乡镇卫生院院长胜任力研究

乡镇卫生院是我国在乡级设立的惟一公立卫生机构，是我国农村卫生服务体系的基础。乡镇卫生院具有公共卫生和基本医疗等多项卫生服务与管理功能，在建设社会主义新农村中具有重要地位和作用。乡镇卫生院院长作为农村乡镇卫生院的领导者，其管理行为和工作绩效不仅关乎卫生院的长足发展，甚至可以影响到整个农村卫生工作目标的实现。乡镇卫生院院长只有具备同乡镇卫生院组织战略目标及院长岗位要求相匹配的胜任力，才能高效地发挥经营管理职能，实现卫生院的组织发展目标。     

不可逾越的收支监管

乡镇卫生院收支管理不仅影响乡镇卫生院的服务能力和资产状态,同时也决定政府能否对乡镇卫生院的经营实行有效掌控,能够确保乡镇卫生院始终运行在公益轨道,能否使乡镇卫生院充满活力。因此,如何选择乡镇卫生院收支管理的适宜形式,就成了农村卫生发展与改革中必须探讨的基本问题之一。     

泰兴市乡镇卫生院改革的实践与探讨

随着农村经济社会结构的不断调整,农村卫生发展的社会环境发生了重大变化,乡镇卫生院面临着许多困难与问题,为寻求激发其生机与活力的良策,2002年9月,泰兴市启动了以"两权分离"为主要模式的乡镇卫生院经营体制改革,将卫生院的所有权和经营权相分离,所有制形式公有,经营权有偿转让,尝试以公有民营的形式为乡镇卫生院探索出一条振兴之路.     

乡镇卫生院经营现状与对策

纵观乡镇卫生院改革和发展的十几年历程,从经济核算制、承包经营责任制、综合目标责任制到院长负责制,对促进乡镇卫生院的发展起到了积极的推动作用,但仍然经营状况欠佳,资金缺乏,生机与活力不够,还没有使乡镇卫生院彻底摆脱困境。为了在社会主义市场经济条件下,全面推进乡镇卫生院的经营管理水平和发展速度,必须通过对其经营现状的分析,寻求经     

陕西省乡镇卫生院2004-2010年经营状况分析

目的:通过分析陕西省乡镇卫生院经营状况,为乡镇卫生院的建设提供政策建议.方法:提取和分析2007-2010年陕西省卫生总费用核算数据及2004-2010年陕西省财务决算数据.结果:乡镇卫生院存在费用总量不足、医疗收支亏损较大、服务效率低下等问题.结论:建议继续加大政府投入力度,逐步提高反映医务人员劳动价值的医疗服务价格,以保障医务人员的收入与社会经济发展同步.     

开远市乡镇卫生院管理体制改革的实践与体会

文章针对乡镇卫生院普遍存在管理体制不顺 ,投入不足 ,医疗技术低 ,医疗设备落后 ,经营状况欠佳的状况 ,介绍了开远市乡镇卫生院改革中改革管理体制 ,上划乡镇卫生院、城市医院委托管理乡镇卫生院、企业医院与一般卫生院联合经营卫生院、中心卫生院委托管理一般卫生院的做法。讨论了乡镇卫生院发展中建立长效投入机制 ,发展农村医疗服务市场 ,通过调整卫生资源布局 ,使城市医疗机构既能支援农村卫生工作 ,又能发展     

实施乡镇卫生院经营体制改革促进农村卫生事业健康发展

从2003年初到2004年底,历经两年的艰辛努力,我市以乡镇卫生院所有权与经营权相分离的改革（以下简称“两权分离”革）为模式、以强化经营者责任和风险意识为主要手段、以激活卫生院内部运行机制、保障职工合法权益和公有资产保值增值为主要目的的乡镇卫生院经营体制改革已基本完成,全市34家乡镇卫生院有33家分三批改革完毕.通过一段时间的运行,改革的成效已初步显现.     

