一个优秀科室主任的ABCD

科室主任的综合能力是医院创新能力的核心与关键,决定着医院核心竞争力的强弱,关系着医院的可持续发展。本文重点围绕卓越的品质（Ambition）、扎实的基础（Basement）、团结协作精神（Cooperation）和敬业奉献精神（Devotion）四个方面,论述一个优秀科室主任应具备的四项基本素质。     

加强科室主任管理的思考

医院建设发展的实质是学科建设与人才建设,这在很大程度上取决于科室主任的管理能力和管理水平。文章从强化科室主任的几种意识、工作重点、整体素质及怎样协调科室主任的工作关系等方面进行了探讨。     

基于平衡计分卡的科室主任年度述职设计与实施

运用平衡计分卡战略管理理念,探索军队医院战略管理新模式;结合医院战略目标,探讨对科室主任综合管理能力及水平的测评方式;通过对2009年度科室主任述职制度的实证研究,讨论本制度的设计与实施所具有的科学性与可行性。     

发挥科室主任作用促进医院全面建设

医院建设的实质就是学科建设与人才建设。全面提高科室主任素质，发挥和调动科室主任的潜力与积极性，对加快学科建设和医院的建设与发展，将起到重要的促进作用。发挥科室主任作用可从三方面着手，一要提高科室主任的素质；二要充分调动科室主任的潜力与积极性；三要处理好与科室主任的关系。只有这样，才能使医院的建设与发展取得显著成绩。     

设计临床科室主任综合水平考核评估标准体系的探讨

临床科室管理是医院管理的重要环节之一,从某种意义上讲,医院能否得到发展取决于科室管理水平的高低。临床科主任是临床科室的带头人,故科室主任必须具有较高的业务水平和较全面的行政管理能力。医院在抓全面质量管理的同时,也应抓科室带头人的管理,并对其实行考核评估,以促进发挥科室主任的最大管理作用。作者结合多年的医院管理经验,对如何设计临床科室主任综合水平考核评估标准体系作一探讨,并制定了一套“临床科室主任综合水平考核评估标准体系”,以供各医院制定临床科室主任考核评估标准时参考。     

增强医院科室主任综合能力的思考

为探讨医院科室主任的综合能力的培养，本阐述了找准全能复合型人才定位；建立健全科学的竞争机制，把好科主任选用考核关，为提高医院科室主任的综合能力提供参考。     

医院科主任的角色定位与作用

一个医院的发展快慢、效益好坏,与院长的领导组织能力直接相关。各个科室的协调发展是医院发展的有效保证和支撑。而科室的业务发展与科主任密切相关,一个科主任就是一个科室、一个学术专业的带头人,是榜样,是旗帜。各个科室的主任就是医院的顶梁柱,特别是在现代化医院发展的潮流中,科主任的作用显的尤其重要。     

院长要做科主任的朋友

办好一所医院，需要多方面的条件，最主要的是专家队伍，其中核心的是学科带头人的培养和使用。一般来说，医院的学科带头人同时都是各个科室的主任，他们在医院里承上启下，因此，团结、使用好科室主任这一群体，是当好医院院长的基本功，也是医院发展的前提。     

“空降兵”的尴尬

案例背景2009年10月份,A医院外科的一次人事变动至今让人力资源部主任刘梅记忆犹新:副主任医师林晓突然提出离职申请,要自费出国深造。而在这之前,没有任何征兆。林晓待人真诚、做事踏实,业务能力强,而且还有较高的管理能力,协助外科主任把科室的各项工作都做得井井有条。由于科室主任即将退休,医院领导班子有意让他接替科室主任一职。谁成想这个节骨眼上,他居然要离开。     

通过绩效考核提升科室主任的管理水平

医院实施绩效考核,以科学量化的评价体系考评医院员工的工作实绩,是公立医院内部运行机制改革的重要内容,也是卫生部强化医院管理的要求[1]。临床科室主任是医院科室管理的中流砥柱,在医院管理结构中处于承上启下的中间环节。科主任的品德、能力、对科室工作的投入及管理水平的高低,将直接影响科室的进步与发展,也影响到科室的绩效评估结果。我院从2007年开始,应用绩效考评制度对各临床科室的医疗质量、工作量、医疗安全、教学、科研等各方面进行综合考评,由此也提升了科室主任的责任感和工作积极性[2]。     

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.     

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.     

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.     

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 risk of heat exhaustion at a deep underground metalliferous mine in relation to surface temperatures

The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.