医院图书馆为重点学科建设服务的思考与实践

本文针对医院重点学科建设的需要，结合医院图书馆的实际工作，阐述了医院图书馆参与重点学科建设的作用与意义，指出医院图书馆要为重点学科建设提供全面的文献信息保障，积极开展全方位、多层次的情报信息服务工作。     

对医院文化建设的思考

医院文化建设在医院工作中有着不可替代的作用，它决定着医院经营管理、领导决策以及全院职工的工作态度和医疗作风，对提高医疗质量，强化医院管理有着十分重要的意义。开展医院文化建设的作用包括：导向作用、约束作用、凝聚作用、融合作用、激励作用和辐射作用。医院文化建设的核心是树立正确的共同价值观。同时，医院文化建设不能千篇一律，一定要从实际出发，根据本单位的工作特点、人员结构、历史文化情况等，采取行之有效的措施，建设各具特色的医院文化。     

省千佛山医院的信息化建设

医院的信息化建设是医院现代化建设必不可少的工作。山东省千佛山医院领导班子非常重视信息化工作，把其列入医院工作的重要日程，确定为“一把手工程”。目前信息化已基本涵盖医院的主要业务，包括HIS、CIS、LIS、PACS、OA、数字图书馆、医院网站、视频监控、手术现场观摩、病理远程会诊等，整合了医疗资源和保健服务资源，促进了医院发展。     

医院网站设计思路及前景展望

随着我国医疗卫生事业的发展和医疗体制改革的不断深入，医疗市场的竞争日益激烈，充分利用Internet技术，建立自己的网站，树立自身的网络形象，在竞争中扩大市场份额，已成为广大医院经营者和管理者的共识。德州市人民医院是一所集医疗、教学、科研、预防保健和急救为一体的现代化大型三级综合医院，2003年6月，医院网站正式开通，2004年7月又进行了全面改版。新版网站在塑造医院形象、提高工作效率、方便患者等方面发挥着强大的作用。现结合医院网站建设情况，谈谈医院网站的设计体会及前景展望。     

倡导科室文化建设与促进保健工作发展

所谓文化,就是全体员工普遍认同并共同遵循的价值理念、思维方式、行为准则和习惯养成.医院文化具有一定的社会性、连续性、时代性和效益性,是医院从长期发展过程中培育和积淀下来的重要的非物质财富,能够反映全体医务工作者的共同价值,是每个员工都应该遵守的共同职业守则.科室作为医院的基本构成单位,必须秉承医院文化.科室文化建设作为医院文化建设的重要组成部分,是科室的灵魂,是科室可持续发展的精神源泉[1].保健科作为医院为兵服务的前沿和具体实施单位,其科室文化塑造与培养对于推动保健工作的全面发展将发挥重要作用.     

武装山东省总队医院

中国人民武装警察部队山东省总队医院始建于1950年，是一所集医疗、保健、预防、科研、教学为一体的三级综合性医院。自建院以来，始终坚持全心全意为人民服务的宗旨，坚定地走科技兴院，质量建院的道路，全面加强医院建设、医疗服务质量和规范不断迈上新的台阶。     

加强医学影像学科建设 全面提升医院整体实力

总结了大型综合医院医学影像学科的管理模式和学科建设的特点,围绕建设医学影像重点学科的背景和意义、中心工作及基本措施,深入分析了影像重点学科的建设,对于医院医、教、研、预防保健工作的影响至关重要,直接影响着医院的发展壮大。指出了学科建设要抓好7个方面．即硬件设施、技术能力、学术能力、人才队伍建设、人才培养能力、科室制度及科室文化。提出了医学影像学科只有坚持实行统一管理、资源共享、科学分组．遵循全面发展的学科建设模式,才能培养全方位、高素质的医学影像人才,提高医学影像诊疗水平,从而全面提升医院的整体实力．促进医院的现代化发展进程。     

论新形势下医院科主任队伍建设

科主任是医院建设和发展的中坚力量。科室既是医院最基本的经营单位，又是医院最重要的医疗主体，这种功能与地位的双重性，决定了科主任职能与责任的双重性。其能力的强弱，将直接影响到科室的建设，进而影响到医院的发展。近年来，面对新形势，医院党委高度重视科主任队伍的建设，对科主任的培养、监督和使用等方面的工作进行了深入的思考和实践，有效地促进了医院的干部教育管理工作，推进了医院的全面建设。     

思想政治工作与和谐医院建设

文章分析了新的历史时期医院思想政治工作的特点，及其在社会主义和谐医院建设中的作用。面对和谐医院建设中出现的矛盾和问题，医疗卫生机构必须不断加强自身内涵建设，创新发展思路，充分发挥思想政治工作的导向、稳定和服务作用，为推动和谐医院建设提供思想保障。     

浅析医院管理评审中的人事管理工作

医院管理评审工作是关系到医院建设和持续发展的大事，对促进医院内涵建设具有重要作用。结合本单位作法，从依法执业、人力资源管理方面探讨医院管理评审中的人事管理工作。     

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.     

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.     

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.