北京市农村社区卫生服务中心基本公共卫生服务人力和成本现状调查

目的：了解北京市农村地区社区卫生服务中心的基本公共卫生服务人力资源和服务成本情况,为推进基本公共卫生服务均等化提供政策依据。方法：自行设计调查问卷和调查表,选择北京市昌平区、通州区、怀柔区和密云县作为调查地区。根据经济发展水平高、中、低,以整群抽样法抽取12个社区卫生服务中心、108位基本公共卫生服务人员进行调查。结果：在基本公共卫生服务人员中,年轻女性、防保人员和低职称人员占的比例较大;农村地区为预防接种和健康教育等项目分配的人员较多,为妇女保健和生殖健康等项目分配的人员较少;设置健康教育专栏、现场疫点处理等项目的单位成本较高;近郊地区为每个项目分配的工作人员数大多高于远郊地区,而每个项目的单位成本则大多低于远郊地区。结论：北京市农村地区基本公共卫生服务队伍的人力资源建设有待加强;各项基本公共卫生服务所需的成本差异较大,应结合实际需求情况和资源现状进行政策和财政上的调整。     

北京市公共卫生信息化建设中存在问题探讨

目的对北京市公共卫生信息建设发展中存在的主要问题进行分析,探讨北京市公共卫生信息化建设的策略,为加强首都公共卫生体系建设提供参考依据。方法 2017年9月19日-10月18日,通过文献调研和半结构访谈问卷对北京市卫生行政部门和公共卫生专业机构的管理人员及部分公共卫生专家进行深度访谈和焦点组访谈,了解北京市公共卫生信息化建设现状、存在的主要问题并提出发展策略建议等。结果北京市现有公共卫生信息系统多是围绕特定领域和范围建设的,属于相对封闭的系统,信息化建设资源统筹与整合利用、业务协同和数据共享、公共资金投入和信息公开惠民服务建设不足;信息化建设人才缺乏,复合型卫生信息化人才明显缺乏,信息安全建设也面临问题和挑战。结论北京市现有公共卫生信息缺少能满足互联互通、信息共享的信息平台,不能满足全生命周期健康管理服务需求,需要实施符合首都发展特色以及功能定位的公共卫生健康信息管理策略。     

邯郸市社区公共卫生人力资源现状

目的调查邯郸市社区公共卫生人力资源现状,为基层公共卫生人力资源管理提供理论依据。方法调查邯郸市4个区20个社区卫生服务中心、44个社区卫生服务站,对单位领导人采用个人访谈法。结果邯郸市社区公共卫生技术人员配备不足,特别是防保人员数量低于所需比例要求,人员学历水平偏低,职称结构不平衡。结论应加快邯郸市社区公共卫生人才的引进或培养,促进邯郸市公共卫生事业的发展。     

北京市公共卫生医师规范化培训体系设计与启动试行

目的为适应公共卫生人才培养需要,将医学院校预防医学专业毕业生培养成疾病预防控制工作的实用型人才,探索构建北京市公共卫生医师规范化培训体系模式。方法采用研讨论证和座谈会的方式,组织相关专家和疾病预防控制机构相关人员对培训的必要性和培训的专业设置、培训内容、基地标准等进行研讨和论证,组织专家编写规范化培训体系文件,由北京市卫生局发布并启动试行。结果 2006—2011年,初步完成了北京市公共卫生医师规范化培训体系模式框架设计,设置了7个公共卫生亚专业和3个临床亚专业,制定了各亚专业的培训细则,编写了各亚专业的登记手册和考核手册及考核管理规定,制定了公共卫生各亚专业基地标准以及评估指标,完成了基地评审和认证,在市区两级疾病预防控制中心开展北京市公共卫生医师规范化培训试行工作。结论 2011年招收了首批由市、区两级疾病预防控制中心选送的新入职的预防医学专业本科毕业生14人进入基地培训,现正在逐步健全和完善。     

河南省疾病预防控制系统公共卫生人力资源调查

目的对河南省疾病预防控制系统公共卫生人力资源配置进行调查分析。方法制定统一调查问卷,从公共卫生人员的数量、性别、职称、学历、专业等方面,对省和省辖市公共卫生人员进行了的调查。结果河南省和省辖市级疾控中心公共卫生人员配置不足,人员老龄化,职称学历较低,非专业人员比例偏大。结论需解决我省公共卫生人才的需求,促进我省公共卫生事业的健康发展,并应积极开展公共卫生人员的继续学历教育和专业培训。     

