加强制度建设 提高医疗质量

医疗质量是医院管理的核心。加强制度建设是提高医疗质量的保证，提高医疗质量，确保医疗安全，才能为患者提供高效、优质的医疗服务。医院采取建立规章制度、完善监督机制、加强内部管理等方面的约束机制，以此来提高医疗质量的一些做法，充分阐述了加强制度建设对提高医疗质量的重要性和迫切性。     

军队医学计量三级站建设的探讨

目的：分析现阶段医学计量三级站在军队医疗单位的现状,通过规范化管理,达到保障医院医疗设备质量安全的目的。方法：医院领导的高度重视、硬件齐备和制度建立、人才队伍建设、奖惩机制实施、计量管理信息化和交流合作是促进计量站发展的有效手段。结果：规范化管理不仅提高了计量站的管理效能,而且保障了医疗设备的质量安全。结论：计量站的建设是医院管理的重要组成部分,加强计量管理工作,才能保障医疗质量安全。     

医疗质量长效机制的探讨

通过加强对医务人员的培训,建立医疗质量监控和规章制度执行的跟踪问效问责制度,加强医德医风建设和医院文化建设等,探索建立医疗质量的长效机制。提出了提高人员技能素质、落实规章制度、增强工作责任心分别是提高医疗质量的根本、关键和保证的观点。     

PDCA循环在医疗核心制度落实中的应用

医疗质量与医疗安全是医院的根本,落实医疗核心制度是医院确保质量与安全的关键.在Plan阶段,加强医务人员培训,强化核心制度落实意识;在Do阶段,完善质量管理组织体系,确保核心制度严格执行;在Check阶段,建立督查机制,实施监管;在Action阶段,加强反馈与干预,持续改进.PDCA循环的应用确保了医疗核心制度的落实.     

军队医院与医疗质量评价的若干问题

医院评价与医疗质量评价对医院发展具有重要意义。通过分析临床工作中发生的问题,提出：注意医院评价与医疗质量评价的联系与区别;坚持军趴医院姓“军”的总方向;坚持医院质量体系评价与医疗效果评价相结合;建立多层次、多侧面的综合评价体系;不断完善军卫工程的医院信息系统的统计功能;注重统计报表制度与抽样调查相结合。     

医疗设备规范化管理探讨

目的：探讨医疗设备规范化管理的意义.方法：通过对医疗设备采购管理、使用管理、信息管理以及维修和报废管理相关制度规范化,促进医院医疗设备管理水平的提高.结果：提出医疗设备管理规范化的方法：①规范医疗设备采购程序;②完善医疗设备管理制度;③建立医疗设备档案管理系统;④加强医疗设备维护与报废管理.结论：医疗设备管理规范化是医院正规化建设的重要组成部分之一,对医院医疗、教学、科研水平的保障具有重要意义.     

从等级医院评审看军队医院信息化建设热点

介绍了医院信息化建设的现状,分析了医院数字化建设中存在医院信息系统孤岛、专业信息医疗人才短缺、数据资源共享利用不足等问题,提出了新时期军队医院信息化建设应以加强推进以电子病历为核心的辅助临床信息系统、建立完善的信息管理制度、加强信息化技术人员的培养等为研究热点,指出了今后医院发展的方向是医疗质量的持续改进和医疗服务的不断完善。     

军队医院建立医疗质量长效机制的思考

本文针对促进医疗质量持续改进和提高进行探讨,提出医院领导必须高度重视医疗质量建设,关键是要加强制度建设,加强内涵建设.     

医疗设备质量检测对医学工程科质量管理的促进

目的：通过落实医院等级评审细则对医学装备质量控制的要求,提高医院医学工程科的管理水平。方法：对比医院医疗设备质量检测和管理评定细则,分析医学工程科现状,提出通过建立从业人员准入制度,提高医学工程人员素质;将医学工程科的管理定位为医院质量管理的一项内容,其内涵向医疗设备质量管理转变;重视医疗设备质量控制与检测,拓展医疗设备检测的广度;加强医用设备及耗材的检测,以质量管理为主要服务模式等方式。结果：按照细则改进后,医学工程科的质量管理、服务水平得到进一步提高。结论：借助医院等级评审,真正达到以评促改,落实医疗设备质量控制的要求,全面提升医学工程科质量管理水平。     

医风建设严把关 医技医德口碑传

加强医德医风建设,提高医疗服务质量是建立基本医疗卫生制度,提高全民健康水平的重要内容,是关系党和政府威信的大事,也是医院提高医疗服务水平、树立良好形象的基础。加强医德医风建设,改善就医环境,弘扬敬业精神,塑造医院形象,将从根本上营造出温馨的就医环境和和谐的医患关系。     

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.     

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.     

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.     

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.     

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.     

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.