慢性病防控人力资源现状与新时期基本职责任务适应性研究

目的了解疾控系统慢性病防控人力资源的现状与新时期基本职责任务的适应性。方法对江西省各级疾控系统慢性病防控相关工作人员进行调查,同时查询人事档案进行核实补充。结果江西省疾控系统慢性病防控人员总量为0.56人/10万服务人口;慢性病防控工作人员的平均年龄为39.93岁,45岁及以上组占35.9%;工龄21年及以上者比例最高,占47.6%;本科学历人员比例最高为33.9%,硕士及以上学历仅占3.1%;职称以初级和中级为主(占68.5%),高级职称仅占6.7%。结论江西省疾控系统慢性病防控人员总量、职称结构和学历层次等尚不能完全满足当前慢性病防治服务需求,需要进一步调整江西省疾控系统慢性病防控人员结构,加大慢性病防治人力资源开发力度。     

预防医学生突发公共卫生事件教学需求和效果评价

目的为了解我国预防医学专业大学生对公共卫生突发事件处理技能的教学需求和教学评价情况,探讨教学中存在的问题,寻求满足人才需求的对策。方法对两所综合性大学预防医学专业学生进行问卷调查,内容涉及对公共卫生突发事件处理知识的认识,教学需求,教学效果评价等方面。结果所有被调查的学生认为掌握公共卫生突发事件处理知识非常必要,熟练掌握公共卫生突发事件处理技能对提高自己的实践工作能力有帮助,要加强实践知识的学习。78．1％学生认为掌握公共卫生突发事件处理知识能提高自己就业竞争力,84．8％的学生认为现行专业教材中突发公共卫生事件的相关知识还很欠缺,75．2％的认为应增加专业实习内容。结论现行教学计划不能满足学生对公共卫生突发事件处理知识的需求,因此,教育部门应改革预防医学的课程规划,制定课程教材,增加公共卫生突发事件处理技能的教学内容,增加实习时间,充实实习内容,提高学生现场处理突发事件的能力。     

安阳市疾病预防控制系统慢性病预防控制能力调查

目的掌握安阳市各级疾病预防控制(CDC)机构的慢性病防控能力现状,为加强该市的慢性病防控能力建设提供对策。方法采用2012年中国疾病预防控制中心制定的"全国慢性病预防控制能力调查表"(适用于疾控系统),对2011年的情况进行调查。结果各级政府和卫生行政部门均无制定现行的慢性病防控相关规划和工作(实施)方案,政府领导均无参加过当地慢性病防控相关活动。在两会上,市级有3个以慢性病防控为主题的提案,均无CDC参与编写或提供素材。10家CDC机构的慢性病工作经费占工作总经费比例为6.9%,专职从事慢性病工作在岗人员22人,占同级在岗人员总数的比例为3.0%,以无职称和初级占的比例高,占48.6%,平均年限在5年以下者占的比例最高,为48.6%,慢性病工作人员参加培训的次数和总人次数最高为省级,未参加2个月以上的培训,仅与同级二级以上医院合作过,专病防治机构设有肿瘤防治办公室2家;开展监测和干预工作仅为死因和全民健康生活方式行动,开展的慢性病危险因素监测指标为血压、血糖,干预的场所为社区和工作场所;参与了对所辖区基层医疗卫生机构国家基本公共卫生服务项目慢性病工作的考核。结论安阳市政府和卫生行政部门应加强制定慢性病相关规划,加大慢性病工作专项经费投入。CDC机构监测和干预能力亟需提高,加强卫生领域内外部门和媒体的合作能力,县区级CDC基础配置应进一步完善。     

医药卫生管理本科生创新能力就业需求、评价及教学改革探讨

目的:基于用人单位视角,结合现实需求、评价及影响因素,调查研究医药卫生管理本科生创新能力现状,分析探讨本专业本科生教学改革措施方法:采用立意抽样方法,选择在医疗卫生等本专业相关机构工作的南京医科大学校友,发放自制问卷进行调查结果:定量分析结果提示分析解决问题的能力(8.68±1.469)最为重要;医药卫生管理本科生创新能力满足现实需要的影响因素包括性别、发现问题的能力、知识更新学习能力和科研成果结论:医药类高校应根据实际工作需要,结合专业背景与特性,加强创新能力培养多途径完善教学实践活动和培养方案,以不断提高医药卫生管理本科生的创新能力.     

