浅议医疗服务机构放射诊疗现状与思考

目的 确保医用辐射安全,了解放射诊疗新设备、新技术不断更新现状,全面掌握开展放射诊疗工作的医疗机构和从业人员的情况。方法 通过日常监督检查、听取汇报、现场检查、信息上报等统计分析,获得可靠的医疗服务机构放射诊疗现状与数据。结果 国家实施颁布了一系列法律法规和规章及放射卫生防护标准,但在医疗服务机构开展放射诊疗活动中,仍存在法律法规意识不强、放射工作场所及个体防护措施不到位、设备性能检测不及时等问题。结论 解决这些问题的有效手段是增强法律法规意识、提高日常监督管理力度、加强放射卫生技术服务机构能力建设等措施。     

广西钦州市医学放射工作人员职业健康监护的现状分析

【目的】了解广西钦州市放射诊疗机构放射工作人员职业健康监护情况,为放射防护效果评价及卫生监督部门监督检查提供参考依据,以最大限度地保护放射诊疗工作人员的职业健康。【方法】对钦州市辖区内放射诊疗机构发放调查表,收集调查表后进行数据整理汇总和分析。【结果】共收集钦州市取得放射诊疗许可证的放射诊疗机构101家,共850名放射工作人员。其中放射诊疗工作人员体检率为96.94%,个人剂量计监测率为93.41%。参加放射防护知识和相关法律知识培训率94.12%,设备性能稳定监测率51.49%。医院等级级别高的放射诊疗机构开展放射工作人员职业健康监护工作比较规范,乡镇卫生院及未定级的私立医院、口腔诊所等放射诊疗机构职业健康监护工作管理不规范。全市放射设备性能监测率普遍偏低。【结论】卫生监督执法部门应加大执法力度,促使放射诊疗机构依法有序开展放射职业健康监护工作,最大限度保护放射诊疗工作人员的健康权益。     

2012年无锡市放射诊疗卫生管理现状调查

目的了解无锡市放射诊疗管理工作的现状及存在问题,为加强放射防护工作及监管工作提供依据。方法通过现场检查、资料查阅,对2012年全市放射卫生监督数据进行汇总分析。结果无锡市放射工作人员职业健康体检率91.64%,个人剂量监测率97.85%,放射工作场所放射防护检测合格率为99.85%,均配备了放射诊防护设施、防护用品。结论应继续加强对放射诊疗单位卫生监管,提高负责人及从业人员的放射防护意识。     

某市223家放射诊疗机构放射卫生管理现状分析

目的 为了解某市放射诊疗机构放射卫生管理现状,为有关部门加强放射卫生管理提供依据,促进放射诊疗工作安全、有序的开展。方法 采用放射诊疗机构基本情况调查表和医疗机构开展放射诊疗频度调查记录表,收集医疗机构放射卫生管理基本情况,并随机抽取部分机构设备进行检测。结果 某市223家放射诊疗机构配有放射诊疗设备754台,放射工作人员1754人,男女比例3∶1;日常放射诊疗工作以X射线诊断为主,设备数量、放射工作人员数和放射诊疗应用频次分别占总数的95%、78%、98.4%;全部机构均配置了防护用品,X射线诊断和介入放射学项目符合率分别为97%和94.1%;随机抽取的17家放射诊疗机构中,设备质量控制检测合格率为91.8%,放射防护检测合格率为98.4%;全部放射工作人员均参加了放射防护培训、个人剂量监测及职业健康检查并持有《放射工作人员证》。结论 该市223家放射诊疗机构放射卫生管理现状总体良好,但设备种类、人员来源、放射防护管理等方面仍存在一些问题有待进一步解决。     

军队放射诊疗许可管理问题与对策探讨

军改新时期军队放射诊疗许可管理实践中发现,军队放射防护工作在放射防护管理制度、放射工作人员职业健康监护、射线装置和场所防护检测、新改扩射线建设项目“三同时”落实情况、放射防护与放射诊疗质量控制等方面还不够规范,需要在放射防护培训、放射诊疗机构的自主管理、放射诊疗许可管理机构的监督管理和发挥多部门联动作用等方面重点加强。按照军地新的法规标准,在军改新时期创造性地开展放射诊疗许可管理工作,加强依法治军,对于规范军队放射防护工作,保证军队放射诊疗事业的健康发展有重要意义。     

