做好效益分析,医疗设备够用不闲置

本文以实例介绍了在用医疗设备的经济效益分析方法,同时提出了在进行经济效益分析时应注意的问题,最后指出效益分析的意义在于分析评价在用医疗设备的工作状况,采取措施提高其使用率,同时为医院添置同类医疗设备提供论证依据,指导医院的医疗设备装备规划和立项。     

医疗设备的分类管理研究

研究了国内各种医疗装备分类方法,即风险学分类、物品学分类、经济型分类、应用型分类和管理型分类,特别介绍了管理型的分类办法,分析了各种分类方法的由来、适用范围和利弊,指出了各种管理分类方法在现实工作中的作用,以期提高医疗装备采购的有效性和医疗设备使用的高效性。     

浅谈建立医院医疗设备基金

医疗设备的科学投资和合理购置,关系到医院的生存和发展大局。本文针对部分医院在医疗设备管理中存在的问题,分析建立医疗设备投资规划基金制度的意义,并简单介绍我院建立医疗设备投资规划基金,特别是制定特殊医疗设备成本优惠核算的方法和经验。     

卫生部公布“十一五”期间医疗设备采购计划

7月28日,卫生部召开医疗设备采购信息新闻发布会.会上,卫生部规划财务司副司长何锦国通报了“十一五”期间卫生建设规划和将开展的项目工作及设备采购范围,并介绍了开展医学装备选型评估工作、加强医疗器械集中采购管理的情况.中国医学装备协会秘书长白知朋介绍了医学装备评估选型工作的有关情况.最后,卫生部国际交流与合作中心主任李洪山介绍了将于今年9月7日至9日在北京展览馆举办的第十五届中国国际医用仪器设备展览会暨技术交流会的相关情况.     

对购置大型医疗设备管理工作的探讨

近几年,我军医疗设备有了较大发展。设备总值比80年代初增加了十倍之多,其中进口医疗设备增长速度更快。先进的医疗设备,加速了我军医疗装备现代化,提高了我军医疗水平和救护能力。然而在大型医疗设备的购进管理中,还有一些问题需要不断研究和改进一、大型医疗设备的审批应与装备经费补贴同步进行装备大型医疗设备,如 X-CT、核磁共振、直线加速器、大型 X 线机、综合型 B 超仪等,按《全军医疗仪器设备管理办法》(试行)8万元以上医疗     

医疗设备引进中纪检、监察的监督作用

本文从纪检、监察部门的角度出发，论述了纪检、监察部门在医院医疗设备采购管理中的监督管理作用和意义。强化管理，建立健全制度化的设备管理体系；建立健全设备采购管理与监督的领导机构；加强设备配置规划，确立立项制度监督的工作原则；通过过程控制，强化监督制约。     

加强医疗设备管理 提高设备使用率

1．1医院装备的选择首先应注意技术的先进性，同时，也要注意先进技术对客观条件的适应性与可行性医院应根据医学技术全面发展，重点提高，从实际出发，分轻重缓急，统筹规划，分批分期有计划地更新设备，逐步进行配套，从医院发展的长期规划和实际出发，首先考虑在医疗活动中大量使用的用于诊断和治疗的基本医疗设备。在常规医疗设备配备较齐全的基础上逐步考虑引进高、精、尖设备。     

军队医疗设备发展策略初探

医疗设备是医疗单位现代化建设的物质基础,其装备水平是医疗单位规模和技术水平的重要标志。军队和全国的情况一样,真正具有现代意义的医院是始于80年代初批量装备纤维内窥镜、超声成像设备、大毫安 X 机等诊断设备而初具规模的。短短十来年的时间,军队医疗设备迅速发展,在卫生资源中所占的比重越来越大,对军队医学科学技术的发展起了极     

医疗设备使用率调查分析及应用

目的：统计分析医院医疗设备使用率，促进资产管理部门掌握科室设备使用情况，优化全院资产管理的配置及使用合理性、创建资源共享管理机制、为设备购置立项论证提供科学的决策性依据。方法：结合医院现有综合运营管理系统和医院信息系统，设计增加了设备使用效率调查模块。根据最终调查结果和设备收费项目信息数据，导出并匹配融合数据，进行统计分析获取设备使用率。结果：医疗设备使用率数据的获取，为医院医疗设备立项购置论证、使用等管理环节提供了数据支撑，为管理中的决策实施提供有效的结论依据。结论：经实践，该模块的开发应用有助于医院管理部门进行医疗设备的使用情况监测，通过监测数据分析，了解各科室设备使用情况。能显著提升医院对于医疗设备管理的精细化程度，促进医疗设备资源利用率提升。     

医疗设备的更新与转让

医疗设备是诊断、治疗疾病的物质基础,也是衡量医疗水平的客观尺度。长期以来,大中型医疗设备都是由上级拨款装备,设备作为固定资产在医院不存在折旧,因此也不规定使用年限;另外,医疗收费不按成本,也不存在价值的转移。由于以上原因,医院的设备一旦装备了就使用到报废为止,这就形成了医院装备水平低,设备陈旧,诊断、治疗疾病的手段落后,不能适应医疗任务日益噌长的需要,这已成为应及早解决的     

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.     

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.     

Stress in police officers: a study of the origins,prevalence and severity of stress-related symptoms within a county police force

BACKGROUND: High levels of stress-related illness are causing concern across industry. Against a background of impending legislative moves to try to improve this situation, there is a need to identify key work-related stressors. Police work tends to be regarded as inherently stressful because of the personal risk of exposure to confrontation and violence and the day-to-day involvement in a variety of traumatic incidents. As a result, high levels of stress-related symptoms might be expected in this population. OBJECTIVE: To examine the sources of stress-related symptoms within police officers and measure the prevalence of significant associated mental ill-health. METHOD: A cross-sectional questionnaire survey of a population of 1206 police officers was performed to assess levels of strain associated with a series of potential home and work related stressors. Participants were then split into low and high scoring groups on the basis of a General Health Questionnaire (GHQ) threshold score in order to identify those stressors most associated with mental ill-health effects. RESULTS: Occupational stressors ranking most highly within the population were not specific to policing, but to organizational issues such as the demands of work impinging upon home life, lack of consultation and communication, lack of control over workload, inadequate support and excess workload in general. The high scoring group constituted 41% of the population and differed significantly from those with low scores in perception of all stressors, ranking both personal and occupational stressors more highly, and from personality constraints appeared significantly more 'stress-prone'. A significant association between gender and mental ill-health was found, with females more likely to score more highly on the GHQ than males. CONCLUSION: This study confirms previous findings of organizational culture and workload as the key issues in officer stress. Given that the degree of symptomatology appears to be worsening, management action is required. Further research is indicated within the police population into a possible increased susceptibility in female officers.