野战方舱医院在五官模块抗震救灾中的应用及体会

目的:探讨野战方舱医院五官模块在抗震救灾中的使用。方法:根据野战方舱医院参加抗震救灾五官科遂行的卫勤保障任务,对实际展开工作的特点及遇到的困难,以及针对五官科模块配置装备少、需多渠道筹措等情况进行分析。结果:野战方舱医院配置使用五官模块,在参加汶川抗震救灾和玉树抗震救灾中提高了方舱抗震救灾保障能力。结论:野战方舱医院使用五官模块,适应抗震救灾需要,极大提高了野战方舱医院的救治能力。     

野战方舱医院在玉树抗震救灾中的快速配置及其作用

以野战方舱医院参加玉树抗震救灾卫勤保障为背景,总结了野战方舱医院从人员抽组、物资准备、机动方式、迅速展开等方面着手,快速配置形成保障能力的实践,指出了野战方舱医院在玉树抗震救灾快速配置中存在的问题,并提出了相应的对策和建议,为今后执行抗震救灾任务提供决策参考依据和经验。     

非战争军事行动方舱医院的抽组与部署

结合抗震救灾等非战争军事行动的任务和要求,总结了方舱医院执行非战争军事行动卫勤保障任务的主要特点。从理解行动任务、明确抽组任务,针对现实特点、确立抽组目标,科学抽组力量、适应不同行动要求等方面阐述了方舱医院的抽组方法;从针对任务样式、灵活配置部署,快速优先部署方舱医院、提高救治能力,慎重初次配置、快速机动展开等方面阐述了方舱医院的部署方法。指出正确把握方舱医院的合理抽组和部署方法,赢得了救治时间,提高了救治能力,确保了救治效果。     

野战方舱医院高原抗震救灾展开流程及分析

介绍了野战方舱医院执行高原抗震救灾的展开流程,并对其展开流程进行详细的分析,指出了分区分步地展开野战方舱医院能够满足野战方舱医院执行高原抗震救灾保障任务的需要,能够担负起现场救治的任务。     

方舱医院病房帐篷模块保障方舱的设计研究

目的：研制一套病房帐篷模块保障方舱,为方舱医院提供50个床位的病房保障。方法：采用方舱加帐篷的结构形式,病房内部的设备设施采用模块箱组化设计,方舱作为载体对其进行运载。结果：设计的病房帐篷模块保障方舱在工作时可作为护士工作站,并为病房帐篷提供电力、空调和暖风等保障。结论：病房帐篷模块保障方舱设计时充分考虑了模块化、通用性和可扩展性,使该系统可根据任务大小和性质对病房数量、用途和展开形式进行模块化配置．为新型方舱医院系统提供了完善的病房保障模块。     

折叠便携式方舱医院执行高原寒区卫勤保障任务的方案要点浅析

以新型折叠式方舱医院部分功能模块在高原寒区展开为任务背景,围绕卫勤保障任务的准备、队伍行进、方舱医院展开以及撤收四个行动步骤,探讨行动各阶段的组织指挥、力量编成及转换、物资准备与运输等关键问题。     

武警方舱医院装备训练探讨

目的:分析武警方舱医院的展开训练情况,探讨方舱医院快速展开模式.方法:回顾分析武警第一代方舱医院的展开训练情况,结合在救灾中的特点,对其展开流程进行详细分析,并根据方舱医院的特点,利用分解步骤、规范流程的训练方法,将方舱医院的展开分为卸载物资、搭建帐篷、展开物资3个主要环节.结果:通过科学管理和分工,使得方舱医院可以在4h内展开并投入使用.结论:开展方舱医院快速展开模式研究,对提高装备使用效率,提升卫勤保障能力具有重要意义.     

结合非战争军事行动卫勤保障谈方舱医院药材保障体会

研究了如何做好方舱医院药学保障模块的平时管理和战时保障,解决了方舱医院药学模块存在的药品管理难、人员职责不清、保障能力差的问题,从而确保药学模块适用于野战方舱医院遂行各种任务时药品保障的需要,以提高方舱医院的救治能力.     

用于紧急医学救援的方舱医院研制

目的:研发具有机动灵活、功能完善、性能可靠、自我保障能力强的方舱医院.方法:用通用运输底盘将手术方舱、术前X线和生化检查方舱以及医疗充气帐篷快速运至救援现场,通过医疗充气帐篷将手术方舱和检查方舱无缝连接组成方舱医院,整个医院的占地面积约为360 m2,并可根据需要进行功能模块组合.结果:该方舱医院具有高机动性,展开撤收迅速,占地面积小,自我保障能力全面.结论:该方舱医院实现了功能模块化,能够快速进入、快速通过、快速展开,对地形、地貌的要求较低.     