四川省医用辐射防护调查分析

目的 了解医用辐射防护现状,科学实施医疗机构放射诊疗防护监督管理。方法 对抽取的14个地市开展放射诊疗的医疗机构进行全面调查。结果 开展放射诊疗的医疗机构2 696家,放射诊疗设备3 695台套,年放射诊疗总量1 580万人次,放射工作人员9 038人。组织机构及制度建设、防护配套设施、诊疗设备性能检测与职业病危害评估总体状况仍不理想。结论 规范开展放射诊疗活动,仍需卫生监管部门和放射诊疗机构共同努力。     

鹤壁市医疗卫生机构放射卫生监督结果分析

目的 了解鹤壁市医疗卫生机构开展放射诊疗工作情况,找出当前医疗卫生机构放射诊疗防护中存在的问题,并提出合理化的建议,促进医疗卫生机构放射诊疗工作的健康发展。方法 通过对医疗卫生机构放射诊疗活动的监督检查,同时收集、整理工作总结、报表等,对医疗卫生机构放射防护工作现状进行综合分析。结果 鹤壁市医疗卫生机构放射诊疗许可证持证率94.29%,放射诊疗场所及设备检测率为42.86%。2014年放射工作人员体检率和个人剂量监测率为73.91%。结论 鹤壁市医疗卫生机构对放射诊疗场所及设备检测不足,放射工作人员防护意识不够,以后要加大对放射卫生防护知识的宣传教育,加强对医疗卫生机构放射防护工作的监督管理,确保放射诊疗防护安全。     

建设项目职业病危害放射防护评价管理探讨

目的 分析放射诊疗单位建设项目职业病危害放射防护评价管理中存在的问题,提出相关对策。方法 针对放射诊疗单位、放射工作人员、放射卫生监督执法机构、建设项目职业病危害放射防护评价机构探讨建设项目职业病危害放射防护评价管理中存在的问题。结果 基层放射诊疗单位普遍不重视建设项目职业病危害放射防护评价,放射防护措施和管理落实不到位。结论 放射卫生监督执法机构和放射防护评价机构应加强自身能力建设,加强对基层放射诊疗单位、放射工作人员的防护知识培训和相关法律法规教育。     

浙江省基层医疗机构放射防护现状的调查分析

目的了解全省基层医疗机构放射防护现状,分析存在的问题,为进一步加强基层医疗机构放射诊疗防护管理提供对策和建议。方法采用事先设计的《基层医疗机构放射防护情况调查表》,重点调查放射诊疗设备和放射影像医师配备情况、放射工作人员职业健康管理情况、个人防护用品配置情况、放射防护检测和设备性能检测情况、放射诊疗建设项目审查情况。结果 CT、DR和CR约占放射诊疗设备的50%,透视机占5.6%,使用10年以上的设备占11.1%;9.9%的基层医疗机构未配备放射影像医师;放射工作人员的体检率、培训率和个人剂量监测率分别为98.6%、98.3%、99.9%;个人防护用品配置率和合格率分别是100%和98%;放射防护检测和设备性能检测合格率分别是99%和99.7%;有25.9%和20.6%的建设项目未进行放射防护预评价和控制效果评价。结论设备落后、陈旧情况依然存在;放射影像医师配备相对不足;放射诊疗建设项目卫生审查率较低;放射工作人员的职业健康管理较规范;个人防护用品的配备率、合格率以及放射防护检测和设备性能检测合格率较高。     

天津市放射卫生监督现状及对策建议

目的 分析天津市放射卫生监督体系建设情况,以期为天津市放射卫生监督执法工作提供参考。方法 收集2017年天津市放射诊疗机构日常监督档案、行政处罚档案,以及天津市卫生计生监督平台数据,应用Excel 2007进行统计、分析,总结天津市放射诊疗机构和放射卫生技术服务机构依法执业现状。通过访谈法探讨存在的问题并提出对策建议。结果 天津市放射卫生监督工作扎实、稳步提升,执法水平持续规范;外省备案的放射卫生技术服务机构难于管理。结论 在今后的工作中,落实放射诊疗机构和放射卫生技术服务机构自我管理主体责任,加大事中事后监管力度,提升监督执法能力和水平,促进依法执业。     