基层医疗机构糖尿病社区管理的相关问题及发展对策的定性研究

采用专题组讨论法,对我国东、中、西部41个基层卫生系统相关机构从事慢性病管理工作的关键知情人员93人进行访谈,以期了解基层医疗卫生服务机构开展糖尿病社区管理工作现状,找出影响糖尿病防治工作开展的深层次问题及原因,为促进我国慢性病防治工作可持续发展提供政策建议.     

2012年红河州基层医疗卫生机构慢性病防控能力调查

目的了解红河州当前基层医疗卫生机构慢性病防控能力和应对情况,为政府制定相关政策和防控策略提供依据。方法利用2012年全国慢性病预防控制能力调查表收集红河州基层医疗卫生机构调查数据,用SPSS16.0进行描述性分析。结果调查应答率100%,红河州基层医疗卫生机构从事公共卫生服务人员占在岗人员总数的20.23%,基本公共卫生服务经费占财政拨款经费比例中位数为42.68%,在调查的11项设备中平均配置7.17项。基层医疗卫生机构开展了培训指导、慢性病防控知识宣传普及、慢性病患者及其高危人群发现和管理工作,在调查的10本国家现行慢性病工作规范平均持有2.46本,在调查的6个宣传日中平均开展宣传3.19个,开展高危人群随访管理、患者自我管理和双向转诊的基层医疗卫生机构的比例分别为8.10%、11.04%和27.92%。开展过慢性病项目和慢性病社区康复的基层医疗卫生机构的比例分别为1.30%和1.95%。结论红河州基层医疗卫生机构慢性病防控能力较弱,急需加强慢性病防控能力建设,健全和完善基层医疗卫生机构"六位一体"服务功能。     

清远市清城区午托工作人员传染病防控知信行现状

了解清远市清城区午托人员传染病防控知信行现状,为其他地区开展相关调查提供借鉴经验.方法 在清城区7 个街镇中各随机抽取93 家午托机构共307 名午托工作人员,采用自行设计的问卷进行调查,问卷内容包含基本信息、传染病知识、态度、行为和需求5 部分.结果 午托工作人员传染病防控知识总体知晓率为28.66%.>40 岁人员传染病知识知晓率的掌握不如<40 岁人员(OR= 0.58, 95%CI = 0.35~ 0.97),具有高中或中专学历是知晓的有利因素(OR = 2.16, 95%CI = 1.18~ 3.96),食堂工作人员和保洁人员传染病知识知晓率的掌握不如管理人员和看护老师(OR = 0.33,95% CI = 0.12~ 0.87).在态度方面,有15.63%的人员对消毒措施持消极态度或不清楚; 行为方面,28.01%的工作人员采取错误的消毒方法.有73.62%受访者认为午托机构在传染病预防方面需要改进.有98.37%的人员认为需要学习传染病知识.结论 午托机构工作人员传染病防控知识掌握不足,部分人员对消毒持消极态度,不能采取正确的传染病消毒措施.相关部门应针对薄弱环节,加强对午托机构工作人员传染病知识的普及,满足其对于防控的需求.     

韶关市基层医疗卫生机构慢性病预防控制能力调查

目的 了解韶关市基层医疗卫生机构慢性病防控能力现状及能力建设现状,为加强韶关市慢性病防控能力建设、制定相关政策和防控策略提供依据。
方法 利用中国疾病预防控制中心提供的《全国慢性病预防控制能力调查表》,对韶关市所有基层医疗卫生机构（108个乡镇卫生院或社区卫生服务中心）进行问卷调查,对数据进行描述性统计分析。
结果 问卷回收率100%。2016年韶关市从事慢性病管理工作的人员占在岗卫生技术人员的9.6%。慢性病管理经费均来自基本公共卫生服务项目经费。基层医疗卫生机构体检仪器齐全率为73.1%,开展慢性病相关知识培训、业务指导和健康教育知识讲座分别为3.4、3.3和4.9次（/乡·年）。4.6%的基层医疗卫生机构参与了慢性病防控相关项目或科研工作。11.1%的基层医疗卫生机构开展了慢性病社区康复服务,69.4%的基层医疗卫生机构开展了45岁以上居民免费测血糖。所有基层医疗卫生机构开展了35岁以上居民首诊测血压及慢性病患者的建档和随访管理工作。分别有50.9%和23.1%的基层医疗卫生机构对高血压、糖尿病高危人群进行建档和随访管理。分别有60.2%和57.4%的基层医疗卫生机构开展高血压、糖尿病患者自我管理。
结论 韶关市近几年的基层医疗卫生机构慢性病防控工作在逐步规范,但在慢性病防控经费保障、人员配备、慢性病防治工作项目执行能力等方面还较薄弱,应进一步加强慢性病预防控制能力建设,从政策、经费、人员等方面给予支持。
     

