深圳市福田区小型印刷企业负责人职业卫生知识态度行为调查

目的了解深圳市福田区小型印刷企业负责人职业卫生知识、态度和企业职业卫生行为现状,探索促进企业开展职业病防治工作的有效措施。方法采用随机抽样的方法,对福田辖区86名小型印刷企业负责人进行横断面问卷调查。结果被调查对象知识得分,在文化程度、近3年内是否参加过职业卫生知识培训、近3年内被卫生监督次数组间差异有统计学意义(P<0.05或P<0.01);态度和行为得分,在近3年内是否参加过职业卫生培训、近3年内被卫生监督次数组间差异有统计学意义(P<0.05或P<0.01)。影响企业负责人知识的因素依次为近3年内被监督次数、文化程度、近3年内是否参加过职业卫生培训,影响企业负责人态度和行为的因素依次为近3年内被监督次数、近3年内是否参加过职业卫生培训。结论深圳市福田区小型印刷企业负责人知识水平不高,对职业病防治工作不够重视,加强对小型印刷企业的职业卫生监督、职业卫生培训是行之有效的干预措施,同时对低文化水平的负责人要加强干预。     

武汉市某医院青年管理人员能力导向型轮转培养方式的实践与思考

我国部分大型公立医院对新入职行政管理人员实行轮岗培训。本文结合国内部分医院的管理实践,分析了现行的轮转培养方式特点及其局限性：培训规范性不够、职业生涯发展缺乏规划等。在此基础上,参考总结武汉市某公立医院实践经验：设计轮转制度及内容、整合院内外优质培训资源、规划职业生涯等,提出“能力导向型”青年管理人员轮转培养方式,以供参考。     

Optical Feedback Training of Inhalation with Autohaler<Superscript>®</Superscript> and Turbuhaler<Superscript>®</Superscript> in COPD Patients

The success of inhalation therapy depends on patients inhalation technique and correct handling of the inhalation device. In this study the effort to train correct handling and optimal inhalation technique of patients using Autohaler^® and Turbuhaler^® was assessed. The Bad-Reichenhall-Aerosol-Therapy-Trial (BREATH) was a prospective, randomized, cross-over trial in 200 patients who were not familiar with either of the test systems. The correct handling of Autohaler^® and Turbuhaler^® was assessed by means of a checklist (observation score). An optimal inhalation maneuver was used evaluated with the computer-based Inhalation Manager (optical feedback, computer score). The Autohaler^® reached 6.58±3.64 (mean ± SD) out of nine points in the observation score and 66.85 ± 29.84% in the computer score before training. After training the scores increased significantly to 8.33 ± 2.08 points and 86 ± 23.40% respectively. The use of the Turbuhaler^® also significantly improved from 4.28 ± 4.24 points and 56.67 ± 42.97% to 7.78 ± 2.74 points and 85.80 ± 27.63%, respectively. The significant improvement of patients inhalation technique after training emphasizes the importance of training in inhalation therapy. In addition, it could be demonstrated that the optical feedback given by the Inhalation Manager was a useful tool for improving the inhalation technique of patients using Autohaler^® and Turbuhaler^®.     

关于职业医院管理者的探讨

讨论了职业医院管理者的概念和意义，指出职业医院管理者应掌握捏“管理科学”和“医学”两大类理论知识体系，拥有熟练的管理操作技能，具有管理者的综合素养，以及对管理职业的执著热情。当前，对于职业医院管理者的培养，可采取学校培养管理专业学生和在职管理人员学习管理科学知识的应急方法。对职业医院管理者的选拔应该遵循“科学、公平、公正、公开”的原则，在考核中重视“心理测验”和“实际案例操作”等方法的使用。对职业医院管理者的使用和监管可以实施签订聘用协议、实行风险抵押、实施年薪制等措施。     

Role of technology in controlling health care costs

The objectives of medical technology are to define basic knowledge about the function of the body and to aid in making patients better. Because the escalation of costs for advanced technology has been dramatic, it has been labelled one of the culprits for the great increases in health care costs in the past decade. Yet technology can improve the quality of care while providing mechanisms for lowering costs. Such an approach requires improved productivity. Several approaches to improve productivity, with emphasis on the electronic and computer revolution that has been brought to medicine, are discussed. In addition, it is suggested that the use of technology gives medical staff more time to meet the personal needs of patients.     