Leadership, organization and health at work: a case study of a Swedish industrial company

The application of knowledge on organization and leadership is important for the promotion of health at workplace. The purpose of this article is to analyse the leadership and organization, including the organizational culture, of a Swedish industrial company in relation to the health of the employees. The leadership in this company has been oriented towards developing and actively promoting a culture and a structure of organization where the employees have a high degree of control over their work situation. According to the employees, this means extensive possibilities for personal development and responsibility, as well as good companionship, which makes them feel well at work. This is also supported by the low sickness rate of the company. The results indicate that the leadership and organization of this company may have been conducive to the health of the employees interviewed. However, the culture of personal responsibility and the structure of self-managed teams seemed to suit only those who were able to manage the demands of the company and adapt to that kind of organization. Therefore, the findings indicate that the specific context of the technology, the environment and the professional level of the employees need to be taken into consideration when analysing the relation between leadership, organization and health at work.     

秦皇岛市海港区疾病预防控制机构人力资源现状

目的了解秦皇岛市海港区疾病预防控制中心(以下简称"疾控")人力资源的现状,为今后人力资源的合理配置提供参考依据。方法对海港区疾控中心2011年6月在岗职工的存档资料进行整理分析,从性别、年龄、职称、学历和专业5个方面对海港区疾控中心人员构成进行描述。结果海港区疾控中心2011年6月共有在职职工78人,男女比例为0.32∶1。年龄以25～35岁所占比例最大,为39.74%。专业技术职称以中级职称人员所占比例最大,为51.22%;高级职称人员不足,初级职称及无职称人员所占比例较高。第1学历以中专为主,最高学历以大专为主,总体学历偏低。所学的专业初始学历和最高学历中均以非医学类专业(包括法律、会计专业等)为主,预防医学和检验专业人员比例均偏低。结论海港区疾控中心人员配备不足,男女比例不均衡,以中青年为主,总体学历偏低,高级职称人员偏少,所学专业中非医学类专业人员过多,人员结构不够合理,需加快对现有人员的补充、更新和专业技术培训,引进高层次、专业对口人才,以适应疾控事业发展的需要。     

Work organization and the health of bank employees

The Brazilian banking sector has undergone an intense restructuring process and taken a leading position in the incorporation of new technologies and organizational innovations. Computerization in the industry, in association with forms of work organization, has resulted in changes that reflect on the workers' health. Based on the theoretical and methodological frameworks of historical and dialectical materialism, this qualitative study investigates the work conditions of bank employees in order to identify the extent to which changes in work organization interfere with these workers' health. Data were collected through interviews held with 11 bank employees. In addition to physical sickening due to occupational diseases directly related to work intensification, the results also show an increased incidence of mental suffering and a feeling of loss of professional identity. Work-related frustration, instability and concerns related to psychological pressure resulting from the need to achieve goals predominated in the reports.     

Men in kindergartens: work culture and gender

This article examines the impact on work culture when men work in kindergartens. In Norway, as in other countries there has been a call for more male staff in kindergartens. Increasing the amount of men may imply that institutionalized norms and practice are put under pressure. By using a case study approach, the focus is on employees’ experiences and practice in daily life in the kindergarten. Two processes, negotiation about work organization and the division of labour, illustrate the empirical part of this article. The findings indicate that female staff negotiate for standardized workdays and norms of sameness, while the males negotiate for a flexible workday and division of labour based on their interests. The difference in practice between males and females and negotiation about the division of labour contribute to constructing gendered work cultures.     

卫生机构组织文化的认知调查与分析

文章采用问卷调查的方式,从员工价值观取向、员工对组织文化建设的认可状况、员工的文化需求和期待等方面展开调查,把握员工对组织文化的整体认知情况,提出要从和谐社会的高度去构建医疗卫生机构组织文化,增强员工的归属感、幸福感,形成特色鲜明、内涵丰富的组织文化.     