沙洋县3所乡镇卫生院经营状况比较分析

目的了解该县乡镇卫生院业务工作效率及收支经营现状,发现存在的问题及差距,并提出相应的改进策略.方法采用分层随机抽样方法(按经济发展水平)从全县抽取3所乡镇卫生院作为调查样本,收集近2年的数据做纵向和横向对比分析.结果 3所乡镇卫生院职工以中专学历、初级职称人数居多;后港镇中心医院业务量、病床使用率等指标明显高于其他2个镇:3所乡镇卫生院药品收入占总收入的比例达到70%～80%之间,但彼此之间在医疗费用、财务收支及资产负债等方面差距显著,其中毛李镇卫生院基本处于亏损状态,资产负债率高达45%左右.结论乡镇卫生院的建设在很大程度上受制于地方经济发展水平,需进一步明确乡镇卫生院的目标与功能定位,积极引进农村卫生人才,增加财政投入,规范诊疗行为,完善农村卫生服务网络体系.     

苏州市乡镇（中心）卫生院管理人员现状分析

苏州市乡镇（中心）卫生院管理人员现状分析刘广德（江苏省苏州市卫生局２１５００６）乡镇（中心）卫生院管理人员是院内医疗业务组织领导者，又是社区卫生工作规划管理者；不仅是组织管理者，而且也是具体业务实施者，根据其职责、权限决定了他们在卫生院所处核心地位，...     

市场经济条件下乡镇卫生院生存发展问题的调查

乡镇卫生院是农村三级医疗网的中枢,随着市场经济的实行,竞争的加剧,政府支持力度的弱化,主要是乡镇卫生院经营管理不善等原因,乡镇卫生院面临许多问题:医疗服务质量长期停滞不前,业务量下降,在亏损中经营,有的处于破产的边缘。为此,建议对乡镇卫生院进行改革,强化经营管理;通过多种途径,开发适宜乡镇卫生院需要和发展的各种卫生资源。     

四川省不同经济水平地区乡镇卫生院公共卫生服务现况研究

乡镇卫生院是我国三级医疗保健网的中心,承担重要公共卫生职能。研究发现:在四川省不同经济水平地区,乡镇卫生院间规模已不存在统计学差异;而其服务能力,尤其是健康教育、孕产妇系统管理、慢病管理等公共卫生服务能力却呈现出经济欠发达,服务越薄弱的现状。在此基础上,讨论现况原因并提出建议。     

基于典型案例的民营医院托管乡镇卫生院服务能力研究

目的分析民营医院托管下乡镇卫生院服务能力变化情况。方法选取托管前后(2013—2017年)乡镇卫生院卫生技术人员数量、总诊疗人次数、门诊次均费用和医师日均担负诊疗人次4个关键指标来分析服务能力变化,并以同一时期本区域基层医疗机构均值为对照。结果托管前后乡镇卫生院卫生技术人员数量与该区域平均水平的差距在不断缩小,诊疗人次数呈显著上升趋势,门诊次均费用增幅低于均值,医师日均担负诊疗人次不断上升,高于平均水平。结论托管后上级医院在管理和临床服务能力等方面的整合举措对乡镇卫生院服务能力产生了积极影响。     

“健康牙齿”对不同病因牙痛镇痛效果的临床分析

目的:了解生物制剂"健康牙齿" (THC)对不同病因牙痛的镇痛效果.方法:随机选择各种牙痛患者计 180例,用 THC 含漱 30秒, 10分钟后检查疼痛缓解度, 3小时后再复查一次疼痛缓解持续时间.结果: THC使用后疼痛中度以上缓 解并持续 3小时以上达 85%,无任何其他不良反应.结论: THC作为快速缓解牙痛的高科技生物制剂,可广泛应用 于口腔科临床.     

