湖北省通山县乡村医生执业现状调查分析

目的探讨如何提高乡村医生队伍的整体素质和水平。方法以通山县354名乡村医生的全样本为研究对象,采用半结构式问卷对其进行问卷调查。结果通山县乡村医生的学历水平以中专及以下学历为主;整体执业水平还较低,仍有相当一部分乡村医生不具备执业资质,而已取得执业资格证书的以乡村医生执业证书为主;培训需求方面,乡村医生对培训时间、培训内容等方面有不同程度的需求。结论加强教育培训和准入管理,提高乡村医生执业水平;明确政府投入责任,确保乡村医生基本待遇;完善乡村医生保障体系,促进乡医人才队伍建设。     

中国乡村医生队伍的现状与发展

目的:分析乡村医生队伍的现状与问题,并提出相关发展建议。资料来源:历年中国卫生统计年鉴、国家卫生服务总调查研究报告、《中国乡村医生历史回顾与现状研究》数据、《乡村医生队伍发展的关键问题策略研究》资料和相关研究文献。结果:当前,我国乡村医生队伍面临着:身份与其承担的职能相矛盾;队伍年龄老化,整体素质偏低,向执业(助理)医师转化困难;乡村医生收入偏低,待遇无保障;乡村医生"老无所养"问题严重等。建议:本问题出4点相关建议:明确乡村医生身份定位,逐步纳入事业编制管理;加强乡村医生教育培训,增设"乡村医生执业助理医师考试";多渠道保障乡村医生合理收入;政府主导,地区选择建立适宜的乡村医生养老保险。     

浅谈如何应对乡村医生执业资格考试

<正>山东省将于2008年2月份组织一次乡村医生执业资格考试,经考试合格的人员可按规定程序申请乡村医生执业注册并取得《山东省乡村医生执业证书》。此次乡村医生执业资格考试是《乡村医生从业管理条例》实施以来全省范围内进行的第一次充实乡村医生队伍的考试,是卫生技术人员进入乡村医生队伍的唯一途径,对那些想要进入乡村医生队伍的人员来说既是一次机会也是     

乡村医生稳定与发展问题研究

目的:调查分析大连市某区乡村医生队伍稳定与发展情况,为相关卫生决策提供建议。通过问卷调查法、访谈法和文献分析法等方法发现问题:乡村医生队伍稳定性较差、发展空间较小,待遇和保障水平较低。结论:应稳固乡医队伍,加强待遇及保障,完善培训,使其得到发展的机会。     

论增设乡村全科执业助理医师资格考试的必要性及可行性

乡村全科执业助理医师资格考试的增设符合乡村医生合法行医的需要,有利于加快乡村医生队伍执业医师化的进程,并提高其素质,同时在规范乡村医生队伍管理和稳定乡村医生队伍方面具有重要意义。乡镇执业助理医师资格考试的增设、现行相关法律政策提供的法律依据以及政策实施的客体——乡村医生群体的强烈诉求和居民支持使得乡村全科执业助理医师资格考试的增设具备了可行性。为保障乡村医生的执业医师化进程,还需完善现行法律法规和政策、加强针对乡村医生参加执业医师资格考试的医学专业培训及全科医师培训、建立合理的乡村全科执业助理医师补偿、养老等社会保障机制。     

南京市六合区乡村医生现状与分析

目的：了解和分析六合区在岗乡村医生基本情况,探讨如何提高农村医疗服务水平。方法：对六合区562名在岗乡村医生的性别、年龄、学历、执业情况和继续教育情况进行分析。结果：现有乡村医生队伍存在人员老化,培训力度不足,后备力量不足等问题。建议：拓宽乡村医生培训的实施途径,提高乡村医生学历层次和业务水平;提高乡村医生社会保障水平,改善乡村医生执业环境,提升其岗位的吸引力;强化面向农村基层的医学生培养,为基层引进卫生人才;健全财政保障机制,保障乡村医生合理收入待遇。     

甘肃省贫困地区乡村医生现状调查及对策建议

目的了解甘肃省贫困地区乡村医生队伍的现状、存在的问题并探讨对策建议。方法对甘肃省参加2019年乡村医生规范化培训项目来自贫困县的1 000名乡村医生进行问卷调查研究,了解贫困地区乡村医生的现状和存在的问题及改进的建议。结果乡村医生队伍中男性和女性的比例约为3∶1;平均年龄为42.39岁,40~50岁的人数约占总人数的1/2;学历层次以高中(中专)学历为主,比例最高为69.3%;助理执业医师占19.9%,执业医师占5.2%,相较于全国平均水平甘肃省乡村医生执业化程度依然偏低;有73.6%的乡村医生月收入在2 500元以下,收入水平偏低;养老保障的参保比例为87.5%;大多数乡村医生有2~3次的岗位培训,有25.23%的乡村医生从未参加过任何培训。结论乡村医生队伍依然是我省基层医疗卫生服务体系中最薄弱的环节,应加强队伍建设,提高乡村医生待遇,建立完善养老保险制度,加强乡村医生岗前和继续教育培训。     

靖江市乡村医生的现状调查与对策研究

目的：通过对靖江市乡村医生队伍的现状调查,探讨目前靖江乡村医疗卫生工作中存在的问题,提出培养和建设靖江乡村医生队伍的对策。方法：采用回顾性分析及问卷调查的方法对靖江市乡村医生进行调查。调查内容为基层医生的年龄、学历、收入和保障等情况。结果：靖江市乡村医生队伍老龄化现象严重,学历偏低,知识陈旧。结论：需要提高乡村医生的地位和待遇,加强在职培训与管理,吸引各类医务人才。     

医改背景下解决乡村医生待遇与保障问题的探讨

当前医改背景下,解决乡村医生待遇与保障问题是稳定乡村医生队伍发展、促进相关医改措施实施的一项重要任务。长期以来,村卫生室以个体为主导的经营模式,乡村医生"半农半医"、"非卫生专业技术人员"的身份,加之相关政策的缺失与不完善是造成乡村医生队伍待遇相对偏低,养老保障缺乏的深层次原因。通过对医改文件分析和医改背景下地方经验的总结,有针对性的提出以下四点对策建议:大力推进乡村一体化管理;政府多种方式补助,保证乡村医生合理收入;政府主导,多种模式解决乡村医生养老问题;开辟途径,解决乡村医生身份。     

剑川县乡村医生现状调查分析

目的:通过对剑川县乡村医生的现状调查,分析目前乡村医生队伍同发展农村卫生服务的矛盾,为加强乡村医生管理和提高乡村医生队伍素质提供建议.方法:采用问卷调查和访谈的方式,调查全县287名乡村医生.调查内容为乡村医生的年龄、学历、工作年限、收入和保障等情况.结果:目前剑川县乡村医生年龄偏大、学历偏低、接受规范教育培训少,管理体制不顺和待遇低,收入差距大.结论:剑川县应加强乡村医生在岗教育培训,提高乡村医生的地位和待遇,并建立有效管理制度,吸引各类卫生人才.     

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.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

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.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

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.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.