武警方舱医院研究与设计

目的:研制适宜武警部队执行突发事件或灾害医疗救援任务的方舱医院,即可在特定情况下能够有效实施快速、持续、综合的医疗救援保障,又可在平时到边远地方进行身体检查和治疗。方法:在总结分析现有方舱医院不足的基础上,采用现有手动推拉翻版扩展方式,研制一种武警方舱医院。结果:武警方舱医院由8台方舱医疗单元、2台技术保障车辆、通道帐篷和病房帐篷等单元组成。与以往方舱医院相比,拓展了救治范围、增强了救治能力。结论:武警方舱医院系统完全满足武警部队遂行多样化任务保障需求。同时,对于维护社会稳定也具有极其重要的作用。     

Fangcang shelter hospitals during the COVID-19 epidemic,Wuhan, China

ObjectiveTo design models of the spread of coronavirus disease-2019 (COVID-19) in Wuhan and the effect of Fangcang shelter hospitals (rapidly-built temporary hospitals) on the control of the epidemic.MethodsWe used data on daily reported confirmed cases of COVID-19, recovered cases and deaths from the official website of the Wuhan Municipal Health Commission to build compartmental models for three phases of the COVID-19 epidemic. We incorporated the hospital-bed capacity of both designated and Fangcang shelter hospitals. We used the models to assess the success of the strategy adopted in Wuhan to control the COVID-19 epidemic.FindingsBased on the 13 348 Fangcang shelter hospitals beds used in practice, our models show that if the Fangcang shelter hospitals had been opened on 6 February (a day after their actual opening), the total number of COVID-19 cases would have reached 7 413 798 (instead of 50 844) with 1 396 017 deaths (instead of 5003), and the epidemic would have lasted for 179 days (instead of 71).ConclusionWhile the designated hospitals saved lives of patients with severe COVID-19, it was the increased hospital-bed capacity of the large number of Fangcang shelter hospitals that helped slow and eventually stop the COVID-19 epidemic in Wuhan. Given the current global pandemic of COVID-19, our study suggests that increasing hospital-bed capacity, especially through temporary hospitals such as Fangcang shelter hospitals, to isolate groups of people with mild symptoms within an affected region could help curb and eventually stop COVID-19 outbreaks in communities where effective household isolation is not possible.     

Hospitals: place for the sick and other challenged persons

The hospitals were, since its source, a place of retirement and shelter of sick people. The Church, in Middle Age, founded hospitals in their monasteries, where sick people took care and a assistance, more religious than therapeutic. In the final of Middle Age the hospital became an exclusion's place for the crazy people, the leprous people, the bec people and the sick people were guided to. With de arisemens hospital became privilegious space where sick people could be observed and the art of care was consolidate. The apprehension of care practices by the capitalism way of production changed the welcoming character of the hospital that would be an instrument of work, productive space not only of treatment but, foremost, of values.     

Partners against violence. Two Minnesota hospitals join community-wide effort

Mercy/Unity Hospitals, in the Minneapolis-St. Paul suburbs, have joined other local organizations in an attempt to respond to increasing reports of domestic violence in the community. Their effort has focused primarily on three fronts. In 1991 the hospitals began screening their emergency department patients for signs of domestic violence. Volunteers from a local women's shelter originally provided all advocacy services for battered Mercy/Unity patients, but in 1995 the hospitals set up their own advocacy office. More recently, the hospitals have created steering committees to guide the screening and treatment of battering victims and to educate employees and patients about domestic violence. In 1992, under the leadership of the county health department, Mercy/Unity and other local groups launched a study of violence against pregnant women in the community. Two hundred women volunteered for the study. The study indicated that healthcare professionals are sometimes slow to recognize signs of domestic violence. In 1993 each judicial district in Minnesota was told to create an organization to educate the community about child abuse and domestic violence. Mercy/Unity Hospitals are represented on their county's Domestic Violence Council.     

新型冠状病毒肺炎防治工作中方舱医院信息化快速支撑方案探讨

2019年12月,武汉市发生了新型冠状病毒肺炎疫情。武汉大学中南医院是全省唯一的"1+3"模式收治新冠肺炎患者定点医院,院区先后托管武汉市第七医院、武汉客厅方舱医院、武汉雷神山医院,共提供5 400余张床位,其中武汉客厅方舱医院是规模最大的方舱医院。医院快速响应,在36小时内完成了方舱医院的信息化建设,目前武汉客厅方舱医院信息化运行效果良好。就医院在此疫情防控期间,针对方舱医院信息化快速部署进行梳理,希望为我国其他地区及医院的疫情防治信息化快速部署提供参考。     

Nowhere to go: exploring the social and economic influences on discharging people experiencing homelessness to appropriate destinations in Toronto,Canada