Taking the call-bell home: a qualitative evaluation of Tele-HomeCare for children

Tele-HomeCare (THC) delivers health care at home using telephone technologies. A THC service was developed as an adjunct to existing hospital and community care systems. It connected healthcare providers to children and families at home, during the initial transition from hospital to home, using video-conferencing phones and remote vital signs monitors. The goal was to support the transition from hospital to home, for children with subacute healthcare needs. This paper reports the qualitative evaluation of THC and describes the experiences of families supported by THC. A total of 16 mothers, four fathers and two adolescents from 16 families participated in a series of interviews conducted before, during and after THC. The interviews focused on the impact of THC on the children, on the families, and on their overall healthcare experience. Analysis of their accounts identified three subthemes: the stable child, a sense of security, and the healthcare-proficient parent. These subthemes were consistent across all time points and participants. Together they contributed to the overall effect of THC: the timely reunification of the family at home. THC was consistently reported to be an important resource that supported children and families during the transition from hospital to home. The benefits to children and families observed in this study may have also been a consequence of returning to their home environment, since THC allowed these children to be discharged home at a much earlier period. However, our findings are consistent with previous reports of the benefits of THC. Thus, THC is a successful method of healthcare service delivery that enables a safe return home with professional support provided remotely.     

Job satisfaction and its modeling among township health center employees: a quantitative study in poor rural China

Background  

Job satisfaction is important to staff management of township health centers (THCs), as it is associated with organizational performance, quality of care and employee retention. The purpose of this study was to measure job satisfaction level of THC employees in poor rural China and to identify relevant features in order to provide policy advice on human resource development of health service institutions in poor regions.     

Epidemiology of substance use in a representative sample of 18-year-old males

AIMS: To assess recent drug use through urine testing as well as the prevalence of tobacco and alcohol dependence among young males and to analyse the associations between tobacco dependence and cannabis use (delta-9-tetrahydrocannabinol, THC), tobacco dependence, and alcohol dependence as well as between THC use and other illicit drug use. METHODS: Urine samples were collected, and nicotine and alcohol questionnaires were administered. Carbon monoxide was assessed in exhaled air. Data from young males from representative, selected districts of Lower Austria were recorded during the annual physical examination for mandatory military service. Out of all 18-year-old males in Austria 3.8% (n = 1902) were included in the study. Prevalence of recent illicit drug use, tobacco dependence (heavy smoking index, HSI), alcohol dependence (The 4-item cutting down, annoyance by criticism, guilty feeling, and eye-openers (CAGE) questionnaire), and associations between substance categories by means of logistic regression analyses were calculated. RESULTS: Alcohol abuse was found in 15.1% and alcohol dependence was found in 3.2%. According to the HSI 51.5% of males reported daily smoking, of whom 43.7% showed a mild level, and 7.8% a high level, of nicotine dependence. About 5.1% of the sample evidenced THC in urine. Opiates were identified in 2.7% of urine samples. Smokers showed a higher risk of THC use. THC users had a tendency to use cocaine and amphetamines more frequently than THC abstainers. CONCLUSION: Nicotine and alcohol dependence is common among young males. Biological assessment of illicit drug use seems to confirm previous questionnaire-based findings of associations between THC use and other illicit drugs. Urine testing seems to be an adequate method to analyse associations of THC use and other illicit drugs. In combination with questionnaires urine testing may be used for the assessment of associations of tobacco dependence and recent illicit drug use based on epidemiological surveys.     

Effects of concomitant use of THC and irinotecan on tumour growth and biochemical markers in a syngeneic mouse model of colon cancer

Clinical treatment with the antineoplastic drug irinotecan (IRI) is often hindered by side effects that significantly reduce the quality of life of treated patients. Due to the growing public support for products with Δ⁹-tetrahydrocannabinol (THC), even though relevant scientific literature does not provide clear evidence of their high antitumour potential, some cancer patients take unregistered preparations containing up to 80 % THC. This study was conducted on a syngeneic colorectal cancer mouse model to test the efficiency and safety of concomitant treatment with IRI and THC. Male BALB/c mice subcutaneously injected with CT26 cells were receiving 60 mg/kg of IRI intraperitoneally on day 1 and 5 of treatment and/or 7 mg/kg of THC by gavage a day for 7 days. Treatment responses were evaluated based on changes in body, brain, and liver weight, tumour growth, blood cholinesterase activity, and oxidative stress parameters. Irinotecan’s systemic toxicity was evidenced by weight loss and high oxidative stress. The important finding of this study is that combining THC with IRI diminishes IRI efficiency in inhibiting tumour growth. However, further studies, focused on more subtle molecular methods in tumour tissue and analytical analysis of IRI and THC distribution in tumour-bearing mice, are needed to prove our observations.KEY WORDS: antitumour activity, cannabinoid-based preparations, oxidative stress, systemic toxicity     