The technical and interpersonal aspects of telemedicine: effects on doctor-patient communication

The influence of telemedicine on the nature and content of doctor-patient communication stems from both its technical and its interpersonal aspects. While the technical aspects are concerned with the communication technologies used and the clinical processes enabled by those technologies, the interpersonal aspects are concerned with relationships between system personnel, providers and patients, and the way in which those relationships are organized. On the one hand, this paper posits that the influence of the technical environment stems from depersonalization of the doctor-patient relationship, participatory enhancements and impediments, and sensory and non-verbal limitations. On the other hand, it posits that the influence of the interpersonal environment stems from third-party participation, social and professional distancing, and underdeveloped norms and standards. A combined positivist and interpretivist evaluation strategy would enable researchers to make better-informed connections between telemedicine, medical encounter behaviour and health outcomes.     

数据协调委员会在不孕症临床研究不同阶段的作用和特点

数据协调委员会(Data Coordination Committee,DCC)是临床试验中一个独立第三方的数据管理机构,是提高临床试验数据质量,使数据结果更为准确、真实、可信的有效途径之一。文章以黑龙江中医药大学附属第一医院妇科临床基地一项大型不孕症临床研究为例,对数据协调委员会的建立、人员组成、在不孕症试验中的特色和优势及其具体职能进行描述;阐明了DCC在不孕症临床试验中的重要作用,能够最大程度地避免临床试验过程中的偏倚,增加试验透明度和可信度,提高临床试验管理效率。     

Productivity management: applying it personally and professionally

Productivity management is a major step in analyzing and documenting our professional tasks. Defining ratios, measuring, and evaluating are the first steps in accounting to consumers, employees, government bodies, and ourselves for our resources and services. Self-evaluation with empirical productivity data can provide the key information necessary for growth and change in the individual and, in turn, in the organization. Professional productivity management can be a managerial tool essential in documenting our professional worth. The significance of productivity management to the individual and her/his career needs to be self-examined by every dietetic professional. Well-defined goals and documented accomplishments are important, if not essential, to our existence as a profession. We can no longer afford not to accept the responsibility to manage and improve our professional lives.     

The impact of two corporate lactation programs on the incidence and duration of breast-feeding by employed mothers

PURPOSE. The goal of this study was to examine the impact of two corporate lactation programs on breast-feeding behavior among employed women. DESIGN. Breast-feeding behavior was measured for up to one year among women who had given birth during 1989, 1990, 1991, and 1992 and compared with national norms. SETTING. The study was conducted at two corporations: a utilities company with 11,000 employees of which 22% were female with approximately 100 births each year and a space corporation with 3,900 employees of which 31% were female with approximately 30 births per year. SUBJECTS. Participants were 187 employees returning to work following maternity leave for a medically uncomplicated birth. INTERVENTION. Participants collected and stored breast milk using the worksite breast pump room at scheduled times during the workshift and were counseled by a lactation professional throughout the study. MEASURES. A questionnaire was used to establish breast-feeding behavior. Duration was reported by the lactation professional. RESULTS. Since program inception, 75% of the participants who returned to work while breast-feeding continued until their child was six months old. This represented 139 of the 187 mothers at the two companies. Average duration of breast-feeding overall was 8.1 months. DISCUSSION. Participants were able to maintain a breast-feeding regimen for at least six months at rates equivalent to the statistical norms for women who are not employed outside the home. This was not an experimental study. Participants were self-selected and there was no control group. On a year-to-year basis, the numbers of participants were relatively small.(ABSTRACT TRUNCATED AT 250 WORDS)     

The importance of organizational culture on development activities in a primary health care organization

The aim of this article is to examine, by means of an empirical study, the: a) relationship between formal and cultural structures; b) similarities and differences between professional subcultures (medical, nursing and managerial); and, c) the effects of the social assumptions of the work teams on development activities in one large primary health care organization. The results show that different professional groups have created quite different sets of social values, norms and assumptions, which have significant consequences, both for patients care and organizational performance.