医技检查预约平台建设与应用

目的 建设医院医技检查预约平台,充分利用辅诊检查资源,缩短患者就医时间,提供高效优质的预约服务。方法 研制智能规则库,开发医技检查预约平台。结果 该平台上线应用4年来,全面实现医技（放射、超声、内镜、心电）检查的最佳路径、最佳时间的全自动预约,已完成检查预约门诊患者110万余人次。结论 该平台充分利用医院现有医技检查资源,安排最合理的预约时间服务于患者。同时,在智慧医院建设中实现了跨系统的医技检查项目的应用支撑,显著提高了患者检查业务效率,提升了医疗资源利用率,为患者提供了便捷的医疗服务。     

基于知识库引擎的检查自助预约系统研究△

目的：为就诊患者提供一种更为智能的医技检查自助预约方式。方法：设计多种预约知识库和预约知识库算法来构建预约知识库引擎，并实践应用到医院检查预约系统中，通过知识库引擎自动计算出符合各种规则的号源，辅助患者预约。结果：建立了一套满足患者使用需求、功能灵活强大的自助检查预约系统。结论：通过完善患者自助预约，可减少预约患者排队时长，改善患者就医体验，改善以患者为中心的医疗服务。     

医共体检查预约集成平台构建及相关问题探讨

医共体医院智能化医技检查预约集成平台的构建,对提升医院仪器设备使用效率、优化医院医技检查流程及医共体分院患者享受总院检查同等服务、减少患者不必要的经济支出起到重要作用,同时规范各项检查业务流程,提升患者就医体验。文章从医共体检查预约集成平台构建的意义、平台设计应用、具体方法、功能特点、应用效果等方面进行阐述,探索新冠肺炎疫情防控常态化期间医共体检查预约集成平台的模式,为进一步推动医共体建设提供参考。     

大数据驱动下精准检查预约的探索与实践

目的:避免检查项目间规则禁忌冲突、缩减患者检查预约等待时间,有效整合医院资源,提高工作效率和医疗质量。方法:通过设立检查服务中心、建立检查预约信息平台,实现大型检查集中精准预约,在运行过程中推行“一科一策”,拓展检查预约管理内涵,持续提高大型检查工作效率。结果:(1)实现检查服务资源统一管理,各项检查精确到具体时间点,患者检查服务全流程管理。(2)医技科室24小时检查率、72小时检查率有显著提高,大幅度减少检查预约等候天数,明显减少患者流失;(3)与入院服务中心深度融合,平均住院日得到进一步缩短,显著提高医院经济和社会效益。结论:剖析传统检查业务流程,构建闭环集中式检查预约信息服务平台,打造检查预约新模式,可使医院检查服务流程进一步优化。     

医院医技统一预约平台应用效果分析

目的:以江苏省人民医院为例,描述大型综合性医院的医技预约优化流程并对应用效果进行分析,为各大医院检查预约服务工作的推进提供参考依据.方法:分别以系统上线前一个月和上线后一个月的数据为调查对象,采用两独立样本数据的t检验对数据进行对比分析.结果:与对照组相比,改进组的预约等候时间、检查候诊时间等均明显缩短.结论:医技统一预约平台的应用明显缩短了患者的预约和候诊时间,提升了医患满意度.     

我院开展预约服务的探讨

目前,国内医院通过各种途径开展了医疗业务的预约服务,大大减少了病人在医院的等候时间,提高了服务质量。医院预约服务不只是作为门诊工作的一个补充,而且还是医院前线系统服务的一项主要内容。随着信息技术的发展及就诊模式的改变,医院预约将成为患者就诊的主要途径。现将我院开展预约服务的模式介绍如下。 一、预约服务的必要性 (一)最大限度地利用医疗资源:有效的预约系统可保证     

医院信息系统中检查申请预约处理系统的应用

医院信息系统管理(HIS)是医院现代化管理的标志。为提高医疗服务质量，我院建立了医院计算机网络管理系统，其检查申请预约处理子系统于2000-10-31正式在医技科室(B超、CT、MRI、放射等)运行，实现了住院病人检查申请预约网上操作与应用，实施申请-划价-预约一体化服务，提高了工作效率，改善了服务质量，推动了医院管理的正规化、科学化。现将三年来使用情况总结如下。     

门诊预约挂号系统的设计与应用

目的 为方便患者来院就医,规范预约挂号流程,缩短患者排队等候时间,提升医院服务质量。方法 设计模块化门诊预约挂号系统,实现医院在人数高峰期时期,能够合理地安排患者分时段预约分诊、预约检查。该系统将院内医师坐诊号源及时同步至同河南省预约平台及其他可信的第三方平台,对外公布医师坐诊信息,方便患者选择医师就诊。结果 通过一年的研究观察,随着院内外患者预约率不断增加,预约诊疗率基本保持在80%以上,患者预约后等待时间在10min左右。结论 该预约系统改善了医院的医疗服务质量,提升了患者的就医满意度。     

基于医院信息平台的医疗设备预约系统

目的：利用医院信息平台优化医院检查流程,缩短患者等候检查时间,提高医疗检查设备的整体利用率。方法：实现医院信息系统（HIS）与影像归档及传输系统（PACS）信息集成,开发一套医疗设备预约系统。医生在工作站通过该系统即可实时为患者预约检查项目,免去患者预约登记步骤。结果：医疗设备预约系统的成功应用不仅优化了医院检查流程,缩短患者排队等候检查时间,并使MR设备的利用率提高了35%。结论：利用医疗设备预约系统,节省了患者排队登记、等候检查的时间,提高了医院医疗设备利用率,为医院创造经济效益的同时也为医院带来社会效益。     

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.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.