The THC content of cannabis in Australia: evidence and implications

OBJECTIVE: To examine evidence on three claims that: 1) the THC content of Australian cannabis plants has increased up to 30 times; 2) problems experienced by cannabis users have increased in Australia in recent years; and 3) an increase in THC content is the most likely explanation of any increase in cannabis-related problems. METHODS: These claims were assessed by examining data: 1) on THC potency in Australia, the United States and New Zealand; 2) on cannabis-related problems; and 3) from the 1998 National Drug Strategy Household Survey on patterns of cannabis use. RESULTS: 1) Published data do not show a 30-fold increase in THC potency of cannabis but show a more modest increase in the US. 2) There is suggestive evidence of an increase in cannabis-related problems among people seeking treatment for alcohol and drug problems, juvenile offenders and young adults with psychosis. 3) There are two other more plausible explanations for these reportedly higher rates of cannabis-related problems among adolescents and young adults: (i) more potent forms of cannabis ('heads') are more widely used; and (ii) cannabis users are initiating cannabis at an earlier age, thereby increasing the prevalence of harmful patterns of use. CONCLUSIONS: There has probably been a modest increase in the THC content of cannabis, but changing patterns of cannabis use have probably made a larger contribution to any increase in rates of cannabis-related problems among young Australian adults. IMPLICATIONS: Better data on the THC content of cannabis, the extent of cannabis-related problems and the ability of users to titrate the dose of cannabis would contribute to more informed debate.     

Tetrahydrocurcumin Upregulates the Adiponectin-AdipoR Pathway and Improves Insulin Signaling and Pancreatic β-Cell Function in High-Fat Diet/Streptozotocin-Induced Diabetic Obese Mice

Impairment of adiponectin production and function is closely associated with insulin resistance and type 2 diabetes, which are linked to obesity. Studies in animal models have documented the anti-diabetic effects of tetrahydrocurcumin (THC). Although several possible mechanisms have been proposed, the contribution of adiponectin signaling on THC-mediated antihyperglycemic effects remains unknown. Here, we report that adiposity, steatosis, and hyperglycemia were potently attenuated in high-fat diet/streptozotocin-induced diabetic obese mice after they received 20 and 100 mg/kg THC for 14 weeks. THC upregulated UCP-1 in adipose tissue and elevated adiponectin levels in the circulation. THC upregulated the AdipoR1/R2-APPL1-mediated pathway in the liver and skeletal muscle, which contributes to improved insulin signaling, glucose utilization, and lipid metabolism. Furthermore, THC treatment significantly (p < 0.05) preserved islet mass, reduced apoptosis, and restored defective insulin expression in the pancreatic β-cells of diabetic obese mice, which was accompanied by an elevation of AdipoR1 and APPL1. These results demonstrated a potential mechanism underlying the beneficial effects of THC against hyperglycemia via the adiponectin-AdipoR pathway, and thus, may lead to a novel therapeutic use for type 2 diabetes.     

Tetrahydrocurcumin prevents brain lipid peroxidation in streptozotocin-induced diabetic rats

Oxidative damage has been suggested to be a contributory factor in the development and complication of diabetes. To investigate the effect of tetrahydrocurcumin (THC) on the occurrence of oxidative stress in the brain of rats during diabetes, we investigated the extent of oxidative damage as well as the status of the antioxidant defense system. Oral administration of THC at 80 mg/kg of body weight to diabetic rats for 45 days resulted in a significant reduction in blood glucose and significant increase in plasma insulin levels. In addition, THC caused significant increases in the activities of superoxide dismutase, catalase, glutathione peroxidase, glutathione S-transferase, and reduced glutathione in the brains of diabetic rats with significant decrease in the lipid peroxidative markers thiobarbituric acid-reactive substances and hydroperoxides in brain, suggesting efficacy for protection against lipid peroxidation-induced membrane damage. The effect of THC was greater than that of curcumin. Results of the present study suggest that THC showed antioxidant effects in addition to its antidiabetic effect in type 2 diabetic rats.