利用PACS/RIS实现放射科工作的量化管理

目的:探讨医院PACS/RIS的建设及实施。方法:我院放射科数字化、信息化建设经历了3个阶段。第一阶段放射科实现了数字化影像和报告的保存,第二阶段放射科依据DICOM等标准建立了科室级的PACS和RIS系统,第三阶段放射科将科室的系统与医院其他信息系统进行集成。结果:通过PACS/RIS实现了放射科工作人员的量化管理,并且实现了以影像科室为重点,覆盖以影像为诊断依据科室的PACS实现了数字图像的传输、存储、管理、备份等。使临床医师能快速同步的得到影像科室的诊断报告和相应的影像;利于患者的诊断及治疗。结论:PACS/RIS的建设实施证明该系统的建设是一项系统工程必须做好总体规划。     

三级综合医院临床科室门诊及病房医师人力资源配置测算方案的设计

目的设计三级综合医院临床科室门诊及病房医师人力资源配置测算方案。方法通过文献研究法及关键人咨询法确定三级综合医院临床科室门诊及病房医师人力资源配置测算方案设计思路;通过问卷调查法确定方案中涉及的相关指标及对其取值初值进行确定;通过德尔菲专家咨询法最终确定测算指标及其相关取值。结果设计出科学合理的三级综合医院临床科室门诊及病房医师人力资源配置测算方案。结论该方案能够为三级综合医院科学合理配地置临床科室门诊及病房医师人力资源提供依据。     

温州市综合医院精神卫生服务现状调查

目的：了解温州市综合医院精神卫生服务状况。方法：在温州市11所综合性医院进行问卷调查,内容包括医院规模及医疗服务总体资源,设置精神卫生服务机构及人员配置状况,精神卫生问题会诊情况,精神科联络情况及医院对临床医师进行精神卫生知识培训情况。结果：（1）11所综合医院中有5所设立了精神卫生科室,占45.5%;被调查的3所二甲医院均没有设立精神卫生科室。（2）设立精神卫生科室的5所综合性医院中,精神科会诊率平均为0.57%,在未开设精神卫生科室的医院中,精神科平均会诊率为0.13%,两者之间的差异非常显著。（3）11所医院都没有建立符合我国精神卫生特点的会诊—联络精神病学模式,都没有成立由精神科医师和临床医师共同参加的会诊联络小组。结论：温州市综合性医院精神卫生服务正处在起步阶段,已经开始重视精神卫生服务工作,但是资源配置、精神障碍的识别与处理、会诊联络精神病学工作及继续教育和培训等尚较粗略。     

武汉某公立医院培训选留制医师考核现状及管理对策研究

作者阐述了医院培训选留制度产生的背景、意义,分析了武汉市某公立医院培训选留制医师考核现状,发现医院多院区发展增加了轮转管理和考核难度,科研考核成绩下降明显,八年制博士医师存在科研短板.建议青年医师在一定时期内相对固定院区工作,推行八年制博士医师院内博士后制度,由科室为考核未通过人员制定"一对一"帮扶计划.     

以需求为导向探索医院青年医师科研能力提升对策

目的 了解北京某医院青年医师科研需求,探讨科研能力提升的对策。方法 通过查阅医院科研管理部门的数据、发放调查问卷和访谈一线科室等方式,对医院青年医师科研需求进行调查分析。结果 当前青年医师开展科学研究的主要原因和障碍是职称晋升和临床工作繁忙,以及青年医师科研需求量大。结论 结合青年医师的实际需求,提出完善政策引导、院级基金支持、搭建科研技术平台和加强交流培训的对策,促进医院青年医师科研能力的提升。     

对2007至2011年招聘青年医师综合素质的评估分析

通过对肿瘤医院2007至2011年招聘青年医师的调查评估,总结医师招聘和培养过程中的经验.结果显示,科室对青年医师的“医德、职业价值观”、“理论知识”、“临床能力”等方面评价均较高,说明医院这几年自校园招聘的青年医师具有较高综合素质.另外,结果还显示,科室对青年医师的“外语口头表达能力”、“科研能力”、“创新能力”等5种能力的评价相比较而言偏低.因此,医院应继续加大对青年医师的选聘和针对性培养.     

医技科室建设现状与趋势

概念:理解不同、功能明确 对于"医技"的概念,不同建筑师、设计师有着自己不同的理解,且对其用途和轮廓都有着清晰的认识. <综合医院建筑设计规范>(2010 报批稿)中的医技科室包括:药剂科、检验科、医学影像科、放射科、核医学、超声科、病理科、中心供应、输血科等.而有些设计师常把手术部也列入医技范围内.     

区属三级综合医院临床科室医师编制测算的实践探索

<正>临床医师是医院人力资源的核心组成部分，其合理配置事关医院的可持续发展。自新型冠状病毒感染疫情发生以来，区属三级综合医院的临床医师除完成本职工作外，还先后承担了支援发热门诊、外派核酸采样、开展疫苗接种、进驻隔离酒店和方舱医院及定点医院从事诊疗工作等疫情防控任务，工作量增加；同时，医院临床科室医师配置也面临着更高的要求。如何对临床科室医师编制进行科学测算及合理配置，是摆在区属三级综合医院面前的重要课题。本文以广州市白云区第二人民医院的临床科室医师编制测算为例，探析其创新和不足，为其他区属三级综合医院的相关工作提供经验借鉴和方法参考。本研究所选取的临床科室医师为科室同时拥有门诊和住院病房，     