医院感染管理队伍职业化建设的思考

目的提高医院感染管理专职人员的职业素质。方法探讨医院感染管理队伍职业化的必要性,对医院感染管理人员的现状和问题进行分析,提出了医院感染管理队伍职业化建设的思路。结果加强医院感染管理队伍的职业化建设,建立职业化的教育和培养体系,完善各项保障机制,稳定医院感染管理人员队伍。结论推行医院感染管理队伍的职业化建设,是加快医院感染学科建设和发展的客观需要。     

卫生机构管理者培训研究

阐明了当前加强卫生机构管理者培训的重要意义；分析了卫生机构管理者培训在管理体系、培训数量、方法以及内容方面存在的问题；建议采取建立健全培训管理体系、扩大培训规模、导入新的培训方法、按需设置培训课程以及创建学习型卫生机构等措施，以切实提高卫生机构管理者培训成效。     

The impact on the workload of the Ward Manager with the introduction of administrative assistants

Locke R., Leach C., Kitsell F. & Griffith J. (2011) Journal of Nursing Management 19, 177–185
The impact on the workload of the Ward Manager with the introduction of administrative assistants Aim To evaluate the impact on the workload of the Ward Manager (WM) with the introduction of administrative assistants into eight trusts in the South of England in a year-long pilot. Background Ward Managers are nurse leaders who are responsible for ward management and delivering expert clinical care to patients. They have traditionally been expected to achieve this role without administrative assistance. Meeting the workload demands of multiple roles and overload has meant the leadership and clinical role has suffered, presenting issues of low morale among existing WMs and issues of recruiting the next generation of WMs. Method Sixty qualitative interviews were carried out with 16 WMs, 12 Ward Manager Assistants (WMAs), and six senior nurse executives about the impact of the introduction of the WMA post. Quantitative data to measure change in WM workload and ward activity was supplied by 24 wards. Results Ward Managers reported spending reduced time on administrative tasks and having increased time available to spend on the ward with patients and leading staff. With the introduction of WMAs, there was also improvement in key performance measures (the maintenance of quality under service pressures) and increased staff motivation. Conclusions There was overwhelming support for the introduction of administrative assistants from participating WMs. The WMAs enabled WMs to spend more time with patients and, more widely, to provide greater support to ward teams. The success of the pilot is reflected in wards working hard to be able to extend contracts of WMAs. The extent of the success is reflected in wards that were not participants in the pilot, observing the benefits of the post, having worked to secure funding to recruit their own WMAs. Implications for nursing management The widespread introduction of administrative assistance could increase ward productivity and provide support for clinical leaders. Continuing professional development for WMs needs to incorporate training about management responsibilities and how to best use administrative support.     

Monosynaptic inputs to specific cell types of the intermediate and deep layers of the superior colliculus

The intermediate and deep layers of the midbrain superior colliculus (SC) are a key locus for several critical functions, including spatial attention, multisensory integration, and behavioral responses. While the SC is known to integrate input from a variety of brain regions, progress in understanding how these inputs contribute to SC-dependent functions has been hindered by the paucity of data on innervation patterns to specific types of SC neurons. Here, we use G-deleted rabies virus-mediated monosynaptic tracing to identify inputs to excitatory and inhibitory neurons of the intermediate and deep SC. We observed stronger and more numerous projections to excitatory than inhibitory SC neurons. However, a subpopulation of excitatory neurons thought to mediate behavioral output received weaker inputs, from far fewer brain regions, than the overall population of excitatory neurons. Additionally, extrinsic inputs tended to target rostral excitatory and inhibitory SC neurons more strongly than their caudal counterparts, and commissural SC neurons tended to project to similar rostrocaudal positions in the other SC. Our findings support the view that active intrinsic processes are critical to SC-dependent functions, and will enable the examination of how specific inputs contribute to these functions.