to intervene in health-care contexts.     

Volunteer bias in medical education research: an empirical study of over three decades of longitudinal data

CONTEXT: The issue of whether medical education research outcomes can be biased by students' refusal to allow their data to be used in outcomes research should be empirically addressed to assure the validity of research findings. Given that institutions are expected to document the outcomes of their educational programmes, evaluations of clinical performance subsequent to medical school are crucial, but are often incomplete when graduates decline to permit data collection. OBJECTIVES: This study aimed to examine the demographic and performance differences between research volunteers and others. METHODS: A total of 7415 doctors graduated from Jefferson Medical College between 1970 and 2004; 75% (n = 5575) agreed to participate in medical education research by granting written permission for the collection of data from their postgraduate training directors on their behalf (research volunteers); 20% (n = 1489) refused to grant such permission (non-volunteers), and 5% (n = 351) did not return the permission form (non-respondents). This prospective longitudinal study compared research volunteers, non-volunteers and non-respondents on gender, ethnicity, performance measures prior to, during and after medical school, scores on medical licensing examinations, and board certification status. RESULTS: Doctors who granted permission (volunteers) generally performed better during and after medical school. In addition, they scored higher on medical licensing examinations and had a higher certification rate. Women and members of ethnic minority groups were less likely to grant permission. CONCLUSIONS: The study raises questions about the validity of research findings as a result of volunteerism in medical education research. The implications for guidelines regarding the protection of human subjects in medical education research, and for educational outcomes, are discussed.     

基础与临床结合的运行模式与实践

文章阐述了医院与研究所合并后,"基础与临床结合"运行模式的构建和运行效果.构建了"人才上实行复合培养与流动使用并举;成果应用上,建立基础研究成果到临床验证和应用的内部机制;互相渗透,加强战创伤学科特色的建设;面向部队,建立军事医学研究和服务体系"的运行模式,取得了促进复合型人才的成长,使人才拥挤和青黄不接的矛盾得以缓解;"院所一体"的科研机制得以建立,基础与临床的协同攻关初见成效;建立多个科研合作的外部基地,建成全军训练基地;形成战伤和创伤学科特色与优势的良好效果.     

Medical researchers evaluate their methodological skills

BACKGROUND AND OBJECTIVE: Clinical epidemiology and statistics skills of clinical researchers are often limited. We assessed methodological skills of medical researchers and identified factors associated with higher skill levels. METHODS: In a cross-sectional mail survey at two Swiss teaching hospitals, participants (N=409) rated their ability to perform 26 research-related activities, such as identifying the research question, selecting a study design, computing the required sample size, performing data analysis, and reporting results. RESULTS: The proportion of respondents who were able to perform a specific activity was 33.2% on average, ranging from 1.5% for "numerical statistics (bootstrap, simulation, cross-validation,...)" to 76.0% for "oral presentation of results." The overall skill level (expressed as a percentage of the 26 activities) was associated with principal investigator experience (+8.7%), greater percentage of time devoted to research (+12.4% for near full-time versus no time commitment), years of research experience (+17.6% for 15-40 years versus 0 years), past number of clinical research projects (+18.0% for 15-230 projects versus 0-1 projects), and hours of formal methodological training (+32.6% for 200-1200 hours versus 0-9 hours). CONCLUSION: Self-reported methodological skills were generally modest. The most important covariates of skill levels were current time commitment to research, past experience, and formal training.