湖南省公共卫生人才队伍建设现状与建议

 

在抗击新型冠状病毒肺炎（简称新冠肺炎）疫情的斗争中,湖南省率先启动重大突发公共卫生事件一级响应,采取一系列前所未有的防控和救治举措,确诊病例的总体治愈率在全国名列前茅。但此次新冠肺炎的暴发也暴露出了湖南省公共卫生人才数量不足、结构不合理、人员经费投入不足、人员考核和激励机制不够完善等突出问题。本文从以下四个方面提出建设意见：深化公共卫生与预防医学人才培养改革,为公共卫生事业提供人才支撑;完善公共卫生人才准入原则与使用办法;加大公共卫生的政府投入,提高人员待遇保障;完善公共卫生人员考核评价和激励机制,增强人员工作效率和发展高质量公共卫生服务等。

     

加快人才梯队建设，增强应对突发公共卫生事件的能力

人才梯队建设是应对突发公共卫生事件的重要保障。本文分析了目前公共卫生人员的小足之处：人手不足、水平不高、队伍不稳定、传统教育等。为进一步加强公共卫生人才梯队建设，提高他们应对突发公共卫生事件的能力，我们采取了一系列措施，使本中心公共卫生专业人员的学历、职称结构显著改善，人才建设成效显著。     

江苏省公共卫生队伍调查及思考

随着社会经济的发展、人民生活水平的提高以及近几年突发公共卫生事件不断发生,使得人们对公共卫生越来越重视,同时对其要求也越来越高,所以培养一支高素质的公共卫生队伍是当前公共卫生事业迫切需要解决的问题。目前我国的公共卫生人员素质虽然在逐步提高,但队伍还不够完善,人员还存在许多问题[1]。本文对江苏省各市、区、县级疾病预防控制中心和卫生监督所等的公共卫生人员的组成和结构状况以及各公共卫生机构工作内容和职责进行了调查和分析,旨为我国公共卫生人才培养提供依据,更为各卫生机构更好的建设人才梯队提供一些建议。1材料与方…     

综合医院临床护士化疗防护知识的调查

目的了解北京市郊区综合医院临床护士对化疗药物使用中的防护知识掌握情况,为采取有针对性的防护措施提供依据。方法采用调查问卷对北京市郊区4家二级综合医院232名接触化疗药物的护士进行调查。结果北京市郊区综合医院护士对化疗防护知识的掌握程度不高,总答对率为76.3%。肿瘤科与非肿瘤科护士化疗知识水平存在差异(t=2.80,P0.05);接受过岗前培训的答对得分高于未经过培训人员的得分,差异有统计学意义(t=2.59,P0.05);不同学历、职称的护士化疗防护知识得分情况比较,差异无统计学意义(P0.05)。结论重视岗前培训,加强化疗防护临床管理有助于提高护士的化疗防护水平。     

北京市疾控体系预防保健人力现状调查分析

目的了解北京市基层防保人员现状，为加强基层疾控机构队伍建设提供决策依据。方法采用统一调查表，对北京市六个区县的基层防保人员学历、职称、专业、年龄等方面进行全面调查。用SPSS软件进行统计分析。结果全市六区县基层防保人员具有高级职称占4．15％，中级占33．68％，初级占46．44％，士级占10．39％。硕士学位占0．31％，本科占11．24％，大专占39．94%，中专以下占48．52％。公共卫生专业人员占20．44％，临床医疗占46．22％，护理占21．93％。职业医师类别公共卫生占31．14％，临床医疗占40．57％，护士占19．31％。结论六区县基层疾病控制机构整体学历偏低，公共卫生专业人员缺乏，年龄偏大。应建立疾控体系准入标准．加强人才培训和管理，全面提高理论素质、文化素质、专业素质。     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

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.     

Hydrazine inhalation hepatotoxicity

Abstract Hydrazine is a hazardous chemical commonly used as a reactant in rocket and jet fuel cells. Animal studies have demonstrated hepatic changes after hydrazine inhalation. Human case reports of hydrazine inhalation hepatotoxicity are rare. We report a case of mild hepatotoxicity following brief hydrazine vapour inhalation in a healthy young man, which resolved completely on expectant management.     

Fitness standards in airline staff

Employers have a legal duty to manage safety and to meet this duty it is necessary to control risks arising from pre-existing medical conditions. Such conditions can be identified at the time of job placement, but there is little published information about the approach to fitness standards by most airlines. This review is therefore limited to the practice of one major airline. It is illustrated by reference to various occupations within the airline, with the associated rationale.