海口市慢性病管理人员从业能力和工作满意度评估

目的了解海口市社区慢性病管理工作人员从业能力及工作满意度现状,并探讨两者的关联性。方法运用综合性从业能力量表(CWAI)和工作满意度量表(CHIEJSQ),对海口市社区卫生服务机构从事慢性病管理的服务人员210人进行现场调查。结果 71.4%的海口市社区慢性病管理服务人员从业能力优秀,30%的从业人员对工作较满意,两量表得分呈显著正相关(r=0.508,P0.01)。经多元回归拟合,居住条件、对文学和音乐的爱好、平均月收入、专业和职称对慢性病管理服务人员从业能力影响较大,离职意愿、平均月收入、对文学的爱好对慢性病管理人员工作满意度影响较大。结论海口市社区慢性病管理服务人员从业能力与其工作满意度关系密切。通过提高管理服务人员的工作满意度,进而提高其从业能力。     

美国临床医学的预防医学培训和卫生系统改革

最近，预防和控制环境和职业危害因素、传染病的死灰复燃以及作为死亡和发病的主要原因的慢性病和伤残，控制医疗费用的增长，提高医疗保健的价值、质量和效果，实施基本的医疗，发展全科医生的培养，完善学术性卫生中心对社区的职责，这些需求使得预防和初级保健已成为改革卫生系统的基本内容。但是在这些领域中医学本科教学和住院医生培训却明显跟不广当前改革的需要。美国R．W．Eggert和MD．Parkinson在《美国医学会杂忐》（JAMA，Sept7，1994）上撰文介绍了美国如何在通科医生教学实践中强化预防医学专业培训和实践的问题。通过对…     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

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 reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.     

The Life Events Inventory: re-scaling based on an occupational sample.

The objective of this study was to compare the validity of the original weightings used by the Life Events Inventory (LEI) with those obtained from a contemporary occupational sample. Fifty male and 62 female manufacturing employees (age range 16-55 years) assigned scores to each item on a slightly modified version of the LEI scale. The current sample consistently assigned higher weights to events/items than did the original sample, but there was high agreement in terms of item ranking. Some distinct age and gender differences in scoring were apparent, and are discussed further. It was concluded that when separate weightings are employed for age and gender groups, the LEI remains a useful tool for quantifying background levels of stress in both workplace stress audits and epidemiological studies where statistical control for non-occupational sources of stress is required.     

Maxillofacial injuries related to work accidents: a new concept of a hospital-based full electronic occupational trauma surveillance system

The objective of this study was to investigate the occurrence of occupational maxillofacial injuries using a newly installed relational database. Twenty-six injuries were identified out of 28,624 patients admitted to the emergency unit during a 12 month period. Falls from height or being struck by moving objects were common causes of these injuries. Two-thirds of those identified were construction workers. This paper demonstrates the power of modern databases to identify specific occurrences that may provide the basis for prevention in the future.     

Rôles physiologiques des endocannabinoïdes dans le contrôle de l’homéostasie énergétique

Endocannabinoids are endogenous lipids which modulate the release of neurotransmitters and activate different signaling pathways, through the binding to cannabinoïd receptors, CB1 and CB2. Endocannabinoids are involved in the control of a variety of behavioural and neuroendocrine functions, including feeding behaviour. In the central nervous system, they essentially modulate the expression of orexigen or anorexigen neuropeptides thus resulting in the stimulation of food intake. Their peripheral targets are mainly the liver and the white adipose tissue where they stimulate lipogenesis, through the modulation of several enzymes and proteins expressions. Cannabinoïd receptor agonists are nowadays prescribed to improve appetite of people suffering from cancer or AIDS. In the same way, CB1 antagonist, such as Rimonabant, could provide efficient treatment of obesity.