ObjectivesA main component of discharging patients from hospital is identifying an appropriate destination to meet their post-hospitalization needs. In Canada, meeting this goal is challenged when discharging people experiencing homelessness, who are frequently discharged to the streets or shelters. This study aimed to understand why and how the ability of hospital workers to find appropriate discharge destinations for homeless patients is influenced by dynamic social and economic contexts.MethodsGuided by critical realism, we conducted semi-structured, in-depth interviews with 33 participants: hospital workers on general medicine wards at three urban hospitals; shelter workers; and researchers, policy advisors, and advocates working at the intersection of homelessness and healthcare.ResultsHistorical and contemporary social and economic contexts (e.g., shrinking financial resources) have triggered the adoption of efficiency and accountability measures in hospitals, and exclusion criteria and rules in shelters, both conceptualized as mechanisms in this article. Hospitals are pressured to move patients out as soon as they are medically stable, but they struggle to discharge patients to shelters: to prevent inappropriate discharges, shelters have adopted exclusion and eligibility rules and criteria. These mechanisms contribute to an explanation of why identifying an appropriate discharge destination for people experiencing homelessness is challenging.ConclusionOur results point to a systems gap in this discharge pathway where there is nowhere for people experiencing homelessness to go who no longer need acute care, but whose needs are too complex for shelters. Systemic changes are needed to better support hospital and shelter frontline workers to improve discharge processes.     

CT方舱CT选型及舱内布局研究

为保证CT方舱的实用性,对CT方舱CT机的选择和舱内布局进行了研究。结合应用需求,采用对比研究的方法,对常用CT机的功能、结构、尺寸等进行了对比和分析,对舱内布局进行了多种方案设计和比较。通过综合分析最终确定了CT方舱最佳设备型号和最优舱内布局方案。该结果为CT方舱设备选型和科学布局的优化提供了重要依据,使得CT方舱能够发挥最佳作用。     

一种新型手术/急救医疗方舱方案探讨

目的：研究一种新型手术/急救医疗方舱,使该舱在方舱医院系统模块化组合中更加灵活,有效减少装备数量.方法：分析原方舱医院中手术方舱和急救方舱的功能、配置和布局,从医学勤务布局等方面探讨手术/急救方舱复合的可能性.结果：将手术/急救2种功能集中在1个方舱内方案可行.在抽组30张床位的移动方舱医院时,较原方舱医院减少了方舱模块,床位配置更加合理.结论：开展手术/急救方舱功能研究,能保证在满足原方舱医院战技指标的情况下,使得方舱医院抽组更加合理,使用更加方便,机动性大大提高.     

CT方舱电离辐射适形防护方法的研究

目的：研究一种CT机电离辐射的适形防护方法,以减轻CT方舱的整体质量,使其在复杂路况的运输成为可能.方法：分析CT机X线剂量分布曲线,结合CT方舱的使用环境,研究防护材料的特性,推导出CT方舱电离辐射适形防护的计算方法.结果：在满足辐射防护国标要求的前提下,采用适形防护方法,将防护材料的用量减少60.2％,满足了CT方舱的运输条件.结论：电离辐射的适形防护方法可有效减少防护材料的用量,降低CT方舱的总体质量,对于日常电离辐射的防护设计也有一定的参考意义.     

Advances in the management of an animal shelter

Changes in the Barcelona animal shelter from 2002 to 2005 are presented. In 2003, routine euthanasia of unclaimed stray animals was discontinued, due to a political decision of the city council. Changes were also made in the management of the shelter: from January 2003 to July 2004 the shelter was operated by an animal protection organization, and then directly again by the city public health agency. Management of the shelter by the animal welfare organization was associated with an increase in the proportion of dogs rescued and adopted. The suspension of routine euthanasia was associated with a marked increase in the number of stray dogs. Canine distemper became endemic in the shelter until late 2004, due to a certain unwillingness to use euthanasia to control infection transmission. Direct operation by public health services in a context of transparency and high social expectations has led to the development and adoption of standardized work protocols in the shelter, improving quality.     

Mental health consultation at a youth shelter: An ethnographic approach

Shelters for homeless and runaway youth offer temporary, safe shelter to children and youth who have no alternative available to them other than life on the streets, many of whom also present a wide range of mental health problems. Traditional office- or clinic-based mental health services may not be available to or may not meet the needs of this population, yet many shelter programs are not equipped to deal with youth who enter with mental health problems. This article describes a non-traditional model to enhance mental health service delivery in a shelter for homeless and runaway youth. Through the use of an ethnographic approach to mental health consultation, the rate of unplanned discharge from the shelter was reduced by more than half and other benefits were noted. Similar approaches might be applicable in other child and youth shelter settings.