分析PBL教学法与PACS系统在放射科进修医师培训中的应用价值

目的研究放射科进修医师培训期间应用PACS系统和PBL教学法的价值。方法选取50名放射科学习进修的医师,样本选取时间为2016年1月—2018年1月,采取随机方法将其均分为对照组和观察组进行培训,每组25名进修医师,其中对照组进修医师的培训方法为传统教学法,观察组进修医师的培训方法为PACS系统和PBL教学法,对两组进修医师的培训成绩进行对比分析。结果研究结果表明,不管是理论成绩还是实践成绩,观察组都高于对照组,且进修医师对观察组采取的教学方法评价较好,对对照组采取的教学方法评价较差(P<0.05)。结论针对放射科进修医师进行培训的时候,以PACS系统载体,结合PBL教学方法,可以达到理想的培训目的。     

对进修医师的规范化培训与管理

进修医师的规范化培训与管理是提高进修质量,培养合格医务人员的重要途径。我院是一所市级综合性医院,承担县、乡等基层医院医务人员的进修培训任务。１９９６年以来,医院实施了进修医师的规范化培训,采取了“统一制定培训计划,科室分阶段实施”的方法,严格各项管理考核措施,取得了较好的效果。２年中已有１７６名进修医师合格结业。一、规范化培训进修医师的规范化培训分为岗前培训、第一阶段培训、第二阶段培训３个阶段进行。（一）岗前培训：１．理论知识培训：进修医师提出进修申请后,医院根据进修的专业,制定基础理论知识复习…     

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.     

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.     

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.     

Psychopathological features of a patient population of targets of workplace bullying

BACKGROUND: A strong association between workplace bullying and subsequent anxiety and depression, indicated by empirical research, suggests that bullying is an aetiological factor for mental health problems. AIMS: To evaluate levels of stress and anxiety-depression disorder developed by targets of workplace bullying together with outcome at 12 months and to characterize this population in terms of psychopathology and sociodemographic features. METHODS: Forty-eight patients (36 women and 12 men) meeting Leymann Inventory of Psychological Terror criteria for bullying were included in a prospective study. Evaluations were performed at first consultation and at 12 months using a standard clinical interview, a visual analogue scale of stress, the Hospital Anxiety and Depression (HAD) scale, the Beech scale of stress in the workplace and a projective test (Picture-Frustration Study). RESULTS: At first consultation, 81% of patients showed high levels of perceived stress at work and 83 and 52% presented with anxiety or depression, respectively. At 12 months, only 19% of working patients expressed a feeling of stress at work. There was a significant change in symptoms of anxiety while there was no change in symptoms of depression. Stress at work and depression influenced significatively capacity to go back to work. At 12-month assessments, workers showed a significantly better score on the HAD scale than non-workers. Over half the targets presented a neuroticism-related predominant personality trait. CONCLUSION: Workplace bullying can have severe mental health repercussions, triggering serious and persistent underlying disorders.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.     

Organophosphate toxicity and occupational exposure

The ubiquitous organophosphates present a continuing health hazard in agriculture, public health eradication programmes and as chemical warfare agents. Despite significant progress in understanding the potential mechanisms of toxicity far beyond the commonly accepted mechanism of cholinesterase inhibition in intentional exposures, the precise health effects following occupational exposures are yet to be completely defined. A much greater understanding exists of the clinical features of organophosphate poisoning. These are characterized by a triphasic response involving an initial acute cholinergic phase, an intermediate syndrome (both associated with high mortality) and a disabling but non-lethal delayed polyneuropathy. The delayed polyneuropathy may occur in the absence of the cholinergic or intermediate phases. However, progress is still required in order to improve the quantification and assessment of occupational exposures and the implementation of appropriate preventive measures. Finally, evidence-based guidelines for appropriate or optimal therapeutic interventions following poisoning are required urgently and collaborative work with colleagues in developing countries, where the occurrence of organophosphate exposures is more frequent, may provide the answers.     

Miliaria rubra of the lower limbs in underground miners

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.     

Planning research

The starting point for any research project should be a question.Once this has been defined and the relevant scientific literaturereviewed, a protocol should be drawn up. This will be used notonly as a guide to the conduct of the study and in the preparationof the final report, but also in seeking any financial supportand approvals that are required for the investigation. A protocolis normally arranged in sections covering the background tothe study, the question(s) that it will address, the methodsthat will be used for the collection and analysis of data, thestatistical power of the investigation (where relevant), anyethical considerations, and the financial input that will beneeded. A pilot study is often helpful where aspects of thestudy method are untried or of uncertainvalidity.     

Stress in the Norwegian police service

BACKGROUND: High levels of stress have been attributed to the conditions of police work, but there is little empirical evidence for this. AIMS: To develop a new instrument to measure job stress in the police; to assess the most severe and frequent police stressors; to compare levels of stress according to the demographic and organizational factors; and to study stress in relation to personality traits, work locus of control and coping strategies. METHODS: A comprehensive nationwide questionnaire survey of 3272 Norwegian police at all hierarchical levels, including the Norwegian Police Stress Survey (NPSS), the Job Stress Survey, the Basic Character Inventory, the Work Locus of Control Scale, and the Coping Strategies Scale. RESULTS: Work injuries were appraised as the most stressful but least frequent stressor and job pressure was reported the least severe but most frequent stressor. Females experienced job stressors less frequently, but appraised them as more severe than men did. Older police officers reported more job pressure severity and fewer work injuries. The police in districts where peer support was planned but not implemented, and who worked in districts with more than 50,000 inhabitants, perceived the lack of support more severely than others. The correlations between stress and personality traits, work locus of control, and coping were moderate. CONCLUSIONS: The NPSS captures police-specific stressors that are not adequately measured by global stress instruments. The study of stress in police work should preferably involve a nationwide use of police-specific stress instruments.