医技科室发展趋势的预测与管理方法的探讨

我国的医技领域，高科技成果应用正处于上升期；计算机的应用正处于拓展期；医技科室在治疗领域的优势正处于起步期；人们对医技科室优势的认只正处于加深期。由此提高：在我国，医技科室向高层次的发展刚刚开始，今后１０年将是我国医技科室发展的高潮。     

实行科室目标成本管理的几点举措

成本核算是医院经济管理工作的重点和难点。医院科室实行成本核算是医院适应市场发展的必然趋势，也是医疗服务进入市场参与竞争的必然结果。我院的成本核算经过几年的运行，由部分成本核算到全成本核算，再到现在的目标成本管理，有了一定的成效；为进一步适应医疗保险制度改革的需要，结合新医疗价格体系的调整，更好地将成本核算运用于服务和医疗管理中，为此，我院实行科室目标成本管理的经验与大家探讨如下：     

军队医院开展特色技术管理的探讨

本介绍了我院近年特色技术，新技术开展的选题申报，论证立项，过程监控，总结激励和自我发展的规范化，科学化管理方法，以及取得的成效，保证了技术开展的先进性和高质量，调动了医务人员的积极性和创造性；强化了科室的学科优势；促进了新的技术特色形成；实现了社会，军事、技术和经济效益的最佳结合。     

试论医技术科室全面质量管理

在提高医院整体医疗质量的大前提下，实施对医技科室的全面质量管理，应注意：在医学教育中重视医技系列人才培养；创造良好质量环境；建立统一医技科室管理部门；制定医技科室工作质量及考核标准；完善医技科室工作质量监控手段。     

创特色专科 促科技发展

社会主义市场经济的发展和改革开放的进一步扩大，为军队疗养院建设和发展注入了新的生机与活力。面对层出不穷的新情况、新问题，军队疗养院的工作思路、工作方法和工作措施，也要适应时间、条件和各种因素的变化。我院在科技发展中，紧紧抓住特色专科建设这个重点环节，取得了明显的效果。１９９７年精简整编后，我院由原来的２０个临床科室，缩编为现有的１４个科室。而医学心理科原是隶属于疗养一科的“医学心理室”，它由小小的一个心理室纳编入心理科，并成为我院重点和特色专科，这是军队疗养院系统的首创。它的发展过程，也是我院在…     

综合医院手术科室病房管理模式的探讨

现阶段，综合医院手术科室病房的管理基本上有两种主要模式，即医疗模式和主任模式。在医疗质量管理中，这两种模式各存在一些弊端：医疗组模式造成的科室内部的分割自治，在对疑难、危重病人的抢救治疗方面暴露出不足；主任模式在科室后备人才的培养方面存在缺陷，影响科室的长远发展。为克服这些弊端，建议在手术科室病房管理方面，应坚持个性化的管理原则，坚持以质量和学术为重心，重建大查房制度，充分发挥副主任医师的作用，建立手术分级管理制度。     

新形势下医技科室质量管理面临的问题与对策

试就市场经济高度发展的新形势下，如何实施医技科室质量管理问题进行初步探讨。认为目前医技科室质量管理面临的主要问题，一是基础工作质量相对薄弱；二是环节工作质量缺乏有效监控手段；三是终末工作质量没有量化评价指标；四是专科技术发展过快，对传统质量管理方法构成影响。为改善这种状况应采取的主要对策为：突出标准化管理，强化基础工作质量；坚持系统化管理，确保环节工作质量；注重规范化管理，把握终末工作质量；加强科     

基于科室绩效评价的医院奖金分配系统变革

医院奖金分配制度始终随着医院改革的发展不断调整和完善[1] ,并为我国医院的更深层次变革和发展做出更大的贡献。本文将我院所进行的基于科室绩效评价的医院绩效工资分配模式介绍出来 ,希望能为持续变革提供一种新的思路和借鉴。一、我院开展科室绩效评价改革奖金分配的实践[2 5](一 )基于科室绩效评价的绩效工资分配模式的设计1.我院以科室、部门为单位 ,初步分为临床科室、医技科室、辅助科室 (主要包括不创收但以前划归医技类的科室 ,如统计室、病案室等 )和行政后勤部门 4个部分进行分别设计 ,对每科室、每部门均建立自己的绩效评价和…     

加强乡镇卫生院手术质量的管理

近几年来，乡镇卫生院手术科室有较大发展，但管理中也存在人员业务素质差，技术力量不配套；基础设施不全，仪器设备陈旧；手术审批制度不严，忽视手术质量的问题。为此，加强手术科室质量管理的有效措施；应着力提高要素质量，重点改善手术科室的设备条件，努力建立一支较高素质的技术队伍；狠抓环节质量，严格手术审批权限，规范和类医师的手术范围；克何手术质量，加纺术前，术中，术后管理，开展全程优势服务，强化质量控制，层     

我院抗菌药物应用的管理与控制

目的 控制抗菌药物的滥用。方法 建立健全合理使用抗菌药物的管理组织和管理制度；加强对医务人员合理使用抗菌药物的知识培训；制定抗菌药物的用药原则；每月公布细菌培养的病原菌和药敏结果；对全院抗菌药物的使用认真督查，把督查情况以简报的形式及时向全院各科反馈，并对滥用抗菌药物的科室和个人进行一定的经济处罚；严把抗菌药物购进关。结果 我院抗菌药物的滥用得到有效的控制。结论 我们采取的这些综合管理与控制措施行之有效。     

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.     

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.     

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.     

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.     

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.